Emerging non-invasive neuroplastic-targeting therapies for substance use disorder treatment

Abstract

Context: America is in the midst of a substance use disorder (SUD) epidemic, which has only worsened in the current COVID-19 pandemic. SUD is a public health crisis that affects an everincreasing proportion of the population and is extraordinarily difficult to treat. Misused substances induce neuroplastic changes that not only predispose individuals to relapse but also persist after completing treatment recommendations.

Objective: To establish the phenomenon of neuroplasticity in relation to SUD and summarize noninvasive neuroplastic therapies designed to return the brain to its pre-dependency state. Methods: On October 29, 2019, the search term “neuroplasticity addiction” was entered into PubMed. Articles were selected based on description of neuroplastic changes occurring in SUD and treatment modalities that foster neuroplastic improvements for SUD treatment.

Results: 1241 articles were excluded based on irrelevance to the specific topic, language or redundancy. 41 articles met inclusion criteria, with 18 illustrating neuroplastic effects induced by SUD and 23 describing therapeutic interventions.

Conclusions: SUD induces neuroplastic changes that predispose an individual to relapse and persist after completing SUD recommendations. Transcranial magnetic stimulation, environmental enrichment and exercise are shown to affect altered brain composition and reduce SUD-related negative behavior, while motor training appears to block neurophysiological changes normally caused by substance use. This illustrates that therapies targeting neuroplastic changes reduce adverse behaviors in those with SUD. The implementation of these modalities with current standard-of-care treatment may increase treatment success. Additional research into these modalities and their potential to enhance current treatments is warranted.