Repetitive Transcranial Magnetic Stimulation (rTMS) for decreasing gambling craving in patients with gambling disorder: A call for advanced clinical investigations

Abstract

Gambling disorder (GD) is an addictive behavioral disorder that alters the frontostriatal neural circuitry and prefrontal control of reward-associated brain areas. An intrusion between prefrontal cortex and the mesolimbic reward pathway has been proposed as the major mechanism behind the pathogenesis of GD. Repetitive transcranial magnetic stimulation (rTMS) is a noninvasive treatment that utilizes magnetic fields to stimulate nerve cells linked to mood and behavioral control; this stimulation is usually applied either on the left or right side of the dorsolateral prefrontal cortex of the brain. rTMS selectively modulates the activities of brain circuits and possess the ability to overturn the alterations in the neurocircuitry of the brain linked to the pathophysiology of GD. rTMS adjusts impulsivity, cognitive/attentional control, cognitive plasticity, and decision-making, which are crucial in decreasing gambling craving and relapse. However, innovative clinical investigations are needed to analyze and establish the impact of rTMS on gambling craving and cessation, using a larger sample size.