Potential TMS biomarkers for GABAB receptor engagement in alcohol use disorder: A systematic review of existing evidence.

Alcohol use disorder (AUD) is a major global health issue, with current treatments often limited in efficacy and patient acceptance. The gamma‐aminobutyric acid (GABA) system, particularly GABAB receptors (GABABR), is crucial in the pathophysiology of AUD. This review aimed to evaluate the potential...

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Publicado en:Alcohol, Clinical & Experimental Research Vol. 49; no. 12; pp. 2633 - 2649
Autores principales: Montemitro, Chiara, Terrezza, Sara, Maruottolo, Federico, Costumati, Andrea, Heilig, Markus
Formato: pictorial research systematic review tables/charts Journal Article
Publicado: Wiley-Blackwell Dec2025
Acceso en línea:Ver este registro en EBSCOhost
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      jtl: Alcohol, Clinical & Experimental Research
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      dt: Dec2025
      vid: 49
      iid: 12
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      pub: Wiley-Blackwell
      place: Malden, Massachusetts
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        10.1111/acer.70180
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        atl: Potential TMS biomarkers for GABAB receptor engagement in alcohol use disorder: A systematic review of existing evidence.
      aug:
        au:
          Montemitro, Chiara
          Terrezza, Sara
          Maruottolo, Federico
          Costumati, Andrea
          Heilig, Markus
        affil: Center for Social and Affective Neuroscience, Linköping University, Linköping, Sweden
      sug:
        subj:
          Transcranial Magnetic Stimulation
          Biological Markers
          Receptors, G-Protein-Coupled Antagonists and Inhibitors
          Alcoholism Physiopathology
          Alcoholism Diagnosis
          Neurophysiology
          Human
          Funding Source
          Systematic Review
          Medline
          Psycinfo
          Embase
          Baclofen
          GABA
          Quality Assessment
          Electromyography
          Electroencephalography
      ab: Alcohol use disorder (AUD) is a major global health issue, with current treatments often limited in efficacy and patient acceptance. The gamma‐aminobutyric acid (GABA) system, particularly GABAB receptors (GABABR), is crucial in the pathophysiology of AUD. This review aimed to evaluate the potential of transcranial magnetic stimulation (TMS) as a tool for identifying neurophysiological biomarkers of GABABR engagement in AUD. Two independent systematic literature reviews were conducted using MEDLINE, PsychINFO, and EMBASE databases to evaluate: (1) the neurophysiological effects of GABABR pharmacological manipulation, and (2) the neurophysiological alterations linked to alcohol consumption and addiction. Studies included human subjects and assessed cortical excitability using TMS‐EMG or TMS‐EEG. Data on study design, sample characteristics, TMS protocols, and neurophysiological outcomes were extracted and analyzed. The final analysis included 13 studies evaluating the effects of GABABR agonism (mainly baclofen administration) and 16 studies on acute and chronic alcohol consumption. The GABABR agonism studies were primarily randomized, placebo‐controlled experimental medicine studies in healthy controls. Results showed that GABABR agonism enhanced long‐interval intracortical inhibition (LICI) and increased post‐TMS N100 amplitude, indicating the sensitivity of these parameters to GABABR manipulation. The alcohol consumption studies were mostly case–control or within‐subject designs, with fewer randomized controlled trials. Acute and chronic alcohol consumption was found to alter LICI, N100 amplitude, and the cortical silent period (CSP). However, no alcohol‐induced changes were observed in short‐interval intracortical inhibition (SICI), which depends on GABAAR activation. Despite limitations, this review indicates GABABR functioning to be measurable and different in AUD compared to healthy controls. Overall, the reviewed literature supports the hypothesis that GABABR is involved in the neurotransmission imbalances induced by both acute and chronic alcohol intake, with potential regional differences that warrant further investigation. Standardized protocols and larger studies are needed to validate these findings and their clinical relevance.
      pubtype: Academic Journal
      doctype:
        pictorial
        research
        systematic review
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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