Addictions
Addiction can gradually take more and more control over your life. What initially brings relaxation, pleasure, or relief can grow into an urge that is difficult to manage.
You may have already tried to stop or change your behavior several times. Yet, the need to use alcohol, nicotine, or other substances again can return with particular intensity.
Certain behaviors, such as gambling or gaming, can also become problematic when control over them is lost.
Addiction is not simply a lack of willpower. It is a complex condition involving brain networks related to reward, motivation, habit formation, and self-control, among others.
A key characteristic is craving: an intense urge for a substance or a specific activity, which can make it difficult to resist.
Scientific research shows that this urge is linked to the activity of several specific brain regions.
At BRAI3N, we investigate and treat the brain networks involved in addictive behavior, which can help reduce cravings.
This treatment is considered a supplement to psychological, psychiatric, and other specialized addiction care.
What is it?
What is an addiction?
An addiction develops when the use of a substance or the performance of a certain behavior becomes increasingly difficult to control, despite the negative consequences.
What was initially a conscious choice can gradually become a deeply ingrained behavioral pattern.
People with an addiction may experience, among other things, that they:
- Constantly think about the substance or activity.
- Feel a strong urge to use again or repeat the behavior.
- Use more or continue for longer than originally intended.
- Have difficulty stopping, despite repeated attempts.
- Use the substance or behavior to reduce tension or negative feelings.
- Neglecting certain responsibilities, relationships, or activities.
- Relapsing, even after a long period of abstinence.
Not everyone experiences all of these symptoms. The severity and progression also vary greatly from person to person.
What types of addiction are there?
Substance addiction
A substance addiction arises from the problematic use of psychoactive substances, such as alcohol, nicotine, cannabis, cocaine, opioids, or certain medications.
These substances affect various chemical messengers and brain networks.
They can cause temporary pleasure, relaxation, or relief, but repeated use can also lead to tolerance, physical dependence, altered reward processing, and a strong urge to continue using.
Some people use substances primarily to experience a pleasant effect. Others find that their use increasingly serves to reduce tension, anxiety, sadness, or withdrawal symptoms.
Both processes can occur together in an addiction.
Behavioral addictions
Certain behaviors can also become so overwhelming that someone loses control over them.
Gambling disorder is a recognized behavioral addiction. Gaming disorder is also recognized within the international classification of diseases as a disorder due to addictive behavior.
With these conditions, the desire to gamble or game again can become increasingly important, despite negative consequences for daily life.
Other problematic behavior patterns, such as excessive internet use or compulsive sexual behavior, can also cause serious impairment. However, not all of these patterns are medically classified as addictions in the same way.
Problematic eating behavior with addictive characteristics
Some people experience a particularly strong craving for certain foods, often products rich in sugar, fat, or salt.
They may feel they are losing control over their eating habits and continue to eat despite being full or experiencing negative consequences.
In scientific studies, this is often described as food addiction.
Although food addiction is not currently a formally recognized diagnosis, there is evidence that a subgroup of people with problematic eating behaviors involves brain networks that also play a role in substance addiction.
BRAI3N-related research has made significant scientific contributions to this field.
What is craving and why is it so hard to resist?
Craving is an intense, sometimes overwhelming urge for a substance or a specific activity.
This need can arise suddenly, for example, triggered by a scent, a place, a memory, or an emotional event.
Someone trying to quit alcohol, for instance, may experience a strong urge when seeing a familiar bar. With problematic eating behavior, a certain scent or emotion can trigger a strong need to eat.
Craving is influenced by three processes, among others:
- Reward: The expectation that the substance or behavior will produce a pleasant feeling.
- Stress and negative emotions: The expectation that consumption will provide temporary relief from tension, anxiety, sadness, or an unpleasant feeling.
- Learned triggers: Environmental cues, memories, or situations that have become associated with the substance or behavior through past experiences.
These processes can reinforce one another.
This is why a strong craving can return, even when someone is motivated to stop.
What happens in the brain during addiction?
Addiction is associated with changes in various brain networks.
These networks normally help to evaluate rewards, make choices, control impulses, and adapt behavior when circumstances change.
In the case of an addiction, these processes can become unbalanced.
Several brain regions play an important role in this process.
The nucleus accumbens: reward and motivation
The nucleus accumbens is part of a key network involved in motivation, reward anticipation, and behavioral learning.
Dopamine plays a major role within this system.
When a substance or activity is repeatedly experienced as important or rewarding, the associated cues can trigger increasing levels of attention and motivation.
As a result, the craving for the substance can remain intense, even when the original pleasure has diminished.
The anterior cingulate cortex: craving, choices, and behavioral control
The anterior cingulate cortex (ACC) is a key brain region involved in processing motivation, emotions, conflicts, and behavioral adaptation.
Different parts of the ACC have interconnected but partially distinct functions.
- The dorsal anterior cingulate cortex (dACC) plays a role in, among other things, recognizing behavioral conflicts and adjusting responses.
- The pregenual anterior cingulate cortex (pgACC) is involved in emotional and motivational processes and in integrating information about one's own physical and emotional state.
Scientific research has identified changes in these areas in people experiencing intense craving.
This makes the ACC an interesting target for neuromodulation.
The prefrontal cortex: behavioral control
The prefrontal cortex supports functions such as planning, decision-making, assessing consequences, and regulating impulses.
When someone tries to resist craving, these functions play a significant role.
Changes in prefrontal brain networks can make it more difficult to suppress automatic or learned behaviors.
The posterior cingulate cortex: memories and learned patterns
The posterior cingulate cortex (PCC) is part of the Default Mode Network.
This network is involved in, among other things, self-referential thoughts, memories, and the processing of personal experiences.
In addiction, memories of past rewards and learned behavioral patterns can contribute to the recurrence of craving.
Research into addiction and problematic eating behavior has also demonstrated changes in the activity and connectivity of the PCC.
What has BRAI3N research shown about this?
Researchers includingProf. Dr. Dirk De RidderandProf. Dr. Sven Vanneste have studied the neurobiological mechanisms of craving in various forms of addiction.
A 2018 study combined functional MRI and electroencephalography (EEG) to map brain activity during alcohol craving.
The study identified changes in a network of brain regions, including the dACC, pgACC, nucleus accumbens, and PCC.
These findings support the idea that craving does not originate from a single, isolated brain region, but rather from the interaction between multiple networks.
BRAI3N-related research has also found similarities between the brain activity involved in alcohol addiction and that of individuals with problematic eating behaviors and addiction traits.
This does not mean that food and alcohol addictions are identical. However, the findings point to partially overlapping neurobiological mechanisms.
These insights are important because they offer potential targets for treatments that aim to influence the activity of the involved brain networks.
How to treat
Treating addiction: more than just stopping a substance
Addiction treatment focuses on more than just reducing or stopping substance use.
The mechanisms that sustain addictive behavior also require attention.
For this reason, treatment typically consists of a combination of medical guidance, psychological or psychiatric care, and support for behavioral change.
Depending on the addiction, pharmacological treatments, cognitive behavioral therapy, motivational interviewing, relapse prevention, and support for withdrawal symptoms may be indicated.
An important treatment goal is learning to recognize and regulate craving.
Neuromodulation offers an additional approach in which we target the brain networks involved in craving and behavioral control.
Neuromodulation: influencing the brain networks behind craving
Neuromodulation is a treatment approach that uses electrical or magnetic stimulation to influence the activity of nerves and brain networks.
In the context of addiction, scientific research primarily focuses on networks involved in:
- Craving and reward anticipation.
- Motivation and habit formation.
- Impulse control.
- Emotion regulation and stress.
- Modifying learned behavior.
The goal is to influence specific processes that maintain addiction, potentially reducing the intensity of cravings and better supporting behavioral change.
Depending on the condition and the clinical presentation, various forms of non-invasive neuromodulation may be considered.
These include transcranial electrical stimulation (tES), transcranial magnetic stimulation (TMS), and certain forms of neurofeedback.
The anterior cingulate cortex as a target
A key component of the scientific research conducted by Prof. Dr. Dirk De RidderandProf. Dr. Sven Vanneste focuses on the anterior cingulate cortex.
In patients with severe alcohol dependence, researchers investigated whether influencing this brain region could alter the intensity of cravings.
In an early clinical case, targeted magnetic stimulation of the dorsal ACC led to a temporary reduction in alcohol cravings.
A subsequent case study and a small feasibility study examined whether longer-term stimulation via implanted electrodes could impact severe, treatment-resistant alcohol dependence.
In the feasibility study involving eight patients, an average reduction in reported alcohol cravings of approximately 61% was observed.
These studies are scientifically relevant because they demonstrate that influencing a specific brain region can be associated with changes in cravings.
However, the results of implanted stimulation cannot be directly equated with those of non-invasive neuromodulation.
At BRAI3N, the clinical focus is on non-invasive techniques.
Transcranial electrical stimulation and cravings
Transcranial electrical stimulation is also being investigated as an adjunctive treatment for addiction issues.
In international evidence-based guidelines, a specific tDCS protocol targeting the prefrontal cortex received a Level B recommendation—or probably effective—as early as 2017 for addiction and cravings.
Since then, scientific research has expanded further.
A 2025 systematic review and meta-analysis found that non-invasive brain stimulation has a moderately positive effect on the intensity of cravings in patients with alcohol dependence.
Clinically relevant changes in cravings are also being investigated for other substance addictions.
However, the strength of the evidence varies depending on the type of addiction, the stimulation technique, and the treatment protocol.
Furthermore, a reduction in cravings does not automatically mean that long-term abstinence or relapse prevention has been demonstrated.
Neurofeedback and problematic eating behavior
Neurofeedback is also an interesting area of research.
In neurofeedback, brain activity is measured and the patient is provided with information that can be used to train specific activity patterns.
In a randomized, double-blind, placebo-controlled study, Prof. Dirk De Ridder, MD, PhD,Prof. Sven Vanneste, PhD and colleagues investigated the effect of infraslow neurofeedback in women with overweight or obesity and characteristics of food addiction.
The training focused on the posterior cingulate cortex.
After six treatment sessions, changes were found in the electrical activity of this brain region, along with a decrease in certain types of food cravings.
Another exploratory study investigated high-definition transcranial pink noise stimulation (HD-tPNS), targeting the anterior cingulate cortex.
There, too, evidence was found for a temporary reduction in the intense urge to eat.
These results support further research into the possibility of influencing cravings via different brain networks.
Why combine psychological counseling with neuromodulation?
Addiction develops and persists through an interplay of physical, neurological, psychological, and social factors.
Neuromodulation can attempt to influence processes involved in craving and behavioral control.
Psychological counseling helps to recognize triggers, build new behavioral patterns, and cope with difficult emotions or the risk of relapse.
When anxiety disorders,depressive symptoms or other psychiatric issues are present, it is important to treat these as well.
The combination of neuromodulation with specialized addiction care aligns with our vision of connecting neuroscientific insights with a broader, patient-centered treatment.
Neuromodulation is not a substitute for medical detoxification or psychiatric care. Especially in cases of alcohol or certain medication dependency, stopping abruptly can cause dangerous withdrawal symptoms, making medical supervision necessary.
The BRAI3N treatment process
1. Assessment
During an initial evaluation, we discuss the addiction issues, the progression of symptoms, previous treatments, and the circumstances under which cravings arise.
We pay attention to factors such as the intensity of cravings, triggers, stress, sleep, mood, and any co-occurring psychiatric symptoms.
AnqEEG measurement and analysis provides additional information about electrical brain activity. However, it is not a standalone diagnostic test for addiction and cannot determine on its own which neuromodulation protocol will yield the best results.
2. Targeted treatment
Based on the clinical assessment, we determine whether neuromodulation is a meaningful additional treatment option.
The treatment can target brain networks involved in craving, motivation, or behavioral control.
Where indicated, this is coordinated with psychological, psychiatric, or other specialized addiction treatments.
3. Stabilization
During the treatment process, we monitor how symptoms evolve.
We look at factors such as the intensity and frequency of cravings, substance use or addictive behavior, daily functioning, and progress within the broader recovery journey.
If there is insufficient improvement, the chosen treatment approach is re-evaluated.
4. Maintenance
When improvement occurs, we look at how to maintain it as effectively as possible.
Continued psychological or psychiatric counseling, relapse prevention, and social support remain essential components of recovery.
Not every patient requires neuromodulation or follows the same path.
Can neuromodulation help with my addiction?
Are you experiencing persistent or strongly recurring cravings despite previous treatments?
If so, it may be worthwhile to explore whether neuromodulation offers an additional treatment option.
BRAI3N is an international center of expertise for neuromodulation, where science and patient care converge.
Through close collaboration between neuroscientists and clinicians, scientific insights are carefully translated into clinical practice.
During an initial evaluation, we will review your symptoms, previous treatments, and the possibilities for an individualized treatment plan.
Contact us for a no-obligation consultation or to schedule an appointment
What does scientific research show?
Anterior Cingulate Implant for Alcohol Dependence: Case Report
De Ridder D, Manning P, Glue P, Cape G, Langguth B, Vanneste S.Neurosurgery. 2016;78(6)–E893.
Digitalized transcranial electrical stimulation: A consensus statement
Brunoni AR, Ekhtiari H, Antal A, Auvichayapat P, Baeken C, Benseñor IM, et al.Clinical Neurophysiology. 2022;143:154–165.
Lefaucheur JP, André-Obadia N, Antal A, Ayache SS, Baeken C, Benninger DH, et al.Clinical Neurophysiology. 2014;125(11):2150–2206.
Evidence-based guidelines on the therapeutic use of transcranial direct current stimulation (tDCS)
Lefaucheur JP, Antal A, Ayache SS, Benninger DH, Brunelin J, Cogiamanian F, et al.Clinical Neurophysiology. 2017;128(1):56–92.
Neuromodulation as an intervention for addiction: current status and future perspectives
Luigjes J, Breteler R, Vanneste S, De Ridder D.Journal of Psychiatry. 2013;55(11):841–852.
Psychosurgery Reduces Uncertainty and Increases Free Will? A Review
De Ridder D, Vanneste S, Gillett G, Manning P, Glue P, Langguth B.Neuromodulation. 2016;19(3):239–248.
The brain, obesity and addiction: an EEG neuroimaging study
De Ridder D, Manning P, Leong SL, Ross S, Sutherland W, Horwath C, Vanneste S.Scientific Reports. 2016;6:34122.
The neural correlates of the unified percept of alcohol-related craving: a fMRI and EEG study
Huang Y, Mohan A, De Ridder D, Sunaert S, Vanneste S.Scientific Reports. 2018;8:923.
De Ridder D, Vanneste S, Kovacs S, Sunaert S, Dom G.Neuroscience Letters. 2011;496(1):5–10.
Leong SL, Vanneste S, Lim J, Smith M, Manning P, De Ridder D.Scientific Reports. 2018;8:11659.
Allostasis in health and food addiction
De Ridder D, Manning P, Leong SL, Ross S, Vanneste S.Scientific Reports. 2016;6:37126.
Anterior Cingulate Cortex Implants for Alcohol Addiction: A Feasibility Study
Leong SL, Glue P, Manning P, Vanneste S, Lim JL, Mohan A, et al.Neurotherapeutics. 2020;17(3):1287–1299.
Anterior Cingulate Cortex in Addiction: New Insights for Neuromodulation
Zhao Y, Sallie SN, Cui H, Zeng N, Du J, Yuan T, et al.Neuromodulation. 2021;24(2):187–196.
Authored by Prof. Dr. Sven Vanneste, Prof. Dr. Dirk De Ridder and Jan Ost- 10/22/2026
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