Abstract
<p>Introduction: Non-invasive brain stimulation (NIBS) techniques have emerged as promising interventions for addiction, yet their effects on the cognitive processes underlying addictive behaviors remain inconclusive.Methods: Following PRISMA 2020 guidelines, we systematically reviewed sham-controlled studies identified through PubMed, PsycInfo, and EMBASE (search through November 2025) examining the effects of NIBS on cognitive processes in substance use and behavioral addictions. 39 studies were included and narratively synthesized across four cognitive domains: attentional and behavioral bias, inhibitory control, valuation and decision-making, and reward processing and learning.Results: Across studies, the dorsolateral prefrontal cortex (DLPFC) was the predominant stimulation target, with excitatory protocols (e.g., anodal tDCS, high-frequency rTMS) most commonly applied. Effect direction analysis indicated domain-specific patterns: NIBS most consistently modulated reward-related learning processes, whereas attentional bias measures showed little evidence of change. Findings for inhibitory control and decision-making tasks were mixed.Discussion: Results suggest that some cognitive processes may be more sensitive to cortical neuromodulation than others. A major limitation of the current literature is the reliance on aggregate task performance measures, which obscure the specific cognitive computations influenced by stimulation. Future research may benefit from applying computational modeling approaches, particularly reinforcement learning frameworks, to decompose behavioral performance into latent parameters with clear psychological interpretations. Such approaches may enable more precise mechanistic understanding of NIBS effects and support the development of targeted neuromodulation interventions for addiction.</p>