Abstract: Using mapping injury networks, the researchers identified brain circuits associated with addiction remission. The findings provide a new goal for the development of addiction treatments.
Source: Brigham and Women’s Hospital
In the United States, substance use disorders are one of the leading causes of death among young people. Treatments such as deep brain stimulation are promising to help people overcome addiction, but there are still many questions about which areas of the brain to target.
Researchers are getting new ideas from patients who are no longer addicted to nicotine after experiencing a brain injury, such as a stroke.
Using a new technique known as injury network mapping, researchers at Brigham and Women’s Hospital have mapped the remission of addiction to whole brain circuits rather than specific regions of the brain, pointing to new targets for treatment.
Their results are published in Nature Medicine.
“By looking beyond individual brain regions and instead the brain circuit, we have found targets for addiction remission and are looking forward to testing them rigorously through clinical trials,” said Michael Fox, MD, PhD , from the Brigham Department of Neurology.
“Ultimately, our goal is to take bigger steps to improve existing therapies for addiction and open the door to remission.”
Neuromodulation therapies, such as deep brain stimulation, transcranial magnetic stimulation, and focused ultrasound-guided focused ultrasound, allow doctors at Brigham’s Center for Brain Circuit Therapeutics to go directly to the brain circuits and improve symptoms in ways. which may not be possible with medication.
But knowing the location to aim for is key. In a previous study, researchers used the mapping of the lesion network to examine patients whose essential tremors were resolved, confirming the goals used in treatment with deep brain stimulation.
The study authors proposed to apply the same approach to addiction remission.
“Although we know a lot about the neurobiological mechanisms of addiction, treatment options are still very limited.
“Our findings with Essential Tremors made us realize the potential of this approach to locating key brain circuits that mediated the improvement of symptoms,” said Juho Joutsa, MD, PhD, of the Turku Brain and Mind Center and Clinical Neuroscience. University of Turku.
Fox and colleagues used data from two independent cohorts of nicotine-addicted patients who later suffered a brain injury, usually from a stroke.
The Fox team compared injuries in patients who could not stop smoking with injuries that led to remission of smoking addiction. They then used a database known as the human connectome to map each lesion to the largest brain circuit. They found that the two sets of smoking injury data sets that led to the remission of smoking addiction were mapped to a specific brain circuit.
To their surprise, they also found in a third set of alcoholism injury data that a reduced risk of alcoholism was associated with a similar brain circuit, suggesting a potentially therapeutic and orientable neuronal pathway for alcoholism. addiction in general, rather than addiction to a specific substance.
“While neuromodulation treatments with electricity or even brain injury have been shown to be promising in relieving substance addiction, the therapeutic goal has not been clear,” Fox said.
“Now that our study has identified a target, a specific human brain circuit, we hope to test whether neuromodulation targeting that brain circuit provides sustainable symptom relief to our patients.”
The authors acknowledge two main limitations of the study. First, the results are based solely on retrospective analysis of existing data sets, and second, the data sets examined only covered specific substances of abuse.
Therefore, researchers advocate for prospective validation of their findings through clinical trial testing and an examination of additional addictive substances to determine whether their findings can be widely applied.
Treatments such as deep brain stimulation are promising to help people overcome addiction, but there are still many questions about which areas of the brain to target. The image is in the public domain
“We were thrilled to find that our mapped lesions associated with addiction remission led to a common brain circuit. Although our findings point to therapeutic goals for addiction, we need to test these goals in trials. randomized clinicians, “Fox said.
“We study brain damage in the context of the brain circuit because it provides a powerful way to understand the causal links between addiction and our neuroanatomy. We hope to make significant progress in helping patients with substance use disorders. “.
Disclosures: Fox and Shan H. Siddiqi own patents on the use of brain connectivity to guide brain stimulation. Fox and Siddiqi have received research funding initiated by the Neuronetics Inc. researcher, and both are consultants at Magnus Medical, which are not related to the present work.
Funding: This work was supported by the Finnish Academy (No. 295580), the Finnish Medical Foundation, the Finnish Foundation for Alcohol Studies, the National Institute on Drug Abuse (NIDA DA 048085) , Brain and Behavior Research Foundation, NIDA / NIH Intramural Research Program, Sidney R. Baer Jr Foundation, NIH (R01MH113929, R21MH126271, R56AG069086, R21NS123813), Nancy Lurie Marks Foundation, Kaye Family Research Fund , Ellison / Baszucki Foundation and Mather’s Foundation.
See also
About this addiction research news
Author: Jessica PastoreSource: Brigham and Women’s HospitalContact: Jessica Pastore – Brigham and Women’s HospitalImage: Image is in the public domain
Original search: closed access. “Brain Injuries Disrupting the Map of Addiction to a Common Human Brain Circuit” by Michael Fox et al. Natural Medicine
Summary
Brain injuries that alter the map of addiction to a common human brain circuit
Drug addiction is a public health crisis for which new treatments are urgently needed. In rare cases, regional brain damage can lead to a remission of addiction. These cases can be used to identify therapeutic targets for neuromodulation.
Two cohorts of smoking-addicted patients at the time of focal brain damage were analyzed (cohort 1 n = 67; cohort 2 n = 62). Injury locations were mapped to a brain atlas and the functionally connected brain network at each injury location was calculated using human connectome data (n = 1,000).
Associations with addiction remission were identified.
Generalization was assessed by an independent cohort of patients with focal brain damage and alcohol addiction risk scores (n = 186). Specificity was assessed by comparison with 37 other neuropsychological variables.
Injuries that altered smoking addiction occurred in many different brain locations, but were characterized by a specific pattern of brain connectivity. This pattern involved positive connectivity with the dorsal cingulate, lateral and insular prefrontal cortex, and negative connectivity with the medial prefrontal and temporal cortex.
This circuit was reproducible in cohorts of independent lesions, associated with a reduced risk of alcohol addiction and specific to addiction metrics. The centers that best suited the connectivity profile for addiction remission were the paracingulate gyrus, the left frontal operculum, and the medial frontopolar cortex.
We conclude that brain injuries that disrupt addiction map to a specific human brain circuit and that the centers of that circuit provide probable targets for therapeutic neuromodulation.