Researchers at the Sunnybrook Center for Health Sciences have provided early evidence that deep brain stimulation (DBS), a type of brain surgery, is a safe and effective treatment for severe alcohol consumption disorder (AUD) and resistant to treatment.
The results of this phase I pilot trial suggest that DBS may lead to significant reductions in daily alcohol intake among participants. All patients experienced a significant reduction in their alcohol cravings and some patients were able to drastically curb their alcohol consumption.
This is the first study in North America to investigate DBS for treatment-resistant AUD in which patients have not responded to conventional treatments such as psychotherapy and medication.
The results of the innovative pilot study have been published in Molecular Psychiatry.
The Sunnybrook Harquail Neuromodulation Center is currently among the few centers worldwide that perform DBS for AUD.
“Deep brain stimulation points to brain pathways specifically associated with addiction and reward,” says Dr. Nir Lipsman, the study’s lead researcher, neurosurgeon and director of the Harquail Center for Neuromodulation at Sunnybrook. “Our preliminary results show that this direct brain intervention was safe and well tolerated by patients. Although far from a cure for alcohol-related disorder, the results are promising and suggest that DBS could be an approach. new to curb alcohol cravings “.
AUD is a medical condition that occurs when a person cannot control the amount of alcohol they consume. AUD can cause debilitating health problems and difficulty functioning in daily life. Researchers in the study say AUD affects more than 10 percent of the general population. Conventional treatments include detoxification, psychotherapy, medication, and abstinence. Experts say the relapse rate is 75 percent.
DBS is a pacemaker for the brain. It is a neurosurgical procedure that involves implanting electrodes in very specific regions to stimulate the brain circuits responsible for the abnormal symptoms. In Canada and around the world, DBS is commonly used in the treatment of Parkinson’s disease, essential tremor, and obsessive-compulsive disorder.
In this study, the researchers pointed to the nucleus accumbens, a part of the brain’s reward circuits that is critical in addiction, managing alcohol cravings, as well as mood and anxiety.
The pilot study included a total of six participants (two women and four men) living with severe chronic AUD from six to more than 25 years of alcohol-intensive use. Individual consumption ranged from six to 18 alcoholic beverages per day. The median age was 49 years.
Participants enrolled and underwent DBS surgery between December 2018 and October 2020. Targeted brain pathway stimulation and patient follow-up continued for a period of 12 months.
“An important finding of the study was the significant change in the experience of consuming alcohol. That is, a reduction in the ‘high’ euphoria that is associated with alcohol,” explains Dr. Benjamin Davidson, first author of the study and surgical resident in Sunnybrook. “After one year, all study participants experienced a significant reduction in alcohol-related desires and compulsivity and anxiety.”
The marked decrease in alcohol consumption varied among participants, with some experiencing a drop of 50 to 100 percent in daily drinks.
“These are significant and promising early findings that point to the opportunity for a new innovative way to treat alcohol use disorder,” says Dr. Davidson. “Our analysis suggests that deep brain simulation affects the way related brain pathways work together and reduces an individual’s typical response to visual indications of alcohol that may help curb alcohol cravings, however, more research “.
“The next steps will include investigating how next-generation DBS technology can be used to adjust and tailor more personalized treatments for patients in the future,” says Dr. Lipsman. “This is an exciting time of discovery as we expand our reach and gain global experience in direct brain interventions for psychiatric illnesses.”
The generous philanthropic investment in the Sunnybrook Harquail Neuromodulation Center, including the main support of the Harquail family, is a catalyst for advancing this study and other innovative neuromodulation work at Sunnybrook.
For more information on deep brain stimulation at Sunnybrook: sunnybrook.ca/dbs
Learn more about the Harquail Center for Neuromodulation in Sunnybrook
Media contacts:
Jennifer Palisoc Communications AdvisorSunnybrook Health Sciences Centerjennifer.palisoc@sunnybrook.ca
Samantha Sexton Communications AdvisorSunnybrook Health Sciences Centamantamantha.sexton@sunnybrook.ca