Brain Circuits and Addiction
Vadali (2022) published “Human Brain Lesions Provide Lead to Brain Circuit That Could Be Targeted to Treat Addiction” in Harvard Gazette June 16, 2022. This is important work in that it addresses substance use disorders, noting that they “are a leading cause of death among young people.” The work is based on findings in patients “no longer addicted to nicotine after experiencing a brain lesion, such as a stroke. . . . Neuromodulation therapies, such as deep brain stimulation, transcranial magnetic stimulation, and MRI-guided focused ultrasound, allow clinicians to directly target brain circuits and improve symptoms in ways that may not be possible through treatment with medication. But knowing the location to target is critical.”
Michael D. Fox, HMS associate professor of neurology at Brigham and Women's Hospital describes much of the research: “Ultimately, our goal is to take larger steps towards improving existing therapies for addiction and open the door for remission.” His team compared lesions in patients who went into remission with those who could not stop smoking.
“They then used a database known as the human connectome to map each lesion to the larger brain circuit. They found that the two smoking lesion datasets that led to remission of smoking addiction mapped to a specific brain circuit. To their surprise, they also discovered in a third alcoholism lesion dataset that a reduced risk of alcoholism mapped to a similar brain circuit, suggesting a potentially therapeutic, targetable neural pathway for addiction in general, rather than addiction to a specific substance.”
Vadali adds that, “The authors acknowledge two primary study limitations. First, the results are solely based on retrospective analysis of existing datasets and, second, the datasets examined covered only specific substances of abuse. The researchers therefore advocate for prospective validation of their findings through clinical trials testing and an examination of additional substances of addiction to determine whether their findings can be applied widely.”
This is exciting work, especially for those professionals who work with clients with severe substance use disorders.