BRAIN INJURY

According to a study, brain scans of cigarette smokers who quit after suffering brain damage such as strokes reveal that interconnected brain regions underpin addiction.

According to the Centers for Disease Control and Prevention, one in every 14 Americans has a substance addiction disorder. Existing treatment may be insufficient and may include a combination of medicine, psychotherapy, and more intrusive treatments such as electrical impulse delivery to the brain. The researchers hope that their discoveries will pave the path for targeted new treatments or the optimization of existing ones.

“One of the biggest problems in addiction is that we don’t really know where in the brain the main problem lies that we should target with treatment,” Dr. Juho Joutsa, a neurologist at the University of Turku, Finland, and co-author of the study published in Nature, told The New York Times of the findings.

“We’re expecting that at the end of this, we’ll have a solid sense of those regions and networks.”

The researchers looked at 129 brain scans from two different groups of nicotine smokers who had brain lesions such as strokes and then quit smoking.

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The team reviewed scans of a further 186 persons with alcoholism who suffered brain injuries and quit drinking to determine if the findings held true for other substance-use disorders and found the same trends. This could imply that other substance-use problems are caused by interconnected brain regions, though more research is needed to prove this.

The New York Times quoted Thomas McLellan, an emeritus professor of psychiatry at the University of Pennsylvania who was not involved in the study, as saying that he feels the study “may be one of the most impactful articles not only of the year, but of the decade.”

“It lays to rest so many of the misconceptions that still plague the field of addiction: that addiction is lousy parenting, addiction is a weak personality, addiction is a lack of morals,” McLellan, a former deputy director of the Office of National Drug Control Policy, said.

New medicines may be able to target specific parts of the brain

According to the researchers, treatments that deliver electrical impulses to the brain, such as deep brain stimulation or transcranial magnetic stimulation (TMS), can target brain circuits in ways that tablets cannot, and some of whom own patents on using brain connectivity to guide brain stimulation. It is feasible, for example, to simulate brain injury by suppressing electrical activity in a specific location.

The Food and Drug Administration has already approved a TMS device for addiction that targets two previously related brain areas.

Any new or improved treatments resulting from the study are likely years away, as more research is needed to determine whether the findings apply to other substance use disorders, how long the effects of any targeted treatments last, and whether there are any side effects, according to the study authors.

Michael D. Fox, the founding director of Brigham and Women’s Hospital’s Center for Brain Circuit Therapeutics and study co-author, said in a statement that the team was keen to rigorously test the “newly discovered targets for addiction remission” through clinical studies.

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