Neurologists Look Beyond Traditional Addiction Treatment Techniques

By Jonathan Springston, Editor, Relias Media

Various groups of researchers have noted how some patients reported addiction remission after sustaining brain damage, such as that caused by a stroke. Recently, a group of neurologists looked closer at brain circuitry to learn how and why this phenomenon occurs and how this might provide a unique tool to help more patients battling addiction.

Researchers identified 129 patients who were daily smokers when they acquired a brain lesion. Thirty-four patients quit smoking with no difficulty right after the lesion. They did not relapse, and they reported no nicotine cravings since cessation. The neurologists noted that for these 34 patients, there were lesions that intersected with the insula, but this was not a uniform pattern for everyone.

The authors went deeper, turning to connected brain circuits, where they found a lesion that leads to addiction remission would be positively connected to the cingulate and insula. In a surprising twist, the researchers found some overlap in circuitry regarding the risk of alcoholism.

This was a retrospective analysis with a small patient cohort and a narrow addiction focus. Still, the authors are excited about targeted, therapeutic solutions to addiction generally, instead of addiction to one specific substance.

“We were excited to discover that our mapped lesions associated with addiction remission led back to a common brain circuit. While our findings point toward therapeutic targets for addiction, we need to test these targets in randomized clinical trials,” said study co-author Michael Fox, MD, PhD, who works in the department of neurology at Brigham and Women’s Hospital in Boston. “We study brain lesions in the context of the brain circuit because it provides a powerful way to understand the causal links between addiction and our neuroanatomy. We have hope that we can make significant strides toward helping patients with substance use disorders.”

For more on this and related subjects, be sure to read the latest issues of Neurology Alert.