Brain Circuits and Addiction | Harvard Medical School

Researchers at Harvard Medical School using a new technique known as lesion network mapping At Brigham and Women’s Hospital It maps addiction remissions to the entire brain circuit rather than to specific brain regions, pointing to new therapeutic targets.Those results will be published on June 13th Nature medicine..

Substance use disorders are the leading cause of death in adolescents in the United States. Treatments such as deep brain stimulation may help people overcome their addiction, but many questions remain as to which brain region should be targeted.

New jobs contribute to the growth of the acquired knowledge From patients who are no longer dependent on nicotine after experiencing brain lesions such as stroke.

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“By looking beyond individual brain regions and instead looking at brain circuits, we find targets for addiction remission and are eager to test them rigorously through clinical trials,” he said. Michael D. FoxHMS Associate Professor of Neurology In Brigham and Women’s.

“Ultimately, our goal is to take a bigger step towards improving existing treatments for addiction and open the door to remission,” he said.

Neuromodulatory therapies such as deep brain stimulation, transcranial magnetic stimulation, and MRI-guided focused ultrasound can directly target brain circuits and improve symptoms in ways that drug therapy cannot. However, it is important to know where to target.

In previous studiesResearchers used lesion network mapping to examine patients who had resolved essential tremor and identified targets used for treatment with deep brain stimulation. The authors of the study set out to apply the same approach to remission of addiction.

“We know a lot about the neurobiological mechanisms of addiction, but treatment options are still very limited. Our findings on essential tremor mediate improvement of symptoms. It made us aware of the potential of this approach to identify the major brain circuits that do. ” Juho Youza of Turku Brain and Mind Center and Clinical Neuroscience At the University of Turku.

Fox et al. Used data from two independent cohorts of patients with nicotine addiction. These patients usually suffered from stroke and brain lesions.

Comparison of lesions

Fox’s team compared the lesions of patients who were unable to quit smoking with those that resulted in remission of smoking addiction. We then used a database called the Human Connectome to map each lesion to a larger brain circuit.

They found that two smoking lesion datasets leading to remission of smoking addiction were mapped to specific brain circuits.

Surprisingly, they also discovered In the third alcoholism [KS1] A lesion dataset in which a reduced risk of alcoholism is mapped to similar brain circuits. It suggests potentially therapeutic and targetable neural pathways for general addiction rather than addiction to specific substances.

“Neuromodulatory treatments using electricity and brain lesions have been shown to be promising in alleviating drug addiction, but the therapeutic target was unclear,” Fox said.

“Our study has identified a target, a specific human brain circuit, and we would like to test whether targeted neural regulation of this brain circuit provides sustainable symptom relief for patients.” He said.

The author acknowledges the limitations of two major studies. First, the results were based solely on retrospective analysis of existing datasets, and second, the datasets investigated targeted only specific substances of abuse.

Therefore, researchers advocate a positive verification of their findings through clinical trials and testing for additional substances of addiction to determine if their findings are widely applicable.

“We were thrilled to discover that the mapped lesions associated with addiction remission return to the general brain circuit, although our findings indicate therapeutic targets for addiction. , We need to test these targets in randomized clinical trials, “Fox said.

“We study brain lesions in the context of brain circuits, because they provide a powerful way to understand brain circuits. Causal relationship Between addiction and our neuroanatomy. We hope we can make great strides towards helping patients with substance use disorders, “he added.

This work has been supported by the Finnish Academy (# 295580), Finnish Medical Foundation, Finnish Alcohol Research Foundation, National Institute on Drug Abuse (NIDA DA 048085), Brain and Behavior Research Foundation, and NIDA / NIH on-campus research programs. rice field. , Sidney R. Baer, ​​Jr. Foundation, NIH (R01MH113929, R21MH126271, R56AG069086, R21NS123813), Nancy Lurie Marks Foundation, Kaye Family Research Fund, Ellison / Baszucki Foundation, and Mothers Foundation.

Disclosure: Fox and Shan H. Siddiqi own a patent on using brain connectivity to induce brain stimulation. Fox and Siddiqi receive researcher-led research funding from Neuronetics Inc., both of which are Magnus Medical consultants and are all unrelated to their current work.

Revised from Brigham and Women’s news releases.