Discovery of a brain network implicated in addiction

By studying long-time smokers who quit suddenly after brain damage, researchers have successfully mapped a brain network linked to addiction. According to the authors of the study, published Monday in Nature Medicine, these findings could help target future treatments for addiction to a range of substances.

To determine where addiction is located in the brain, researchers studied 129 patients (60% male, average age 56) who had smoked daily and had brain damage. While more than half of them continued to smoke normally after the injury, a quarter of them stopped smoking immediately without difficulty and even reported “no cravings,” according to the study.

“The Forgiveness Network of Addiction”

The remission-related lesions were located in several areas of the brain, but all were connected to a specific network, the researchers believed, who mapped it into a number of brain regions called the “addiction remission network.” They found that the lesion that caused a person to abandon the addiction likely affected parts of the brain such as the dorsolateral anterior cingulate cortex, lateral prefrontal cortex, and insular cortex, but not the medial prefrontal cortex.

Previous research has shown that lesions in the insular cortex reduce addiction, but it did not take into account other parts of the brain identified in this new study. To confirm their findings, the researchers studied 186 patients with brain damage who completed an alcohol risk assessment. They found that damage to the addiction-related brain network they found in smokers also reduced the risk of alcohol dependence, “suggesting that there is a shared network of addiction across these substances.”

“The identified network provides a testable target for treatment attempts,” said study author Juhu Gutsa, a neurologist at Finland’s University of Turku. “Some of the network’s axons were located in the cerebral cortex, which can be targeted even using non-invasive neuromodulation techniques,” he said. Neuromodulation combines all techniques used to modify the activity of the central, peripheral, or autonomic nervous system.

One such technology, transcranial magnetic stimulation coils, approved in May by the US Drug Administration (FDA) for obsessive-compulsive disorder, already targets many of the same brain regions as the addiction remission network. The study author hopes his research will help develop a profile targeting addiction. “However, the best way to modify this network remains to be determined, and carefully designed trials to verify the clinical benefits of targeting the network have yet to be determined,” he said.

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