Addiction remission is tied to specific brain circuits, not single brain centers. Researchers studied smokers who quit after a stroke or other brain injury. Their damage sat at different sites, but all of the sites belonged to the same circuits. Future treatment could target those circuits. Tools could include transcranial magnetic stimulation or MRI-guided ultrasound.
Summary: Substance abuse, or addiction, is the top cause of death among young adults. It is very preventable. But relapse rates are high, so modern addiction care falls far short. We need better ways to treat addiction. In this retrospective study, researchers looked at people with damage to certain parts of the brain. These people were able to quit smoking. The quitting was tied to changes in brain circuits. Researchers think these findings may help treat addiction one day. Doctors could find these circuits and then change how they work. They could do it with methods that do not cut into the body.
Substance abuse is the top cause of death among young adults. It causes several hundred thousand deaths in the US alone each year. Most of these deaths could be prevented through effective addiction treatment. But after years of research, addiction treatment still falls far short, and relapse rates are high. The truth is that most people do not benefit from addiction treatment. The problem with today’s treatments is that they do not aim at exact brain areas. Instead, doctors use methods like nicotine replacement therapy to cut nicotine cravings. They might also use drugs to cut cravings for other substances. But science also knows that some people’s brains are wired quite differently. They do not become addicted, even after long substance use. On top of that, researchers have found that many people can shake their addiction, or fully recover, after a stroke or certain brain injuries. Again, this shows how much specific brain pathways, or circuits, matter in substance abuse. If science could clearly understand the role of each brain center and circuit in addiction, researchers might be able to help. They could create brain lesions through surgery. Or they could use non-invasive methods to stimulate certain brain circuits. That could help people get rid of their addictions.
Is addiction driven by brain circuits or single brain areas?
This new study is a step forward in addiction treatment. Researchers were able to link certain brain circuits to addiction. Earlier studies looked at certain brain centers. This study is different, because it looked at specific brain circuits. It means that stimulating different parts of the brain may help end addiction. But it also means the focus must be on changing brain circuits, not single brain centers. This study is a retrospective study, meaning it looked back at past cases. Researchers found that some people were able to quit smoking after a stroke or other brain lesions. They reasoned that this must be tied to breaks in certain brain circuits. In the study, the people who were able to quit all had lesions in different places. But these places were all part of specific brain circuits. So it is not vital to change how single brain centers work to treat addiction. Instead, doctors need to focus on specific brain circuits. There could be many ways to change these circuits, like creating lesions through surgery. But researchers are more interested in non-invasive methods like deep brain stimulation, MRI-guided ultrasound, and transcranial magnetic stimulation. These non-invasive methods are fairly safe and can help change brain circuits. Researchers think they are on the right path. Understanding how brain circuits work in different disorders may also help treat other brain and nerve conditions. For example, it may help manage the tremors seen in some brain disorders. Researchers say their findings still have some limits. This study mainly looked at nicotine addiction in people who had brain lesions. They are not sure if similar brain circuits drive other addictions, like alcohol. Also, these are retrospective studies of people who had brain lesions from some disease. Researchers would still need to find safe ways to change these brain circuits in healthy adults, to help them overcome addiction.
Frequently asked questions
Can a stroke or brain injury stop an addiction?
In some people, yes. Researchers found that some smokers were able to quit after a stroke or another brain injury. Their injuries sat in different places. But every site belonged to the same brain circuits. That points to the circuit, not one brain center, as the engine that keeps an addiction running. It is also the target that treatment needs to reach.
Why do so many people relapse after addiction treatment?
Addiction treatment still has high relapse rates, and most people fail to benefit from it. One reason is that current treatments do not target the exact brain areas involved. Doctors rely on tools such as nicotine replacement therapy or drugs that ease cravings. They do not change the brain circuits that drive the addiction itself.
How could doctors target addiction circuits in the brain?
Surgery can create lesions. But researchers are more interested in gentler ways to change how a circuit works. These include transcranial magnetic stimulation, MRI-guided ultrasound and deep brain stimulation. Researchers consider these methods fairly safe. The same circuit approach may also help other brain and nerve problems, such as the tremors seen in some brain disorders.
Does this research apply to alcohol and other addictions?
Not yet. This study looked at nicotine addiction in people with brain lesions from disease. Researchers do not yet know if the same circuits drive other addictions, such as alcohol. It was also a retrospective study, meaning it looked back at past cases. The next step is to find safe ways to change these circuits in healthy adults who want to beat addiction.
Related reading
Telephone Counseling to Quit Smoking · TMS for Anxious Depression · Why FindTreatment.gov Needs Fixing · Drug Addiction Treatment, St. Louis
Sources
- Joutsa J, Moussawi K, Siddiqi SH, et al. Brain lesions disrupting addiction map to a common human brain circuit. Nat Med. 2022;28(6):1249-1255. PMID 35697842 · DOI 10.1038/s41591-022-01834-y.