Brain area associated with smoking addiction identified

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Brain area associated with smoking addiction identified
Washington, Jan 27: US researchers have discovered that a silver dollar-sized region deep in the brain insula is intimately involved in smoking addiction, and damage to it can completely erase the body's urge to smoke.

Although brain damage is not a treatment option for nicotine addiction, the researchers believe that their findings may offer leads for therapies to help smokers kick the habit, or for monitoring smokers' progress while using existing therapies.

The study, authored by Antoine Bechara of the University of Southern California and the University of Iowa, was largely inspired by a patient who had smoked around 40 cigarettes a day before his insula was damaged by a stroke and then his body "forgot the urge to smoke."

The insula receives information from other parts of the body and is thought to help translate those signals into what people subjectively feel – hunger, pain, or craving for a drug. Some imaging studies have shown that this region of the brain gets activated by drug-associated cues, such as the sight of people doing drugs.

"One of the most difficult problems in any form of addiction is the difficulty in stopping the urge to smoke, to take a drug, or to eat for that matter. Now we have identified a brain target for further research into dealing with that urge," said.

"This kind of study is quite forward-looking. In addition to investigating a basic scientific mechanism underlying drug addiction, these authors have come up with innovative ideas about how we may be able to treat addiction and prevent relapse," said Science senior editor Peter Stern.

In a bid to investigate whether the insula played a major role in smoking addiction, the authors studied 69 patients who had been smokers before they suffered the brain damage, of which 19 had suffered damage to their insula.

Thirteen of the insula-damaged patients had quit smoking, of which 12 did it very quickly and easily, reporting that they had felt no urges to smoke since quitting. The reason as to why the other six patients did not quit smoking is, however, not known.

Some of the patients with other forms of brain damage also stopped smoking without effort, but patients relinquishing the habit were most likely to be amongst those who had suffered damage to the insula.
Bechara said that insula damage did not seem to affect patients' desire to eat or their food intake during a follow-up survey.

He further said that another possible approach to treating smoking addiction might be to use a technique called transcranialmagnetic stimulation, which involves inducing weak electrical currents in the brain tissue, to disrupt the insula's activity. But this technique does not penetrate deep enough to reach the insula at present.

"The insula also carries out lots of normal everyday functions so we would want to make sure we only interfere with functions that disrupt bad habits like smoking but not something vital like eating," cautioned Bechara. The findings have been published in the journal Science.
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