Changes in Addictive Behaviors After Brain Lesions

脑损伤后成瘾行为的变化

• 批准号: 8293403
• 负责人: ANTOINE BECHARA
• 金额: $ 45.9万
• 依托单位: UNIVERSITY OF SOUTHERN CALIFORNIA
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-08-01 至 2015-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8293403
• 关键词: Addictive Behavior; Address; Adverse effects; Amygdaloid structure; Anterior; Area; Attention; Automobile Driving; Award; Basic Science; Behavior; Behavioral; Biological Neural Networks; Brain; Brain Injuries; Brain region; Cereals; Cognitive; Corpus striatum structure; Cues; Databases; Decision Making; Drug Addiction; Emotional; Emotions; Exploratory/Developmental Grant for Diagnostic Cancer Imaging; Functional Imaging; Funding; Gender; Goals; Habits; Handedness; Human; Impairment; Individual; Insula of Reil; Iowa; Laboratories; Lead; Left; Lesion; Life; Light; Link; Literature; Location; Maintenance; Maps; Methods; Monitor; Motivation; Neurologic; Neurology; Nicotine; Nicotine Dependence; Patients; Pharmaceutical Preparations; Play; Prefrontal Cortex; Process; Prospective Studies; Relapse; Research; Retrospective Studies; Right-On; Role; Sample Size; Sampling; Sex Characteristics; Side; Smoke; Smoker; Smoking; Smoking Behavior; Stroke; Structure; Techniques; Therapeutic; Time; Universities; Ventral Striatum; Withdrawal; Woman; Work; abstracting; addiction; cigarette smoking; cingulate cortex; clinically significant; cognitive function; drug craving; effective therapy; experience; follow-up; interest; men; neural circuit; novel strategies; novel therapeutic intervention; patient registry; prospective; psychologic; smoking cessation; social

Project Summary/ Abstract A network of neural structures crucial for the cognitive and behavioral processes of drug addiction, including nicotine, includes the orbitofrontal cortex, anterior cingulate, insular cortices, the amygdala, and the striatum. However, no work has addressed how damage to different components of this neural network in humans may impact the maintenance of addiction to drugs. Under the tenure of an R21 awarded through CEBRA (Cutting- Edge Basic Research Awards), we began addressing this important issue in patients addicted to cigarette smoking and who had suffered a stroke that included any of these areas. It was found that although lesions of the ventromedial prefrontal cortex (VMPFC) were associated with a marked impairment of cue-induced urge in the laboratory, they were not associated with an increased likelihood of quitting smoking. In fact, lesions of the insular cortex were associated with an ability to quit smoking easily, immediately, without relapses and without a lasting urge to smoke. Although preliminary, these results suggest that, while VMPFC lesions may disrupt cue-induced urges, they do not disrupt smoking addiction. However, the insula, which also plays a key role in urges, seems most critical for maintaining smoking addiction and driving smoking behavior. The results also suggest that the insula functions in psychological processes that may contribute to the difficulty of quitting smoking. Encouraged by these intriguing, but preliminary, results, our primary aims are to (1) expand and confirm these findings in a larger sample, using more precise anatomical analyses to characterize the size and placement of lesions; (2) examine whether there are gender differences in terms of the ease to quit smoking after a lesion; and (3) conduct prospective studies on smokers who suffer strokes and monitor their smoking behavior for several years after the lesion onset. The proposed research is a beginning of a novel approach with potential for developing more effective therapies for breaking the vicious cycle of addiction. Specifically, one therapeutic approach called up by the proposed research would be to directly modulate the function of the insula. Project Narrative A prune-sized region deep in the brain called the insula is intimately involved in smoking addiction, and damage to this structure can completely erase the body's urge to smoke. Obviously brain damage is not a treatment option for nicotine addiction, but if confirmed, these results may offer leads for therapies to help smokers kick the habit, or for monitoring smokers' progress while using existing therapies.

项目概要/摘要 对毒瘾的认知和行为过程至关重要的神经结构网络，包括 尼古丁，包括眶额皮质、前扣带皮层、岛叶皮质、杏仁核和纹状体。 然而，目前还没有研究表明人类神经网络的不同组成部分受到损害会如何产生影响。 影响药物成瘾的维持。在 CEBRA 授予的 R21 任期内（切割- Edge 基础研究奖），我们开始解决烟瘾患者的这一重要问题 吸烟以及曾患过上述任何部位中风的人。研究发现，虽然病变 腹内侧前额叶皮层（VMPFC）与提示诱发的冲动的显着损害有关 在实验室中，它们与戒烟可能性的增加无关。事实上，病变部位 岛叶皮质与轻松、立即戒烟、不复吸且不复发的能力相关。 持久的吸烟冲动。尽管是初步的，但这些结果表明，虽然 VMPFC 损伤可能会破坏 提示引起的冲动，它们不会破坏吸烟成瘾。然而，岛叶也起着关键作用 冲动，似乎对于维持吸烟成瘾和驱动吸烟行为最为关键。结果还 表明岛叶在心理过程中的功能可能导致戒烟困难 吸烟。受到这些有趣但初步的结果的鼓舞，我们的主要目标是（1）扩展和 使用更精确的解剖分析来表征大小和在更大的样本中证实这些发现 病灶的放置； (2)考察戒烟容易程度是否存在性别差异 病变后； (3) 对患有中风的吸烟者进行前瞻性研究并监测他们的吸烟情况 病变发生后数年的行为。拟议的研究是一种新方法的开始 有潜力开发出更有效的疗法来打破成瘾的恶性循环。具体来说， 拟议研究提出的一种治疗方法是直接调节 岛。项目叙述 大脑深处一个李子大小的区域，称为岛叶，与吸烟成瘾密切相关，并且 这种结构的损坏可以完全消除人体吸烟的冲动。显然脑损伤不是 尼古丁成瘾的治疗选择，但如果得到证实，这些结果可能会为帮助治疗提供线索 吸烟者戒掉这个习惯，或者在使用现有疗法的同时监测吸烟者的进展。