ROCHESTER, N.Y., Sept. 8 (UPI) — Two studies with stroke patients who smoke cigarettes showed that a specific part of the brain, the insular cortex, may play a major role in addiction.
The conclusion is based on patients in the study whose strokes occurred in that region of the brain having fewer nicotine withdrawal symptoms while they were in the hospital and a lower rate of relapsing into nicotine addiction.
Drugs such as bupropion and varenicline, as well as nicotine replacement treatments such as patches and gum, have a relatively low success rate — researchers estimate that as many as 70 percent of people who use them to quit eventually start smoking again.
Targeting the part of the brain which powers addiction, rather than blocking reward pathways in the brain by interfering with dopamine function, could be a more effective method of treating addiction, researchers at the University of Rochester found.
“These findings indicate that the insular cortex may play a central role in addiction,” said Dr. Amir Abdolahi, a clinical research scientist at Philips Research North America who lead the research while he was a student at the University of Rochester, in a press release. “When this part of the brain is damaged during stroke, smokers are about twice as likely to stop smoking and their craving and withdrawal symptoms are far less severe.”
The researchers worked with 156 smokers who’d been admitted to hospitals for acute ischemic stroke, 38 with insular infarctions and 118 with non-insular infarctions.
In a study published in the journal Addiction, researchers measured withdrawal symptoms among the patients while they were in the hospital. Using the Wisconsin Smoking Withdrawal Scale and Minnesota Nicotine Withdrawal Scale, researchers found that patients with insular infarctions experienced fewer and less intense withdrawal symptoms during hospitalization, where they were not permitted to smoke.
The study showed that patients with insular infarctions were less likely to need nicotine replacement treatment than were those with non-insular infarctions.
A companion study published in Addictive Behaviors measured how many relapsed into smoking by following the patients for 3 months after their release from the hospital.
Researchers found that those with damage to the insular cortex had better odds of abstaining from nicotine for three continuous months than those with with non-insular infarctions. They also found that patients who’d had an insular infarction took longer to relapse, if they did, than the patients with non-insular infarctions.
“Much more research is needed in order for us to more fully understand the underlying mechanism and specific role of the insular cortex, but it is clear that something is going on in this part of the brain that is influencing addiction,” said Abdolahi.
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