Friday, January 26, 2007

Damage to a brain structure called the Insula disrupts addiction to cigarette smoking:

Scientists have reported recently that damage to a portion of the brain called the insula kills the urge to smoke. The insula is a region that lies underneath the cerebral cortex behind the upper lobes of our ears. It is a deep brain structure and is thought to the implicated in the intermeshing of physical activity and emotion and the translation of one to the other (including the attendant effects of motivation and craving for the ‘fix’). This may be the first time that scientists have obtained definitive proof that the insula may be the seat and originator for cravings that develop within all of us. Of course we cannot go ahead and damage a person’s insula in the hope that the person may quit smoking, but we could develop alternative therapies like selective ablation of certain portions of the insula or stem cell based mediated growth (or death) to relevant portions of the insula to stop the urge to smoke. All of that is conjecture at this point in time and only a lot more concentrated research in this field will prove to us the viability of technologies outlined above...

Dr. Antoine Bechara of the University of Southern California who led the research said that he was initially puzzled when a patient with stroke related damage to the insula suddenly gave up the smoking habit. This prompted him to look at stroke registries for correlation between location of the stroke related injuries in the brain and the predilection of the person to go back to smoking. This led to the ultimate pinpointing of the region on the brain that kills the urge in an individual to smoke. The rest they say is concentrated research and history... He has published his results in today’s issue of the science magazine... Unfortunately I have not been able to get my hands on the paper.

In light of the enormous amount of research that needs to be carried out in this area, it may be a while until we see troops of smokers heading to the operating table for brain surgery to quit smoking... Meanwhile if you want to quit smoking, I would say, just drop the bad habit.

4 comments:

jafabrit said...

I read that article and it was very interesting.

ian gordon said...

Okay, so it might stop one craving for a cigarette - but what else will it mess with in the process? I dread to think.

Anyway, as we already live in a world where doctors are reluctant to treat smokers for self induced ailments, i don't think we'll see surgery becoming an option. Certainly I hope not with my taxes.

Sunflower Optimism said...

I wonder if this will impact other types of addictions?

Sunil said...

Sunflower and Ian,
Thanks for coming by...
I think your question was spot on and I am sure that there are many more such issues that need to be dealt with rather than just the vanilla effect of the cessation of the urge to smoke.

Neglect After Right Insular Cortex Infarction
F. Manes, MD et. al. form the journal Stroke. 1999;30:946-948.

"The human insular cortex is an island of cortical tissue beneath the frontoparietal and temporal opercula5 that phylogenetically is considered paralimbic cortex.Because of its connections with limbic and sensorimotor cortices, the insular cortex is believed to play a role in affective and attentional aspects of human behavior. Paralimbic insular regions have functional specialization for behaviors requiring integration between extrapersonal stimuli and the internal milieu. Based on these connections, one might expect that lesions of the insular cortex may result in disorders of neglect. This was recently observed in a right-handed individual who developedsevere multimodal neglect after injury to the right nsula, adjacent white matter, and the inner face of the overlying operculum."

Translated it means the follows:

Neglect is a form of mental condition that a patient is capable of experiencing and is manifested in the form of failure to report, respond, or orient to meaningful or new stimuli. In extreme cases neglect can take the form of the patient telling the physician that her/his right hand is someone else’s and they spent the whole of last night trying to get the 'other person' out of the bed that she/he was sleeping in... The human insular cortex by virtue of its proximity and connections to the emotional and sensory centers of the brain (limbic and sensorimotor cortices) is most prone to blood vessel ruptures taking place anywhere in this area. The insular cortex also mediates integration between external stimuli and internal neural connections. In light of the above connections, this paper describes a patient where severe ‘neglect’ was shown in multiple areas of the sensory apparatus due to blood vessel ruptures taking place in and around the insula.


Thanks for rescuing me from the spin that the papers sometimes put out by asking that simple question...

Paper here: http://stroke.ahajournals.org/cgi/reprint/30/5/946.pdf