Brain lesions disrupting addiction map to a common human brain circuit.

Autor: Joutsa J; Turku Brain and Mind Center, Clinical Neurosciences, University of Turku, Turku, Finland. jtjout@utu.fi.; Neurocenter and Turku PET Center, Turku University Hospital, Turku, Finland. jtjout@utu.fi.; Berenson-Allen Center for Noninvasive Brain Stimulation, Beth Israel Deaconess Medical Center, Boston, MA, USA. jtjout@utu.fi., Moussawi K; National Institute on Drug Abuse-Intramural Research Program, Baltimore, MD, USA.; Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA., Siddiqi SH; Berenson-Allen Center for Noninvasive Brain Stimulation, Beth Israel Deaconess Medical Center, Boston, MA, USA.; Center for Brain Circuit Therapeutics, Departments of Neurology Psychiatry and Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA., Abdolahi A; Clinical Affairs, Philips Healthcare, Cambridge, MA, USA., Drew W; Berenson-Allen Center for Noninvasive Brain Stimulation, Beth Israel Deaconess Medical Center, Boston, MA, USA.; Center for Brain Circuit Therapeutics, Departments of Neurology Psychiatry and Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA., Cohen AL; Berenson-Allen Center for Noninvasive Brain Stimulation, Beth Israel Deaconess Medical Center, Boston, MA, USA.; Center for Brain Circuit Therapeutics, Departments of Neurology Psychiatry and Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.; Department of Neurology, Boston Children's Hospital, Boston, MA, USA.; Computational Radiology Laboratory, Department of Radiology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA., Ross TJ; National Institute on Drug Abuse-Intramural Research Program, Baltimore, MD, USA., Deshpande HU; National Institute on Drug Abuse-Intramural Research Program, Baltimore, MD, USA., Wang HZ; Department of Imaging Sciences, University of Rochester Medical Center, Rochester, NY, USA., Bruss J; Departments of Pediatrics, Neurology & Psychiatry, University of Iowa Hospitals and Clinics, Iowa City, IA, USA., Stein EA; National Institute on Drug Abuse-Intramural Research Program, Baltimore, MD, USA., Volkow ND; Intramural Research Program, National Institute of Alcohol Abuse and Alcoholism, Bethesda, MD, USA., Grafman JH; Shirley Ryan AbilityLab, Chicago, IL, USA.; Department of Physical Medicine and Rehabilitation, Neurology, Cognitive Neurology and Alzheimer's Center, Northwestern University, Chicago, IL, USA.; Department of Psychiatry, Feinberg School of Medicine and Department of Psychology, Weinberg College of Arts and Sciences, Northwestern University, Chicago, IL, USA., van Wijngaarden E; Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, USA., Boes AD; Departments of Pediatrics, Neurology & Psychiatry, University of Iowa Hospitals and Clinics, Iowa City, IA, USA., Fox MD; Berenson-Allen Center for Noninvasive Brain Stimulation, Beth Israel Deaconess Medical Center, Boston, MA, USA. foxmdphd@gmail.com.; Center for Brain Circuit Therapeutics, Departments of Neurology Psychiatry and Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. foxmdphd@gmail.com.
Jazyk: angličtina
Zdroj: Nature medicine [Nat Med] 2022 Jun; Vol. 28 (6), pp. 1249-1255. Date of Electronic Publication: 2022 Jun 13.
DOI: 10.1038/s41591-022-01834-y
Abstrakt: Drug addiction is a public health crisis for which new treatments are urgently needed. In rare cases, regional brain damage can lead to addiction remission. These cases may be used to identify therapeutic targets for neuromodulation. We analyzed two cohorts of patients addicted to smoking at the time of focal brain damage (cohort 1 n = 67; cohort 2 n = 62). Lesion locations were mapped to a brain atlas and the brain network functionally connected to each lesion location was computed using human connectome data (n = 1,000). Associations with addiction remission were identified. Generalizability was assessed using an independent cohort of patients with focal brain damage and alcohol addiction risk scores (n = 186). Specificity was assessed through comparison to 37 other neuropsychological variables. Lesions disrupting smoking addiction occurred in many different brain locations but were characterized by a specific pattern of brain connectivity. This pattern involved positive connectivity to the dorsal cingulate, lateral prefrontal cortex, and insula and negative connectivity to the medial prefrontal and temporal cortex. This circuit was reproducible across independent lesion cohorts, associated with reduced alcohol addiction risk, and specific to addiction metrics. Hubs that best matched the connectivity profile for addiction remission were the paracingulate gyrus, left frontal operculum, and medial fronto-polar cortex. We conclude that brain lesions disrupting addiction map to a specific human brain circuit and that hubs in this circuit provide testable targets for therapeutic neuromodulation.
(© 2022. The Author(s).)
Databáze: MEDLINE
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