Wednesday, February 07, 2007

The Insula: Addiction and Compulsions

Recent research on smoking addiction revealed something surprising!

Subjects in the study who had damage to a prune-size slab of brain tissue called the Insula were able to give up cigarettes instantly.

The Insula is a brain region that among other things in the Lymbic System, mediates hunger and craving.

Research in this brain region could offer new ways to think about treating drug addiction, alcoholism, anxiety and eating disorders that may not respond to psychotherapy.

The focus in the future will be how treatment can address addiction and compulstions with preserving the beneficial functions of the Insula.

Exciting news.

Naqvi, N. H. et. al. (2007). Damage to the insula disrupts addiction to cigarette smoking. Science , Vol. 315: 531 - 534


Godwhacker said...

Hi Deb,
Once I made my mind up to quit smoking, I did just that. It would have been great to have the compulsion to smoke removed instantly, but fighting that desire and winning made me a stronger (better) person.

How's the weather? :)

Dr. Deborah Serani said...

Hey GW,

Weather here is c-c-c-cold!

I think that adversity does give us inner strength, character and wisdom. My delight in this research is not for the "quick fix" or the magic bullet, so to speak, but to highlight that unique brain and body systems now explain why some disorders are more "sticky" in people than others. For those who have life threatening addictions, where therapy and medication have not been successful, maybe specific treatment in this brain region can being relief. And life!

Peace out, my friend,

Godwhacker said...

Did you see Boston Legal last night? They had a great story-line on that very topic. The writers there are really some of the best on TV.

Godwhacker said...

----- Still chilly in Florida, but I guess its all relative :)

CrackerLilo said...

I am a huge fan of free will, and don't like the idea of actually damaging a part of the brain in order to help people give up a habit. I've long noticed that many "bad" things are "good" things taken to an extreme. (Good: "She always tells such great stories." Bad: "She never shuts up!") I think the urge to keep smoking would be in that category. Effort does work for most people, even if it has to be repeated effort, and I don't see what's so wrong with that that there must be talk of damaging a part of the brain.

CrackerLilo said...

Aaaand...I repeated myself. Sorry. *blush*

Ian Lidster said...

I saw an item on this in a weekend paper. Having been in the field, I find it fascinating. If the theory has validity it could also go a long way to explaining why some people can drink, smoke, even shoot heroin and not become addicts, but others do.
One thing that any recovering alcholic or drug addict will tell you and that is that it's easier to quit alcohol or hard drugs than it is to quit tobacco. My little chilling but true factoid for the mmorning, and one that leaves 'big tobacco' a lot to answer for, Deb.

OHN said...

There is so much untapped information about how the brain works and reacts to the world around you. My humble opinion is that there are a multitude of answers buried there..we just have to find them.

MeMe said...

Hello Deb,
This is interesting. I have that bad habit of smoking.. cigarettes. So therefore... I have a healthy Insula, yet... what am I doing to the rest of my body??? One thing that is sooo key, my opinion only, is that I have to really want to give up smoking. Why OOOH why I don't want to, at the moment anyway??? Maybe I have not seen the results of such a habit. I keep puffing... riding in a vehicle that is going 150 MPH heading straight into a brick wall. Geesh.... but... at least my Insula is intact. OK.... that is not really funny. I need the "want to" first and foremost, I think.

Dr. Deborah Serani said...

Dear GW,
I DVR-d Boston Legal. It is one of Hubby and I's favorites. He's a lwayer and finds the summations and the writing therein beautiful. Can't wait to watch it later tonite!

Dear Cracker,
I know what you mean...but think of this example. Someone who has chronic epilepsy who hasn't gotten success with medication can have surgery to help the seizures to stop. I liken the Insula potential to that. But, there is ALWAYS room for evil doing with advances like this.

Dear Ian,
I agree. So much in our innate wiring can explain behavior, traits etc. I think we are just in the beginning of truly understanding.

Dear Ohn,
Well said!

Dear Meme,
The more we find out about our bodies and our behaviors the more we may be able to accept strengths and weaknesses in ourselves. You are right, wanting it is a big first step.


Dr Dork said...

Time for insular lobotomies..?

Just kidding

jumpinginpuddles said...

oh we need one of those now we are currently on zyban to quit smoking and will successfully do it this time we hope, but wow the cravings are killers and thats by simply trying to go longer and longer between smokes.
Official quit day saturday and believe me we arent looking forward to it :P

prioritybooks said...

I smoked in college for two years and when I saw my aunt dying from lung cancer, not being able to breath but asking for a cigarette, I immediately quit cold turkey. Why can't I do the same with food? This is exciting news...

CrackerLilo said...

I guess I find it insulting to the human capacity for free will.

Then again, I'm on Lexapro, so...huh. And I do see potential for good. I just see more for bad in this particular thing. I'm not sure why.

alan said...

Just think if we dropped some of the money into research that we're giving to Halliburton!


Nancy said...

I quit smoking 20 years ago. I told myself, I was not quiting, I was giving them up until I was fifty. At the time I thought fifty was OLD. Now I just turned 50, I had a co worker come up to me and ask if i was still going to "go puff" with her now that I am fifty. It was a weird way to say Happy Birthday, but it really scared me that at 20 I thought it would be OK to start up again.
Anyways it worked and I have no intention of starting again even though I love the smell of a newly lit cigarette, but hate the smell of a cigarettes in general.

Dr. Deborah Serani said...

Dear Dr. Dork,
Complete removal of the Insula, as you know, would be a terrible thing. So, no lobotomies! That would be just a terrible outcome from this research.

Dear JIP,
It always amazes me how some people can stop an addictive behavior in a snap while others are tortured by it. It is a hopeful piece of research. I hope you can make more gains as you try to stop smoking.

Dear Priority,
I know!

Dear Cracker,
I'm highlighting the issue that brain and behavior are intimately tied together. I hope that technology helps to take away the stigma of "illness" or "disorder". Taking away free will is a great concern, especially with research. But my hope is that the discoveries will be used to help those who suffer profoundly.

Dear Alan,
Oy vey! What's going on with tax dollars and the Iraq war makes me head spin.

Dear Nancy,
What a poignant story! Thanks for sharing that....and bravo for being able to hold off on smoking for all those years!


dawn said...

this IS really good news. It'll be interesting to see what the research will bring to enrich the lives of some people. excellent. thanks for the info :)

Fallen Angels said...

How did damage to the insula occur? Here's the direction my research would go. Is it really damage? Or is it selective adaptation? People with addictions have an alarming tendency to die. Those without addictions or who have kicked addictions tend to live longer. Therefore, a gene varient that causes a difference in the insula might increase chances of survival.


PS...My post about Ed's is up. :)

jane said...

This is interesting. Is the insula responsible for whether or not someone has an addictive personality?

Dr. Deborah Serani said...

Hey Dawn,
Research can be cool.

Dear Fallen,
In the study, subjects had damage from strokes.

Dear Jane,
I never believe that one thing causes something. I believe in multi-determinant causes. The Insula may certainly be part of the multi-determining system though.


MYSTI said...

Oh how wonderful will that be! I have several members of my family addicted to smoking. Some have tried quitting, only to find that they could not. I shall have to tell them about this study!

astrorat said...

How cool! we just spoke about this in class! :D sadly, my uni does not have the financial bone to invest in research in this area. have a good weekend Deb :D

J.D. said...

Another fascinating post. I really LOVE that graphic! Someone once said to me, and maybe this is obvious, that behind research like this there lies a person affected by addiction in a big way. I think this research important, and I also worry that as we tweak and pull in different ways, we lose the "whole" imperfect picture of what makes us tick. You address these connections, thankfully!

I can't imagine that a pill or an operation for my alcoholism would have made me the wonder of who I am today.
Cheers, my dear.

Battle Weary said...

I geuss the stroke aspect negates my idea! Oh well. Maybe I'll come up with another idea sometime soon;)


The Angry Medic said...

Ooh, we learnt about this in Neuro classes today!

That's it, I've found a new way to skip Neuro classes. I'm just gonna read your blog from now on, and at the expulsion hearing, I'll tell the Education Board I was conducting "alternative revision" :)

Am with Dr Dork on the insular lobotomies. They'd be way more interesting than nicotine patches.

Candace said...

With this new info, they'll figure out a treatment that won't involve destroying or removing the insula (eventually.) This is fantastic news. Quitting smoking (other any other addiction, I'm sure) is a bitch, no doubt about it.

Flea said...

Dork was kidding but I'm not. Isn't radiofrequency ablation where this research is heading? If so, it's a compelling idea, but I hope it's never tried.



HP said...

Aha! Now I can say 'my insula made me do it!'

Very interesting, Deb.

east village idiot said...

that is really cool.

puhpaul said...

Wow! That's amazing. I sure hope they can find a way to do this safely.


Belizegial said...

Hello Dr. Deb,

I tried smoking in my 20s when hanging out with a friend who was a smoker. This could have become an addictive habit for me given full reign.

Mercifully, I did not have the finance to allow this habit to grow. As far as I know, my friend still smokes. However, time and family pressures don't allow us to get together as often as before.


dragonflyfilly said...

Well, this IS very interesting, and not surprising, when one looks at the research going back, how many years? - 30 or so odd years, and the rates of relapse.

It surprises me how day to day and year to year i am learning more about the nature of addictions.

cheers for now, and pop over to my Blog for your Valentine's Day Greeting.

Anonymous said...

This is amazing research. Thanks for sharing it.

Dr. Deborah Serani said...

Dear Mysti,
This is a good think as long as interventions are used for good and not evil!

Dear Astro,
How timely!

Dear J.D.
I so agree. All that I am today is a result of the cumulative experience of the good the bad and the difficult. But for those who are in a life threatening situation, this could be a wonderful intervention.

Dear Battle,
Sadly, yes, the results were noted becasue certain subjects had damage from strokes. The key is to discover what the Insula does without permanently damaging it.

Dear Angry,
What a coincidence! I'd stick to your Neuro class as I'm but an armchair researcher ;)

Dear Candace,
That's the goal! BTW, I've been having troublke leaving comments on your blog. Dumb stupid Blogger.

Dear Flea,
Well....let's hope not. I was thinking Big Pharma would gobble this up and find a way to isolate Insula functions without ablating it altogether. We need the Insula!

Dear HP,
Yup, the Insula made me do it!

Dear EVI,
With great discoveries come great responisbility. I borrowed that phrase and tweaked it a bit from "Spiderman". But you know what I mean. It's cool as long as technology does good things with it.

Dear Pupaul,
Safely and ethically!

Dear Belize,
It is *so* hard for some to kick certain behaviors.

Dear Dragon,
Relapse occurs so often and the function of the Insula may help explain why.

Dear Traci,
I like to bring relevant data to the ol' bloggerino.


Candace said...

Deb, sorry to hear about the comments problem you're having with mah blog! Have you switched to the "New Blogger" yet? Oh wait, I think I read that you couldn't because you had so many posts, but they were supposedly working on that. Yeah, dumb stupid Blogger. But, it's free, so ... :)

STAG said...

The hardest thing I ever did was to stop smoking. Actually I never DID stop smoking, about 25 years ago, I decided that "I would not smoke today". Sometimes, it was "I will not smoke this hour". I still get cravings, even now that I am fifty. I never could have done it if another member of my family smoked!
Tobacco is a green eyed demon. It still hurts after all these years.
The compulsion HAS to have a physical cause. That is to say, there HAS to be something wrong in the brain to want something so bad. I am encouraged to discover that there is a possible cure. I am sure that the cure to "food addiction" is much the same. If people can get stomach stapling done, I don't think a little focused blast of x-rays to the right part of the brain is much different.
I suspect that alcohol and drug addiction may be different than food and cigarette addictions.

Dr. Deborah Serani said...

Dear Candace,
I have switched over to the new Bogger. I seem to have trouble connecting to your actual site. It takes forever. I'll check the link to be sure it isn't broken on my template.

Dear Stag,
I think your approach to "today", "this hour" etc is such a wise way to work addiction. It is very promising that technology and research can now show us where these areas are!


Cheesemeister said...

That would be a great thing. I do not seem to be able to win the battle against my ED.