Towards a targeted neuromodulation intervention for substance abuse disorders

Lead Research Organisation: University of Plymouth
Department Name: Sch of Psychology

Abstract

The impact of alcohol and drug addictions extends globally, affecting a staggering 148 million individuals. In the year 2019 alone, these addictions directly caused 296,000 deaths, while indirectly contributing to an additional 2.44 million fatalities. Over the span of a decade (2009-2019), the prevalence of substance use disorders (SUD) surged by 45%, encompassing 39.5 million individuals worldwide. In the United Kingdom, the economic ramifications of Alcohol Use Disorder (AUD) amounted to an annual cost exceeding £23 billion due to healthcare expenses, diminished work productivity, and criminal implications.

Despite existing treatments for SUD and AUD offering some benefits, their success rates remain suboptimal, particularly considering the intricate interplay of treatment outcomes influenced by concurrent conditions. This inadequacy necessitates a comprehensive reassessment of current strategies. A novel approach is imperative - one that dissects and characterizes the fundamental neural and cognitive factors affected and altered by addiction, integrating this understanding into treatment methodologies and recovery monitoring.

Recent strides in deep brain stimulation (DBS) technology have successfully identified neural markers associated with reward processing and craving, notably within the Nucleus Accumbens (NAcc). This technology holds promise in regulating cravings linked to SUD, akin to its success in addressing uncontrollable eating behaviors. These breakthroughs pave the way for future research aimed at crafting targeted treatments tailored specifically for the complexities of addiction.

Since the inception of my Fellowship, my team and I have led research in non-invasive focused ultrasound stimulation, holding potential for transformative advancements in SUD and AUD treatments. Our laboratory findings confirm that Transcranial Ultrasound Stimulation (TUS) surpasses established brain stimulation methods by enabling transient manipulation of neural activity deep within the brain, with unprecedented precision. TUS offers a unique avenue for precise deep brain neuromodulation without surgical intervention or device implantation. Its potential as a treatment for psychiatric conditions is a burgeoning area of interest, and our research has demonstrated its efficacy in inducing cognitive and behavioral changes, notably in dopaminergic-related circuits, particularly the NAcc relevant to SUD. This has been replicated across three human studies.

In the subsequent phase of my UKRI fellowship, I aim to capitalize on the groundwork laid in the initial stage by demonstrating the safety, tolerability, and feasibility of TUS targeting the NAcc in healthy individuals. Our objectives include assessing its short-term impact (on the day of intervention) and longitudinal effects (over 90 days) on substance craving among individuals with AUD.

Publications

10 25 50