Immediate and Sustained Decrease in Smoking Urges After Acute Insular Cortex Damage

Abdolahi, Amir; Williams, Geoffrey; Benesch, Curtis; Spitzer, Eric M.; Scott, Bryan E.; Block, Robert C.; Wijngaarden, Edwin van

doi:10.1093/ntr/ntx046

Cited by 20 publications

(10 citation statements)

References 36 publications

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“…The insular cortex contains a high density of hypocretin-1–containing neurons. Immediate and sustained reduction in craving and withdrawal symptoms has been observed in hospitalized smokers following stroke damage to the insular cortex compared to hospitalized smokers without brain lesions ( 46 ).…”

Section: Tobacco Product Use and Nicotine Addictionmentioning

confidence: 99%

Current advances in research in treatment and recovery: Nicotine addiction

2019

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The health harms of combusted tobacco use are undeniable. With market and regulatory pressures to reduce the harms of nicotine delivery by combustion, the tobacco product landscape has diversified to include smokeless, heated, and electronic nicotine vaping products. Products of tobacco combustion are the main cause of smokinginduced disease, and nicotine addiction sustains tobacco use. An understanding of the biology and clinical features of nicotine addiction and the conditioning of behavior that occurs via stimuli paired with frequent nicotine dosing, as with a smoked cigarette, is important for informing pharmacologic and behavioral treatment targets. We review current advances in research on nicotine addiction treatment and recovery, with a focus on conventional combustible cigarette use. Our review covers evidence-based methods to treat smoking in adults and policy approaches to prevent nicotine product initiation in youth. In closing, we discuss emerging areas of evidence and consider new directions for advancing the field.

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Section: Tobacco Product Use and Nicotine Addictionmentioning

confidence: 99%

Current advances in research in treatment and recovery: Nicotine addiction

2019

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“…Although, insular damage is associated with increased odds of smoking cessation, those that do relapse tend to remain abstinent for longer periods than those with non-insular damage (Abdolahi et al, 2015a). It has also been shown that smokers with insular damage experience less frequent and severe withdrawal symptoms of nicotine (Abdolahi et al, 2015b) and less smoking urges (Abdolahi et al, 2017). Also, damage to the insula was associated with complete abstinence from all nicotine products (Abdolahi et al, 2015a).…”

Section: Clinical Evidence For the Insulamentioning

confidence: 99%

The Insula: A Brain Stimulation Target for the Treatment of Addiction

et al. 2019

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Substance use disorders (SUDs) are a growing public health concern with only a limited number of approved treatments. However, even approved treatments are subject to limited efficacy with high long-term relapse rates. Current treatment approaches are typically a combination of pharmacotherapies and behavioral counselling. Growing evidence and technological advances suggest the potential of brain stimulation techniques for the treatment of SUDs. There are three main brain stimulation techniques that are outlined in this review: transcranial magnetic stimulation (TMS), transcranial direct current stimulation (tDCS), and deep brain stimulation (DBS). The insula, a region of the cerebral cortex, is known to be involved in critical aspects underlying SUDs, such as interoception, decision making, anxiety, pain perception, cognition, mood, threat recognition, and conscious urges. This review focuses on both the preclinical and clinical evidence demonstrating the role of the insula in addiction, thereby demonstrating its promise as a target for brain stimulation. Future research should evaluate the optimal parameters for brain stimulation of the insula, through the use of relevant biomarkers and clinical outcomes for SUDs.

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“…Imaging studies in humans, have heavily implicating the IC in self-referential processes shaping conscious awareness (Kurth, 2010 ; Critchley and Seth, 2012 ; Pais-Vieira et al, 2016 ). Further studies of the local activity and functional connectivity of the IC thus hold particular promise in relation to their link to autism (Odriozola et al, 2016 ), panic disorders (Banzett et al, 2000 ; Brannan et al, 2001 ), anorexia nervosa (Rolls, 1989 , 2005 ; Shelley and Trimble, 2004 ), pain insensitivity (Singh et al, 2006 ; Potvin and Marchand, 2008 ), schizophrenia (Allen et al, 2004 ; Stephane et al, 2010 ), as well as alcohol and nicotine addiction (Fuehrlein et al, 2014 ; Abdolahi et al, 2017 ; Addicott et al, 2017 ).…”

Section: Learning and Re-learning In The Insulamentioning

confidence: 99%

The Insula and Taste Learning

Yiannakas

Rosenblum

2017

Front. Mol. Neurosci.

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The sense of taste is a key component of the sensory machinery, enabling the evaluation of both the safety as well as forming associations regarding the nutritional value of ingestible substances. Indicative of the salience of the modality, taste conditioning can be achieved in rodents upon a single pairing of a tastant with a chemical stimulus inducing malaise. This robust associative learning paradigm has been heavily linked with activity within the insular cortex (IC), among other regions, such as the amygdala and medial prefrontal cortex. A number of studies have demonstrated taste memory formation to be dependent on protein synthesis at the IC and to correlate with the induction of signaling cascades involved in synaptic plasticity. Taste learning has been shown to require the differential involvement of dopaminergic GABAergic, glutamatergic, muscarinic neurotransmission across an extended taste learning circuit. The subsequent activation of downstream protein kinases (ERK, CaMKII), transcription factors (CREB, Elk-1) and immediate early genes (c-fos, Arc), has been implicated in the regulation of the different phases of taste learning. This review discusses the relevant neurotransmission, molecular signaling pathways and genetic markers involved in novel and aversive taste learning, with a particular focus on the IC. Imaging and other studies in humans have implicated the IC in the pathophysiology of a number of cognitive disorders. We conclude that the IC participates in circuit-wide computations that modulate the interception and encoding of sensory information, as well as the formation of subjective internal representations that control the expression of motivated behaviors.

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Immediate and Sustained Decrease in Smoking Urges After Acute Insular Cortex Damage

Cited by 20 publications

References 36 publications

Current advances in research in treatment and recovery: Nicotine addiction

Current advances in research in treatment and recovery: Nicotine addiction

The Insula: A Brain Stimulation Target for the Treatment of Addiction

The Insula and Taste Learning

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