Scientists ID Brain Area For Smoking Urge

(AP)  Damage to a coin-sized spot deep in the brain seems to wipe out the urge to smoke, a surprising discovery that may shed important new light on addiction.

The research was inspired by a stroke survivor who claimed he simply forgot his two-pack-a-day addiction — no cravings, no nicotine patches, not even a conscious desire to quit.

"The quitting is like a light switch that went off," said Dr. Antoine Bechara of the University of Southern California, who scanned the brains of 69 smokers and ex-smokers to pinpoint the region involved. "This is very striking."

The finding, reported in Friday's edition of the journal Science, points scientists toward new ways to develop anti-smoking aids by targeting this little-known brain region called the insula. And it sparked excitement among addiction specialists who expect the insula to play a key role in other addictions, too.

"It's a fantastic paper, it's a fantastic finding," said Dr. Nora Volkow, director of the National Institute on Drug Abuse and a longtime investigator of the brain's addiction pathways.

"What this study shows unequivocally is the insula is a key structure in the brain for perceiving the urges to take the drug," urges that are "the backbone of the addiction," Volkow added.

Why? The insula appears to be where the brain turns physical reactions into feelings, such as feeling anxious when your heart speeds up. When those reactions are caused by a particular substance, the insula may act like sort of a headquarters for cravings.

Some 44 million Americans smoke, and the government says more than 400,000 a year die of smoking-related illnesses. Declines in smoking have slowed in recent years, making it unlikely that the nation will reach a public health goal of reducing the rate to 12 percent by 2010.

Nicotine is one of the most addictive substances known, and it is common for smokers to suffer repeated relapses when they try to quit.

So imagine Bechara's surprise at hearing a patient he code-named "Nathan" note nonchalantly that "my body forgot the urge to smoke" right after his stroke.

At the time, Bechara was at the University of Iowa studying the effects of certain types of brain damage after strokes or other injury. While Nathan was hospitalized, stroke specialists sent his information to that brain registry. He was 38, had smoked since 14, said he enjoyed it and had had no intention to quit. But his last puff was the night before his stroke. His surprised wife said he never even asked for a smoke while in the hospital.

It is not unusual for a health scare to prompt an attempt at quitting. "That's the quitting that's not as interesting," Bechara said.

Instead, Nathan experienced what Bechara calls a "disruption of smoking addiction," and he wanted to know why.

Bechara and colleagues culled their brain-damage registry for 69 patients who had smoked regularly before their injuries. Nineteen, including Nathan, had damage to the insula. Thirteen of the insula-damaged patients had quit smoking, with 12 of them quitting within a day of the brain injury and neither smoking nor even feeling the urge since then.

Of the remaining 50 patients with damage in other brain regions, 19 quit smoking but only four met the broken-addiction criteria.

If Bechara's findings are validated, they suggest that developing drugs that target the insula might help smokers quit. There are nicotine receptors in the insula, meaning it should be possible to create a nicotine-specific drug, Bechara said — albeit years from now.

More immediately, NIDA's Volkow wants to try a different experiment: Scientists can temporarily alter function of certain brain regions with pulses of magnetic energy, called "transcranial magnetic stimulation." She wants to see if it is possible to focus such magnetic pulses on the insula, and thus verify its role.

Other neurologic functions are known to be involved with addiction, too, such as the brain's "reward" or pleasure pathways. The insula discovery does not contradict that work, but adds another layer to how addiction grips the brain, Bechara said.

[jposton11]

In 2003 I smoked up to 3 pack of cig. daily. I went in hospital for 12 days for leg surgery with vascular problems. I was taking alot of drugs for pain. When I went home my wife put my cig. on table beside me. I never picked up another one. I had no craving nor desire for a cig. My wife smokes and my friends but the smoke does not bother me nor the smell. No one could beleive it after 44 years of smoking. The Dr. you had on show put some lite on it. It must have been that part of brain called insula. I never knew how I did it. If you have any questions about meds. or anything please contact me. It was as if I never smoked before. Thanks Jerry Poston, Fayetteville NC 28311

[rangerdudley]

Overweight people contribute much to those dying with cardiovascular disease. Lets sue and criminalize all the food manufacturers while we are at it - especially any manufacturers that allow fat in there food. Only broccoli manufactures will be exempted. Until the suits go through, the government can just outlaw food for fat people. Just think of how perfect life will be when the government makes all our life decisions.

[elstonraider]

I smoked for about 8 or 9 years. I had a migrane headache one day, which involves the brain, and from that moment on I have not wanted a cigarette. Maybe there is something to be said about this. If they can figure out a safe way to do this and it helps people more power to them.

[gaye5]

The government says more than 400,000 a year die of smoking-related illnesses.
You have to be joking and the government does nothing to stop this.. Manufactures should be charged with murder...along with the government, simply because they allow it, something like being accessory to murder eh...
Well lets face it, the government and pharmaceutical companies try to stop natural products from being sold because the odd person is affected by it, but do nothing about smoking where 400,000 a year die..
They cut back the amounts allowed in natural products which renders them useless but do nothing about smoking... Come on America wake up, you have been sleeping to long in to many areas...who said you are a democracy... you are a democracy only in areas that suits the Government...
We have to have rules for safety sake to protect the people but 400,000 dying is not protecting the people. Smoking is addictive, so should come under a criminal law if produced..

[racookster]

In a related story, researchers at UCLA have discovered that amputation of the hands results in complete elimination of the incidence of hangnails.

[racookster]

In a related story, researchers at UCLA have discovered that amputation of the hands results in complete elimination of the incidence of hangnails.

[larry8104]

I smoked for 45 years. Tried to quit several times. I had a stroke 12 years ago and never had the urge to smoke again. I forgot a lot of things but recovered quite well, but never wanted to smoke again.

[olebd]

I quit a year ago and still have a craving occasionally.

I wonder what the technique will be to get to this coin sized part of the brain to deaden it? Reminds me of the medevel days when doctors used to drill holes in your head to let the demons out :)

Seems a bit extreme.

[jjp735i]

Tabacco is enhanced and sold because of big money. Those that make the product are allowed to continue to do so because they can buy Congress.

Buy hell, they bought and now own the Congress. Along with other powerful companies. And we let it happen.

[peaceforusa]

It has amazed me for years why such a drug is allowed to be available to everyone who wants it. It is not only addicting, but a health risk to all who use it, but it is still on the market. We all know it speaks large $$$ signs for the tobacco industry, government through taxation, the health industry and insurance companies. Why would they ban such a money making drug??? I have struggled with this addiction for 36 years, the last 5 making a total effort to quit without success, and on Monday I begin my newest regiment of treatment to quit. It is the new pill Chantix approved last year by the FDA. They have all sorts of drugs to help people addicted to crack/heroin/coke, but all they could produce for years is anti-smoking aids that put more of the drug you are already addicted to (nicotine) into your system. Like I said, goverment and all those involved will actually lose too much money if everyone was able to quit smoking so why would they put any effort into helping us save our lives? I will kick this thing..I only hope it isn't too late...