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Doctors At West Virginia University Trying To Change How Addiction Is Treated By Using Deep Brain Stimulation

MORGANTOWN, W. Va. (KDKA) -- Deep brain stimulation has helped thousands of people battle Parkinson's disease for decades.

In recent years, doctors have started using it for other things, like epilepsy and obsessive-compulsive disorder.

Now they're hoping to use it to treat one of America's biggest current crises: addiction.

"It doesn't start out as a brain disease, but becomes a brain disease over time," said Dr. Ali Rezai, a neurosurgeon at WVU's Rockefeller Neuroscience Institute.

Addiction is more than just drinking too much or getting high all the time.

It's a complex illness involving brain circuits, genetics, the environment and a person's life experiences.

People with addiction feel compelled to use substances and engage in risky behaviors that become compulsive, even after harmful consequences.

For people with addiction who've struggled for years, and have tried ⁠— but failed ⁠— to get clean using medicines and counseling, deep brain stimulation may one day be the answer.

A study is currently underway at West Virginia University, funded by the National Institute of Drug Abuse.

surgery
(Photo Credit: WVU Medicine)

"We're the only center in the country doing it," said Dr. Rezai.

Multiple governmental and medical regulatory agencies are overseeing the trial in which four patients will get a stimulator implanted in their brains.

The doctors are targeting the nucleus accumbens, which plays a key role in how the brain processes reward.

Addiction alters that area of the brain.

"This area is metabolically abnormal, physiologically abnormal, electrically abnormal. So this area is changed," Dr. Rezai said.

During surgery to implant the stimulator, doctors make two dime-sized holes in the skull and insert the electrodes to the target.

They then thread the wries down the neck and under the skin to the battery and microchip pack in the chest, just under the collarbone.

The next step is adjusting the level of stimulation, so the desire to get drunk or high fades away.

"We ask how are you feeling? What is your mood? What is your cravings? And we are looking at craving scales," said Dr. Rezai. "We're doing pet scans, and other imaging, so we want to see how this area of the brain changes over time. We're also monitoring urine toxicology. So we know objectively if there are any drugs in the system."

The WVU team has performed only one case so far. That patient got hooked on Percocet after having surgery as a teen, which led to an addiction to other opiates and eventually a near-fatal overdose.

"Our hope is to first demonstrate safety, and also demonstrate that we can improve behavioral control," said Dr. Rezai.

One potential concern is what if it doesn't work? The person now has wires and electrodes permanently implanted in the brain.

If they're an IV drug user, that could set them up for a deadly infection.

But researchers hope these first few cases are successful, leading to a larger, multi-center trial and eventually to deep brain stimulation as an option to help people break their addiction.

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