Anterior Cingulate Cortex Implants for Alcohol Addiction: A Feasibility Study
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ORIGINAL ARTICLE
Anterior Cingulate Cortex Implants for Alcohol Addiction: A Feasibility Study Sook Ling Leong 1,2 & Paul Glue 3 & Patrick Manning 4 & Sven Vanneste 1,5 & Louisa Joyce Lim 2 & Anusha Mohan 1 & Dirk De Ridder 2
# The American Society for Experimental NeuroTherapeutics, Inc. 2020
Abstract Abnormal neural activity, particularly in the rostrodorsal anterior cingulate cortex (rdACC), appears to be responsible for intense alcohol craving. Neuromodulation of the rdACC using cortical implants may be an option for individuals with treatment-resistant alcohol dependence. This study assessed the effectiveness and feasibility of suppressing alcohol craving using cortical implants of the rdACC using a controlled one-group pre- and post-test study design. Eight intractable alcohol-dependent participants (four males and four females) were implanted with two Lamitrode 44 electrodes over the rdACC bilaterally connected to an internal pulse generator (IPG). The primary endpoint, self-reported alcohol craving reduced by 60.7% (p = 0.004) post- compared to prestimulation. Adverse events occurred in four out of the eight participants. Electrophysiology findings showed that among responders, there was a post-stimulation decrease (p = 0.026) in current density at the rdACC for beta 1 band (13–18 Hz). Results suggest that rdACC stimulation using implanted electrodes may potentially be a feasible method for supressing alcohol craving in individuals with severe alcohol use disorder. However, to further establish safety and efficacy, larger controlled clinical trials are needed. Keywords Alcohol dependence . Alcohol craving . Cortical stimulation . Anterior cingulate cortex
Introduction Electronic supplementary material The online version of this article (https://doi.org/10.1007/s13311-020-00851-4) contains supplementary material, which is available to authorized users. * Sook Ling Leong [email protected] * Dirk De Ridder [email protected] 1
Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
2
Department of Surgical Sciences, University of Otago, Dunedin, New Zealand
3
Department of Psychological Medicine, University of Otago, Dunedin, New Zealand
4
Department of Medicine, University of Otago, Dunedin, New Zealand
5
Lab for Clinical and Integrative Neuroscience, School of Behavioral and Brain Sciences, University of Texas at Dallas, Richardson, TX, USA
Alcohol dependence is a worldwide debilitating disorder [1]. Apart from the health and social detriments for the affected individual, it impacts society. Its estimated societal cost is 223.5 billion dollars a year in the USA, with 125 billion dollars related to alcohol-involved vehicle accidents [1]. Compared to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) [2], the most recent version, DSM-V [3], has removed the distinction between alcohol abuse (non-dependent hazardous use of alcohol) and alcohol dependence, and both conditions are now included in the single category of alcohol use disorder (AUD).
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