If you’ve snorted too much coke over the years, chances are your dopamine receptors are all screwed up (and maybe your septum is shot, too). This can lead to an inability to have healthy emotional reactions to the good, the bad and the repulsive in life—you become completely flat. The good news is there may be a cure for this kind of brain damage, although you’d have to be willing to have your skull sawed open.
Cocaine affects the pleasure center of the brain, scientifically known as the nucleus accumbens, which plays a starring role in addiction. Within the pleasure center are a bunch of circuits that run on dopamine, and because coke spikes dopamine levels, these circuits go apeshit when you snort (or freebase). As a result, cognition, planning, emotion and context disappear in a chronic user.
Researchers at the University of Geneva have been obsessing over this circuitry in the nucleus accumbens for years. Neuroscientist Christian Luscher believed Deep Brain Stimulation (DBS)—also known as a brain pacemaker—might help addicts regain their marbles. No, it’s not the same as electroconvulsive therapy (ECT), although docs sometimes use it for depression.
Traditionally, DBS is used to treat Parkinson’s disease and epilepsy. But this anti-epileptic treatment is far more invasive than popping a pill. First, the docs have to drill through your skull, then they implant electrodes in your brain that send electronic pulses to alter your neuroactivity, and then they stretch a wire beneath your skin from the electrodes to an implanted pulse generator (IPG), which controls the electrical pulses. The IPG gets shoved down in the tissue near your collar bone, and sometimes the abdomen.
No, it’s not sci-fi, but it’s pretty close.
Luscher, who held the reins of a recent study to test out this electronic therapy, found DBS won’t help with cocaine addiction on its own. For years he’s been trying to reconfigure coked-up brains of mice using the technique, convinced it could help rewire all those circuits.
At first glance, there was no benefit from the therapy. But after scrutinizing his rodent specimens under a microscope, he realized the electrical pulses fixed the broken synaptic signaling from cocaine use, but unfortunately they also boosted dopamine levels, which screwed everything up. Instead of throwing in the towel, Luscher gave the mice a dopamine-inhibiting drug in tandem with the DBS, and voilà! The effect of the cocaine vanished completely from the little mice brains.
“When we then added a pharmacological substance that would block the effect of the dopamine, then we got the result,” he said. “After one day it’s totally gone, and after one week it’s partially coming back but it’s still very much suppressed.”
The mice weren’t monitored for a long period of time after the study (who knows what they did with them?), so it’s hard to say how effective this treatment will be long-term. Luscher is convinced that the success with the mice will lead to funding and approval for clinical trials with humans in the near future.
“We have FDA approval to implant electrodes,” Luscher said. “The antagonist we used is also FDA approved. So I think all the ingredients could be there and one could try that.”
Worth the Effort?
While the clinical trials in humans don’t even have a start date, it’s pretty nifty that there’s a possibility for science to reverse the damage of chronic cocaine use. Of course, having a bunch of wires and electrodes tangled up in your brain is a bit unnerving—and probably costly—so who knows how effective this will be on a grand scale for treating cocaine-induced brain damage.
I’d give the procedure another 10 years to work out the kinks before going under the knife.
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