Deep Brain Stimulation: A Double-Edged Sword for Cocaine Addiction
- Olivier George
- Jan 27
- 2 min read
Cocaine addiction remains a critical public health crisis with no FDA-approved medication currently available. In our latest research, a collaboration between our team and the lab of Eric Kandel at Columbia University, we explored the potential of Deep Brain Stimulation (DBS) as a high-tech solution. While DBS has successfully treated movement disorders for decades, its role in addiction is more complex than we initially thought.
The Question: Can We "Zap" Away Cocaine Use?
Previous studies showed that stimulating the nucleus accumbens shell (a key part of the brain's reward center) could reduce drug-seeking in animals that were already abstinent. However, we wanted to know what happens if DBS is used while an individual is still actively using drugs. Would it help them cut back, or would it change their experience of the drug entirely?
The Study: Active Use vs. Withdrawal
We worked with rats that had developed a stable, escalated pattern of cocaine use. We implanted electrodes into the nucleus accumbens shell and applied high-frequency stimulation while they were self-administering cocaine and also while they were experiencing withdrawal. We specifically looked at three things:
How much cocaine they chose to take.
Their "irritability-like" behavior during withdrawal.
The level of AMPA receptors (GluR1) in the amygdala, which helps us understand how the brain's "software" is being rewritten.
Key Findings: A Surprising Twist
Contrary to our expectations, we found that DBS has two very different effects depending on the situation:
Active Use: When cocaine was available, DBS actually produced a slight increase in cocaine intake and boosted the drug's physical effects, such as locomotor activity.
Withdrawal Relief: On the flip side, DBS significantly decreased irritability-like behavior during withdrawal. It essentially helped "smooth out" the negative emotional state that makes quitting so difficult.
Molecular Rewiring: We discovered that DBS triggered a robust increase in GluR1 receptors specifically in the central nucleus of the amygdala, a region heavily involved in emotions and stress.
Why It Matters
These results suggest that DBS of the nucleus accumbens shell is not a "silver bullet" for stopping active drug use; in fact, it could make things worse if an individual continues to use. However, it may be a powerful tool for helping people stay abstinent by easing the painful emotional symptoms of withdrawal. This highlights the need for a targeted approach: using technology not just to block pleasure, but to help the brain heal from the stress of addiction.
Full Reference: Kallupi M, Kononoff J, Melas PA, Qvist JS, de Guglielmo G, Kandel ER, George O. Deep brain stimulation of the nucleus accumbens shell attenuates cocaine withdrawal but increases cocaine self-administration, cocaine-induced locomotor activity, and GluR1/GluA1 in the central nucleus of the amygdala in male cocaine-dependent rats. Brain Stimulation. 2022;15(1):13-22.
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