Insula: brain region responsible for craves?

John (Gold)
John (Gold)

January 29th, 2007, 3:57 am #1

New Research Findings
on The Insular Cortex
Is the insula the brain region responsible for awareness of urges and craves?
What if a smoker awoke after sustaining a brain injury or stoke that damaged a region of the brain known as the "insula" and no longer felt any urge to smoke - none? What if no urge or crave arrived when handed the newspaper, when drinking their morning coffee, stepping outside, traveling to work, when break-time arrived, while talking on the phone, when seeing others smoke, after meals or when bored, angry or stressed - none? What if going through the nicotine withdrawal and detox process did not produce a single crave, urge and desire? Impossible?

As the below study and stories suggest, the brain regions responsible for different aspects of chemical dependency may have been just become a bit clearer. Aside from dopamine "aaah" reward sensations, high definition pre-frontal lobe salient memories that record smoking associations, and the mind sensing and collecting smoking cue data, what region of brain allows human consciousness to sense an urge or crave to bring a new supply of nicotine into the brain?

Although each new understanding seems to bring more questions than answers the pace of discoveries in one of the final frontiers - the human mind - is amazing. The essence of human existence isn't that the body or mind can perform a particular function but conscious awareness that it is doing so. During nicotine dependency recovery the most important aspect of that awareness is what's happening with each challenge overcome, as we demonstrate to our consciousness that another aspect of life is entirely do-able without nicotine.

What we've each discovered is that we don't have to damage, destroy or even understand any brain region associated with chemical dependency in order to reclaim normal function. We've each come to realize that is that we have a 100% guarantee of success so long as our bloodstreams remain nicotine-free. Still just one guiding principle determining the outcome for all ... no nicotine today, Never Take Another Puff, Dip or Chew!

Breathe deep, hug hard, live long!


What is the Insula
The following paragraphs are from Wikipedia's "

insular cortex
Last edited by John (Gold) on February 17th, 2009, 1:45 pm, edited 1 time in total.

John (Gold)
John (Gold)

January 29th, 2007, 4:10 am #2

In Clue to Addiction,
Brain Injury Halts Smoking
Published: January 26, 2007

Scientists studying stroke patients are reporting today that an injury to a specific part of the brain, near the ear, can instantly and permanently break a smoking habit. People with the injury who stopped smoking found that their bodies, as one man put it, "forgot the urge to smoke."

The finding, which appears in the journal Science, is based on a small study. But experts say it is likely to alter the course of addiction research, pointing researchers toward new ideas for treatment.

While no one is suggesting brain injury as a solution for addiction, the finding suggests that therapies might focus on the insula, a prune-size region under the frontal lobes that is thought to register gut feelings and is apparently a critical part of the network that sustains addictive behavior.

Previous research on addicts focused on regions of the cortex involved in thinking and decision making. But while those regions are involved in maintaining habits, the new study suggests that they are not as central as the insula is.

The study did not examine dependence on alcohol, cocaine or other substances. Yet smoking is at least as hard to quit as any other habit, and it probably involves the same brain circuits, experts said. Most smokers who manage to quit do so only after repeated attempts, and the craving for cigarettes usually lasts for years, if not a lifetime.

"This is the first time we've shown anything like this, that damage to a specific brain area could remove the problem of addiction entirely," said Dr. Nora Volkow, director of the National Institute on Drug Abuse, which financed the study, along with the National Institute of Neurological Disorders and Stroke. "It's absolutely mind-boggling."

Others cautioned that scientists still knew little about the widely distributed neural networks involved in sustaining habits.

"One has to be careful not to extrapolate too much based on brain injuries to what's going on in all addictive behavior, in healthy brains," said Dr. Martin Paulus, a psychiatric researcher at the University of California, San Diego, and the San Diego V.A. Medical Center. Still, Dr. Paulus said, the study "opens up a whole new way to think about addiction."

The researchers, from the University of Iowa and the University of Southern California, examined 32 former smokers, all of whom had suffered a brain injury. The men and women were lucid enough to answer a battery of questions about their habits, and to rate how hard it was to quit and the strength of their subsequent urges to smoke.

They all had smoked at least five cigarettes a day for two years or more, and 16 of them said they had quit with ease, losing their cravings entirely.

The researchers performed M.R.I. scans on all of the patients' brains to specify the location and extent of each injury.

They found that the 16 who had quit easily were far more likely to have an injury to their insula than to any other area. The researchers found no association between a diminished urge to smoke and injuries to other regions of the brain, including tissue surrounding the insula.

"There's a whole neural circuit critical to maintaining addiction, but if you knock out this one area, it appears to wipe out the behavior," said Dr. Antoine Bechara, a senior author of the new paper, who is a neuroscientist at the Brain and Creativity Institute at U.S.C. His co-authors were Dr. Hanna Damasio, also of U.S.C., and Nasir Naqvi and David Rudrauf of the University of Iowa.

The patients' desire to eat, by contrast, was intact. This suggests, the authors wrote, that the insula is critical for behaviors whose bodily effects become pleasurable because they are learned, like cigarette smoking.

The insula, for years a wallflower of brain anatomy, has emerged as a region of interest based in part on recent work by Dr. Antonio Damasio, a neurologist and director of the Brain and Creativity Institute. The insula has widely distributed connections, both in the thinking cortex above, and down below in subcortical areas, like the brain stem, that maintain heart rate, blood pressure and body temperature, the body's primal survival systems.

Based on his studies and others', Dr. Damasio argues that the insula, in effect, maps these signals from the body's physical plant, and integrates them so the conscious brain can interpret them as a coherent emotion.

The system works from the bottom up. First, the body senses cues in the outside world, and responds. The heart rate might elevate at the sight of a stranger's angry face, for example; other muscles might relax in response to a pleasant whiff of smoke.

All of this happens instantaneously and unconsciously, Dr. Damasio said - until the insula integrates the information and makes it readable to the conscious regions of the brain.

"In a sense it's not surprising that the insula is an important part of this circuit maintaining addiction, because we realized some years ago that it was going to be a critical platform for emotions," Dr. Damasio said in a telephone interview. "It is on this platform that we first anticipate pain and pleasure, not just smoking but eating chocolate, drinking a glass of wine, all of it."

This explains why cravings are so physical, and so hard to shake, he said: they have taken hold in the visceral reaches of the body well before they are even conscious.
Other researchers have found that the insula is activated in unpleasant circumstances, like a bad smell or the anticipation of a painful shock, or even in shoppers when they see a price that seems too high. Damage to the insula is associated with slight impairment of some social function.

While antismoking treatments based on the new findings are still a long way off, the authors suggest that therapies that replicate some of the physical sensations of the habit, like inhalers, could be useful.

And at least two previous studies suggest that people can reduce the sensation of pain by learning to modulate the activity in an area of their brain.

In experiments, healthy volunteers watched real-time M.R.I. images of a cortical region linked strongly to pain sensation and learned to moderate that neural activity, reducing the pain they felt from a heated instrument pressed to their palms. The same kind of technique could be tried with addicts watching images of their insulas.

"The question is, Can you learn to deactivate the insula?" Dr. Volkow said. "Now, everybody's going to be looking at the insula."
Copyright 2007 New York Times

forza d animo
forza d animo

January 29th, 2007, 7:29 am #3

While I find it interesting because I am always facinated by the workings of the human body and especially the mind, I am grateful that knowing how the insula cortex functions is not a requirement to overcome nicotine addiction. As John wrote above "Still just one guiding principle determining the outcome for all ... no nicotine today, Never Take Another Puff,"

Though sometimes it may seem like we need it, a smack in the head is not a requirement either. While in this case the discovery was seredipitous, all of the effort that is made to invent some "painless" method of quitting only serves to disappoint those who will try anything except for the one thing that is guaranteed to work, one day at a time without nicotine.

Thanks John, for another infomative article. Knowledge is power.

Gold x2

come clean
come clean

January 29th, 2007, 9:33 am #4

I heard this news on National Public Radio this past week, and was wondering when it would be added. I agree with forza-d-animo, the brain is fascinating and these discoveries intrigue me.

"This is the first time we've shown anything like this, that damage to a specific brain area could remove the problem of addiction entirely,"

Great, now someone could interpret this to mean they can find hope in brain damage. What else does it remove? In the 1930's - 60's frontal labotomies seemed like a great answer for extreme pathology, and left many of its clients in a perpetual state of present thought, unable to think about or plan for the future. Though it is fascinating to just learn about the brain, I'd rather stick to NTAP then wait the 20 plus years science will need to explore, experiment, realize they didn't know something, re-explore, experiement and maybe figure out something.

Alex 50 days.


February 4th, 2007, 5:56 am #5

I found this article interesting because that's what happened to my stepfather--he had a stroke in 1988 and quit smoking afterwards because he basically just "forgot" about his addiction after 30+ years. He never even missed smoking or had any cravings at all.

I always thought that my stepfather's "method" seemed like an easy way to quit--to just forget you smoked. But having a stroke obviously isn't the easiest way to do it! And the doctors did blame the stroke on smoking in the first place...

This does make you wonder though if they'll look for a way to exploit that region of the brain for quitting...