People suffering from severe alcohol and opioid addiction are to be offered a revolutionary new technique involving planting electrodes in the brain to modulate brain activity and cravings and improve self-control.
We've seen how effective deep brain stimulation can be for neurological disorders from Parkinson's to OCD to depression. We want to see if it can also transform the lives of people with intractable alcohol and opioid addiction
Valerie Voon
The technique - known as deep brain stimulation - is to be trialled at Addenbrooke's Hospital, Cambridge, and King's College Hospital, London. The team behind the Brain-PACER: Brain Pacemaker Addiction Control to End Relapse study is currently recruiting individuals with severe alcohol or opioid addiction who are interested in taking part.
Deep brain stimulation (DBS) is a neurosurgical procedure that delivers ongoing stimulation to the brain. DBS acts as a brain pacemaker to normalise abnormal brain activity. It is well-tolerated, effective and widely used for neurological disorders and obsessive compulsive disorder.
Although there have been several proof-of-concept studies that suggest DBS is effective in addictions, Brain-PACER - a collaboration between the University of Cambridge, Kings College London and the University of Oxford - is the first major, multicentre study to use DBS to treat craving and relapse in severe addiction.
Chief Investigator Professor Valerie Voon, from the Department of Psychiatry at the University of Cambridge, said: "While many people who experience alcohol or drug addiction can, with the right support, control their impulses, for some people, their addiction is so severe that no treatments are effective. Their addiction is hugely harmful to their health and wellbeing, to their relationships and their everyday lives.
"Initial evidence suggests that deep brain stimulation may be able to help these individuals manage their conditions. We've seen how effective it can be for other neurological disorders from Parkinson's to OCD to depression. We want to see if it can also transform the lives of people with intractable alcohol and opioid addiction."
The primary aim of the Brain-PACER study is to assess the effects of DBS to treat alcohol and opioid addiction in a randomised controlled trial study. Its mission is twofold: to develop effective treatments for addiction and to understand the brain mechanisms that drive addiction disorders.
DBS is a neurosurgical treatment that involves implanting a slender electrode in the brain and a pacemaker under general anaesthesia. These electrodes deliver electrical impulses to modulate neural activity, which can help alleviate symptoms of various neurological and psychiatric disorders.
Keyoumars Ashkan, Professor of Neurosurgery at King's College Hospital and the lead surgeon for the study, said: "Deep brain stimulation is a powerful surgical technique that can transform lives. It will be a major leap forward if we can show efficacy in this very difficult disease with huge burden to the patients and society."
During surgery, thin electrodes are carefully placed in precise locations of the brain. These locations are chosen based on the condition being treated. For addiction, the electrodes are placed in areas involved in reward, motivation, and decision-making.
Harry Bulstrode, Honorary Consultant Neurosurgeon at Cambridge University Hospitals NHS Foundation Trust and Clinical Lecturer at the University of Cambridge, said: "We see first-hand how deep brain stimulation surgery can be life-changing for patients with movement disorders such as Parkinson's disease and essential tremor. Thanks to this trial, I am now hopeful that we can help patients and their families - who have often struggled for years - by targeting the parts of the brain linked to addiction."
Dr David Okai, Visiting Senior Lecturer from the Institute of Psychiatry, Psychology & Neuroscience, King's College London, added: "DBS is safe, reversible and adjustable, so it offers a flexible option for managing chronic conditions. We hope it will offer a lifeline to help improve the quality of life for patients whose treatment until now has been unsuccessful."
Details on the trial, including criteria for participation and how to sign up, can be found on the Brain-PACER website.
The research is supported by the Medical Research Council, UK Research & Innovation.
