From patient to rat, from rat to patient: innovation for the treatment of addictions

Abstract

Deep Brain Stimulation (DBS) has gained a revival for psychiatric disorders after its application in the SubThalamic Nucleus (STN) for neurological disorders such as Parkinson's disease. The involvement of STN in non-motor processes has also been demonstrated and led to target it for the treatment of obsessive-compulsive disorders. In the context of another disease related to loss of impulse control, addiction, we suggest STN to be an appropriate target. We have tested the effects of STN “inactivation” by lesions or DBS in rats on motivation for food (sucrose), cocaine, heroin, alcohol and nicotine. Inactivation of the STN does not affect consummatory processes, but seems to act on incentive motivation (responses to cues associated with a given reward). STN inactivation can induce opposite effects on motivation for natural reward or for various drugs of abuse, decreasing motivation for drugs, while increasing motivation for sweet food reward [1,2]. STN inactivation by either lesion or DBS can also prevent the loss of control over cocaine or alcohol intake, as assessed in the model of escalation of drug intake. These data, in line with clinical observation in Parkinsonian patients suffering from addiction to their dopaminergic treatment, support our hypothesis that STN could be an interesting target for the treatment of addiction and DBS could be the appropriate surgical tool.