A new study was able to determine the region of the brain that may be responsible for tobacco addiction. Researchers were able to do so after discovering that active smokers who had a stroke in the insular cortex were more likely to drop their smoking habits and develop lesser and milder withdrawal signs and symptoms compared to those who sustained a stroke in other areas of the brain.

Although present nicotine dependence treatments are well tolerated, recurrence rates remain high. These medicines focused on the reward pathway of the brain to alleviate smoking addiction problems. However, according to emergent evidence, the insular cortex, which is a brain area that is often not noticed when studying addiction, may hold a valuable key in determining the mechanisms of emotions and cognition associated with drug utilization.

The researchers wanted to find out the changes in smoking habits that patients will exhibit after suffering from a stroke, including the restoration of smoking and the severity of wanting to have a cigarette while admitted in the hospital.

The study involved 156 active smokers, who suffered from a stroke and were eventually hospitalized in three Rochester medical facilities. The researchers identified the location of the brain where the patients had a stroke and subsequently classified them into two groups. The first group comprised of patients who had a stroke in the insular cortex and the second group had a stroke in another area of the brain.

While admitted, the patients were subjected to forced smoking abstinence, which is a good circumstance under which the researchers may assess the patients' level of craving for smoking, as well as the severity of clinical withdrawal. Specifically, the authors utilized two different assessment tools to determine the different features of withdrawal such as anxiety, anger, hunger, concentration, sleep and sadness.

The experts also conducted the study for three months to find out if the patients had resumed smoking or not. The authors noted the possibility that smoking was the main cause of the stroke and thus, is a forceful motivator for the patients to quit, as reinforced by their care providers during hospitalization.

The findings of the study, published in the journal Addiction, showed that there is a wide difference between the rates of smoking cessation between the two groups. The results of the investigations yielded that 70 percent of the patients who had a stroke in the insular cortex stopped smoking while only 37 percent quit from those who suffered from stroke in another region of the brain. The researchers were also able to discover that the insular cortex stroke group had milder and lesser withdrawal symptoms compared to the other group.

The research findings implicate that addiction may be significantly influenced by the insular cortex, said Amir Abdolahi Ph.D., the research lead author.

The results of the study may help encourage experts to explore treatments such as drugs and deep brain stimulation that focus on the insular cortex to battle smoking addiction. The researchers also assumed that their research findings may be applicable to other types of addiction.

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