Focused Ultrasound Therapy
Focused ultrasound is a rapidly evolving, therapeutic technology that could transform the quality of life and decrease the cost of care for patients with nicotine addiction. This was traditionally found in those smoking cigarettes, but with the advent of other forms to obtain nicotine, it has expanded its way of impacting patients. This novel technology focuses beams of ultrasound energy precisely and accurately on targets deep in the body without damaging the surrounding normal tissue.
How it Works
Where the beams converge, focused ultrasound produces a neuromodulatory effect on the dorsal Anterior Insula (dAI). The dAI is part of the saliance network of intracellular neurons, which is involved in assigning significance and emotional value to stimuli. Furthermore, it is consistently activated with exposure to smoking cues and craving. Patients with damage to the insula were able to stop smoking easily and without experiencing cravings or relapse. As such, the insula is a promising target for reducing craving and use in individuals with nicotine addiction.
The primary options for treatment of nicotine addiction are by and large, not reliably effective, with fewer than 1/10 being able to stay off cigarettes for a year.
For certain patients, focused ultrasound could provide a safer and more effective alternative to current therapy.
Advantages
- Focused ultrasound is non-invasive, so it does not carry added concerns like surgical wound healing or infection.
- Focused ultrasound can reach the desired target without damaging surrounding tissue.
- It can be repeated, if necessary.
Clinical Trials
A clinical trial in Washington, D.C. is treating patients with low intensity focused ultrasound to see if this reduces the cravings from nicotine addiction.
The Foundation updates these pages regularly, but with the increasing number of clinical trials, we want to be sure that our audience has the latest information available. Therefore, we also added the website search information for the above trials. If you click here, it will take you to the latest information available from https://www.clinicaltrials.gov/.
Regulatory Approval and Reimbursement
Focused ultrasound treatment for nicotine addiction is not yet approved by regulatory bodies or covered by medical insurance companies.
Notable Papers
Wang C, Shen Z, Huang P, Qian W, Zhou C, Li K, Zeng Q, Luo X, Gu Q, Yu H, Yang Y, Zhang M. Increased interregional functional connectivity of anterior insula is associated with improved smoking cessation outcome. Brain Imaging Behav. 2020 Apr;14(2):408-415. doi: 10.1007/s11682-019-00197-2. PMID: 31494823
Abdolahi A, Williams GC, Benesch CG, Wang HZ, Spitzer EM, Scott BE, Block RC, van Wijngaarden E Damage to the insula leads to decreased nicotine withdrawal during abstinence. Addiction. 2015 Dec;110(12):1994-2003. doi: 10.1111/add.13061. Epub 2015 Sep 8. PMID: 26347067
Zhang X, Salmeron BJ, Ross TJ, Geng X, Yang Y, Stein EA. Factors underlying prefrontal and insula structural alterations in smokers. Neuroimage. 2011 Jan 1;54(1):42-8. doi: 10.1016/j.neuroimage.2010.08.008. Epub 2010 Aug 10. PMID: 20699124
Naqvi NH, Rudrauf D, Damasio H, Bechara A. Damage to the insula disrupts addiction to cigarette smoking. Science. 2007 Jan 26;315(5811):531-4. doi: 10.1126/science.1135926. PMID: 17255515
Click here for additional references from PubMed.