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A Canadian first: Sunnybrook researchers use deep-brain stimulation to treat severe alcoholism in new trial

Dec 13, 2018

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For the first time in Canada, Sunnybrook researchers are studying the use of deep brain stimulation (DBS) for treatment-resistant alcohol use disorder (AUD).

AUD occurs when a person cannot control how much alcohol they consume. Powerful cravings and symptoms of withdrawal perpetuate drinking. Withdrawals can be so severe that patients may experience seizures or require hospitalization. Despite treatments such as detoxification, psychotherapy, and medication, the rate of relapse is 75%.

“Alcohol use disorder is a chronic and debilitating disease which affects up to 14% of Canadians,” says Dr. Nir Lipsman, neurosurgeon and director of the Harquail Centre for Neuromodulation at Sunnybrook Health Sciences Centre. “It is the leading risk factor for disease in Canadians aged 15-49."

The trial will investigate the safety and efficacy of DBS for treatment-resistant AUD. DBS is a neurosurgical procedure that involves the administration of small amounts of electricity to disrupt abnormal activity of brain structures associated with the disease. For refractory AUD, the focus is on the nucleus accumbens, a region of the brain, that plays a role in addiction.

In Canada and around the world, DBS has been used to alleviate symptoms of Parkinson’s disease, essential tremor and obsessive-compulsive disorder.

“This is a new frontier in the future treatment of alcohol use disorder,” says Dr. Lipsman. “Our investigation into the safety of deep brain stimulation in treating this disease will be a key factor in helping patients who aren’t responding to therapy and medication, and may one day offer another option for treatment.”

Five participants will be enrolled in the one year study. For more information on trial eligibility, please contact Anusha Baskaran at harquailcentre@sunnybrook.ca

Media contact:
Jennifer Palisoc
Sunnybrook Communications & Stakeholder Relations
jennifer.palisoc@sunnybrook.ca
416-480-4040


Learn more about deep brain stimulation:

Deep brain stimulation (DBS) is currently being studied by Sunnybrook researchers who are investigating the safety and efficacy for treatment-resistant alcohol use disorder (AUD) at the Harquail Centre for Neuromodulation.

Q. What is DBS?
A. Deep brain stimulation (DBS) is a neurosurgical procedure. It involves inserting electrodes into the brain to influence abnormal activity in circuits of the brain. It is also considered to be one of the most effective treatments for major depressive disorder, OCD. It is being investigated at Sunnybrook as an experimental treatment for symptoms of chronic alcoholism for the first time in North America.

Q. Why would DBS be used for treatment refractory alcohol use disorder?
A. Current treatment options for alcohol use disorder include: psychotherapy and medications. For some patients, these treatments do not work. DBS is a brain-based targeted therapy for treatment that is being investigated for safety in order to help provide more options for patients in the future.

Q. Is DBS a first-line treatment for AUD?
A. No. At this point, DBS is a new experimental procedure that is being tested for safety and feasibility for the treatment of chronic alcoholism. To be included in the DBS trial, a patient must have tried and exhausted all other treatments including medication, psychotherapy, and detoxification. The one year study at Sunnybrook will involve five patients.

Q. Is DBS safe?
A. DBS is used in Canada and around the world to help alleviate symptoms of Parkinson’s disease and obsessive compulsive disorder (OCD). For the first time in Canada, Sunnybrook researchers are studying DBS for safety in treating treatment refractory AUD.

Q. What part of the brain will be treated and why?
A. The DBS trial will focus on an area of the brain known as the nucleus accumbens, which plays a role in addiction and is also known to be successful in managing alcohol cravings and helping maintain abstinence.

Q. How effective is it?
A. DBS for difficult to treat chronic alcoholism is currently being tested for safety and feasibility as an experimental treatment at Sunnybrook. As a result, the effectiveness of DBS for AUD is still being investigated. However, DBS is an established treatment for movement disorders such as essential tremor, Parkinson’s disease, and obsessive-compulsive disorder.

Q. What are the potential risks with this procedure and these patients?
A. Any type of surgery has the risk of complications. Risks of DBS are similar to any neurosurgical procedure such as damage to the brain, hermorrhage and infection, stroke, cardiac problems, seizures, pain (e.g. headaches) and nausea. Other side effects may include unexpected mood changes or issues with concentration.

Q. Will DBS affect my personality?
A. Deep brain stimulation to the nucleus accumbens, the part of the brain that will be treated, is relatively new, but the evidence suggests personality is unchanged. In rare cases, patients may experience abnormally elevated mood or depressed mood, which can be reversed by lowering the DBS stimulation settings.

Q. Who do I contact for more information?
A. Enrolment in this deep brain stimulation trial is limited to patients with treatment resistant alcohol use disorder, who are 18-70 years old and Canadian residents.

For more information or to inquire about eligibility for the trial please contact Anusha Baskaran at harquailcentre@sunnybrook.ca