Brain research connects to drug addiction
Dr. Ali Rezai is a neuroscience pioneer at the Rockefeller Neuroscience Institute at VWU, who has developed treatments for Parkinson's and other brain disorders like Alzheimer’s and dementia, which led to other discoveries, including the connection between brain function and drug addiction. Dr. Rezai has spent 25 years exploring this frontier of medicine and his surgical techniques and therapies are in use around the world. That includes revolutionary treatments for a brain disease suffered by 24 million Americans – drug addiction. The results so far have been life changing.
Here’s the link to the 60 Minutes report. Go to 14:30 mark of the video HERE.
If you can’t view the video, following is a condensed transcript of the section on addiction from the 60 Minutes report. Sharyn Alfonsi is the 60 Minutes interviewer.
The human brain contains 100 billion neurons. That's as many cells as there are stars across the milky way. Dr. Ali Rezai has spent 25 years exploring this frontier of medicine. The surgical techniques and therapies he pioneered are in use around the world. Dr. Rezai allowed us to see his latest research over the last year at the Institute in Morgantown, West Virginia. It includes revolutionary treatments for a brain disease suffered by 24 million Americans - drug addiction. The results so far have been life changing for people once trapped by drugs.
Gerod Buckhalter is the son of a coal miner. At 6 foot 3, he was a high school football standout who dreamed of playing wide receiver at Penn State…but after a shoulder injury, he got hooked on painkillers.
Gerod Buckhalter: Looking back, I didn't have a chance. I couldn't do anything without having that drug--um in my system. The very first time that I -- that I took that first pill, um -- I-- I knew that I wanted that feeling for the rest of my life.
Four years ago, a psychologist who'd worked with Buckhalter introduced him to Dr. Rezai, who was gearing up to perform a new kind of brain surgery to treat severe addiction.
Dr. Ali Rezai: Our protocol was people who have failed everything. Everything. Residential programs, multiple failures, detox multiple times, outpatient, inpatient, multiple overdoses.
Gerod Buckhalter: I think he classified it as-- end-stage drug user – end stage makes you think that this is the end of your life. And hearing that at the age of 34 um, it - it was crazy.
Dr. Rezai thought he might be able to adapt technology he helped develop years earlier to treat Parkinson's disease to treat people with severe addiction. We've been able to map out with neuroscience imaging there's a specific part of the brain that is electrically and chemically malfunctioning that is associated with addiction.
It's a brain disease, it's an electrical and chemical abnormality in the brain that occurs over time with recurrent use of drugs. And this can be any substance, alcohol, opioids, amphetamines, cocaine and they all are involving the same part of the brain.
Dr. Ali Rezai: Parkinson's we implant that in the movement part of the brain that is electrically malfunctioning causing shaking. In this case, we're going in the behavioral regulation, anxiety, and craving parts of the brain.
People maybe 50 years ago, they say "A implant in the heart sounds creepy." Now it's, like, normal. Twenty-five years ago, people are saying, "What are you doing? You're putting an implant in the brain for Parkinson's?" but now it's routine part of standard of care for advanced Parkinson's.
Dr. Rezai opened a nickel-sized hole in Burkhalter's skull. Then he directed a thin wire with four electrodes deep inside. Gerod was awake during the surgery.
To map the brain we have tiny microphones the size of a hair we put inside the brain. And they're going slowly with micro-robots. They go at increments of a thousandth of a millimetre. Very slow, we drive them into the brain, and we're listening to the neurons talking to each other. In addiction, we want to find the area in the reward center, so that confirms where we are in the brain. Once we listen, we say, "Okay, that's the right sound," then we put the final therapeutic pacemaker.
Gerod Buckhalter: When they turned them on it was an immediate change. Just felt better. You know, just felt like I did prior to ever using drugs, but a little bit better. And it was at that point that I knew that I was gonna have a legitimate shot at doing well.
In all – four patients with severe drug addiction had the implant surgery. One had a minor relapse. Another dropped out of the trial completely. But two have been drug free since their operations, including Gerod Buckhalter, who’s been clean for four years.
The surgery was a success but opening someone's skull is always risky. Dr. Rezai thought he could reach more patients quickly if he used ultrasound. He was already using it to treat other brain disorders…and was convinced focused ultrasound could target the same area of the brain as the implant. So there's no skin cutting. There's no opening the skull. So it is brain surgery without cutting the skin, indeed.
Dr. Ali Rezai: So the area that we're treating is the reward center in the brain, which is the nucleus accumbens, which is right down at the base of this dark area. And then we deliver-- ultrasound waves to that specific part of the brain, and we watch how acutely, on the table your cravings and your anxiety changes in response to ultrasound. Ultrasound energy is changing the electrical and chemical milieu, or activity, in this structure in the brain involving addiction and cravings.
At this point, it seems like the brain is being reset, or rebooting of the brain, and the cravings are less, they are managed, anxiety is better. So now that allows them to interact with the therapist. It's very important to know that this is not a cure, but an augmentation of the therapy by reducing the cravings and anxiety that's so overwhelming that the therapist has difficulty working with the patient.
Sharyn Alfonsi: Then they can walk away after this? There's no--
Dr. Ali Rezai: They get off the table and go home.
Sharyn Alfonsi: And how long does this entire procedure take?
Dr. Ali Rezai: One hour.
Dr. Ali Rezai is trying the same ultrasound therapy on 45 more addiction patients and is already thinking about expanding the use of ultrasound to help people with other brain disorders including post traumatic stress disorder and obesity.
Produced by Guy Campanile and Lucy Hatcher. Broadcast associate, Erin DuCharme. Edited by Jorge J. García.