Committee on the Neurobiology of Addictive Disorders, The Scripps Research Institute, La Jolla, CA, USA.
CNRS and Aix Marseille Université, INT UMR7289, Marseille, France.
Neuropsychopharmacology. 2017 Aug;42(9):1850-1859. doi: 10.1038/npp.2016.270. Epub 2016 Dec 5.
Opioid addiction, including addiction to heroin, has markedly increased in the past decade. The cost and pervasiveness of heroin addiction, including resistance to recovery from addiction, provide a compelling basis for developing novel therapeutic strategies. Deep brain stimulation may represent a viable alternative strategy for the treatment of intractable heroin addiction, particularly in individuals who are resistant to traditional therapies. Here we provide preclinical evidence of the therapeutic potential of high-frequency stimulation of the subthalamic nucleus (STN HFS) for heroin addiction. STN HFS prevented the re-escalation of heroin intake after abstinence in rats with extended access to heroin, an animal model of compulsive heroin taking. STN HFS inhibited key brain regions, including the substantia nigra, entopeduncular nucleus, and nucleus accumbens shell measured using brain mapping analyses of immediate-early gene expression and produced a robust silencing of STN neurons as measured using whole-cell recording ex vivo. These results warrant further investigation to examine the therapeutic effects that STN HFS may have on relapse in humans with heroin addiction.
在过去的十年中，阿片类药物成瘾（包括海洛因成瘾）显著增加。海洛因成瘾的成本和普遍性，包括对成瘾康复的抵抗，为开发新的治疗策略提供了强有力的依据。深部脑刺激可能代表一种治疗难治性海洛因成瘾的可行替代策略，特别是在对传统疗法有抵抗的个体中。在这里，我们提供了高频刺激丘脑底核（STN HFS）治疗海洛因成瘾的临床前证据。STN HFS 防止了在具有延长海洛因接触的大鼠中，即强迫性海洛因摄入的动物模型中，海洛因戒断后的复吸。STN HFS 抑制了关键的脑区，包括使用即时早期基因表达的脑图谱分析测量的黑质、脚间核和伏隔核壳，并且使用离体全细胞记录测量产生了 STN 神经元的强烈沉默。这些结果值得进一步研究，以检查 STN HFS 对人类海洛因成瘾者复吸可能产生的治疗效果。
