Stopping the deterioration of the brain’s white matter can reduce relapses in patients who consume alcohol

A study led by the Institute of Neurosciences (IN), a joint center of the Supreme Council of Scientific Research and the Miguel Hernández University of Elche, has found a way to stop the progression of deterioration of the white matter of the brain in patients with depressive disorder. Alcohol consumption, which is accompanied by a decrease in alcohol consumption Relapse into consumption. This work was published in the journal Psychiatry and clinical neuroscienceshows that the alteration of this substance is a central feature of the pathology and not a collateral damage of consumption, and opens a new therapeutic route to prevent relapses.

Researchers from IN’s Neural Network Plasticity and Translational Imaging Biomarkers Laboratories led by Santiago canals And Silvia De Santis or a few years ago showed that alcohol consumption causes damage to the white matter of the brain and that this damage does not stop when you stop drinking, but that it progresses very significantly during abstinence. In this work, they not only reproduced the data from this previous research on a new patient group, but also applied one non-invasive method based on deep transcranial magnetic stimulation (Deep TMSfor its acronym in English), which prevents the progression of white matter damage during withdrawal.

“It is a non-invasive neuromodulatory technique that consists of the repeated application of a magnetic field to the head. This creates an electric field that increases excitability and activates large populations of neurons,” he explains. Mohamed Selim, first author of the article. In addition, the researcher highlights that although TMS is not an easy technique to perform from a clinical point of view since it requires specialized facilities, it has previously been used to treat other addictions, such as smoking, and has produced positive results.

It is a non-invasive neuromodulatory technique that involves repeatedly applying a magnetic field to the head.

Mohamed Selim, first author of the article

Santiago Canals, Hohamed Selim and Silvia De Santis. / IN

Longitudinal study of patients

In this study, which also involved researchers from Ben-Gurion University (Beer Sheva, Israel), Linköping University Hospital (Sweden) and the Central Institute of Mental Health (Mannheim, Germany), experts regularly administered TMS treatment over several periods weeks applied to a group of patients consisting of men and women who were present Detoxification process. In order to exclude a possible placebo effect, a simulation of this stimulation was also carried out on a group of control patients.

The researchers recorded images of the patients’ brains before the intervention began and after treatment. In fact, they confirmed that only in the patients who had received stimulation, TMS was enough to stop the progression of the change in white matter microstructure that occurs when patients stop drinking. And what’s even more significant: Their relapse rates had decreased three months later the treatment, so these are stable long-term results.

The results obtained are the result of an international collaboration that has allowed several research groups to share their experiences on alcohol use disorders. IN researcher Santiago Canals emphasizes the importance of collaboration between experts: “We were able to do this thanks to the fact that we are a large consortium combine TMS technology, structural and functional imaging of the brain, and clinical experience and perspective as well as basic experiments. Without all these legs, a translational research structure cannot be sustained if it aims to make a real impact in the clinic.”

Because we are a large consortium, we were able to combine TMS technology, structural and functional brain imaging, and clinical experience and perspective with those of fundamental experiments.

Santiago Canals, IN researcher

The white matter

Alcohol dependence is the most common form of addiction and is characterized by excessive and long-term alcohol consumption. This addiction represents a great burden on society, since in the population between 15 and 49 years old, 3.8% of female deaths and a 12.2% of male deaths are due to alcohol consumption worldwide. It is a chronic disease that alternates cycles of sobriety and relapse. Therefore, the biggest challenge, in addition to prevention, is to break these cycles to prevent consumption from resuming.

The white matter, the tissue that connects different things brain regionsIt consists of axons that connect neurons and accompanying glial cells and perform various functions. “One of these functions is the production of myelin, which coats the axons and ensures their correct function,” says IN researcher Silvia De Santis, adding: “The change in microstructure that we found in the patients correlated with the amount of consumption .” ” Alcohol. “In addition, we found the same result in two different animal models that we had previously studied, which allowed us to investigate the biological basis of this change and discover that it was associated with a decrease in myelin.”

The evidence collected by the team pointed to white matter as a possible therapeutic target: “Our reasoning was that stimulating the brain due to a process known as myelin plasticity would regenerate patients’ white matter, thereby protecting the brain and preventing patients from becoming ill “could.” from a relapse,” says Selim. When the cells produce Myelin They detect neuronal activity and respond by producing more myelin. In addition, progenitor cells mature so that there are more cells capable of myelinating axons.

One of these functions is the production of myelin, which coats the axons and ensures their proper function.

Silvia De Santis, IN researcher

After finding that when using TMS treatment, the areas of stimulated white matter were protected during abstinence, the researchers confirmed that they also regained function. Communication between protected brain regions was more similar to that in healthy subjects than in subjects with alcohol dependence. The patients reported a reduced desire to consume and after 3 months it was noted that the relapses had subsided.

Now researchers want to study the mechanism of plasticity in detail in order to propose even more effective therapies. “Our goal now is to refine that Brain stimulation protocols and their combinationpossibly with pharmacological treatments aimed at maximizing the therapeutic window that we have discovered,” emphasizes Canals.