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Science for Sapiens A year in research (2024)

hronic alcohol consumption causes al- stop the progression of the alteration in the microstructure of
terations in the brain microstructure that the white matter that occurs when patients stop drinking. And,
are noticeable in the white matter of the even more significantly, their relapse rates had declined three
brain and progress even during sobriety. months after treatment, so these are stable long-term results.
Slowing down the damage to the white
matter in the brain can reduce the risk Alcohol use disorder is the most prevalent form of addiction,
of a relapse in patients with alcoholism. characterised by excessive and prolonged alcohol use. This
C Two laboratories of the Institute for Neu- addiction has a great burden on society, since, among the
rosciences, a joint centre of the National Spanish Research population aged 15 to 49, 3.8% of female deaths and 12.2%
Council (CSIC) and the University Miguel Hernández (UMH) of of male deaths are attributed to alcohol consumption world-
Elche, have managed to protect the white matter of patients wide. It is a chronic disease that alternates cycles of sobriety
using a non-invasive method of transcranial magnetic stimula- and relapse. Therefore, the main challenge, together with that
tion. This work, published in the journal Psychiatry and Clinical of prevention, is to break those cycles to prevent the restart of
Neurosciences, proves that the alteration of the white matter consumption.
is a central characteristic of the pathology, and not a collateral
damage of alcohol consumption, and opens a new therapeu- The white matter
tic pathway to prevent relapses. The white matter, the tissue that connects the different brain
regions, is made up of the axons that interconnect the neu-
Researchers from the Plasticity of Neural Networks and Trans- rons and the glia cells that are with them, performing various
lational Imaging Biomarkers laboratories of the Institute for functions. The researcher of the Institute for Neurosciences
Neurosciences, led by Santiago Canals and Silvia de Santis Silvia de Santis points out that one of these functions is the
respectively, already proved a few years ago that alcohol con- production of myelin that surrounds the axons and ensures
sumption causes damage to the white matter of the brain and their correct functioning. In addition, the expert explains that
that this damage does not stop when the person stops drin- the alteration of the microstructure found in patients was di-
king, but get worse very noticeably in the first week of sobriety. rectly related to the level of alcohol consumption. Importantly,
In the new study, they have not only reproduced results from they found similar results in two different animal models, which
that previous research in a new group of patients, but have allowed them to study with invasive technologies, only avai-
applied a non-invasive method based on deep transcranial lable in animal experiments, the biological underpinnings of
magnetic stimulation (Deep TMS) that prevents the progres- the change and to discover that they were associated with a
sion of damage to the white matter during sobriety. decrease in myelin.

A new method to treat addictions The evidence collected by the team pointed to the white matter
According to researcher Mohamed Selim, the first author of as a possible therapeutic target. According to Selim, his reaso-
the article, it is a non-invasive neuromodulating technique ning was that brain stimulation, by virtue of a process known as
that consists of the application of a magnetic field repeated- myelin plasticity, could regenerate the white matter of patients
ly on the head. Thus, an electric field that activates large po- and thereby protect the brain and prevent relapses. When the
pulations of neurons is generated. Although it is not a simple cells that produce myelin detect neuronal activity, they react by
technique to perform from the clinical point of view because it producing more myelin. In addition, progenitor cells mature, so
requires specific facilities, it has already been used successfu- there are more cells with the ability to myelinate axons.
lly to treat other addictions such as smoking.
After verifying that, when applying TMS treatment, the areas
A brain reconstructed from patient data and in which the re- of the stimulated white matter were protected during sobrie-
gion where TMS protects the white matter in a more significant ty, the researchers found that, in addition, they regained their
way has been highlighted in blue. The meat-coloured hat mar- function. Communication between protected brain regions
ks the area of influence of the TMS. The blue region contains was more like that of healthy subjects than that of subjects
the nerve fibres (green and red) that connect several brain with alcohol use disorder. At the same time, patients reported
areas (yellow) whose activity is normally altered in patients and a lower alcohol craving, and it was registered, after 3 months,
that the TMS intervention normalises. that relapses had decreased.

Longitudinal study in patients Now the researchers are considering studying in detail the me-
In this study, which also involved researchers from Ben-Gurion chanism of plasticity in order to propose even more effective
University (Beer Sheva, Israel), the University Hospital of Linkö- therapies. Their goal, according to Santiago Canals, is to refine
ping (Sweden) and the Central Institute for Mental Health the protocols of brain stimulation and combine them, possibly
(Mannheim, Germany), the experts have applied the magnetic with pharmacological treatments aimed at exploiting to the
stimulation treatment periodically for several weeks to a group maximum the therapeutic window they have discovered.
of patients made up of people who were in the process of de-
toxification. In addition, to rule out a possible placebo effect, This work has been possible thanks to the funding of the Ho-
a simulation of this stimulation was performed on a group of rizon 2020 Research and Innovation Programme of the Euro-
control patients. pean Union, the Ministry of Science and Innovation of Spain,
the State Agency for Research, the Severo Ochoa Research
The researchers acquired images of the patients’ brains befo- Centre Programme, the Generalitat Valenciana, through the
re they started the intervention and after receiving treatment. PROMETEO and CIDEGENT aids, the Swedish Research Coun-
Indeed, they confirmed that only in those patients who had cil, “la Caixa” Fundation and the Marie Skłodowska-Curie-CO-
received the stimulation, the treatment had been sufficient to FUND agreement.

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