A few months ago, there was an article in the New York Times about a finding many scientists thought was sensational: some people with damage to a prune-size slab of brain tissue called the insula were able to give up cigarettes instantly.

According to neuroscientists, the insula is a region of the brain that has emerged as crucial to understanding what it feels like to be human. It is the wellspring of social emotions, things like lust and disgust, pride and humiliation, guilt and atonement. It helps give rise to moral intuition, empathy and the capacity to respond emotionally to music.

It also reads body states like hunger and craving and helps push people into reaching for the next sandwich, cigarette or line of cocaine.

Recent insula research offers new ways to think about treating drug addiction, alcoholism, anxiety and eating disorders. If scientists could figure out a way to tweak the insula without damaging it permanently, they might be able to create the perfect drug to help quit smoking.

That dream, which may not be too far off, puts the insula in the spotlight. What is the insula and how could it possibly exert such profound effects on human behavior?

From Science 26 January 2007:
Vol. 315. no. 5811, pp. 531 - 534
DOI: 10.1126/science.1135926

We found that smokers with brain damage involving the insula, a region implicated in conscious urges, were more likely than smokers with brain damage not involving the insula to undergo a disruption of smoking addiction, characterized by the ability to quit smoking easily, immediately, without relapse, and without persistence of the urge to smoke. This result suggests that the insula is a critical neural substrate in the addiction to smoking.

The human insula is also important for processing events that have yet to happen. For instance, when you decide to go outside on a sunny day, your body gets ready before you feel the heat of the sun. It starts pumping blood to where you need it, releases sweat, and adjusts your metabolism. Your insula tells you what it will feel like before you step outside.

The same goes for drug addicts. When an addict is confronted with sights, sounds, smells, situations or other stimuli associated with drug use, the insula is activated before using the drug. Same as with cigarettes.

However it is not all too easy.

Lesions in the frontal insula can wipe out the ability to appreciate the emotional content of music. It may also be involved in the human sense of the progress of time, since it can create an anticipatory signal of how people may feel as opposed to how they feel now. Intensely emotional moments can affect our sense of time. It may stand still, and that may be happening in the insula, a crossroads of time and desire.

Time will tell whether the insula can be at the forefront of addiction cessation or too delicate to mess with.

In the meantime, if you are trying to quit smoking now, your best bet is a strong will and a good product like Nicocure to help you avoid withdrawal symptoms and remove strong cravings.

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