Project Overview
Alcohol use disorder (AUD) is a common and serious illness in which people keep drinking despite major harms. Even with today’s best medications and addiction treatments, relapse is frequent, and severe AUD can shorten life expectancy by many years.
This project (the CRAVE Study) will test a novel, neuroscience-based treatment for people with severe, treatment-refractory AUD: deep brain stimulation (DBS) targeting a small brain region called the nucleus accumbens, which plays a key role in craving and reward. DBS is an implanted “pacemaker-like” device that delivers tiny electrical pulses to help normalize abnormal brain circuit activity. In a previous pilot study from the same team, nucleus accumbens DBS was associated with a large reduction in alcohol consumption, supporting the need for a more rigorous trial.
In this Phase-2 study, 10 participants will be enrolled. The trial uses a double-blind, randomized design: for the first 6 months, half of participants will receive active stimulation and half will receive sham (inactive) stimulation, so that expectations alone cannot explain improvements. After 6 months, everyone will receive active DBS.
A second major goal is to identify a personal “craving signal” from the implanted device’s recordings of brain activity. Participants will record real-world craving events at home and complete clinic-based cue reactivity sessions; these ratings will be linked to brain signals to find a reliable marker of craving for each person.
Finally, the study will explore adaptive (closed-loop) DBS, where stimulation turns on only when the craving signal is detected - an approach that could improve outcomes and reduce side effects and battery use. If successful, CRAVE could open a new treatment path for the most severe cases and advance our understanding of the brain circuitry that drives addiction and relapse.
Partners & Donors
Azrieli Foundation
