My research at Columbia University focuses on the neural mechanisms by which addictive behavior can be regulated through the appreciation of risks and negative consequences. My work is rooted in the neurobiological framework for emotion and risky decision-making pioneered by my PhD mentors, Antonio Damasio and Antoine Bechara, along with recent work on the neuroscience of emotion regulation and behavior change mechanisms in addiction by my colleagues at Columbia University, Kevin Ochsner and Jon Morgenstern.
In 2007, I discovered that cigarette smokers who sustain damage to the insula, a relatively primitive part of the cerebral cortex, appear to lose their addiction to smoking. This finding highlighted the insula as a potential target for addiction treatments, and spawned a new area of research on this previously overlooked brain region. My research was published in the journal Science and was reported on the front page of the New York Times. Here I am talking about it on CBS News:
I am currently trying to understand why the insula is so important for addiction. The insula is known to play a role in conscious feelings, the awareness of bodily states and risky decision-making. My working hypothesis is that cravings are feelings that are tied to memories of the bodily effects of addictive substances, such as the taste of alcohol, the cardiovascular effects of cocaine or the feel of cigarette smoke in the back of the throat, and that the insula plays a role in the recall of these embodied memories. This function of the insula is especially important for driving substance use in addicted individuals when there is a high level of conflict or subjective risk. This recalled information is transmitted to the ventral striatum (also known as the nucleus accumbens), where it is intergrated with value signals from regions such as the ventromedial prefrontal cortex and the amygdala. I elaborate on this model in a recent review article. Here’s a visual depiction of this model:
I am also studying the neural mechanisms by which addictive behaviors can be regulated by an appreciate of risks and negative consequences. Specifically, I am interested in how the prefrontal cortex, a more recently evolved brain region involved in emotion regulation, decision-making and thinking about the future, regulates the functions of more primitive regions that are involved in generating cravings, such as the insula the ventral striatum. Furthermore, I am interested in how these regulatory mechanisms play a role in psychotherapies for addiction, such as Relapse Prevention Therapy, Motivational Interviewing and Alcoholics Anonymous, and how medications can optimize the functioning of these mechanisms. Here is a picture, from my colleague Kevin Ochsner, of brain areas that become active when cigarette smokers control their cigarette craving by thinking about negative consequences.
To address these questions, I use a combination of techniques, including functional brain imaging, experimental psychology, behavioral pharmacology, psychophysiology and clinical trials of psychotherapies and medications.
While my research involves working with patients, for ethical reasons I do not include patients from my private practice in my research. You can learn about how to participate in my research here.