The Daily Telegraph

Brain surgery

The groundbrea­king new cure for alcoholism

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Sitting calmly in his blue hospital gown, Dr Frank Plummer felt nothing as doctors made an incision across his skull and drilled two holes into his brain. They were each “the size of a 25-cent Canadian piece”. A non-medic watching the operation, in 2018, might have guessed that Dr Plummer suffered from a serious tumour that needed removing, but the world-renowned microbiolo­gist actually suffered from a far more common affliction: alcoholism.

It was part of a world-first experiment in which doctors treated alcoholism with Deep Brain Stimulatio­n (DBS), a neurosurgi­cal procedure in which electrodes are drilled directly into the brain in an attempt to “re-wire” the organ’s signal circuits. DBS has been used in the past to treat drug addiction and various mental illnesses, and is commonly used to treat neurodegen­erative disorders like Parkinson’s, but has never before been used on alcoholics.

Having tried every form of convention­al treatment available, including one-on-one therapy and Alcoholics Anonymous, his remarkable recovery has sparked hope that DBS could provide the last-resort “cure” for which thousands of “treatment-resistant” alcoholics are looking.

“It’s restored me to life,” says Dr Plummer, 67, the former scientific director of Canada’s National Microbiolo­gy Laboratory. “I was on a path where I was not going to live much longer.”

Describing himself as a former “high-functionin­g alcoholic” who kept his successful work life insulated from his drinking, Dr Plummer says his problem developed while he was living in Kenya in the Eighties and Nineties, trying to stem the outbreak of Aids at the height of the country’s crisis.

He increasing­ly found himself turning to the bottle as several of his colleagues died from Aids, and the severe stresses of the job began to take their toll. Soon, he found himself in the grips of alcoholism, knocking back four glasses of whisky each evening.

But he did not realise he had a

‘Your head shakes with the drilling and it’s noisy, but it only lasts a short time’

problem until 2012, 12 years after returning to his native Canada, when he was diagnosed with cirrhosis and end-stage liver disease.

“I never felt drunk and don’t think I appeared drunk,” he says. “That was part of the problem. I could consume a lot without falling down. I didn’t get angry and throw things and that kind of stuff.”

He was given a successful liver transplant in 2014, but quickly slipped back into his old whisky habit.

He heard of the DBS trial at the Sunnybrook Research Institute of Health Sciences in Toronto, and – with a certain degree of scientific curiosity – signed up.

Dr Nir Lipsman, who led the six-patient study, says that years of drug or alcohol addiction can rewire a patient’s brain chemistry so that its signals do not zap around the brain in the way they should.

This faulty wiring tends to occur in the nucleus accumbens, an area of the brain responsibl­e for pleasure and reward, meaning that healthy forms of stimuli – dancing, food, meeting friends, laughing with your children – will not provide the same “reward” as they once did, and addicts are forced to rely on drugs or alcohol to get their “kick”. He says that DBS acts

as a “pacemaker for the brain” by administer­ing small electric shocks to the nucleus accumbens every few seconds in order to kick-start the brain’s “reward centre” back to life.

Dr Plummer remembers the operation itself as “pretty innocuous”: he was awake for the duration but felt nothing due to the local anaestheti­c administer­ed to his head, which was placed into a metal halo to stop him moving.

“Your whole head shakes with the drilling, and it’s noisy. But it only lasts a short time,” he explains.

After years of unsuccessf­ul treatment, Dr Plummer was amazed when he made a total recovery.

With his “pacemaker” switched on and emitting signals around the clock, he no longer feels the emotional pull of alcohol, and has easily weaned himself off his whisky habit, delighting his wife, Jo, and three children.

Dr Lipsman now hopes to test DBS in a larger study, which will compare the results of alcoholic patients receiving DBS with a control group who receive “dud” electrodes which do not emit any electric signals.

This way, researcher­s will have a clearer idea of whether the supposed benefits of DBS are more than just a placebo effect.

With each implant costing between £9,000 and £15,000, plus an extra £9,000 to £12,000 for the battery, which needs replacemen­t every three to four years, DBS is very much a last-resort treatment, says Dr Lipsman.

“I’m not sure if it will ever be in widespread use. It’s for patients who are treatment-resistant, and who are able to undergo surgery. It’s still an invasive procedure.”

Dr Plummer is certain that his own transforma­tion is no placebo effect, and he looks forward to a retirement free from the perils of alcoholism.

“I’ve reconnecte­d with family and friends, and I’m planning a return trip to Kenya in about two weeks,” he says. “I’ve discovered cooking again, so I’m always anxious to have people for dinner and to come up with something new. Life is very full of joy.”

‘I’ve reconnecte­d with family and friends. Life is very full of joy now’

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 ??  ?? Pacemaker for the brain: Dr Frank Plummer, left, undergoes the Deep Brain Stimulatio­n treatment for his alcoholism
Pacemaker for the brain: Dr Frank Plummer, left, undergoes the Deep Brain Stimulatio­n treatment for his alcoholism
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