151
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Jollans L, Whelan R. The Clinical Added Value of Imaging: A Perspective From Outcome Prediction. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2016; 1:423-432. [DOI: 10.1016/j.bpsc.2016.04.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Revised: 04/06/2016] [Accepted: 04/28/2016] [Indexed: 01/02/2023]
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152
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Cabrera EA, Wiers CE, Lindgren E, Miller G, Volkow ND, Wang GJ. Neuroimaging the Effectiveness of Substance Use Disorder Treatments. J Neuroimmune Pharmacol 2016; 11:408-33. [PMID: 27184387 DOI: 10.1007/s11481-016-9680-y] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2016] [Accepted: 04/26/2016] [Indexed: 12/18/2022]
Abstract
Neuroimaging techniques to measure the function and biochemistry of the human brain such as positron emission tomography (PET), proton magnetic resonance spectroscopy ((1)H MRS), and functional magnetic resonance imaging (fMRI), are powerful tools for assessing neurobiological mechanisms underlying the response to treatments in substance use disorders. Here, we review the neuroimaging literature on pharmacological and behavioral treatment in substance use disorder. We focus on neural effects of medications that reduce craving (e.g., naltrexone, bupropion hydrochloride, baclofen, methadone, varenicline) and that improve cognitive control (e.g., modafinil, N-acetylcysteine), of behavioral treatments for substance use disorders (e.g., cognitive bias modification training, virtual reality, motivational interventions) and neuromodulatory interventions such as neurofeedback and transcranial magnetic stimulation. A consistent finding for the effectiveness of therapeutic interventions identifies the improvement of executive control networks and the dampening of limbic activation, highlighting their values as targets for therapeutic interventions in substance use disorders.
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Affiliation(s)
- Elizabeth A Cabrera
- National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD, USA.
| | - Corinde E Wiers
- National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD, USA
| | - Elsa Lindgren
- National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD, USA
| | - Gregg Miller
- National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD, USA
| | - Nora D Volkow
- National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD, USA
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD, USA
| | - Gene-Jack Wang
- National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD, USA
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153
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Koob GF, Volkow ND. Neurobiology of addiction: a neurocircuitry analysis. Lancet Psychiatry 2016; 3:760-773. [PMID: 27475769 PMCID: PMC6135092 DOI: 10.1016/s2215-0366(16)00104-8] [Citation(s) in RCA: 1752] [Impact Index Per Article: 219.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Revised: 03/09/2016] [Accepted: 03/11/2016] [Indexed: 12/17/2022]
Abstract
Drug addiction represents a dramatic dysregulation of motivational circuits that is caused by a combination of exaggerated incentive salience and habit formation, reward deficits and stress surfeits, and compromised executive function in three stages. The rewarding effects of drugs of abuse, development of incentive salience, and development of drug-seeking habits in the binge/intoxication stage involve changes in dopamine and opioid peptides in the basal ganglia. The increases in negative emotional states and dysphoric and stress-like responses in the withdrawal/negative affect stage involve decreases in the function of the dopamine component of the reward system and recruitment of brain stress neurotransmitters, such as corticotropin-releasing factor and dynorphin, in the neurocircuitry of the extended amygdala. The craving and deficits in executive function in the so-called preoccupation/anticipation stage involve the dysregulation of key afferent projections from the prefrontal cortex and insula, including glutamate, to the basal ganglia and extended amygdala. Molecular genetic studies have identified transduction and transcription factors that act in neurocircuitry associated with the development and maintenance of addiction that might mediate initial vulnerability, maintenance, and relapse associated with addiction.
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Affiliation(s)
- George F Koob
- National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Rockville, MD, USA.
| | - Nora D Volkow
- National Institute on Drug Abuse, National Institutes of Health, Rockville, MD, USA
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154
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Falcone M, Cao W, Bernardo L, Tyndale RF, Loughead J, Lerman C. Brain Responses to Smoking Cues Differ Based on Nicotine Metabolism Rate. Biol Psychiatry 2016; 80:190-7. [PMID: 26805583 PMCID: PMC5625335 DOI: 10.1016/j.biopsych.2015.11.015] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2015] [Revised: 10/22/2015] [Accepted: 11/18/2015] [Indexed: 12/17/2022]
Abstract
BACKGROUND Inherited differences in the rate of metabolism of nicotine, the addictive chemical in tobacco, affect smoking behavior and quitting success. The nicotine metabolite ratio (3'-hydroxycotinine/cotinine) is a reliable measure of nicotine clearance and a well-validated predictive biomarker of response to pharmacotherapy. To clarify the mechanisms underlying these associations, we investigated the neural responses to smoking cues in normal and slow nicotine metabolizers. METHODS Treatment-seeking smokers (N = 69; 30 slow metabolizers and 39 normal metabolizers) completed a visual cue reactivity task during functional magnetic resonance imaging on two separate occasions: once during smoking satiety and once after 24 hours of smoking abstinence. RESULTS In whole-brain analysis, normal (compared with slow) metabolizers exhibited heightened abstinence-induced neural responses to smoking cues in the left caudate, left inferior frontal gyrus, and left frontal pole. These effects were more pronounced when extreme groups of slow and normal metabolizers were examined. Greater activation in the left caudate and left frontal pole was associated with abstinence-induced subjective cravings to smoke. CONCLUSIONS Inherited differences in rate of nicotine elimination may drive neural responses to smoking cues during early abstinence, providing a plausible mechanism to explain differences in smoking behaviors and response to cessation treatment. Normal metabolizers may benefit from adjunctive behavioral smoking cessation treatments, such as cue exposure therapy.
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Affiliation(s)
- Mary Falcone
- Center for Interdisciplinary Research on Nicotine Addiction, Department of Psychiatry, University of Pennsylvania, 3535 Market Street, Suite 4100, Philadelphia, PA 19104
| | - Wen Cao
- Center for Interdisciplinary Research on Nicotine Addiction, Department of Psychiatry, University of Pennsylvania, 3535 Market Street, Suite 4100, Philadelphia, PA 19104
| | - Leah Bernardo
- Center for Interdisciplinary Research on Nicotine Addiction, Department of Psychiatry, University of Pennsylvania, 3535 Market Street, Suite 4100, Philadelphia, PA 19104
| | - Rachel F Tyndale
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health and Departments of Psychiatry, and Pharmacology & Toxicology, University of Toronto, Canada M5S 1A8
| | - James Loughead
- Center for Interdisciplinary Research on Nicotine Addiction, Department of Psychiatry, University of Pennsylvania, 3535 Market Street, Suite 4100, Philadelphia, PA 19104
| | - Caryn Lerman
- Center for Interdisciplinary Research on Nicotine Addiction, Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania.
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155
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Li Y, Yuan K, Guan Y, Cheng J, Bi Y, Shi S, Xue T, Lu X, Qin W, Yu D, Tian J. The implication of salience network abnormalities in young male adult smokers. Brain Imaging Behav 2016; 11:943-953. [DOI: 10.1007/s11682-016-9568-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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156
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Parvaz MA, Moeller SJ, Malaker P, Sinha R, Alia-Klein N, Goldstein RZ. Abstinence reverses EEG-indexed attention bias between drug-related and pleasant stimuli in cocaine-addicted individuals. J Psychiatry Neurosci 2016; 41:150358. [PMID: 27434467 PMCID: PMC5373704 DOI: 10.1503/jpn.150358] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Revised: 03/15/2016] [Accepted: 04/19/2016] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND Increased attention bias toward drug-related cues over non-drug-related intrinsically pleasant reinforcers is a hallmark of drug addiction. In this study we used the late positive potential (LPP) to investigate whether such increased attention bias toward drug-related relative to non-drug-related cues changes over a protracted period of reduced drug use in treatment-seeking individuals with a cocaine use disorder (CUD). METHODS Treatment-seeking individuals with CUD and matched healthy controls passively viewed a series of pleasant, neutral and drug-related pictures while their event-related potentials were recorded at baseline (≤ 3 weeks after treatment initiation) and at 6-month follow-up (only CUD). RESULTS We included 19 treatment-seeking individuals with CUD and 18 matched controls in our analyses. The results showed a reversal in attention bias (i.e., LPP amplitude) from baseline (i.e., drug > pleasant) to follow-up (i.e., pleasant > drug) driven by an increased attentional engagement with pleasant pictures; this LPP reversal was paralleled by a concomitant reduction in self-reported wanting and craving for cocaine in the CUD group. Furthermore, reduced attention bias toward drug-related cues (relative to pleasant cues) was correlated with longer duration of abstinence at baseline, and the extent of its longitudinal reversal was correlated with decreased craving at follow-up, providing support for abstinence as a putative mechanism of this bottom-up attentional change. LIMITATIONS A limited sample size and the use of the same set of pictures at baseline and follow-up were the major limitations of this study. CONCLUSION Results collectively indicate that, by tracking with drug abstinence, LPP in response to drug-related relative to pleasant cues may serve as an indicator of clinical progress in treatment-seeking individuals with CUD.
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Affiliation(s)
- Muhammad A. Parvaz
- From the Icahn School of Medicine, Mount Sinai, New York, NY, USA (Parvaz, Moeller, Malaker, Alia-Klein, Goldstein); and Yale University School of Medicine, New Haven, Conn., USA (Sinha)
| | - Scott J. Moeller
- From the Icahn School of Medicine, Mount Sinai, New York, NY, USA (Parvaz, Moeller, Malaker, Alia-Klein, Goldstein); and Yale University School of Medicine, New Haven, Conn., USA (Sinha)
| | - Pias Malaker
- From the Icahn School of Medicine, Mount Sinai, New York, NY, USA (Parvaz, Moeller, Malaker, Alia-Klein, Goldstein); and Yale University School of Medicine, New Haven, Conn., USA (Sinha)
| | - Rajita Sinha
- From the Icahn School of Medicine, Mount Sinai, New York, NY, USA (Parvaz, Moeller, Malaker, Alia-Klein, Goldstein); and Yale University School of Medicine, New Haven, Conn., USA (Sinha)
| | - Nelly Alia-Klein
- From the Icahn School of Medicine, Mount Sinai, New York, NY, USA (Parvaz, Moeller, Malaker, Alia-Klein, Goldstein); and Yale University School of Medicine, New Haven, Conn., USA (Sinha)
| | - Rita Z. Goldstein
- From the Icahn School of Medicine, Mount Sinai, New York, NY, USA (Parvaz, Moeller, Malaker, Alia-Klein, Goldstein); and Yale University School of Medicine, New Haven, Conn., USA (Sinha)
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157
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Ashare RL, Lerman C, Cao W, Falcone M, Bernardo L, Ruparel K, Hopson R, Gur R, Pruessner JC, Loughead J. Nicotine withdrawal alters neural responses to psychosocial stress. Psychopharmacology (Berl) 2016; 233:2459-67. [PMID: 27087432 PMCID: PMC4907902 DOI: 10.1007/s00213-016-4299-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2016] [Accepted: 04/04/2016] [Indexed: 12/18/2022]
Abstract
INTRODUCTION Psychosocial stress is considered to be an important mechanism underlying smoking behavior and relapse. Thus, understanding the effects of acute nicotine withdrawal on responses to stress is important to intervene to prevent stress-induced relapse. The current study investigated the neural correlates of psychosocial stress during acute nicotine withdrawal in chronic smokers. METHODS Thirty-nine treatment-seeking smokers were randomized to one of two conditions (abstinent 24 h (n = 21) or smoking as usual (n = 18)). They were then exposed to the Montreal Imaging Stress Task (MIST), a psychosocial stress task consisting of difficult mental arithmetic problems while receiving negative performance feedback while undergoing functional magnetic resonance imaging (fMRI). RESULTS Subjective measures of stress increased following the MIST, compared to baseline. Whole brain between-group analysis identified significant activation clusters in four regions for the stress induction minus control contrast: inferior frontal gyrus (IFG), anterior/para cingulate cortex (ACC), precuneus, and supramarginal gyrus (SMG). In all regions, the deprived group showed significantly greater activation compared to the non-deprived group. No significant correlations were found between subjective stress and BOLD signal activation (ps > 0.07). CONCLUSIONS This study provides new evidence that brain regions previously shown to be predictive of relapse, such as the precuneus and IFG, display heightened neural responses to stress during nicotine deprivation. These data identify the brain regions that may be associated with withdrawal-related stress responses. Increased stress-related activation during nicotine withdrawal may identify those most vulnerable to relapse and represent a target for novel pharmacological intervention.
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Affiliation(s)
- Rebecca L Ashare
- Center for Interdisciplinary Research on Nicotine Addiction, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3535 Market St., Suite 4100, Philadelphia, PA, 19104, USA.
| | - Caryn Lerman
- Center for Interdisciplinary Research on Nicotine Addiction, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3535 Market St., Suite 4100, Philadelphia, PA, 19104, USA
| | - Wen Cao
- Center for Interdisciplinary Research on Nicotine Addiction, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3535 Market St., Suite 4100, Philadelphia, PA, 19104, USA
| | - Mary Falcone
- Center for Interdisciplinary Research on Nicotine Addiction, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3535 Market St., Suite 4100, Philadelphia, PA, 19104, USA
| | - Leah Bernardo
- Center for Interdisciplinary Research on Nicotine Addiction, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3535 Market St., Suite 4100, Philadelphia, PA, 19104, USA
| | - Kosha Ruparel
- Brain Behavior Laboratory, Neuropsychiatry Department, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - Ryan Hopson
- Brain Behavior Laboratory, Neuropsychiatry Department, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - Ruben Gur
- Brain Behavior Laboratory, Neuropsychiatry Department, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - Jens C Pruessner
- Departments of Psychology, Psychiatry, Neurology and Neurosurgery, Douglas Institute, McGill University, Montreal, Quebec, Canada
| | - James Loughead
- Center for Interdisciplinary Research on Nicotine Addiction, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3535 Market St., Suite 4100, Philadelphia, PA, 19104, USA
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158
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The first day is always the hardest: Functional connectivity during cue exposure and the ability to resist smoking in the initial hours of a quit attempt. Neuroimage 2016; 151:24-32. [PMID: 26975550 DOI: 10.1016/j.neuroimage.2016.03.015] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2015] [Revised: 02/25/2016] [Accepted: 03/04/2016] [Indexed: 12/29/2022] Open
Abstract
Quitting smoking is the single best change in behavior that smokers can make to improve their health and extend their lives. Although most smokers express a strong desire to stop using cigarettes, the vast majority of quit attempts end in relapse. Relapse is particularly likely when smokers encounter cigarette cues. A striking number of relapses occur very quickly, with many occurring within as little as 24h. Characterizing what distinguishes successful quit attempts from unsuccessful ones, particularly just after cessation is initiated, is a research priority. We addressed this significant issue by examining the association between functional connectivity during cigarette cue exposure and smoking behavior during the first 24h of a quit attempt. Functional MRI was used to measure brain activity during cue exposure in nicotine-deprived daily smokers during the first day of a quit attempt. Participants were then given the opportunity to smoke. Using data collected in two parent studies, we identified a subset of participants who chose to smoke and a matched subset who declined (n=38). Smokers who were able to resist smoking displayed significant functional connectivity between the left anterior insula and the dorsolateral prefrontal cortex, whereas there was no such connectivity for those who chose to smoke. Notably, there were no differences in mean levels of activation in brain regions of interest, underscoring the importance of assessing interregional connectivity when investigating the links between cue-related neural responses and overt behavior. To our knowledge, this is the first study to link patterns of functional connectivity and actual cigarette use during the pivotal first hours of attempt to change smoking behavior.
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159
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Blunted striatal response to monetary reward anticipation during smoking abstinence predicts lapse during a contingency-managed quit attempt. Psychopharmacology (Berl) 2016; 233:751-60. [PMID: 26660448 PMCID: PMC5330670 DOI: 10.1007/s00213-015-4152-2] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Accepted: 11/10/2015] [Indexed: 10/22/2022]
Abstract
RATIONALE Tobacco smoking is associated with dysregulated reward processing within the striatum, characterized by hypersensitivity to smoking rewards and hyposensitivity to non-smoking rewards. This bias toward smoking reward at the expense of alternative rewards is further exacerbated by deprivation from smoking, which may contribute to difficulty maintaining abstinence during a quit attempt. OBJECTIVE We examined whether abstinence-induced changes in striatal processing of rewards predicted lapse likelihood during a quit attempt supported by contingency management (CM), in which abstinence from smoking was reinforced with money. METHODS Thirty-six non-treatment-seeking smokers participated in two functional MRI (fMRI) sessions, one following 24-h abstinence and one following smoking as usual. During each scan, participants completed a rewarded guessing task designed to elicit striatal activation in which they could earn smoking and monetary rewards delivered after the scan. Participants then engaged in a 3-week CM-supported quit attempt. RESULTS As previously reported, 24-h abstinence was associated with increased striatal activation in anticipation of smoking reward and decreased activation in anticipation of monetary reward. Individuals exhibiting greater decrements in right striatal activation to monetary reward during abstinence (controlling for activation during non-abstinence) were more likely to lapse during CM (p < 0.025), even when controlling for other predictors of lapse outcome (e.g., craving); no association was seen for smoking reward. CONCLUSIONS These results are consistent with a growing number of studies indicating the specific importance of disrupted striatal processing of non-drug reward in nicotine dependence and highlight the importance of individual differences in abstinence-induced deficits in striatal function for smoking cessation.
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160
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Schulte EM, Grilo CM, Gearhardt AN. Shared and unique mechanisms underlying binge eating disorder and addictive disorders. Clin Psychol Rev 2016; 44:125-139. [PMID: 26879210 PMCID: PMC5796407 DOI: 10.1016/j.cpr.2016.02.001] [Citation(s) in RCA: 149] [Impact Index Per Article: 18.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2015] [Revised: 01/28/2016] [Accepted: 02/01/2016] [Indexed: 12/23/2022]
Abstract
Scientific interest in "food addiction" is growing, but the topic remains controversial. One critique of "food addiction" is its high degree of phenotypic overlap with binge eating disorder (BED). In order to examine associations between problematic eating behaviors, such as binge eating and "food addiction," we propose the need to move past examining similarities and differences in symptomology. Instead, focusing on relevant mechanisms may more effectively determine whether "food addiction" contributes to disordered eating behavior for some individuals. This paper reviews the evidence for mechanisms that are shared (i.e., reward dysfunction, impulsivity) and unique for addiction (i.e., withdrawal, tolerance) and eating disorder (i.e., dietary restraint, shape/weight concern) frameworks. This review will provide a guiding framework to outline future areas of research needed to evaluate the validity of the "food addiction" model and to understand its potential contribution to disordered eating.
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Affiliation(s)
- Erica M Schulte
- Department of Psychology, University of Michigan, Ann Arbor, MI, United States.
| | - Carlos M Grilo
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States; Department of Psychology, Yale University, New Haven, CT, United States; CASAColumbia, Yale University, New Haven, CT, United States
| | - Ashley N Gearhardt
- Department of Psychology, University of Michigan, Ann Arbor, MI, United States
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161
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Altered resting state functional connectivity of anterior insula in young smokers. Brain Imaging Behav 2016; 11:155-165. [DOI: 10.1007/s11682-016-9511-z] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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162
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Hippocampal and Insular Response to Smoking-Related Environments: Neuroimaging Evidence for Drug-Context Effects in Nicotine Dependence. Neuropsychopharmacology 2016; 41:877-85. [PMID: 26179147 PMCID: PMC4707833 DOI: 10.1038/npp.2015.214] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2015] [Revised: 06/12/2015] [Accepted: 07/01/2015] [Indexed: 02/05/2023]
Abstract
Environments associated with prior drug use provoke craving and drug taking, and set the stage for lapse/relapse. Although the neurobehavioral bases of environment-induced drug taking have been investigated with animal models, the influence of drug-environments on brain function and behavior in clinical populations of substance users is largely unexplored. Adult smokers (n=40) photographed locations personally associated with smoking (personal smoking environments; PSEs) or personal nonsmoking environment (PNEs). Following 24-h abstinence, participants underwent fMRI scanning while viewing PSEs, PNEs, standard smoking and nonsmoking environments, as well as proximal smoking (eg, lit cigarette) and nonsmoking (eg, pencil) cues. Finally, in two separate sessions following 6-h abstinence they viewed either PSEs or PNEs while cue-induced self-reported craving and smoking behavior were assessed. Viewing PSEs increased blood oxygen level-dependent signal in right posterior hippocampus (pHPC; F(2,685)=3.74, p<0.024) and bilateral insula (left: F(2,685)=6.87, p=0.0011; right: F(2,685)=5.34, p=0.005). In the laboratory, viewing PSEs, compared with PNEs, was associated with higher craving levels (F(2,180)=18.32, p<0.0001) and greater ad lib smoking (F(1,36)=5.01, p=0.032). The effect of PSEs (minus PNEs) on brain activation in right insula was positively correlated with the effect of PSEs (minus PNEs) on number of puffs taken from a cigarette (r=0.6, p=0.001). Our data, for the first time in humans, elucidates the neural mechanisms that mediate the effects of real-world drug-associated environments on drug taking behavior under conditions of drug abstinence. These findings establish targets for the development and evaluation of treatments seeking to reduce environment provoked relapse.
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163
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Dias NR, Peechatka AL, Janes AC. Insula reactivity to negative stimuli is associated with daily cigarette use: A preliminary investigation using the Human Connectome Database. Drug Alcohol Depend 2016; 159:277-80. [PMID: 26748411 PMCID: PMC4724488 DOI: 10.1016/j.drugalcdep.2015.12.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2015] [Revised: 12/14/2015] [Accepted: 12/14/2015] [Indexed: 01/29/2023]
Abstract
BACKGROUND Individuals who smoke more cigarettes per day are at greater risk for developing smoking-related illness and have more difficulty quitting. Withdrawal-related negative mood is one factor thought to motivate drug use. However, heavy smokers are generally more sensitive to negative affect, not just negative emotion stemming from withdrawal. One possibility is that individual differences in how the brain processes negative stimuli may impact smoking use. Given the wealth of data implicating the insula in nicotine dependence and affective processing we hypothesize that the number of cigarettes an individual smokes per day will relate to insula reactivity to negative stimuli. METHODS A functional magnetic resonance imaging (fMRI) emotional processing task collected by the Human Connectome Project was assessed in 21 daily tobacco smokers who reported smoking between 5 and 20 cigarettes per day. The number of cigarettes smoked per day was correlated with right and left anterior insula reactivity to faces expressing a negative emotion relative to a control. This anterior insula region of interest has been associated with treatment outcome and smoking cue-reactivity in our prior work. RESULTS Those who smoked more daily cigarettes showed greater right insula reactivity to negative stimuli (r=0.564, p=0.008). Left insula reactivity was not associated with cigarettes smoked per day. CONCLUSION Smokers who use more cigarettes per day have greater insula reactivity to negative stimuli, furthering the field's understanding of the insula's involvement in nicotine use. This preliminary work also suggests a mechanism contributing to higher rates of daily smoking.
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Affiliation(s)
- NR Dias
- McLean Neuroimaging Center, McLean Hospital, Belmont, MA, USA,Department of Psychiatry, Harvard Medical School, Belmont, MA, USA
| | - AL Peechatka
- McLean Neuroimaging Center, McLean Hospital, Belmont, MA, USA,Suffolk University, Boston, MA, USA
| | - AC Janes
- McLean Neuroimaging Center, McLean Hospital, Belmont, MA, USA,Department of Psychiatry, Harvard Medical School, Belmont, MA, USA,Corresponding author at: McLean Neuroimaging Center, McLean Hospital, 115 Mill St. Belmont, MA 02478.
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164
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Vingerhoets WAM, Koenders L, van den Brink W, Wiers RW, Goudriaan AE, van Amelsvoort T, de Haan L, Cousijn J. Cue-induced striatal activity in frequent cannabis users independently predicts cannabis problem severity three years later. J Psychopharmacol 2016; 30:152-8. [PMID: 26645206 DOI: 10.1177/0269881115620436] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Cannabis is the most frequently used illicit drug worldwide, but little is known about the mechanisms underlying continued cannabis use. Cue-reactivity (the physical, psychological, behavioural and neural reaction to substance-related cues) might be related to continued cannabis use. In this 3-year prospective neuroimaging study we investigated whether cannabis cue-induced brain activity predicted continued cannabis use and associated problem severity 3 years later. In addition, baseline brain activations were compared between dependent and non-dependent cannabis users at follow-up. Analyses were focussed on brain areas known to be important in cannabis cue-reactivity: anterior cingulate cortex, orbitofrontal cortex, ventral tegmental area, amygdala and striatum. At baseline, 31 treatment-naive frequent cannabis users performed a cue-reactivity functional magnetic resonance imaging task. Of these participants, 23 completed the 3-year follow-up. None of the cue-induced region of interest activations predicted the amount of cannabis use at follow-up. However, cue-induced activation in the left striatum (putamen) significantly and independently predicted problem severity at follow-up (p < 0.001) as assessed with the Cannabis Use Disorder Identification Test. Also, clinically dependent cannabis users at follow-up showed higher baseline activation at trend level in the left striatum compared with non-dependent users. This indicates that neural cue-reactivity in the dorsal striatum is an independent predictor of cannabis use-related problems. Given the relatively small sample size, these results are preliminary and should be replicated in larger samples of cannabis users.
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Affiliation(s)
- W A M Vingerhoets
- Department of Psychiatry and Psychology, Maastricht University, Maastricht, the Netherlands Department of Nuclear Medicine, Academic Medical Centre, University of Amsterdam, Amsterdam, the Netherlands
| | - L Koenders
- Department of Psychiatry, Academic Medical Centre, University of Amsterdam, Amsterdam, the Netherlands
| | - W van den Brink
- Department of Psychiatry, Academic Medical Centre, University of Amsterdam, Amsterdam, the Netherlands
| | - R W Wiers
- Addiction, Development and Psychopathology (ADAPT) lab, Department of Developmental Psychology, University of Amsterdam, Amsterdam, the Netherlands
| | - A E Goudriaan
- Department of Psychiatry, Academic Medical Centre, University of Amsterdam, Amsterdam, the Netherlands Arkin Mental Health Care, Amsterdam, the Netherlands
| | - T van Amelsvoort
- Department of Psychiatry and Psychology, Maastricht University, Maastricht, the Netherlands
| | - L de Haan
- Department of Psychiatry, Academic Medical Centre, University of Amsterdam, Amsterdam, the Netherlands
| | - J Cousijn
- Department of Psychiatry, Academic Medical Centre, University of Amsterdam, Amsterdam, the Netherlands Addiction, Development and Psychopathology (ADAPT) lab, Department of Developmental Psychology, University of Amsterdam, Amsterdam, the Netherlands Department of Developmental and Experimental Psychology, Utrecht University, Utrecht, the Netherlands
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165
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Le Foll B. What does addiction medicine expect from neuroscience? From genes and neurons to treatment responses. PROGRESS IN BRAIN RESEARCH 2016; 224:419-47. [DOI: 10.1016/bs.pbr.2015.11.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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Luijten M, Kleinjan M, Franken IHA. Event-related potentials reflecting smoking cue reactivity and cognitive control as predictors of smoking relapse and resumption. Psychopharmacology (Berl) 2016; 233:2857-68. [PMID: 27277662 PMCID: PMC4933734 DOI: 10.1007/s00213-016-4332-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2016] [Accepted: 05/09/2016] [Indexed: 12/11/2022]
Abstract
RATIONALE Given that most attempts to quit smoking fail, it is critical to increase knowledge about the mechanisms involved in smoking relapse and resumption (i.e., the increase in smoking over time after a quit attempt). Neurocognitive measures, such as event-related potentials (ERPs), may provide novel insights into smoking relapse and resumption. OBJECTIVES The objective of the present study is to investigate the association between smoking relapse and resumption and ERPs reflecting smoking cue reactivity (i.e., P300, LPP), inhibitory control (i.e., N2, P3), and error processing (i.e., error-related negativity (ERN), Pe). METHODS Seventy-two smokers viewed smoking and neutral pictures and performed a Go-NoGo and an Eriksen Flanker task, while ERPs were measured using electroencephalography. All smokers started a quit attempt in the week following the laboratory visit. Smoking behavior after the quit attempt was measured at 4, 8, and 12 weeks. Both relapse (i.e., 7-day point prevalence at 12 weeks) and smoking resumption (i.e., the number of cigarettes a day at 4, 8, and 12 weeks) were used as outcome measures. RESULTS Logistic regression analyses showed that smaller P3 amplitudes, reflecting brain activation associated with inhibitory control, are related to an increased relapse risk. Latent growth curve analyses showed that reduced post-error slowing, the main behavioral measure reflecting error processing, is associated with stronger smoking resumption. ERPs reflecting smoking cue reactivity were unrelated to smoking relapse or resumption. CONCLUSIONS The finding that smaller inhibitory control-related P3 amplitudes are associated with increased relapse risks suggests that strategies to increase inhibitory control in smokers are worth further investigation in the search for more effective smoking cessation interventions.
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Affiliation(s)
- Maartje Luijten
- Behavioural Science Institute, Radboud University, P.O. Box 9104, 6500, HE, Nijmegen, The Netherlands.
- Institute of Psychology, Erasmus University Rotterdam, P.O. Box 1738, 3000, DR, Rotterdam, The Netherlands.
| | - Marloes Kleinjan
- Trimbos Institute (Netherlands Institute of Mental Health and Addiction), P.O. Box 725, 3500, AS, Utrecht, The Netherlands
| | - Ingmar H A Franken
- Institute of Psychology, Erasmus University Rotterdam, P.O. Box 1738, 3000, DR, Rotterdam, The Netherlands
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167
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Courtney KE, Schacht JP, Hutchison K, Roche DJO, Ray LA. Neural substrates of cue reactivity: association with treatment outcomes and relapse. Addict Biol 2016; 21:3-22. [PMID: 26435524 DOI: 10.1111/adb.12314] [Citation(s) in RCA: 155] [Impact Index Per Article: 19.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2015] [Revised: 07/26/2015] [Accepted: 08/27/2015] [Indexed: 12/18/2022]
Abstract
Given the strong evidence for neurological alterations at the basis of drug dependence, functional magnetic resonance imaging (fMRI) represents an important tool in the clinical neuroscience of addiction. fMRI cue-reactivity paradigms represent an ideal platform to probe the involvement of neurobiological pathways subserving the reward/motivation system in addiction and potentially offer a translational mechanism by which interventions and behavioral predictions can be tested. Thus, this review summarizes the research that has applied fMRI cue-reactivity paradigms to the study of adult substance use disorder treatment responses. Studies utilizing fMRI cue-reactivity paradigms for the prediction of relapse and as a means to investigate psychosocial and pharmacological treatment effects on cue-elicited brain activation are presented within four primary categories of substances: alcohol, nicotine, cocaine and opioids. Lastly, suggestions for how to leverage fMRI technology to advance addiction science and treatment development are provided.
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Affiliation(s)
- Kelly E. Courtney
- Department of Psychology; University of California; Los Angeles CA USA
| | - Joseph P. Schacht
- Department of Psychiatry and Behavioral Sciences; Medical University of South Carolina; Charleston SC USA
| | - Kent Hutchison
- Department of Psychology and Neuroscience; University of Colorado at Boulder; Boulder CO USA
| | | | - Lara A. Ray
- Department of Psychology; University of California; Los Angeles CA USA
- Department of Psychiatry and Biobehavioral Sciences; University of California; Los Angeles CA USA
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168
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Campanella S. Neurocognitive rehabilitation for addiction medicine. PROGRESS IN BRAIN RESEARCH 2016; 224:85-103. [DOI: 10.1016/bs.pbr.2015.07.014] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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169
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Hartwell KJ, Hanlon CA, Li X, Borckardt JJ, Canterberry M, Prisciandaro JJ, Moran-Santa Maria MM, LeMatty T, George MS, Brady KT. Individualized real-time fMRI neurofeedback to attenuate craving in nicotine-dependent smokers. J Psychiatry Neurosci 2016; 41:48-55. [PMID: 26505139 PMCID: PMC4688028 DOI: 10.1503/jpn.140200] [Citation(s) in RCA: 67] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND Cue-induced craving plays an important role in relapse, and the neural correlates of cue-induced craving have been elucidated using fMRI. This study examined the utility of real-time fMRI (rtfMRI) neurofeedback to strengthen self-regulation of craving-related neural activation and cue-reactivity in cigarette smokers. METHODS Nicotine-dependent smokers were randomized to rtfMRI neurofeedback or to a no-feedback control group. Participants completed 3 neuroimaging visits. Within each visit, an initial run during which smoking-related cues were used to provoke craving, an individualized craving-related region of interest (ROI) in the prefrontal cortex or anterior cingulate cortex was identified. In the rtfMRI group, activity from the ROI was fed back via a visual display during 3 subsequent runs while participants were instructed to reduce craving during cue exposure. The control group had an identical experience with no feedback provided. RESULTS Forty-four nicotine-dependent smokers were recruited to participate in our study; data from the 33 participants who completed a 1-week follow-up visit were included in the analysis. Subjective craving ratings and cue-induced brain activation were lower in the rtfMRI group than in the control group. LIMITATIONS As participants were not seeking treatment, clinical outcomes are lacking. CONCLUSION Nicotine-dependent smokers receiving rtfMRI feedback from an individualized ROI attenuated smoking cue-elicited neural activation and craving, relative to a control group. Further studies are needed in treatment-seeking smokers to determine if this intervention can translate into a clinically meaningful treatment modality.
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Affiliation(s)
- Karen J. Hartwell
- Correspondence to: K.J. Hartwell, 125 Doughty St, Suite 190, Charleston, SC 29403;
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170
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Neuroscience of resilience and vulnerability for addiction medicine. PROGRESS IN BRAIN RESEARCH 2016; 223:3-18. [DOI: 10.1016/bs.pbr.2015.09.004] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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171
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Neuroscience of drug craving for addiction medicine: From circuits to therapies. PROGRESS IN BRAIN RESEARCH 2015; 223:115-41. [PMID: 26806774 DOI: 10.1016/bs.pbr.2015.10.002] [Citation(s) in RCA: 80] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Drug craving is a dynamic neurocognitive emotional-motivational response to a wide range of cues, from internal to external environments and from drug-related to stressful or affective events. The subjective feeling of craving, as an appetitive or compulsive state, could be considered a part of this multidimensional process, with modules in different levels of consciousness and embodiment. The neural correspondence of this dynamic and complex phenomenon may be productively investigated in relation to regional, small-scale networks, large-scale networks, and brain states. Within cognitive neuroscience, this approach has provided a long list of neural and cognitive targets for craving modulations with different cognitive, electrical, or pharmacological interventions. There are new opportunities to integrate different approaches for carving management from environmental, behavioral, psychosocial, cognitive, and neural perspectives. By using cognitive neuroscience models that treat drug craving as a dynamic and multidimensional process, these approaches may yield more effective interventions for addiction medicine.
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172
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Jansen JM, van Wingen G, van den Brink W, Goudriaan AE. Resting state connectivity in alcohol dependent patients and the effect of repetitive transcranial magnetic stimulation. Eur Neuropsychopharmacol 2015; 25:2230-9. [PMID: 26481907 DOI: 10.1016/j.euroneuro.2015.09.019] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2015] [Revised: 07/13/2015] [Accepted: 09/28/2015] [Indexed: 01/15/2023]
Abstract
Alcohol dependence is thought to result from an overactive neural motivation system and a deficient cognitive control system, and rebalancing these systems may mitigate excessive alcohol use. This study examines the differences in functional connectivity of the fronto-parietal cognitive control network (FPn) and the motivational network (striatum and orbitofrontal cortex) between alcohol dependent patients (ADPs) and healthy controls (HCs), and the effect of repetitive transcranial magnetic stimulation (rTMS) on these networks. This randomized controlled trial included 38 ADPs and 37 HCs, matched on age, gender and education. Participants were randomly assigned to sham or right dorsolateral prefrontal cortex (dlPFC) stimulation with rTMS. A 3T resting state functional Magnetic Resonance Imaging (fMRI) scan was acquired before and after active or sham 10Hz rTMS. Group differences of within and between network connectivity and the effect of rTMS on network connectivity was assessed using independent component analysis. Results showed higher connectivity within the left FPn (p=0.012) and the left fronto-striatal motivational network (p=0.03) in ADPs versus HCs, and a further increase in connectivity within the left FPn after active stimulation in ADPs. ADPs also showed higher connectivity between the left and the right FPns (p=0.025), and this higher connectivity was related to fewer alcohol related problems (r=0.30, p=0.06). The results show higher within and between network connectivity in ADPs and a further increase in fronto-parietal connectivity after right dlPFC rTMS in ADPs, suggesting that frontal rTMS may have a beneficial influence on cognitive control and may result in lower relapse rates.
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Affiliation(s)
- Jochem M Jansen
- Academic Medical Centre (AMC), Department of Psychiatry, University of Amsterdam, Amsterdam, The Netherlands; Amsterdam Institute for Addiction Research, University of Amsterdam, Amsterdam, The Netherlands.
| | - Guido van Wingen
- Academic Medical Centre (AMC), Department of Psychiatry, University of Amsterdam, Amsterdam, The Netherlands.
| | - Wim van den Brink
- Academic Medical Centre (AMC), Department of Psychiatry, University of Amsterdam, Amsterdam, The Netherlands; Amsterdam Institute for Addiction Research, University of Amsterdam, Amsterdam, The Netherlands.
| | - Anna E Goudriaan
- Academic Medical Centre (AMC), Department of Psychiatry, University of Amsterdam, Amsterdam, The Netherlands; Amsterdam Institute for Addiction Research, University of Amsterdam, Amsterdam, The Netherlands; Arkin Mental Health, Amsterdam, The Netherlands.
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173
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Fadardi JS, Cox WM, Rahmani A. Neuroscience of attentional processes for addiction medicine: from brain mechanisms to practical considerations. PROGRESS IN BRAIN RESEARCH 2015; 223:77-89. [PMID: 26806772 DOI: 10.1016/bs.pbr.2015.08.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The present chapter first argues how having a goal for procuring alcohol or other substances leads to the development of a time-binding, dynamic, and goal oriented motivational state termed current concern, as the origin of substance-related attentional bias. Next, it discusses the importance of attentional bias in the development, continuation of, and relapsing to substance abuse. It further proceeds with a review of selective evidence from cognitive psychology that helps account for making decisions about using an addictive substance or refraining from using it. A discussion on the various brain loci that are involved in attentional bias and other kinds of cue reactivity is followed by presenting findings from neurocognitive research. Finally, from an interdisciplinary perspective, the chapter presents new trends and ideas that can be applied to addiction-related cognitive measurement and training.
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Affiliation(s)
- Javad Salehi Fadardi
- Ferdowsi University of Mashhad, Mashhad, Iran; Bangor University, Bangor, UK; Addiction Research Centre, Mashhad University of Medical Sciences, Mashhad, Iran.
| | | | - Arash Rahmani
- Iranian National Center for Addiction Studies, Tehran University of Medical Sciences, Tehran, Iran
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174
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Cognitive interventions for addiction medicine: Understanding the underlying neurobiological mechanisms. PROGRESS IN BRAIN RESEARCH 2015; 224:285-304. [PMID: 26822363 DOI: 10.1016/bs.pbr.2015.07.019] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Neuroimaging provides a tool for investigating the neurobiological mechanisms of cognitive interventions in addiction. The aim of this review was to describe the brain circuits that are recruited during cognitive interventions, examining differences between various treatment modalities while highlighting core mechanisms, in drug addicted individuals. Based on a systematic Medline search we reviewed neuroimaging studies on cognitive behavioral therapy, cognitive inhibition of craving, motivational interventions, emotion regulation, mindfulness, and neurofeedback training in addiction. Across intervention modalities, common results included the normalization of aberrant activity in the brain's reward circuitry, and the recruitment and strengthening of the brain's inhibitory control network. Results suggest that different cognitive interventions act, at least partly, through recruitment of a common inhibitory control network as a core mechanism. This implies potential transfer effects between training modalities. Overall, results confirm that chronically hypoactive prefrontal regions implicated in cognitive control in addiction can be normalized through cognitive means.
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175
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The effects of N-Acetylcysteine on frontostriatal resting-state functional connectivity, withdrawal symptoms and smoking abstinence: A double-blind, placebo-controlled fMRI pilot study. Drug Alcohol Depend 2015; 156:234-242. [PMID: 26454838 PMCID: PMC4633320 DOI: 10.1016/j.drugalcdep.2015.09.021] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2015] [Revised: 09/14/2015] [Accepted: 09/15/2015] [Indexed: 12/11/2022]
Abstract
BACKGROUND Chronic exposure to drugs of abuse disrupts frontostriatal glutamate transmission, which in turn meditates drug seeking. In animal models, N-Acetylcysteine normalizes dysregulated frontostriatal glutamatergic neurotransmission and prevents reinstated drug seeking; however, the effects of N-Acetylcysteine on human frontostriatal circuitry function and maintaining smoking abstinence is unknown. Thus, the current study tested the hypothesis that N-Acetylcysteine would be associated with stronger frontostriatal resting-state functional connectivity (rsFC), attenuated nicotine withdrawal and would help smokers to maintain abstinence over the study period. METHODS The present study examined the effects of N-Acetylcysteine on frontostriatal rsFC, nicotine-withdrawal symptoms and maintaining abstinence. Healthy adult, non-treatment seeking smokers (N=16; mean (SD) age 36.5±11.9; cigs/day 15.8±6.1; years/smoking 15.7±8.9) were randomized to a double-blind course of 2400mg N-Acetylcysteine (1200mg b.i.d.) or placebo over the course of 3½ days of monetary-incentivized smoking abstinence. On each abstinent day, measures of mood and craving were collected and participants attended a lab visit in order to assess smoking (i.e., expired-air carbon monoxide [CO]). On day 4, participants underwent fMRI scanning. RESULTS As compared to placebo (n=8), smokers in the N-Acetylcysteine group (n=8) maintained abstinence, reported less craving and higher positive affect (all p's<.01), and concomitantly exhibited stronger rsFC between ventral striatal nodes, medial prefrontal cortex and precuneus-key default mode network nodes, and the cerebellum [p<.025; FWE]). CONCLUSIONS Taken together, these findings suggest that N-Acetylcysteine may positively affect dysregulated corticostriatal connectivity, help to restructure reward processing, and help to maintain abstinence immediately following a quit attempt.
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176
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Feng C, Li Z, Feng X, Wang L, Tian T, Luo YJ. Social hierarchy modulates neural responses of empathy for pain. Soc Cogn Affect Neurosci 2015; 11:485-95. [PMID: 26516169 DOI: 10.1093/scan/nsv135] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Accepted: 10/20/2015] [Indexed: 01/09/2023] Open
Abstract
Recent evidence indicates that empathic responses to others' pain are modulated by various situational and individual factors. However, few studies have examined how empathy and underlying brain functions are modulated by social hierarchies, which permeate human society with an enormous impact on social behavior and cognition. In this study, social hierarchies were established based on incidental skill in a perceptual task in which all participants were mediumly ranked. Afterwards, participants were scanned with functional magnetic resonance imaging while watching inferior-status or superior-status targets receiving painful or non-painful stimulation. The results revealed that painful stimulation applied to inferior-status targets induced higher activations in the anterior insula (AI) and anterior medial cingulate cortex (aMCC), whereas these empathic brain activations were significantly attenuated in response to superior-status targets' pain. Further, this neural empathic bias to inferior-status targets was accompanied by stronger functional couplings of AI with brain regions important in emotional processing (i.e. thalamus) and cognitive control (i.e. middle frontal gyrus). Our findings indicate that emotional sharing with others' pain is shaped by relative positions in a social hierarchy such that underlying empathic neural responses are biased toward inferior-status compared with superior-status individuals.
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Affiliation(s)
- Chunliang Feng
- Institute of Affective and Social Neuroscience, School of Psychology and Sociology, Shenzhen University, Shenzhen, China, State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China, and
| | - Zhihao Li
- Institute of Affective and Social Neuroscience, School of Psychology and Sociology, Shenzhen University, Shenzhen, China
| | - Xue Feng
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China, and
| | - Lili Wang
- School of Educational Science, Huaiyin Normal University, Huaian, China
| | - Tengxiang Tian
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China, and
| | - Yue-Jia Luo
- Institute of Affective and Social Neuroscience, School of Psychology and Sociology, Shenzhen University, Shenzhen, China, Collaborative Innovation Center of Sichuan for Elder Care and Health, Chengdu Medical College, Chengdu, China
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177
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Nichols TT, Foulds J, Yingst JM, Veldheer S, Hrabovsky S, Richie J, Eissenberg T, Wilson SJ. Cue-reactivity in experienced electronic cigarette users: Novel stimulus videos and a pilot fMRI study. Brain Res Bull 2015; 123:23-32. [PMID: 26478134 DOI: 10.1016/j.brainresbull.2015.10.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2015] [Revised: 09/19/2015] [Accepted: 10/10/2015] [Indexed: 12/31/2022]
Abstract
Some individuals who try electronic cigarettes (e-cigarettes) continue to use long-term. Previous research has investigated the safety of e-cigarettes and their potential for use in smoking cessation, but comparatively little research has explored chronic or habitual e-cigarette use. In particular, the relationship between e-cigarette cues and craving is unknown. We sought to bridge this gap by developing a novel set of e-cigarette (salient) and electronic toothbrush (neutral) videos for use in cue-reactivity paradigms. Additionally, we demonstrate the utility of this approach in a pilot fMRI study of 7 experienced e-cigarette users. Participants were scanned while viewing the cue videos before and after 10min use of their own e-cigarettes (producing an 11.7ng/ml increase in plasma nicotine concentration). A significant session (pre- and post-use) by video type (salient and neutral) interaction was exhibited in many sensorimotor areas commonly activated in other cue-reactivity paradigms. We did not detect significant cue-related activity in other brain regions notable in the craving literature. Possible reasons for this discrepancy are discussed, including the importance of matching cue stimuli to participants' experiences.
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Affiliation(s)
- Travis T Nichols
- Department of Psychology, The Pennsylvania State University, University Park, PA, United States.
| | - Jonathan Foulds
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, United States
| | - Jessica M Yingst
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, United States
| | - Susan Veldheer
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, United States
| | - Shari Hrabovsky
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, United States
| | - John Richie
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, United States
| | - Thomas Eissenberg
- Center for The Study of Tobacco Products, Department of Psychology, Virginia Commonwealth University, Richmond, VA, United States
| | - Stephen J Wilson
- Department of Psychology, The Pennsylvania State University, University Park, PA, United States
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178
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Shiffman S, Li X, Dunbar MS, Tindle HA, Scholl SM, Ferguson SG. Does laboratory cue reactivity correlate with real-world craving and smoking responses to cues? Drug Alcohol Depend 2015; 155:163-9. [PMID: 26277429 PMCID: PMC4581999 DOI: 10.1016/j.drugalcdep.2015.07.673] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Revised: 07/04/2015] [Accepted: 07/25/2015] [Indexed: 01/25/2023]
Abstract
BACKGROUND Laboratory cue reactivity (CR) assessments are used to assess smokers' responses to cues. Likewise, EMA recording is used to characterize real-world response to cues. Understanding the relationship between CR and EMA responses addresses the ecological validity of CR. METHODS In 190 daily smokers not currently quitting, craving and smoking responses to cues were assessed in laboratory CR and by real-world EMA recording. Separate CR sessions involved 5 smoking-relevant cues (smoking, alcohol, negative affect, positive affect, smoking prohibitions), and a neutral cue. Subjects used EMA to monitor smoking situations for 3 weeks, completing parallel situational assessments (presence of others smoking, alcohol consumption, negative affect, positive affect, and smoking prohibitions, plus current craving) in smoking and non-smoking occasions (averaging 70 and 60 occasions each). Analyses correlated CR craving and smoking cue responses with EMA craving and smoking correlations with similar cues. RESULTS Although some cues did not show main effects on average craving or smoking, a wide range of individual differences in response to cues was apparent in both CR and EMA data, providing the necessary context to assess their relationship. Laboratory CR measures of cue response were not correlated with real-world cue responses assessed by EMA. The average correlation was 0.03; none exceeded 0.32. One of 40 correlations examined was significantly greater than 0. CONCLUSIONS Laboratory CR measures do not correlate with EMA-assessed craving or smoking in response to cues, suggesting that CR measures are not accurate predictors of how smokers react to relevant stimuli in the real world.
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Affiliation(s)
- Saul Shiffman
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA 15213, USA.
| | - Xiaoxue Li
- Department of Biostatistics, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Michael S Dunbar
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Hilary A Tindle
- Division of General Internal Medicine, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Sarah M Scholl
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA 15213, USA
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179
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Vrana SR, Calhoun PS, Dennis MF, Kirby AC, Beckham JC. Acoustic startle and prepulse inhibition predict smoking lapse in posttraumatic stress disorder. J Psychopharmacol 2015; 29:1070-6. [PMID: 26253620 PMCID: PMC4586071 DOI: 10.1177/0269881115598319] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Most smokers who attempt to quit lapse within the first week and are ultimately unsuccessful in their quit attempt. Nicotine withdrawal exacerbates cognitive and attentional problems and may be one factor in smoking relapse. The startle reflex response and prepulse inhibition (PPI) of the response are sensitive to arousal and early attentional dysregulation. The current study examined whether startle response and PPI are related to early smoking lapse, and if this differs in people with and without posttraumatic stress disorder (PTSD). Participants with (N = 34) and without (N = 57) PTSD completed a startle reflex and PPI assessment during (1) ad lib smoking (2) on the first day of abstinence during a quit attempt. Most (88%) participants lapsed within the first week of the quit attempt. PTSD status predicted shorter time to lapse. Larger startle magnitude and greater PPI predicted a longer duration before smoking lapse. When diagnostic groups were examined separately, greater PPI predicted a longer successful quit attempt only in participants with a PTSD diagnosis. The startle reflex response and PPI may provide an objective, neurophysiological evaluation of regulation of arousal and early attentional processes by nicotine, which are important factors in smoking cessation success.
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Affiliation(s)
- Scott R. Vrana
- Virginia Commonwealth University, 508 Fulton St., Durham, NC, 27705
| | - Patrick S. Calhoun
- Durham VA Medical Center, 508 Fulton St., Durham, NC, 27705,MidAtlantic Research Education and Clinical Center, 508 Fulton St., Durham, NC, 27705,Duke University School of Medicine, Department of Psychiatry & Behavioral Sciences, Durham, NC, 27708
| | - Michelle F. Dennis
- Durham VA Medical Center, 508 Fulton St., Durham, NC, 27705,MidAtlantic Research Education and Clinical Center, 508 Fulton St., Durham, NC, 27705,Duke University School of Medicine, Department of Psychiatry & Behavioral Sciences, Durham, NC, 27708
| | | | - Jean C. Beckham
- Durham VA Medical Center, 508 Fulton St., Durham, NC, 27705,MidAtlantic Research Education and Clinical Center, 508 Fulton St., Durham, NC, 27705,Duke University School of Medicine, Department of Psychiatry & Behavioral Sciences, Durham, NC, 27708
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180
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Increased Functional Connectivity in an Insula-Based Network is Associated with Improved Smoking Cessation Outcomes. Neuropsychopharmacology 2015; 40:2648-56. [PMID: 25895453 PMCID: PMC4569957 DOI: 10.1038/npp.2015.114] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Revised: 04/13/2015] [Accepted: 04/14/2015] [Indexed: 11/08/2022]
Abstract
Little is known regarding the underlying neurobiology of smoking cessation. Neuroimaging studies indicate a role for the insula in connecting the interoceptive awareness of tobacco craving with a larger brain network that motivates smoking. We investigated differences in insula-based functional connectivity between smokers who did not relapse during a quit attempt vs those who relapsed. Smokers (n=85) underwent a resting-state functional connectivity scan and were then randomized into two groups (either smoking usual brand cigarettes or smoking very low nicotine cigarettes plus nicotine replacement therapy) for 30 days before their target quit date. Following the quit date, all participants received nicotine replacement therapy and their smoking behavior was observed for 10 weeks. Participants were subsequently classified as nonrelapsed (n=44) or relapsed (i.e., seven consecutive days of smoking ⩾1 cigarette/day; n=41). The right and left insula, as well as insula subdivisions (posterior, ventroanterior, and dorsoanterior) were used as seed regions of interest in the connectivity analysis. Using the right and left whole-insula seed regions, the nonrelapsed group had greater functional connectivity than the relapsed group with the bilateral pre- and postcentral gyri. This effect was isolated to the right and left posterior insula seed regions. Our results suggest that relapse vulnerability is associated with weaker connectivity between the posterior insula and primary sensorimotor cortices. Perhaps greater connectivity in this network improves the ability to inhibit a motor response to cigarette cravings when those cravings conflict with a goal to remain abstinent. These results are consistent with recent studies demonstrating a positive relationship between insula-related functional connectivity and cessation likelihood among neurologically intact smokers.
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181
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Xu J, Healy SM, Truong DQ, Datta A, Bikson M, Potenza MN. A Feasibility Study of Bilateral Anodal Stimulation of the Prefrontal Cortex Using High-Definition Electrodes in Healthy Participants. THE YALE JOURNAL OF BIOLOGY AND MEDICINE 2015; 88:219-25. [PMID: 26339204 PMCID: PMC4553641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Transcranial direct current stimulation (tDCS) studies often use one anode to increase cortical excitability in one hemisphere. However, mental processes may involve cortical regions in both hemispheres. This study's aim was to assess the safety and possible effects on affect and working memory of tDCS using two anodes for bifrontal stimulation. A group of healthy subjects participated in two bifrontal tDCS sessions on two different days, one for real and the other for sham stimulation. They performed a working memory task and reported their affect immediately before and after each tDCS session. Relative to sham, real bifrontal stimulation did not induce significant adverse effects, reduced decrement in vigor-activity during the study session, and did not improve working memory. These preliminary findings suggest that bifrontal anodal stimulation is feasible and safe and may reduce task-related fatigue in healthy participants. Its effects on neuropsychiatric patients deserve further study.
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Affiliation(s)
- Jiansong Xu
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut,To whom all correspondence should be addressed: Jiansong Xu, Department of Psychiatry, Yale School of Medicine, 1 Church St., Room 729, New Haven, CT 06519; Tele: 203-785-5306; Fax: 203-737-3591;
| | - Stephen M. Healy
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut
| | - Dennis Q. Truong
- Department of Biomedical Engineering, City University of New York, City College, New York, New York
| | - Abhishek Datta
- Department of Biomedical Engineering, City University of New York, City College, New York, New York
| | - Marom Bikson
- Department of Biomedical Engineering, City University of New York, City College, New York, New York
| | - Marc N. Potenza
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut,Child Study Center, Yale School of Medicine, New Haven, Connecticut,Department of Neurobiology, Yale School of Medicine, New Haven, Connecticut
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182
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Li Q, Li W, Wang H, Wang Y, Zhang Y, Zhu J, Zheng Y, Zhang D, Wang L, Li Y, Yan X, Chang H, Fan M, Li Z, Tian J, Gold MS, Wang W, Liu Y. Predicting subsequent relapse by drug-related cue-induced brain activation in heroin addiction: an event-related functional magnetic resonance imaging study. Addict Biol 2015; 20:968-78. [PMID: 25214465 DOI: 10.1111/adb.12182] [Citation(s) in RCA: 87] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Abnormal salience attribution is implicated in heroin addiction. Previously, combining functional magnetic resonance imaging (fMRI) and a drug cue-reactivity task, we demonstrated abnormal patterns of subjective response and brain reactivity in heroin-dependent individuals. However, whether the changes in cue-induced brain response were related to relapse was unknown. In a prospective study, we recruited 49 heroin-dependent patients under methadone maintenance treatment, a gold standard treatment (average daily dose 41.8 ± 16.0 mg), and 20 healthy subjects to perform the heroin cue-reactivity task during fMRI. The patients' subjective craving was evaluated. They participated in a follow-up assessment for 3 months, during which heroin use was assessed and relapse was confirmed by self-reported relapse or urine toxicology. Differences between relapsers and non-relapsers were analyzed with respect to the results from heroin-cue responses. Compared with healthy subjects, relapsers and non-relapsers commonly demonstrated significantly increased brain responses during the processing of heroin cues in the mesolimbic system, prefrontal regions and visuospatial-attention regions. However, compared with non-relapsers, relapsers demonstrated significantly greater cue-induced craving and the brain response mainly in the bilateral nucleus accumbens/subcallosal cortex and cerebellum. Although the cue-induced heroin craving was low in absolute measures, the change in craving positively correlated with the activation of the nucleus accumbens/subcallosal cortex among the patients. These findings suggest that in treatment-seeking heroin-dependent individuals, greater cue-induced craving and greater specific regional activations might be related to reward/craving and memory retrieval processes. These responses may predict relapse and represent important targets for the development of new treatment for heroin addiction.
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Affiliation(s)
- Qiang Li
- Department of Radiology; Tangdu Hospital; The Fourth Military Medical University; Xi'an China
- Department of Psychiatry; McKnight Brain Institute; University of Florida College of Medicine; Gainesville FL USA
| | - Wei Li
- Department of Radiology; Tangdu Hospital; The Fourth Military Medical University; Xi'an China
| | - Hanyue Wang
- Department of Radiology; Tangdu Hospital; The Fourth Military Medical University; Xi'an China
| | - Yarong Wang
- Department of Radiology; Tangdu Hospital; The Fourth Military Medical University; Xi'an China
| | - Yi Zhang
- School of Life Science and Technology; Xidian University; Xi'an China
| | - Jia Zhu
- Department of Radiology; Tangdu Hospital; The Fourth Military Medical University; Xi'an China
| | - Ying Zheng
- Department of Radiology; Tangdu Hospital; The Fourth Military Medical University; Xi'an China
| | - Dongsheng Zhang
- Department of Radiology; Tangdu Hospital; The Fourth Military Medical University; Xi'an China
| | - Lina Wang
- Department of Radiology; Tangdu Hospital; The Fourth Military Medical University; Xi'an China
| | - Yongbin Li
- Department of Radiology; Tangdu Hospital; The Fourth Military Medical University; Xi'an China
| | - Xuejiao Yan
- Department of Radiology; Tangdu Hospital; The Fourth Military Medical University; Xi'an China
| | - Haifeng Chang
- Department of Radiology; Tangdu Hospital; The Fourth Military Medical University; Xi'an China
| | - Min Fan
- Department of Radiology; Tangdu Hospital; The Fourth Military Medical University; Xi'an China
| | - Zhe Li
- Department of Radiology; Tangdu Hospital; The Fourth Military Medical University; Xi'an China
| | - Jie Tian
- Department of Radiology; Tangdu Hospital; The Fourth Military Medical University; Xi'an China
- School of Life Science and Technology; Xidian University; Xi'an China
| | - Mark S. Gold
- Department of Psychiatry; McKnight Brain Institute; University of Florida College of Medicine; Gainesville FL USA
| | - Wei Wang
- Department of Radiology; Tangdu Hospital; The Fourth Military Medical University; Xi'an China
| | - Yijun Liu
- Department of Radiology; Tangdu Hospital; The Fourth Military Medical University; Xi'an China
- Department of Psychiatry; McKnight Brain Institute; University of Florida College of Medicine; Gainesville FL USA
- College of Engineering; Peking University; Beijing China
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183
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Robinson CD, Pickworth WB, Heishman SJ, Wetter DW, Cinciripini PM, Li Y, Rowell B, Waters AJ. Black Cigarette Smokers Report More Attention to Smoking Cues Than White Smokers: Implications for Smoking Cessation. Nicotine Tob Res 2015; 17:1022-8. [PMID: 26180228 PMCID: PMC4838045 DOI: 10.1093/ntr/ntu263] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2014] [Accepted: 11/27/2014] [Indexed: 11/14/2022]
Abstract
INTRODUCTION Black cigarette smokers have lower rates of smoking cessation compared with Whites. However, the mechanisms underlying these differences are not clear. Many Blacks live in communities saturated by tobacco advertisements. These cue-rich environments may undermine cessation attempts by provoking smoking. Moreover, attentional bias to smoking cues (attention capture by smoking cues) has been linked to lower cessation outcomes. Cessation attempts among Blacks may be compromised by attentional bias to smoking cues and a cue-rich environment. METHOD Attention to smoking cues in Black and White smokers was examined in 2 studies. In both studies, assessments were completed during 2 laboratory visits: a nonabstinent session and an abstinent session. In study 1, nontreatment-seeking smokers (99 Whites, 104 Blacks) completed the Subjective Attentional Bias Questionnaire (SABQ; a self-report measure of attention to cues) and the Smoking Stroop task (a reaction time measure of attentional bias to smoking cues). In study 2, 110 White and 74 Black treatment-seeking smokers completed these assessments and attempted to quit. RESULTS In study 1, Blacks reported higher ratings than Whites on the SABQ (p = .005). In study 2, Blacks also reported higher ratings than Whites on the SABQ (p = .003). In study 2, Blacks had lower biochemical-verified point prevalence abstinence than Whites, and the between-race difference in outcome was partially mediated by SABQ ratings. CONCLUSION Blacks reported greater attention to smoking cues than Whites, possibly due to between-race differences in environments. Greater attention to smoking cues may undermine cessation attempts.
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Affiliation(s)
- Cendrine D Robinson
- Department of Medical and Clinical Psychology, Uniformed Services, University of the Health Sciences, Bethesda, MD;
| | | | - Stephen J Heishman
- National Institute on Drug Abuse, Intramural Research Program, Baltimore, MD
| | - David W Wetter
- University of Texas MD Anderson Cancer Center, Houston, TX
| | | | - Yisheng Li
- University of Texas MD Anderson Cancer Center, Houston, TX
| | | | - Andrew J Waters
- Department of Medical and Clinical Psychology, Uniformed Services, University of the Health Sciences, Bethesda, MD
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184
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Abstract
The capacity for self-regulation allows people to control their thoughts, behaviors, emotions, and desires. In spite of this impressive ability, failures of self-regulation are common and contribute to numerous societal problems, from obesity to drug addiction. Such failures frequently occur following exposure to highly tempting cues, during negative moods, or after self-regulatory resources have been depleted. Here we review the available neuroscientific evidence regarding self-regulation and its failures. At its core, self-regulation involves a critical balance between the strength of an impulse and an individual's ability to inhibit the desired behavior. Although neuroimaging and patient studies provide consistent evidence regarding the reward aspects of impulses and desires, the neural mechanisms that underlie the capacity for control have eluded consensus, with various executive control regions implicated in different studies. We outline the necessary properties for a self-regulation control system and suggest that the use of resting-state functional connectivity analyses may be useful for understanding how people regulate their behavior and why they sometimes fail in their attempts.
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Affiliation(s)
- William M. Kelley
- Department of Psychological and Brain Sciences, Dartmouth College, Hanover, New Hampshire 03755;
| | - Dylan D. Wagner
- Department of Psychology, The Ohio State University, Columbus, Ohio 43210
| | - Todd F. Heatherton
- Department of Psychological and Brain Sciences, Dartmouth College, Hanover, New Hampshire 03755;
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185
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Olsen VV, Lugo RG, Sütterlin S. The somatic marker theory in the context of addiction: contributions to understanding development and maintenance. Psychol Res Behav Manag 2015; 8:187-200. [PMID: 26185474 PMCID: PMC4501162 DOI: 10.2147/prbm.s68695] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Recent theoretical accounts of addiction have acknowledged that addiction to substances and behaviors share inherent similarities (eg, insensitivity to future consequences and self-regulatory deficits). This recognition is corroborated by inquiries into the neurobiological correlates of addiction, which has indicated that different manifestations of addictive pathology share common neural mechanisms. This review of the literature will explore the feasibility of the somatic marker hypothesis as a unifying explanatory framework of the decision-making deficits that are believed to be involved in addiction development and maintenance. The somatic marker hypothesis provides a neuroanatomical and cognitive framework of decision making, which posits that decisional processes are biased toward long-term prospects by emotional marker signals engendered by a neuronal architecture comprising both cortical and subcortical circuits. Addicts display markedly impulsive and compulsive behavioral patterns that might be understood as manifestations of decision-making processes that fail to take into account the long-term consequences of actions. Evidence demonstrates that substance dependence, pathological gambling, and Internet addiction are characterized by structural and functional abnormalities in neural regions, as outlined by the somatic marker hypothesis. Furthermore, both substance dependents and behavioral addicts show similar impairments on a measure of decision making that is sensitive to somatic marker functioning. The decision-making deficits that characterize addiction might exist a priori to addiction development; however, they may be worsened by ingestion of substances with neurotoxic properties. It is concluded that the somatic marker model of addiction contributes a plausible account of the underlying neurobiology of decision-making deficits in addictive disorders that is supported by the current neuroimaging and behavioral evidence. Implications for future research are outlined.
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Affiliation(s)
- Vegard V Olsen
- Section of Psychology, Lillehammer University College, Lillehammer, Norway
| | - Ricardo G Lugo
- Section of Psychology, Lillehammer University College, Lillehammer, Norway
| | - Stefan Sütterlin
- Section of Psychology, Lillehammer University College, Lillehammer, Norway ; Department of Psychosomatic Medicine, Division of Surgery and Clinical Neuroscience, Oslo University Hospital - Rikshospitalet, Oslo, Norway
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186
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Li Y, Yuan K, Cai C, Feng D, Yin J, Bi Y, Shi S, Yu D, Jin C, von Deneen KM, Qin W, Tian J. Reduced frontal cortical thickness and increased caudate volume within fronto-striatal circuits in young adult smokers. Drug Alcohol Depend 2015; 151:211-9. [PMID: 25865908 DOI: 10.1016/j.drugalcdep.2015.03.023] [Citation(s) in RCA: 79] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2014] [Revised: 03/21/2015] [Accepted: 03/22/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND Smoking during early adulthood results in neurophysiological and brain structural changes that may promote nicotine dependence later in life. Previous studies have revealed the important roles of fronto-striatal circuits in the pathology of nicotine dependence; however, few studies have focused on both cortical thickness and subcortical striatal volume differences between young adult smokers and nonsmokers. METHODS Twenty-seven young male adult smokers and 22 age-, education- and gender-matched nonsmokers were recruited in the present study. The cortical thickness and striatal volume differences of young adult smokers and age-matched nonsmokers were investigated in the present study and then correlated with pack-years and Fagerström Test for Nicotine Dependence (FTND). RESULTS The following results were obtained: (1) young adult smokers showed significant cortical thinning in the frontal cortex (left caudal anterior cingulate cortex (ACC), right lateral orbitofrontal cortex (OFC)), left insula, left middle temporal gyrus, right inferior parietal lobule, and right parahippocampus; (2) in regards to subcortical striatal volume, the volume of the right caudate was larger in young adult smokers than nonsmokers; and (3) the cortical thickness of the right dorsolateral prefrontal cortex (DLPFC) and OFC were associated with nicotine dependence severity (FTND) and cumulative amount of nicotine intake (pack-years) in smokers, respectively. CONCLUSIONS This study revealed reduced frontal cortical thickness and increased caudate volume in the fronto-striatal circuits in young adult smokers compared to nonsmokers. These deficits suggest an imbalance between cognitive control (reduced protection factors) and reward drive behaviours (increased risk factors) associated with nicotine addiction and relapse.
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Affiliation(s)
- Yangding Li
- School of Life Science and Technology, Xidian University, Xi'an 710071, Shaanxi, PR China; Engineering Research Center of Molecular and Neuro Imaging, Ministry of Education, Xi'an, PR China
| | - Kai Yuan
- School of Life Science and Technology, Xidian University, Xi'an 710071, Shaanxi, PR China; Engineering Research Center of Molecular and Neuro Imaging, Ministry of Education, Xi'an, PR China.
| | - Chenxi Cai
- School of Life Science and Technology, Xidian University, Xi'an 710071, Shaanxi, PR China; Engineering Research Center of Molecular and Neuro Imaging, Ministry of Education, Xi'an, PR China
| | - Dan Feng
- School of Life Science and Technology, Xidian University, Xi'an 710071, Shaanxi, PR China; Engineering Research Center of Molecular and Neuro Imaging, Ministry of Education, Xi'an, PR China
| | - Junsen Yin
- School of Life Science and Technology, Xidian University, Xi'an 710071, Shaanxi, PR China; Engineering Research Center of Molecular and Neuro Imaging, Ministry of Education, Xi'an, PR China
| | - Yanzhi Bi
- School of Life Science and Technology, Xidian University, Xi'an 710071, Shaanxi, PR China; Engineering Research Center of Molecular and Neuro Imaging, Ministry of Education, Xi'an, PR China
| | - Sha Shi
- School of Life Science and Technology, Xidian University, Xi'an 710071, Shaanxi, PR China; Engineering Research Center of Molecular and Neuro Imaging, Ministry of Education, Xi'an, PR China
| | - Dahua Yu
- Information Processing Laboratory, School of Information Engineering, Inner Mongolia University of Science and Technology, Baotou, Inner Mongolia 014010, PR China
| | - Chenwang Jin
- Department of Medical Imaging, The First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an 710061, Shaanxi, PR China
| | - Karen M von Deneen
- School of Life Science and Technology, Xidian University, Xi'an 710071, Shaanxi, PR China; Engineering Research Center of Molecular and Neuro Imaging, Ministry of Education, Xi'an, PR China
| | - Wei Qin
- School of Life Science and Technology, Xidian University, Xi'an 710071, Shaanxi, PR China; Engineering Research Center of Molecular and Neuro Imaging, Ministry of Education, Xi'an, PR China
| | - Jie Tian
- School of Life Science and Technology, Xidian University, Xi'an 710071, Shaanxi, PR China; Engineering Research Center of Molecular and Neuro Imaging, Ministry of Education, Xi'an, PR China; Institute of Automation, Chinese Academy of Sciences, Beijing 100190, PR China.
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187
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Insula-Dorsal Anterior Cingulate Cortex Coupling is Associated with Enhanced Brain Reactivity to Smoking Cues. Neuropsychopharmacology 2015; 40:1561-8. [PMID: 25567427 PMCID: PMC4915269 DOI: 10.1038/npp.2015.9] [Citation(s) in RCA: 67] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2014] [Revised: 12/16/2014] [Accepted: 12/19/2014] [Indexed: 11/09/2022]
Abstract
The insula plays a critical role in maintaining nicotine dependence and reactivity to smoking cues. More broadly, the insula and the dorsal anterior cingulate cortex (dACC) are key nodes of the salience network (SN), which integrates internal and extrapersonal information to guide behavior. Thus, insula-dACC interactions may be integral in processing salient information such as smoking cues that facilitate continued nicotine use. We evaluated functional magnetic resonance imaging (fMRI) data from nicotine-dependent participants during rest, and again when they viewed smoking-related images. Greater insula-dACC coupling at rest was significantly correlated with enhanced smoking cue-reactivity in brain areas associated with attention and motor preparation, including the visual cortex, right ventral lateral prefrontal cortex, and the dorsal striatum. In an independent cohort, we found that insula-dACC connectivity was stable over 1-h delay and was not influenced by changes in subjective craving or expired carbon monoxide, suggesting that connectivity strength between these regions may be a trait associated with heightened cue-reactivity. Finally, we also showed that insula reactivity to smoking cues correlates with a rise in cue-reactivity throughout the entire SN, indicating that the insula's role in smoking cue-reactivity is not functionally independent, and may actually represent the engagement of the entire SN. Collectively, these data provide a more network-level understanding of the insula's role in nicotine dependence and shows a relationship between inherent brain organization and smoking cue-reactivity.
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188
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Christiansen P, Schoenmakers TM, Field M. Less than meets the eye: reappraising the clinical relevance of attentional bias in addiction. Addict Behav 2015; 44:43-50. [PMID: 25453782 DOI: 10.1016/j.addbeh.2014.10.005] [Citation(s) in RCA: 129] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2014] [Revised: 10/01/2014] [Accepted: 10/02/2014] [Indexed: 12/13/2022]
Abstract
Recent years have seen an explosion of interest in attentional bias in addiction, particularly its clinical relevance. Specifically, numerous articles claimed to demonstrate either that (1) attentional bias measured in treatment settings could predict subsequent relapse to substance use, or (2) direct modification of attentional bias reduced substance use and improved treatment outcomes. In this paper, we critically evaluate empirical studies that investigated these issues. We show that the evidence regarding both of these claims is decidedly mixed, and that many of the studies that appear to yield positive findings have serious methodological and statistical limitations. We contend that the available literature suggests that attentional bias for drug cues fluctuates within individuals because it is an output of the underlying motivational state at that moment in time, but there is no convincing evidence that it exerts a causal influence on substance use. Future research should make use of experience sampling methodology to characterise the clinical significance of fluctuations in attentional bias over time.
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Affiliation(s)
- Paul Christiansen
- Department of Psychological Sciences, University of Liverpool, Liverpool, United Kingdom; UK Centre for Tobacco and Alcohol Studies (UKCTAS), United Kingdom.
| | - Tim M Schoenmakers
- IVO Addiction Research Institute, Rotterdam, The Netherlands; Erasmus Medical Center, Rotterdam, The Netherlands
| | - Matt Field
- Department of Psychological Sciences, University of Liverpool, Liverpool, United Kingdom; UK Centre for Tobacco and Alcohol Studies (UKCTAS), United Kingdom
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189
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Gabrieli JDE, Ghosh SS, Whitfield-Gabrieli S. Prediction as a humanitarian and pragmatic contribution from human cognitive neuroscience. Neuron 2015; 85:11-26. [PMID: 25569345 DOI: 10.1016/j.neuron.2014.10.047] [Citation(s) in RCA: 336] [Impact Index Per Article: 37.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Neuroimaging has greatly enhanced the cognitive neuroscience understanding of the human brain and its variation across individuals (neurodiversity) in both health and disease. Such progress has not yet, however, propelled changes in educational or medical practices that improve people's lives. We review neuroimaging findings in which initial brain measures (neuromarkers) are correlated with or predict future education, learning, and performance in children and adults; criminality; health-related behaviors; and responses to pharmacological or behavioral treatments. Neuromarkers often provide better predictions (neuroprognosis), alone or in combination with other measures, than traditional behavioral measures. With further advances in study designs and analyses, neuromarkers may offer opportunities to personalize educational and clinical practices that lead to better outcomes for people.
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Affiliation(s)
- John D E Gabrieli
- Poitras Center for Affective Disorders Research at the McGovern Institute for Brain Research, Massachusetts Institute of Technology, Cambridge, MA 02139, USA; Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Cambridge, MA 02139, USA; Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA 02139, USA.
| | - Satrajit S Ghosh
- Poitras Center for Affective Disorders Research at the McGovern Institute for Brain Research, Massachusetts Institute of Technology, Cambridge, MA 02139, USA; Department of Otology and Laryngology, Harvard Medical School, Boston, MA 02115, USA
| | - Susan Whitfield-Gabrieli
- Poitras Center for Affective Disorders Research at the McGovern Institute for Brain Research, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
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190
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Measuring cigarette smoking-induced cortical dopamine release: A [¹¹C]FLB-457 PET study. Neuropsychopharmacology 2015; 40:1417-27. [PMID: 25502631 PMCID: PMC4397400 DOI: 10.1038/npp.2014.327] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2014] [Revised: 12/04/2014] [Accepted: 12/04/2014] [Indexed: 01/01/2023]
Abstract
Striatal dopamine (DA) is thought to have a fundamental role in the reinforcing effects of tobacco smoking and nicotine. Microdialysis studies indicate that nicotine also increases DA in extrastriatal brain areas, but much less is known about its role in addiction. High-affinity D2/3 receptor radiotracers permit the measurement of cortical DA in humans using positron emission tomography (PET). [(11)C]FLB-457 PET scans were conducted in 10 nicotine-dependent daily smokers after overnight abstinence and reinstatement of smoking. Voxel-wise [(11)C]-FLB-457-binding potential (BPND) in the frontal lobe, insula, and limbic regions was estimated in the two conditions. Paired t-tests showed BPND values were reduced following smoking (an indirect index of DA release). The overall peak t was located in the cingulate gyrus, which was part of a larger medial cluster (BPND change -12.1±9.4%) and this survived false discovery rate correction for multiple comparisons. Clusters were also identified in the left anterior cingulate cortex/medial frontal gyrus, bilateral prefrontal cortex (PFC), bilateral amygdala, and the left insula. This is the first demonstration of tobacco smoking-induced cortical DA release in humans; it may be the result of both pharmacological (nicotine) and non-pharmacological factors (tobacco cues). Abstinence increased craving but had minimal cognitive effects, thus limiting correlation analyses. However, given that the cingulate cortex, PFC, insula, and amygdala are thought to have important roles in tobacco craving, cognition, and relapse, these associations warrant investigation in a larger sample. [(11)C]FLB-457 PET imaging may represent a useful tool to investigate individual differences in tobacco addiction severity and treatment response.
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191
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Abstract
For the past 30 years, research examining predictors of successful smoking cessation treatment response has focused primarily on clinical variables, such as levels of tobacco dependence, craving, and self-efficacy. However, recent research has begun to determine biomarkers (such as genotype, nicotine and metabolite levels, and brain imaging findings) that may have utility in predicting smoking cessation. For genotype, genes associated with nicotinic acetylcholine receptors (nAChRs) and related proteins have been found to predict response to first-line medications (e.g. nicotine replacement therapy [NRT], bupropion, or varenicline) or quitting over time without a controlled treatment trial. For nicotine and metabolite levels, function of the cytochrome P450 2A6 liver enzyme, which can be assessed with the nicotine metabolite ratio or via genotype, has been found to predict response, with slow nicotine metabolizers having less severe nicotine dependence and a greater likelihood of quitting with NRT than normal metabolizers. For brain imaging, decreased activation of brain regions associated with emotion regulation and increased connectivity in emotion regulation networks, increased responsiveness to pleasant cues, and altered activation with the Stroop effect have been found in smokers who quit with the first-line medications listed above or counseling. In addition, our group recently demonstrated that lower pre-treatment brain nAChR density is associated with a greater chance of quitting smoking with NRT or placebo. Several of these studies found that specific biomarkers may provide additional information for predicting response beyond subjective symptom or rating scale measures, thereby giving an initial indication that biomarkers may, in the future, be useful for guiding smoking cessation treatment intensity, duration, and type.
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192
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Alonso-Alonso M, Woods SC, Pelchat M, Grigson PS, Stice E, Farooqi S, Khoo CS, Mattes RD, Beauchamp GK. Food reward system: current perspectives and future research needs. Nutr Rev 2015; 73:296-307. [PMID: 26011903 PMCID: PMC4477694 DOI: 10.1093/nutrit/nuv002] [Citation(s) in RCA: 125] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
This article reviews current research and cross-disciplinary perspectives on the neuroscience of food reward in animals and humans, examines the scientific hypothesis of food addiction, discusses methodological and terminology challenges, and identifies knowledge gaps and future research needs. Topics addressed herein include the role of reward and hedonic aspects in the regulation of food intake, neuroanatomy and neurobiology of the reward system in animals and humans, responsivity of the brain reward system to palatable foods and drugs, translation of craving versus addiction, and cognitive control of food reward. The content is based on a workshop held in 2013 by the North American Branch of the International Life Sciences Institute.
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Affiliation(s)
- Miguel Alonso-Alonso
- M. Alonso-Alonso is with the Center for the Study of Nutrition Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA. S.C. Woods is with the Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, Cincinnati, Ohio, USA. M. Pelchat and G.K. Beauchamp are with the Monell Chemical Senses Center, Philadelphia, Pennsylvania, USA. P.S. Grigson is with the Department of Neural and Behavioral Sciences, Penn State College of Medicine, Hershey, Pennsylvania, USA. E. Stice is with the Department of Psychology, University of Texas at Austin, Austin, Texas, USA. S. Farooqi is with the Wellcome Trust-MRC Institute of Metabolic Science, University of Cambridge, Cambridge, United Kingdom. C.S. Khoo is with the North American Branch of the International Life Sciences Institute, Washington, DC, USA. R.D. Mattes is with the Department of Nutrition Science, Purdue University, West Lafayette, Indiana, USA.
| | - Stephen C Woods
- M. Alonso-Alonso is with the Center for the Study of Nutrition Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA. S.C. Woods is with the Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, Cincinnati, Ohio, USA. M. Pelchat and G.K. Beauchamp are with the Monell Chemical Senses Center, Philadelphia, Pennsylvania, USA. P.S. Grigson is with the Department of Neural and Behavioral Sciences, Penn State College of Medicine, Hershey, Pennsylvania, USA. E. Stice is with the Department of Psychology, University of Texas at Austin, Austin, Texas, USA. S. Farooqi is with the Wellcome Trust-MRC Institute of Metabolic Science, University of Cambridge, Cambridge, United Kingdom. C.S. Khoo is with the North American Branch of the International Life Sciences Institute, Washington, DC, USA. R.D. Mattes is with the Department of Nutrition Science, Purdue University, West Lafayette, Indiana, USA
| | - Marcia Pelchat
- M. Alonso-Alonso is with the Center for the Study of Nutrition Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA. S.C. Woods is with the Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, Cincinnati, Ohio, USA. M. Pelchat and G.K. Beauchamp are with the Monell Chemical Senses Center, Philadelphia, Pennsylvania, USA. P.S. Grigson is with the Department of Neural and Behavioral Sciences, Penn State College of Medicine, Hershey, Pennsylvania, USA. E. Stice is with the Department of Psychology, University of Texas at Austin, Austin, Texas, USA. S. Farooqi is with the Wellcome Trust-MRC Institute of Metabolic Science, University of Cambridge, Cambridge, United Kingdom. C.S. Khoo is with the North American Branch of the International Life Sciences Institute, Washington, DC, USA. R.D. Mattes is with the Department of Nutrition Science, Purdue University, West Lafayette, Indiana, USA
| | - Patricia Sue Grigson
- M. Alonso-Alonso is with the Center for the Study of Nutrition Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA. S.C. Woods is with the Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, Cincinnati, Ohio, USA. M. Pelchat and G.K. Beauchamp are with the Monell Chemical Senses Center, Philadelphia, Pennsylvania, USA. P.S. Grigson is with the Department of Neural and Behavioral Sciences, Penn State College of Medicine, Hershey, Pennsylvania, USA. E. Stice is with the Department of Psychology, University of Texas at Austin, Austin, Texas, USA. S. Farooqi is with the Wellcome Trust-MRC Institute of Metabolic Science, University of Cambridge, Cambridge, United Kingdom. C.S. Khoo is with the North American Branch of the International Life Sciences Institute, Washington, DC, USA. R.D. Mattes is with the Department of Nutrition Science, Purdue University, West Lafayette, Indiana, USA
| | - Eric Stice
- M. Alonso-Alonso is with the Center for the Study of Nutrition Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA. S.C. Woods is with the Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, Cincinnati, Ohio, USA. M. Pelchat and G.K. Beauchamp are with the Monell Chemical Senses Center, Philadelphia, Pennsylvania, USA. P.S. Grigson is with the Department of Neural and Behavioral Sciences, Penn State College of Medicine, Hershey, Pennsylvania, USA. E. Stice is with the Department of Psychology, University of Texas at Austin, Austin, Texas, USA. S. Farooqi is with the Wellcome Trust-MRC Institute of Metabolic Science, University of Cambridge, Cambridge, United Kingdom. C.S. Khoo is with the North American Branch of the International Life Sciences Institute, Washington, DC, USA. R.D. Mattes is with the Department of Nutrition Science, Purdue University, West Lafayette, Indiana, USA
| | - Sadaf Farooqi
- M. Alonso-Alonso is with the Center for the Study of Nutrition Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA. S.C. Woods is with the Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, Cincinnati, Ohio, USA. M. Pelchat and G.K. Beauchamp are with the Monell Chemical Senses Center, Philadelphia, Pennsylvania, USA. P.S. Grigson is with the Department of Neural and Behavioral Sciences, Penn State College of Medicine, Hershey, Pennsylvania, USA. E. Stice is with the Department of Psychology, University of Texas at Austin, Austin, Texas, USA. S. Farooqi is with the Wellcome Trust-MRC Institute of Metabolic Science, University of Cambridge, Cambridge, United Kingdom. C.S. Khoo is with the North American Branch of the International Life Sciences Institute, Washington, DC, USA. R.D. Mattes is with the Department of Nutrition Science, Purdue University, West Lafayette, Indiana, USA
| | - Chor San Khoo
- M. Alonso-Alonso is with the Center for the Study of Nutrition Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA. S.C. Woods is with the Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, Cincinnati, Ohio, USA. M. Pelchat and G.K. Beauchamp are with the Monell Chemical Senses Center, Philadelphia, Pennsylvania, USA. P.S. Grigson is with the Department of Neural and Behavioral Sciences, Penn State College of Medicine, Hershey, Pennsylvania, USA. E. Stice is with the Department of Psychology, University of Texas at Austin, Austin, Texas, USA. S. Farooqi is with the Wellcome Trust-MRC Institute of Metabolic Science, University of Cambridge, Cambridge, United Kingdom. C.S. Khoo is with the North American Branch of the International Life Sciences Institute, Washington, DC, USA. R.D. Mattes is with the Department of Nutrition Science, Purdue University, West Lafayette, Indiana, USA
| | - Richard D Mattes
- M. Alonso-Alonso is with the Center for the Study of Nutrition Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA. S.C. Woods is with the Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, Cincinnati, Ohio, USA. M. Pelchat and G.K. Beauchamp are with the Monell Chemical Senses Center, Philadelphia, Pennsylvania, USA. P.S. Grigson is with the Department of Neural and Behavioral Sciences, Penn State College of Medicine, Hershey, Pennsylvania, USA. E. Stice is with the Department of Psychology, University of Texas at Austin, Austin, Texas, USA. S. Farooqi is with the Wellcome Trust-MRC Institute of Metabolic Science, University of Cambridge, Cambridge, United Kingdom. C.S. Khoo is with the North American Branch of the International Life Sciences Institute, Washington, DC, USA. R.D. Mattes is with the Department of Nutrition Science, Purdue University, West Lafayette, Indiana, USA
| | - Gary K Beauchamp
- M. Alonso-Alonso is with the Center for the Study of Nutrition Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA. S.C. Woods is with the Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, Cincinnati, Ohio, USA. M. Pelchat and G.K. Beauchamp are with the Monell Chemical Senses Center, Philadelphia, Pennsylvania, USA. P.S. Grigson is with the Department of Neural and Behavioral Sciences, Penn State College of Medicine, Hershey, Pennsylvania, USA. E. Stice is with the Department of Psychology, University of Texas at Austin, Austin, Texas, USA. S. Farooqi is with the Wellcome Trust-MRC Institute of Metabolic Science, University of Cambridge, Cambridge, United Kingdom. C.S. Khoo is with the North American Branch of the International Life Sciences Institute, Washington, DC, USA. R.D. Mattes is with the Department of Nutrition Science, Purdue University, West Lafayette, Indiana, USA
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Promoting pre-quit physical activity to reduce cue reactivity among low-income sedentary smokers: A randomized proof of concept study. Contemp Clin Trials 2015; 42:158-66. [PMID: 25795145 DOI: 10.1016/j.cct.2015.03.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2014] [Revised: 03/07/2015] [Accepted: 03/09/2015] [Indexed: 11/23/2022]
Abstract
BACKGROUND Smoking and lack of physical activity (PA) contribute to disproportionate rates of disease among low-income adults. Interventions that simultaneously address both risk behaviors have strong potential to reduce health disparities. Existing smoking-PA studies indicate promising results but have limited generalizability to low-income populations. The goal of this study is to assess the effects of an integrated behavioral counseling approach to promote low-to-moderate intensity PA (LMPA) and reduce short-term smoking cue reactivity among low-income sedentary smokers. METHODS This study uses a randomized, 2-group design with 4 measurement time points: baseline, quit day (week 4), 1-week and 1-month follow-up. Participants (sedentary, smoke>6 cigs/day) receive 4 weeks of either (a) standard smoking cessation counseling (SCC control) or (b) our Step-Up to Quit (SUTQ) intervention that integrates advice for LMPA with SCC. SUTQ counseling focuses on increasing daily steps (walking) to reach 7500-10,000/day by week 4 (quit day) and explicitly links short bouts of LMPA with smoking urge management. Potential for SUTQ to facilitate urge management will be assessed by comparing between-group differences in the reduction (extinction) of quit day cue reactivity. We will explore group differences in quit rates at 1-week and 1-month follow-up. DISCUSSION This novel approach overcomes gaps in the PA-smoking intervention literature by promoting a more realistic PA approach for sedentary populations, using an ecologically valid strategy, integrating LMPA with evidence-based SCC during a 4-week pre-quit period, and testing the SUTQ counseling model in a high-risk sample. Results will guide future efficacy and dissemination studies.
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194
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Franklin TR, Jagannathan K, Wetherill RR, Johnson B, Kelly S, Langguth J, Mumma J, Childress AR. Influence of menstrual cycle phase on neural and craving responses to appetitive smoking cues in naturally cycling females. Nicotine Tob Res 2015; 17:390-7. [PMID: 25762748 DOI: 10.1093/ntr/ntu183] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
INTRODUCTION Functional magnetic resonance imaging (fMRI) has been used extensively in an attempt to understand brain vulnerabilities that mediate maladaptive responses to drug cues. Using perfusion fMRI, we have consistently shown reward-related activation (medial orbitofrontal cortex/ventral striatum) to smoking cues (SCs). Because preclinical and clinical studies generally show that progesterone may reduce reward and craving, we hypothesized that females in the follicular phase of the cycle (FPs; when progesterone levels are low) would have greater reward-related neural responses to SCs compared with females in the luteal phase (LPs). METHODS Sated cigarette-dependent premenopausal naturally cycling females underwent pseudo-continuous arterial spin-labeled perfusion fMRI during exposure to 10-min audio visual clips of appetitive SCs and non-SCs. Brain responses to SCs relative to non-SCs were examined among females grouped according to menstrual cycle (MC) phase at the time of scanning (22 FPs, 15 LPs). Craving scores were acquired pre- and post-SC exposure. RESULTS FPs showed increased neural responses to SCs compared with non-SCs in the medial orbitofrontal cortex (p ≤ .05 corrected), whereas LPs did not. FPs reported SC-elicited craving (p ≤ .005), whereas LPs did not. Within FPs, SC-induced craving correlated with increased neural responses in the anterior insula (r = 0.73, p < .0001). CONCLUSIONS FPs may be more vulnerable to relapse during appetitive SC exposure than LPs. Because the influence of MC phase on drug cue neural activity has not been examined, these results contribute to our knowledge of the neurobiological underpinnings of responses to drug cues, and they highlight the importance of monitoring menstrual cycle phase in all areas of addiction research.
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Affiliation(s)
- Teresa R Franklin
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104
| | - Kanchana Jagannathan
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104
| | - Reagan R Wetherill
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104
| | - Barbara Johnson
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104
| | - Shannon Kelly
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104
| | - Jamison Langguth
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104
| | - Joel Mumma
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104
| | - Anna Rose Childress
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104
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195
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Wang AL, Romer D, Elman I, Turetsky BI, Gur RC, Langleben DD. Emotional graphic cigarette warning labels reduce the electrophysiological brain response to smoking cues. Addict Biol 2015; 20:368-76. [PMID: 24330194 DOI: 10.1111/adb.12117] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
There is an ongoing public debate about the new graphic warning labels (GWLs) that the Food and Drug Administration (FDA) proposes to place on cigarette packs. Tobacco companies argued that the strongly emotional images FDA proposed to include in the GWLs encroached on their constitutional rights. The court ruled that FDA did not provide sufficient scientific evidence of compelling public interest in such encroachment. This study's objectives were to examine the effects of the GWLs on the electrophysiological and behavioral correlates of smoking addiction and to determine whether labels rated higher on the emotional reaction (ER) scale are associated with greater effects. We studied 25 non-treatment-seeking smokers. Event-related potentials (ERPs) were recorded while participants viewed a random sequence of paired images, in which visual smoking (Cues) or non-smoking (non-Cues) images were preceded by GWLs or neutral images. Participants reported their cigarette craving after viewing each pair. Dependent variables were magnitude of P300 ERPs and self-reported cigarette craving in response to Cues. We found that subjective craving response to Cues was significantly reduced by preceding GWLs, whereas the P300 amplitude response to Cues was reduced only by preceding GWLs rated high on the ER scale. In conclusion, our study provides experimental neuroscience evidence that weighs in on the ongoing public and legal debate about how to balance the constitutional and public health aspects of the FDA-proposed GWLs. The high toll of smoking-related illness and death adds urgency to the debate and prompts consideration of our findings while longitudinal studies of GWLs are underway.
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Affiliation(s)
- An-Li Wang
- Annenberg Public Policy Center; University of Pennsylvania; Philadelphia PA USA
| | - Dan Romer
- Annenberg Public Policy Center; University of Pennsylvania; Philadelphia PA USA
| | - Igor Elman
- Department of Psychiatry; Cambridge Health Alliance and Harvard Medical School; Cambridge MA USA
- Providence VA Medical Center; Providence RI USA
| | - Bruce I. Turetsky
- Department of Psychiatry; Perelman School of Medicine; University of Pennsylvania; Philadelphia PA USA
| | - Ruben C. Gur
- Department of Psychiatry; Perelman School of Medicine; University of Pennsylvania; Philadelphia PA USA
| | - Daniel D. Langleben
- Annenberg Public Policy Center; University of Pennsylvania; Philadelphia PA USA
- Department of Psychiatry; Perelman School of Medicine; University of Pennsylvania; Philadelphia PA USA
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196
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Janes AC, Ross RS, Farmer S, Frederick BB, Nickerson LD, Lukas SE, Stern CE. Memory retrieval of smoking-related images induce greater insula activation as revealed by an fMRI-based delayed matching to sample task. Addict Biol 2015; 20:349-56. [PMID: 24261848 DOI: 10.1111/adb.12112] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Nicotine dependence is a chronic and difficult to treat disorder. While environmental stimuli associated with smoking precipitate craving and relapse, it is unknown whether smoking cues are cognitively processed differently than neutral stimuli. To evaluate working memory differences between smoking-related and neutral stimuli, we conducted a delay-match-to-sample (DMS) task concurrently with functional magnetic resonance imaging (fMRI) in nicotine-dependent participants. The DMS task evaluates brain activation during the encoding, maintenance and retrieval phases of working memory. Smoking images induced significantly more subjective craving, and greater midline cortical activation during encoding in comparison to neutral stimuli that were similar in content yet lacked a smoking component. The insula, which is involved in maintaining nicotine dependence, was active during the successful retrieval of previously viewed smoking versus neutral images. In contrast, neutral images required more prefrontal cortex-mediated active maintenance during the maintenance period. These findings indicate that distinct brain regions are involved in the different phases of working memory for smoking-related versus neutral images. Importantly, the results implicate the insula in the retrieval of smoking-related stimuli, which is relevant given the insula's emerging role in addiction.
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Affiliation(s)
- Amy C. Janes
- McLean Imaging Center; McLean Hospital, Harvard Medical School; Belmont MA USA
| | - Robert S. Ross
- Center for Memory and Brain; Boston University; Boston MA USA
- Department of Psychology; University of New Hampshire; Durham NH USA
| | - Stacey Farmer
- McLean Imaging Center; McLean Hospital, Harvard Medical School; Belmont MA USA
| | - Blaise B. Frederick
- McLean Imaging Center; McLean Hospital, Harvard Medical School; Belmont MA USA
| | - Lisa D. Nickerson
- McLean Imaging Center; McLean Hospital, Harvard Medical School; Belmont MA USA
| | - Scott E. Lukas
- McLean Imaging Center; McLean Hospital, Harvard Medical School; Belmont MA USA
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197
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McKee SA, Potenza MN, Kober H, Sofuoglu M, Arnsten AFT, Picciotto MR, Weinberger AH, Ashare R, Sinha R. A translational investigation targeting stress-reactivity and prefrontal cognitive control with guanfacine for smoking cessation. J Psychopharmacol 2015; 29:300-11. [PMID: 25516371 PMCID: PMC4376109 DOI: 10.1177/0269881114562091] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Stress and prefrontal cognitive dysfunction have key roles in driving smoking; however, there are no therapeutics for smoking cessation that attenuate the effects of stress on smoking and enhance cognition. Central noradrenergic pathways are involved in stress-induced reinstatement to nicotine and in the prefrontal executive control of adaptive behaviors. We used a novel translational approach employing a validated laboratory analogue of stress-precipitated smoking, functional magnetic resonance imaging (fMRI), and a proof-of-concept treatment period to evaluate whether the noradrenergic α2a agonist guanfacine (3 mg/day) versus placebo (0 mg/day) reduced stress-precipitated smoking in the laboratory, altered cortico-striatal activation during the Stroop cognitive-control task, and reduced smoking following a quit attempt. In nicotine-deprived smokers (n=33), stress versus a neutral condition significantly decreased the latency to smoke, and increased tobacco craving, ad-libitum smoking, and systolic blood pressure in placebo-treated subjects, and these effects were absent or reduced in guanfacine-treated subjects. Following stress, placebo-treated subjects demonstrated decreased cortisol levels whereas guanfacine-treated subjects demonstrated increased levels. Guanfacine, compared with placebo, altered prefrontal activity during a cognitive-control task, and reduced cigarette use but did not increase complete abstinence during treatment. These preliminary laboratory, neuroimaging, and clinical outcome data were consistent and complementary and support further development of guanfacine for smoking cessation.
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Affiliation(s)
- Sherry A. McKee
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT,Cancer Prevention and Control Research Program, Yale Cancer Center, New Haven, CT,Corresponding Author: Sherry A. McKee, Ph.D., Dept. of Psychiatry, Yale University School of Medicine, 2 Church St South, Suite 109, New Haven, CT., 06519 USA phone: 203-737-3529, fax 203-737-4243,
| | - Marc N. Potenza
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT,Department of Neurobiology, Yale University School of Medicine, New Haven, CT,Yale Child Study Center, Yale University School of Medicine, New Haven, CT
| | - Hedy Kober
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT
| | - Mehmet Sofuoglu
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT,VA Connecticut Healthcare System, West Haven, CT
| | - Amy F. T. Arnsten
- Department of Neurobiology, Yale University School of Medicine, New Haven, CT
| | | | - Andrea H. Weinberger
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT,Cancer Prevention and Control Research Program, Yale Cancer Center, New Haven, CT
| | - Rebecca Ashare
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Rajita Sinha
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT
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Dempsey JP, Harris KS, Shumway ST, Kimball TG, Herrera JC, Dsauza CM, Bradshaw SD. Functional near infrared spectroscopy as a potential biological assessment of addiction recovery: preliminary findings. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2015; 41:119-26. [DOI: 10.3109/00952990.2014.983273] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
| | - Kitty S. Harris
- Addictive Disorders and Recovery Studies Program, Department of Community, Family, & Addiction Services, Texas Tech University, Lubbock, TX, USA
| | - Sterling T. Shumway
- Addictive Disorders and Recovery Studies Program, Department of Community, Family, & Addiction Services, Texas Tech University, Lubbock, TX, USA
| | - Thomas G. Kimball
- Addictive Disorders and Recovery Studies Program, Department of Community, Family, & Addiction Services, Texas Tech University, Lubbock, TX, USA
| | - J. Caleb Herrera
- Addictive Disorders and Recovery Studies Program, Department of Community, Family, & Addiction Services, Texas Tech University, Lubbock, TX, USA
| | - Cynthia M. Dsauza
- Addictive Disorders and Recovery Studies Program, Department of Community, Family, & Addiction Services, Texas Tech University, Lubbock, TX, USA
| | - Spencer D. Bradshaw
- Addictive Disorders and Recovery Studies Program, Department of Community, Family, & Addiction Services, Texas Tech University, Lubbock, TX, USA
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Viswanath H, Velasquez KM, Savjani R, Molfese DL, Curtis K, Molfese PJ, Eagleman DM, Baldwin PR, Frueh BC, Fowler JC, Salas R. Interhemispheric insular and inferior frontal connectivity are associated with substance abuse in a psychiatric population. Neuropharmacology 2015; 92:63-8. [PMID: 25592214 DOI: 10.1016/j.neuropharm.2014.12.030] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2014] [Revised: 11/24/2014] [Accepted: 12/22/2014] [Indexed: 10/24/2022]
Abstract
Substance abuse is highly comorbid with major psychiatric disorders. While the neural underpinnings of drug abuse have been studied extensively, most existing studies compare drug users without comorbidities and healthy, non-user controls. Such studies do not generalize well to typical patients with substance abuse disorders. Therefore, we studied a population of psychiatric inpatients (n = 151) with a range of mental illnesses. Psychiatric disorders were diagnosed via structured interviews. Sixty-five percent of patients met criteria for at least one substance use disorder. Patients were recruited for resting state functional connectivity (RSFC) and diffusion tensor imaging (DTI) experiments to examine the interhemispheric connectivity between brain regions hypothesized to be involved in drug addiction, namely: the inferior, medial, and superior frontal gyri; insula; striatum; and anterior cingulate cortex. The World Health Organization Alcohol, Smoking, and Substance Involvement Screening Test (WHOA) questionnaire was used to further assess drug use. An association between use of tobacco, alcohol, cocaine, sedatives, and hallucinogens with increased insular interhemispheric connectivity was observed. In addition, increased inferior frontal gyrus interhemispheric connectivity was associated with amphetamine and inhalant use. Our results suggest that increased inter-hemispheric insula connectivity is associated with the use of several drugs of abuse. Importantly, psychiatric inpatients without a history of drug dependence were used as an ecologically valid control group rather than the more typical comparison between "mentally ill vs. healthy control" populations. We suggest that dysfunction of interhemispheric connectivity of the insula and to a lesser extent of the inferior frontal gyrus, are related to drug abuse in psychiatric populations.
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Affiliation(s)
- Humsini Viswanath
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, 77030, USA
| | - Kenia M Velasquez
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, 77030, USA
| | - Ricky Savjani
- Department of Neuroscience, Baylor College of Medicine, Houston, TX, 77030, USA
| | - David L Molfese
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, 77030, USA
| | - Kaylah Curtis
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, 77030, USA
| | - Peter J Molfese
- Department of Psychology, University of Connecticut, Mansfield, CT, 06269, USA; Haskins Laboratories, New Haven, CT, 06511, USA
| | - David M Eagleman
- Department of Neuroscience, Baylor College of Medicine, Houston, TX, 77030, USA
| | - Philip R Baldwin
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, 77030, USA
| | - B Christopher Frueh
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, 77030, USA; University of Hawaii, Department of Psychology, Hilo, HI, USA
| | - J Christopher Fowler
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, 77030, USA
| | - Ramiro Salas
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, 77030, USA.
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200
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Striatal morphology is associated with tobacco cigarette craving. Neuropsychopharmacology 2015; 40:406-11. [PMID: 25056595 PMCID: PMC4443954 DOI: 10.1038/npp.2014.185] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2014] [Revised: 06/27/2014] [Accepted: 07/15/2014] [Indexed: 01/28/2023]
Abstract
The striatum has a clear role in addictive disorders and is involved in drug-related craving. Recently, enhanced striatal volume was associated with greater lifetime nicotine exposure, suggesting a bridge between striatal function and structural phenotypes. To assess this link between striatal structure and function, we evaluated the relationship between striatal morphology and this brain region's well-established role in craving. In tobacco smokers, we assessed striatal volume, surface area, and shape using a new segmentation methodology coupled with local shape indices. Striatal morphology was then related with two measures of craving: state-based craving, assessed by the brief questionnaire of smoking urges (QSU), and craving induced by smoking-related images. A positive association was found between left striatal volume and surface area with both measures of craving. A more specific relationship was found between both craving measures and the dorsal, but not in ventral striatum. Evaluating dorsal striatal subregions showed a single relationship between the caudate and QSU. Although cue-induced craving and the QSU were both associated with enlarged striatal volume and surface area, these measures were differentially associated with global or more local striatal volumes. We also report a connection between greater right striatal shape deformations and cue-induced craving. Shape deformations associated with cue-induced craving were specific to striatal subregions involved in habitual responding to rewarding stimuli, which is relevant given the habitual nature of cue-induced craving. The current findings confirm a relationship between striatal function and morphology and suggest that variation in striatal morphology may be a biomarker for craving severity.
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