301
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Engelmann JM, Versace F, Robinson JD, Minnix JA, Lam CY, Cui Y, Brown VL, Cinciripini PM. Neural substrates of smoking cue reactivity: a meta-analysis of fMRI studies. Neuroimage 2011; 60:252-62. [PMID: 22206965 DOI: 10.1016/j.neuroimage.2011.12.024] [Citation(s) in RCA: 281] [Impact Index Per Article: 21.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2011] [Revised: 11/21/2011] [Accepted: 12/13/2011] [Indexed: 01/12/2023] Open
Abstract
Reactivity to smoking-related cues may be an important factor that precipitates relapse in smokers who are trying to quit. The neurobiology of smoking cue reactivity has been investigated in several fMRI studies. We combined the results of these studies using activation likelihood estimation, a meta-analytic technique for fMRI data. Results of the meta-analysis indicated that smoking cues reliably evoke larger fMRI responses than neutral cues in the extended visual system, precuneus, posterior cingulate gyrus, anterior cingulate gyrus, dorsal and medial prefrontal cortex, insula, and dorsal striatum. Subtraction meta-analyses revealed that parts of the extended visual system and dorsal prefrontal cortex are more reliably responsive to smoking cues in deprived smokers than in non-deprived smokers, and that short-duration cues presented in event-related designs produce larger responses in the extended visual system than long-duration cues presented in blocked designs. The areas that were found to be responsive to smoking cues agree with theories of the neurobiology of cue reactivity, with two exceptions. First, there was a reliable cue reactivity effect in the precuneus, which is not typically considered a brain region important to addiction. Second, we found no significant effect in the nucleus accumbens, an area that plays a critical role in addiction, but this effect may have been due to technical difficulties associated with measuring fMRI data in that region. The results of this meta-analysis suggest that the extended visual system should receive more attention in future studies of smoking cue reactivity.
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Affiliation(s)
- Jeffrey M Engelmann
- Department of Behavioral Science – Unit 1330, The University of Texas MD Anderson Cancer Center, P. O. Box 301439, Houston, TX 77030, USA.
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302
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Yalachkov Y, Kaiser J, Naumer MJ. Functional neuroimaging studies in addiction: multisensory drug stimuli and neural cue reactivity. Neurosci Biobehav Rev 2011; 36:825-35. [PMID: 22198678 DOI: 10.1016/j.neubiorev.2011.12.004] [Citation(s) in RCA: 84] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2011] [Revised: 11/26/2011] [Accepted: 12/09/2011] [Indexed: 12/31/2022]
Abstract
Neuroimaging studies on cue reactivity have substantially contributed to the understanding of addiction. In the majority of studies drug cues were presented in the visual modality. However, exposure to conditioned cues in real life occurs often simultaneously in more than one sensory modality. Therefore, multisensory cues should elicit cue reactivity more consistently than unisensory stimuli and increase the ecological validity and the reliability of brain activation measurements. This review includes the data from 44 whole-brain functional neuroimaging studies with a total of 1168 subjects (812 patients and 356 controls). Correlations between neural cue reactivity and clinical covariates such as craving have been reported significantly more often for multisensory than unisensory cues in the motor cortex, insula and posterior cingulate cortex. Thus, multisensory drug cues are particularly effective in revealing brain-behavior relationships in neurocircuits of addiction responsible for motivation, craving awareness and self-related processing.
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Affiliation(s)
- Yavor Yalachkov
- Institute of Medical Psychology, Goethe-University, Heinrich-Hoffmann-Strasse 10, Frankfurt am Main, Germany.
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303
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Versace F, Engelmann JM, Jackson EF, Costa VD, Robinson JD, Lam CY, Minnix JA, Brown VL, Wetter DW, Cinciripini PM. Do brain responses to emotional images and cigarette cues differ? An fMRI study in smokers. Eur J Neurosci 2011; 34:2054-63. [PMID: 22097928 DOI: 10.1111/j.1460-9568.2011.07915.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Chronic smoking is thought to cause changes in brain reward systems that result in overvaluation of cigarette-related stimuli and undervaluation of natural rewards. We tested the hypotheses that, in smokers, brain circuits involved in emotional processing: (i) would be more active during exposure to cigarette-related than neutral pictures; and (ii) would be less active to pleasant compared with cigarette-related pictures, suggesting a devaluation of intrinsically pleasant stimuli. We obtained whole-brain blood oxygenation level-dependent (BOLD) functional magnetic resonance imaging data from 35 smokers during the presentation of pleasant (erotica and romance), unpleasant (mutilations and sad), neutral, and cigarette-related pictures. Whole-brain analyses showed significantly larger BOLD responses during presentation of cigarette-related pictures relative to neutral ones within the secondary visual areas, the cingulate gyrus, the frontal gyrus, the dorsal striatum, and the left insula. BOLD responses to erotic pictures exceeded responses to cigarette-related pictures in all clusters except the insula. Within the left insula we observed larger BOLD responses to cigarette-related pictures than to all other picture categories. By including intrinsically pleasant and unpleasant pictures in addition to neutral ones, we were able to conclude that the presentation of cigarette-related pictures activates brain areas supporting emotional processes, but we did not find evidence of overall reduced activation of the brain reward systems in the presence of intrinsically pleasant stimuli.
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Affiliation(s)
- Francesco Versace
- Department of Behavioral Science-Unit 1330, The University of Texas MD Anderson Cancer Center, PO Box 30149, Houston, TX 77230, USA.
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304
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A double-blind, placebo-controlled trial of the NMDA glycine site antagonist, GW468816, for prevention of relapse to smoking in females. J Clin Psychopharmacol 2011; 31:597-602. [PMID: 21869693 PMCID: PMC3741043 DOI: 10.1097/jcp.0b013e31822bb390] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Relapse to smoking is common after initial abstinence with pharmacotherapy and behavioral support and represents a major clinical challenge. Although mechanisms underlying relapse to smoking have not been elucidated, preclinical studies suggest that glutamate receptors may be involved. We sought to test a selective antagonist of the glycine coagonist site on the glutamate N-methyl-D-aspartate receptor, GW468816, for prevention of relapse in recently abstinent smokers. To do so, we enrolled 264 healthy female smokers in an open 8-week smoking cessation intervention with behavioral therapy and a standard dose of transdermal nicotine replacement therapy with taper and additional gum or lozenge as needed for nicotine withdrawal symptoms. Ninety-eight participants achieved 7-day point prevalence abstinence and were randomized into a 5-week double-blind, placebo-controlled, relapse-prevention trial of GW468816 (200 mg/d) and then followed for 60 days after randomization. There was no effect of treatment on abstinence rates at the end of treatment (χ² [1, n = 96] = 0.168, P = 0.838), on the rates of relapse (χ² [1, n = 98] = 0.031, P = 1.000) or lapse (χ² [1, n = 62] = 0.802, P = 0.423), or on time to relapse (χ² [1, n = 98) = 0.001, P = 0.972). No significant relationships were detected between plasma GW468816 concentrations and abstinence, time to relapse, or self-reported craving. In conclusion, despite promising preclinical data that support the use of a selective NMDA glycine site antagonist for prevention of relapse to smoking, we observed no effect of GW468816 on relapse or lapse rates, time to relapse, or craving compared to placebo.
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305
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Wilson SJ, Sayette MA, Fiez JA. Quitting-unmotivated and quitting-motivated cigarette smokers exhibit different patterns of cue-elicited brain activation when anticipating an opportunity to smoke. JOURNAL OF ABNORMAL PSYCHOLOGY 2011; 121:198-211. [PMID: 21859165 DOI: 10.1037/a0025112] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
The authors examined the effects of smoking expectancy on cue-reactivity among those motivated and those unmotivated to quit smoking using functional MRI. Cue-elicited activation was observed in the rostral prefrontal cortex (PFC) in smokers who expected to smoke within seconds, but not in those who expected to have to wait hours before having the chance to smoke, regardless of quitting motivation. For quitting-unmotivated smokers expecting to smoke, rostral PFC activation was strongly positively correlated with the activation of several areas previously linked to cue-reactivity, including the medial orbitofrontal cortex (OFC) and rostral anterior cingulate cortex (ACC). In contrast, there was a nonsignificant negative relationship between activation of the rostral PFC and activation of the medial OFC/rostral ACC in quitting-motivated smokers expecting to smoke. Results extend previous work examining the effects of smoking expectancy and highlight the utility of examining interregional covariation during cue exposure. Findings also suggest that investigators may need to pay close attention to the motivational contexts associated with their experiments when studying cue-reactivity, as these contexts can modulate not only responses to drug cues, but perhaps also the functional implications of observed activity.
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Affiliation(s)
- Stephen J Wilson
- Department of Psychology, The Pennsylvania State University, University Park, PA 16802, USA.
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306
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Mashhoon Y, Janes AC, Jensen JE, Prescot AP, Pachas G, Renshaw PF, Fava M, Evins AE, Kaufman MJ. Anterior cingulate proton spectroscopy glutamate levels differ as a function of smoking cessation outcome. Prog Neuropsychopharmacol Biol Psychiatry 2011; 35:1709-13. [PMID: 21616118 PMCID: PMC3303218 DOI: 10.1016/j.pnpbp.2011.05.006] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2011] [Revised: 05/03/2011] [Accepted: 05/10/2011] [Indexed: 10/18/2022]
Abstract
BACKGROUND Cigarette smoking is the leading preventable cause of death. Unfortunately, the majority of smokers who attempt to quit smoking relapse within weeks. Abnormal dorsal anterior cingulate cortex (dACC) function may contribute to tobacco smoking relapse vulnerability. Growing evidence suggests that glutamate neurotransmission is involved in mediating nicotine dependence. We hypothesized that prior to a cessation attempt, dACC glutamate levels would be lower in relapse vulnerable smokers. METHODS Proton magnetic resonance spectra (MRS) were obtained from dACC and a control region, the parieto-occipital cortex (POC), using two-dimensional J-resolved MRS at 4T and analyzed using LCModel. Nine nicotine-dependent women were scanned prior to making a quit attempt. Subjects then were divided into two groups; those able to maintain subsequent abstinence aided by nicotine replacement therapy (NRT) and those who slipped while on NRT (smoked any part of a cigarette after attaining at least 24h of abstinence). RESULTS Slip subjects exhibited significantly reduced dACC MRS glutamate (Glu/Cr) levels (p<0.03) compared to abstinent subjects. This effect was not observed in the POC control region. CONCLUSIONS Our preliminary findings suggest that dACC Glu levels as measured with MRS may help identify and/or be a biomarker for relapse vulnerable smokers. Future research following up on these findings may help clarify the role of dACC Glu in smoking dependence that may lead to new treatment strategies.
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Affiliation(s)
- Yasmin Mashhoon
- McLean Hospital/Harvard Medical School, 115 Mill St., Belmont, MA 02478, United States.
| | - Amy C. Janes
- McLean Hospital/Harvard Medical School, 115 Mill St. Belmont, MA 02478, USA
| | - J. Eric Jensen
- McLean Hospital/Harvard Medical School, 115 Mill St. Belmont, MA 02478, USA
| | - Andrew P. Prescot
- McLean Hospital/Harvard Medical School, 115 Mill St. Belmont, MA 02478, USA
| | - Gladys Pachas
- Massachusetts General Hospital/Harvard Medical School, 55 Fruit St. Boston, MA 02114, USA
| | - Perry F. Renshaw
- McLean Hospital/Harvard Medical School, 115 Mill St. Belmont, MA 02478, USA
| | - Maurizio Fava
- Massachusetts General Hospital/Harvard Medical School, 55 Fruit St. Boston, MA 02114, USA
| | - A. Eden Evins
- Massachusetts General Hospital/Harvard Medical School, 55 Fruit St. Boston, MA 02114, USA
| | - Marc J. Kaufman
- McLean Hospital/Harvard Medical School, 115 Mill St. Belmont, MA 02478, USA
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307
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Yalachkov Y, Naumer MJ. Involvement of action-related brain regions in nicotine addiction. J Neurophysiol 2011; 106:1-3. [DOI: 10.1152/jn.00195.2011] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The study of Wagner et al. ( J Neurosci 31: 894–898, 2011) reveals the neural correlates of spontaneously activated action representations in smokers when subjects watch movie characters smoke. We stress the importance of differentiating how these representations are activated: while the anterior intraparietal sulcus and inferior frontal gyrus are part of the mirror neuron system of smokers, the middle frontal gyrus, premotor cortex, and superior parietal lobule represent the smoking-related tool use skills and action knowledge activated by smoking paraphernalia.
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Affiliation(s)
- Yavor Yalachkov
- Institute of Medical Psychology, Goethe-University, Frankfurt am Main, Germany; and
| | - Marcus J. Naumer
- Institute of Medical Psychology, Goethe-University, Frankfurt am Main, Germany; and
- Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
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308
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309
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Hanlon CA, Wesley MJ, Stapleton JR, Laurienti PJ, Porrino LJ. The association between frontal-striatal connectivity and sensorimotor control in cocaine users. Drug Alcohol Depend 2011; 115:240-3. [PMID: 21193273 PMCID: PMC3499027 DOI: 10.1016/j.drugalcdep.2010.11.008] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2010] [Revised: 10/21/2010] [Accepted: 11/01/2010] [Indexed: 11/17/2022]
Abstract
BACKGROUND In addition to cognitive and emotional processing dysfunction, chronic cocaine users are also impaired at simple sensorimotor tasks. Many diseases characterized by compulsive movements, repetitive actions, impaired attention and planning are associated with dysfunction in frontal-striatal circuits. The aim of this study was to determine whether cocaine users had impaired frontal-striatal connectivity during a simple movement task and whether this was associated with sensorimotor impairment. METHODS Functional MRI data were collected from 14 non-treatment seeking cocaine users and 15 healthy controls as they performed a finger-tapping task. Functional coupling was quantified by correlating the timecourses of each pair of anatomically connected regions of interest. Behavioral performance was correlated with all functional coupling coefficients. RESULTS In controls there was a significant relationship between the primary motor cortex and the supplementary motor area (SMA), as well as the SMA and the dorsal striatum during ongoing movement. Cocaine users exhibited weaker fronto-striatal coupling than controls, while the cortical-cortical coupling was intact. Coupling strength between the SMA and the caudate was negatively correlated with reaction time in the users. CONCLUSIONS The observation that cocaine users have impaired cortical-striatal connectivity during simple motor performance, suggests that these individuals may have a fundamental deficit in information processing that influences more complex cognitive processes.
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Affiliation(s)
- Colleen A. Hanlon
- Department of Physiology and Pharmacology, Wake Forest University School of Medicine, Winston-Salem, NC 27157 (U.S.A.)
| | - Michael J. Wesley
- Department of Physiology and Pharmacology, Wake Forest University School of Medicine, Winston-Salem, NC 27157 (U.S.A.)
| | - Jennifer R. Stapleton
- Department of Physiology and Pharmacology, Wake Forest University School of Medicine, Winston-Salem, NC 27157 (U.S.A.)
| | - Paul J. Laurienti
- Department of Radiology, Wake Forest University School of Medicine, Winston-Salem, NC 27157 (U.S.A.)
| | - Linda J. Porrino
- Department of Physiology and Pharmacology, Wake Forest University School of Medicine, Winston-Salem, NC 27157 (U.S.A.)
- Center for the Neurobiological Investigation of Drug Abuse, Wake Forest University School of Medicine, Winston-Salem, NC 27157 (U.S.A.)
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310
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Differences in "bottom-up" and "top-down" neural activity in current and former cigarette smokers: Evidence for neural substrates which may promote nicotine abstinence through increased cognitive control. Neuroimage 2011; 56:2258-75. [PMID: 21440645 DOI: 10.1016/j.neuroimage.2011.03.054] [Citation(s) in RCA: 136] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2010] [Revised: 03/17/2011] [Accepted: 03/21/2011] [Indexed: 11/21/2022] Open
Abstract
Drug-related stimuli, through conditioning, are thought to acquire incentive motivational properties that code possible reward availability and elicit an attentional bias, possibly through increased "bottom-up" neural processing. The processes underlying this attentional bias are considered important in the maintenance of addiction, and crucially, in relapse among substance users attempting to remain abstinent. Equally, impaired "top-down" cognitive control may impair the ability to restrain "bottom-up" pre-potent behaviours, such as drug use, following exposure to drug-related stimuli. Two experiments sought to identify the neural loci of bottom-up/top-down processing during fMRI. Experiment 1 utilised an attentional bias paradigm to examine the behavioural and neural responses to neutral, emotionally evocative and smoking-related cues in control (n=13), ex-smoking (n=10 - abstinent >12months) and smoking (n=13 - mean >6.5years of use) groups. Experiment 2 used a go/no-go paradigm to examine the neural correlates of motor response inhibition and error monitoring in the same sample. The results of Experiment 1 demonstrated that, across conditions, current smokers had significantly less neural activity in cortical but significantly more activity in subcortical areas compared to both controls and ex-smokers. Ex-smokers exhibited more neural activity than both control and smoker groups in prefrontal cortical regions. Similarly, Experiment 2 revealed that smokers had reduced neural activity in prefrontal cortical regions during motor response inhibition compared to controls while ex-smokers demonstrated greater neural activity in prefrontal cortical regions compared to both controls and smokers during error monitoring. The results reveal cortical and subcortical differences between current smokers and controls and a general pattern of increased prefrontal cortical activity in ex-smokers. These findings may suggest that elevated topdown control might be an important characteristic of successful abstinence in individuals formerly dependent on nicotine.
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311
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Decker SA, Gay JN. Cognitive-bias toward gaming-related words and disinhibition in World of Warcraft gamers. COMPUTERS IN HUMAN BEHAVIOR 2011. [DOI: 10.1016/j.chb.2010.11.005] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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312
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Potenza MN, Sofuoglu M, Carroll KM, Rounsaville BJ. Neuroscience of behavioral and pharmacological treatments for addictions. Neuron 2011; 69:695-712. [PMID: 21338880 PMCID: PMC3063555 DOI: 10.1016/j.neuron.2011.02.009] [Citation(s) in RCA: 141] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/04/2011] [Indexed: 01/30/2023]
Abstract
Although substantial advances have been made in behavioral and pharmacological treatments for addictions, moving treatment development to the next stage may require novel ways of approaching addictions, particularly ways based on new findings regarding the neurobiological underpinnings of addictions that also assimilate and incorporate relevant information from earlier approaches. In this review, we first briefly review theoretical and biological models of addiction and then describe existing behavioral and pharmacologic therapies for the addictions within this framework. We then propose new directions for treatment development and targets that are informed by recent evidence regarding the heterogeneity of addictions and the neurobiological contributions to these disorders.
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Affiliation(s)
- Marc N Potenza
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06519, USA.
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313
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Perkins KA, Lerman C. Early human screening of medications to treat drug addiction: novel paradigms and the relevance of pharmacogenetics. Clin Pharmacol Ther 2011; 89:460-3. [PMID: 21270792 DOI: 10.1038/clpt.2010.254] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Affiliation(s)
- K A Perkins
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
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314
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Franklin T, Wang Z, Suh JJ, Hazan R, Cruz J, Li Y, Goldman M, Detre JA, O'Brien CP, Childress AR. Effects of varenicline on smoking cue–triggered neural and craving responses. ACTA ACUST UNITED AC 2011; 68:516-26. [PMID: 21199958 DOI: 10.1001/archgenpsychiatry.2010.190] [Citation(s) in RCA: 126] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
CONTEXT Varenicline, an effective smoking cessation medication, functions as an α4β2 nicotinic acetylcholine receptor partial agonist. It indirectly affects the dopaminergic reward system by reducing withdrawal symptoms during abstinence and by decreasing the reinforcement received from nicotine while smoking. We hypothesize that varenicline would have a third mechanism to blunt responses to smoking cues in the reward-related ventral striatum and medial orbitofrontal cortex and would be associated with a reduction in smoking cue–elicited craving. DESIGN A laboratory model of conditioned responding and arterial spin-labeled perfusion functional magnetic resonance imaging, a biomarker of regional brain activity, was used to test our hypothesis. Perfusion functional magnetic resonance imaging is quantitative and stable across time, facilitating the measurement of medication-induced neural modifications in the brain in response to a challenge (smoking cue exposure) and in the brain in the resting condition (without provocation). Smokers were imaged during rest and during smoking cue exposure before and after a 3-week randomized placebo-controlled medication regimen. Subjects were nonabstinent to explicitly examine the effects of varenicline on cue reactivity independent of withdrawal. SETTING Center for the Study of Addictions, University of Pennsylvania, Philadelphia. Subjects Subjects were nicotine-dependent smokers who responded to advertisements placed on local radio and Listservs to participate in a medication-related research study that specifically stated "this is not a Quit Smoking Study" and "smokers may be contemplating but not currently considering quitting." RESULTS Prerandomization smoking cues vs nonsmoking cues activated the ventral striatum and medial orbitofrontal cortex (t = 3.77) and elicited subjective reports of craving (P = .006). Craving reports correlated with increased activity in the posterior cingulate (t = 4.11). Administration of varenicline diminished smoking cue–elicited ventral striatum and medial orbitofrontal cortex responses (t values from –3.75 to –5.63) and reduced self-reported smoking cue–elicited craving, whereas placebo-treated subjects exhibited responses similar to those observed prior to randomization. Varenicline-induced activation of lateral orbitofrontal cortex in the brain at rest (t = 5.63) predicted blunting of smoking cue responses in the medial orbitofrontal cortex (r = –0.74). CONCLUSIONS Varenicline's reciprocal actions in the reward-activated medial orbitofrontal cortex and in the reward-evaluating lateral orbitofrontal cortex underlie a diminished smoking cue response, revealing a distinctive new action that likely contributes to its clinical efficacy.
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Affiliation(s)
- Teresa Franklin
- Department of Psychiatry, University of Pennsylvania and Veterans Affairs Medical Center, Philadelphia, PA 19104, USA.
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315
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Janes AC, Pizzagalli DA, Richardt S, Frederick BDB, Holmes AJ, Sousa J, Fava M, Evins AE, Kaufman MJ. Neural substrates of attentional bias for smoking-related cues: an FMRI study. Neuropsychopharmacology 2010; 35:2339-45. [PMID: 20703221 PMCID: PMC2955848 DOI: 10.1038/npp.2010.103] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Attentional bias for drug-related stimuli, as measured by emotional Stroop (ES) tasks, is predictive of treatment outcomes for tobacco smoking and other abused drugs. Characterizing relationships between smoking-related attentional bias and brain reactivity to smoking images may help in identifying neural substrates critical to relapse vulnerability. To this end, we investigated putative relationships between interference effects in an offline smoking ES task and functional MRI (fMRI) measures of brain reactivity to smoking vs neutral images in women smokers. Positive correlations were found between attentional bias and reactivity to smoking images in brain areas involved in emotion, memory, interoception, and visual processing, including the amygdala, hippocampus, parahippocampal gyrus, insula, and occipital cortex. These findings suggest that smokers with elevated attentional biases to smoking-related stimuli may more readily shift attention away from other external stimuli and toward smoking stimuli-induced internal states and emotional memories. Such attentional shifts may contribute to increased interference by smoking cues, possibly increasing relapse vulnerability. Treatments capable of inhibiting shifts to drug cue-induced memories and internal states may lead to personalized tobacco dependence treatment for smokers with high attentional bias to smoking-related stimuli.
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Affiliation(s)
- Amy C Janes
- Brain Imaging Center, McLean Hospital, Belmont, MA 02478, USA.
| | | | | | | | - Avram J Holmes
- Department of Psychology, Harvard University, Cambridge, MA, USA
| | - Jessica Sousa
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Maurizio Fava
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - A Eden Evins
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
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