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Courtney KE, Baca R, Thompson C, Andrade G, Doran N, Jacobson A, Liu TT, Jacobus J. The effects of nicotine use during adolescence and young adulthood on gray matter cerebral blood flow estimates. Brain Imaging Behav 2024; 18:34-43. [PMID: 37851272 PMCID: PMC10844445 DOI: 10.1007/s11682-023-00810-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/09/2023] [Indexed: 10/19/2023]
Abstract
Nicotine and tobacco product (NTP) use remains prevalent in adolescence/young adulthood. The effects of NTPs on markers of brain health during this vulnerable neurodevelopmental period remain largely unknown. This report investigates associations between NTP use and gray matter cerebral blood flow (CBF) in adolescents/young adults. Adolescent/young adult (16-22 years-old) nicotine users (NTP; N = 99; 40 women) and non-users (non-NTP; N = 95; 56 women) underwent neuroimaging sessions including anatomical and optimized pseudo-continuous arterial spin labeling scans. Groups were compared on whole-brain gray matter CBF estimates and their relation to age and sex at birth. Follow-up analyses assessed correlations between identified CBF clusters and NTP recency and dependence measures. Controlling for age and sex, the NTP vs. non-NTP contrast revealed a single cluster that survived thresholding which included portions of bilateral precuneus (voxel-wise alpha < 0.001, cluster-wise alpha < 0.05; ≥7 contiguous voxels). An interaction between NTP group contrast and age was observed in two clusters including regions of the left posterior cingulate (PCC)/lingual gyrus and right anterior cingulate cortex (ACC): non-NTP exhibited positive correlations between CBF and age in these clusters, whereas NTP exhibited negative correlations between CBF and age. Lower CBF from these three clusters correlated with urine cotinine (rs=-0.21 - - 0.16; ps < 0.04) and nicotine dependence severity (rs=-0.16 - - 0.13; ps < 0.07). This is the first investigation of gray matter CBF in adolescent/young adult users of NTPs. The results are consistent with literature on adults showing age- and nicotine-related declines in CBF and identify the precuneus/PCC and ACC as potential key regions subserving the development of nicotine dependence.
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Affiliation(s)
- Kelly E Courtney
- Department of Psychiatry, University of California San Diego, 9500 Gilman Drive, MC 0405, La Jolla, CA, 92093, USA
| | - Rachel Baca
- Department of Psychiatry, University of California San Diego, 9500 Gilman Drive, MC 0405, La Jolla, CA, 92093, USA
| | - Courtney Thompson
- Department of Psychiatry, University of California San Diego, 9500 Gilman Drive, MC 0405, La Jolla, CA, 92093, USA
| | - Gianna Andrade
- Department of Psychiatry, University of California San Diego, 9500 Gilman Drive, MC 0405, La Jolla, CA, 92093, USA
| | - Neal Doran
- Department of Psychiatry, University of California San Diego, 9500 Gilman Drive, MC 0405, La Jolla, CA, 92093, USA
- Veterans Affairs San Diego Healthcare System, La Jolla, CA, USA
| | - Aaron Jacobson
- Department of Radiology, University of California San Diego, La Jolla, CA, USA
| | - Thomas T Liu
- Department of Radiology, University of California San Diego, La Jolla, CA, USA
| | - Joanna Jacobus
- Department of Psychiatry, University of California San Diego, 9500 Gilman Drive, MC 0405, La Jolla, CA, 92093, USA.
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Tabibnia G, Ghahremani DG, Pochon JBF, Diaz MP, London ED. Negative affect and craving during abstinence from smoking are both linked to default mode network connectivity. Drug Alcohol Depend 2023; 249:109919. [PMID: 37270935 PMCID: PMC10516582 DOI: 10.1016/j.drugalcdep.2023.109919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 04/11/2023] [Accepted: 05/09/2023] [Indexed: 06/06/2023]
Abstract
BACKGROUND Negative affect and craving during abstinence from cigarettes predict resumption of smoking. Therefore, understanding their neural substrates may guide development of new interventions. Negative affect and craving have traditionally been linked to functions of the brain's threat and reward networks, respectively. However, given the role of default mode network (DMN), particularly the posterior cingulate cortex (PCC), in self-related thought, we examined whether DMN activity underlies both craving and negative affective states in adults who smoke. METHODS 46 adults who smoke abstained from smoking overnight and underwent resting-state fMRI, after self-reporting their psychological symptoms (negative affect) and craving on the Shiffman-Jarvik Withdrawal Scale and state anxiety (negative affect) on the Spielberger State-Trait Anxiety Inventory. Within-DMN functional connectivity using 3 different anterior PCC seeds was tested for correlations with self-report measures. Additionally, independent component analysis with dual regression was performed to measure associations of self-report with whole-brain connectivity of the DMN component. RESULTS Craving correlated positively with connectivity of all three anterior PCC seeds with posterior PCC clusters (pcorr<0.04). The measures of negative affective states correlated positively with connectivity of the DMN component to various brain regions, including posterior PCC (pcorr=0.02) and striatum (pcorr<0.008). Craving and state anxiety were correlated with connectivity of an overlapping region of PCC (pcorr=0.003). Unlike the state measures, nicotine dependence and trait anxiety were not associated with PCC connectivity within DMN. CONCLUSIONS Although negative affect and craving are distinct subjective states, they appear to share a common neural pathway within the DMN, particularly involving the PCC.
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Affiliation(s)
- Golnaz Tabibnia
- Department of Psychological Science, University of California, Irvine, CA, USA.
| | - Dara G Ghahremani
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
| | - Jean-Baptiste F Pochon
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
| | - Maylen Perez Diaz
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
| | - Edythe D London
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
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Chen H, Zha R, Lai X, Liu Y, Wei Z, Wang M, Zuo H, Hong W, Fan C, Jin C, Cui G, Tao R, Liang P, Zhang X. Internet gaming disorder and tobacco use disorder share neural connectivity patterns between the subcortical and the motor network. Hum Brain Mapp 2023; 44:2607-2619. [PMID: 36807959 PMCID: PMC10028654 DOI: 10.1002/hbm.26233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 01/09/2023] [Accepted: 01/26/2023] [Indexed: 02/22/2023] Open
Abstract
Internet gaming disorder (IGD) and tobacco use disorder (TUD) are globally common, non-substance-related disorders and substance-related disorders worldwide, respectively. Recognizing the commonalities between IGD and TUD will deepen understanding of the underlying mechanisms of addictive behavior and excessive online gaming. Using node strength, 141 resting-state data were collected in this study to compute network homogeneity. The participants included participants with IGD (PIGD: n = 34, male = 29, age: 15-25 years), participants with TUD (PTUD: n = 33, male = 33, age: 19-42 years), and matched healthy controls (control-for-IGD: n = 41, male = 38, age: 17-32 years; control-for-TUD: n = 33, age: 21-27 years). PIGD and PTUD exhibited common enhanced node strength between the subcortical and motor networks. Additionally, a common enhanced resting-state functional connectivity (RSFC) was found between the right thalamus and right postcentral gyrus in PIGD and PTUD. Node strength and RSFC were used to distinguish PIGD and PTUD from their respective healthy controls. Interestingly, models trained on PIGD versus controls could classify PTUD versus controls and vice versa, suggesting that these disorders share common neurological patterns. Enhanced connectivity may indicate a greater association between rewards and behaviors, inducing addiction behaviors without flexible and complex regulation. This study discovered that the connectivity between the subcortical and motor networks is a potential biological target for developing addiction treatment in the future.
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Affiliation(s)
- Hui Chen
- Hefei National Research Center for Physical Sciences at the Microscale, and Department of Radiology, the First Affiliated Hospital of USTC, Division of Life Science and Medicine, University of Science and Technology of China, Hefei, Anhui, China
- Department of Psychology, School of Humanities & Social Science, University of Science and Technology of China, Hefei, Anhui, China
| | - Rujing Zha
- Hefei National Research Center for Physical Sciences at the Microscale, and Department of Radiology, the First Affiliated Hospital of USTC, Division of Life Science and Medicine, University of Science and Technology of China, Hefei, Anhui, China
- Department of Psychology, School of Humanities & Social Science, University of Science and Technology of China, Hefei, Anhui, China
| | - Xin Lai
- Hefei National Research Center for Physical Sciences at the Microscale, and Department of Radiology, the First Affiliated Hospital of USTC, Division of Life Science and Medicine, University of Science and Technology of China, Hefei, Anhui, China
- Department of Psychology, School of Humanities & Social Science, University of Science and Technology of China, Hefei, Anhui, China
| | - Yan Liu
- Application Technology Center of Physical Therapy to Brain Disorders, Institute of Advanced Technology, University of Science and Technology of China, Hefei, Anhui, China
| | - Zhengde Wei
- Hefei National Research Center for Physical Sciences at the Microscale, and Department of Radiology, the First Affiliated Hospital of USTC, Division of Life Science and Medicine, University of Science and Technology of China, Hefei, Anhui, China
- Department of Psychology, School of Humanities & Social Science, University of Science and Technology of China, Hefei, Anhui, China
| | - Min Wang
- Hefei National Research Center for Physical Sciences at the Microscale, and Department of Radiology, the First Affiliated Hospital of USTC, Division of Life Science and Medicine, University of Science and Technology of China, Hefei, Anhui, China
- Department of Psychology, School of Humanities & Social Science, University of Science and Technology of China, Hefei, Anhui, China
| | - Huilin Zuo
- Hefei National Research Center for Physical Sciences at the Microscale, and Department of Radiology, the First Affiliated Hospital of USTC, Division of Life Science and Medicine, University of Science and Technology of China, Hefei, Anhui, China
- Department of Psychology, School of Humanities & Social Science, University of Science and Technology of China, Hefei, Anhui, China
| | - Wei Hong
- Hefei National Research Center for Physical Sciences at the Microscale, and Department of Radiology, the First Affiliated Hospital of USTC, Division of Life Science and Medicine, University of Science and Technology of China, Hefei, Anhui, China
- Department of Psychology, School of Humanities & Social Science, University of Science and Technology of China, Hefei, Anhui, China
| | - Chuan Fan
- Hefei National Research Center for Physical Sciences at the Microscale, and Department of Radiology, the First Affiliated Hospital of USTC, Division of Life Science and Medicine, University of Science and Technology of China, Hefei, Anhui, China
- Department of Psychology, School of Humanities & Social Science, University of Science and Technology of China, Hefei, Anhui, China
| | - Chen Jin
- Hefei National Research Center for Physical Sciences at the Microscale, and Department of Radiology, the First Affiliated Hospital of USTC, Division of Life Science and Medicine, University of Science and Technology of China, Hefei, Anhui, China
- Department of Psychology, School of Humanities & Social Science, University of Science and Technology of China, Hefei, Anhui, China
| | - Guanbao Cui
- Hefei National Research Center for Physical Sciences at the Microscale, and Department of Radiology, the First Affiliated Hospital of USTC, Division of Life Science and Medicine, University of Science and Technology of China, Hefei, Anhui, China
- Department of Psychology, School of Humanities & Social Science, University of Science and Technology of China, Hefei, Anhui, China
| | - Ran Tao
- Beijing Shijian Integrated Medicine Science Institute, Beijing, China
| | - Peipeng Liang
- School of Psychology, Beijing Key Laboratory of Learning and Cognition, Capital Normal University, Beijing, China
| | - Xiaochu Zhang
- Hefei National Research Center for Physical Sciences at the Microscale, and Department of Radiology, the First Affiliated Hospital of USTC, Division of Life Science and Medicine, University of Science and Technology of China, Hefei, Anhui, China
- Department of Psychology, School of Humanities & Social Science, University of Science and Technology of China, Hefei, Anhui, China
- Application Technology Center of Physical Therapy to Brain Disorders, Institute of Advanced Technology, University of Science and Technology of China, Hefei, Anhui, China
- Institute of Health and Medicine, Hefei Comprehensive National Science Center, Hefei, Anhui, China
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4
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Chen Y, Dhingra I, Chaudhary S, Fucito L, Li CSR. Overnight Abstinence Is Associated With Smaller Secondary Somatosensory Cortical Volumes and Higher Somatosensory-Motor Cortical Functional Connectivity in Cigarette Smokers. Nicotine Tob Res 2022; 24:1889-1897. [PMID: 35796689 PMCID: PMC9653081 DOI: 10.1093/ntr/ntac168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 05/31/2022] [Accepted: 07/05/2022] [Indexed: 01/03/2023]
Abstract
INTRODUCTION Abstinence symptoms present challenges to successful cessation of cigarette smoking. Chronic exposure to nicotine and long-term nicotine abstinence are associated with alterations in cortical and subcortical gray matter volumes (GMVs). AIMS AND METHODS We aimed at examining changes in regional GMVs following overnight abstinence and how these regional functions relate to abstinence symptoms. Here, in a sample of 31 regular smokers scanned both in a satiety state and after overnight abstinence, we employed voxel-wise morphometry and resting-state functional connectivity (rsFC) to investigate these issues. We processed imaging data with published routines and evaluated the results with a corrected threshold. RESULTS Smokers showed smaller GMVs of the left ventral hippocampus and right secondary somatosensory cortex (SII) after overnight abstinence as compared to satiety. The GMV alterations in right SII were positively correlated with changes in withdrawal symptom severity between states. Furthermore, right SII rsFC with the precentral gyrus was stronger in abstinence as compared to satiety. The inter-regional rsFC was positively correlated with motor impulsivity and withdrawal symptom severity during abstinence and negatively with craving to smoke during satiety. CONCLUSIONS These findings highlight for the first time the effects of overnight abstinence on cerebral volumetrics and changes in functional connectivity of a higher-order sensory cortex. These changes may dispose smokers to impulsive behaviors and aggravate the urge to smoke at the earliest stage of withdrawal from nicotine. IMPLICATIONS Overnight abstinence leads to changes in gray matter volumes and functional connectivity of the second somatosensory cortex in cigarette smokers. Higher somatosensory and motor cortical connectivity in abstinence is significantly correlated with trait motor impulsivity and withdrawal symptom severity. The findings add to the literature of neural markers of nicotine addiction.
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Affiliation(s)
- Yu Chen
- Corresponding Author: Dr. Yu Chen, PhD, Department of Psychiatry, Yale University School of Medicine, Connecticut Mental Health Center S110A, 34 Park Street, New Haven, CT 06519, USA. Telephone: +1 (347) 819-2969; E-mail:
| | - Isha Dhingra
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06520, USA
| | - Shefali Chaudhary
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06520, USA
| | - Lisa Fucito
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06520, USA
| | - Chiang-Shan R Li
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06520, USA
- Department of Neuroscience, Yale University School of Medicine, New Haven, CT 06520, USA
- Inter-department Neuroscience Program, Yale University, New Haven, CT 06520, USA
- Wu Tsai Institute, Yale University, New Haven, CT 06520, USA
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5
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Tolomeo S, Yu R. Brain network dysfunctions in addiction: a meta-analysis of resting-state functional connectivity. Transl Psychiatry 2022; 12:41. [PMID: 35091540 PMCID: PMC8799706 DOI: 10.1038/s41398-022-01792-6] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 01/05/2022] [Accepted: 01/12/2022] [Indexed: 11/16/2022] Open
Abstract
Resting-state functional connectivity (rsFC) provides novel insights into variabilities in neural networks associated with the use of addictive drugs or with addictive behavioral repertoire. However, given the broad mix of inconsistent findings across studies, identifying specific consistent patterns of network abnormalities is warranted. Here we aimed at integrating rsFC abnormalities and systematically searching for large-scale functional brain networks in substance use disorder (SUD) and behavioral addictions (BA), through a coordinate-based meta-analysis of seed-based rsFC studies. A total of fifty-two studies are eligible in the meta-analysis, including 1911 SUD and BA patients and 1580 healthy controls. In addition, we performed multilevel kernel density analysis (MKDA) for the brain regions reliably involved in hyperconnectivity and hypoconnectivity in SUD and BA. Data from fifty-two studies showed that SUD was associated with putamen, caudate and middle frontal gyrus hyperconnectivity relative to healthy controls. Eight BA studies showed hyperconnectivity clusters within the putamen and medio-temporal lobe relative to healthy controls. Altered connectivity in salience or emotion-processing areas may be related to dysregulated affective and cognitive control-related networks, such as deficits in regulating elevated sensitivity to drug-related stimuli. These findings confirm that SUD and BA might be characterized by dysfunctions in specific brain networks, particularly those implicated in the core cognitive and affective functions. These findings might provide insight into the development of neural mechanistic biomarkers for SUD and BA.
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Affiliation(s)
- Serenella Tolomeo
- Institute of High Performance Computing, Agency for Science, Technology and Research (A*STAR), Singapore, Singapore.
| | - Rongjun Yu
- Department of Management, Hong Kong Baptist University, Hong Kong, China.
- Department of Sport, Physical Education and Health, Hong Kong Baptist University, Hong Kong, China.
- Department of Physics, Hong Kong Baptist University, Hong Kong, China.
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6
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Ward HB, Brady RO, Halko MA, Lizano P. Noninvasive Brain Stimulation for Nicotine Dependence in Schizophrenia: A Mini Review. Front Psychiatry 2022; 13:824878. [PMID: 35222123 PMCID: PMC8863675 DOI: 10.3389/fpsyt.2022.824878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 01/14/2022] [Indexed: 11/13/2022] Open
Abstract
Individuals with schizophrenia are 10 times more likely to have a tobacco use disorder than the general population. Up to 80% of those with schizophrenia smoke tobacco regularly, a prevalence three-times that of the general population. Despite the striking prevalence of tobacco use in schizophrenia, current treatments are not tailored to the pathophysiology of this population. There is growing support for use of noninvasive brain stimulation (NIBS) to treat substance use disorders (SUDs), particularly for tobacco use in neurotypical smokers. NIBS interventions targeting the dorsolateral prefrontal cortex have been effective for nicotine dependence in control populations-so much so that transcranial magnetic stimulation is now FDA-approved for smoking cessation. However, this has not borne out in the studies using this approach in schizophrenia. We performed a literature search to identify articles using NIBS for the treatment of nicotine dependence in people with schizophrenia, which identified six studies. These studies yielded mixed results. Is it possible that nicotine has a unique effect in schizophrenia that is different than its effect in neurotypical smokers? Individuals with schizophrenia may receive additional benefit from nicotine's pro-cognitive effects than control populations and may use nicotine to improve brain network abnormalities from their illness. Therefore, clinical trials of NIBS interventions should test a schizophrenia-specific target for smoking cessation. We propose a generalized approach whereby schizophrenia-specific brain circuitry related to SUDs is be identified and then targeted with NIBS interventions.
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Affiliation(s)
- Heather Burrell Ward
- Department of Neurology, Berenson-Allen Center for Noninvasive Brain Stimulation, Beth Israel Deaconess Medical Center, Boston, MA, United States.,Department of Psychiatry, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, United States
| | - Roscoe O Brady
- Department of Neurology, Berenson-Allen Center for Noninvasive Brain Stimulation, Beth Israel Deaconess Medical Center, Boston, MA, United States.,Department of Psychiatry, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, United States.,McLean Hospital, Belmont, MA, United States.,Harvard Medical School, Boston, MA, United States
| | - Mark A Halko
- McLean Hospital, Belmont, MA, United States.,Harvard Medical School, Boston, MA, United States
| | - Paulo Lizano
- Department of Psychiatry, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, United States
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7
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Ward HB, Beermann A, Nawaz U, Halko MA, Janes AC, Moran LV, Brady RO. Evidence for Schizophrenia-Specific Pathophysiology of Nicotine Dependence. Front Psychiatry 2022; 13:804055. [PMID: 35153877 PMCID: PMC8829345 DOI: 10.3389/fpsyt.2022.804055] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 01/03/2022] [Indexed: 12/30/2022] Open
Abstract
Tobacco use is the top preventable cause of early mortality in schizophrenia. Over 60% of people with schizophrenia smoke, three times the general prevalence. The biological basis of this increased risk is not understood, and existing interventions do not target schizophrenia-specific pathology. We therefore used a connectome-wide analysis to identify schizophrenia-specific circuits of nicotine addiction. We reanalyzed data from two studies: In Cohort 1, 35 smokers (18 schizophrenia, 17 control) underwent resting-state fMRI and clinical characterization. A multivariate pattern analysis of whole-connectome data was used to identify the strongest links between cigarette use and functional connectivity. In Cohort 2, 12 schizophrenia participants and 12 controls were enrolled in a randomized, controlled crossover study of nicotine patch with resting-state fMRI. We correlated change in network functional connectivity with nicotine dose. In Cohort 1, the strongest (p < 0.001) correlate between connectivity and cigarette use was driven by individual variation in default mode network (DMN) topography. In individuals with greater daily cigarette consumption, we observed a pathological expansion of the DMN territory into the identified parieto-occipital region, while in individuals with lower daily cigarette consumption, this region was external to the DMN. This effect was entirely driven by schizophrenia participants. Given the relationship between DMN topography and nicotine use we observed in Cohort 1, we sought to directly test the impact of nicotine on this network using an independent second cohort. In Cohort 2, nicotine reduced DMN connectivity in a dose-dependent manner (R = -0.50; 95% CI -0.75 to -0.12, p < 0.05). In the placebo condition, schizophrenia subjects had hyperconnectivity compared to controls (p < 0.05). Nicotine administration normalized DMN hyperconnectivity in schizophrenia. We here provide direct evidence that the biological basis of nicotine dependence is different in schizophrenia and in non-schizophrenia populations. Our results suggest the high prevalence of nicotine use in schizophrenia may be an attempt to correct a network deficit known to interfere with cognition.
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Affiliation(s)
- Heather Burrell Ward
- Beth Israel Deaconess Medical Center, Boston, MA, United States.,Harvard Medical School, Boston, MA, United States
| | - Adam Beermann
- Beth Israel Deaconess Medical Center, Boston, MA, United States
| | - Uzma Nawaz
- Beth Israel Deaconess Medical Center, Boston, MA, United States
| | - Mark A Halko
- Harvard Medical School, Boston, MA, United States.,McLean Hospital, Belmont, MA, United States
| | - Amy C Janes
- Harvard Medical School, Boston, MA, United States.,McLean Hospital, Belmont, MA, United States
| | - Lauren V Moran
- Harvard Medical School, Boston, MA, United States.,McLean Hospital, Belmont, MA, United States
| | - Roscoe O Brady
- Beth Israel Deaconess Medical Center, Boston, MA, United States.,Harvard Medical School, Boston, MA, United States.,McLean Hospital, Belmont, MA, United States
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8
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Linli Z, Huang X, Liu Z, Guo S, Sariah A. A multivariate pattern analysis of resting-state functional MRI data in Naïve and chronic betel quid chewers. Brain Imaging Behav 2021; 15:1222-1234. [PMID: 32712800 DOI: 10.1007/s11682-020-00322-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Betel quid (BQ) is the fourth most commonly consumed psychoactive substance in the world. However, comprehensive functional magnetic resonance imaging (fMRI) studies exploring the neurophysiological mechanism of BQ addiction are lacking. Betel-quid-dependent (BQD) individuals (n = 24) and age-matched healthy controls (HC) (n = 26) underwent fMRI before and after chewing BQ. Multivariate pattern analysis (MVPA) was used to explore the acute effects of BQ-chewing in both groups. A cross-sectional comparison was conducted to explore the chronic effects of BQ-chewing. Regression analysis was used to investigate the relationship between altered circuits of BQD individuals and the severity of BQ addiction. MVPA achieved classification accuracies of up to 90% in both groups for acute BQ-chewing. Suppression of the default-mode network was the most prominent feature. BQD showed more extensive and intensive within- and between-network dysconnectivity of the default, frontal-parietal, and occipital regions associated with high-order brain functions such as self-awareness, inhibitory control, and decision-making. In contrast, the chronic effects of BQ on the brain function were mild, but impaired circuits were predominately located in the default and frontal-parietal networks which might be associated with compulsive drug use. Simultaneously quantifying the effects of both chronic and acute BQ exposure provides a possible neuroimaging-based BQ addiction foci. Results from this study may help us understand the neural mechanisms involved in BQ-chewing and BQ dependence.
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Affiliation(s)
- Zeqiang Linli
- MOE-LCSM, School of Mathematics and Statistics, Hunan Normal University, Changsha, People's Republic of China
- Key Laboratory of Applied Statistics and Data Science, Hunan Normal University, College of Hunan Province, Changsha, People's Republic of China
| | - Xiaojun Huang
- Mental Health Institute of the Second Xiangya Hospital, Central South University, Changsha, Hunan, People's Republic of China
| | - Zhening Liu
- Mental Health Institute of the Second Xiangya Hospital, Central South University, Changsha, Hunan, People's Republic of China
| | - Shuixia Guo
- MOE-LCSM, School of Mathematics and Statistics, Hunan Normal University, Changsha, People's Republic of China.
- Key Laboratory of Applied Statistics and Data Science, Hunan Normal University, College of Hunan Province, Changsha, People's Republic of China.
| | - Adellah Sariah
- Mental Health Institute of the Second Xiangya Hospital, Central South University, Changsha, Hunan, People's Republic of China.
- Department of Mental Health and Psychiatric Nursing, Hubert Kairuki Memorial University, Dar es Salaam, Tanzania.
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9
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Zhornitsky S, Le TM, Wang W, Dhingra I, Chen Y, Li CSR, Zhang S. Midcingulate Cortical Activations Interrelate Chronic Craving and Physiological Responses to Negative Emotions in Cocaine Addiction. BIOLOGICAL PSYCHIATRY GLOBAL OPEN SCIENCE 2021; 1:37-47. [PMID: 35664438 PMCID: PMC9164547 DOI: 10.1016/j.bpsgos.2021.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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10
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Zhang X, Wang S, Liu Y, Chen H. More restriction, more overeating: conflict monitoring ability is impaired by food-thought suppression among restrained eaters. Brain Imaging Behav 2020; 15:2069-2080. [PMID: 33033984 DOI: 10.1007/s11682-020-00401-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2020] [Indexed: 11/30/2022]
Abstract
Numerous studies have shown that restrained eating is not an effective weight loss strategy. Restrained eaters often suppress their desires and thoughts about tasty food, which makes it more difficult to control themselves in subsequent eating behavior. The ego depletion impairs conflict monitoring abilities. Therefore, this study explored the effects of food thoughts suppression on restrained eaters' conflict monitoring. Therefore, this study used functional magnetic resonance imaging (fMRI) methods to explore changes in the activity of brain regions involved in conflict monitoring when restrained eaters choose between high- and low-calorie foods after either suppressing or not suppressing thoughts about food. The results showed that, compared to the control condition, after suppression of such thoughts, restrained eaters chose more high-calorie foods and displayed decreased activity in the dorsal anterior cingulate cortex-an important region in charge of conflict monitoring. At the same time, the functional coupling of the dorsal anterior cingulate cortex and the precuneus increased. Our findings suggest that restrained eaters' suppression of thoughts about tasty food could lead to a decline in their ability to monitor conflicts between current behaviors and goals, which in turn leads to unhealthy eating behavior.
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Affiliation(s)
- Xuemeng Zhang
- School of Psychology, Southwest University, No. 2 Tiansheng road, Beibei district, Chongqing, 400715, China
- Key Laboratory of Cognition and Personality (Ministry of Education), Southwest University, Chongqing, China
| | - Shaorui Wang
- School of Psychology, Southwest University, No. 2 Tiansheng road, Beibei district, Chongqing, 400715, China
- Key Laboratory of Cognition and Personality (Ministry of Education), Southwest University, Chongqing, China
| | - Yong Liu
- School of Psychology, Southwest University, No. 2 Tiansheng road, Beibei district, Chongqing, 400715, China
- Key Laboratory of Cognition and Personality (Ministry of Education), Southwest University, Chongqing, China
| | - Hong Chen
- School of Psychology, Southwest University, No. 2 Tiansheng road, Beibei district, Chongqing, 400715, China.
- Key Laboratory of Cognition and Personality (Ministry of Education), Southwest University, Chongqing, China.
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11
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Improvement in Uncontrolled Eating Behavior after Laparoscopic Sleeve Gastrectomy Is Associated with Alterations in the Brain-Gut-Microbiome Axis in Obese Women. Nutrients 2020; 12:nu12102924. [PMID: 32987837 PMCID: PMC7599899 DOI: 10.3390/nu12102924] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 09/17/2020] [Accepted: 09/21/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Bariatric surgery is proven to change eating behavior and cause sustained weight loss, yet the exact mechanisms underlying these changes are not clearly understood. We explore this in a novel way by examining how bariatric surgery affects the brain-gut-microbiome (BGM) axis. METHODS Patient demographics, serum, stool, eating behavior questionnaires, and brain magnetic resonance imaging (MRI) were collected before and 6 months after laparoscopic sleeve gastrectomy (LSG). Differences in eating behavior and brain morphology and resting-state functional connectivity in core reward regions were correlated with serum metabolite and 16S microbiome data. RESULTS LSG resulted in significant weight loss and improvement in maladaptive eating behaviors as measured by the Yale Food Addiction Scale (YFAS). Brain imaging showed a significant increase in brain volume of the putamen (p.adj < 0.05) and amygdala (p.adj < 0.05) after surgery. Resting-state connectivity between the precuneus and the putamen was significantly reduced after LSG (p.adj = 0.046). This change was associated with YFAS symptom count. Bacteroides, Ruminococcus, and Holdemanella were associated with reduced connectivity between these areas. Metabolomic profiles showed a positive correlation between this brain connection and a phosphatidylcholine metabolite. CONCLUSION Bariatric surgery modulates brain networks that affect eating behavior, potentially through effects on the gut microbiota and its metabolites.
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12
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Smith LC, Kimbrough A. Leveraging Neural Networks in Preclinical Alcohol Research. Brain Sci 2020; 10:E578. [PMID: 32825739 PMCID: PMC7565429 DOI: 10.3390/brainsci10090578] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2020] [Revised: 08/17/2020] [Accepted: 08/18/2020] [Indexed: 12/25/2022] Open
Abstract
Alcohol use disorder is a pervasive healthcare issue with significant socioeconomic consequences. There is a plethora of neural imaging techniques available at the clinical and preclinical level, including magnetic resonance imaging and three-dimensional (3D) tissue imaging techniques. Network-based approaches can be applied to imaging data to create neural networks that model the functional and structural connectivity of the brain. These networks can be used to changes to brain-wide neural signaling caused by brain states associated with alcohol use. Neural networks can be further used to identify key brain regions or neural "hubs" involved in alcohol drinking. Here, we briefly review the current imaging and neurocircuit manipulation methods. Then, we discuss clinical and preclinical studies using network-based approaches related to substance use disorders and alcohol drinking. Finally, we discuss how preclinical 3D imaging in combination with network approaches can be applied alone and in combination with other approaches to better understand alcohol drinking.
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Affiliation(s)
- Lauren C. Smith
- Department of Psychiatry, School of Medicine, University of California San Diego, MC 0667, La Jolla, CA 92093, USA;
| | - Adam Kimbrough
- Department of Psychiatry, School of Medicine, University of California San Diego, MC 0667, La Jolla, CA 92093, USA;
- Department of Basic Medical Sciences, College of Veterinary Medicine, Purdue University, 625 Harrison Street, West Lafayette, IN 47907, USA
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13
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DiFranza JR. Neural Remodeling Begins With the First Cigarette. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2020; 5:629-630. [PMID: 32198003 DOI: 10.1016/j.bpsc.2019.09.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Accepted: 01/27/2020] [Indexed: 06/10/2023]
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14
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Rakesh D, Allen NB, Whittle S. Balancing act: Neural correlates of affect dysregulation in youth depression and substance use - A systematic review of functional neuroimaging studies. Dev Cogn Neurosci 2020; 42:100775. [PMID: 32452461 PMCID: PMC7139159 DOI: 10.1016/j.dcn.2020.100775] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Revised: 03/03/2020] [Accepted: 03/09/2020] [Indexed: 12/22/2022] Open
Abstract
Both depression and substance use problems have their highest incidence during youth (i.e., adolescence and emerging adulthood), and are characterized by emotion regulation deficits. Influential neurodevelopmental theories suggest that alterations in the function of limbic and frontal regions render youth susceptible to these deficits. However, whether depression and substance use in youth are associated with similar alterations in emotion regulation neural circuitry is unknown. In this systematic review we synthesized the results of functional magnetic resonance imaging (fMRI) studies investigating the neural correlates of emotion regulation in youth depression and substance use. Resting-state fMRI studies focusing on limbic connectivity were also reviewed. While findings were largely inconsistent within and between studies of depression and substance use, some patterns emerged. First, youth depression appears to be associated with exaggerated amygdala activity in response to negative stimuli; second, both depression and substance use appear to be associated with lower functional connectivity between the amygdala and prefrontal cortex during rest. Findings are discussed in relation to support for existing neurodevelopmental models, and avenues for future work are suggested, including studying neurodevelopmental trajectories from a network perspective.
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Affiliation(s)
- Divyangana Rakesh
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Melbourne, Victoria, Australia
| | - Nicholas B Allen
- Department of Psychology, University of Oregon, Eugene, Oregon, USA
| | - Sarah Whittle
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Melbourne, Victoria, Australia; Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Victoria, Australia.
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15
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Aronson Fischell S, Ross TJ, Deng ZD, Salmeron BJ, Stein EA. Transcranial Direct Current Stimulation Applied to the Dorsolateral and Ventromedial Prefrontal Cortices in Smokers Modifies Cognitive Circuits Implicated in the Nicotine Withdrawal Syndrome. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2020; 5:448-460. [PMID: 32151567 DOI: 10.1016/j.bpsc.2019.12.020] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 12/30/2019] [Accepted: 12/31/2019] [Indexed: 12/14/2022]
Abstract
BACKGROUND The nicotine withdrawal syndrome remains a major impediment to smoking cessation. Cognitive and affective disturbances are associated with altered connectivity within and between the executive control network, default mode network (DMN), and salience network. We hypothesized that functional activity in cognitive control networks, and downstream amygdala circuits, would be modified by application of transcranial direct current stimulation (tDCS) to the left (L) dorsolateral prefrontal cortex (dlPFC, executive control network) and right (R) ventromedial prefrontal cortex (vmPFC, DMN). METHODS A total of 15 smokers (7 women) and 28 matched nonsmokers (14 women) participated in a randomized, sham-controlled, double-blind, exploratory crossover study of 3 tDCS conditions: anodal-(L)dlPFC/cathodal-(R)vmPFC, reversed polarity, and sham. Cognitive tasks probed withdrawal-related constructs (error monitoring, working memory, amygdalar reactivity), while simultaneous functional magnetic resonance imaging measured brain activity. We assessed tDCS impact on trait (nonsmokers vs. sated smokers) and state (sated vs. abstinent) smoking aspects. RESULTS Single-session, anodal-(L)dlPFC/cathodal-(R)vmPFC tDCS enhanced deactivation of DMN nodes during the working memory task and strengthened anterior cingulate cortex activity during the error-monitoring task. Smokers were more responsive to tDCS-induced DMN deactivation when sated (vs. withdrawn) and displayed greater cingulate activity during error monitoring than nonsmokers. Nicotine withdrawal reduced task engagement and attention and reduced suppression of DMN nodes. CONCLUSIONS Cognitive circuit dysregulation associated with nicotine withdrawal may be modifiable by anodal tDCS applied to L-dlPFC and cathodal tDCS applied to R-vmPFC. tDCS may have stronger effects as a complement to existing therapies, such as nicotine replacement, owing to possible enhanced plasticity in the sated state.
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Affiliation(s)
- Sarah Aronson Fischell
- Neuroimaging Research Branch, National Institute on Drug Abuse, Intramural Research Program, National Institutes of Health, Baltimore, Maryland; School of Medicine, University of Maryland, Baltimore, Maryland
| | - Thomas J Ross
- Neuroimaging Research Branch, National Institute on Drug Abuse, Intramural Research Program, National Institutes of Health, Baltimore, Maryland
| | - Zhi-De Deng
- Noninvasive Neuromodulation Unit, Experimental Therapeutics and Pathophysiology Branch, National Institute of Mental Health, Intramural Research Program, National Institutes of Health, Bethesda, Maryland
| | - Betty Jo Salmeron
- Neuroimaging Research Branch, National Institute on Drug Abuse, Intramural Research Program, National Institutes of Health, Baltimore, Maryland
| | - Elliot A Stein
- Neuroimaging Research Branch, National Institute on Drug Abuse, Intramural Research Program, National Institutes of Health, Baltimore, Maryland.
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16
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12-h abstinence-induced functional connectivity density changes and craving in young smokers: a resting-state study. Brain Imaging Behav 2020; 13:953-962. [PMID: 29926324 DOI: 10.1007/s11682-018-9911-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Studying the neural correlates of craving to smoke is of great importance to improve treatment outcomes in smoking addiction. According to previous studies, the critical roles of striatum and frontal brain regions had been revealed in addiction. However, few studies focused on the hub of brain regions in the 12 h abstinence induced craving in young smokers. Thirty-one young male smokers were enrolled in the present study. A within-subject experiment design was carried out to compare functional connectivity density between 12-h smoking abstinence and smoking satiety conditions during resting state in young adult smokers by using functional connectivity density mapping (FCDM). Then, the functional connectivity density changes during smoking abstinence versus satiety were further used to examine correlations with abstinence-induced changes in subjective craving. We found young adult smokers in abstinence state (vs satiety) had higher local functional connectivity density (lFCD) and global functional connectivity density (gFCD) in brain regions including striatal subregions (i.e., bilateral caudate and putamen), frontal regions (i.e., anterior cingulate cortex (ACC) and orbital frontal cortex (OFC)) and bilateral insula. We also found higher lFCD during smoking abstinence (vs satiety) in bilateral thalamus. Additionally, the lFCD changes of the left ACC, bilateral caudate and right OFC were positively correlated with the changes in craving induced by abstinence (i.e., abstinence minus satiety) in young adult smokers. The present findings improve the understanding of the effects of acute smoking abstinence on the hubs of brain gray matter in the abstinence-induces craving and may contribute new insights into the neural mechanism of abstinence-induced craving in young smokers in smoking addiction.
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17
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Darnai G, Perlaki G, Zsidó AN, Inhóf O, Orsi G, Horváth R, Nagy SA, Lábadi B, Tényi D, Kovács N, Dóczi T, Demetrovics Z, Janszky J. Internet addiction and functional brain networks: task-related fMRI study. Sci Rep 2019; 9:15777. [PMID: 31673061 PMCID: PMC6823489 DOI: 10.1038/s41598-019-52296-1] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Accepted: 10/11/2019] [Indexed: 12/14/2022] Open
Abstract
A common brain-related feature of addictions is the altered function of higher-order brain networks. Growing evidence suggests that Internet-related addictions are also associated with breakdown of functional brain networks. Taking into consideration the limited number of studies used in previous studies in Internet addiction (IA), our aim was to investigate the functional correlates of IA in the default mode network (DMN) and in the inhibitory control network (ICN). To observe these relationships, task-related fMRI responses to verbal Stroop and non-verbal Stroop-like tasks were measured in 60 healthy university students. The Problematic Internet Use Questionnaire (PIUQ) was used to assess IA. We found significant deactivations in areas related to the DMN (precuneus, posterior cingulate gyrus) and these areas were negatively correlated with PIUQ during incongruent stimuli. In Stroop task the incongruent_minus_congruent contrast showed positive correlation with PIUQ in areas related to the ICN (left inferior frontal gyrus, left frontal pole, left central opercular, left frontal opercular, left frontal orbital and left insular cortex). Altered DMN might explain some comorbid symptoms and might predict treatment outcomes, while altered ICN may be the reason for having difficulties in stopping and controlling overuse.
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Affiliation(s)
- Gergely Darnai
- Institute of Psychology, University of Pécs, Pécs, Hungary. .,Department of Neurology, University of Pécs, Medical School, Pécs, Hungary. .,MTA-PTE Clinical Neuroscience MR Research Group, Pécs, Hungary.
| | - Gábor Perlaki
- MTA-PTE Clinical Neuroscience MR Research Group, Pécs, Hungary.,Pécs Diagnostic Centre, Pécs, Hungary.,Department of Neurosurgery, University of Pécs, Medical School, Pécs, Hungary
| | - András N Zsidó
- Institute of Psychology, University of Pécs, Pécs, Hungary
| | - Orsolya Inhóf
- Institute of Psychology, University of Pécs, Pécs, Hungary
| | - Gergely Orsi
- MTA-PTE Clinical Neuroscience MR Research Group, Pécs, Hungary.,Pécs Diagnostic Centre, Pécs, Hungary.,Department of Neurosurgery, University of Pécs, Medical School, Pécs, Hungary
| | - Réka Horváth
- Department of Neurology, University of Pécs, Medical School, Pécs, Hungary
| | - Szilvia Anett Nagy
- MTA-PTE Clinical Neuroscience MR Research Group, Pécs, Hungary.,Pécs Diagnostic Centre, Pécs, Hungary.,Department of Neurosurgery, University of Pécs, Medical School, Pécs, Hungary.,MTA-PTE Stress Neurobiology Research Group, Pécs, Hungary
| | - Beatrix Lábadi
- Institute of Psychology, University of Pécs, Pécs, Hungary
| | - Dalma Tényi
- Department of Neurology, University of Pécs, Medical School, Pécs, Hungary
| | - Norbert Kovács
- Department of Neurology, University of Pécs, Medical School, Pécs, Hungary.,MTA-PTE Clinical Neuroscience MR Research Group, Pécs, Hungary
| | - Tamás Dóczi
- MTA-PTE Clinical Neuroscience MR Research Group, Pécs, Hungary.,Department of Neurosurgery, University of Pécs, Medical School, Pécs, Hungary
| | - Zsolt Demetrovics
- Institute of Psychology, Eötvös Loránd University, Budapest, Hungary
| | - József Janszky
- Department of Neurology, University of Pécs, Medical School, Pécs, Hungary.,MTA-PTE Clinical Neuroscience MR Research Group, Pécs, Hungary
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18
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Zhang R, Volkow ND. Brain default-mode network dysfunction in addiction. Neuroimage 2019; 200:313-331. [DOI: 10.1016/j.neuroimage.2019.06.036] [Citation(s) in RCA: 131] [Impact Index Per Article: 26.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Revised: 06/14/2019] [Accepted: 06/17/2019] [Indexed: 12/21/2022] Open
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19
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Lin F, Wu G, Zhu L, Lei H. Region-Specific Changes of Insular Cortical Thickness in Heavy Smokers. Front Hum Neurosci 2019; 13:265. [PMID: 31417384 PMCID: PMC6685069 DOI: 10.3389/fnhum.2019.00265] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Accepted: 07/16/2019] [Indexed: 11/13/2022] Open
Abstract
Insula plays an essential role in maintaining the addiction to cigarette smoking and smoking-related alterations on the insular volume and density have been reported in smokers. However, less is known about the effects of chronic cigarette smoking on the insular cortical thickness. In this study, we explored the region-specific changes of insular cortical thickness in heavy smokers and their relations with smoking-related variables. 37 heavy smokers (29 males, mean age 47.19 ± 7.22 years) and 37 non-smoking healthy controls (29 males, mean age 46.95 ± 8.45 years) participated in the study. Subregional insular cortical thickness was evaluated and compared between the two groups. Correlation analysis was performed to investigate relationships between the insular cortical thickness and clinical characteristics in heavy smokers. There was no statistical difference on the cortical thickness in the left insula (p = 0.536) between the two groups while heavy smokers had a slightly thinner cortical thickness in the right insula (p = 0.048). In addition, heavy smokers showed a greater cortical thinning in the anterior (p = 0.0084) and superior (p = 0.0054) segment of the circular sulcus of the right insula as well as the inferior (p = 0.012) segment of the circular sulcus of the left insula. Moreover, the cortical thickness of the superior segment of the circular sulcus of the left insula was correlated negatively with nicotine severity (r = −0.423; p = 0.009) and the longer cigarette exposure was associated with the cortical thinning in the long insular gyrus and central sulcus of the right insula (r = −0.475; p = 0.003). Our findings indicate that chronic cigarette use is associated with region-specific insular thinning, which has the potential to improve our understanding of the specific roles of insular subregions in nicotine addiction.
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Affiliation(s)
- Fuchun Lin
- National Center for Magnetic Resonance in Wuhan, State Key Laboratory of Magnetic Resonance and Atomic and Molecular Physics, Wuhan Institute of Physics and Mathematics, Chinese Academy of Sciences, Wuhan, China.,University of Chinese Academy of Sciences, Beijing, China
| | - Guangyao Wu
- Department of Radiology, Zhongnan Hospital, Wuhan University, Wuhan, China.,Department of Medical Imaging, Shenzhen University General Hospital, Medical College of Shenzhen University, Shenzhen, China
| | - Ling Zhu
- Department of Radiology, Zhongnan Hospital, Wuhan University, Wuhan, China
| | - Hao Lei
- National Center for Magnetic Resonance in Wuhan, State Key Laboratory of Magnetic Resonance and Atomic and Molecular Physics, Wuhan Institute of Physics and Mathematics, Chinese Academy of Sciences, Wuhan, China.,University of Chinese Academy of Sciences, Beijing, China
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20
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Ibrahim C, Rubin-Kahana DS, Pushparaj A, Musiol M, Blumberger DM, Daskalakis ZJ, Zangen A, Le Foll B. The Insula: A Brain Stimulation Target for the Treatment of Addiction. Front Pharmacol 2019; 10:720. [PMID: 31312138 PMCID: PMC6614510 DOI: 10.3389/fphar.2019.00720] [Citation(s) in RCA: 66] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Accepted: 06/05/2019] [Indexed: 12/15/2022] Open
Abstract
Substance use disorders (SUDs) are a growing public health concern with only a limited number of approved treatments. However, even approved treatments are subject to limited efficacy with high long-term relapse rates. Current treatment approaches are typically a combination of pharmacotherapies and behavioral counselling. Growing evidence and technological advances suggest the potential of brain stimulation techniques for the treatment of SUDs. There are three main brain stimulation techniques that are outlined in this review: transcranial magnetic stimulation (TMS), transcranial direct current stimulation (tDCS), and deep brain stimulation (DBS). The insula, a region of the cerebral cortex, is known to be involved in critical aspects underlying SUDs, such as interoception, decision making, anxiety, pain perception, cognition, mood, threat recognition, and conscious urges. This review focuses on both the preclinical and clinical evidence demonstrating the role of the insula in addiction, thereby demonstrating its promise as a target for brain stimulation. Future research should evaluate the optimal parameters for brain stimulation of the insula, through the use of relevant biomarkers and clinical outcomes for SUDs.
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Affiliation(s)
- Christine Ibrahim
- Translational Addiction Research Laboratory, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Pharmacology, University of Toronto, Toronto, ON, Canada
| | - Dafna S. Rubin-Kahana
- Translational Addiction Research Laboratory, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Abhiram Pushparaj
- Qunuba Sciences, Toronto, ON, Canada
- Ironstone Product Development, Toronto, ON, Canada
| | | | - Daniel M. Blumberger
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Temerty Centre for Therapeutic Brain Intervention, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Zafiris J. Daskalakis
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Temerty Centre for Therapeutic Brain Intervention, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Abraham Zangen
- Department of Life Sciences and the Zlotowski Center for Neuroscience, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Bernard Le Foll
- Translational Addiction Research Laboratory, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Pharmacology, University of Toronto, Toronto, ON, Canada
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Addictions Division, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Institute of Medical Sciences, University of Toronto, Toronto, ON, Canada
- Alcohol Research and Treatment Clinic, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
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21
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Regner MF, Tregellas J, Kluger B, Wylie K, Gowin JL, Tanabe J. The insula in nicotine use disorder: Functional neuroimaging and implications for neuromodulation. Neurosci Biobehav Rev 2019; 103:414-424. [PMID: 31207255 DOI: 10.1016/j.neubiorev.2019.06.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Revised: 05/18/2019] [Accepted: 06/03/2019] [Indexed: 12/30/2022]
Abstract
Insula dysfunction contributes to nicotine use disorders. Yet, much remains unknown about how insular functions promote nicotine use. We review current models of brain networks in smoking and propose an extension to those models that emphasizes the role of the insula in craving. During acute withdrawal, the insula provides the sensation of craving to the cerebrum and is thought to negotiate craving sensations with cognitive control to guide behavior - either to smoke or abstain. Recent studies have shown that insula processing is saturable, such that different insular functions compete for limited resources. We propose that this saturability explains how craving during withdrawal can overload insular processing to the exclusion of other functions, such as saliency and network homeostasis. A novel signal flow model illustrates how limited insular capacity leads to breakdown of normal function. Finally, we discuss suitability of insula as a neuromodulation target to promote cessation. Given the limited efficacy of standard-of-care treatments for nicotine use disorder, insular neuromodulation offers an innovative, potentially therapeutic target for improving smoking cessation.
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Affiliation(s)
- Michael F Regner
- Department of Radiology, University of Colorado School of Medicine, United States; Department of Bioengineering, University of Colorado School of Medicine, United States.
| | - Jason Tregellas
- Department of Radiology, University of Colorado School of Medicine, United States; Department of Psychiatry, University of Colorado School of Medicine, United States; Research Service, Rocky Mountain Regional VA Medical Center, United States
| | - Benzi Kluger
- Department of Psychiatry, University of Colorado School of Medicine, United States; Department of Neurology, University of Colorado School of Medicine, United States
| | - Korey Wylie
- Department of Psychiatry, University of Colorado School of Medicine, United States
| | - Joshua L Gowin
- Department of Radiology, University of Colorado School of Medicine, United States
| | - Jody Tanabe
- Department of Radiology, University of Colorado School of Medicine, United States; Department of Psychiatry, University of Colorado School of Medicine, United States; Department of Neurology, University of Colorado School of Medicine, United States
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22
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Wilcox CE, Abbott CC, Calhoun VD. Alterations in resting-state functional connectivity in substance use disorders and treatment implications. Prog Neuropsychopharmacol Biol Psychiatry 2019; 91:79-93. [PMID: 29953936 PMCID: PMC6309756 DOI: 10.1016/j.pnpbp.2018.06.011] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Revised: 06/18/2018] [Accepted: 06/23/2018] [Indexed: 02/06/2023]
Abstract
Substance use disorders (SUD) are diseases of the brain, characterized by aberrant functioning in the neural circuitry of the brain. Resting state functional connectivity (rsFC) can illuminate these functional changes by measuring the temporal coherence of low-frequency fluctuations of the blood oxygenation level-dependent magnetic resonance imaging signal in contiguous or non-contiguous regions of the brain. Because this data is easy to obtain and analyze, and therefore fairly inexpensive, it holds promise for defining biological treatment targets in SUD, which could help maximize the efficacy of existing clinical interventions and develop new ones. In an effort to identify the most likely "treatment targets" obtainable with rsFC we summarize existing research in SUD focused on 1) the relationships between rsFC and functionality within important psychological domains which are believed to underlie relapse vulnerability 2) changes in rsFC from satiety to deprived or abstinent states 3) baseline rsFC correlates of treatment outcome and 4) changes in rsFC induced by treatment interventions which improve clinical outcomes and reduce relapse risk. Converging evidence indicates that likely "treatment target" candidates, emerging consistently in all four sections, are reduced connectivity within executive control network (ECN) and between ECN and salience network (SN). Other potential treatment targets also show promise, but the literature is sparse and more research is needed. Future research directions include data-driven prediction analyses and rsFC analyses with longitudinal datasets that incorporate time since last use into analysis to account for drug withdrawal. Once the most reliable biological markers are identified, they can be used for treatment matching, during preliminary testing of new pharmacological compounds to establish clinical potential ("target engagement") prior to carrying out costly clinical trials, and for generating hypotheses for medication repurposing.
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23
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Fedota JR, Ding X, Matous AL, Salmeron BJ, McKenna MR, Gu H, Ross TJ, Stein EA. Nicotine Abstinence Influences the Calculation of Salience in Discrete Insular Circuits. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2017. [PMID: 29529410 DOI: 10.1016/j.bpsc.2017.09.010] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND Insular subdivisions show distinct patterns of resting-state functional connectivity (rsFC) with specific brain regions, each with different functional significance. Seeds in these subdivisions are employed to characterize the effects of acute nicotine abstinence on rsFC between insula subdivisions and brain networks implicated in addiction and attentional control. METHODS In a within-subjects design, resting-state blood oxygen level-dependent data were collected from treatment-seeking smokers (N= 20) following smoking satiety and again following 48 hours of nicotine abstinence. Three right hemisphere insular regions of interest (dorsal, ventral, and posterior) served as seeds for analyses. Indices of both static and dynamic rsFC were obtained and correlated with indices of subjective withdrawal and behavioral performance. RESULTS Abstinence-induced physiological, subjective, and cognitive differences were observed. Overall dynamic rsFC was reduced during abstinence, and circuits containing each insular seed showed changes in rsFC as a function of nicotine abstinence. Specifically, dorsal and posterior insular connections to the default mode and salience networks were enhanced, while a previously undescribed ventral insular connection to the executive control network was reduced. Further, static rsFC was significantly correlated with subjective ratings of aversive affect and withdrawal in the modified ventral and posterior insular-seeded circuits. CONCLUSIONS As predicted, divergent connections between insula subdivisions and anticorrelated resting brain networks were observed during abstinence. These changes reflect an attentional bias toward aversive affective processing and not directly away from exogenous cognitive processing, suggesting a coordinated modulation of circuits associated with interoceptive and affective processing that instantiates an aversive state during nicotine abstinence.
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Affiliation(s)
- John R Fedota
- Neuroimaging Research Branch, Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, Baltimore, Maryland.
| | - Xiaoyu Ding
- Neuroimaging Research Branch, Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, Baltimore, Maryland
| | - Allison L Matous
- Neuroimaging Research Branch, Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, Baltimore, Maryland
| | - Betty Jo Salmeron
- Neuroimaging Research Branch, Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, Baltimore, Maryland
| | - Michael R McKenna
- Neuroimaging Research Branch, Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, Baltimore, Maryland
| | - Hong Gu
- Neuroimaging Research Branch, Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, Baltimore, Maryland
| | - Thomas J Ross
- Neuroimaging Research Branch, Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, Baltimore, Maryland
| | - Elliot A Stein
- Neuroimaging Research Branch, Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, Baltimore, Maryland
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Wilcox CE, Calhoun VD, Rachakonda S, Claus ED, Littlewood RA, Mickey J, Arenella PB, Hutchison KE. Functional network connectivity predicts treatment outcome during treatment of nicotine use disorder. Psychiatry Res 2017; 265:45-53. [PMID: 28525877 PMCID: PMC5522183 DOI: 10.1016/j.pscychresns.2017.04.011] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2017] [Revised: 04/28/2017] [Accepted: 04/28/2017] [Indexed: 11/22/2022]
Abstract
Altered resting state functional connectivity (rsFC) and functional network connectivity (FNC), which is a measure of coherence between brain networks, may be associated with nicotine use disorder (NUD). We hypothesized that higher connectivity between insula and 1) dorsal anterior cingulate cortex (dACC) and 2) dorsolateral prefrontal cortex (dlPFC) would predict better treatment outcomes. We also performed an exploratory analysis of the associations between FNC values between additional key frontal and striatal regions and treatment outcomes. One hundred and forty four individuals with NUD underwent a resting state session during functional MRI prior to randomization to treatment with varenicline (n=82) or placebo. Group independent component analysis (ICA) was utilized to extract individual subject components and time series from intrinsic connectivity networks in aforementioned regions, and FNC between all possible pairs were calculated. Higher FNC between insula and dACC (rho=0.21) was significantly correlated with lower levels of baseline smoking quantity but did not predict treatment outcome upon controlling for baseline smoking. Higher FNC between putamen and dACC, caudate and dACC, and caudate and dlPFC significantly predicted worse treatment outcome in participants reporting high subjective withdrawal before the scan. FNC between key regions hold promise as biomarkers to predict outcome in NUD.
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Affiliation(s)
- Claire E Wilcox
- Department of Psychiatry, University of New Mexico, Albuquerque, NM, USA.
| | - Vince D Calhoun
- Department of Psychiatry, University of New Mexico, Albuquerque, NM, USA; Mind Research Network and Lovelace Biomedical and Environmental Research Institute, Albuquerque, NM, USA; Department of Electrical and Computer Engineering, University of New Mexico, Albuquerque, NM, USA
| | - Srinivas Rachakonda
- Mind Research Network and Lovelace Biomedical and Environmental Research Institute, Albuquerque, NM, USA
| | - Eric D Claus
- Mind Research Network and Lovelace Biomedical and Environmental Research Institute, Albuquerque, NM, USA
| | - Rae A Littlewood
- Mind Research Network and Lovelace Biomedical and Environmental Research Institute, Albuquerque, NM, USA
| | - Jessica Mickey
- Mind Research Network and Lovelace Biomedical and Environmental Research Institute, Albuquerque, NM, USA
| | - Pamela B Arenella
- Department of Psychiatry, University of New Mexico, Albuquerque, NM, USA
| | - Kent E Hutchison
- Mind Research Network and Lovelace Biomedical and Environmental Research Institute, Albuquerque, NM, USA; Department of Psychology, University of Colorado Boulder, Boulder, CO, USA
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Bi Y, Zhang Y, Li Y, Yu D, Yuan K, Tian J. 12h abstinence-induced right anterior insula network pattern changes in young smokers. Drug Alcohol Depend 2017; 176:162-168. [PMID: 28544994 DOI: 10.1016/j.drugalcdep.2017.02.019] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2016] [Revised: 02/14/2017] [Accepted: 02/19/2017] [Indexed: 11/28/2022]
Abstract
BACKGROUND The strong craving to smoke is a core factor of smoking abstinence that precipitates relapse. Insula plays critical roles in maintaining nicotine dependence, especially in the interoceptive awareness of craving. Despite evidence indicating a link between insula and abstinence-induced craving, less is known about the neural basis of abstinence-induced craving from the circuit level of insula. METHODS The present study examined the effects of 12h of abstinence from smoking on the resting state functional connectivity (RSFC) of anterior (AI) and posterior insula in young smokers using a within-subject design. Thirty-three young male smokers underwent functional magnetic resonance imaging scanning on two separate sessions: (1) smoking satiety and (2) abstinence (after ≥12h of smoking deprivation), in counterbalanced order. Multiple regression analysis was applied to investigate the possible relationships between the RSFC changes of insula (abstinence minus satiety) and the abstinence-induced craving changes. RESULTS Smoking abstinence state (versus satiety) was associated with increased RSFC between right AI and right medial orbitofrontal cortex (OFC), ventromedial prefrontal cortex as well as anterior cingulate cortex. The abstinence-induced RSFC changes between right AI and right lateral OFC was significantly correlated with the craving changes. CONCLUSIONS These findings improve the understanding of the effects of short-term smoking abstinence on insula circuit connectivity and may contribute new insights into the neural basis of abstinence-induced craving to smoke.
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Affiliation(s)
- Yanzhi Bi
- School of Life Science and Technology, Xidian University, Xi'an, PR China; Engineering Research Center of Molecular and Neuro Imaging, Ministry of Education, PR China
| | - Yajuan Zhang
- School of Life Science and Technology, Xidian University, Xi'an, PR China; Engineering Research Center of Molecular and Neuro Imaging, Ministry of Education, PR China
| | - Yangding Li
- Guangxi Key Laboratory of Multi-source Information Mining and Security, Guangxi Normal University, Guilin, PR China
| | - Dahua Yu
- Information Processing Laboratory, School of Information Engineering, Inner Mongolia University of Science and Technology, Baotou, Inner Mongolia, PR China
| | - Kai Yuan
- School of Life Science and Technology, Xidian University, Xi'an, PR China; Engineering Research Center of Molecular and Neuro Imaging, Ministry of Education, PR China; Information Processing Laboratory, School of Information Engineering, Inner Mongolia University of Science and Technology, Baotou, Inner Mongolia, PR China.
| | - Jie Tian
- School of Life Science and Technology, Xidian University, Xi'an, PR China; Engineering Research Center of Molecular and Neuro Imaging, Ministry of Education, PR China; Institute of Automation, Chinese Academy of Sciences, Beijing, PR China.
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Towns S, DiFranza JR, Jayasuriya G, Marshall T, Shah S. Smoking Cessation in Adolescents: targeted approaches that work. Paediatr Respir Rev 2017; 22:11-22. [PMID: 26187717 DOI: 10.1016/j.prrv.2015.06.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2015] [Accepted: 06/04/2015] [Indexed: 01/06/2023]
Abstract
Smoking Cessation in adolescents can be considered in a developmental context to enable the clinician to individualise the appropriate assessment and management of the young person they are seeing whether it is in a primary or tertiary care setting. Adolescence is a time of rapid neurocognitive and hormonal change with these factors affected by personality and behavioural factors as well as family, cultural and psychosocial context. Adolescents are uniquely vulnerable to smoking initiation and nicotine addiction throughout these years. Increased awareness of the risks of smoking and using opportunities to assess and intervene regarding smoking cessation are integral to clinical practice for all clinicians seeing young people. This review will discuss the demographics of adolescent smoking, risk factors, assessing smoking and nicotine addiction, the importance of brief interventions, the evidence base for appropriate interventions, particularly in high risk groups and will emphasise innovative training for health professionals in adolescent smoking cessation.
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Affiliation(s)
- Susan Towns
- Department of Adolescent Medicine, The Children's Hospital at Westmead, Sydney, NSW, Australia; Department of Respiratory Medicine, The Children's Hospital at Westmead, Sydney, NSW, Australia; Faculty Paediatrics and Child Health, Sydney Medical School, University of Sydney, Sydney, NSW, Australia.
| | - Joseph R DiFranza
- Family Medicine and Community Health, University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | - Geshani Jayasuriya
- Department of Respiratory Medicine, The Children's Hospital at Westmead, Sydney, NSW, Australia
| | - Tracey Marshall
- Department of Respiratory Medicine, The Children's Hospital at Westmead, Sydney, NSW, Australia
| | - Smita Shah
- Primary Health Care Education and Research Unit, Western Sydney Local Health District, NSW, Australia
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Bahelah R, DiFranza JR, Fouad FM, Ward KD, Eissenberg T, Maziak W. Early symptoms of nicotine dependence among adolescent waterpipe smokers. Tob Control 2016; 25:e127-e134. [PMID: 27113610 PMCID: PMC5079840 DOI: 10.1136/tobaccocontrol-2015-052809] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Revised: 03/24/2016] [Accepted: 04/04/2016] [Indexed: 11/04/2022]
Abstract
BACKGROUND Although waterpipe smoking is increasingly popular among youth and can lead to nicotine dependence (ND), no studies have documented how ND develops in waterpipe smokers. We examined the emerging symptoms of ND among adolescent waterpipe smokers in Lebanon. METHODS Individual confidential interviews were used to evaluate ND in 160 waterpipe smokers and 24 cigarette smokers from a sample of 498 students enrolled in 8th and 9th grades in Lebanon. RESULTS Among waterpipe smokers, 71.3% endorsed at least one Hooked on Nicotine Checklist (HONC) symptom and 38.1% developed the full syndrome of ND (≥3 criteria using the International Classification of Diseases, 10th revision). The early symptoms of ND among waterpipe smokers were craving (25%), feeling addicted (22.5%), and failed quit attempts (14.3%). Among those who reached the respective milestones, median tobacco use when the first HONC symptom emerged was 7.5 waterpipes/month with smoking frequency of 6 days/month; the median tobacco use for the full syndrome of ND was 15 waterpipes/month with smoking frequency of 15 days/month. Among those who had already reached these milestones, the first HONC symptom appeared 10.9 months after the initiation of waterpipe smoking, and the full syndrome of ND was reached at 13.9 months. In addition, cues such as seeing or smelling waterpipe, and the café environment triggered craving in most waterpipe smokers with symptoms of ND. CONCLUSIONS Symptoms of ND develop among adolescent waterpipe smokers at low levels of consumption and frequency of use. Craving for nicotine triggered by waterpipe-specific cues is reported even at this young age. Waterpipe-specific ND prevention and intervention programmes for youth are needed.
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Affiliation(s)
- Raed Bahelah
- Department of Epidemiology, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, FL, USA
- Faculty of Medicine and Health Sciences, Aden University, Yemen
| | - Joseph R. DiFranza
- Department of Family Medicine and Community Health, University of Massachusetts Medical School, Worcester, MA, USA
| | - Fouad M. Fouad
- Syrian Center for Tobacco Studies, Aleppo, Syria
- American University of Beirut, Lebanon
| | - Kenneth D. Ward
- Syrian Center for Tobacco Studies, Aleppo, Syria
- University of Memphis School of Public Health, Memphis, TN, USA
| | - Thomas Eissenberg
- Department of Psychology and Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, VA, USA
| | - Wasim Maziak
- Department of Epidemiology, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, FL, USA
- Syrian Center for Tobacco Studies, Aleppo, Syria
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Walton D, Newcombe R, Li J, Tu D, DiFranza JR. Stages of physical dependence in New Zealand smokers: Prevalence and correlates. Addict Behav 2016; 63:161-4. [PMID: 27513594 DOI: 10.1016/j.addbeh.2016.07.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2016] [Revised: 07/25/2016] [Accepted: 07/30/2016] [Indexed: 11/19/2022]
Abstract
BACKGROUND Physically dependent smokers experience symptoms of wanting, craving or needing to smoke when too much time has passed since the last cigarette. There is interest in whether wanting, craving and needing represent variations in the intensity of a single physiological parameter or whether multiple physiological processes may be involved in the developmental progression of physical dependence. AIM Our aim was to determine how a population of cigarette smokers is distributed across the wanting, craving and needing stages of physical dependence. METHODS A nationwide survey of 2594 New Zealanders aged 15years and over was conducted in 2014. The stage of physical dependence was assessed using the Levels of Physical Dependence measure. Ordinal logistic regression analysis was used to assess relations between physical dependence and other variables. RESULTS Among 590 current smokers (weighted 16.2% of the sample), 22.3% had no physical dependence, 23.5% were in the Wanting stage, 14.4% in the Craving stage, and 39.8% in the Needing stage. The stage of physical dependence was predicted by daily cigarette consumption, and the time to first cigarette, but not by age, gender, ethnicity or socioeconomic status. CONCLUSION Fewer individuals were in the craving stage than either the wanting or needing stages. The resulting inverted U-shaped curve with concentrations at either extreme is difficult to explain as a variation of a single biological parameter. The data support an interpretation that progression through the stages of wanting, craving and needing may involve more than one physiological process. WHAT THIS RESEARCH ADDS Physical dependence to tobacco develops through a characteristic sequence of wanting, craving and needing which correspond to changes in addiction pathways in the brain. It is important to neuroscience research to determine if the development of physical dependence involves changes in a single brain process, or multiple processes. Our data suggests that more than one physiologic process is involved in the progression of physical dependence.
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Affiliation(s)
- Darren Walton
- University of Canterbury, Christchurch, New Zealand; Health Promotion Agency, Wellington, New Zealand
| | | | - Judy Li
- Health Promotion Agency, Wellington, New Zealand
| | - Danny Tu
- Health Promotion Agency, Wellington, New Zealand
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Wollman SC, Alhassoon OM, Hall MG, Stern MJ, Connors EJ, Kimmel CL, Allen KE, Stephan RA, Radua J. Gray matter abnormalities in opioid-dependent patients: A neuroimaging meta-analysis. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2016; 43:505-517. [DOI: 10.1080/00952990.2016.1245312] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Scott C. Wollman
- California School of Professional Psychology, San Diego, CA, USA
| | - Omar M. Alhassoon
- California School of Professional Psychology, San Diego, CA, USA
- Department of Psychiatry, University of California, San Diego, CA, USA
| | - Matthew G. Hall
- California School of Professional Psychology, San Diego, CA, USA
| | - Mark J. Stern
- California School of Professional Psychology, San Diego, CA, USA
| | - Eric J. Connors
- California School of Professional Psychology, San Diego, CA, USA
| | | | - Kenneth E. Allen
- California School of Professional Psychology, San Diego, CA, USA
| | - Rick A. Stephan
- California School of Professional Psychology, San Diego, CA, USA
| | - Joaquim Radua
- FIDMAG Germanes Hospitalàries – CIBERSAM, Barcelona, Spain
- Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
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DiFranza JR. Can tobacco dependence provide insights into other drug addictions? BMC Psychiatry 2016; 16:365. [PMID: 27784294 PMCID: PMC5081932 DOI: 10.1186/s12888-016-1074-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2016] [Accepted: 10/17/2016] [Indexed: 11/10/2022] Open
Abstract
Within the field of addiction research, individuals tend to operate within silos of knowledge focused on specific drug classes. The discovery that tobacco dependence develops in a progression of stages and that the latency to the onset of withdrawal symptoms after the last use of tobacco changes over time have provided insights into how tobacco dependence develops that might be applied to the study of other drugs.As physical dependence on tobacco develops, it progresses through previously unrecognized clinical stages of wanting, craving and needing. The latency to withdrawal is a measure of the asymptomatic phase of withdrawal, extending from the last use of tobacco to the emergence of withdrawal symptoms. Symptomatic withdrawal is characterized by a wanting phase, a craving phase, and a needing phase. The intensity of the desire to smoke that is triggered by withdrawal correlates with brain activity in addiction circuits. With repeated tobacco use, the latency to withdrawal shrinks from as long as several weeks to as short as several minutes. The shortening of the asymptomatic phase of withdrawal drives an escalation of smoking, first in terms of the number of smoking days/month until daily smoking commences, then in terms of cigarettes smoked/day.The discoveries of the stages of physical dependence and the latency to withdrawal raises the question, does physical dependence develop in stages with other drugs? Is the latency to withdrawal for other substances measured in weeks at the onset of dependence? Does it shorten over time? The research methods that uncovered how tobacco dependence emerges might be fruitfully applied to the investigation of other addictions.
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Affiliation(s)
- Joseph R. DiFranza
- Department of Family Medicine and Community Health, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01655 USA
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Dorsal anterior cingulate glutamate is associated with engagement of the default mode network during exposure to smoking cues. Drug Alcohol Depend 2016; 167:75-81. [PMID: 27522872 PMCID: PMC5037039 DOI: 10.1016/j.drugalcdep.2016.07.021] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Revised: 07/22/2016] [Accepted: 07/25/2016] [Indexed: 01/29/2023]
Abstract
BACKGROUND When exposed to smoking cues, nicotine dependent individuals activate brain regions overlapping with the default mode network (DMN), a network of regions involved in internally-focused cognition. The salience network (SN), which includes the dorsal anterior cingulate cortex (dACC), is thought to interact with the DMN and aids in directing attention toward salient internal or external stimuli. One possibility is that neurochemical variation in SN regions such as the dACC impact DMN reactivity to personally relevant stimuli such as smoking cues. This is consistent with emerging evidence suggesting an association between midline cortical glutamate (Glu) and activity in brain regions overlapping with the DMN. METHODS In 18 nicotine-dependent individuals, we assessed the relationship between DMN activation to smoking relative to neutral cues using functional magnetic resonance imaging and dACC Glu as measured by magnetic resonance spectroscopy. This association also was tested in a replication sample of 14 nicotine-dependent participants. RESULTS Not only was the DMN significantly less suppressed during smoking cue exposure, but also there was a positive association between DMN reactivity to smoking relative to neutral cues and dACC Glu (r=0.56, p<0.02). This finding was confirmed in the independent replication cohort (r=0.64, p<0.02). CONCLUSIONS The current findings confirm that the DMN is less suppressed when smokers view smoking relative to neutral cues, suggesting that smoking cues engage self-relevant processing. Furthermore, these results indicate that dACC Glu is associated with enhanced DMN engagement when nicotine-dependent individuals are exposed to self-relevant smoking cues.
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Wu Y, Sun D, Wang Y, Wang Y, Ou S. Segmentation of the Cingulum Bundle in the Human Brain: A New Perspective Based on DSI Tractography and Fiber Dissection Study. Front Neuroanat 2016; 10:84. [PMID: 27656132 PMCID: PMC5013069 DOI: 10.3389/fnana.2016.00084] [Citation(s) in RCA: 76] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Accepted: 08/17/2016] [Indexed: 11/24/2022] Open
Abstract
The cingulum bundle (CB) is a critical white matter fiber tract in the brain, which forms connections between the frontal lobe, parietal lobe and temporal lobe. In non-human primates, the CB is actually divided into distinct subcomponents on the basis of corticocortical connections. However, at present, no study has verified similar distinct subdivisions in the human brain. In this study, we reconstructed these distinct subdivisions in the human brain, and determined their exact cortical connections using high definition fiber tracking (HDFT) technique on 10 healthy adults and a 488-subject template from the Human Connectome Project (HCP-488). Fiber dissections were performed to verify tractography results. Five CB segments were identified. CB-I ran from the subrostral areas to the precuneus and splenium, encircling the corpus callosum (CC). CB-II arched around the splenium and extended anteriorly above the CC to the medial aspect of the superior frontal gyrus (SFG). CB-III connected the superior parietal lobule (SPL) and precuneus with the medial aspect of the SFG. CB-IV was a relatively minor subcomponent from the SPL and precuneus to the frontal region. CB-V, the para-hippocampal cingulum, stemmed from the medial temporal lobe and fanned out to the occipital lobes. Our findings not only provide a more accurate and detailed description on the associated architecture of the subcomponents within the CB, but also offer new insights into the functional role of the CB in the human brain.
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Affiliation(s)
- Yupeng Wu
- Department of Neurosurgery, The First Affiliated Hospital of China Medical University Shenyang, China
| | - Dandan Sun
- Department of Cardiovascular Ultrasound, The First Affiliated Hospital of China Medical University Shenyang, China
| | - Yong Wang
- Department of Neurosurgery, The First Affiliated Hospital of China Medical University Shenyang, China
| | - Yibao Wang
- Department of Neurosurgery, The First Affiliated Hospital of China Medical University Shenyang, China
| | - Shaowu Ou
- Department of Neurosurgery, The First Affiliated Hospital of China Medical University Shenyang, China
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Smoking Abstinence-Induced Changes in Resting State Functional Connectivity with Ventral Striatum Predict Lapse During a Quit Attempt. Neuropsychopharmacology 2016; 41:2521-9. [PMID: 27091382 PMCID: PMC4987851 DOI: 10.1038/npp.2016.56] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2015] [Revised: 03/19/2016] [Accepted: 04/12/2016] [Indexed: 01/13/2023]
Abstract
The ventral and dorsal striatum are critical substrates of reward processing and motivation and have been repeatedly linked to addictive disorders, including nicotine dependence. However, little is known about how functional connectivity between these and other brain regions is modulated by smoking withdrawal and may contribute to relapse vulnerability. In the present study, 37 smokers completed resting state fMRI scans during both satiated and 24-h abstinent conditions, prior to engaging in a 3-week quit attempt supported by contingency management. We examined the effects of abstinence condition and smoking outcome (lapse vs non-lapse) on whole-brain connectivity with ventral and dorsal striatum seed regions. Results indicated a significant condition by lapse outcome interaction for both right and left ventral striatum seeds. Robust abstinence-induced increases in connectivity with bilateral ventral striatum were observed across a network of regions implicated in addictive disorders, including insula, superior temporal gyrus, and anterior/mid-cingulate cortex among non-lapsers; the opposite pattern was observed for those who later lapsed. For dorsal striatum seeds, 24-h abstinence decreased connectivity across both groups with several regions, including medial prefrontal cortex, posterior cingulate cortex, hippocampus, and supplemental motor area. These findings suggest that modulation of striatal connectivity with the cingulo-insular network during early withdrawal may be associated with smoking cessation outcomes.
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Garrison KA, Sinha R, Lacadie CM, Scheinost D, Jastreboff AM, Constable RT, Potenza MN. Functional Connectivity During Exposure to Favorite-Food, Stress, and Neutral-Relaxing Imagery Differs Between Smokers and Nonsmokers. Nicotine Tob Res 2016; 18:1820-9. [PMID: 26995796 PMCID: PMC4978981 DOI: 10.1093/ntr/ntw088] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Accepted: 03/09/2016] [Indexed: 01/03/2023]
Abstract
INTRODUCTION Tobacco-use disorder is a complex condition involving multiple brain networks and presenting with multiple behavioral correlates including changes in diet and stress. In a previous functional magnetic resonance imaging (fMRI) study of neural responses to favorite-food, stress, and neutral-relaxing imagery, smokers versus nonsmokers demonstrated blunted corticostriatal-limbic responses to favorite-food cues. Based on other recent reports of alterations in functional brain networks in smokers, the current study examined functional connectivity during exposure to favorite-food, stress, and neutral-relaxing imagery in smokers and nonsmokers, using the same dataset. METHODS The intrinsic connectivity distribution was measured to identify brain regions that differed in degree of functional connectivity between groups during each imagery condition. Resulting clusters were evaluated for seed-to-voxel connectivity to identify the specific connections that differed between groups during each imagery condition. RESULTS During exposure to favorite-food imagery, smokers versus nonsmokers showed lower connectivity in the supramarginal gyrus, and differences in connectivity between the supramarginal gyrus and the corticostriatal-limbic system. During exposure to neutral-relaxing imagery, smokers versus nonsmokers showed greater connectivity in the precuneus, and greater connectivity between the precuneus and the posterior insula and rolandic operculum. During exposure to stress imagery, smokers versus nonsmokers showed lower connectivity in the cerebellum. CONCLUSIONS These findings provide data-driven insights into smoking-related alterations in brain functional connectivity patterns related to appetitive, relaxing, and stressful states. IMPLICATIONS This study uses a data-driven approach to demonstrate that smokers and nonsmokers show differential patterns of functional connectivity during guided imagery related to personalized favorite-food, stress, and neutral-relaxing cues, in brain regions implicated in attention, reward-related, emotional, and motivational processes. For smokers, these differences in connectivity may impact appetite, stress, and relaxation, and may interfere with smoking cessation.
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Affiliation(s)
| | - Rajita Sinha
- Department of Psychiatry, Child Study Center, and Neurobiology, Yale School of Medicine, New Haven, CT
| | - Cheryl M Lacadie
- Department of Diagnostic Radiology, Yale School of Medicine, New Haven, CT
| | - Dustin Scheinost
- Department of Diagnostic Radiology, Yale School of Medicine, New Haven, CT
| | - Ania M Jastreboff
- Department of Internal Medicine, Division of Endocrinology, and Department of Pediatrics, Division of Pediatric Endocrinology, Yale School of Medicine, New Haven, CT
| | - R Todd Constable
- Department of Diagnostic Radiology, Yale School of Medicine, New Haven, CT
| | - Marc N Potenza
- Department of Psychiatry and Child Study Center, Neurobiology, and CASA Columbia, Yale School of Medicine, and Connecticut Mental Health Center, New Haven, CT
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Christophi CA, Pampaka D, Paisi M, Ioannou S, DiFranza JR. Levels of physical dependence on tobacco among adolescent smokers in Cyprus. Addict Behav 2016; 60:148-53. [PMID: 27149692 PMCID: PMC4894124 DOI: 10.1016/j.addbeh.2016.04.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2015] [Revised: 03/29/2016] [Accepted: 04/14/2016] [Indexed: 10/25/2022]
Abstract
PURPOSE The purpose of this study is to assess tobacco dependence among Cypriot adolescents and examine its association to cigarette consumption and attitudes towards smoking. METHODS The current study used cross-sectional data from the 2011 Cyprus Global Youth Tobacco Survey which adopted multistage cluster sampling methods to select adolescents registered in middle and high schools in Cyprus. Tobacco use, physical dependence on tobacco, and attitudes towards tobacco use were measured in 187 adolescents aged 13-18years old who reported that they had smoked at least once in the preceding 30days. Physical dependence was assessed using the Levels of Physical Dependence scale. RESULTS Physical dependence was present in 86% of the adolescent smokers. The mean latency to needing among smokers in the highest dependence group was 101h. Significant associations were observed between physical dependence and the perceived difficulty in quitting (OR=13.1, 95% CI: 4.0, 43.0) as well as the expectation to continue smoking for the next five years (OR=3.3, 95% CI: 1.3, 8.4). Significant associations were also observed between physical dependence and the number of smoking days per month, daily smoking, daily cigarette consumption, lifetime cigarette consumption, and perceived difficulty in abstaining from smoking for one week. CONCLUSIONS Physical dependence provides a symptom-based approach to assess dependence and it is a strong predictor of adolescents' perceptions of their ability to quit or to refrain from smoking for a week. Physical dependence on tobacco was highly prevalent among adolescent smokers in Cyprus and it was associated with greater perceived difficulty in quitting. Interventions targeting adolescent smoking must account for the high prevalence of physical dependence.
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Shen Z, Huang P, Qian W, Wang C, Yu H, Yang Y, Zhang M. Severity of dependence modulates smokers' functional connectivity in the reward circuit: a preliminary study. Psychopharmacology (Berl) 2016; 233:2129-2137. [PMID: 26955839 DOI: 10.1007/s00213-016-4262-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2015] [Accepted: 02/24/2016] [Indexed: 12/01/2022]
Abstract
RATIONALE Nicotine dependence is characterized as a neural circuit dysfunction, particularly with regard to the reward circuit. Although dependence severity moderates cue reactivity in the brain regions involved in reward processing, the direction of its influence remains controversial. OBJECTIVES Investigating the functional organization of the reward circuit may provide complementary information. Here, we used resting-state functional connectivity (rsFC) to evaluate the integrity of the reward circuit in smokers with different severities of nicotine dependence. METHODS Totals of 65 smokers and 37 non-smokers underwent resting-state functional magnetic resonance imaging (fMRI). The smokers were divided into low-dependent (FTND < 5, n = 26) and high-dependent smoker groups (FTND ≥ 5, n = 39) based on their nicotine-dependence severity (as measured by the Fagerström test for nicotine dependence [FTND]). The region of interest (ROI)-wise rsFC within the reward circuit was compared between smokers and non-smokers as well as between low-dependent and high-dependent smokers and then correlated with smokers' FTND scores. RESULTS Widespread rsFC attenuation was observed in the reward circuit of smokers compared with non-smokers. Compared with low-dependent smokers, high-dependent smokers showed greater rsFC between the right amygdala and the left nucleus accumbens (NAcc) as well as between the bilateral hippocampus. Furthermore, a positive correlation between the inter-hippocampus rsFC and the severity of nicotine dependence (FTND) was detected among all smokers (r = 0.416, p = 0.001). CONCLUSIONS Our results indicate a dysfunction of the reward circuit in nicotine-dependent individuals. Moreover, our study improves the understanding of the neuroplastic changes that occur during the development of nicotine dependence.
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Affiliation(s)
- Zhujing Shen
- Department of Radiology, the Second Affiliated Hospital, Zhejiang University School of Medicine, No. 88 Jiefang Road, Hangzhou, Zhejiang, 310009, China
| | - Peiyu Huang
- Department of Radiology, the Second Affiliated Hospital, Zhejiang University School of Medicine, No. 88 Jiefang Road, Hangzhou, Zhejiang, 310009, China
| | - Wei Qian
- Department of Radiology, the Second Affiliated Hospital, Zhejiang University School of Medicine, No. 88 Jiefang Road, Hangzhou, Zhejiang, 310009, China
| | - Chao Wang
- Department of Radiology, the Second Affiliated Hospital, Zhejiang University School of Medicine, No. 88 Jiefang Road, Hangzhou, Zhejiang, 310009, China
| | - Hualiang Yu
- Department of Psychiatry, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yihong Yang
- Neuroimaging Research Branch, National Institute on Drug Abuse, National Institutes of Health, Baltimore, Maryland, USA
| | - Minming Zhang
- Department of Radiology, the Second Affiliated Hospital, Zhejiang University School of Medicine, No. 88 Jiefang Road, Hangzhou, Zhejiang, 310009, China.
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37
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Liu T, Li J, Zhao Z, Zhong Y, Zhang Z, Xu Q, Yang G, Lu G, Pan S, Chen F. Betel quid dependence is associated with functional connectivity changes of the anterior cingulate cortex: a resting-state fMRI study. J Transl Med 2016; 14:33. [PMID: 26837944 PMCID: PMC4736480 DOI: 10.1186/s12967-016-0784-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2015] [Accepted: 01/13/2016] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVE It is generally acknowledged that drug dependence is connected with abnormal functional organization in the individual's brain. The present study aimed to identify the anterior cingulate cortex (ACC) abnormality with the cerebral networks involved in betel quid dependence (BQD) by resting-state functional connectivity (rsFC) using functional magnetic resonance imaging (fMRI). METHODS With fMRI data measured from 33 resting-state BQD individuals and 32 non-addicted and age-, sex-, education-matched healthy controls, we inquired into the BQD-related changes in FC between the regions of ACC with the whole brain involved in BQD individuals using a region of interest vised method, and to identify the relation of the alteration with the severity of BQD and duration. RESULTS Compared to controls, the BQD group showed increased connectivity from ACC to the regions of the reward network (brainstem including midbrain regions such as the ventral tegmental area and pons, caudate, thalamus) and cerebellum. Decreased connectivity was observed in the BQD group in regions from ACC to the default mode network (medial prefrontal cortex and precuneus) and para Hippocampal/hypothalamus. Specifically, the BQD scale was positively correlated with increased FC of right ACC to left thalamus and left ACC to pons; the durations were negatively correlated with FC of right ACC to left precuneus. CONCLUSION These disturbances in rsFC from ACC to the reward network and DMN revealed by fMRI may have a key function in providing insights into the neurological pathophysiology underlying BQD-associated executive dysfunction and disinhibition. These findings may contribute to our better understanding of the mechanisms underlying BQD.
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Affiliation(s)
- Tao Liu
- Department of Neurology, Nanfang Hospital, Southern Medical University, 510515, Guangzhou, China. .,Department of Neurology, People's Hospital of Hainan Province, 570311, Haikou, China.
| | - Jianjun Li
- Department of Radiology, People's Hospital of Hainan Province, Xiuhua Road 19, Xiuying District, 570311, Haikou, China.
| | - Zhongyan Zhao
- Department of Neurology, People's Hospital of Hainan Province, 570311, Haikou, China.
| | - Yuan Zhong
- Department of Medical Imaging, Jinling Hospital, Clinical School of Southern Medical University, 210000, Nanjing, China. .,School of Psychology, Nanjing Normal University, 210000, Nanjing, China.
| | - Zhiqiang Zhang
- Department of Medical Imaging, Jinling Hospital, Clinical School of Southern Medical University, 210000, Nanjing, China.
| | - Qiang Xu
- Department of Medical Imaging, Jinling Hospital, Clinical School of Southern Medical University, 210000, Nanjing, China.
| | - Guoshuai Yang
- Department of Neurology, Nanfang Hospital, Southern Medical University, 510515, Guangzhou, China.
| | - Guangming Lu
- Department of Medical Imaging, Jinling Hospital, Clinical School of Southern Medical University, 210000, Nanjing, China.
| | - Suyue Pan
- Department of Neurology, Nanfang Hospital, Southern Medical University, 510515, Guangzhou, China.
| | - Feng Chen
- Department of Radiology, People's Hospital of Hainan Province, Xiuhua Road 19, Xiuying District, 570311, Haikou, China. .,Department of Medical Imaging, Jinling Hospital, Clinical School of Southern Medical University, 210000, Nanjing, China.
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Moeller SJ, London ED, Northoff G. Neuroimaging markers of glutamatergic and GABAergic systems in drug addiction: Relationships to resting-state functional connectivity. Neurosci Biobehav Rev 2016; 61:35-52. [PMID: 26657968 PMCID: PMC4731270 DOI: 10.1016/j.neubiorev.2015.11.010] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Revised: 11/05/2015] [Accepted: 11/21/2015] [Indexed: 12/29/2022]
Abstract
Drug addiction is characterized by widespread abnormalities in brain function and neurochemistry, including drug-associated effects on concentrations of the excitatory and inhibitory neurotransmitters glutamate and gamma-aminobutyric acid (GABA), respectively. In healthy individuals, these neurotransmitters drive the resting state, a default condition of brain function also disrupted in addiction. Here, our primary goal was to review in vivo magnetic resonance spectroscopy and positron emission tomography studies that examined markers of glutamate and GABA abnormalities in human drug addiction. Addicted individuals tended to show decreases in these markers compared with healthy controls, but findings also varied by individual characteristics (e.g., abstinence length). Interestingly, select corticolimbic brain regions showing glutamatergic and/or GABAergic abnormalities have been similarly implicated in resting-state functional connectivity deficits in drug addiction. Thus, our secondary goals were to provide a brief review of this resting-state literature, and an initial rationale for the hypothesis that abnormalities in glutamatergic and/or GABAergic neurotransmission may underlie resting-state functional deficits in drug addiction. In doing so, we suggest future research directions and possible treatment implications.
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Affiliation(s)
- Scott J Moeller
- Departments of Psychiatry and Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA.
| | - Edythe D London
- Departments of Psychiatry and Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Departments of Psychiatry and Biobehavioral Sciences, and Molecular and Medical Pharmacology, University of California Los Angeles, Los Angeles, CA, USA
| | - Georg Northoff
- Brain Imaging and Neuroethics Research Unit, Institute of Mental Health Research, Ottawa, Canada.
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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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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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41
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Pbert L, Farber H, Horn K, Lando HA, Muramoto M, O'Loughlin J, Tanski S, Wellman RJ, Winickoff JP, Klein JD. State-of-the-art office-based interventions to eliminate youth tobacco use: the past decade. Pediatrics 2015; 135:734-47. [PMID: 25780075 DOI: 10.1542/peds.2014-2037] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/13/2015] [Indexed: 11/24/2022] Open
Abstract
Tobacco use and tobacco smoke exposure are among the most important preventable causes of premature disease, disability, and death and therefore constitute a major pediatric health concern. The pediatric primary care setting offers excellent opportunities to prevent tobacco use in youth and to deliver cessation-related treatment to youth and parents who use tobacco. This report updates a "state-of-the-art" article published a decade ago on office-based interventions to address these issues. Since then there has been marked progress in understanding the nature, onset, and trajectories of tobacco use and nicotine addiction in youth with implications for clinical practice. In addition, clinicians need to remain abreast of emerging nicotine delivery systems, such as electronic cigarettes, that may influence uptake or continuation of smoking. Although evidence-based practice guidelines for treating nicotine addiction in youth are not yet available, research continues to build the evidence base toward that goal. In the interim, practical guidelines are available to assist clinicians in addressing nicotine addiction in the pediatric clinical setting. This article reports current practices in addressing tobacco in pediatric primary care settings. It reviews our increasing understanding of youth nicotine addiction, summarizes research efforts on intervention in the past decade and additional research needed going forward, and provides practical guidelines for pediatric health care providers to integrate tobacco use prevention and treatment into their clinical practice. Pediatric providers can and should play an important role in addressing tobacco use and dependence, both in the youth they care for and in parents who use tobacco.
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Affiliation(s)
| | - Harold Farber
- Department of Pediatrics, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas
| | - Kimberly Horn
- Department of Prevention and Community Health, The George Washington University, Washington, District of Columbia
| | - Harry A Lando
- Division of Epidemiology, University of Minnesota, Minneapolis, Minnesota
| | - Myra Muramoto
- Department of Family and Community Medicine, College of Medicine, University of Arizona, Tucson, Arizona
| | - Jennifer O'Loughlin
- Department of Social and Preventive Medicine, University of Montreal, Montreal, Quebec, Canada
| | - Susanne Tanski
- Department of Pediatrics, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire
| | - Robert J Wellman
- Department of Family Medicine and Community Health University of Massachusetts Medical School, Worcester, Massachusetts
| | | | - Jonathan D Klein
- Julius B. Richmond Center of Excellence, American Academy of Pediatrics, Elk Grove Village, Illinois
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Huang W, Tam K, Fernando J, Heffernan M, King J, DiFranza JR. Nicotine and Resting-State Functional Connectivity: Effects of Intermittent Doses. Nicotine Tob Res 2015; 17:1311-7. [PMID: 25646348 DOI: 10.1093/ntr/ntv009] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2014] [Accepted: 01/07/2015] [Indexed: 11/12/2022]
Abstract
INTRODUCTION It is unknown how the timing between doses might affect nicotine's impact on neural activity. Our objective was to examine how the interdose interval affects nicotine's impact on resting-state functional connectivity (rsFC). MATERIALS AND METHODS Adult male Sprague-Dawley rats were administered nicotine daily (0.4 mg/kg) over 6 days while control animals received saline vehicle. Functional magnetic resonance imaging was used to measure rsFC before and after a challenge dose of nicotine (0.4 mg/kg) delivered for the first time and 3, 6, 12, or 24hr after the previous dose. RESULTS As the interval between nicotine doses increased from 3 to 24hr, the strength of rsFC increased in some circuits, particularly the nucleus accumbens and prefrontal circuits, and decreased in others, namely the interpeduncular nucleus, hippocampus, caudoputamen, retrosplenial cortex, ventral tegmental, and the insular circuits. CONCLUSIONS These data indicate that the effect that nicotine has on the brain is affected by the amount of time that has passed since the previous dose. The effect on rsFC of cumulative doses is not additive. This may have important implications for the study of nicotine addiction as it implies that the same dose of nicotine might have a different impact on the brain depending on the time elapsed from the previous exposure.
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Affiliation(s)
- Wei Huang
- Center for Comparative NeuroImaging, Department of Psychiatry, University of Massachusetts Medical School, Worcester, MA
| | - Kelly Tam
- Center for Comparative NeuroImaging, Department of Psychiatry, University of Massachusetts Medical School, Worcester, MA
| | - Janaque Fernando
- Center for Comparative NeuroImaging, Department of Psychiatry, University of Massachusetts Medical School, Worcester, MA
| | - Meghan Heffernan
- Center for Comparative NeuroImaging, Department of Psychiatry, University of Massachusetts Medical School, Worcester, MA
| | | | - Joseph R DiFranza
- Center for Comparative NeuroImaging, Department of Psychiatry, University of Massachusetts Medical School, Worcester, MA; Department of Family Medicine and Community Health, University of Massachusetts Medical School, Worcester, MA
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Wellman RJ, DiFranza JR, O'Loughlin J. Recalled first reactions to inhaling nicotine predict the level of physical dependence. Drug Alcohol Depend 2014; 143:167-72. [PMID: 25108583 DOI: 10.1016/j.drugalcdep.2014.07.021] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2014] [Revised: 07/15/2014] [Accepted: 07/16/2014] [Indexed: 11/30/2022]
Abstract
BACKGROUND The level of physical dependence is a measure of addiction that correlates highly with addiction-associated changes in brain structure. We sought to determine whether age at first inhalation and initial reactions to inhaling nicotine are related to level of physical dependence in early adulthood. METHODS Young adults (n=312; mean age=24 years; 51% female) from the Nicotine Dependence in Teens study who had smoked at least once in the preceding three months completed self-report questionnaires in 2011-12. We assessed level of physical dependence with three validated self-report items assessing 'wanting,' 'craving' and 'needing' triggered by nicotine deprivation. Survey items assessed smoking behavior, including age at first inhalation, and recalled first reactions to inhaling nicotine. RESULTS After adjusting for covariates, experiencing relaxation, heart racing/pounding, rush or "buzz" (OR=1.45; 95% CI: 1.08, 1.94) and dizziness (OR=1.58; 95% CI: 1.15, 2.18) at first nicotine inhalation were associated with an increased odds of being at a higher level of physical dependence in young adulthood; the association for experiencing relaxation (OR=1.78; 95% CI: 1.20, 2.64) and heart racing/pounding (OR=1.51; 95% CI: 1.00, 2.28) persisted after additionally controlling for all other first reactions. Neither age at first inhalation nor unpleasant first reactions predicted level of physical dependence. CONCLUSIONS In accordance with prior research, our findings suggest that smokers who are particularly sensitive to the pleasant, "buzz-related" and generally arousing effects of nicotine may be more likely to attain higher levels of physical dependence.
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Affiliation(s)
- Robert J Wellman
- Department of Family Medicine and Community Health, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, Massachusetts, 01655, USA
| | - Joseph R DiFranza
- Department of Family Medicine and Community Health, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, Massachusetts, 01655, USA.
| | - Jennifer O'Loughlin
- Department of Social and Preventive Medicine, University of Montréal, 3875 St. Urbain, 1st Floor, Montreal, Quebec, H2W 1V1, Canada; Centre de recherche du Centre Hospitalier de l'Université de Montréal, Tour St-Antoine, 850 St-Denis, Montreal, Quebec, H2X 0A9, Canada; Institut national de santé publique du Québec, 945 Wolfe Avenue, Quebec (QC) G1V 5B3, Canada
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DiFranza JR. Commentary on Hu et al. (2014): the validity of the DSM is not a 'given'. Addiction 2014; 109:1529-30. [PMID: 25103104 DOI: 10.1111/add.12670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Joseph R DiFranza
- Department of Family Medicine and Community Health, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA, 01655, USA.
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