Early onset cigarette smokers exhibit greater P300 reactivity to smoking-related stimuli and report greater craving

Associations of the P300 Event-Related Potentials and Self-Reported Craving in Substance Use Disorders: A Systematic Review

INTRODUCTION

The phenomenon of craving and attention bias towards drug cues is theorized to operate cooperatively, owing to the principles of associative learning. In this context, the conditioned response to drug-related stimuli activates reward mechanisms within the brain, consequently inducing craving and fostering the underlying mechanisms that contribute to relapse in individuals with substance use disorders. Multiple studies have assessed the relationship between attention to substance-related cues and subjective craving through electroencephalography (EEG), but their findings have yet to be synthesized and examined. This review summarizes the association between the amplitude of the P300 event-related potential (ERP) and substance use craving, compares discrepancies in results by type of substance, and discusses gaps in the literature to inform future research.

METHODS

A systematic search was conducted on Embase, Web of Science, CINAHL, and PsychINFO databases. Studies were published in English and included peer-reviewed human research investigating the relationship between EEG P300 ERP and self-reported substance use craving. The included study samples comprised of in treatment or non-treatment-seeking participants who use substances. The primary outcomes of interest were those derived from inferential statistics assessing P300 amplitude and substance use craving.

RESULTS

Ten studies were included in the final search and were organized by substance type: three alcohol, three cocaine, two tobacco, one heroin, and one cannabis. Results were mixed for alcohol and cocaine. Studies on tobacco, heroin, and cannabis use were congruent for associations between the P300 amplitude and craving.

CONCLUSIONS

Overall findings are mixed between studies addressing the association of the EEG P300 amplitude and craving. These results should be considered in the context of the limited sample size, underpowered analyses, and methodological differences that potentially contribute to discrepancies in outcomes. Further research is required to assess the role of craving assessment, EEG methodology, and substance-related factors on the association between P300 amplitude and self-reported craving.

Cue-reactivity targeted smoking cessation intervention in individuals with tobacco use disorder: a scoping review

Objectives

Cue-reactivity is a critical step leading to the emergence of addictive psychology and the triggering of addictive behaviors within the framework of addiction theory and is considered a significant risk factor for addiction-related behaviors. However, the effect of cue-reactivity targeted smoking cessation intervention and the cue-reactivity paradigms used in the randomized controlled trials varies, which introduces more heterogeneity and makes a side-by-side comparison of cessation responses difficult. Therefore, the scoping review aims to integrate existing research and identify evidence gaps.

Methods

We searched databases in English (PubMed and Embase) and Chinese (CNKI and Wanfang) using terms synonymous with 'cue' and 'tobacco use disorder (TUD)' to April 2023, and via hand-searching and reference screening of included studies. Studies were included if they were randomized controlled trials taking cue-reactivity as an indicator for tobacco use disorder (TUD) defined by different kinds of criteria.

Results

Data were extracted on each study's country, population, methods, timeframes, outcomes, cue-reactivity paradigms, and so on. Of the 2,944 literature were retrieved, 201 studies met the criteria and were selected for full-text screening. Finally, 67 pieces of literature were selected for inclusion and data extraction. The results mainly revealed that non-invasive brain stimulation and exercise therapy showed a trend of greater possibility in reducing subjective craving compared to the remaining therapies, despite variations in the number of research studies conducted in each category. And cue-reactivity paradigms vary in materials and mainly fall into two main categories: behaviorally induced craving paradigm or visually induced craving paradigm.

Conclusion

The current studies are still inadequate in terms of comparability due to their heterogeneity, cue-reactivity can be conducted in the future by constructing a standard library of smoking cue materials. Causal analysis is suggested in order to adequately screen for causes of addiction persistence, and further explore the specific objective cue-reactivity-related indicators of TUD.

Electrophysiological indexes for impaired response inhibition and salience attribution in substance (stimulants and depressants) use disorders: A meta-analysis

The impairment of inhibitory control and reward system is the core feature underlying substance use disorder (SUD). Previous studies suggested that it can be regarded as impaired response inhibition and salience attribution syndrome (iRISA). The neural substrates of the two deficit functions were widely investigated in neuroimaging studies, and the impaired prefrontal cortex, limbic-orbitofrontal network, and fronto-insular-parietal network were observed. Previous Event-related potential (ERP) studies were also conducted to explore EEG indexes related to abnormal brain function. In the current meta-analysis, we aimed to explore the consistency of ERP indexes that can reflect the two aberrant processes: P300/slow potential (SP) for salience attribution and Error-related negativity (ERN)/Nogo-N200/Nogo-P300 for inhibitory control and conflict monitoring. Subgroup analyses for drug type and drug use conditions were also conducted. According to the 60 research studies, we found significantly enhanced drug-cue-induced P300 amplitude and attenuated Nogo-N200 amplitude in SUD individuals relative to Healthy control (HC), which supports the dual model. Moreover, the drug-cue-induced P300 displayed time-dependence recovery, suggesting a potential index for treatment evaluation. In conclusion, drug-cue-induced P300 and Nogo-N200 demonstrated high consistency, and the drug-cue-induced P300 can be used to track the changes of functional recovery for SUD. The integration of the two ERP components could be regarded as a potential biomarker for SUD, which may provide a new insight for clinical treatment and investigation.

Causes of smoking relapse in the 12 months after smoking cessation treatment: Affective and cigarette dependence-related factors

Despite advances in smoking cessation treatments, smoking relapse remains common. Experiencing positive or negative affect and cigarette dependence are the most common causes of relapse; however, little is known about the characteristics that increase the risk of relapse from these causes among current treatment-seeking smokers. Thus, this study aimed to identify the most frequent causes of relapse and the individual characteristics that increase the risk of relapse from these causes during a 12-month period after smoking cessation. Participants included 121 treatment-seeking smokers who quit smoking at the end of treatment and relapsed during a 12-month follow-up period (60.3% female;Mage = 42.57, SD = 11.07). Results indicated that the most frequent smoking relapse situations occurred when smokers experienced positive (e.g., being relaxed; 43.0%) or negative (e.g., being angry; 37.2%) affect or cigarette dependence-related situations (e.g., craving; 19.8%). At an individual level, males with a higher level of education and without a psychopharmaceutical prescription had a higher risk of relapsing in positive-affect situations. Smoking the first cigarette at an older age increased the risk of relapse in negative-affect situations. Finally, being younger and less motivated to quit at pretreatment increased the likelihood of relapse in cigarette dependence-related situations. These findings provide detailed information about smoking relapse situations and identify a set of characteristics that might help to improve current relapse-prevention interventions.

Adolescent Substance Use and the Brain: Behavioral, Cognitive and Neuroimaging Correlates

Adolescence is an important ontogenetic period that is characterized by behaviors such as enhanced novelty-seeking, impulsivity, and reward preference, which can give rise to an increased risk for substance use. While substance use rates in adolescence are generally on a decline, the current rates combined with emerging trends, such as increases in e-cigarette use, remain a significant public health concern. In this review, we focus on the neurobiological divergences associated with adolescent substance use, derived from a cross-sectional, retrospective, and longitudinal studies, and highlight how the use of these substances during adolescence may relate to behavioral and neuroimaging-based outcomes. Identifying and understanding the associations between adolescent substance use and changes in cognition, mental health, and future substance use risk may assist our understanding of the consequences of drug exposure during this critical window.

Biomarkers and neuromodulation techniques in substance use disorders

Addictive disorders are a severe health concern. Conventional therapies have just moderate success and the probability of relapse after treatment remains high. Brain stimulation techniques, such as transcranial Direct Current Stimulation (tDCS) and Deep Brain Stimulation (DBS), have been shown to be effective in reducing subjectively rated substance craving. However, there are few objective and measurable parameters that reflect neural mechanisms of addictive disorders and relapse. Key electrophysiological features that characterize substance related changes in neural processing are Event-Related Potentials (ERP). These high temporal resolution measurements of brain activity are able to identify neurocognitive correlates of addictive behaviours. Moreover, ERP have shown utility as biomarkers to predict treatment outcome and relapse probability. A future direction for the treatment of addiction might include neural interfaces able to detect addiction-related neurophysiological parameters and deploy neuromodulation adapted to the identified pathological features in a closed-loop fashion. Such systems may go beyond electrical recording and stimulation to employ sensing and neuromodulation in the pharmacological domain as well as advanced signal analysis and machine learning algorithms. In this review, we describe the state-of-the-art in the treatment of addictive disorders with electrical brain stimulation and its effect on addiction-related neurophysiological markers. We discuss advanced signal processing approaches and multi-modal neural interfaces as building blocks in future bioelectronics systems for treatment of addictive disorders.

Two-Hour Tobacco Abstinence Has No Effect on Cognitive Control in Male Patients With Nicotine Dependence: An ERP Study

The average nicotine half-life in body tissues is 2 h. Understanding the influence of pure nicotine abstinence on cognitive control may be helpful in eliminating nicotine dependence (ND) and preventing smoking relapse. This study was to investigate the effects of 2-h tobacco abstinence on cognitive control in patients with ND. Twenty-five patients with ND completed event-related potential (ERP) P300 measurements at the normality state and the abstinence state. Twenty-five healthy controls (HCs) were measured with P300 twice with a 2-h time interval. HAMD and HAMA were used to assess the emotional state. Results showed that there were significant differences in Carbon monoxide (CO) levels between the abstinence state and the normality state in the ND group. There were no significant differences in HAMD and HAMA scores for the abstinence state in the ND group or the normality state in the ND group and the HC group. For P3a, P3b amplitude, and P3a latency, the main effect for ND group was significant. For P3a, P3b amplitude, and latency, the interaction effect for group × time point was not significant, and the main effect for time point was not significant. It concluded that patients with ND present cognitive control deficits, and 2-h tobacco abstinence has no effect on cognitive control deficits in male patients with ND. Our findings may be helpful in eliminating nicotine dependence and preventing smoking relapse.

Experimentation with tobacco during adolescence as a factor influencing treatment of smoking in adulthood. A retrospective cohort

BACKGROUND

There are still few studies on predictors of smoking cessation in Brazilian samples. Experimentation with tobacco during adolescence (ETA) may be one of the important predictors.

OBJECTIVE

This study aimed, within the context of a treatment-seeking group of subjects, to test the hypothesis that ETA negatively affects the outcome of smoking cessation during adulthood.

DESIGN AND SETTING

Retrospective (historic) cohort study conducted at a psychosocial care center in São Paulo, Brazil, between 2007 and 2010.

METHODS

Data on sociodemographics, smoking and medical profiles were obtained through self-report questionnaires that were completed at the baseline and at any follow-up appointment. Logistic regression models were constructed to describe factors associated with the outcome of smoking cessation, measured according to the self-reported four-week success rate among 367 outpatient smokers.

RESULTS

ETA was found to be associated with not quitting smoking through the treatment (odds ratio = 0.57; 95% confidence interval = 0.33-0.96; P < 0.05), even after adjustment for dependence level, sociodemographics, nicotine patch use and number of years of smoking.

CONCLUSIONS

Early exposure to nicotine may lead to higher risk of continuing smoking after treatment, in adulthood.