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White AM, Craig AJ, Richie DL, Corley C, Sadek SM, Barton HN, Gipson CD. Nicotine is an Immunosuppressant: Implications for Women's Health and Disease. J Neuroimmunol 2024; 397:578468. [PMID: 39461120 DOI: 10.1016/j.jneuroim.2024.578468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2024] [Revised: 09/04/2024] [Accepted: 10/18/2024] [Indexed: 10/29/2024]
Abstract
A plethora of evidence supports that nicotine, the primary alkaloid in tobacco products that is generally accepted for maintaining use, is immunoregulatory and may function as an immunosuppressant. Women have unique experiences with use of nicotine-containing products and also undergo significant reproductive transitions throughout their lifespan which may be impacted by nicotine use. Within the extant literature, there is conflicting evidence that nicotine may confer beneficial health effects in specific disease states (e.g., in ulcerative colitis). Use prevalence of nicotine-containing products is exceptionally high in individuals presenting with some comorbid disease states that impact immune system health and can be a risk factor for the development of diseases which disproportionately impact women; however, the mechanisms underlying these relationships are largely unclear. Further, little is known regarding the impacts of nicotine's immunosuppressive effects on women's health during the menopausal transition, which is arguably an inflammatory event characterized by a pro-inflammatory peri-menopause period. Given that post-menopausal women are at a higher risk than men for the development of neurodegenerative diseases such as Alzheimer's disease and are also more vulnerable to negative health effects associated with diseases such as HIV-1 infection, it is important to understand how use of nicotine-containing products may impact the immune milieu in women. In this review, we define instances in which nicotine use confers immunosuppressive, anti-inflammatory, or pro-inflammatory effects in the context of comorbid disease states, and focus on how nicotine impacts neuroimmune signaling to maintain use. We posit that regardless of potential health benefits, nicotine use cessation should be a priority in the clinical care of women. The synthesis of this review demonstrates the importance of systematically defining the relationships between volitional nicotine use, immune system function, and comorbid disease states in women to better understand how nicotine impacts women's health and disease.
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Affiliation(s)
- Ashley M White
- Department of Pharmacology and Nutritional Sciences, University of Kentucky, Lexington, KY, USA
| | - Ashley J Craig
- Department of Pharmacology and Nutritional Sciences, University of Kentucky, Lexington, KY, USA
| | - Daryl L Richie
- Department of Pharmacology and Nutritional Sciences, University of Kentucky, Lexington, KY, USA
| | - Christa Corley
- Department of Pharmacology and Nutritional Sciences, University of Kentucky, Lexington, KY, USA
| | - Safiyah M Sadek
- Department of Pharmacology and Nutritional Sciences, University of Kentucky, Lexington, KY, USA
| | - Heather N Barton
- Beebe Health, Gastroenterology and Internal Medicine, Lewes, Delaware, USA
| | - Cassandra D Gipson
- Department of Pharmacology and Nutritional Sciences, University of Kentucky, Lexington, KY, USA.
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Qiu X, Han X, Wang Y, Ding W, Sun Y, Lei H, Zhou Y, Lin F. Sex Differences in Alterations of Brain Functional Network in Tobacco Use Disorder. Nicotine Tob Res 2024; 26:1049-1056. [PMID: 38195240 DOI: 10.1093/ntr/ntae002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Revised: 12/26/2023] [Accepted: 01/02/2024] [Indexed: 01/11/2024]
Abstract
INTRODUCTION Many studies have found sex differences in alterations of brain function in cigarette-smoking adults from the perspective of functional activity or connectivity. However, no studies have systematically found different alteration patterns in brain functional topology of cigarette-smoking men and women from three perspectives: nodal and network efficiency and modular connections. AIMS AND METHODS Fifty-six tobacco use disorder (TUD) participants (25 women) and 66 non-TUD participants (28 women) underwent a resting-state functional magnetic resonance imaging scan. The whole-brain functional networks were constructed, and a two-way analysis of covariance with false discovery rate correction (q < 0.05) was performed to investigate whether men and women TUD participants had different alterations in the topological features at global, modular, and nodal levels. RESULTS Compared to non-TUD participants, men but not women TUD participants showed significantly lower global efficiency (lower intermodular connections between the visual and executive control and between the visual and subcortical modules did not pass the correction) and significantly lower nodal global efficiency in the right superior occipital gyrus, bilateral fusiform gyrus, the right pallidum, right putamen, the bilateral paracentral lobule, the postcentral gyrus, and lower nodal local efficiency in the left paracentral lobule. CONCLUSIONS Men and women TUD participants have different topological properties of brain functional network, which may contribute to our understanding of neural mechanisms underlying sex differences in TUD. IMPLICATIONS Compared to non-TUD participants, we found men but not women TUD participants with significantly lower network metrics at global, modular, and nodal levels, which could improve our understanding of neural mechanisms underlying sex differences in TUD and lay a solid foundation for future sex-based TUD prevention and treatment.
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Affiliation(s)
- Xianxin Qiu
- Institute of Mental Health, College of Medicine and Health Sciences, China Three Gorges University, Yichang, China
- National Center for Magnetic Resonance in Wuhan, State Key Laboratory of Magnetic Resonance and Atomic and Molecular Physics, Wuhan Institute of Physics and Mathematics, Innovation Academy for Precision Measurement Science and Technology, Chinese Academy of Sciences, Wuhan, China
| | - Xu Han
- Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Yao Wang
- Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Weina Ding
- Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Yawen Sun
- Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, 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, Innovation Academy for Precision Measurement Science and Technology, Chinese Academy of Sciences, Wuhan, China
- University of Chinese Academy of Sciences, Beijing, China
| | - Yan Zhou
- Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - 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, Innovation Academy for Precision Measurement Science and Technology, Chinese Academy of Sciences, Wuhan, China
- University of Chinese Academy of Sciences, Beijing, China
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Macatee RJ, Cannon MJ, Schermitzler BS, Preston TJ, Afshar K. Biological sex and hormonal contraceptive associations with drug cue reactivity in cannabis use disorder. J Psychiatr Res 2024; 174:121-128. [PMID: 38626562 PMCID: PMC11195151 DOI: 10.1016/j.jpsychires.2024.04.016] [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: 05/10/2023] [Revised: 02/18/2024] [Accepted: 04/09/2024] [Indexed: 04/18/2024]
Abstract
Biological sex differences in Cannabis Use Disorder (CUD) progression, cannabis withdrawal severity, and pharmacotherapy response have been reported, suggesting that CUD mechanisms may differ by sex. Drug cue reactivity is an established predictor of drug use behavior, but the literature on sex differences in drug cue reactivity is mixed, including in CUD. One possible moderator of sex differences in drug cue reactivity is hormonal contraceptive (HC) use. The aim of the present study was to test whether sex differences in neural cannabis cue reactivity and craving varied by female HC use in a CUD sample. As part of a larger study, 152 adults reporting frequent cannabis use completed a drug cue reactivity task during electrocenphalogram recording. Late positive potential (LPP) amplitude modulation by cannabis cues was used to measure neural cue reactivity. Craving after the cue reactivity task was also assessed. Males (n = 74) and naturally-cycling females (n = 26), who did not differ from each other, showed significantly greater LPP enhancement to cannabis vs. neutral cues compared to HC-using females (n = 52), an effect mostly driven by neutral cues. Craving was significantly higher in naturally-cycling but not HC-using females compared to males, but only in covariate-unadjusted analyses. Exploratory analyses of HC and menstrual phase characteristics indicate a progesterone-related mechanism may underlie HC effects on cannabis cue reactivity. The present study's results suggest that mixed findings on drug cue reactivity sex differences may be due to variability in HC use, which has implications for sex-specific models of CUD progression and treatment.
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Affiliation(s)
| | | | | | | | - Kaveh Afshar
- Auburn University, Department of Psychological Sciences, USA
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Flentje A, Sunder G, Ceja A, Lisha NE, Neilands TB, Aouizerat BE, Lubensky ME, Capriotti MR, Dastur Z, Lunn MR, Obedin-Maliver J. Substance Use Over Time Among Sexual and Gender Minority People: Differences at the Intersection of Sex and Gender. LGBT Health 2024; 11:269-281. [PMID: 38206680 PMCID: PMC11522414 DOI: 10.1089/lgbt.2023.0055] [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] [Indexed: 01/13/2024] Open
Abstract
Purpose: Sexual and gender minority (SGM) people are at greater risk for substance use than heterosexual and cisgender people, but most prior work is limited by cross-sectional analyses or the examination of single substance use. This study examined substance use over time among SGM people to identify patterns of polysubstance use at the intersection of sex and gender. Methods: Data were collected annually over 4 years from SGM respondents (n = 11,822) in The Population Research in Identity and Disparities for Equality (PRIDE) Study. Differences in substance use patterns (any prior 30-day use of 15 substances) by gender subgroup were examined with latent class analysis, and multinomial regression models tested relationships between gender subgroup and substance use. Results: Eight classes of substance use were observed. The three most common patterns were low substance use (49%), heavy episodic alcohol use (≥5 alcoholic drinks on one occasion) with some cannabis and tobacco use (14%), and cannabis use with some tobacco and declining heavy episodic alcohol use (13%). Differences observed included lower odds of patterns defined by heavy episodic alcohol use with some cannabis and tobacco use in all gender subgroups relative to cisgender men and persons with low substance use (odds ratios [ORs] 0.26-0.60). Gender expansive people assigned female at birth, gender expansive people assigned male at birth, and transgender men had greater odds of reporting cannabis use with small percentages of heavy episodic alcohol and tobacco use (ORs: 1.41-1.60). Conclusion: This study suggests that there are unique patterns of polysubstance use over time among gender subgroups of SGM people.
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Affiliation(s)
- Annesa Flentje
- Community Health Systems, School of Nursing, University of California, San Francisco, San Francisco, California, USA
- Alliance Health Project, Department of Psychiatry and Behavioral Sciences, School of Medicine, University of California, San Francisco, San Francisco, California, USA
- The PRIDE Study/PRIDEnet, Stanford University School of Medicine, Stanford, California, USA
| | - Gowri Sunder
- Community Health Systems, School of Nursing, University of California, San Francisco, San Francisco, California, USA
- The PRIDE Study/PRIDEnet, Stanford University School of Medicine, Stanford, California, USA
| | - Alexis Ceja
- Community Health Systems, School of Nursing, University of California, San Francisco, San Francisco, California, USA
- The PRIDE Study/PRIDEnet, Stanford University School of Medicine, Stanford, California, USA
| | - Nadra E. Lisha
- Center for Tobacco Control and Research and Education, University of California, San Francisco, San Francisco, California, USA
| | - Torsten B. Neilands
- Division of Prevention Science, Department of Medicine, University of California, San Francisco, San Francisco, California, USA
| | - Bradley E. Aouizerat
- College of Dentistry, Translational Research Center, New York University, New York, New York, USA
- Rory Meyers College of Nursing, New York University, New York, New York, USA
| | - Micah E. Lubensky
- Community Health Systems, School of Nursing, University of California, San Francisco, San Francisco, California, USA
- The PRIDE Study/PRIDEnet, Stanford University School of Medicine, Stanford, California, USA
| | - Matthew R. Capriotti
- Department of Psychology, College of Social Sciences, San José State University, San José, California, USA
| | - Zubin Dastur
- The PRIDE Study/PRIDEnet, Stanford University School of Medicine, Stanford, California, USA
- Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, California, USA
| | - Mitchell R. Lunn
- The PRIDE Study/PRIDEnet, Stanford University School of Medicine, Stanford, California, USA
- Division of Nephrology, Department of Medicine, Stanford University School of Medicine, Stanford, California, USA
- Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, California, USA
| | - Juno Obedin-Maliver
- The PRIDE Study/PRIDEnet, Stanford University School of Medicine, Stanford, California, USA
- Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, California, USA
- Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, California, USA
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Lewitus VJ, Blackwell KT. Estradiol Receptors Inhibit Long-Term Potentiation in the Dorsomedial Striatum. eNeuro 2023; 10:ENEURO.0071-23.2023. [PMID: 37487741 PMCID: PMC10405883 DOI: 10.1523/eneuro.0071-23.2023] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 05/25/2023] [Accepted: 06/19/2023] [Indexed: 07/26/2023] Open
Abstract
Estradiol, a female sex hormone and the predominant form of estrogen, has diverse effects throughout the brain including in learning and memory. Estradiol modulates several types of learning that depend on the dorsomedial striatum (DMS), a subregion of the basal ganglia involved in goal-directed learning, cued action-selection, and motor skills. A cellular basis of learning is synaptic plasticity, and the presence of extranuclear estradiol receptors ERα, ERβ, and G-protein-coupled estrogen receptor (GPER) throughout the DMS suggests that estradiol may influence rapid cellular actions including those involved in plasticity. To test whether estradiol affects synaptic plasticity in the DMS, corticostriatal long-term potentiation (LTP) was induced using theta-burst stimulation (TBS) in ex vivo brain slices from intact male and female C57BL/6 mice. Extracellular field recordings showed that female mice in the diestrous stage of the estrous cycle exhibited LTP similar to male mice, while female mice in estrus did not exhibit LTP. Furthermore, antagonists of ERα or GPER rescued LTP in estrous females and agonists of ERα or GPER reduced LTP in diestrous females. In males, activating ERα but not GPER reduced LTP. These results uncover an inhibitory action of estradiol receptors on cellular learning in the DMS and suggest a cellular mechanism underlying the impairment in certain types of DMS-based learning observed in the presence of high estradiol. Because of the dorsal striatum's role in substance use disorders, these findings may provide a mechanism underlying an estradiol-mediated progression from goal-directed to habitual drug use.
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Affiliation(s)
| | - Kim T Blackwell
- Interdisciplinary Neuroscience PhD Program
- Department of Bioengineering, George Mason University, Fairfax, VA 22030
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Firdaus I, Kleiboer AM, Huizink AC, Kaag AM. The Moderating Role of Sex in the Relation between Cue-Induced Craving and Resting-State Functional Connectivity in the Salience Network of Non-Clinically Diagnosed Drinkers. Eur Addict Res 2023; 29:294-304. [PMID: 37423204 PMCID: PMC10614227 DOI: 10.1159/000531090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 04/18/2023] [Indexed: 07/11/2023]
Abstract
INTRODUCTION Previous research indicates a relation between craving and increased connectivity in the resting-state salience network. However, the link between cue-induced craving and connectivity in the salience network remains unclear. Further investigation is needed to understand the effect of sex on the relationship between cue-induced craving and the salience network. We investigated the role of sex in the association between the resting-state functional connectivity (RSFC) salience network and subjective cue-induced craving. METHODS Twenty-six males (mean age = 25.3) and 23 females (mean age = 26.0), with a score of 12 or higher on the alcohol use disorder identification test, were included in the current study. No significant difference in age was observed between males and females. Participants underwent a resting-state MRI scan for 6 min. Following the MRI scan, participants completed an alcohol cue-exposure task for 5.5 min to assess cue-induced craving using the desire to drink alcohol questionnaire. We applied independent component analysis methods to determine functional connectivity within the salience network. Subsequently, we investigated how cue-induced craving is related to the salience network's RSFC and if this relationship is moderated by sex. RESULTS The association between the salience network and cue-induced craving was not statistically significant nor did we find a moderating effect for sex. CONCLUSION The null findings in the study may be explained by a lack of power. Alternatively, alcohol use sex disparities may be more prevalent in the recreational/impulsive stage, whereas participants in our study were in the later stage of addiction.
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Affiliation(s)
- Insan Firdaus
- Department of Clinical, Neuro- and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Annet M Kleiboer
- Department of Clinical, Neuro- and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Anja C Huizink
- Department of Clinical, Neuro- and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Anne Marije Kaag
- Department of Clinical, Neuro- and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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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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8
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Altered white matter functional network in nicotine addiction. Psychiatry Res 2023; 321:115073. [PMID: 36716553 DOI: 10.1016/j.psychres.2023.115073] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 01/17/2023] [Accepted: 01/22/2023] [Indexed: 01/25/2023]
Abstract
Nicotine addiction is a neuropsychiatric disorder with dysfunction in cortices as well as white matter (WM). The nature of the functional alterations in WM remains unclear. The small-world model can well characterize the structure and function of the human brain. In this study, we utilized the small-world model to compare the WM functional connectivity between 62 nicotine addiction participants (called the discovery sample) and 66 matched healthy controls (called the control sample). We also recruited an independent sample comprising 32 nicotine addicts (called the validation sample) for clinical application. The WM functional network data at the network level showed that the nicotine addiction group revealed decreased small-worldness index (σ) and normalized clustering coefficient (γ) compared with healthy controls. For clinical application, the small-world topology of WM functional connectivity could distinguish nicotine addicts from healthy controls (classification accuracy=0.59323, p = 0.0464). We trained abnormal small-world properties on the discovery sample to identify the severity of nicotine addiction, and the identification was successfully applied to the validation sample (classification accuracy=0.65625, p = 0.0106). Our neuroimaging findings provide direct evidence for WM functional changes in nicotine addiction and suggest that the small-world properties of WM function could be qualified as potential biomarkers in nicotine addiction.
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Sodhi A, Cox-Flaherty K, Greer MK, Lat TI, Gao Y, Polineni D, Pisani MA, Bourjeily G, Glassberg MK, D'Ambrosio C. Sex and Gender in Lung Diseases and Sleep Disorders: A State-of-the-Art Review: Part 2. Chest 2023; 163:366-382. [PMID: 36183784 PMCID: PMC10083131 DOI: 10.1016/j.chest.2022.08.2240] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 08/30/2022] [Accepted: 08/31/2022] [Indexed: 01/14/2023] Open
Abstract
There is now ample evidence that differences in sex and gender contribute to the incidence, susceptibility, presentation, diagnosis, and clinical course of many lung diseases. Some conditions are more prevalent in women, such as pulmonary arterial hypertension and sarcoidosis. Some life stages-such as pregnancy-are unique to women and can affect the onset and course of lung disease. Clinical presentation may differ as well, such as the higher number of exacerbations experienced by women with cystic fibrosis (CF), more fatigue in women with sarcoidosis, and more difficulty in achieving smoking cessation. Outcomes such as mortality may be different as well, as indicated by the higher mortality in women with CF. In addition, response to therapy and medication safety may also differ by sex, and yet, pharmacogenomic factors are often not adequately addressed in clinical trials. Various aspects of lung/sleep biology and pathobiology are impacted by female sex and female reproductive transitions. Differential gene expression or organ development can be impacted by these biological differences. Understanding these differences is the first step in moving toward precision medicine for all patients. This article is the second part of a state-of-the-art review of specific effects of sex and gender focused on epidemiology, disease presentation, risk factors, and management of selected lung diseases. We review the more recent literature and focus on guidelines incorporating sex and gender differences in pulmonary hypertension, CF and non-CF bronchiectasis, sarcoidosis, restless legs syndrome and insomnia, and critical illness. We also provide a summary of the effects of pregnancy on lung diseases and discuss the impact of sex and gender on tobacco use and treatment of nicotine use disorder.
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Affiliation(s)
- Amik Sodhi
- Division of Allergy, Pulmonary and Critical Care Medicine, University of Wisconsin, Madison, WI
| | - Katherine Cox-Flaherty
- Division of Pulmonary, Critical Care and Sleep Medicine, Brown University, Providence, RI
| | - Meredith Kendall Greer
- Division of Pulmonary, Critical Care and Sleep Medicine, Emory University School of Medicine, Atlanta, GA
| | - Tasnim I Lat
- Division of Pulmonary, Critical Care and Sleep Medicine, Baylor Scott & White Health, Temple, TX
| | - Yuqing Gao
- Division of Pulmonary, Critical Care and Sleep Medicine, University of Arizona College of Medicine Phoenix, Phoenix, AZ
| | - Deepika Polineni
- Division of Pulmonary, Critical Care and Sleep Medicine, Washington University at St. Louis, St. Louis, MO
| | - Margaret A Pisani
- Division of Pulmonary, Critical Care and Sleep Medicine, Yale University School of Medicine, New Haven, CT
| | - Ghada Bourjeily
- Division of Pulmonary, Critical Care and Sleep Medicine, Brown University, Providence, RI
| | - Marilyn K Glassberg
- Division of Pulmonary, Critical Care and Sleep Medicine, University of Arizona College of Medicine Phoenix, Phoenix, AZ
| | - Carolyn D'Ambrosio
- Division of Pulmonary, Critical Care and Sleep Medicine, Yale University School of Medicine, New Haven, CT.
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Franklin TR, Spilka NH, Keyser H, Maron M, Jagannathan K, Wetherill RR. Impact of the natural hormonal milieu on ventral striatal responses to appetitive cigarette smoking cues: A prospective longitudinal study. DRUG AND ALCOHOL DEPENDENCE REPORTS 2022; 5:100119. [PMID: 36844172 PMCID: PMC9948852 DOI: 10.1016/j.dadr.2022.100119] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 10/25/2022] [Accepted: 11/12/2022] [Indexed: 11/15/2022]
Abstract
Background The female sex hormones estradiol (E) and progesterone (P) galvanize the ventral striatal reward pathway. E elevates ventral striatal dopamine and accelerates drug-cued reinstatement, while P has opposing 'protective' effects on drug-related behavior. We hypothesize that women may exhibit greater ventral striatal responses to smoking cues (SCs) during the late follicular phase of the menstrual cycle (MC) when E is high and unimpeded by P, and reduced responses during the late luteal phase when P is high. Methods To test our hypothesis, 24 naturally cycling cigarette-dependent women completed functional magnetic resonance (fMRI) sessions over the course of 3 MCs at select time points to reflect the early follicular (low E and P; LEP, control condition), late follicular (high E, low P; HE) and mid-luteal (high E, high P; HEP) MC phases. During fMRI sessions (counterbalanced by phase), women were exposed to a SC versus nonSC audio-visual clip. Ovulation was verified for each MC, and hormone levels were acquired prior to sessions. Results Contrasts within conditions showed that ventral striatal brain responses to SCs versus nonSCs were negligible during LEP and greater during HE (p=0.009) and HP (p=0.016). Contrasts across conditions showed that HE and HEP had greater responses than LEP (p=0.005), and HE had greater responses than HEP (p=0.049). Conclusions Results support and extend our retrospective cross-sectional study of the influence of the hormonal milieu on SC reactivity. Results are clinically relevant as they may guide novel, hormonally-informed and immediately translatable treatment strategies that can potentially reduce relapse in naturally cycling women.
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Affiliation(s)
- Teresa R. Franklin
- The Center for Studies of Addiction, Department of Psychiatry, The University of Pennsylvania Perelman School of Medicine, 3535 Market Street Suite 500, Philadelphia, PA 19104, United States
| | - Nathaniel H. Spilka
- The Center for Studies of Addiction, Department of Psychiatry, The University of Pennsylvania Perelman School of Medicine, 3535 Market Street Suite 500, Philadelphia, PA 19104, United States
| | - Heather Keyser
- The Center for Studies of Addiction, Department of Psychiatry, The University of Pennsylvania Perelman School of Medicine, 3535 Market Street Suite 500, Philadelphia, PA 19104, United States
| | - Melanie Maron
- The Center for Studies of Addiction, Department of Psychiatry, The University of Pennsylvania Perelman School of Medicine, 3535 Market Street Suite 500, Philadelphia, PA 19104, United States
| | - Kanchana Jagannathan
- The Center for Studies of Addiction, Department of Psychiatry, The University of Pennsylvania Perelman School of Medicine, 3535 Market Street Suite 500, Philadelphia, PA 19104, United States
| | - Reagan R. Wetherill
- The Center for Studies of Addiction, Department of Psychiatry, The University of Pennsylvania Perelman School of Medicine, 3535 Market Street Suite 500, Philadelphia, PA 19104, United States
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11
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Zeng F, Hong W, Zha R, Li Y, Jin C, Liu Y, Liu H, Liu M, Liu M, Xu F, Hu D, Song H, Wu H, Yu Y, Zhang X. Smoking related attention alteration in chronic obstructive pulmonary disease-smoking comorbidity. BMC Pulm Med 2022; 22:182. [PMID: 35524207 PMCID: PMC9078025 DOI: 10.1186/s12890-022-01964-6] [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] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 04/22/2022] [Indexed: 11/22/2022] Open
Abstract
Background Chronic obstructive pulmonary disease (COPD) is a respiratory disease that causes a wide range of cognitive impairments. Although COPD-Smoking comorbidity is common, the relationship between smoking and cognitive function in COPD-Smoking comorbidity remains unclear. This study aimed to investigate the effect of smoking on cognitive function like attention in COPD-Smoking patients. Methods In this study, we used the Montreal Cognitive Assessment (MoCA) scale and resting-state functional magnetic resonance imaging (fMRI) to explore the effect of smoking on attention in patients with COPD. Results Behavioral analysis revealed that among patients with COPD the smokers had a shorter course of COPD and showed a worse attention performance than the non-smokers. Resting-state fMRI analysis revealed that among patients with COPD smokers showed lower regional homogeneity (ReHo) value of the fusiform gyrus than non-smokers. Importantly, the ReHo of the fusiform gyrus is positively associated with attention and mediates the effect of smoking on attention in COPD. Conclusions In summary, our study provides behavioral and neurobiological evidence supporting the positive effect of smoking on attention in COPD. This may be helpful for understanding and treating COPD and even other diseases comorbid with smoking. Supplementary Information The online version contains supplementary material available at 10.1186/s12890-022-01964-6.
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Affiliation(s)
- Feiyan Zeng
- Department of Radiology, the First Affiliated Hospital of USTC, Department of Psychology, School of Humanities & Social Science, Division of Life Science and Medicine, University of Science & Technology of China, Hefei, 230027, China
| | - Wei Hong
- Department of Radiology, the First Affiliated Hospital of USTC, Department of Psychology, School of Humanities & Social Science, Division of Life Science and Medicine, University of Science & Technology of China, Hefei, 230027, China
| | - Rujing Zha
- Department of Radiology, the First Affiliated Hospital of USTC, Department of Psychology, School of Humanities & Social Science, Division of Life Science and Medicine, University of Science & Technology of China, Hefei, 230027, China.
| | - Ying Li
- Department of Radiology, the First Affiliated Hospital of USTC, Department of Psychology, School of Humanities & Social Science, Division of Life Science and Medicine, University of Science & Technology of China, Hefei, 230027, China
| | - Chen Jin
- Department of Radiology, the First Affiliated Hospital of USTC, Department of Psychology, School of Humanities & Social Science, Division of Life Science and Medicine, University of Science & Technology of China, Hefei, 230027, China
| | - Ying Liu
- Department of Radiology, the First Affiliated Hospital of USTC, Department of Psychology, School of Humanities & Social Science, Division of Life Science and Medicine, University of Science & Technology of China, Hefei, 230027, China
| | - Hao Liu
- School of Earth and Space Science, University of Science & Technology of China, Hefei, 230027, China
| | - Mengqiu Liu
- Department of Radiology, the First Affiliated Hospital of USTC, Department of Psychology, School of Humanities & Social Science, Division of Life Science and Medicine, University of Science & Technology of China, Hefei, 230027, China
| | - Mei Liu
- Department of Radiology, the First Affiliated Hospital of USTC, Department of Psychology, School of Humanities & Social Science, Division of Life Science and Medicine, University of Science & Technology of China, Hefei, 230027, China
| | - Fei Xu
- Department of Radiology, the First Affiliated Hospital of USTC, Department of Psychology, School of Humanities & Social Science, Division of Life Science and Medicine, University of Science & Technology of China, Hefei, 230027, China
| | - Daiju Hu
- Department of Radiology, the First Affiliated Hospital of USTC, Department of Psychology, School of Humanities & Social Science, Division of Life Science and Medicine, University of Science & Technology of China, Hefei, 230027, China
| | - Hongwen Song
- Department of Radiology, the First Affiliated Hospital of USTC, Department of Psychology, School of Humanities & Social Science, Division of Life Science and Medicine, University of Science & Technology of China, Hefei, 230027, China
| | - Haiyan Wu
- Centre for Cognitive and Brain Sciences (CCBS), University of Macau (UM), Macau SAR, China
| | - Yongqiang Yu
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei, 230022, China.
| | - Xiaochu Zhang
- Department of Radiology, the First Affiliated Hospital of USTC, Department of Psychology, School of Humanities & Social Science, Division of Life Science and Medicine, University of Science & Technology of China, Hefei, 230027, China. .,Application Technology Center of Physical Therapy to Brain Disorders, Institute of Advanced Technology, University of Science & Technology of China, Hefei, 230031, China. .,Hefei Medical Research Center on Alcohol Addiction, Affiliated Psychological Hospital of Anhui Medical University, Hefei Fourth People's Hospital, Anhui Mental Health Center, Hefei, 230017, China. .,Biomedical Sciences and Health Laboratory of Anhui Province, University of Science & Technology of China, Hefei, 230027, China.
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12
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Wen Z, Han X, Wang Y, Ding W, Sun Y, Kang Y, Zhou Y, Lei H, Lin F. Sex-Dependent Alterations of Regional Homogeneity in Cigarette Smokers. Front Psychiatry 2022; 13:874893. [PMID: 35546937 PMCID: PMC9082268 DOI: 10.3389/fpsyt.2022.874893] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Accepted: 03/28/2022] [Indexed: 11/13/2022] Open
Abstract
Biological sex may play a large role in cigarette use and cessation outcomes and neuroimaging studies have demonstrated that cigarette smoking is associated with sex-related differences in brain structure and function. However, less is known about sex-specific alterations in spontaneous brain activity in cigarette smokers. In this study, we investigated the sex-related effects of cigarette smoking on local spontaneous brain activity using regional homogeneity (ReHo) based on resting-state fMRI. Fifty-six smokers (24 females) and sixty-three (25 females) healthy non-smoking controls were recruited. Whole-brain voxelwise 2-way analysis of covariance of ReHo was performed to detect brain regions with sex-dependent alterations on the spontaneous brain activity. Compared to non-smokers, smokers exhibited significant ReHo differences in several brain regions, including the right medial orbitofrontal cortex extended to the ventral striatum/amygdala/parahippocampus, left precuneus, and bilateral cerebellum crus. Smoking and sex interaction analysis revealed that male smokers showed significantly lower ReHo in the right ventral striatum, left cerebellum crus1, and left fusiform gyrus compared to male non-smokers, whereas there are no significant differences between female smokers and non-smokers. Furthermore, the ReHo within the left cerebellum crus1 was negatively correlated with craving scores in male smokers but not in female smokers. Such sex-dependent differences in spontaneous brain activity lays a foundation for further understanding the neural pathophysiology of sex-specific effects of nicotine addiction and promoting more effective health management of quitting smoking.
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Affiliation(s)
- Zhi Wen
- Department of Radiology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Xu Han
- Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yao Wang
- Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Weina Ding
- Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yawen Sun
- Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yan Kang
- State Key Laboratory of Magnetic Resonance and Atomic and Molecular Physics, National Center for Magnetic Resonance in Wuhan, Wuhan Institute of Physics and Mathematics, Innovation Academy for Precision Measurement Science and Technology, Chinese Academy of Sciences, Wuhan, China
| | - Yan Zhou
- Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Hao Lei
- State Key Laboratory of Magnetic Resonance and Atomic and Molecular Physics, National Center for Magnetic Resonance in Wuhan, Wuhan Institute of Physics and Mathematics, Innovation Academy for Precision Measurement Science and Technology, Chinese Academy of Sciences, Wuhan, China
- University of Chinese Academy of Sciences, Beijing, China
| | - Fuchun Lin
- State Key Laboratory of Magnetic Resonance and Atomic and Molecular Physics, National Center for Magnetic Resonance in Wuhan, Wuhan Institute of Physics and Mathematics, Innovation Academy for Precision Measurement Science and Technology, Chinese Academy of Sciences, Wuhan, China
- University of Chinese Academy of Sciences, Beijing, China
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13
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Feasibility and acceptability of testing a menstrual-cycle timed smoking cessation intervention for women of reproductive age (Project Phase): Results of a pilot randomized control trial. Addict Behav 2022; 125:107153. [PMID: 34739974 PMCID: PMC8629968 DOI: 10.1016/j.addbeh.2021.107153] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 10/07/2021] [Accepted: 10/11/2021] [Indexed: 02/03/2023]
Abstract
INTRODUCTION Menstrual phase influences cigarette smoking-related outcomes. Telephone-based cessation programs (e.g., quitlines) may incorporate the role of the menstrual cycle in an effort to tailor interventions for women. PURPOSE The goal of this preliminary randomized clinical trial was to examine the feasibility and acceptability of timing quit date to menstrual phase in women in a quitline setting. METHODS We recruited treatment-seeking women with regular menstrual cycles between the ages of 18-40 years. Participants were randomized to the follicular phase (FP; quit date set 6-8 days post onset of menses) or standard of care (SC; no menstrual timing of quit date). All participants received four weeks of nicotine replacement therapy transdermal patch concurrent with six weeks of telephone-based counseling. We explored self-reported and biochemically-verified seven-day point prevalence abstinence at end-of-treatment and three-month follow-up. RESULTS Participants (n = 119; FP: n = 58, SC: n = 61) were, on average, 33.4 years old and smoked 13.6 cigarettes/day. The median number of counseling sessions completed was 6 out of 6 available, and 66% of participants completed the intervention. Over 90% of participants reported they would recommend this study to friends/family. Cessation rates did not significantly vary by randomization. CONCLUSIONS Results of this preliminary trial indicate that timing quit date to FP is an acceptable and feasible approach to address smoking cessation in women of reproductive age. While we observed similar smoking cessation rates between groups, this preliminary study was not fully powered to determine efficacy. Therefore, the feasibility and acceptability results indicate that a fully-powered efficacy trial is warranted.
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14
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Shi Z, Langleben DD, O'Brien CP, Childress AR, Wiers CE. Multivariate pattern analysis links drug use severity to distributed cortical hypoactivity during emotional inhibitory control in opioid use disorder. Neuroimage Clin 2021; 32:102806. [PMID: 34525436 PMCID: PMC8436158 DOI: 10.1016/j.nicl.2021.102806] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 08/17/2021] [Accepted: 08/20/2021] [Indexed: 11/22/2022]
Abstract
Opioid use disorder (OUD) is characterized by emotional and cognitive impairements that are associated with poor treatment outcomes. The present study investigated the neural mechanism underlying emotion evaluation and inhibitory control using an affective go/no-go (AGN) task and its association with drug use severity and craving in patients with OUD. Twenty-six recently detoxified patients with OUD underwent functional magnetic resonance imaging (fMRI) while performing the AGN task that required response to frequently presented appetitive stimuli ("go") and inhibition of response to infrequently presented aversive stimuli ("no-go"). The fMRI session was immediately followed by an injection of extended-release opioid antagonist naltrexone (XR-NTX). Participants' opioid craving was assessed immediately before fMRI and 10 ± 2 days after XR-NTX injection. Multivariate pattern analysis (MVPA) showed that drug use severity was associated with distributed brain hypoactivity in response to aversive no-go stimuli, with particularly large negative contributions from the cognitive control and dorsal attention brain networks. While drug use severity and its associated MVPA brain response pattern were both correlated with opioid craving at baseline, only the brain response pattern predicted craving during XR-NTX treatment. Our findings point to widespread functional hypoactivity in the brain networks underlying emotional inhibitory control in OUD. Such a distributed pattern is consistent with the multifaceted nature of OUD, which affects multiple brain networks. It also highlights the utility of the multivariate approach in uncovering large-scale cortical substrates associated with clinical severity in complex psychiatric disorders and in predicting treatment response.
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Affiliation(s)
- Zhenhao Shi
- Center for Studies of Addiction, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, 3535 Market St Ste 500, Philadelphia, PA 19104, USA.
| | - Daniel D Langleben
- Center for Studies of Addiction, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, 3535 Market St Ste 500, Philadelphia, PA 19104, USA
| | - Charles P O'Brien
- Center for Studies of Addiction, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, 3535 Market St Ste 500, Philadelphia, PA 19104, USA
| | - Anna Rose Childress
- Center for Studies of Addiction, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, 3535 Market St Ste 500, Philadelphia, PA 19104, USA
| | - Corinde E Wiers
- Center for Studies of Addiction, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, 3535 Market St Ste 500, Philadelphia, PA 19104, USA
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15
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Shi Z, Jagannathan K, Padley JH, Wang A, Fairchild VP, O'Brien CP, Childress AR, Langleben DD. The role of withdrawal in mesocorticolimbic drug cue reactivity in opioid use disorder. Addict Biol 2021; 26:e12977. [PMID: 33098179 DOI: 10.1111/adb.12977] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 09/21/2020] [Accepted: 09/26/2020] [Indexed: 01/08/2023]
Abstract
Opioid use disorder (OUD) is characterized by heightened cognitive, physiological, and neural responses to opioid-related cues that are mediated by mesocorticolimbic brain pathways. Craving and withdrawal are key symptoms of addiction that persist during physiological abstinence. The present study evaluated the relationship between the brain response to drug cues in OUD and baseline levels of craving and withdrawal. We used functional magnetic resonance imaging (fMRI) to examine brain responses to opioid-related pictures and control pictures in 29 OUD patients. Baseline measures of drug use severity, opioid craving, and withdrawal symptoms were assessed prior to cue exposure and correlated with subsequent brain responses to drug cues. Mediation analysis was conducted to test the indirect effect of drug use severity on brain cue reactivity through craving and withdrawal symptoms. We found that baseline drug use severity and opioid withdrawal symptoms, but not craving, were positively associated with the neural response to drug cues in the nucleus accumbens, orbitofrontal cortex, and amygdala. Withdrawal, but not craving, mediated the effect of drug use severity on the nucleus accumbens' response to drug cues. We did not find similar effects for the neural responses to stimuli unrelated to drugs. Our findings emphasize the central role of withdrawal symptoms as the mediator between the clinical severity of OUD and the brain correlates of sensitization to opioid-related cues. They suggest that in OUD, baseline withdrawal symptoms signal a high vulnerability to drug cues.
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Affiliation(s)
- Zhenhao Shi
- Center for Studies of Addiction, Department of Psychiatry University of Pennsylvania Perelman School of Medicine Philadelphia Pennsylvania USA
| | - Kanchana Jagannathan
- Center for Studies of Addiction, Department of Psychiatry University of Pennsylvania Perelman School of Medicine Philadelphia Pennsylvania USA
| | - James H. Padley
- Center for Studies of Addiction, Department of Psychiatry University of Pennsylvania Perelman School of Medicine Philadelphia Pennsylvania USA
| | - An‐Li Wang
- Department of Psychiatry Icahn School of Medicine at Mount Sinai New York New York USA
| | - Victoria P. Fairchild
- Department of Psychology, Queens College The City University of New York New York New York USA
| | - Charles P. O'Brien
- Center for Studies of Addiction, Department of Psychiatry University of Pennsylvania Perelman School of Medicine Philadelphia Pennsylvania USA
| | - Anna Rose Childress
- Center for Studies of Addiction, Department of Psychiatry University of Pennsylvania Perelman School of Medicine Philadelphia Pennsylvania USA
| | - Daniel D. Langleben
- Center for Studies of Addiction, Department of Psychiatry University of Pennsylvania Perelman School of Medicine Philadelphia Pennsylvania USA
- Annenberg Public Policy Center University of Pennsylvania Philadelphia Pennsylvania USA
- Behavioral Health Service Corporal Michael J. Crescenz Veterans Administration Medical Center Philadelphia Pennsylvania USA
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16
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Franklin TR, Jagannathan K, Spilka NH, Keyser H, Rao H, Ely AV, Janes AC, Wetherill RR. Smoking-induced craving relief relates to increased DLPFC-striatal coupling in nicotine-dependent women. Drug Alcohol Depend 2021; 221:108593. [PMID: 33611027 PMCID: PMC8026729 DOI: 10.1016/j.drugalcdep.2021.108593] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 01/18/2021] [Accepted: 01/19/2021] [Indexed: 01/23/2023]
Abstract
BACKGROUND Craving is a major contributor to drug-seeking and relapse. Although the ventral striatum (VS) is a primary neural correlate of craving, strategies aimed at manipulating VS function have not resulted in efficacious treatments. This incongruity may be because the VS does not influence craving in isolation. Instead, craving is likely mediated by communication between the VS and other neural substrates. Thus, we examined how striatal functional connectivity (FC) with key nodes of networks involved in addiction affects relief of craving, which is an important step in identifying viable treatment targets. METHODS Twenty-four nicotine-dependent non-abstinent women completed two resting-state (rs) fMRI scans, one before and one following smoking a cigarette in the scanner, and provided craving ratings before and after smoking the cigarette. A seed-based approach was used to examine rsFC between the VS, putamen and germane craving-related brain regions; the dorsolateral prefrontal cortex (dlPFC), the posterior cingulate cortex, and the anterior ventral insula. RESULTS Smoking a cigarette was associated with a decrease in craving. Relief of craving correlated with increases in right dlPFC- bilateral VS (r = 0.57, p = 0.003, corrected) as did increased right dlPFC-left putamen coupling (r = 0.62, p = 0.001, corrected). CONCLUSIONS Smoking-induced relief of craving is associated with enhanced rsFC between the dlPFC, a region that plays a pivotal role in decision making, and the striatum, the neural structure underlying motivated behavior. These findings are highly consistent with a burgeoning literature implicating dlPFC-striatal interactions as a neurobiological substrate of craving.
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Affiliation(s)
- Teresa R Franklin
- Center for Studies of Addiction, Department of Psychiatry, The University of Pennsylvania Perelman School of Medicine, 3535 Market Street Suite 500, Philadelphia, PA, 19104, USA.
| | - Kanchana Jagannathan
- Center for Studies of Addiction, Department of Psychiatry, The University of Pennsylvania Perelman School of Medicine, 3535 Market Street Suite 500, Philadelphia, PA, 19104, USA
| | - Nathaniel H Spilka
- Center for Studies of Addiction, Department of Psychiatry, The University of Pennsylvania Perelman School of Medicine, 3535 Market Street Suite 500, Philadelphia, PA, 19104, USA
| | - Heather Keyser
- Center for Studies of Addiction, Department of Psychiatry, The University of Pennsylvania Perelman School of Medicine, 3535 Market Street Suite 500, Philadelphia, PA, 19104, USA
| | - Hengy Rao
- Center for Functional Neuroimaging, Department of Neurology, The University of Pennsylvania Perelman School of Medicine, 3700 Hamilton Walk, Philadelphia, PA, USA
| | - Alice V Ely
- Center for Studies of Addiction, Department of Psychiatry, The University of Pennsylvania Perelman School of Medicine, 3535 Market Street Suite 500, Philadelphia, PA, 19104, USA
| | - Amy C Janes
- Functional Integration of Addiction Research Lab, Department of Psychiatry, Harvard Medical School/McLean Hospital, 115 Mill St. Belmont, MA, 02478, USA
| | - Reagan R Wetherill
- Center for Studies of Addiction, Department of Psychiatry, The University of Pennsylvania Perelman School of Medicine, 3535 Market Street Suite 500, Philadelphia, PA, 19104, USA
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Wetherill RR, Spilka NH, Maron M, Keyser H, Jagannathan K, Ely AV, Franklin TR. Influence of the natural hormonal milieu on brain and behavior in women who smoke cigarettes: Rationale and methodology. Contemp Clin Trials Commun 2021; 21:100738. [PMID: 33718654 PMCID: PMC7932892 DOI: 10.1016/j.conctc.2021.100738] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 01/19/2021] [Accepted: 02/05/2021] [Indexed: 12/19/2022] Open
Abstract
Women experience more severe health consequences from smoking, have greater difficulty quitting, and respond less favorably to nicotine replacement therapy than men. The influence of fluctuating ovarian hormones, specifically estradiol (E) and progesterone (P), on brain and behavioral responses during exposure to smoking reminders (i.e., cues) may be a contributing factor. Results from our laboratory suggest that women in the late follicular phase of their menstrual cycle (MC) have enhanced smoking cue (SC) vulnerabilities and reduced functional connectivity in neurocircuitry underlying cognitive control, potentially placing them at greater risk for continued smoking and relapse. The primary aim of this study is to examine and link hormonal status with brain and behavioral responses to SCs over the course of three monthly MCs in naturally cycling women who are chronic cigarette smokers. This longitudinal, counterbalanced study collects brain and behavioral responses to SCs at three time points during a woman's MC. Participants complete psychological and physical examinations, biochemical hormonal verification visits, and at least three laboratory/neuroimaging scan visits. The scan visits include a 10-min SC task during blood oxygen level-dependent (BOLD) data acquisition and are timed to occur during the early follicular phase (low E and P), late follicular phase (high E, unopposed by P), and mid-luteal phase (high P, high E). The primary outcomes include brain responses to SCs (compared to non-SCs), subjective craving, E and P hormone levels, and behavioral responses to SCs. This study addresses a critical gap in our knowledge: namely, the impact of the natural hormonal milieu on brain and behavioral responses to SCs, a powerful relapse trigger. Additionally, this study will provide a roadmap for human sex differences researchers who are obliged to consider the often confounding cyclic hormonal fluctuations of women.
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Affiliation(s)
| | | | - Melanie Maron
- Perelman School of Medicine, The University of Pennsylvania, The Department of Psychiatry, 3535 Market Street Suite 500, Philadelphia, PA, 19104, USA
| | - Heather Keyser
- Perelman School of Medicine, The University of Pennsylvania, The Department of Psychiatry, 3535 Market Street Suite 500, Philadelphia, PA, 19104, USA
| | - Kanchana Jagannathan
- Perelman School of Medicine, The University of Pennsylvania, The Department of Psychiatry, 3535 Market Street Suite 500, Philadelphia, PA, 19104, USA
| | - Alice V. Ely
- Perelman School of Medicine, The University of Pennsylvania, The Department of Psychiatry, 3535 Market Street Suite 500, Philadelphia, PA, 19104, USA
| | - Teresa R. Franklin
- Perelman School of Medicine, The University of Pennsylvania, The Department of Psychiatry, 3535 Market Street Suite 500, Philadelphia, PA, 19104, USA
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18
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Ambrase A, Lewis CA, Barth C, Derntl B. Influence of ovarian hormones on value-based decision-making systems: Contribution to sexual dimorphisms in mental disorders. Front Neuroendocrinol 2021; 60:100873. [PMID: 32987043 DOI: 10.1016/j.yfrne.2020.100873] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Revised: 07/28/2020] [Accepted: 09/15/2020] [Indexed: 12/22/2022]
Abstract
Women and men exhibit differences in behavior when making value-based decisions. Various hypotheses have been proposed to explain these findings, stressing differences in functional lateralization of the brain, functional activation, neurotransmitter involvement and more recently, sex hormones. While a significant interaction of neurotransmitter systems and sex hormones has been shown for both sexes, decision-making in women might be particularly affected by variations of ovarian hormones. In this review we have gathered information from animal and human studies on how ovarian hormones affect decision-making processes in females by interacting with neurotransmitter systems at functionally relevant brain locations and thus modify the computation of decision aspects. We also review previous findings on impaired decision-making in animals and clinical populations with substance use disorder and depression, emphasizing how little we know about the role of ovarian hormones in aberrant decision-making.
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Affiliation(s)
- Aiste Ambrase
- Department of Psychiatry and Psychotherapy, University of Tuebingen, Tübingen, Germany; International Max Planck Research School for Cognitive and Systems Neuroscience, University of Tübingen, Tuebingen, Germany
| | - Carolin A Lewis
- Department of Psychiatry and Psychotherapy, University of Tuebingen, Tübingen, Germany; Emotion Neuroimaging Lab, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany; International Max Planck Research School on Neuroscience of Communication: Function, Structure, and Plasticity, Leipzig, Germany
| | - Claudia Barth
- Norwegian Centre for Mental Disorders Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Birgit Derntl
- Department of Psychiatry and Psychotherapy, University of Tuebingen, Tübingen, Germany; International Max Planck Research School for Cognitive and Systems Neuroscience, University of Tübingen, Tuebingen, Germany; TübingenNeuroCampus, University of Tübingen, Tübingen, Germany; LEAD Research School and Graduate Network, University of Tübingen, Tübingen, Germany.
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Pandria N, Athanasiou A, Konstantara L, Karagianni M, Bamidis PD. Advances in biofeedback and neurofeedback studies on smoking. Neuroimage Clin 2020; 28:102397. [PMID: 32947225 PMCID: PMC7502375 DOI: 10.1016/j.nicl.2020.102397] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 08/02/2020] [Accepted: 08/19/2020] [Indexed: 11/19/2022]
Abstract
Smoking is a leading cause of morbidity and premature death constituting a global health challenge. Although, pharmacological and behavioral approaches comprise the mainstay of smoking cessation interventions, the efficacy and safety of pharmacotherapy is not demonstrated for some populations. Non-pharmacological approaches, such as biofeedback (BF) and neurofeedback (NF) could facilitate self-regulation of predisposing factors of relapse such as craving and stress. The current review aims to aggregate the existing evidence regarding the effects of BF and NF training on smokers. Relevant studies were identified through searching in Scopus, PubMed and Cochrane Library, and through hand-searching the references of screened articles. Peer-reviewed controlled and uncontrolled studies, where BF and/or NF training was administered, were included and evaluated according to PICOS framework. Narrative qualitative synthesis of ten eligible studies was performed, aggregated into three categories according to training provided. BF outcomes seem to be affected by smoking behavior prior to training; individualized EEG NF training holds promise for modulating craving-related response while minimizing the required number of sessions. Real-time fMRI NF studies concluded that nicotine-dependent individuals could modulate craving-related brain responses, while mixed results were revealed regarding smokers' ability to modulate brain responses related to resistance towards the urge to smoke. BF and NF training seem to facilitate modulation of autonomous and/or central nervous system activity while also transferring this learned self-regulation to behavioral outcomes. BF and NF training should a) address remaining issues on specificity and scientific validity, b) target diverse demographics, and c) produce robust reproducible methodologies and clinical guidelines for relevant health care providers, in order to be considered as viable complementary tools to standard smoking cessation care.
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Affiliation(s)
- N Pandria
- Lab of Medical Physics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki (AUTH), Thessaloniki, Greece; Northern Greece Neurofeedback Center, Thessaloniki, Greece.
| | - A Athanasiou
- Lab of Medical Physics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki (AUTH), Thessaloniki, Greece.
| | - L Konstantara
- Lab of Medical Physics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki (AUTH), Thessaloniki, Greece.
| | - M Karagianni
- Lab of Medical Physics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki (AUTH), Thessaloniki, Greece.
| | - P D Bamidis
- Lab of Medical Physics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki (AUTH), Thessaloniki, Greece.
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Lieberz J, Scheele D, Spengler FB, Matheisen T, Schneider L, Stoffel-Wagner B, Kinfe TM, Hurlemann R. Kinetics of oxytocin effects on amygdala and striatal reactivity vary between women and men. Neuropsychopharmacology 2020; 45:1134-1140. [PMID: 31785587 PMCID: PMC7235226 DOI: 10.1038/s41386-019-0582-6] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 11/20/2019] [Accepted: 11/25/2019] [Indexed: 02/06/2023]
Abstract
Accumulating evidence suggests that intranasal oxytocin (OXT; 24 IU) reduces amygdala responses to fear-related stimuli in men, while exerting inverse effects in women. However, OXT enhances activity of the brain reward system in both sexes. Importantly, a crucial and still open question is whether there are sex-specific dose-response relationships for the amygdala and striatal regions. To address this question, a total of 90 healthy women participated in a double-blind, placebo-controlled crossover functional magnetic resonance imaging (fMRI) study and the results were compared with our previous findings from men. Participants were randomly assigned to three doses of OXT (6 IU, 12 IU, and 24 IU) and completed an emotional face recognition task including fearful and happy faces of varying emotional intensities. Across doses, OXT enhanced amygdala reactivity to low fearful faces compared to placebo and increased responses to happy faces in the dorsal striatum in women. While treatment effects on amygdala reactivity were evident at each given dose, the OXT effect on striatal responses to social stimuli was more pronounced with higher doses, but this dose-dependent effect did not survive correction for multiple comparisons. Importantly, OXT effects on amygdala and striatal activation significantly differed between sexes and striatal baseline sexual-dimorphic response patterns were diminished after administration of OXT. Our findings suggest that OXT increases the salience of social signals by strengthening the sensitivity for these signals in the amygdala and in the striatum in women, while OXT may primarily induce anxiolysis by reducing amygdala responses in men.
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Affiliation(s)
- Jana Lieberz
- 0000 0001 2240 3300grid.10388.32Division of Medical Psychology, University of Bonn, 53105 Bonn, Germany
| | - Dirk Scheele
- Division of Medical Psychology, University of Bonn, 53105, Bonn, Germany.
| | - Franny B. Spengler
- grid.5963.9Institute for Psychology, University of Freiburg, 79104 Freiburg, Germany
| | - Tatjana Matheisen
- 0000 0001 2240 3300grid.10388.32Division of Medical Psychology, University of Bonn, 53105 Bonn, Germany
| | - Lìa Schneider
- 0000 0001 2240 3300grid.10388.32Division of Medical Psychology, University of Bonn, 53105 Bonn, Germany
| | - Birgit Stoffel-Wagner
- 0000 0001 2240 3300grid.10388.32Institute of Clinical Chemistry and Clinical Pharmacology, University of Bonn, 53105 Bonn, Germany
| | - Thomas M. Kinfe
- 0000 0001 2107 3311grid.5330.5Department of Neurosurgery, Division of Functional Neurosurgery and Stereotaxy, Friedrich-Alexander University (FAU) Erlangen-Nürnberg, 91054 Erlangen, Germany
| | - René Hurlemann
- 0000 0001 2240 3300grid.10388.32Division of Medical Psychology, University of Bonn, 53105 Bonn, Germany ,0000 0001 2240 3300grid.10388.32Department of Psychiatry, University of Bonn, 53105 Bonn, Germany ,0000 0001 1009 3608grid.5560.6Department of Psychiatry, University of Oldenburg Medical Campus, 26160 Bad Zwischenahn, Germany
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Ketcherside A, Jagannathan K, Dolui S, Hager N, Spilka N, Nutor C, Rao H, Franklin T, Wetherill R. Baclofen-induced Changes in the Resting Brain Modulate Smoking Cue Reactivity: A Double-blind Placebo-controlled Functional Magnetic Resonance Imaging Study in Cigarette Smokers. CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE 2020; 18:289-302. [PMID: 32329309 PMCID: PMC7242101 DOI: 10.9758/cpn.2020.18.2.289] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Revised: 11/01/2019] [Accepted: 01/04/2020] [Indexed: 01/04/2023]
Abstract
Objective Smoking cue-(SC) elicited craving can lead to relapse in SC-vulnerable individuals. Thus, identifying treatments that target SC-elicited craving is a top research priority. Reduced drug cue neural activity is associated with recovery and is marked by a profile of greater tonic (resting) activation in executive control regions, and increased connectivity between executive and salience regions. Evidence suggests the GABA-B agonist baclofen can reduce drug cue-elicited neural activity, potentially through its actions on the resting brain. Based on the literature, we hypothesize that baclofen’s effects in the resting brain can predict its effects during SC exposure. Methods In this longitudinal, double blind, placebo-controlled neuropharmacological study 43 non-abstinent, sated treatment-seeking cigarette smokers (63% male) participated in an fMRI resting-state scan and a SC-reactivity task prior to (T1) and 3 weeks following randomization (T2; baclofen: 80 mg/day; n = 21). Subjective craving reports were acquired before and after SC exposure to explicitly examine SC-induced craving. Results Whole-brain full-factorial analysis revealed a group-by-time interaction with greater resting brain activation of the right dorsolateral prefrontal cortex (dlPFC) at T2 in the baclofen group (BAC) (pFWEcorr = 0.02), which was associated with reduced neural responses to SCs in key cue-reactive brain regions; the anterior ventral insula and ventromedial prefrontal cortex (pFWEcorr < 0.01). BAC, but not the placebo group reported decreased SC-elicited craving (p = 0.02). Conclusion Results suggest that baclofen mitigates the reward response to SCs through an increase in tonic activation of the dlPFC, an executive control region. Through these mechanisms, baclofen may offer SC-vulnerable smokers protection from SC-induced relapse.
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Affiliation(s)
- Ariel Ketcherside
- The Center for Studies of Addiction, The University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Kanchana Jagannathan
- The Center for Studies of Addiction, The University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Sudipto Dolui
- The Center for Studies of Addiction, The University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Nathan Hager
- The Center for Studies of Addiction, The University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.,Department of Psychology, Old Dominion University, Norfolk, VA, USA
| | - Nathaniel Spilka
- The Center for Studies of Addiction, The University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Chaela Nutor
- The Center for Studies of Addiction, The University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Hengyi Rao
- The Center for Studies of Addiction, The University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Teresa Franklin
- The Center for Studies of Addiction, The University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Reagan Wetherill
- The Center for Studies of Addiction, The University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
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Zhao H, Turel O, Brevers D, Bechara A, He Q. Smoking cues impair monitoring but not stopping during response inhibition in abstinent male smokers. Behav Brain Res 2020; 386:112605. [DOI: 10.1016/j.bbr.2020.112605] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Revised: 02/16/2020] [Accepted: 02/19/2020] [Indexed: 11/27/2022]
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Molokotos E, Peechatka AL, Wang KS, Pizzagalli DA, Janes AC. Caudate reactivity to smoking cues is associated with increased responding to monetary reward in nicotine-dependent individuals. Drug Alcohol Depend 2020; 209:107951. [PMID: 32145666 PMCID: PMC7127934 DOI: 10.1016/j.drugalcdep.2020.107951] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2019] [Revised: 02/25/2020] [Accepted: 02/26/2020] [Indexed: 01/20/2023]
Abstract
Quitting smoking is challenging in part because environmental smoking cues can trigger the desire to smoke. Neurobiological responses to smoking cues are often observed in reward-related brain regions such as the caudate and nucleus accumbens (NAc). While reward plays a well-established role in the formation of cue reactivity, whether general reward responsiveness contributes to individual differences in cue-reactivity among chronic smokers is unclear; establishing such link could provide insight into the mechanisms maintaining cue reactivity. The current study explored this relationship by assessing smoking cue reactivity during functional magnetic imaging followed by an out-of-scanner probabilistic reward task (PRT) in 24 nicotine-dependent smokers (14 women). In addition, owing to sex differences in cue reactivity and reward function, this same relationship was examined as a function of sex. Following recent smoking, greater reward responsiveness on the PRT was associated with enhanced left caudate reactivity to smoking cues. No relationship was found in any other striatal subregion. The positive relationship between reward responsiveness and caudate smoking cue reactivity was significant only in male smokers, fitting with the idea that males and females respond to the reinforcing elements of smoking cues differently. These findings are clinically relevant as they show that, following recent smoking, nicotine-dependent individuals who are more cue reactive are also more likely to be responsive to non-drug rewards, which may be useful for making individualized treatment decisions that involve behavioral reward contingencies.
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Affiliation(s)
- Elena Molokotos
- McLean Hospital, Belmont, MA, USA; Department of Psychology, Suffolk University, Boston, MA, USA.
| | | | - Kainan S. Wang
- McLean Hospital, Belmont, MA, USA,Harvard Medical School, Boston, MA, USA
| | | | - Amy C. Janes
- McLean Hospital, Belmont, MA, USA,Harvard Medical School, Boston, MA, USA
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24
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Sex-related differences in subjective, but not neural, cue-elicited craving response in heavy cannabis users. Drug Alcohol Depend 2020; 209:107931. [PMID: 32113057 PMCID: PMC8173440 DOI: 10.1016/j.drugalcdep.2020.107931] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2019] [Revised: 01/27/2020] [Accepted: 02/14/2020] [Indexed: 12/21/2022]
Abstract
BACKGROUND Studies indicate that female cannabis users progress through the milestones of cannabis use disorder (CUD) more quickly than male users, likely due to greater subjective craving response in women relative to men. While studies have reported sex-related differences in subjective craving, differences in neural response and the relative contributions of neural and behavioral response remain unclear. METHODS We examined sex-related differences in neural and behavioral response to cannabis cues and cannabis use measures in 112 heavy cannabis users (54 females). We used principal component analysis to determine the relative contributions of neural and behavioral response and cannabis use measures. RESULTS We found that principal component (PC) 1, which accounts for the most variance in the dataset, was correlated with neural response to cannabis cues with no differences between male and female users (p = 0.21). PC2, which accounts for the second-most variance, was correlated with subjective craving such that female users exhibited greater subjective craving relative to male users (p = 0.003). We also found that CUD symptoms correlated with both PC1 and PC2, corroborating the relationship between craving and CUD severity. CONCLUSIONS These results indicate that neural activity primarily underlies response to cannabis cues and that a complex relationship characterizes a convergent neural response and a divergent subjective craving response that differs between the sexes. Accounting for these differences will increase efficacy of treatments through personalized approaches.
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25
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Bu J, Young KD, Hong W, Ma R, Song H, Wang Y, Zhang W, Hampson M, Hendler T, Zhang X. Effect of deactivation of activity patterns related to smoking cue reactivity on nicotine addiction. Brain 2020; 142:1827-1841. [PMID: 31135053 DOI: 10.1093/brain/awz114] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Revised: 01/24/2019] [Accepted: 02/24/2019] [Indexed: 02/04/2023] Open
Abstract
With approximately 75% of smokers resuming cigarette smoking after using the Gold Standard Programme for smoking cessation, investigation into novel therapeutic approaches is warranted. Typically, smoking cue reactivity is crucial for smoking behaviour. Here we developed a novel closed-loop, smoking cue reactivity patterns EEG-based neurofeedback protocol and evaluated its therapeutic efficacy on nicotine addiction. During an evoked smoking cue reactivity task participants' brain activity patterns corresponding to smoking cues were obtained with multivariate pattern analysis of all EEG channels data, then during neurofeedback the EEG activity patterns of smoking cue reactivity were continuously deactivated with adaptive closed-loop training. In a double-blind, placebo-controlled, randomized clinical trial, 60 nicotine-dependent participants were assigned to receive two neurofeedback training sessions (∼1 h/session) either from their own brain (n = 30, real-feedback group) or from the brain activity pattern of a matched participant (n = 30, yoked-feedback group). Cigarette craving and craving-related P300 were assessed at pre-neurofeedback and post-neurofeedback. The number of cigarettes smoked per day was assessed at baseline, 1 week, 1 month, and 4 months following the final neurofeedback visit. In the real-feedback group, participants successfully deactivated EEG activity patterns of smoking cue reactivity. The real-feedback group showed significant decrease in cigarette craving and craving-related P300 amplitudes compared with the yoked-feedback group. The rates of cigarettes smoked per day at 1 week, 1 month and 4 months follow-up decreased 30.6%, 38.2%, and 27.4% relative to baseline in the real-feedback group, compared to decreases of 14.0%, 13.7%, and 5.9% in the yoked-feedback group. The neurofeedback effects on craving change and smoking amount at the 4-month follow-up were further predicted by neural markers at pre-neurofeedback. This novel neurofeedback training approach produced significant short-term and long-term effects on cigarette craving and smoking behaviour, suggesting the neurofeedback protocol described herein is a promising brain-based tool for treating addiction.
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Affiliation(s)
- Junjie Bu
- Hefei National Laboratory for Physical Sciences at the Microscale and School of Life Sciences, University of Science and Technology of China, Hefei, China
| | - Kymberly D Young
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, USA
| | - Wei Hong
- Hefei National Laboratory for Physical Sciences at the Microscale and School of Life Sciences, University of Science and Technology of China, Hefei, China
| | - Ru Ma
- Hefei National Laboratory for Physical Sciences at the Microscale and School of Life Sciences, University of Science and Technology of China, Hefei, China
| | - Hongwen Song
- School of Humanities and Social Science, University of Science and Technology of China, Hefei, China
| | - Ying Wang
- Hefei National Laboratory for Physical Sciences at the Microscale and School of Life Sciences, University of Science and Technology of China, Hefei, China
| | - Wei Zhang
- Hefei National Laboratory for Physical Sciences at the Microscale and School of Life Sciences, University of Science and Technology of China, Hefei, China
| | - Michelle Hampson
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT, USA
| | - Talma Hendler
- Functional Brain Center, Tel-Aviv University, Tel-Aviv, Israel
| | - Xiaochu Zhang
- Hefei National Laboratory for Physical Sciences at the Microscale and School of Life Sciences, University of Science and Technology of China, Hefei, China.,School of Humanities and Social Science, University of Science and Technology of China, Hefei, China.,Hefei Medical Research Center on Alcohol Addiction, Anhui Mental Health Center, Hefei, China.,Academy of Psychology and Behaviour, Tianjin Normal University, Tianjin, China
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Tosun NL, Fieberg AM, Eberly LE, Harrison KA, Tipp AR, Allen AM, Allen SS. Exogenous progesterone for smoking cessation in men and women: a pilot double-blind, placebo-controlled randomized clinical trial. Addiction 2019; 114:1800-1813. [PMID: 31059177 PMCID: PMC6732045 DOI: 10.1111/add.14645] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Revised: 01/31/2019] [Accepted: 04/22/2019] [Indexed: 12/22/2022]
Abstract
BACKGROUND AND AIMS In some clinical studies men and women have been found to differ in their ability to quit smoking, perhaps as a result of progesterone. The primary aim of this study was to provide a preliminary test of whether progesterone (PRO), compared with placebo (PBO), was more effective for smoking cessation in men and women. DESIGN Pilot double-blind, placebo-controlled randomized clinical trial. SETTING Minneapolis/St Paul metro area, Minnesota, USA. PARTICIPANTS A total of 216 participants were randomized, including 113 men (18-60 years; PRO = 56, PBO = 57) and 103 women (18-50 years, pre-menopausal with self-reported regular menstrual cycles; PRO = 51, PBO = 52). INTERVENTION Participants were randomized (1 : 1 within sex group) to either PRO (200 mg twice daily) or PBO. Participants were assigned a quit date approximately 7 days after starting medication (luteal phase for women) and were followed for 12 weeks to assess relapse. MEASUREMENTS The primary outcome was self-reported 7-day point prevalence abstinence (PPA) at week 4. Secondary outcomes included 7-day PPA at weeks 8 and 12, prolonged abstinence, continuous abstinence, urine cotinine < 50 ng/ml, expired carbon monoxide ≤ 5 parts per million (p.p.m.) and days to relapse. FINDINGS There was a significant difference in 7-day PPA at week 4 among women [PRO: 18 (35.3%) versus PBO: 9 (17.3%), odds ratio (OR) = 2.61, 95% confidence interval (CI) = 1.04, 6.54, P = 0.041], but not among men [PRO: 13 (23.2%) versus PBO: 12 (21.1%), 1.13 (0.47, 2.76), P = 0.782]. There was some evidence that PRO delayed relapse in women (days to relapse; PRO: 20.5 ± 29.6 versus PBO: 14.3 ± 26.8, P = 0.03) but not in men (PRO: 13.4 ± 25.9 versus PBO: 13.3 ± 23.8, P = 0.69). CONCLUSIONS Oral micronized progesterone may aid smoking cessation in women.
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Affiliation(s)
- Nicole L Tosun
- Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, MN, USA
| | - Ann M Fieberg
- Coordinating Center for Biometric Research, University of Minnesota, Minneapolis, MN, USA
| | - Lynn E Eberly
- Division of Biostatistics, University of Minnesota, Minneapolis, MN, USA
| | - Katherine A Harrison
- Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, MN, USA
| | - Angela R Tipp
- Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, MN, USA
| | - Alicia M Allen
- Department of Family & Community Medicine, University of Arizona, Tucson, AZ, USA
| | - Sharon S Allen
- Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, MN, USA
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Franklin TR, Jagannathan K, Ketcherside A, Spilka N, Wetherill RR. Menstrual cycle phase modulates responses to smoking cues in the putamen: Preliminary evidence for a novel target. Drug Alcohol Depend 2019; 198:100-104. [PMID: 30901743 PMCID: PMC6467805 DOI: 10.1016/j.drugalcdep.2019.01.039] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Revised: 01/24/2019] [Accepted: 01/27/2019] [Indexed: 01/16/2023]
Abstract
BACKGROUND The preclinical literature identifies the ventral striatum (VS) as a key player in drug-conditioned responses, guiding hypotheses examining neural substrates involved in human drug cue reactivity, including the study of sex differences. Men show a replicable response that includes the VS, while women's responses have been weaker and variable. New evidence suggests that the hormonal milieu modulates women's responses to drug cues in the dorsal striatum (DS), specifically, in the putamen. Here we tested the hypothesis that the hormonal milieu affects neural responses to smoking cues (SCs) in the putamen in women cigarette smokers. METHODS We re-examined our three previous neuroimaging studies of the influence of sex and menstrual cycle (MC) phase effects on SC neuroactivity, incorporating the DS as a region of interest. RESULTS As previously shown, men exhibited increased ventral medial prefrontal cortex (vmPFC) and VS/V pallidum responses, and women showed increased vmPFC responses that were greater in women during the follicular phase (high estradiol), compared to the luteal phase (high progesterone). Reducing the statistical threshold within luteal phase women revealed select deactivation of the putamen. CONCLUSIONS These preliminary findings shed light upon factors that may modulate drug cue reactivity in women, specifically the influence of hormones on DS responses. Emerging literature suggests that manipulating the hormonal milieu may open a fundamental window into sex-specific treatment targets. More rigorous study of the brain substrates involved in drug cue reactivity and other reward-related behavior that may be influenced by sex and the hormonal milieu is imperative.
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Zhou X, Zimmermann K, Xin F, Zhao W, Derckx RT, Sassmannshausen A, Scheele D, Hurlemann R, Weber B, Kendrick KM, Becker B. Cue Reactivity in the Ventral Striatum Characterizes Heavy Cannabis Use, Whereas Reactivity in the Dorsal Striatum Mediates Dependent Use. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2019; 4:751-762. [PMID: 31204249 DOI: 10.1016/j.bpsc.2019.04.006] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Revised: 03/22/2019] [Accepted: 04/08/2019] [Indexed: 02/06/2023]
Abstract
BACKGROUND Animal models of addiction suggest that the transition from incentive-driven drug use to habitual and ultimately compulsive drug use is mediated by a shift from ventral to dorsal striatal cue control over drug seeking. Previous studies in human cannabis users reported elevated trait impulsivity and neural cue reactivity in striatal circuits; however, these studies were not able to separate addiction-related from exposure-related adaptations. METHODS To differentiate the adaptive changes, the current functional magnetic resonance imaging study examined behavioral and neural cue reactivity in dependent (n = 18) and nondependent (n = 20) heavy cannabis users and a nonusing reference group (n = 44). RESULTS Irrespective of dependence status, cannabis users demonstrated elevated trait impulsivity as well as increased ventral striatal reactivity and striatal frontal coupling in response to drug cues. Dependent users selectively exhibited dorsal striatal reactivity and decreased striatal limbic coupling during cue exposure. An exploratory analysis revealed that higher ventral caudate neural cue reactivity was associated with stronger cue-induced arousal and craving in dependent users, whereas this pattern was reversed in nondependent users. CONCLUSIONS Taken together, the current findings suggest that exaggerated responses of the ventral striatal reward system may promote excessive drug use in humans, whereas adaptations in dorsal striatal systems engaged in habit formation may promote the transition to addictive use.
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Affiliation(s)
- Xinqi Zhou
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China
| | - Kaeli Zimmermann
- Division of Medical Psychology, Department of Psychiatry, University of Bonn, Bonn, Germany
| | - Fei Xin
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China
| | - Weihua Zhao
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China
| | - Roelinka T Derckx
- Division of Medical Psychology, Department of Psychiatry, University of Bonn, Bonn, Germany
| | - Anja Sassmannshausen
- Division of Medical Psychology, Department of Psychiatry, University of Bonn, Bonn, Germany
| | - Dirk Scheele
- Division of Medical Psychology, Department of Psychiatry, University of Bonn, Bonn, Germany
| | - Rene Hurlemann
- Division of Medical Psychology, Department of Psychiatry, University of Bonn, Bonn, Germany
| | - Bernd Weber
- Center for Economics and Neuroscience, Department of Epileptology, University of Bonn, Bonn, Germany; Department of Neurocognition, Life & Brain Center, Bonn, Germany
| | - Keith M Kendrick
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China
| | - Benjamin Becker
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China.
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Allen AM, Weinberger AH, Wetherill RR, Howe CL, McKee SA. Oral Contraceptives and Cigarette Smoking: A Review of the Literature and Future Directions. Nicotine Tob Res 2019; 21:592-601. [PMID: 29165663 PMCID: PMC6468133 DOI: 10.1093/ntr/ntx258] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Accepted: 11/16/2017] [Indexed: 01/08/2023]
Abstract
INTRODUCTION Evidence continues to mount indicating that endogenous sex hormones (eg, progesterone and estradiol) play a significant role in smoking-related outcomes. Although approximately one out of four premenopausal smokers use oral contraceptives (OCs), which significantly alter progesterone and estradiol levels, relatively little is known about how OCs may influence smoking-related outcomes. Thus, the goal of this review article is to describe the state of the literature and offer recommendations for future directions. METHODS In March 2017, we searched seven databases, with a restriction to articles written in English, using the following keywords: nicotine, smoker(s), smoking, tobacco, cigarettes, abstinence, withdrawal, and craving(s). We did not restrict on the publication date, type, or study design. RESULTS A total of 13 studies were identified. Three studies indicated faster nicotine metabolism in OC users compared to nonusers. Five of six laboratory studies that examined physiological stress response noted heightened response in OC users compared to nonusers. Three studies examined cessation-related symptomatology (eg, craving) with mixed results. One cross-sectional study observed greater odds of current smoking among OC users, and no studies have explored the relationship between OC use and cessation outcomes. CONCLUSIONS Relatively few studies were identified on the role of OCs in smoking-related outcomes. Future work could explore the relationship between OC use and mood, stress, weight gain, and brain function/connectivity, as well as cessation outcomes. Understanding the role of OC use in these areas may lead to the development of novel smoking cessation interventions for premenopausal women. IMPLICATIONS This is the first review of the relationship between oral contraceptives (OCs) and smoking-related outcomes. The existing literature suggests that the use of OCs is related to increased nicotine metabolism and physiological stress response. However, the relationship between OC use and smoking-related symptoms (eg, craving) is mixed. Further, no published data were available on OC use and smoking cessation outcomes. Therefore, we recommend additional research be conducted to characterize the relationship between OC use and smoking cessation outcomes, perhaps as a function of the effect of OC use on mood, stress, weight gain, and brain function/connectivity.
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Affiliation(s)
- Alicia M Allen
- Family & Community Medicine Department, College of Medicine, University of Arizona, Tucson, AZ, USA
| | - Andrea H Weinberger
- Ferkauf Graduate School of Psychology, Yeshiva University, New York, NY, USA
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, USA
| | - Reagan R Wetherill
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA
| | - Carol L Howe
- University of Arizona Health Sciences Library, University of Arizona, Tucson, AZ
| | - Sherry A McKee
- Department of Psychiatry, Yale School of Medicine, New Haven, CT
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Zimmermann K, Kendrick KM, Scheele D, Dau W, Banger M, Maier W, Weber B, Ma Y, Hurlemann R, Becker B. Altered striatal reward processing in abstinent dependent cannabis users: Social context matters. Eur Neuropsychopharmacol 2019; 29:356-364. [PMID: 30658938 DOI: 10.1016/j.euroneuro.2019.01.106] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Revised: 11/18/2018] [Accepted: 01/06/2019] [Indexed: 12/14/2022]
Abstract
Public perception of cannabis as relatively harmless, alongside claimed medical benefits, have led to moves towards its legalization. Yet, long-term consequences of cannabis dependence, and whether they differ qualitatively from other drugs, are still poorly understood. A key feature of addictive drugs is that chronic use leads to adaptations in striatal reward processing, blunting responsivity to the substance itself and natural (non-drug) rewards. Against this background, the present study investigated whether cannabis dependence is associated with lasting alterations in behavioral and neural responses to social reward in 23 abstinent cannabis-dependent men and 24 matched non-using controls. In an interpersonal pleasant touch fMRI paradigm, participants were led to believe they were in physical closeness of or touched (CLOSE, TOUCH) by either a male or female experimenter (MALE, FEMALE), allowing contextual modulation of the perceived pleasantness and associated neural responses. Upon female compared to male touch, dependent cannabis users displayed a significantly attenuated increase of pleasantness experience compared to healthy controls. Controls responded to female as compared to male interaction with increased striatal activation whereas cannabis users displayed the opposite activation pattern, with stronger alterations being associated with a higher lifetime exposure to cannabis. Neural processing of pleasant touch in dependent cannabis users was found to be intact. These findings demonstrate that cannabis dependence is linked to blunted striatal processing of non-drug rewards and suggest that these alterations may contribute to social processing deficits.
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Affiliation(s)
- Kaeli Zimmermann
- Department of Psychiatry and Division of Medical Psychology, University of Bonn, 53105 Bonn, Germany
| | - Keith M Kendrick
- MOE Key Laboratory for Neuroinformation, Center for Information in Medicine, Clinical Hospital of the Chengdu Brain Science Institute, University of Electronic Science and Technology of China, Xiyuan Ave 2006, 611731 Chengdu, China
| | - Dirk Scheele
- Department of Psychiatry and Division of Medical Psychology, University of Bonn, 53105 Bonn, Germany
| | - Wolfgang Dau
- Department of Addiction and Psychotherapy, LVR-Clinic Bonn, 53111 Bonn, Germany
| | - Markus Banger
- Department of Addiction and Psychotherapy, LVR-Clinic Bonn, 53111 Bonn, Germany
| | - Wolfgang Maier
- Department of Psychiatry and Division of Medical Psychology, University of Bonn, 53105 Bonn, Germany; German Center for Neurodegenerative Diseases (DZNE), 53175 Bonn, Germany
| | - Bernd Weber
- Department of Epileptology, Center for Economics and Neuroscience, University of Bonn, Germany; Department of NeuroCognition, Life & Brain Center, 53105 Bonn, Germany
| | - Yina Ma
- State Key Laboratory of Cognitive Neuroscience and Learning, IDG/McGovern Institute of Brain Research, Beijing Normal University, 100875 Beijing, China
| | - René Hurlemann
- Department of Psychiatry and Division of Medical Psychology, University of Bonn, 53105 Bonn, Germany
| | - Benjamin Becker
- MOE Key Laboratory for Neuroinformation, Center for Information in Medicine, Clinical Hospital of the Chengdu Brain Science Institute, University of Electronic Science and Technology of China, Xiyuan Ave 2006, 611731 Chengdu, China.
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Zhou F, Zimmermann K, Xin F, Scheele D, Dau W, Banger M, Weber B, Hurlemann R, Kendrick KM, Becker B. Shifted balance of dorsal versus ventral striatal communication with frontal reward and regulatory regions in cannabis-dependent males. Hum Brain Mapp 2018; 39:5062-5073. [PMID: 30277629 DOI: 10.1002/hbm.24345] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Revised: 07/15/2018] [Accepted: 07/26/2018] [Indexed: 12/15/2022] Open
Abstract
The transition from voluntary to addictive behavior is characterized by a loss of regulatory control in favor of reward driven behavior. Animal models indicate that this process is neurally underpinned by a shift in ventral-dorsal striatal control of behavior; however, this shift has not been directly examined in humans. The present resting state functional magnetic resonance imaging (fMRI) study employed a two-step approach to: (a) precisely map striatal alterations using a novel, data-driven network classification strategy combining intrinsic connectivity contrast with multivoxel pattern analysis and, (b) to determine whether a ventral to dorsal striatal shift in connectivity with reward and regulatory control regions can be observed in abstinent (28 days) male cannabis-dependent individuals (n = 24) relative to matched controls (n = 28). Network classification revealed that the groups can be reliably discriminated by global connectivity profiles of two striatal regions that mapped onto the ventral (nucleus accumbens) and dorsal striatum (caudate). Subsequent functional connectivity analysis demonstrated a relative shift between ventral and dorsal striatal communication with fronto-limbic regions that have been consistently involved in reward processing (rostral anterior cingulate cortex [ACC]) and executive/regulatory functions (dorsomedial prefrontal cortex [PFC]). Specifically, in the cannabis-dependent subjects, connectivity between the ventral striatum with the rostral ACC increased, whereas both striatal regions were uncoupled from the regulatory dorsomedial PFC. Together, these findings suggest a shift in the balance between dorsal and ventral striatal control in cannabis dependence. Similar changes have been observed in animal models and may promote the loss of control central to addictive behavior.
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Affiliation(s)
- Feng Zhou
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China
| | - Kaeli Zimmermann
- Department of Psychiatry and Division of Medical Psychology, University of Bonn, Bonn, Germany
| | - Fei Xin
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China
| | - Dirk Scheele
- Department of Psychiatry and Division of Medical Psychology, University of Bonn, Bonn, Germany
| | - Wolfgang Dau
- Department of Addiction and Psychotherapy, LVR-Clinic Bonn, Bonn, Germany
| | - Markus Banger
- Department of Addiction and Psychotherapy, LVR-Clinic Bonn, Bonn, Germany
| | - Bernd Weber
- Center for Economics and Neuroscience, Department of Epileptology, University of Bonn, Bonn, Germany.,Department of Neurocognition, Life & Brain Center, Bonn, Germany
| | - René Hurlemann
- Department of Psychiatry and Division of Medical Psychology, University of Bonn, Bonn, Germany
| | - Keith M Kendrick
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China
| | - Benjamin Becker
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China
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Kaag AM, Wiers RW, de Vries TJ, Pattij T, Goudriaan AE. Striatal alcohol cue-reactivity is stronger in male than female problem drinkers. Eur J Neurosci 2018; 50:2264-2273. [PMID: 29888821 PMCID: PMC6767856 DOI: 10.1111/ejn.13991] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Revised: 05/23/2018] [Accepted: 05/29/2018] [Indexed: 12/27/2022]
Abstract
Despite apparent sex differences in the development and treatment of alcohol use disorder, relatively little is known about the underlying neural mechanisms. In this study, we therefore investigated neural cue-reactivity in a sample of male (n = 28) and female (n = 27) problem drinkers (matched on age and alcohol use severity) with an average alcohol use disorder identification test score of 12 which is indicative of a likely alcohol use disorder. Neural cue-reactivity data were extracted from four regions of interest: the ventral and dorsal striatum and the ventral and dorsal anterior cingulate cortex, with a significance level set at p < 0.05. While the cue-reactivity paradigm induced similar levels of self-reported craving in men and women, visual alcohol cues induced significantly stronger striatal activation in men compared to drinkers. While sex differences in ventral striatal cue-reactivity were partly explained by sex differences in alcohol intake, cannabis use, negative affect and anxiety, this was not the case for sex differences in dorsal striatal cue-reactivity. These results suggest that alcohol cues are differentially processed by men and women and that the neurobiological mechanisms behind cue-reactivity differ between the sexes. Consequently, paradigms using alcohol-related pictures may not be optimal to induce cue-reactivity in female drinkers and may not be optimal to measure neurobiological markers of alcohol use severity and relapse. Future alcohol cue-reactivity studies should, in addition to including both men and women, include different types of cues (e.g., stressors and imagery in addition to pictures) to assess sex differences in alcohol cue-reactivity.
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Affiliation(s)
- Anne Marije Kaag
- Addiction Development and Psychopathology (ADAPT) Lab, Department of Psychology, University of Amsterdam, Amsterdam, the Netherlands.,Amsterdam Brain and Cognition, University of Amsterdam, Amsterdam, the Netherlands.,Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands.,Department of Anatomy and Neurosciences, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, the Netherlands
| | - Reinout W Wiers
- Addiction Development and Psychopathology (ADAPT) Lab, Department of Psychology, University of Amsterdam, Amsterdam, the Netherlands.,Amsterdam Brain and Cognition, University of Amsterdam, Amsterdam, the Netherlands
| | - Taco J de Vries
- Department of Anatomy and Neurosciences, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, the Netherlands
| | - Tommy Pattij
- Department of Anatomy and Neurosciences, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, the Netherlands
| | - Anna E Goudriaan
- Amsterdam Brain and Cognition, University of Amsterdam, Amsterdam, the Netherlands.,Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands.,Arkin Mental Health, Amsterdam, the Netherlands
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Role of Exogenous Progesterone in the Treatment of Men and Women with Substance Use Disorders: A Narrative Review. CNS Drugs 2018; 32:421-435. [PMID: 29761343 PMCID: PMC6235727 DOI: 10.1007/s40263-018-0525-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Substance use disorders (SUDs) remain problematic as many individuals are untreated or do not benefit from the currently available interventions. Thus, there is an urgent need to develop novel pharmacological interventions to treat SUDs. Evidence suggests that the female sex hormone, progesterone, attenuates the craving for and the euphoric effects of drugs of abuse. Research to date has demonstrated that progesterone may modulate responses to drugs of abuse and may have utility as a novel treatment for SUDs. A literature search was conducted to identify and examine studies that administered exogenous progesterone. Sixteen publications were identified, exploring the utility of exogenous progesterone or its metabolite, allopregnanolone, among a range of substances, including amphetamines (one study), benzodiazepines (one study), cocaine (nine studies), and tobacco/nicotine (five studies). Results indicated that exogenous progesterone and, its metabolite allopregnanolone, demonstrated preliminary efficacy as a treatment for substance use in both men and women. Notably, progesterone appears to target negative affect and augment cognitive functioning, especially among female substance users. Additional research is needed to explore the potential use of exogenous progesterone and allopregnanolone in the treatment of SUDs, including that associated with alcohol and opioids, but considering the current promising findings, exogenous progesterone and allopregnanolone may have utility as novel pharmacological treatments for SUDs.
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Franklin TR, Jagannathan K, Hager N, Fang Z, Xu S, Wong J, Childress AR, Detre JA, Rao H, Wetherill R. Brain substrates of early (4h) cigarette abstinence: Identification of treatment targets. Drug Alcohol Depend 2018; 182:78-85. [PMID: 29172122 PMCID: PMC5763480 DOI: 10.1016/j.drugalcdep.2017.10.010] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Revised: 10/03/2017] [Accepted: 10/04/2017] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Research indicates that overnight nicotine abstinence disrupts neural activity in the mesocorticolimbic reward network; however, less is known about the time course of abstinence-induced brain changes. To examine the potential neural effects of early abstinence, we used arterial spin labeling perfusion fMRI, to measure regional cerebral blood flow (rCBF) changes in the resting brain induced by 4h of nicotine abstinence. METHODS In a repeated measures design, 5min of resting perfusion fMRI data were acquired in awake nicotine-dependent individuals (eyes open) during 'smoking as usual' (SMK) and following 4h of monitored nicotine abstinence (ABS) conditions (N=20). Conditions were compared using a paired t test in SPM8. Craving was assessed prior to each condition. RESULTS Compared to SMK, ABS significantly increased craving and reduced rCBF in select regions, including the hippocampus and ventral striatum (cluster corr, α=0.01, 943 contiguous voxels). The magnitude of the abstinence-induced change in rCBF correlated with the magnitude of the change in craving across conditions in select regions, including the medial and lateral orbitofrontal cortices and the anterior ventral insula (r values ranging from 0.59-0.74). CONCLUSIONS Results show that as few as 4h of abstinence can reduce resting rCBF in multiple nodes of the brain's mesocorticolimbic network, disrupting neural processing. Identifying early withdrawal treatment targets has far-reaching implications, which include thwarting relapse proclivities. Results parallel those of the extant human literature and are in agreement with an extensive preclinical literature showing compromised mesolimbic dopaminergic function and impairments in reward function during nicotine withdrawal.
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Affiliation(s)
- Teresa R. Franklin
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, 19104, USA,Corresponding author at: Center for the Studies of Addiction, Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, 3535 Market Street, Philadelphia, PA 19104, USA. (T.R. Franklin)
| | - Kanchana Jagannathan
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Nathan Hager
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Zhuo Fang
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, 19104, USA,Department of Neurology, University of Pennsylvania, Philadelphia, PA, 19104, USA,Laboratory of Applied Brain and Cognitive Sciences, Shanghai International Studies University, Shanghai, China
| | - Sihua Xu
- Department of Neurology, University of Pennsylvania, Philadelphia, PA, 19104, USA,Laboratory of Applied Brain and Cognitive Sciences, Shanghai International Studies University, Shanghai, China
| | - Joyce Wong
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Anna Rose Childress
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - John A. Detre
- Department of Neurology, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Hengyi Rao
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, 19104, USA,Department of Neurology, University of Pennsylvania, Philadelphia, PA, 19104, USA,Laboratory of Applied Brain and Cognitive Sciences, Shanghai International Studies University, Shanghai, China
| | - Reagan Wetherill
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, 19104, USA
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McHugh RK, Votaw VR, Sugarman DE, Greenfield SF. Sex and gender differences in substance use disorders. Clin Psychol Rev 2017; 66:12-23. [PMID: 29174306 DOI: 10.1016/j.cpr.2017.10.012] [Citation(s) in RCA: 498] [Impact Index Per Article: 71.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Revised: 10/26/2017] [Accepted: 10/30/2017] [Indexed: 12/18/2022]
Abstract
The gender gap in substance use disorders (SUDs), characterized by greater prevalence in men, is narrowing, highlighting the importance of understanding sex and gender differences in SUD etiology and maintenance. In this critical review, we provide an overview of sex/gender differences in the biology, epidemiology and treatment of SUDs. Biological sex differences are evident across an array of systems, including brain structure and function, endocrine function, and metabolic function. Gender (i.e., environmentally and socioculturally defined roles for men and women) also contributes to the initiation and course of substance use and SUDs. Adverse medical, psychiatric, and functional consequences associated with SUDs are often more severe in women. However, men and women do not substantively differ with respect to SUD treatment outcomes. Although several trends are beginning to emerge in the literature, findings on sex and gender differences in SUDs are complicated by the interacting contributions of biological and environmental factors. Future research is needed to further elucidate sex and gender differences, especially focusing on hormonal factors in SUD course and treatment outcomes; research translating findings between animal and human models; and gender differences in understudied populations, such as those with co-occurring psychiatric disorders and gender-specific populations, such as pregnant women.
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Affiliation(s)
- R Kathryn McHugh
- Division of Alcohol and Drug Abuse, McLean Hospital, 115 Mill Street, Belmont, MA 02478, United States; Department of Psychiatry, Harvard Medical School, 401 Park Drive, Boston, MA 02155, United States.
| | - Victoria R Votaw
- Division of Alcohol and Drug Abuse, McLean Hospital, 115 Mill Street, Belmont, MA 02478, United States
| | - Dawn E Sugarman
- Division of Alcohol and Drug Abuse, McLean Hospital, 115 Mill Street, Belmont, MA 02478, United States; Department of Psychiatry, Harvard Medical School, 401 Park Drive, Boston, MA 02155, United States
| | - Shelly F Greenfield
- Division of Alcohol and Drug Abuse, McLean Hospital, 115 Mill Street, Belmont, MA 02478, United States; Department of Psychiatry, Harvard Medical School, 401 Park Drive, Boston, MA 02155, United States
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Lynch WJ, Tan L, Narmeen S, Beiter R, Brunzell DH. Exercise or saccharin during abstinence block estrus-induced increases in nicotine-seeking. Physiol Behav 2017; 203:33-41. [PMID: 29080668 DOI: 10.1016/j.physbeh.2017.10.026] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Revised: 09/29/2017] [Accepted: 10/23/2017] [Indexed: 12/11/2022]
Abstract
Recent evidence suggests that adolescent and young adult females may be particularly responsive to nicotine use interventions that include exercise or environmental enrichment. This possibility was addressed in the current study by comparing the efficacy of exercise versus non-exercise environmental enrichment (saccharin) during abstinence at reducing subsequent nicotine-seeking/relapse vulnerability in an adolescent-onset rat model. The efficacy of each intervention was examined as a function of estrous cycle phase given findings indicating that hormonal status influences relapse vulnerability and treatment outcome in females. Once adolescent female rats acquired nicotine self-administration, they were given 23-h/day access to nicotine (0.01mg/kg/infusion) for 10days. Following the last self-administration session, rats began a 10-day forced abstinence period with 2-h/day access to an unlocked wheel (exercise, n=15), a bottle containing a saccharin-sweetened solution (0.25%; saccharin, n=19), or without access to a wheel or saccharin (control, n=20). Nicotine-seeking, as assessed under an extinction/cued-induced reinstatement procedure, was examined on day 11 of abstinence. Levels of nicotine-seeking were highest in females tested during estrus as compared to females tested during non-estrus phases. Exercise or saccharin during abstinence reduced nicotine-seeking in females tested during estrus, but neither affected the low levels of nicotine-seeking observed in females tested during non-estrus phases, presumably due to a floor effect. These results demonstrate that exercise or saccharin during abstinence decrease nicotine-seeking, and suggest that either would be effective as an early intervention for nicotine use and addiction in females.
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Affiliation(s)
- Wendy J Lynch
- Department of Psychiatry and Neurobehavioral Sciences, University of Virginia, Charlottesville, VA 22902, USA.
| | - Lillian Tan
- Department of Psychiatry and Neurobehavioral Sciences, University of Virginia, Charlottesville, VA 22902, USA
| | - Syeda Narmeen
- Department of Psychiatry and Neurobehavioral Sciences, University of Virginia, Charlottesville, VA 22902, USA
| | - Rebecca Beiter
- Department of Psychiatry and Neurobehavioral Sciences, University of Virginia, Charlottesville, VA 22902, USA
| | - Darlene H Brunzell
- Department of Pharmacology and Toxicology, Virginia Commonwealth University, Richmond, VA 23298, USA
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Dumais KM, Franklin TR, Jagannathan K, Hager N, Gawrysiak M, Betts J, Farmer S, Guthier E, Pater H, Janes AC, Wetherill RR. Multi-site exploration of sex differences in brain reactivity to smoking cues: Consensus across sites and methodologies. Drug Alcohol Depend 2017; 178:469-476. [PMID: 28711813 PMCID: PMC5567981 DOI: 10.1016/j.drugalcdep.2017.05.044] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Revised: 05/04/2017] [Accepted: 05/25/2017] [Indexed: 01/27/2023]
Abstract
BACKGROUND Biological sex influences cigarette smoking behavior. More men than women smoke, but women have a harder time quitting. Sex differences in smoking cue (SC) reactivity may underlie such behavioral differences. However, the influence of sex on brain reactivity to SCs has yielded inconsistent findings suggesting the need for continued study. Here, we investigated the effect of sex on SC reactivity across two sites using different imaging modalities and SC stimulus types. METHODS Pseudo-continuous arterial spin-labeled (pCASL) perfusion functional magnetic resonance imaging (fMRI) was used to assess brain responses to SC versus non-SC videos in 40 smokers (23 females) at the University of Pennsylvania. BOLD fMRI was used to assess brain responses to SC versus non-SC still images in 32 smokers (18 females) at McLean Hospital. Brain reactivity to SCs was compared between men and women and was correlated with SC-induced craving. RESULTS In both cohorts, males showed higher SC versus non-SC reactivity compared to females in reward-related brain regions (i.e., ventral striatum/ventral pallidum, ventral medial prefrontal cortex). Brain activation during SC versus non-SC exposure correlated positively with SC-induced subjective craving in males, but not females. CONCLUSIONS The current work provides much needed replication and validation of sex differences in SC-reactivity. These findings also add to a body of literature showing that men have greater reward-related brain activation to drug cues across drug classes. Such sex differences confirm the need to consider sex not only when evaluating SC-reactivity but when examining nicotine dependence etiology and treatment.
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Affiliation(s)
- Kelly M Dumais
- McLean Imaging Center, McLean Hospital, Harvard Medical School,115 Mill Street, Belmont, MA, 02478, USA.
| | - Teresa R Franklin
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania,3900 Chestnut Street, Philadelphia, PA, 19104, USA
| | - Kanchana Jagannathan
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania,3900 Chestnut Street, Philadelphia, PA, 19104, USA
| | - Nathan Hager
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania,3900 Chestnut Street, Philadelphia, PA, 19104, USA
| | - Michael Gawrysiak
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania,3900 Chestnut Street, Philadelphia, PA, 19104, USA
| | - Jennifer Betts
- McLean Imaging Center, McLean Hospital, Harvard Medical School,115 Mill Street, Belmont, MA, 02478, USA
| | - Stacey Farmer
- McLean Imaging Center, McLean Hospital, Harvard Medical School,115 Mill Street, Belmont, MA, 02478, USA
| | - Emily Guthier
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania,3900 Chestnut Street, Philadelphia, PA, 19104, USA
| | - Heather Pater
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania,3900 Chestnut Street, Philadelphia, PA, 19104, USA
| | - Amy C Janes
- McLean Imaging Center, McLean Hospital, Harvard Medical School,115 Mill Street, Belmont, MA, 02478, USA
| | - Reagan R Wetherill
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania,3900 Chestnut Street, Philadelphia, PA, 19104, USA
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Xue YX, Deng JH, Chen YY, Zhang LB, Wu P, Huang GD, Luo YX, Bao YP, Wang YM, Shaham Y, Shi J, Lu L. Effect of Selective Inhibition of Reactivated Nicotine-Associated Memories With Propranolol on Nicotine Craving. JAMA Psychiatry 2017; 74:224-232. [PMID: 28146250 PMCID: PMC6201291 DOI: 10.1001/jamapsychiatry.2016.3907] [Citation(s) in RCA: 63] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
IMPORTANCE A relapse into nicotine addiction during abstinence often occurs after the reactivation of nicotine reward memories, either by acute exposure to nicotine (a smoking episode) or by smoking-associated conditioned stimuli (CS). Preclinical studies suggest that drug reward memories can undergo memory reconsolidation after being reactivated, during which they can be weakened or erased by pharmacological or behavioral manipulations. However, translational clinical studies using CS-induced memory retrieval-reconsolidation procedures to decrease drug craving reported inconsistent results. OBJECTIVE To develop and test an unconditioned stimulus (UCS)-induced retrieval-reconsolidation procedure to decrease nicotine craving among people who smoke. DESIGN, SETTING, AND PARTICIPANTS A translational rat study and human study in an academic outpatient medical center among 96 male smokers (aged 18- 45 years) to determine the association of propranolol administration within the time window of memory reconsolidation (after retrieval of the nicotine-associated memories by nicotine UCS exposure) with relapse to nicotine-conditioned place preference (CPP) and operant nicotine seeking in rats, and measures of preference to nicotine-associated CS and nicotine craving among people who smoke. INTERVENTION The study rats were injected noncontingently with the UCS (nicotine 0.15 mg/kg, subcutaneous) in their home cage, and the human study participants administered a dose of propranolol (40 mg, per os; Zhongnuo Pharma). MAIN OUTCOMES AND MEASURES Nicotine CPP and operant nicotine seeking in rats, and preference and craving ratings for newly learned and preexisting real-life nicotine-associated CS among people who smoke. RESULTS Sixty-nine male smokers completed the experiment and were included for statistical analysis: 24 in the group that received placebo plus 1 hour plus UCS, 23 who received propranolol plus 1 hour plus UCS, and 22 who received UCS plus 6 hours plus propranolol. In rat relapse models, propranolol injections administered immediately after nicotine UCS-induced memory retrieval inhibited subsequent nicotine CPP and operant nicotine seeking after short (CPP, d = 1.72, 95% CI, 0.63-2.77; operant seeking, d = 1.61, 95% CI, 0.59-2.60) or prolonged abstinence (CPP, d = 1.46, 95% CI, 0.42-2.47; operant seeking: d = 1.69, 95% CI, 0.66-2.69), as well as nicotine priming-induced reinstatement of nicotine CPP (d = 1.28, 95% CI, 0.27-2.26) and operant nicotine seeking (d = 1.61, 95% CI, 0.59-2.60) after extinction. Among the smokers, oral propranolol administered prior to nicotine UCS-induced memory retrieval decreased subsequent nicotine preference induced by newly learned nicotine CS (CS1, Cohen d = 0.61, 95% CI, 0.02-1.19 and CS2, d = 0.69, 95% CI, 0.10-1.28, respectively), preexisting nicotine CS (d = 0.57, 95% CI, -0.02 to 1.15), and nicotine priming (CS1, d = 0.82, 95% CI, 0.22-1.41 and CS2, d = 0.78, 95% CI, 0.18-1.37, respectively; preexisting nicotine CS, d = 0.92, 95% CI, 0.31-1.52), as well as nicotine craving induced by the preexisting nicotine CS (d = 0.64, 95% CI, 0.05-1.22), and nicotine priming (d = 1.15, 95% CI, 0.52-1.76). CONCLUSIONS AND RELEVANCE In rat-to-human translational study, a novel UCS-induced memory retrieval-reconsolidation interference procedure inhibited nicotine craving induced by exposure to diverse nicotine-associated CS and nicotine itself. This procedure should be studied further in clinical trials.
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Affiliation(s)
- Yan-Xue Xue
- National Institute on Drug Dependence, Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China
| | - Jia-Hui Deng
- National Institute on Drug Dependence, Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China2Peking University Sixth Hospital (Institute of Mental Health), Peking University, Beijing, China
| | - Ya-Yun Chen
- National Institute on Drug Dependence, Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China2Peking University Sixth Hospital (Institute of Mental Health), Peking University, Beijing, China
| | - Li-Bo Zhang
- National Institute on Drug Dependence, Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China
| | - Ping Wu
- National Institute on Drug Dependence, Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China
| | - Geng-Di Huang
- National Institute on Drug Dependence, Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China
| | - Yi-Xiao Luo
- National Institute on Drug Dependence, Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China2Peking University Sixth Hospital (Institute of Mental Health), Peking University, Beijing, China
| | - Yan-Ping Bao
- National Institute on Drug Dependence, Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China
| | - Yu-Mei Wang
- Peking University Sixth Hospital (Institute of Mental Health), Peking University, Beijing, China
| | - Yavin Shaham
- Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, Baltimore, Maryland
| | - Jie Shi
- National Institute on Drug Dependence, Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China
| | - Lin Lu
- National Institute on Drug Dependence, Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China2Peking University Sixth Hospital (Institute of Mental Health), Peking University, Beijing, China3National Clinical Research Center for Mental Disorders & Key Laboratory of Mental Health, Ministry of Health, Peking University, Beijing, China5Peking-Tsinghua Center for Life Sciences and PKU-IDG/McGovern Institute for Brain Research, Peking University, Beijing, China
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Abstract
The purpose of this review is to discuss ways to think about and study sex differences in preclinical animal models. We use the framework of addiction, in which animal models have excellent face and construct validity, to illustrate the importance of considering sex differences. There are four types of sex differences: qualitative, quantitative, population, and mechanistic. A better understanding of the ways males and females can differ will help scientists design experiments to characterize better the presence or absence of sex differences in new phenomena that they are investigating. We have outlined major quantitative, population, and mechanistic sex differences in the addiction domain using a heuristic framework of the three established stages of the addiction cycle: binge/intoxication, withdrawal/negative affect, and preoccupation/anticipation. Female rats, in general, acquire the self-administration of drugs and alcohol more rapidly, escalate their drug taking with extended access more rapidly, show more motivational withdrawal, and (where tested in animal models of "craving") show greater reinstatement. The one exception is that female rats show less motivational withdrawal to alcohol. The bases for these quantitative sex differences appear to be both organizational, in that estradiol-treated neonatal animals show the male phenotype, and activational, in that the female phenotype depends on the effects of gonadal hormones. In animals, differences within the estrous cycle can be observed but are relatively minor. Such hormonal effects seem to be most prevalent during the acquisition of drug taking and less influential once compulsive drug taking is established and are linked largely to progesterone and estradiol. This review emphasizes not only significant differences in the phenotypes of females and males in the domain of addiction but emphasizes the paucity of data to date in our understanding of those differences.
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Affiliation(s)
- Jill B Becker
- Molecular & Behavioral Neuroscience Institute, Department of Psychiatry, Department of Psychology, University of Michigan, Ann Arbor, Michigan (J.B.B.); and Director, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, Maryland (G.F.K.)
| | - George F Koob
- Molecular & Behavioral Neuroscience Institute, Department of Psychiatry, Department of Psychology, University of Michigan, Ann Arbor, Michigan (J.B.B.); and Director, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, Maryland (G.F.K.)
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Goulopoulou S, McCarthy CG, Webb RC. Toll-like Receptors in the Vascular System: Sensing the Dangers Within. Pharmacol Rev 2016; 68:142-67. [PMID: 26721702 DOI: 10.1124/pr.114.010090] [Citation(s) in RCA: 170] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Toll-like receptors (TLRs) are components of the innate immune system that respond to exogenous infectious ligands (pathogen-associated molecular patterns, PAMPs) and endogenous molecules that are released during host tissue injury/death (damage-associated molecular patterns, DAMPs). Interaction of TLRs with their ligands leads to activation of downstream signaling pathways that induce an immune response by producing inflammatory cytokines, type I interferons (IFN), and other inflammatory mediators. TLR activation affects vascular function and remodeling, and these molecular events prime antigen-specific adaptive immune responses. Despite the presence of TLRs in vascular cells, the exact mechanisms whereby TLR signaling affects the function of vascular tissues are largely unknown. Cardiovascular diseases are considered chronic inflammatory conditions, and accumulating data show that TLRs and the innate immune system play a determinant role in the initiation and development of cardiovascular diseases. This evidence unfolds a possibility that targeting TLRs and the innate immune system may be a novel therapeutic goal for these conditions. TLR inhibitors and agonists are already in clinical trials for inflammatory conditions such as asthma, cancer, and autoimmune diseases, but their study in the context of cardiovascular diseases is in its infancy. In this article, we review the current knowledge of TLR signaling in the cardiovascular system with an emphasis on atherosclerosis, hypertension, and cerebrovascular injury. Furthermore, we address the therapeutic potential of TLR as pharmacological targets in cardiovascular disease and consider intriguing research questions for future study.
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Affiliation(s)
- Styliani Goulopoulou
- Institute for Cardiovascular and Metabolic Diseases, Department of Obstetrics and Gynecology, University of North Texas Health Science Center, Fort Worth, Texas; and Department of Physiology, Augusta University, Augusta, Georgia
| | - Cameron G McCarthy
- Institute for Cardiovascular and Metabolic Diseases, Department of Obstetrics and Gynecology, University of North Texas Health Science Center, Fort Worth, Texas; and Department of Physiology, Augusta University, Augusta, Georgia
| | - R Clinton Webb
- Institute for Cardiovascular and Metabolic Diseases, Department of Obstetrics and Gynecology, University of North Texas Health Science Center, Fort Worth, Texas; and Department of Physiology, Augusta University, Augusta, Georgia
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41
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Influence of menstrual cycle phase on resting-state functional connectivity in naturally cycling, cigarette-dependent women. Biol Sex Differ 2016; 7:24. [PMID: 27168932 PMCID: PMC4862059 DOI: 10.1186/s13293-016-0078-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Accepted: 05/02/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Sex differences in tobacco-related morbidity and mortality exist, with women experiencing more severe health consequences and greater difficulty with smoking cessation than men. One factor that likely contributes to these sex differences is menstrual cycle phase and associated neural and cognitive changes associated with ovarian hormone fluctuations across the menstrual cycle. Previously, we showed that naturally cycling, cigarette-dependent women in the follicular phase of their menstrual cycle showed greater reward-related neural activity and greater craving during smoking cue exposure. To better understand our results and the observed sex differences in smoking behavior and relapse, we explored potential menstrual cycle phase differences in resting-state functional connectivity (rsFC) in naturally cycling, cigarette-dependent women. Understanding how menstrual cycle phase affects neural processes, cognition, and behavior is a critical step in developing more efficacious treatments and in selecting the best treatment option based on a patient's needs. METHODS Resting-state functional connectivity analyses were used to examine connectivity strength differences between naturally cycling, premenopausal, cigarette-dependent women who were in the follicular phase (FPs; n = 22) and those in the luteal phase (LPs, n = 16) of their menstrual cycle. We also explored associations between connectivity strength and attentional bias to smoking cues. RESULTS Compared with LPs, FPs showed decreased rsFC between the dorsal anterior cingulate cortex (dACC) and the subgenual anterior cingulate cortex, medial orbitofrontal cortex (mOFC), and ventral striatum. Among FPs, rsFC strength between the dACC and the bilateral dorsolateral prefrontal cortex (DLPFC), the bilateral dorsal striatum, and the left temporal gyrus was inversely correlated with attentional bias to smoking cues. CONCLUSIONS This is the first study to explore menstrual cycle phase differences in rsFC among cigarette-dependent women, and results suggest that FPs show differences in rsFC underlying cognitive control, which could place them at greater risk for continued smoking and relapse. These findings provide new insights toward individualized treatment strategies.
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Yarmush DE, Manchery L, Luehring-Jones P, Erblich J. Gender and Impulsivity: Effects on Cue-Induced Alcohol Craving. Alcohol Clin Exp Res 2016; 40:1052-7. [PMID: 27028602 DOI: 10.1111/acer.13030] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2015] [Accepted: 01/29/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND Numerous studies have demonstrated that trait impulsivity is linked to increased risk of developing alcohol-use disorders and other substance abuse. Impulsivity has also been shown in some studies to potentiate cue-induced drug cravings. Despite considerable evidence of gender differences in impulsivity and drug craving among individuals suffering from alcohol dependence and other drug use, little research has focused on these processes in healthy young men and women who may be at risk for developing alcohol-use disorders. The objective of this study was to investigate the relationship between impulsivity and cue-induced craving, as well as possible gender differences in these effects among healthy young adults. METHODS To that end, female (n = 22) and male (n = 14) social drinkers aged 18 to 25, recruited from an urban university campus, completed the Barratt Impulsiveness Scale and reported their alcohol cravings immediately before and after laboratory exposure to alcohol cues. RESULTS Findings indicated that exposure to cues elicited increased alcohol cravings, but these effects did not differ by gender. Interestingly, a significant interaction of impulsivity and gender revealed that impulsivity predicted significantly higher cue-induced cravings in women, but not men. CONCLUSIONS Findings underscore the importance of better understanding the interaction of situational factors (e.g., exposure to alcohol cues) and dispositional factors (e.g., impulsivity) as potential contributors to drinking motivation. Future prospective research is needed to identify gender-specific risk factors for the development of problem drinking.
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Affiliation(s)
- Devorah E Yarmush
- Department of Psychology , Hunter College and Graduate Center, City University of New York, New York, New York
| | - Linda Manchery
- Department of Psychology , Hunter College and Graduate Center, City University of New York, New York, New York
| | - Peter Luehring-Jones
- Department of Psychology , City College, City University of New York, New York, New York
| | - Joel Erblich
- Department of Psychology , Hunter College and Graduate Center, City University of New York, New York, New York.,Department of Oncological Sciences , Program for Cancer Prevention and Control, Icahn School of Medicine at Mount Sinai, New York, New York
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Wetherill RR, Franklin TR, Allen SS. Ovarian hormones, menstrual cycle phase, and smoking: a review with recommendations for future studies. CURRENT ADDICTION REPORTS 2016; 3:1-8. [PMID: 27134810 DOI: 10.1007/s40429-016-0093-z] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Cigarette smoking continues to be the leading cause of preventable morbidity and mortality. Similar to other addictive substances, the prevalence of cigarette smoking is greater among men than women, yet women are less successful at quitting smoking. Preclinical and clinical research suggests that ovarian hormones (i.e., estradiol and progesterone), which fluctuate over the course of the menstrual cycle, may contribute to these sex differences. Specifically, research suggests that progesterone may protect against cigarette smoking and nicotine addiction; whereas estradiol may underlie enhanced vulnerability. In this review, we discuss new research on ovarian hormone and menstrual cycle phase effects on smoking-related responses and behavior in women, including studies examining neural responses to smoking cues, hormonal influences on medication-assisted smoking cessation, and acute smoking abstinence. We highlight innovative studies with strong research methodology and provide suggestions for future research that may allow evidence-based knowledge for immediate translation to the clinic to guide novel, hormonally-informed treatment strategies. Thus, rigorous scientific study holds the potential to reduce relapse rates, thus improving the health and saving the lives of the many thousands of women who unfortunately do not respond to current treatments.
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Affiliation(s)
- Reagan R Wetherill
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania; Mailing Address: 3900 Chestnut Street, Philadelphia, Pennsylvania, USA 19104;
| | - Teresa R Franklin
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania; Mailing Address: 3900 Chestnut Street, Philadelphia, Pennsylvania, USA 19104;
| | - Sharon S Allen
- Department of Family Medicine & Community Health, Medical School, University of Minnesota; Mailing Address: 420 Delaware Street SE, MMC 381 Mayo, Minneapolis, Minnesota, USA 55455;
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