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Francis AN, Sebille S, Whitfield-Gabrieli S, Camprodon JA. Multimodal 7T imaging reveals enhanced functional coupling between salience and frontoparietal networks in young adult tobacco cigarette smokers. Brain Imaging Behav 2024; 18:913-921. [PMID: 38639847 DOI: 10.1007/s11682-024-00882-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/04/2024] [Indexed: 04/20/2024]
Abstract
Tobacco cigarette smoking is associated with disrupted brain network dynamics in resting brain networks including the Salience (SN) and Fronto parietal (FPN). Unified multimodal methods [Resting state connectivity analysis, Diffusion Tensor Imaging (DTI), neurite orientation dispersion and density imaging (NODDI), and cortical thickness analysis] were employed to test the hypothesis that the impact of cigarette smoking on the balance among these networks is due to alterations in white matter connectivity, microstructural architecture, functional connectivity and cortical thickness (CT) and that these metrics define fundamental differences between people who smoke and nonsmokers. Multimodal analyses of previously collected 7 Tesla MRI data via the Human Connectome Project were performed on 22 people who smoke (average number of daily cigarettes was 10 ± 5) and 22 age- and sex-matched nonsmoking controls. First, functional connectivity analysis was used to examine SN-FPN-DMN interactions between people who smoke and nonsmokers. The anatomy of these networks was then assessed using DTI and CT analyses while microstructural architecture of WM was analyzed using the NODDI toolbox. Seed-based connectivity analysis revealed significantly enhanced within network [p = 0.001 FDR corrected] and between network functional coupling of the salience and R-frontoparietal networks in people who smoke [p = 0.004 FDR corrected]. The network connectivity was lateralized to the right hemisphere. Whole brain diffusion analysis revealed no significant differences between people who smoke and nonsmokers in Fractional Anisotropy, Mean diffusivity and in neurite orienting and density. There were also no significant differences in CT in the hubs of these networks. Our results demonstrate that tobacco cigarette smoking is associated with enhanced functional connectivity, but anatomy is largely intact in young adults. Whether this enhanced connectivity is pre-existing, transient or permanent is not known. The observed enhanced connectivity in resting state networks may contribute to the maintenance of smoking frequency.
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Affiliation(s)
- Alan N Francis
- Department of Neuroscience, University of Texas, Rio Grande Valley, Edinburg, TX, USA.
| | - Sophie Sebille
- Department of Neuroscience GHU Paris Psychiatrie et Neurosciences, Paris, France
| | | | - Joan A Camprodon
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, USA
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Jiang W, Cai L, Wang Z. Common hyper-entropy patterns identified in nicotine smoking, marijuana use, and alcohol use based on uni-drug dependence cohorts. Med Biol Eng Comput 2023; 61:3159-3166. [PMID: 37718388 PMCID: PMC10842973 DOI: 10.1007/s11517-023-02932-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 09/07/2023] [Indexed: 09/19/2023]
Abstract
Substance use disorders present similar behaviors and psychopathologies related to impaired decision making/inhibition control and information processing, suggesting common alterations in frontal and limbic brain areas. To test this hypothesis, we identified three uni-substance use cohorts with dependence to only one type of substance from the Human Connectome Project: marijuana dependence, nicotine dependence, and alcohol dependence. Fifty-nine marijuana uses, 34 nicotine smokers, 35 alcohol drinkers, and their age and sex-matched non-substance use controls were identified. We used brain entropy mapping to probe brain alterations in substance use disorders. Compared to non-substance use individuals, all three substance use disorder cohorts had increased brain entropy. Marijuana dependence and nicotine dependence showed overlapped hyper-brain entropy in bilateral dorso-lateral prefrontal cortex, anterior cingulate cortex, and right insula. Hyper-brain entropy in marijuana dependence and alcohol dependence overlap in left insula, left doso-lateral prefrontal cortex, and posterior cingulate. Hyper-brain entropy in nicotine dependence and alcohol dependence overlap only in left dorso-lateral prefrontal cortex. Hyper-brain entropy in those areas was correlated with increased impulsivity or reduced inhibition control in substance use disorder but not in controls. Drug dependence is associated with hyper-brain entropy in the prefrontal cortex and the meso-limbic system, independent of a specific addictive drug. Brain entropy in this circuit provides a sensitive marker to detect brain and behavioral alterations in substance user disorders.
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Affiliation(s)
- Wenyu Jiang
- Department of Neurological Rehabilitation, Jiangbin Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Luhui Cai
- Department of Neurological Rehabilitation, Jiangbin Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Ze Wang
- Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, 670 W. Baltimore St, Baltimore, MD, 20201, USA.
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Esteban Ronda V, Pastor Esplá E, Rábade Castedo C. Functional Brain Imaging in the Treatment of Nicotine Dependence. Arch Bronconeumol 2023; 59:543-545. [PMID: 36797140 DOI: 10.1016/j.arbres.2023.01.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Accepted: 01/20/2023] [Indexed: 02/02/2023]
Affiliation(s)
- Violeta Esteban Ronda
- Department of Respiratory Medicine, Hospital Universitario de San Juan, Alicante, Spain.
| | - Esther Pastor Esplá
- Department of Respiratory Medicine, Hospital Universitario de San Juan, Alicante, Spain
| | - Carlos Rábade Castedo
- Department of Respiratory Medicine, Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain
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Zhang T, Zeng Q, Li K, Liu X, Fu Y, Qiu T, Huang P, Luo X, Liu Z, Peng G. Distinct resting-state functional connectivity patterns of Anterior Insula affected by smoking in mild cognitive impairment. Brain Imaging Behav 2023; 17:386-394. [PMID: 37243752 PMCID: PMC10435406 DOI: 10.1007/s11682-023-00766-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/20/2023] [Indexed: 05/29/2023]
Abstract
Smoking is a modifiable risk factor for Alzheimer's disease (AD). The insula plays a vital role in both smoking and cognition. However, the smoking effects on insula-related networks in cognitively normal controls (CN) and mild cognitive impairment (MCI) patients remain unknown. We identified 129 CN (85 non-smokers and 44 smokers) and 83 MCI (54 non-smokers and 29 smokers). Each underwent neuropsychological assessment and MRI (structural and resting-state functional). Seed-based functional analyses in the anterior and posterior insula were performed to calculate the functional connectivity (FC) with voxels in the whole brain. Mixed-effect analyses were performed to explore the interactive effects on smoking and cognitive status. Associations between FC and neuropsychological scales were assessed. Mixed-effect analyses revealed the FC differences between the right anterior insula (RAI) with the left middle temporal gyrus (LMTG) and that with the right inferior parietal lobule (RIPL) (p < 0.01, cluster level < 0.05, two-tailed, gaussian random field correction). The FC of RAI in both LMTG and RIPL sees a significant decrease in MCI smokers (p < 0.01). Smoking affects insula FC differently between MCI and CN, and could decrease the insula FC in MCI patients. Our study provides evidence of neural mechanisms between smoking and AD.
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Affiliation(s)
- Tianyi Zhang
- Department of Neurology, The 1st Affiliated Hospital of Zhejiang University School of Medicine, No.79 Qing-Chun Road, Shang- Cheng District, Hangzhou, 310002 China
| | - Qingze Zeng
- Department of Radiology, The 2nd Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Kaicheng Li
- Department of Radiology, The 2nd Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Xiaocao Liu
- Department of Radiology, The 2nd Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Yanv Fu
- Department of Neurology, The 2nd Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Tiantian Qiu
- Department of Radiology, Linyi People’s Hospital, Linyi, China
| | - Peiyu Huang
- Department of Radiology, The 2nd Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Xiao Luo
- Department of Radiology, The 2nd Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Zhirong Liu
- Department of Neurology, The 2nd Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Guoping Peng
- Department of Neurology, The 1st Affiliated Hospital of Zhejiang University School of Medicine, No.79 Qing-Chun Road, Shang- Cheng District, Hangzhou, 310002 China
| | - for the Alzheimer’s Disease Neuroimaging Initiative (ADNI)
- Department of Neurology, The 1st Affiliated Hospital of Zhejiang University School of Medicine, No.79 Qing-Chun Road, Shang- Cheng District, Hangzhou, 310002 China
- Department of Radiology, The 2nd Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
- Department of Neurology, The 2nd Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
- Department of Radiology, Linyi People’s Hospital, Linyi, China
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Conti AA, Baldacchino AM. Early-onset smoking theory of compulsivity development: a neurocognitive model for the development of compulsive tobacco smoking. Front Psychiatry 2023; 14:1209277. [PMID: 37520221 PMCID: PMC10372444 DOI: 10.3389/fpsyt.2023.1209277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 06/22/2023] [Indexed: 08/01/2023] Open
Abstract
According to the literature, individuals who start tobacco smoking during adolescence are at greater risk of developing severe tobacco addiction and heavier smoking behavior in comparison with individuals who uptake tobacco smoking during subsequent developmental stages. As suggested by animal models, this may be related to the unique neuroadaptive and neurotoxic effects of nicotine on adolescents' fronto-striatal brain regions modulating cognitive control and impulsivity. Previous research has proposed that these neuroadaptive and neurotoxic effects may cause a heightened reward-oriented impulsive behavior that may foster smoking relapses during quit attempts. However, developments in the field of addiction neuroscience have proposed drug addiction to represent a type of compulsive behavior characterized by the persistent use of a particular drug despite evident adverse consequences. One brain region that has received increased attention in recent years and that has been proposed to play a central role in modulating such compulsive drug-seeking and using behavior is the insular cortex. Lesion studies have shown that structural damages in the insular cortex may disrupt smoking behavior, while neuroimaging studies reported lower gray matter volume in the anterior insular cortex of chronic smokers compared with non-smokers, in addition to correlations between gray matter volume in the anterior insular cortex and measures of compulsive cigarette smoking. Based on the findings of our recent study reporting on early-onset smokers (mean age at regular smoking initiation = 13.2 years) displaying lower gray matter and white matter volume in the anterior insular cortex compared to late-onset smokers (mean age at regular smoking initiation = 18.0 years), we propose that the anterior insular cortex may play a central role in mediating the association between smoking uptake during adolescence and smoking heaviness/tobacco addiction during adulthood.
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Affiliation(s)
- Aldo Alberto Conti
- Department of Child and Adolescent Psychiatry, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom
- Division of Population and Behavioral Science, University of St Andrews School of Medicine, St Andrews, United Kingdom
| | - Alexander Mario Baldacchino
- Division of Population and Behavioral Science, University of St Andrews School of Medicine, St Andrews, United Kingdom
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Upton S, Brown AA, Golzy M, Garland EL, Froeliger B. Right inferior frontal gyrus theta-burst stimulation reduces smoking behaviors and strengthens fronto-striatal-limbic resting-state functional connectivity: a randomized crossover trial. Front Psychiatry 2023; 14:1166912. [PMID: 37457779 PMCID: PMC10338839 DOI: 10.3389/fpsyt.2023.1166912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 05/22/2023] [Indexed: 07/18/2023] Open
Abstract
Introduction Functional and anatomical irregularities in the right inferior frontal gyrus (rIFG), a ventrolateral prefrontal region that mediates top-down inhibitory control over prepotent behavioral responding, are implicated in the ongoing maintenance of nicotine dependence (ND). However, there is little research on the effects of neuromodulation of the rIFG on smoking behavior, inhibitory control, and resting-state functional connectivity (rsFC) among individuals with ND. Methods In this double-blind, crossover, theta-burst stimulation (TBS) study, adults with ND (N = 31; female: n = 15) completed a baseline session and were then randomized to two counterbalanced sessions of functionally neuronavigated TBS to the rIFG: continuous TBS (cTBS) on 1 day and intermittent TBS (iTBS) on another. Differences in cigarette cravings, smoking, and fronto-striatal-limbic rsFC were assessed. Results Relative to baseline, cTBS significantly reduced appetitive and withdrawal cravings immediately after treatment. The effects of cTBS on withdrawal craving persisted for 24 h, as well as produced a reduction in smoking. Furthermore, cTBS significantly strengthened rsFC between the rIFG pars opercularis and subcallosal cingulate (fronto-striatal circuit), and between the rIFG pars opercularis and the right posterior parahippocampal gyrus (fronto-limbic circuit). At post-24 h, cTBS-induced increase in fronto-striatal rsFC was significantly associated with less appetitive craving, while the increase in fronto-limbic rsFC was significantly associated with less withdrawal craving and smoking. Discussion These findings warrant further investigation into the potential value of rIFG cTBS to attenuate smoking behavior among individuals with ND.
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Affiliation(s)
- Spencer Upton
- Department of Psychological Sciences, University of Missouri, Columbia, MO, United States
| | - Alexander A. Brown
- Department of Psychological Sciences, University of Missouri, Columbia, MO, United States
- Department of Psychiatry, School of Medicine, University of Missouri, Columbia, MO, United States
- Cognitive Neuroscience Systems Core Facility, University of Missouri, Columbia, MO, United States
| | - Mojgan Golzy
- Biostatistics Unit, Department of Family and Community Medicine, School of Medicine, University of Missouri, Columbia, MO, United States
| | - Eric L. Garland
- Center on Mindfulness and Integrative Health Intervention Development, College of Social Work, University of Utah, Salt Lake City, UT, United States
| | - Brett Froeliger
- Department of Psychological Sciences, University of Missouri, Columbia, MO, United States
- Department of Psychiatry, School of Medicine, University of Missouri, Columbia, MO, United States
- Cognitive Neuroscience Systems Core Facility, University of Missouri, Columbia, MO, United States
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7
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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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Weidacker K, Kim SG, Buhl-Callesen M, Jensen M, Pedersen MU, Thomsen KR, Voon V. The prediction of resilience to alcohol consumption in youths: insular and subcallosal cingulate myeloarchitecture. Psychol Med 2022; 52:2032-2042. [PMID: 33143793 DOI: 10.1017/s0033291720003852] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND The prediction of alcohol consumption in youths and particularly biomarkers of resilience, is critical for early intervention to reduce the risk of subsequent harmful alcohol use. METHODS At baseline, the longitudinal relaxation rate (R1), indexing grey matter myelination (i.e. myeloarchitecture), was assessed in 86 adolescents/young adults (mean age = 21.76, range: 15.75-26.67 years). The Alcohol Use Disorder Identification Test (AUDIT) was assessed at baseline, 1- and 2-year follow-ups (12- and 24-months post-baseline). We used a whole brain data-driven approach controlled for age, gender, impulsivity and other substance and behavioural addiction measures, such as problematic cannabis use, drug use-related problems, internet gaming, pornography use, binge eating, and levels of externalization, to predict the change in AUDIT scores from R1. RESULTS Greater baseline bilateral anterior insular and subcallosal cingulate R1 (cluster-corrected family-wise error p < 0.05) predict a lower risk for harmful alcohol use (measured as a reduction in AUDIT scores) at 2-year follow-up. Control analyses show that other grey matter measures (local volume or fractional anisotropy) did not reveal such an association. An atlas-based machine learning approach further confirms the findings. CONCLUSIONS The insula is critically involved in predictive coding of autonomic function relevant to subjective alcohol cue/craving states and risky decision-making processes. The subcallosal cingulate is an essential node underlying emotion regulation and involved in negative emotionality addiction theories. Our findings highlight insular and cingulate myeloarchitecture as a potential protective biomarker that predicts resilience to alcohol misuse in youths, providing novel identifiers for early intervention.
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Affiliation(s)
| | - Seung-Goo Kim
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- Department of Psychology and Neuroscience, Duke University, Durham, North Carolina, USA
| | - Mette Buhl-Callesen
- Centre for Alcohol and Drug Research, School of Business and Social Sciences, University of Aarhus, Aarhus, Denmark
| | - Mads Jensen
- Center of Functionally Integrative Neuroscience, MINDLab, Aarhus University, Aarhus, Denmark
| | - Mads Uffe Pedersen
- Centre for Alcohol and Drug Research, School of Business and Social Sciences, University of Aarhus, Aarhus, Denmark
| | - Kristine Rømer Thomsen
- Centre for Alcohol and Drug Research, School of Business and Social Sciences, University of Aarhus, Aarhus, Denmark
| | - Valerie Voon
- Department of Psychiatry, University of Cambridge, Cambridge, UK
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Massey SH, Estabrook R, Lapping-Carr L, Newmark RL, Decety J, Wisner KL, Wakschlag LS. Are empathic processes mechanisms of pregnancy's protective effect on smoking? Identification of a novel target for preventive intervention. Soc Sci Med 2022; 305:115071. [PMID: 35660692 DOI: 10.1016/j.socscimed.2022.115071] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Revised: 03/19/2022] [Accepted: 05/22/2022] [Indexed: 01/06/2023]
Abstract
BACKGROUND Spontaneous cessation and reduction in smoking by pregnant women suggest that concern about others, or empathy, could be a malleable target for intervention. We examined various empathy-related processes in relations to reported and biochemically assessed smoking during pregnancy. METHODS Participants were 154 pregnant women (M = 12.4 weeks gestation, SD = 4.6) who were smoking cigarettes immediately prior to pregnancy recognition (85 had quit and 69 were still smoking at enrollment). Empathy-related processes were measured with performance-based paradigms (affect sharing, empathic concern, and theory of mind) and a speech sample (expressed emotion). Smoking was assessed with timeline follow back interviews and urine cotinine assays. Using zero-inflated Poisson regression models, we tested direct and interactive effects of empathy-related processes with respect to biologically verified smoking cessation (zero portion); and mean cigarettes/day smoked after pregnancy recognition among persistent smokers (count portion). RESULTS Affect sharing was inversely related to post-recognition cigarettes/day (B(SE) = -0.17(0.07), 95%C.I. -0.30,-0.04, p = .011) and moderated the relationship between pre-recognition smoking and post-recognition smoking consistent with a buffering effect (B(SE) = -.17(0.05); 95%C.I. - 0.28,-0.06; p = .002). Other empathy related processes showed neither direct nor interactive effects on smoking outcomes. CONCLUSIONS Further research is recommended to clarify the role of empathy in pregnancy smoking.
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Affiliation(s)
- Suena H Massey
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, 676 N Saint Clair Street, Suite 1000, Chicago, IL, 60611, USA; Institute for Innovations in Developmental Sciences, Northwestern University Feinberg School of Medicine, 633 N Saint Clair Street, 19th Floor, Chicago, IL, 60611, USA.
| | - Ryne Estabrook
- Department of Psychology, University of Illinois at Chicago, 1007 W Harrison Street, 1018D, Chicago, IL, 60607, USA
| | - Leiszle Lapping-Carr
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, 676 N Saint Clair Street, Suite 1000, Chicago, IL, 60611, USA
| | - Rebecca L Newmark
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, 676 N Saint Clair Street, Suite 1000, Chicago, IL, 60611, USA; University of California San Francisco School of Medicine, 513 Parnassus Ave, Suite S-224, San Francisco, CA, 94143, USA
| | - Jean Decety
- Department of Psychology, Department of Psychiatry and Behavioral Neuroscience, University of Chicago, 5848 South University Avenue, Chicago, IL, 60637, USA
| | - Katherine L Wisner
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, 676 N Saint Clair Street, Suite 1000, Chicago, IL, 60611, USA
| | - Lauren S Wakschlag
- Institute for Innovations in Developmental Sciences, Northwestern University Feinberg School of Medicine, 633 N Saint Clair Street, 19th Floor, Chicago, IL, 60611, USA; Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 625 N. Michigan, Suite 2100, Chicago, IL, 60611, USA
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The neurobiology of drug addiction: cross-species insights into the dysfunction and recovery of the prefrontal cortex. Neuropsychopharmacology 2022; 47:276-291. [PMID: 34408275 PMCID: PMC8617203 DOI: 10.1038/s41386-021-01153-9] [Citation(s) in RCA: 53] [Impact Index Per Article: 26.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 08/02/2021] [Accepted: 08/06/2021] [Indexed: 01/03/2023]
Abstract
A growing preclinical and clinical body of work on the effects of chronic drug use and drug addiction has extended the scope of inquiry from the putative reward-related subcortical mechanisms to higher-order executive functions as regulated by the prefrontal cortex. Here we review the neuroimaging evidence in humans and non-human primates to demonstrate the involvement of the prefrontal cortex in emotional, cognitive, and behavioral alterations in drug addiction, with particular attention to the impaired response inhibition and salience attribution (iRISA) framework. In support of iRISA, functional and structural neuroimaging studies document a role for the prefrontal cortex in assigning excessive salience to drug over non-drug-related processes with concomitant lapses in self-control, and deficits in reward-related decision-making and insight into illness. Importantly, converging insights from human and non-human primate studies suggest a causal relationship between drug addiction and prefrontal insult, indicating that chronic drug use causes the prefrontal cortex damage that underlies iRISA while changes with abstinence and recovery with treatment suggest plasticity of these same brain regions and functions. We further dissect the overlapping and distinct characteristics of drug classes, potential biomarkers that inform vulnerability and resilience, and advancements in cutting-edge psychological and neuromodulatory treatment strategies, providing a comprehensive landscape of the human and non-human primate drug addiction literature as it relates to the prefrontal cortex.
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Zhang M, Gao X, Yang Z, Wen M, Huang H, Zheng R, Wang W, Wei Y, Cheng J, Han S, Zhang Y. Shared gray matter alterations in subtypes of addiction: a voxel-wise meta-analysis. Psychopharmacology (Berl) 2021; 238:2365-2379. [PMID: 34313804 DOI: 10.1007/s00213-021-05920-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 07/05/2021] [Indexed: 12/26/2022]
Abstract
BACKGROUND Numerous studies based on voxel-based morphometry (VBM) have revealed gray matter (GM) alterations in multiple brain regions for addiction. However, findings are poorly replicated, and it remains elusive whether distinct diagnoses of addiction are underpinned by shared abnormalities. Our aim was to conduct a quantitative meta-analysis of structural neuroimaging studies investigating GM abnormalities in two main categories of addiction: substance use disorders (SUD) and behavioral addictions (BA). METHOD A systematic database search was conducted in several databases from Jan 1, 2010, to Oct 23, 2020, to identify eligible VBM studies. Meta-analysis was performed with the seed-based d mapping software package to compare alternations between individuals with addiction-related disorders and healthy controls (HC). RESULTS A total of 59 VBM studies including 2096 individuals with addiction-related disorders and 2637 HC met the inclusion criteria. Individuals with addiction-related disorders showed shared GM volume decrease in bilateral prefrontal cortex, bilateral insula, bilateral rolandic operculum, left superior temporal gyrus, and right Heschl gyrus and GM increase in right lingual gyrus and right fusiform gyrus comparing with HC (p < 0.005). Subgroup analysis found heterogeneity between SUD and BA mainly in left inferior occipital gyrus and right striatum (p < 0.005). Meta-regression revealed that GM atrophy in right anterior cingulate (r = 0.541, p = 0.03 (uncorrected)) and left inferior frontal gyrus (r = 0.595, p = 0.015) were positively correlated with higher impulsivity. CONCLUSIONS This meta-analysis identified a concordance across subtypes of addiction in terms of the brain structural changes in prefrontal and insula areas, which may relate to higher impulsivity observed across addiction diagnoses. This concordance provides an organizing model that emphasizes the importance of shared neural substrates in addiction.
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Affiliation(s)
- Mengzhe Zhang
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Xinyu Gao
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Zhengui Yang
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Mengmeng Wen
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Huiyu Huang
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Ruiping Zheng
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Weijian Wang
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yarui Wei
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Jingliang Cheng
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
| | - Shaoqiang Han
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
| | - Yong Zhang
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
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12
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Kunas SL, Hilbert K, Yang Y, Richter J, Hamm A, Wittmann A, Ströhle A, Pfleiderer B, Herrmann MJ, Lang T, Lotze M, Deckert J, Arolt V, Wittchen HU, Straube B, Kircher T, Gerlach AL, Lueken U. The modulating impact of cigarette smoking on brain structure in panic disorder: a voxel-based morphometry study. Soc Cogn Affect Neurosci 2021; 15:849-859. [PMID: 32734299 PMCID: PMC7543937 DOI: 10.1093/scan/nsaa103] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2019] [Revised: 06/17/2020] [Accepted: 07/15/2020] [Indexed: 11/13/2022] Open
Abstract
Cigarette smoking increases the likelihood of developing anxiety disorders, among them panic disorder (PD). While brain structures altered by smoking partly overlap with morphological changes identified in PD, the modulating impact of smoking as a potential confounder on structural alterations in PD has not yet been addressed. In total, 143 PD patients (71 smokers) and 178 healthy controls (62 smokers) participated in a multicenter magnetic resonance imaging (MRI) study. T1-weighted images were used to examine brain structural alterations using voxel-based morphometry in a priori defined regions of the defensive system network. PD was associated with gray matter volume reductions in the amygdala and hippocampus. This difference was driven by non-smokers and absent in smoking subjects. Bilateral amygdala volumes were reduced with increasing health burden (neither PD nor smoking > either PD or smoking > both PD and smoking). As smoking can narrow or diminish commonly observed structural abnormalities in PD, the effect of smoking should be considered in MRI studies focusing on patients with pathological forms of fear and anxiety. Future studies are needed to determine if smoking may increase the risk for subsequent psychopathology via brain functional or structural alterations.
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Affiliation(s)
- Stefanie L Kunas
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin 10117, Germany.,Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité - Universitätsmedizin Berlin, Berlin 10117, Germany
| | - Kevin Hilbert
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin 10117, Germany
| | - Yunbo Yang
- Department of Psychiatry and Psychotherapy and Center for Mind Brain and Behavior (CMBB), Philipps-University Marburg, Marburg 35037, Germany
| | - Jan Richter
- Department of Biological and Clinical Psychology/Psychotherapy, University of Greifswald, Greifswald 17489, Germany
| | - Alfons Hamm
- Department of Biological and Clinical Psychology/Psychotherapy, University of Greifswald, Greifswald 17489, Germany
| | - André Wittmann
- Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité - Universitätsmedizin Berlin, Berlin 10117, Germany
| | - Andreas Ströhle
- Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité - Universitätsmedizin Berlin, Berlin 10117, Germany
| | - Bettina Pfleiderer
- Department of Clinical Radiology, University of Münster, Münster 48149, Germany
| | - Martin J Herrmann
- Department of Psychiatry, Psychosomatics and Psychotherapy, Center of Mental Health, University Hospital of Würzburg, University of Würzburg, Würzburg 97080, Germany
| | - Thomas Lang
- Christoph-Dornier-Foundation for Clinical Psychology, Bremen 28359, Germany.,Department of Psychiatry and Psychotherapy, University of Hamburg, Hamburg 20146, Germany
| | - Martin Lotze
- Functional Imaging Unit, Institute for Diagnostic Radiology and Neuroradiology, University of Greifswald, Greifswald 17489, Germany
| | - Jürgen Deckert
- Department of Psychiatry, Psychosomatics and Psychotherapy, Center of Mental Health, University Hospital of Würzburg, University of Würzburg, Würzburg 97080, Germany
| | - Volker Arolt
- Department of Psychiatry, University of Münster, Münster 48149, Germany
| | - Hans-Ulrich Wittchen
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden 01069, Germany
| | - Benjamin Straube
- Department of Psychiatry and Psychotherapy and Center for Mind Brain and Behavior (CMBB), Philipps-University Marburg, Marburg 35037, Germany
| | - Tilo Kircher
- Department of Psychiatry and Psychotherapy and Center for Mind Brain and Behavior (CMBB), Philipps-University Marburg, Marburg 35037, Germany
| | - Alexander L Gerlach
- Department of Psychiatry and Psychotherapy and Center for Mind Brain and Behavior (CMBB), Philipps-University Marburg, Marburg 35037, Germany
| | - Ulrike Lueken
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin 10117, Germany
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13
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Association between functional brain alterations and neuropsychological scales in male chronic smokers using resting-state fMRI. Psychopharmacology (Berl) 2021; 238:1387-1399. [PMID: 33772331 DOI: 10.1007/s00213-021-05819-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 03/08/2021] [Indexed: 10/21/2022]
Abstract
RATIONALE Recent studies have demonstrated that cigarette smoking is related to changes in brain structure and function. However, few studies focus on functional brain differences between male chronic smokers and nonsmokers in both local spontaneous activity and whole-brain functional networks. OBJECTIVES Our study recruited 67 chronic smokers and 43 nonsmokers who underwent functional magnetic resonance imaging (fMRI) scans to investigate functional activity and connectivity alterations in chronic smokers. METHODS We used the mean fractional amplitude of the low-frequency fluctuation (mfALFF) and mean regional homogeneity (mReHo) methods to investigate resting-state spontaneous activity in chronic smokers and nonsmokers. The graph theoretical analysis (GTA) and network-based statistical (NBS) analysis were also used to investigate functional connectivity alterations. RESULTS Compared with nonsmokers, chronic smokers exhibited higher activation in the reward system and portions of the prefrontal cortex but lower activation in the default mode networks (DMN) and visual-related regions. In addition, correlation analysis was conducted to assess the associations between neuroimaging findings and the severity of nicotine dependence or expectations of smoking effects. Our results showed that certain brain regions correlated with the Fagerström Test for Nicotine Dependence (FTND), the positive aspect of the Drug Use Disorders Identification Test Extended (DUDIT-E), and the negative aspect of the DUDIT-E, especially in the attentional control networks and hippocampus. The graph theoretical analysis (GTA) results indicated chronic smokers exhibited a trend toward increased assortativity. Our network-based statistical (NBS) analysis revealed reduced functional connections between the subnetwork in the prefrontal cortex, olfactory cortex, angular gyrus, and cingulate gyrus of chronic smokers. CONCLUSIONS We concluded that chronic smokers have neural adaptations in local spontaneous activity but remain healthy brain functional networks.
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14
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Chang L, Liang H, Kandel SR, He JJ. Independent and Combined Effects of Nicotine or Chronic Tobacco Smoking and HIV on the Brain: A Review of Preclinical and Clinical Studies. J Neuroimmune Pharmacol 2020; 15:658-693. [PMID: 33108618 DOI: 10.1007/s11481-020-09963-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 09/25/2020] [Indexed: 02/07/2023]
Abstract
Tobacco smoking is highly prevalent among HIV-infected individuals. Chronic smokers with HIV showed greater cognitive deficits and impulsivity, and had more psychopathological symptoms and greater neuroinflammation than HIV non-smokers or smokers without HIV infection. However, preclinical studies that evaluated the combined effects of HIV-infection and tobacco smoking are scare. The preclinical models typically used cell cultures or animal models that involved specific HIV viral proteins or the administration of nicotine to rodents. These preclinical models consistently demonstrated that nicotine had neuroprotective and anti-inflammatory effects, leading to cognitive enhancement. Although the major addictive ingredient in tobacco smoking is nicotine, chronic smoking does not lead to improved cognitive function in humans. Therefore, preclinical studies designed to unravel the interactive effects of chronic tobacco smoking and HIV infection are needed. In this review, we summarized the preclinical studies that demonstrated the neuroprotective effects of nicotine, the neurotoxic effects of the HIV viral proteins, and the scant literature on nicotine or tobacco smoke in HIV transgenic rat models. We also reviewed the clinical studies that evaluated the neurotoxic effects of tobacco smoking, HIV infection and their combined effects on the brain, including studies that evaluated the cognitive and behavioral assessments, as well as neuroimaging measures. Lastly, we compared the different approaches between preclinical and clinical studies, identified some gaps and proposed some future directions. Graphical abstract Independent and combined effects of HIV and tobacco/nicotine. Left top and bottom panels: Both clinical studies of HIV infected persons and preclinical studies using viral proteins in vitro or in vivo in animal models showed that HIV infection could lead to neurotoxicity and neuroinflammation. Right top and bottom panels: While clinical studies of tobacco smoking consistently showed deleterious effects of smoking, clinical and preclinical studies that used nicotine show mild cognitive enhancement, neuroprotective and possibly anti-inflammatory effects. In the developing brain, however, nicotine is neurotoxic. Middle overlapping panels: Clinical studies of persons with HIV who were smokers typically showed additive deleterious effects of HIV and tobacco smoking. However, in the preclinical studies, when nicotine was administered to the HIV-1 Tg rats, the neurotoxic effects of HIV were attenuated, but tobacco smoke worsened the inflammatory cascade.
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Affiliation(s)
- Linda Chang
- Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, 670 W. Baltimore Street, HSF III, Baltimore, MD, 21201, USA.
- Department of Neurology, University of Maryland School of Medicine, Baltimore, MD, USA.
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
- Department of Medicine, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI, USA.
| | - Huajun Liang
- Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, 670 W. Baltimore Street, HSF III, Baltimore, MD, 21201, USA
| | - Suresh R Kandel
- Department of Microbiology and Immunology, Chicago Medical School, Center for Cancer Cell Biology, Immunology and Infection, Rosalind Franklin University, 3333 Green Bay Road, Basic Science Building 2.300, North Chicago, IL, 60064, USA
| | - Johnny J He
- Department of Microbiology and Immunology, Chicago Medical School, Center for Cancer Cell Biology, Immunology and Infection, Rosalind Franklin University, 3333 Green Bay Road, Basic Science Building 2.300, North Chicago, IL, 60064, USA.
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15
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Wang C, Wang S, Huang P, Shen Z, Qian W, Luo X, Li K, Zeng Q, Gu Q, Yu H, Yang Y, Zhang M. Abnormal white matter tracts of insula in smokers. Brain Imaging Behav 2020; 15:1955-1965. [PMID: 32974850 DOI: 10.1007/s11682-020-00389-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/31/2020] [Indexed: 11/26/2022]
Abstract
Nicotine addiction is characterized as a neural circuit dysfunction, particularly with regard to the alterations in central reward pathways. The insula, a cortical region that is thought to play a central role in this reward circuitry, has been implicated in the maintenance of nicotine addiction. However, it remains largely unclear about the white matter (WM) microstructural alterations of insula in nicotine addiction and whether the WM alterations of insula could predict smoking cessation outcomes. In this study, 58 male nicotine-dependent smokers and 34 matched male nonsmoking controls were recruited. After a 12-week smoking cessation treatment with varenicline, 38 smokers relapsed, and 20 did not relapse. Diffusion tensor imaging and probabilistic tractography were used to investigate the differences of WM tracts of insula between smokers and nonsmokers. Relative to nonsmokers, in the left hemisphere, smokers showed lower fractional anisotropy (FA) in the fiber tracts of anterior insula cortex-to-nucleus accumbens and posterior insula cortex-to-nucleus accumbens; in the right hemisphere, smokers showed higher FA, and lower axial diffusivity (AD), radial diffusivity (RD), and mean diffusivity (MD) in the fiber tracts of anterior insula cortex-to-medial orbitofrontal cortex, posterior insula cortex-to-medial orbitofrontal cortex, and posterior insula cortex-to-nucleus accumbens. However, there were no differences of WM diffusion properties between relapsers and nonrelapsers. This study is the first using probabilistic tractography to exclusively clarify the precise roles of insular WM tracts in smokers, which may provide new insights into the underlying neurobiology of nicotine addiction.
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Affiliation(s)
- Chao Wang
- Department of Radiology, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
| | - Shuyue Wang
- Department of Radiology, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Peiyu Huang
- Department of Radiology, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
| | - Zhujing Shen
- Department of Radiology, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Wei Qian
- Department of Radiology, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Xiao Luo
- Department of Radiology, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Kaicheng Li
- Department of Radiology, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Qingze Zeng
- Department of Radiology, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Quanquan Gu
- Department of Radiology, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Hualiang Yu
- Department of Psychiatry, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yihong Yang
- Neuroimaging Research Branch, National Institute on Drug Abuse, National Institutes of Health, Baltimore, MD, USA
| | - Minming Zhang
- Department of Radiology, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
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16
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Yang Z, Zhang Y, Cheng J, Zheng R. Meta-analysis of brain gray matter changes in chronic smokers. Eur J Radiol 2020; 132:109300. [PMID: 33010686 DOI: 10.1016/j.ejrad.2020.109300] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 09/11/2020] [Accepted: 09/13/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND Previous studies based on voxel-based morphometry (VBM) had revealed brain gray matter (GM) changes in chronic smokers relative to nonsmokers. However, not all studies reported entirely consistent findings, or even opposite. The aim of this study was to conduct a quantitative meta-analysis of VBM studies of chronic smokers. METHOD A systematic database search was conducted in PubMed and Web of Knowledge from January 1, 2000 to January 31, 2020 to identify eligible VBM studies. Meta-analysis was performed with the Seed-based d Mapping software package to compare alternations between chronic cigarette smokers and nonsmokers. In addition, meta-regression analysis were performed to examine the influences of cigarette per day, smoking history and FTND. RESULTS A total of 17 VBM studies including 905 smokers and 1344 nonsmokers met the inclusion criteria. The results of this meta-analysis showed that the chronic smokers showed a robust GM volume decrease in bilateral prefrontal cortex and left insular and a GM increase in the right lingual cortex and left occipital cortex. Moreover, meta-regression analysis showed that cigarette per day, smoking history and FTND were partly associated with GM changes in chronic smokers. CONCLUSIONS This meta-analysis indicated that chronic cigarette smokers had significant and robust brain GM alternations compared with nonsmokers. Longitudinal studies should be performed in the future to explore whether these brain regions could be used as potential therapeutic neuro-target for nicotine dependence.
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Affiliation(s)
- Zhengui Yang
- First Affiliated Hospital of Zhengzhou University 450002, Zhengzhou, China
| | - Yong Zhang
- First Affiliated Hospital of Zhengzhou University 450002, Zhengzhou, China.
| | - Jingliang Cheng
- First Affiliated Hospital of Zhengzhou University 450002, Zhengzhou, China
| | - Ruiping Zheng
- First Affiliated Hospital of Zhengzhou University 450002, Zhengzhou, China
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17
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Durazzo TC, Meyerhoff DJ. Cigarette smoking history is associated with poorer recovery in multiple neurocognitive domains following treatment for an alcohol use disorder. Alcohol 2020; 85:135-143. [PMID: 31923562 PMCID: PMC8751294 DOI: 10.1016/j.alcohol.2019.12.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Revised: 12/17/2019] [Accepted: 12/22/2019] [Indexed: 12/17/2022]
Abstract
Cigarette smoking is associated with neurocognitive dysfunction in various populations, including those seeking treatment for an alcohol use disorder (AUD). This study compared the rate and extent of recovery on measures of processing speed, executive functions, general intelligence, visuospatial skills and working memory in treatment-seeking alcohol dependent individuals (ALC) who were never-smokers (nvsALC), former-smoker (fsALC), and active smokers (asALC), over approximately 8 months of abstinence from alcohol. Methods: ALC participants were evaluated at approximately 1 month of abstinence (AP1; n = 132) and reassessed after 8 months of sobriety (AP2; n = 54). Never-smoking controls (CON; n = 33) completed a baseline and follow-up (n = 19) assessment approximately 9 months later. Domains evaluated were executive functions, general intelligence, processing speed, visuospatial skills and working memory; a domain composite was formed from the arithmetic average of the foregoing domains. nvsALC showed greater improvement than fsALC, asALC and CON on most domains over the AP1-AP2 interval. fsALC demonstrated greater recovery than asALC on all domains except visuospatial skills; fsALC also showed greater improvements than CON on general intelligence, working memory and domain composite. asALC did not show significant improvement on any domain over the AP1-AP2 interval. At 8 months of abstinence, asALC were inferior to CON and nvsALC on multiple domains, fsALC performed worse than nvsALC on several domains, but nvsALC were not different from CON on any domain. Our results provide robust evidence that smoking status influenced the rate and extent of neurocognitive recovery between 1 and 8 months of abstinence in this ALC cohort. Chronic smoking in AUD likely contributes to the considerable heterogeneity observed in neurocognitive recovery during extended abstinence. The findings provide additional strong support for the benefits of smoking cessation and the increasing clinical movement to offer smoking cessation resources concurrent with treatment for AUD.
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Affiliation(s)
- Timothy C Durazzo
- Mental Illness Research and Education Clinical Centers, VA Palo Alto Health Care System, San Francisco, CA, USA; Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicinecisco, San Francisco, CA, USA.
| | - Dieter J Meyerhoff
- Center for Imaging of Neurodegenerative Diseases (CIND), San Francisco VA Medical Center, San Francisco, CA, USA; Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA
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18
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Altered neural processing of negative stimuli in people with internet gaming disorder: fMRI evidence from the comparison with recreational game users. J Affect Disord 2020; 264:324-332. [PMID: 32056768 DOI: 10.1016/j.jad.2020.01.008] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Revised: 12/19/2019] [Accepted: 01/03/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND Abundant clinical studies have suggested that emotion dysregulation seems to be the essential pathogenesis for Internet gaming disorder (IGD). However, the neural mechanism of emotion regulation for IGD is still unclear. METHODS Subjective evaluation and fMRI data were collected from 50 subjects (IGD: 24; recreational game user (RGU): 26) while they were performing an emotion reappraisal task. We collected and compared their brain features during emotion processing of different visual stimuli. RESULTS Higher activation in the left dorsal anterior cingulate cortex (dACC), right ventral ACC, left claustrum and bilateral insula was observed in participants with IGD during emotion reappraisal relative to that of the RGU participants. In addition, generalized psychophysiological interaction analysis also showed that IGD participants had stronger functional connectivity between the right insula and bilateral dorsolateral prefrontal cortex (DLPFC) than the RGU participants. CONCLUSIONS The results suggest that IGD participants could not down-regulate their negative emotional experiences as efficiently as the RGU participants, although they engaged more cognitive resources. These results reveal the special neural circuits of emotion dysregulation in IGD individuals and provide new neural perspective for the intervention of IGD.
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19
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Qian W, Huang P, Shen Z, Wang C, Yang Y, Zhang M. Brain Gray Matter Volume and Functional Connectivity Are Associated With Smoking Cessation Outcomes. Front Hum Neurosci 2019; 13:361. [PMID: 31680913 PMCID: PMC6803765 DOI: 10.3389/fnhum.2019.00361] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Accepted: 09/26/2019] [Indexed: 11/13/2022] Open
Abstract
Smoking cessation is critical for reducing the risk of respiratory, cardiovascular diseases and cancers. However, most cessation attempts resulted in failure. In the present study, we aim to explore whether alterations of brain gray matter (GM) volume and functional connectivity (FC) are related to cessation outcomes, in hope of providing evidence for improving smoking cessation outcomes. Seventy-three smokers and 41 non-smokers were enrolled in the present study. All smokers participated in a 12-week smoking cessation treatment during which Varenicline was used to aid cessation. At the end of treatment, the smokers were divided into quitters and relapsers based on their abstinence performance. Structural magnetic resonance imaging (MRI) and voxel-based morphometry were applied to quantify the differences of regional brain volumes among the three groups at baseline. In addition, resting-state FC was used to investigate the related functional changes. In comparison with non-smokers, the smokers showed smaller GM volume in the left dorsal medial thalamus. Among the 73 smokers, 29 subjects successfully quitted smoking. The quitters showed greater GM volume than the relapsers in the right postcentral gyrus, right putamen\caudate nucleus and left orbitofrontal cortex (OFC). The GM volume in the left OFC was found to be negatively correlated with the pack years and daily smoking amount in the quitters. Furthermore, we found significantly reduced FC between left thalamus and left cerebellum in the relapsers. These findings extended our knowledge of the neural mechanism of smoking cessation, and suggested that brain structural and functional changes were related to smoking cessation outcomes.
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Affiliation(s)
- Wei Qian
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Peiyu Huang
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Zhujing Shen
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Chao Wang
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yihong Yang
- Neuroimaging Research Branch, National Institute on Drug Abuse, National Institutes of Health, Baltimore, MD, United States
| | - Minming Zhang
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
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20
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Wang C, Shen Z, Huang P, Qian W, Zhou C, Li K, Zeng Q, Luo X, Gu Q, Yu H, Yang Y, Zhang M. Increased interregional functional connectivity of anterior insula is associated with improved smoking cessation outcome. Brain Imaging Behav 2019; 14:408-415. [PMID: 31494823 DOI: 10.1007/s11682-019-00197-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Damage to the insular cortex has been shown to disrupt smoking behavior. However, whether smoking cessation outcomes are associated with abnormal functions of insula and its subregions remains unclear. In this study, we investigated the relationship between insular functions (interregional functional connectivity and regional activity) and treatment outcomes of cigarette smoking. Thirty treatment-seeking smokers were recruited into the treatment study and underwent magnetic resonance imaging (MRI) scans immediately before and after the treatment. Sixteen participants remained abstinent from smoking (quitters), while 14 relapsed to smoking (relapers). Changes in resting-state functional connectivity and fractional amplitude of low frequency fluctuation (fALFF) across groups and visits were assessed using repeated measures ANCOVA. Significant interaction effects were detected: 1) between the left anterior insula and left precuneus; and 2) between the right anterior insula and left precuneus and medial frontal gyrus. Post-hoc region-of-interest analyses in brain areas showing interaction effects indicated significantly increased functional connectivity after treatment compared with before treatment in quitters but opposite longitudinal changes in relapsers. However, no significant effects in fALFF were observed. These novel findings suggest that increased interregional functional connectivity of the anterior insula is associated with improved smoking cessation outcome: individuals with increased functional connectivity of the anterior insula during the treatment would more likely quit smoking successfully. These insular circuits may serve as therapeutic targets for more efficacious treatment of nicotine addiction.
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Affiliation(s)
- Chao Wang
- Department of Radiology, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
| | - Zhujing Shen
- Department of Radiology, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Peiyu Huang
- Department of Radiology, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Wei Qian
- Department of Radiology, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Cheng Zhou
- Department of Radiology, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Kaicheng Li
- Department of Radiology, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Qingze Zeng
- Department of Radiology, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Xiao Luo
- Department of Radiology, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Quanquan Gu
- Department of Radiology, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Hualiang Yu
- Department of Psychiatry, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yihong Yang
- Neuroimaging Research Branch, National Institute on Drug Abuse, National Institutes of Health, Baltimore, MD, USA
| | - Minming Zhang
- Department of Radiology, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
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21
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Lin F, Wu G, Zhu L, Lei H. Region-Specific Changes of Insular Cortical Thickness in Heavy Smokers. Front Hum Neurosci 2019; 13:265. [PMID: 31417384 PMCID: PMC6685069 DOI: 10.3389/fnhum.2019.00265] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Accepted: 07/16/2019] [Indexed: 11/13/2022] Open
Abstract
Insula plays an essential role in maintaining the addiction to cigarette smoking and smoking-related alterations on the insular volume and density have been reported in smokers. However, less is known about the effects of chronic cigarette smoking on the insular cortical thickness. In this study, we explored the region-specific changes of insular cortical thickness in heavy smokers and their relations with smoking-related variables. 37 heavy smokers (29 males, mean age 47.19 ± 7.22 years) and 37 non-smoking healthy controls (29 males, mean age 46.95 ± 8.45 years) participated in the study. Subregional insular cortical thickness was evaluated and compared between the two groups. Correlation analysis was performed to investigate relationships between the insular cortical thickness and clinical characteristics in heavy smokers. There was no statistical difference on the cortical thickness in the left insula (p = 0.536) between the two groups while heavy smokers had a slightly thinner cortical thickness in the right insula (p = 0.048). In addition, heavy smokers showed a greater cortical thinning in the anterior (p = 0.0084) and superior (p = 0.0054) segment of the circular sulcus of the right insula as well as the inferior (p = 0.012) segment of the circular sulcus of the left insula. Moreover, the cortical thickness of the superior segment of the circular sulcus of the left insula was correlated negatively with nicotine severity (r = −0.423; p = 0.009) and the longer cigarette exposure was associated with the cortical thinning in the long insular gyrus and central sulcus of the right insula (r = −0.475; p = 0.003). Our findings indicate that chronic cigarette use is associated with region-specific insular thinning, which has the potential to improve our understanding of the specific roles of insular subregions in nicotine addiction.
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Affiliation(s)
- Fuchun Lin
- National Center for Magnetic Resonance in Wuhan, State Key Laboratory of Magnetic Resonance and Atomic and Molecular Physics, Wuhan Institute of Physics and Mathematics, Chinese Academy of Sciences, Wuhan, China.,University of Chinese Academy of Sciences, Beijing, China
| | - Guangyao Wu
- Department of Radiology, Zhongnan Hospital, Wuhan University, Wuhan, China.,Department of Medical Imaging, Shenzhen University General Hospital, Medical College of Shenzhen University, Shenzhen, China
| | - Ling Zhu
- Department of Radiology, Zhongnan Hospital, Wuhan University, Wuhan, China
| | - Hao Lei
- National Center for Magnetic Resonance in Wuhan, State Key Laboratory of Magnetic Resonance and Atomic and Molecular Physics, Wuhan Institute of Physics and Mathematics, Chinese Academy of Sciences, Wuhan, China.,University of Chinese Academy of Sciences, Beijing, China
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22
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Ibrahim C, Rubin-Kahana DS, Pushparaj A, Musiol M, Blumberger DM, Daskalakis ZJ, Zangen A, Le Foll B. The Insula: A Brain Stimulation Target for the Treatment of Addiction. Front Pharmacol 2019; 10:720. [PMID: 31312138 PMCID: PMC6614510 DOI: 10.3389/fphar.2019.00720] [Citation(s) in RCA: 68] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Accepted: 06/05/2019] [Indexed: 12/15/2022] Open
Abstract
Substance use disorders (SUDs) are a growing public health concern with only a limited number of approved treatments. However, even approved treatments are subject to limited efficacy with high long-term relapse rates. Current treatment approaches are typically a combination of pharmacotherapies and behavioral counselling. Growing evidence and technological advances suggest the potential of brain stimulation techniques for the treatment of SUDs. There are three main brain stimulation techniques that are outlined in this review: transcranial magnetic stimulation (TMS), transcranial direct current stimulation (tDCS), and deep brain stimulation (DBS). The insula, a region of the cerebral cortex, is known to be involved in critical aspects underlying SUDs, such as interoception, decision making, anxiety, pain perception, cognition, mood, threat recognition, and conscious urges. This review focuses on both the preclinical and clinical evidence demonstrating the role of the insula in addiction, thereby demonstrating its promise as a target for brain stimulation. Future research should evaluate the optimal parameters for brain stimulation of the insula, through the use of relevant biomarkers and clinical outcomes for SUDs.
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Affiliation(s)
- Christine Ibrahim
- Translational Addiction Research Laboratory, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Pharmacology, University of Toronto, Toronto, ON, Canada
| | - Dafna S. Rubin-Kahana
- Translational Addiction Research Laboratory, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Abhiram Pushparaj
- Qunuba Sciences, Toronto, ON, Canada
- Ironstone Product Development, Toronto, ON, Canada
| | | | - Daniel M. Blumberger
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Temerty Centre for Therapeutic Brain Intervention, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Zafiris J. Daskalakis
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Temerty Centre for Therapeutic Brain Intervention, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Abraham Zangen
- Department of Life Sciences and the Zlotowski Center for Neuroscience, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Bernard Le Foll
- Translational Addiction Research Laboratory, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Pharmacology, University of Toronto, Toronto, ON, Canada
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Addictions Division, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Institute of Medical Sciences, University of Toronto, Toronto, ON, Canada
- Alcohol Research and Treatment Clinic, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
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23
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Shen Z, Huang P, Wang C, Qian W, Luo X, Gu Q, Chen H, Wang H, Yang Y, Zhang M. Interactions between monoamine oxidase A rs1137070 and smoking on brain structure and function in male smokers. Eur J Neurosci 2018; 50:2201-2210. [PMID: 30456877 DOI: 10.1111/ejn.14282] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2018] [Revised: 10/29/2018] [Accepted: 11/01/2018] [Indexed: 11/28/2022]
Abstract
The monoamine oxidase A (MAOA) enzyme metabolizes monoamine neurotransmitters such as dopamine, serotonin and norepinephrine, and its genetic polymorphism (rs1137070) influences its activity level and is associated with smoking behaviors. However, the underlying neural mechanisms of the gene × environment interactions remain largely unknown. In this study, we aimed to explore the interactive effects of the rs1137070 and cigarette smoking on gray matter volume (GMV) and functional connectivity strength (FCS). A total of 81 smokers and 42 nonsmokers were enrolled in the present study. Voxel-based morphometry analysis showed a significant rs1137070 genotype × smoking effect on the GMV of the left orbitofrontal cortex (OFC), such that individuals with risk allele had greater GMV among nonsmokers but not smokers. Meanwhile, rs1137070 variant and nicotine dependence interactively altered the FCS of the right hippocampus, the left inferior parietal lobule (IPL), the left dorsolateral prefrontal cortex and bilateral OFC. In addition, the FCS in the left IPL was correlated with smoking initiation and smoking years in smokers with the risk allele. These findings suggest that MAOA rs1137070 contributes to the susceptibility to nicotine dependence through its influence on brain circuits involved in reward and attention, and interacts with smoking in the progression.
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Affiliation(s)
- Zhujing Shen
- Department of Radiology, the Second Affiliated Hospital, Zhejiang University School of Medicine, No. 88 Jiefang Road, Hangzhou, Zhejiang, 310009, China
| | - Peiyu Huang
- Department of Radiology, the Second Affiliated Hospital, Zhejiang University School of Medicine, No. 88 Jiefang Road, Hangzhou, Zhejiang, 310009, China
| | - Chao Wang
- Department of Radiology, the Second Affiliated Hospital, Zhejiang University School of Medicine, No. 88 Jiefang Road, Hangzhou, Zhejiang, 310009, China
| | - Wei Qian
- Department of Radiology, the Second Affiliated Hospital, Zhejiang University School of Medicine, No. 88 Jiefang Road, Hangzhou, Zhejiang, 310009, China
| | - Xiao Luo
- Department of Radiology, the Second Affiliated Hospital, Zhejiang University School of Medicine, No. 88 Jiefang Road, Hangzhou, Zhejiang, 310009, China
| | - Quanquan Gu
- Department of Radiology, the Second Affiliated Hospital, Zhejiang University School of Medicine, No. 88 Jiefang Road, Hangzhou, Zhejiang, 310009, China
| | - Huan Chen
- China National Tobacco Quality Supervision & Test Center, Zhengzhou, China
| | - Hongjuan Wang
- China National Tobacco Quality Supervision & Test Center, Zhengzhou, China
| | - Yihong Yang
- Neuroimaging Research Branch, National Institute on Drug Abuse, National Institutes of Health, Baltimore, MD, USA
| | - Minming Zhang
- Department of Radiology, the Second Affiliated Hospital, Zhejiang University School of Medicine, No. 88 Jiefang Road, Hangzhou, Zhejiang, 310009, China
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24
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Graetz C, Gröger A, Luessi F, Salmen A, Zöller D, Schultz J, Siller N, Fleischer V, Bellenberg B, Berthele A, Biberacher V, Havla J, Hecker M, Hohlfeld R, Infante-Duarte C, Kirschke JS, Kümpfel T, Linker R, Paul F, Pfeuffer S, Sämann P, Toenges G, Weber F, Zettl UK, Jahn-Eimermacher A, Antony G, Groppa S, Wiendl H, Hemmer B, Mühlau M, Lukas C, Gold R, Lill CM, Zipp F. Association of smoking but not HLA-DRB1*15:01, APOE or body mass index with brain atrophy in early multiple sclerosis. Mult Scler 2018. [PMID: 29532745 DOI: 10.1177/1352458518763541] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
BACKGROUND The course of multiple sclerosis (MS) shows substantial inter-individual variability. The underlying determinants of disease severity likely involve genetic and environmental factors. OBJECTIVE The aim of this study was to assess the impact of APOE and HLA polymorphisms as well as smoking and body mass index (BMI) in the very early MS course. METHODS Untreated patients ( n = 263) with a recent diagnosis of relapsing-remitting (RR) MS or clinically isolated syndrome underwent standardized magnetic resonance imaging (MRI). Genotyping was performed for single-nucleotide polymorphisms (SNPs) rs3135388 tagging the HLA-DRB1*15:01 haplotype and rs7412 (Ɛ2) and rs429358 (Ɛ4) in APOE. Linear regression analyses were applied based on the three SNPs, smoking and BMI as exposures and MRI surrogate markers for disease severity as outcomes. RESULTS Current smoking was associated with reduced gray matter fraction, lower brain parenchymal fraction and increased cerebrospinal fluid fraction in comparison to non-smoking, whereas no effect was observed on white matter fraction. BMI and the SNPs in HLA and APOE were not associated with structural MRI parameters. CONCLUSIONS Smoking may have an unfavorable effect on the gray matter fraction as a potential measure of MS severity already in early MS. These findings may impact patients' counseling upon initial diagnosis of MS.
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Affiliation(s)
- Christiane Graetz
- Department of Neurology and Neuroimaging Center (NIC), Focus Program Translational Neuroscience (FTN), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Adriane Gröger
- Department of Neurology and Neuroimaging Center (NIC), Focus Program Translational Neuroscience (FTN), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Felix Luessi
- Department of Neurology and Neuroimaging Center (NIC), Focus Program Translational Neuroscience (FTN), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Anke Salmen
- Department of Neurology, St. Josef Hospital, Ruhr-University Bochum, Bochum, Germany; Department of Neurology, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Daniela Zöller
- Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany/Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - Janine Schultz
- Department of Neurology and Neuroimaging Center (NIC), Focus Program Translational Neuroscience (FTN), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Nelly Siller
- Department of Neurology and Neuroimaging Center (NIC), Focus Program Translational Neuroscience (FTN), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Vinzenz Fleischer
- Department of Neurology and Neuroimaging Center (NIC), Focus Program Translational Neuroscience (FTN), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Barbara Bellenberg
- Department of Radiology and Nuclear Medicine, St. Josef Hospital, Ruhr-University Bochum, Bochum, Germany
| | - Achim Berthele
- Department of Neurology, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Viola Biberacher
- Department of Neurology, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany/TUM-NIC Neuroimaging Center, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Joachim Havla
- Institute of Clinical Neuroimmunology, Biomedical Center and University Hospital, Ludwig Maximilians University, Munich, Germany
| | - Michael Hecker
- Department of Neurology, University of Rostock, Rostock, Germany
| | - Reinhard Hohlfeld
- Institute of Clinical Neuroimmunology, Biomedical Center and University Hospital, Ludwig Maximilians University, Munich, Germany/Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Carmen Infante-Duarte
- NeuroCure Clinical Research Center, Department of Neurology and Experimental and Clinical Research Center and Max Delbrück Center for Molecular Medicine, Charité-University Medicine Berlin, Berlin, Germany
| | - Jan S Kirschke
- Department of Neuroradiology, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Tania Kümpfel
- Institute of Clinical Neuroimmunology, Biomedical Center and University Hospital, Ludwig Maximilians University, Munich, Germany
| | - Ralf Linker
- Department of Neurology, University Hospital Erlangen, Erlangen, Germany
| | - Friedemann Paul
- NeuroCure Clinical Research Center, Department of Neurology and Experimental and Clinical Research Center and Max Delbrück Center for Molecular Medicine, Charité-University Medicine Berlin, Berlin, Germany
| | - Steffen Pfeuffer
- Department of Neurology, University of Münster, Münster, Germany
| | | | - Gerrit Toenges
- Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Frank Weber
- Max Planck Institute of Psychiatry, Munich, Germany; Neurological Clinic, Medical Park, Bad Camberg, Germany
| | - Uwe K Zettl
- Department of Neurology, University of Rostock, Rostock, Germany
| | - Antje Jahn-Eimermacher
- Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany/Darmstadt University of Applied Sciences, Darmstadt, Germany
| | - Gisela Antony
- Institute of Clinical Neuroimmunology, Biomedical Center and University Hospital, Ludwig Maximilians University, Munich, Germany
| | - Sergiu Groppa
- Department of Neurology and Neuroimaging Center (NIC), Focus Program Translational Neuroscience (FTN), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Heinz Wiendl
- Department of Neurology, University of Münster, Münster, Germany
| | - Bernhard Hemmer
- Department of Neurology, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany/Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Mark Mühlau
- Department of Neurology, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany/TUM-NIC Neuroimaging Center, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Carsten Lukas
- Department of Radiology and Nuclear Medicine, St. Josef Hospital, Ruhr-University Bochum, Bochum, Germany
| | - Ralf Gold
- Department of Neurology, St. Josef Hospital, Ruhr-University Bochum, Bochum, Germany
| | - Christina M Lill
- Department of Neurology and Neuroimaging Center (NIC), Focus Program Translational Neuroscience (FTN), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany/Genetic and Molecular Epidemiology Group, Institute of Neurogenetics, University of Lübeck, Lübeck, Germany
| | - Frauke Zipp
- Department of Neurology and Neuroimaging Center (NIC), Focus Program Translational Neuroscience (FTN), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
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25
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Tétreault P, Baliki MN, Baria AT, Bauer WR, Schnitzer TJ, Apkarian AV. Inferring distinct mechanisms in the absence of subjective differences: Placebo and centrally acting analgesic underlie unique brain adaptations. Hum Brain Mapp 2018; 39:2210-2223. [PMID: 29417694 DOI: 10.1002/hbm.23999] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Revised: 01/22/2018] [Accepted: 01/30/2018] [Indexed: 12/31/2022] Open
Abstract
Development and maintenance of chronic pain is associated with structural and functional brain reorganization. However, few studies have explored the impact of drug treatments on such changes. The extent to which long-term analgesia is related to brain adaptations and its effects on the reversibility of brain reorganization remain unclear. In a randomized placebo-controlled clinical trial, we contrasted pain relief (3-month treatment period), and anatomical (gray matter density [GMD], assessed by voxel-based morphometry) and functional connectivity (resting state fMRI nodal degree count [DC]) adaptations, in 39 knee osteoarthritis (OA) patients (22 females), randomized to duloxetine (DLX, 60 mg once daily) or placebo. Pain relief was equivalent between treatment types. However, distinct circuitry (GMD and DC) could explain pain relief in each group: up to 85% of variance for placebo analgesia and 49% of variance for DLX analgesia. No behavioral measures (collected at entry into the study) could independently explain observed analgesia. Identified circuitry were outside of nociceptive circuitry and minimally overlapped with OA-abnormal or placebo response predictive brain regions. Mediation analysis revealed that changes in GMD and DC can influence each other across remote brain regions to explain observed analgesia. Therefore, we can conclude that distinct brain mechanisms underlie DLX and placebo analgesia in OA. The results demonstrate that even in the absence of differences in subjective pain relief, pharmacological treatments can be differentiated from placebo based on objective brain biomarkers. This is a crucial step to untangling mechanisms and advancing personalized therapy approaches for chronic pain.
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Affiliation(s)
- Pascal Tétreault
- Department of Physiology, Feinberg School of Medicine, Chicago, Illinois, 60611
| | - Marwan N Baliki
- Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, Chicago, Illinois, 60611.,Shirley Ryan AbilityLab, Chicago, Illinois, 60611
| | - Alexis T Baria
- Department of Physiology, Feinberg School of Medicine, Chicago, Illinois, 60611
| | - William R Bauer
- Department of Neuroscience, University of Toledo, Toledo, Ohio, 43614-2598
| | - Thomas J Schnitzer
- Department of Rheumatology, Feinberg School of Medicine, Chicago, Illinois, 60611
| | - A Vania Apkarian
- Department of Physiology, Feinberg School of Medicine, Chicago, Illinois, 60611.,Anesthesiology Northwestern University, Feinberg School of Medicine, Chicago, Illinois, 60611
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26
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Wilcox CE, Calhoun VD, Rachakonda S, Claus ED, Littlewood RA, Mickey J, Arenella PB, Hutchison KE. Functional network connectivity predicts treatment outcome during treatment of nicotine use disorder. Psychiatry Res 2017; 265:45-53. [PMID: 28525877 PMCID: PMC5522183 DOI: 10.1016/j.pscychresns.2017.04.011] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2017] [Revised: 04/28/2017] [Accepted: 04/28/2017] [Indexed: 11/22/2022]
Abstract
Altered resting state functional connectivity (rsFC) and functional network connectivity (FNC), which is a measure of coherence between brain networks, may be associated with nicotine use disorder (NUD). We hypothesized that higher connectivity between insula and 1) dorsal anterior cingulate cortex (dACC) and 2) dorsolateral prefrontal cortex (dlPFC) would predict better treatment outcomes. We also performed an exploratory analysis of the associations between FNC values between additional key frontal and striatal regions and treatment outcomes. One hundred and forty four individuals with NUD underwent a resting state session during functional MRI prior to randomization to treatment with varenicline (n=82) or placebo. Group independent component analysis (ICA) was utilized to extract individual subject components and time series from intrinsic connectivity networks in aforementioned regions, and FNC between all possible pairs were calculated. Higher FNC between insula and dACC (rho=0.21) was significantly correlated with lower levels of baseline smoking quantity but did not predict treatment outcome upon controlling for baseline smoking. Higher FNC between putamen and dACC, caudate and dACC, and caudate and dlPFC significantly predicted worse treatment outcome in participants reporting high subjective withdrawal before the scan. FNC between key regions hold promise as biomarkers to predict outcome in NUD.
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Affiliation(s)
- Claire E Wilcox
- Department of Psychiatry, University of New Mexico, Albuquerque, NM, USA.
| | - Vince D Calhoun
- Department of Psychiatry, University of New Mexico, Albuquerque, NM, USA; Mind Research Network and Lovelace Biomedical and Environmental Research Institute, Albuquerque, NM, USA; Department of Electrical and Computer Engineering, University of New Mexico, Albuquerque, NM, USA
| | - Srinivas Rachakonda
- Mind Research Network and Lovelace Biomedical and Environmental Research Institute, Albuquerque, NM, USA
| | - Eric D Claus
- Mind Research Network and Lovelace Biomedical and Environmental Research Institute, Albuquerque, NM, USA
| | - Rae A Littlewood
- Mind Research Network and Lovelace Biomedical and Environmental Research Institute, Albuquerque, NM, USA
| | - Jessica Mickey
- Mind Research Network and Lovelace Biomedical and Environmental Research Institute, Albuquerque, NM, USA
| | - Pamela B Arenella
- Department of Psychiatry, University of New Mexico, Albuquerque, NM, USA
| | - Kent E Hutchison
- Mind Research Network and Lovelace Biomedical and Environmental Research Institute, Albuquerque, NM, USA; Department of Psychology, University of Colorado Boulder, Boulder, CO, USA
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27
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Zhou S, Xiao D, Peng P, Wang SK, Liu Z, Qin HY, Li SS, Wang C. Effect of smoking on resting-state functional connectivity in smokers: An fMRI study. Respirology 2017; 22:1118-1124. [PMID: 28374936 DOI: 10.1111/resp.13048] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2016] [Revised: 12/22/2016] [Accepted: 01/01/2017] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND OBJECTIVE Smoking is a leading cause of death in the world. Aberrant brain function has been repeatedly linked to tobacco smoking. However, little is known about insula-based resting-state functional connectivity (rsFC) in non-deprived tobacco-dependent smokers. This study characterized the correlation between insula-based rsFC and tobacco dependence severity in non-deprived smokers. METHODS A total of 37 male smokers and 37 age-matched male non-smokers completed resting-state functional MRI (fMRI) scans. The insula-based rsFC differences between smokers and controls were investigated and the correlation between insula-based rsFC and FTND (Fagerström Test for Nicotine Dependence) scores were then assessed. RESULTS Compared with controls, smokers showed significantly lower rsFC between orbitofrontal cortex, superior frontal gyrus, temporal lobe and insula. The rsFC between orbitofrontal cortex, temporal lobe, inferior parietal cortex, occipital lobe and insula was positively correlated with FTND. However, the rsFC between anterior cingulate cortex and insula was negatively correlated with FTND. CONCLUSION Our findings suggest differences in brain functional connectivity between smokers and non-smokers. This study sheds new insights into the neural mechanisms of tobacco dependence.
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Affiliation(s)
- Shuang Zhou
- Medical Research Center, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Dan Xiao
- National Clinical Research Center for Respiratory Diseases, Center for Respiratory Diseases, China-Japan Friendship Hospital, Beijing, China.,Tobacco Medicine and Tobacco Cessation Center, China-Japan Friendship Hospital, Beijing, China.,WHO Collaborating Centre for Tobacco Cessation and Respiratory Diseases Prevention, China-Japan Friendship Hospital, Beijing, China
| | - Peng Peng
- Department of Radiology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Shuang-Kun Wang
- Department of Radiology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Zhao Liu
- National Clinical Research Center for Respiratory Diseases, Center for Respiratory Diseases, China-Japan Friendship Hospital, Beijing, China.,Tobacco Medicine and Tobacco Cessation Center, China-Japan Friendship Hospital, Beijing, China.,WHO Collaborating Centre for Tobacco Cessation and Respiratory Diseases Prevention, China-Japan Friendship Hospital, Beijing, China
| | - Hai-Yan Qin
- Department of Respiration, Affiliated Hospital of Wei-Fang Medical University, Weifang, China
| | - Sheng-Shu Li
- Department of Respiration, Hainan Branch of the General Hospital of People's Liberation Army, Sanya, China
| | - Chen Wang
- National Clinical Research Center for Respiratory Diseases, Center for Respiratory Diseases, China-Japan Friendship Hospital, Beijing, China.,WHO Collaborating Centre for Tobacco Cessation and Respiratory Diseases Prevention, China-Japan Friendship Hospital, Beijing, China.,Department of Pulmonary and Critical Care Medicine, China-Japan Friendship Hospital, Beijing, China.,Department of Respiratory Medicine, Capital Medical University, Beijing, China.,Capital Medical University, Beijing Key Laboratory of Respiratory and Pulmonary Circulation Disorders, Beijing, China
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28
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Suckling J, Nestor LJ. The neurobiology of addiction: the perspective from magnetic resonance imaging present and future. Addiction 2017; 112:360-369. [PMID: 27452960 PMCID: PMC5244682 DOI: 10.1111/add.13474] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Revised: 11/19/2015] [Accepted: 05/20/2016] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND AIMS Addiction is associated with severe economic and social consequences and personal tragedies, the scientific exploration of which draws upon investigations at the molecular, cellular and systems levels with a wide variety of technologies. Magnetic resonance imaging (MRI) has been key to mapping effects observed at the microscopic and mesoscopic scales. The range of measurements from this apparatus has opened new avenues linking neurobiology to behaviour. This review considers the role of MRI in addiction research, and what future technological improvements might offer. METHODS A hermeneutic strategy supplemented by an expansive, systematic search of PubMed, Scopus and Web of Science databases, covering from database inception to October 2015, with a conjunction of search terms relevant to addiction and MRI. Formal meta-analyses were prioritized. RESULTS Results from methods that probe brain structure and function suggest frontostriatal circuitry disturbances within specific cognitive domains, some of which predict drug relapse and treatment response. New methods of processing imaging data are opening opportunities for understanding the role of cerebral vasculature, a global view of brain communication and the complex topology of the cortical surface and drug action. Future technological advances include increases in MRI field strength, with concomitant improvements in image quality. CONCLUSIONS The magnetic resonance imaging literature provides a limited but convergent picture of the neurobiology of addiction as global changes to brain structure and functional disturbances to frontostriatal circuitry, accompanied by changes in anterior white matter.
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Affiliation(s)
- John Suckling
- Department of Psychiatry and Behavioural and Clinical Neuroscience InstituteUniversity of CambridgeCambridgeUK,Cambridge and Peterborough Foundation NHS TrustCambridgeUK
| | - Liam J. Nestor
- Department of Psychiatry and Behavioural and Clinical Neuroscience InstituteUniversity of CambridgeCambridgeUK,Centre for Neuropsychopharmacology, Division of Brain SciencesImperial College LondonLondonUK
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29
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Fedota JR, Matous AL, Salmeron BJ, Gu H, Ross TJ, Stein EA. Insula Demonstrates a Non-Linear Response to Varying Demand for Cognitive Control and Weaker Resting Connectivity With the Executive Control Network in Smokers. Neuropsychopharmacology 2016; 41:2557-65. [PMID: 27112116 PMCID: PMC4987854 DOI: 10.1038/npp.2016.62] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Revised: 04/07/2016] [Accepted: 04/07/2016] [Indexed: 11/09/2022]
Abstract
Deficits in cognitive control processes are a primary characteristic of nicotine addiction. However, while network-based connectivity measures of dysfunction have frequently been observed, empirical evidence of task-based dysfunction in these processes has been inconsistent. Here, in a sample of smokers (n=35) and non-smokers (n=21), a previously validated parametric flanker task is employed to characterize addiction-related alterations in responses to varying (ie, high, intermediate, and low) demands for cognitive control. This approach yields a demand-response curve that aims to characterize potential non-linear responses to increased demand for control, including insensitivities or lags in fully activating the cognitive control network. We further used task-based differences in activation between groups as seeds for resting-state analysis of network dysfunction in an effort to more closely link prior inconsistencies in task-related activation with evidence of impaired network connectivity in smokers. For both smokers and non-smokers, neuroimaging results showed similar increases in activation in brain areas associated with cognitive control. However, reduced activation in right insula was seen only in smokers and only when processing intermediate demand for cognitive control. Further, in smokers, this task-modulated right insula showed weaker functional connectivity with the superior frontal gyrus, a component of the task-positive executive control network. These results demonstrate that the neural instantiation of salience attribution in smokers is both more effortful to fully activate and has more difficulty communicating with the exogenous, task-positive, executive control network. Together, these findings further articulate the cognitive control dysfunction associated with smoking and illustrate a specific brain circuit potentially responsible.
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Affiliation(s)
- John R Fedota
- Neuroimaging Research Branch, National Institute on Drug Abuse, Intramural Research Program, National Institutes of Health, Baltimore, MD, USA,Neuroimaging Research Branch, National Institute on Drug Abuse, Intramural Research Program, National Institutes of Health, 251 Bayview Boulevard, Baltimore, MD 21224, USA, Tel: +1 443 740 2782, Fax: +1 443 740 2753, E-mail:
| | - Allison L Matous
- Neuroimaging Research Branch, National Institute on Drug Abuse, Intramural Research Program, National Institutes of Health, Baltimore, MD, USA
| | - Betty Jo Salmeron
- Neuroimaging Research Branch, National Institute on Drug Abuse, Intramural Research Program, National Institutes of Health, Baltimore, MD, USA
| | - Hong Gu
- Neuroimaging Research Branch, National Institute on Drug Abuse, Intramural Research Program, National Institutes of Health, Baltimore, MD, USA
| | - Thomas J Ross
- Neuroimaging Research Branch, National Institute on Drug Abuse, Intramural Research Program, National Institutes of Health, Baltimore, MD, USA
| | - Elliot A Stein
- Neuroimaging Research Branch, National Institute on Drug Abuse, Intramural Research Program, National Institutes of Health, Baltimore, MD, USA
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30
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Li Y, Yuan K, Guan Y, Cheng J, Bi Y, Shi S, Xue T, Lu X, Qin W, Yu D, Tian J. The implication of salience network abnormalities in young male adult smokers. Brain Imaging Behav 2016; 11:943-953. [DOI: 10.1007/s11682-016-9568-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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31
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Hyper-resting brain entropy within chronic smokers and its moderation by Sex. Sci Rep 2016; 6:29435. [PMID: 27377552 PMCID: PMC4932513 DOI: 10.1038/srep29435] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Accepted: 06/17/2016] [Indexed: 01/29/2023] Open
Abstract
Cigarette smoking is a chronic relapsing brain disorder, and remains a premier cause of morbidity and mortality. Functional neuroimaging has been used to assess differences in the mean strength of brain activity in smokers’ brains, however less is known about the temporal dynamics within smokers’ brains. Temporal dynamics is a key feature of a dynamic system such as the brain, and may carry information critical to understanding the brain mechanisms underlying cigarette smoking. We measured the temporal dynamics of brain activity using brain entropy (BEN) mapping and compared BEN between chronic non-deprived smokers and non-smoking controls. Because of the known sex differences in neural and behavioral smoking characteristics, comparisons were also made between males and females. Associations between BEN and smoking related clinical measures were assessed in smokers. Our data showed globally higher BEN in chronic smokers compared to controls. The escalated BEN was associated with more years of smoking in the right limbic area and frontal region. Female nonsmokers showed higher BEN than male nonsmokers in prefrontal cortex, insula, and precuneus, but the BEN sex difference in smokers was less pronounced. These findings suggest that BEN mapping may provide a useful tool for probing brain mechanisms related to smoking.
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Sutherland MT, Riedel MC, Flannery JS, Yanes JA, Fox PT, Stein EA, Laird AR. Chronic cigarette smoking is linked with structural alterations in brain regions showing acute nicotinic drug-induced functional modulations. Behav Brain Funct 2016; 12:16. [PMID: 27251183 PMCID: PMC4890474 DOI: 10.1186/s12993-016-0100-5] [Citation(s) in RCA: 76] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Accepted: 05/14/2016] [Indexed: 12/21/2022] Open
Abstract
Background Whereas acute nicotine administration alters brain function which may, in turn, contribute to enhanced attention and performance, chronic cigarette smoking is linked with regional brain atrophy and poorer cognition. However, results from structural magnetic resonance imaging (MRI) studies comparing smokers versus nonsmokers have been inconsistent and measures of gray matter possess limited ability to inform functional relations or behavioral implications. The purpose of this study was to address these interpretational challenges through meta-analytic techniques in the service of clarifying the impact of chronic smoking on gray matter integrity and more fully contextualizing such structural alterations. Methods We first conducted a coordinate-based meta-analysis of structural MRI studies to identify consistent structural alterations associated with chronic smoking. Subsequently, we conducted two additional meta-analytic assessments to enhance insight into potential functional and behavioral relations. Specifically, we performed a multimodal meta-analytic assessment to test the structural–functional hypothesis that smoking-related structural alterations overlapped those same regions showing acute nicotinic drug-induced functional modulations. Finally, we employed database driven tools to identify pairs of structurally impacted regions that were also functionally related via meta-analytic connectivity modeling, and then delineated behavioral phenomena associated with such functional interactions via behavioral decoding. Results Across studies, smoking was associated with convergent structural decreases in the left insula, right cerebellum, parahippocampus, multiple prefrontal cortex (PFC) regions, and the thalamus. Indicating a structural–functional relation, we observed that smoking-related gray matter decreases overlapped with the acute functional effects of nicotinic agonist administration in the left insula, ventromedial PFC, and mediodorsal thalamus. Suggesting structural-behavioral implications, we observed that the left insula’s task-based, functional interactions with multiple other structurally impacted regions were linked with pain perception, the right cerebellum’s interactions with other regions were associated with overt body movements, interactions between the parahippocampus and thalamus were linked with memory processes, and interactions between medial PFC regions were associated with face processing. Conclusions Collectively, these findings emphasize brain regions (e.g., ventromedial PFC, insula, thalamus) critically linked with cigarette smoking, suggest neuroimaging paradigms warranting additional consideration among smokers (e.g., pain processing), and highlight regions in need of further elucidation in addiction (e.g., cerebellum). Electronic supplementary material The online version of this article (doi:10.1186/s12993-016-0100-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Matthew T Sutherland
- Department of Psychology, Florida International University, AHC-4, RM 312, 11200 S.W. 8th St, Miami, FL, 33199, USA.
| | - Michael C Riedel
- Department of Psychology, Florida International University, AHC-4, RM 312, 11200 S.W. 8th St, Miami, FL, 33199, USA.,Department of Physics, Florida International University, Miami, FL, USA
| | - Jessica S Flannery
- Department of Psychology, Florida International University, AHC-4, RM 312, 11200 S.W. 8th St, Miami, FL, 33199, USA
| | - Julio A Yanes
- Department of Psychology, Auburn University, Auburn, AL, USA
| | - Peter T Fox
- Research Imaging Institute, University of Texas Health Science Center, San Antonio, TX, USA.,South Texas Veterans Health Care System, San Antonio, TX, USA.,State Key Laboratory for Brain and Cognitive Sciences, University of Hong Kong, Hong Kong, China
| | - Elliot A Stein
- Neuroimaging Research Branch, National Institute on Drug Abuse, Intramural Research Program, NIH/DHHS, Baltimore, MD, USA
| | - Angela R Laird
- Department of Physics, Florida International University, Miami, FL, USA
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Altered resting state functional connectivity of anterior insula in young smokers. Brain Imaging Behav 2016; 11:155-165. [DOI: 10.1007/s11682-016-9511-z] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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