1
|
Deshpande HU, Fedota JR, Castillo J, Salmeron BJ, Ross TJ, Stein EA. Not all smokers are alike: the hidden cost of sustained attention during nicotine abstinence. Neuropsychopharmacology 2022; 47:1633-1642. [PMID: 35091674 PMCID: PMC9283548 DOI: 10.1038/s41386-022-01275-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 01/11/2022] [Indexed: 11/13/2022]
Abstract
Nicotine Withdrawal Syndrome (NWS)-associated cognitive deficits are notably heterogeneous, suggesting underlying endophenotypic variance. However, parsing this variance in smokers has remained challenging. In this study, we identified smoker subgroups based on response accuracy during a Parametric Flanker Task (PFT) and then characterized distinct neuroimaging endophenotypes using a nicotine state manipulation. Smokers completed the PFT in two fMRI sessions (nicotine sated, abstinent). Based on response accuracy in the stressful, high cognitive demand PFT condition, smokers split into high (HTP, n = 21) and low task performer (LTP, n = 24) subgroups. Behaviorally, HTPs showed greater response accuracy (88.68% ± 5.19 SD) vs. LTPs (51.04% ± 4.72 SD), independent of nicotine state, and greater vulnerability to abstinence-induced errors of omission (EOm, p = 0.01). Neurobiologically, HTPs showed greater BOLD responses in attentional control brain regions, including bilateral insula, dorsal ACC, and frontoparietal Cx for the [correct responses (-) errors of commission] PFT contrast in both states. A whole-brain functional connectivity (FC) analysis with these subgroup-derived regions as seeds identified two circuits: Precentral Cx↔Insula and Insula↔Occipital Cx, with abstinence-induced FC strength increases seen only in HTPs. Finally, abstinence-induced FC and behavior (EOm) differences were positively correlated for HTPs in a Precentral Cx↔Orbitofrontal cortical circuit. In sum, only the HTP subgroup demonstrated sustained attention deficits following 48-hr nicotine abstinence, a stressor in dependent smokers. Unpacking underlying smoker heterogeneity with this 'dual (task and abstinence) stressor' approach revealed discrete smoker subgroups with differential attentional deficits to withdrawal that could be novel pharmacological/behavioral targets for therapeutic interventions to improve cessation outcomes.
Collapse
Affiliation(s)
- Harshawardhan U. Deshpande
- grid.420090.f0000 0004 0533 7147Neuroimaging Research Branch, National Institute on Drug Abuse-Intramural Research Program, National Institutes of Health, Baltimore, MD USA
| | - John R. Fedota
- grid.420090.f0000 0004 0533 7147Neuroimaging Research Branch, National Institute on Drug Abuse-Intramural Research Program, National Institutes of Health, Baltimore, MD USA ,grid.420090.f0000 0004 0533 7147Present Address: Behavioral and Cognitive Neuroscience Branch, Division of Neuroscience Behavior, National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD USA
| | - Juan Castillo
- grid.38142.3c000000041936754XDepartment of Psychology, Harvard University, Cambridge, MA USA
| | - Betty Jo Salmeron
- grid.420090.f0000 0004 0533 7147Neuroimaging Research Branch, National Institute on Drug Abuse-Intramural Research Program, National Institutes of Health, Baltimore, MD USA
| | - Thomas J. Ross
- grid.420090.f0000 0004 0533 7147Neuroimaging Research Branch, National Institute on Drug Abuse-Intramural Research Program, National Institutes of Health, Baltimore, MD USA
| | - Elliot A. Stein
- grid.420090.f0000 0004 0533 7147Neuroimaging Research Branch, National Institute on Drug Abuse-Intramural Research Program, National Institutes of Health, Baltimore, MD USA
| |
Collapse
|
2
|
Panlilio LV, Stull SW, Bertz JW, Burgess-Hull AJ, Lanza ST, Curtis BL, Phillips KA, Epstein DH, Preston KL. Beyond abstinence and relapse II: momentary relationships between stress, craving, and lapse within clusters of patients with similar patterns of drug use. Psychopharmacology (Berl) 2021; 238:1513-1529. [PMID: 33558983 PMCID: PMC8141007 DOI: 10.1007/s00213-021-05782-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Accepted: 01/28/2021] [Indexed: 11/25/2022]
Abstract
RATIONALE Given that many patients being treated for opioid-use disorder continue to use drugs, identifying clusters of patients who share similar patterns of use might provide insight into the disorder, the processes that affect it, and ways that treatment can be personalized. OBJECTIVES AND METHODS We applied hierarchical clustering to identify patterns of opioid and cocaine use in 309 participants being treated with methadone or buprenorphine (in a buprenorphine-naloxone formulation) for up to 16 weeks. A smartphone app was used to assess stress and craving at three random times per day over the course of the study. RESULTS Five basic patterns of use were identified: frequent opioid use, frequent cocaine use, frequent dual use (opioids and cocaine), sporadic use, and infrequent use. These patterns were differentially associated with medication (methadone vs. buprenorphine), race, age, drug-use history, drug-related problems prior to the study, stress-coping strategies, specific triggers of use events, and levels of cue exposure, craving, and negative mood. Craving tended to increase before use in all except those who used sporadically. Craving was sharply higher during the 90 min following moderate-to-severe stress in those with frequent use, but only moderately higher in those with infrequent or sporadic use. CONCLUSIONS People who share similar patterns of drug-use during treatment also tend to share similarities with respect to psychological processes that surround instances of use, such as stress-induced craving. Cluster analysis combined with smartphone-based experience sampling provides an effective strategy for studying how drug use is related to personal and environmental factors.
Collapse
Affiliation(s)
- Leigh V Panlilio
- Intramural Research Program, National Institute on Drug Abuse, 251 Bayview Blvd., Suite 200, Baltimore, MD, 21224, USA.
| | - Samuel W Stull
- Intramural Research Program, National Institute on Drug Abuse, 251 Bayview Blvd., Suite 200, Baltimore, MD, 21224, USA
- Department of Biobehavioral Health, The Pennsylvania State University, State College, PA, USA
| | - Jeremiah W Bertz
- Intramural Research Program, National Institute on Drug Abuse, 251 Bayview Blvd., Suite 200, Baltimore, MD, 21224, USA
| | - Albert J Burgess-Hull
- Intramural Research Program, National Institute on Drug Abuse, 251 Bayview Blvd., Suite 200, Baltimore, MD, 21224, USA
| | - Stephanie T Lanza
- Department of Biobehavioral Health, The Pennsylvania State University, State College, PA, USA
| | - Brenda L Curtis
- Intramural Research Program, National Institute on Drug Abuse, 251 Bayview Blvd., Suite 200, Baltimore, MD, 21224, USA
| | - Karran A Phillips
- Intramural Research Program, National Institute on Drug Abuse, 251 Bayview Blvd., Suite 200, Baltimore, MD, 21224, USA
| | - David H Epstein
- Intramural Research Program, National Institute on Drug Abuse, 251 Bayview Blvd., Suite 200, Baltimore, MD, 21224, USA
| | - Kenzie L Preston
- Intramural Research Program, National Institute on Drug Abuse, 251 Bayview Blvd., Suite 200, Baltimore, MD, 21224, USA
| |
Collapse
|
3
|
Gießing C, Ahrens S, Thiel CM. Healthy Subjects With Extreme Patterns of Performance Differ in Functional Network Topology and Benefits From Nicotine. Front Syst Neurosci 2020; 13:83. [PMID: 31998085 PMCID: PMC6965056 DOI: 10.3389/fnsys.2019.00083] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Accepted: 12/16/2019] [Indexed: 11/13/2022] Open
Abstract
Do subjects with atypical patterns in attentional and executive behaviour show different brain network topology and react differently towards nicotine administration? The efficacy of pro-cognitive drugs like nicotine considerably varies between subjects and previous theoretical and empirical evidence suggest stronger behavioural nicotine effects in subjects with low performance. One problem is, however, how to best define low performance, especially if several cognitive functions are assessed for subject characterisation. We here present a method that used a multivariate, robust outlier detection algorithm to identify subjects with suspicious patterns of performance in attentional and executive functioning. In contrast to univariate approaches, this method is sensitive towards extreme positions within the multidimensional space that do not have to be extreme values in the individual behavioural distributions. The method was applied to a dataset of healthy, non-smoking subjects (n = 34) who were behaviorally characterised by an attention and executive function test on which N = 12 volunteers were classified as outliers. All subjects then underwent a resting-state functional magnetic resonance imaging (fMRI) scan to characterise brain network topology and an experimental behavioural paradigm under placebo and nicotine (7 mg patch) that gauged aspects of attention and executive function. Our results indicate that subjects with an atypical multivariate pattern in attention and executive functioning showed significant differences in nodal brain network integration in visual association and pre-motor brain regions during resting state. These differences in brain network topology significantly predicted larger individual nicotine effects on attentional processing. In summary, the current approach successfully identified a subgroup of healthy volunteers with low behavioural performance who differ in brain network topology and attentional benefit from nicotine.
Collapse
Affiliation(s)
- Carsten Gießing
- Biological Psychology, Department of Psychology, School of Medicine and Health Sciences, Carl-von-Ossietzky Universität Oldenburg, Oldenburg, Germany
- Research Center Neurosensory Science, Carl-von-Ossietzky Universität Oldenburg, Oldenburg, Germany
| | - Stefan Ahrens
- Biological Psychology, Department of Psychology, School of Medicine and Health Sciences, Carl-von-Ossietzky Universität Oldenburg, Oldenburg, Germany
| | - Christiane M. Thiel
- Biological Psychology, Department of Psychology, School of Medicine and Health Sciences, Carl-von-Ossietzky Universität Oldenburg, Oldenburg, Germany
- Research Center Neurosensory Science, Carl-von-Ossietzky Universität Oldenburg, Oldenburg, Germany
- Cluster of Excellence “Hearing4all”, Carl-von-Ossietzky Universität Oldenburg, Oldenburg, Germany
| |
Collapse
|
4
|
Durazzo TC, Meyerhoff DJ, Yoder KK. Cigarette smoking is associated with cortical thinning in anterior frontal regions, insula and regions showing atrophy in early Alzheimer's Disease. Drug Alcohol Depend 2018; 192:277-284. [PMID: 30300802 PMCID: PMC6602071 DOI: 10.1016/j.drugalcdep.2018.08.009] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Revised: 07/17/2018] [Accepted: 08/13/2018] [Indexed: 12/23/2022]
Abstract
BACKGROUND Magnetic resonance imaging studies of cigarette smoking-related effects on human brain structure primarily focused on cortical volumes. Much less is known about the effects of smoking on cortical thickness. Smokers and Non-smokers were compared on regional cortical thickness. We predicted smokers would demonstrate greater age-related thinning localized to anterior frontal regions that serve as nodes for the executive, salience, and emotional regulation networks (ESER regions) and those demonstrating significant atrophy in early Alzheimer's Disease (AD regions). METHODS Non-smokers (n = 41) and smokers (n = 41), 22-70 years of age, completed a 4 T MRI study. Regional cortical thickness was quantitated via FreeSurfer. In smokers, associations between smoking severity, decision-making, impulsivity, and regional cortical thickness were examined. RESULTS Smokers demonstrated cortical thinning in the medial and lateral OFC, insula, entorhinal, fusiform, middle temporal, and Composite AD regions. In Smokers, greater pack-years were associated with thinner lateral OFC, middle temporal, inferior parietal, fusiform, precuneus, and Composite AD regions. In Smokers, poorer decision-making/greater risk taking was related to thinner cortices in caudal ACC, rostral middle frontal and superior frontal gyri, and Composite ESER. Higher self-reported impulsivity was associated with thinner rostral and caudal ACC. CONCLUSIONS This study provides additional evidence that cigarette smoking is associated with thinner cortices in regions implicated in the development and maintenance of substance use disorders and in regions demonstrating significant atrophy in early AD. The novel structure-function relationships in Smokers further our understanding of the neurobiological substrates potentially underlying the neuropsychological abnormalities documented in smokers.
Collapse
Affiliation(s)
- Timothy C Durazzo
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Rd., Stanford, CA 94305, USA; Mental Illness Research and Education Clinical Centers and Sierra-Pacific, War Related Illness and Injury Study Center, VA Palo Alto Health Care System, 301 Miranda Ave., Palo Alto, CA 94304, USA.
| | - Dieter J Meyerhoff
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, 505 Parnassus Ave, San Francisco, CA 94143, USA; Center for Imaging of Neurodegenerative Diseases, San Francisco VA Medical Center, 4150 Clement St., 114M, San Francisco, CA 94121, USA
| | - Karmen K Yoder
- Indiana University Center for Neuroimaging, Department of Radiology and Imaging Sciences, Indiana University School of Medicine, 550 N. University Blvd., Indianapolis, IN 46202, USA
| |
Collapse
|