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Rakesh G, Adams TG, Morey RA, Alcorn JL, Khanal R, Su AE, Himelhoch SS, Rush CR. Intermittent theta burst stimulation and functional connectivity in people living with HIV/AIDS who smoke tobacco cigarettes: a preliminary pilot study. Front Psychiatry 2024; 15:1315854. [PMID: 38501083 PMCID: PMC10945607 DOI: 10.3389/fpsyt.2024.1315854] [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: 10/10/2023] [Accepted: 01/30/2024] [Indexed: 03/20/2024] Open
Abstract
Background People living with HIV (PLWHA) smoke at three times the rate of the general population and respond poorly to cessation strategies. Previous studies examined repetitive transcranial magnetic stimulation (rTMS) over left dorsolateral prefrontal cortex (L. dlPFC) to reduce craving, but no studies have explored rTMS among PLWHA who smoke. The current pilot study compared the effects of active and sham intermittent theta-burst stimulation (iTBS) on resting state functional connectivity (rsFC), cigarette cue attentional bias, and cigarette craving in PLWHA who smoke. Methods Eight PLWHA were recruited (single-blind, within-subject design) to receive one session of iTBS (n=8) over the L. dlPFC using neuronavigation and, four weeks later, sham iTBS (n=5). Cigarette craving and attentional bias assessments were completed before and after both iTBS and sham iTBS. rsFC was assessed before iTBS (baseline) and after iTBS and sham iTBS. Results Compared to sham iTBS, iTBS enhanced rsFC between the L. dlPFC and bilateral medial prefrontal cortex and pons. iTBS also enhanced rsFC between the right insula and right occipital cortex compared to sham iTBS. iTBS also decreased cigarette craving and cigarette cue attentional bias. Conclusion iTBS could potentially offer a therapeutic option for smoking cessation in PLWHA.
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Affiliation(s)
- Gopalkumar Rakesh
- Department of Psychiatry, College of Medicine, University of Kentucky, Lexington, KY, United States
| | - Thomas G. Adams
- Department of Psychology, College of Arts & Sciences, University of Kentucky, Lexington, KY, United States
| | - Rajendra A. Morey
- Brain Imaging and Analyses Center (BIAC), Duke University Medical Center, Durham, NC, United States
| | - Joseph L. Alcorn
- Department of Behavioral Sciences, College of Medicine, University of Kentucky, Lexington, KY, United States
| | - Rebika Khanal
- Department of Psychiatry, College of Medicine, University of Kentucky, Lexington, KY, United States
| | - Amanda E. Su
- Department of Psychiatry, University of Texas Southwestern Medical School, Dallas, TX, United States
| | - Seth S. Himelhoch
- Department of Psychiatry, College of Medicine, University of Kentucky, Lexington, KY, United States
| | - Craig R. Rush
- Department of Behavioral Sciences, College of Medicine, University of Kentucky, Lexington, KY, United States
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Siegel SD, Tindle HA, Bergen AW, Tyndale RF, Schnoll R. The Use of Biomarkers to Guide Precision Treatment for Tobacco Use. ADDICTION NEUROSCIENCE 2023; 6. [PMID: 37089247 PMCID: PMC10121195 DOI: 10.1016/j.addicn.2023.100076] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
This review summarizes the evidence to date on the development of biomarkers for personalizing the pharmacological treatment of combustible tobacco use. First, the latest evidence on FDA-approved medications is considered, demonstrating that, while these medications offer real benefits, they do not contribute to smoking cessation in approximately two-thirds of cases. Second, the case for using biomarkers to guide tobacco treatment is made based on the potential to increase medication effectiveness and uptake and reduce side effects. Next, the FDA framework of biomarker development is presented along with the state of science on biomarkers for tobacco treatment, including a review of the nicotine metabolite ratio, electroencephalographic event-related potentials, and other biomarkers utilized for risk feedback. We conclude with a discussion of the challenges and opportunities for the translation of biomarkers to guide tobacco treatment and propose priorities for future research.
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Cui Y, Robinson JD, Rymer RE, Minnix JA, Cinciripini PM. You Don't Need an App-Conducting Mobile Smoking Research Using a Qualtrics-Based Approach. Front Digit Health 2022; 3:799468. [PMID: 35072151 PMCID: PMC8770325 DOI: 10.3389/fdgth.2021.799468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 12/14/2021] [Indexed: 12/05/2022] Open
Abstract
With the increasing availability of smartphones, many tobacco researchers are exploring smartphone-delivered mobile smoking interventions as a disseminable means of treatment. Most effort has been focused on the development of smartphone applications (apps) to conduct mobile smoking research to implement and validate these interventions. However, developing project-specific smartphone apps that work across multiple mobile platforms (e.g., iOS and Android) can be costly and time-consuming. Here, using a hypothetical study, we present an alternate approach to demonstrate how mobile smoking cessation and outcome evaluation can be conducted without the need of a dedicated app. Our approach uses the Qualtrics platform, a popular online survey host that is used under license by many academic institutions. This platform allows researchers to conduct device-agnostic screening, consenting, and administration of questionnaires through Qualtrics's native survey engine. Researchers can also collect ecological momentary assessment data using text messaging prompts with the incorporation of Amazon Web Services' Pinpoint. Besides these assessment capabilities, Qualtrics has the potential for delivering personalized behavioral interventions through the use of JavaScript code. By customizing the question's web elements in Qualtrics (e.g., using texts, images, videos, and buttons), researchers can integrate interactive web-based interventions and complicated behavioral and cognitive tasks into the survey. In conclusion, this Qualtrics-based methodology represents a novel and cost-effective approach for conducting mobile smoking cessation and assessment research.
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Affiliation(s)
- Yong Cui
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
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Attentional bias towards cannabis cues in cannabis users: A systematic review and meta-analysis. Drug Alcohol Depend 2020; 206:107719. [PMID: 31753732 DOI: 10.1016/j.drugalcdep.2019.107719] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Revised: 10/28/2019] [Accepted: 10/31/2019] [Indexed: 12/24/2022]
Abstract
INTRODUCTION Attentional bias, the automatic selective attentional orientation towards drug-related stimuli is well demonstrated in substance users. However, attentional bias studies of cannabis users specifically have thus far been inconclusive. Thus, the aim of this systematic review and meta-analysis was to synthesize the currently available literature regarding cannabis related attentional bias in cannabis users. METHODS Literature search and selection was carried out, following the PRISMA guidelines, with all included studies investigating the relationship between cannabis use and attentional bias towards cannabis cues. RESULTS Fourteen manuscripts, reporting on 1271 participants (cannabis users n = 1044; controls n = 217), were considered for the systematic-review and majority were included in a meta-analysis. Studies reviewed used three types of attentional bias tasks: pictorial stimuli, word stimuli, and non-cannabis stimuli tasks. Greater attentional bias towards cannabis pictures (d = 0.42, P < 0.0001) and words (d = 0.63, P = 0.03) as well as both types of stimuli overall (d = 0.53, P < 0.0001) was observed in cannabis users compared to controls, though there was evidence of significant heterogeneity for both word stimuli and overall meta-analysis. Bigger effect sizes were associated with shorter durations of exposure to cannabis stimuli suggesting mainly automatic orientating rather than controlled attention processing. CONCLUSIONS These findings suggest that cannabis users display greater attentional bias towards cannabis cues, likely an automatic process, than control groups. Future studies employing shorter exposure durations may validate attentional bias as a treatment target for the development of interventions in people with cannabis use disorder.
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Galindo MN, Navarro JF, Cavas M. The Influence of Placebo Effect on Craving and Cognitive Performance in Alcohol, Caffeine, or Nicotine Consumers: A Systematic Review. Front Psychiatry 2020; 11:849. [PMID: 33005155 PMCID: PMC7479236 DOI: 10.3389/fpsyt.2020.00849] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 08/04/2020] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE The present systematic review aims to analyze the evidence about the influence of placebo effect on craving and cognitive performance in alcohol, caffeine, and nicotine consumers. METHODS Relevant studies were identified via Pubmed, Web of Science, and Scopus databases (up to March 2020). Only those papers published between 2009 and 2019 were searched. RESULTS Of the 115 preliminary papers, 8 studies of database search and 9 of the manual search were finally included in this review. Findings showed that while alcohol expectancies increased craving, caffeine and nicotine expectancies tend to decrease it. Alcohol expectancies caused similar or slower reaction time when alcohol was not consumed, impairments on inhibitory control (especially after alcohol consumption) and similar post-error slowing. The effect of caffeine and nicotine on reaction time has not been elucidated yet, however, caffeine expectancies have been shown to improve accuracy and the attentional filtering of distracting stimuli. CONCLUSIONS Alcohol, caffeine, and nicotine expectancies play an important role on craving. Although expectancies produce an effect on cognitive performance, caffeine and nicotine beliefs show an ambiguous impact on reaction time. Only the influence of alcohol expectancies on reaction time has been clarified. Furthermore, caffeine beliefs enhance accuracy.
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Affiliation(s)
- MarÃa Nerea Galindo
- Department of Psychobiology, School of Psychology, University of Málaga, Málaga, Spain
| | | | - MarÃa Cavas
- Department of Psychobiology, School of Psychology, University of Málaga, Málaga, Spain
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Cui Y, Engelmann JM, Gilbert DG, Waters AJ, Cinciripini PM, Robinson JD. The impact of nicotine dose and instructed dose on smokers' implicit attitudes to smoking cues: An ERP study. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2019; 33:710-720. [PMID: 31657594 DOI: 10.1037/adb0000523] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
It is unclear whether nicotine and perceived nicotine exposure can influence automatic evaluations of cigarette stimuli. In the present study, we investigated the effects of nicotine dose and instructed dose on motivational responses to smoking cues. Forty overnight nicotine-deprived smokers completed an Implicit Association Test (IAT) at each of the four laboratory sessions in a balanced-placebo design that crossed nicotine dose (Given-NIC [given nicotine] vs. Given-DENIC [given denicotinized]) with instructed dose expectancy (Told-NIC [told-nicotine] vs. Told-DENIC. [told-denicotinized]). We measured participants' behavioral performance, including reaction time (RT) and accuracy rate, and the early posterior negativity (EPN) component using the event-related potential (ERP) technique to the target pictures. During congruent trials when the categorization condition was smoking or unpleasant, smokers had greater classification accuracy, shorter RT latency, and greater EPN amplitudes compared to the incongruent trials when the categorization condition was smoking or pleasant. The Given-NIC condition was associated with increased classification accuracy, longer RT latency, and decreased EPN amplitudes compared to the Given-DENIC condition. Similarly, the Told-NIC condition was associated with increased accuracy and decreased EPN amplitudes compared to the Told-DENIC condition, but with shorter RT latency. Cigarette-related pictures produced greater EPN amplitudes than neutral pictures. Both behavioral and ERP results suggest that smokers have negative implicit attitudes toward smoking. While both nicotine dose and expected dose facilitated stimulus categorization, there was no evidence that either factor altered smokers' negative attitudes toward smoking cues. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Affiliation(s)
- Yong Cui
- Department of Behavioral Science
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Mashhoon Y, Betts J, Farmer SL, Lukas SE. Early onset cigarette smokers exhibit greater P300 reactivity to smoking-related stimuli and report greater craving. Brain Res 2018. [PMID: 29524436 DOI: 10.1016/j.brainres.2018.02.037] [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: 12/26/2022]
Abstract
Adolescence is a period during which a number of critical neuromaturation processes occur and the vulnerability for developing nicotine dependence is extremely high. Thus, early-onset (EO; age < 16 years old), relative to late-onset (LO; age ≥ 16 years old), tobacco smoking may be uniquely deleterious for developmentally immature systems that regulate neural signaling reactivity. This study investigated how age of tobacco smoking onset affects neurophysiological measures of smoking cue reactivity and reported craving in adult smokers. EO smokers (EOS; n = 8; 4 females), LO smokers (LOS; n = 10; 5 females), and healthy non-smokers (HNS; n = 10; 5 females) participated in an event-related potential (ERP) cue reactivity study with tactile and image stimuli. Participants handled neutral objects during one interval and smoking-related objects during a second interval. After each interval, they viewed smoking-related, neutral, or arousing images using an oddball paradigm. P300 ERPs and craving for tobacco were recorded during each session. P300 amplitudes were significantly higher in central midline (Cz) channel to smoking, but not neutral or arousing, images after handling smoking objects. Specifically, Cz P300 smoking amplitudes were significantly greater in EOS, relative to LOS and HNS, and associated with greater craving at baseline. There were no other group differences in mood or craving. EOS exhibited greater P300 reactivity to smoking-related stimuli, relative to LOS, suggesting a more sensitized neural response. EO smoking during early neuromaturation may alter neurophysiological signaling involved in responding to smoking-related stimuli, which could impact the outcome of smoking cessation interventions.
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Affiliation(s)
- Yasmin Mashhoon
- Behavioral Psychopharmacology Research Laboratory, McLean Hospital, Belmont, MA, USA; McLean Imaging Center, McLean Hospital, Belmont, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA.
| | - Jennifer Betts
- Behavioral Psychopharmacology Research Laboratory, McLean Hospital, Belmont, MA, USA; McLean Imaging Center, McLean Hospital, Belmont, MA, USA
| | - Stacey L Farmer
- Behavioral Psychopharmacology Research Laboratory, McLean Hospital, Belmont, MA, USA; McLean Imaging Center, McLean Hospital, Belmont, MA, USA
| | - Scott E Lukas
- Behavioral Psychopharmacology Research Laboratory, McLean Hospital, Belmont, MA, USA; McLean Imaging Center, McLean Hospital, Belmont, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA
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Cigarette cues capture attention of smokers and never-smokers, but for different reasons. Drug Alcohol Depend 2018; 185:50-57. [PMID: 29427915 PMCID: PMC5889726 DOI: 10.1016/j.drugalcdep.2017.12.010] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Revised: 12/06/2017] [Accepted: 12/20/2017] [Indexed: 01/22/2023]
Abstract
BACKGROUND While the notion that smokers reliably show higher reactivity to cigarette-related versus neutral cues is both theoretically and empirically supported, it is unclear why never-smokers also show enhanced brain responses to cigarette-related cues. METHODS Using a repetitive picture viewing paradigm, in which responses evoked by affective cues are more resistant to habituation, we assessed the effects of stimulus repetition on event-related potentials (ERPs) evoked by pleasant, unpleasant, cigarette-related, and neutral images in 34 smokers (SMO) and 34 never-smokers (NEV). We examined the early posterior negativity (EPN) and the late positive potential (LPP), two ERP components which are sensitive to a picture's motivational qualities. RESULTS Before stimulus repetition, pleasant, unpleasant, and cigarette-related cues produced greater EPN and LPP amplitudes than neutral cues in all subjects. During stimulus repetition, both components were similarly modulated by emotional arousal, such that pleasant, unpleasant, and cigarette-related cues evoked greater EPN and LPP amplitude, relative to neutral. Smoking status did not modulate these effects. While there were no group differences in self-reported stimulus ratings of valence for pleasant, unpleasant, or neutral stimuli, NEV rated cigarette-related cues as unpleasant. We observed a moderate, negative correlation between LPP amplitude and self-reported valence ratings of cigarette-related cues among NEV. CONCLUSIONS These data suggest that cigarette-related cues capture attentional resources of both SMO and NEV, but for different reasons. For SMO, cigarette-related cues have acquired motivational significance through repeated associations with nicotine delivery, whereas for NEV, cigarette-related cues are perceived as unpleasant.
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Manglani HR, Lewis AH, Wilson SJ, Delgado MR. Pavlovian-to-Instrumental Transfer of Nicotine and Food Cues in Deprived Cigarette Smokers. Nicotine Tob Res 2017; 19:670-676. [PMID: 28486716 DOI: 10.1093/ntr/ntx007] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2016] [Accepted: 01/06/2017] [Indexed: 11/14/2022]
Abstract
Introduction Smoking-related cues can promote drug-seeking behavior and curtail attempts to quit. One way to understand the potential impact of such cues is to compare cue-elicited behaviors for smoking and other reinforcers (eg, food) using the Pavlovian-to-instrumental transfer paradigm, which measures how much control cues can exert over reward-seeking responses. Methods We tested the influence of appetitive cues on smokers' behavior following 12 hours of abstinence from smoking and eating. First, we equated the value of cigarette and food by assessing a Willingness-to-Pay measure for each reinforcer. Second, we evaluated behavioral differences between cues with Pavlovian-to-instrumental transfer. In two phases, participants learned (1) the association between distinct stimuli and cigarette or food outcomes and, (2) specific instrumental responses that yielded such outcomes. Motivated behavior was probed under extinction in a subsequent transfer test assessing instrumental responding in the presence of the cues. Results Participants showed an increase in specific responding (eg, instrumental response associated with cigarette) when faced with the corresponding appetitive cue (eg, stimulus associated with cigarette) despite absence of outcome. Notably, they made more cigarette-seeking than food-seeking instrumental responses, suggesting that cues representative of cigarette outcomes exert stronger influences on behavior than non-drug (food) cues. Using a measure of subjective preference, we also observed that greater preference for cigarette-compared to food-cues correlated with increased cigarette-seeking behavior in the test phase. Conclusion Taken together, these results highlight how drug and non-drug cues differentially influence reward-seeking behaviors during deprivation, which has implications for smoking cessation treatment and relapse. Implications This study examines the motivational influence of both drug and non-drug cues within a single sample of cigarette smokers. Our results demonstrate that the motivational properties of smoking cues differ from cues relating to other types of reward, such as food. This research informs smoking cessation programs to target the salience of nicotine cues and the maladaptive drug-seeking behaviors prompted by them.
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Affiliation(s)
- Heena R Manglani
- Department of Psychology, The Ohio State University, Columbus, OH
| | - Andrea H Lewis
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT
| | - Stephen J Wilson
- Department of Psychology, Pennsylvania State University, University Park, PA
| | - Mauricio R Delgado
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT
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