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Shirazi A, Radgoudarzi N, Brody AL. Adolescent Tobacco/Nicotine Use and the Potential Role of Contingency Management-based Interventions. J Addict Med 2024; 18:97-102. [PMID: 38197859 PMCID: PMC10939979 DOI: 10.1097/adm.0000000000001249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2024]
Abstract
ABSTRACT The high prevalence of tobacco/nicotine use among youth, including e-cigarettes, is a public health problem in the United States. Early exposure leads to an increased risk of dependence and health consequences in adulthood. We reviewed the literature on current treatment approaches for nicotine/tobacco use in adolescents/young adults and highlighted underexplored areas of treatment research. There are no current Food and Drug Administration-approved medications for treatment of nicotine/tobacco use disorders in adolescents. However, in research settings and on a case-to-case basis, clinical practice medications (including nicotine replacement therapy, bupropion, and varenicline) have been prescribed to this population with consideration of risk-benefit analysis when behavioral treatments are not sufficient to address dependence. Among the nonpharmacological interventions, there is evidence to support the potential for expanded use of contingency management in youth. Neural differences predisposing adolescents to substance use, along with higher attentiveness to value of options in decision making (flexible reward system) may enhance the effectiveness of reward-based approaches for treatment of substance use disorders in this population. The overall high rates of nonresponders across psychosocial and pharmacological treatments highlight the importance of considering novel strategies to improve existing interventions. We suggest that future research be done that considers unique characteristics of today's adolescents, such as high social activism and engagement with digital rewards to tailor contingency management for this age group and assess its effectiveness. Adolescents could potentially benefit from rewards administered through digital media (eg, video games, computer-based apps, and social media influencers).
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Affiliation(s)
- Anaheed Shirazi
- Department of Psychiatry, University of California San Diego, San Diego, CA
| | | | - Arthur L. Brody
- Department of Psychiatry, University of California San Diego, San Diego, CA
- Department of Research, VA San Diego Healthcare System, San Diego, CA
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2
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Reed BW, Brody AL, Sanavi AY, Doran N. Associations between Tobacco Use, Surges, and Vaccination Status over Time in the COVID-19 Era. Int J Environ Res Public Health 2023; 20:1153. [PMID: 36673907 PMCID: PMC9859008 DOI: 10.3390/ijerph20021153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Revised: 01/06/2023] [Accepted: 01/06/2023] [Indexed: 06/17/2023]
Abstract
Because COVID-19 is a respiratory and cardiovascular disease, understanding behaviors that impact cardiopulmonary health, such as tobacco use, is particularly important. While early studies suggested no change in prevalence of tobacco use as COVID-19 emerged, pandemic fatigue, shifting levels of COVID-19 transmission, and vaccine availability have all changed since the start of the pandemic. The current study examined whether time, COVID-19 surges, and/or vaccination status were associated with likelihood of daily and non-daily tobacco use over the first 24 months of the pandemic. Data were obtained from electronic health records of healthcare visits (n = 314,787) to four Southern California VA healthcare systems. Multinomial logistic regression analyses indicated that the likelihood of reporting both daily and non-daily tobacco use (versus non-use) increased over time. Daily and non-daily tobacco use were less common at visits that occurred during COVID-19 surges, as well as among veterans vaccinated against COVID-19. Our findings provide new insight into changes of tobacco use patterns and correlates across the first two years of this pandemic, and understanding these associations may facilitate understanding of health-related behaviors and inform clinical treatment of tobacco use disorder during the COVID-19 pandemic.
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Affiliation(s)
- Brandon W. Reed
- Mental Health Care Line, VA San Diego Healthcare System, San Diego, CA 92161, USA
- Department of Psychiatry, University of California San Diego, La Jolla, CA 92093, USA
| | - Arthur L. Brody
- Mental Health Care Line, VA San Diego Healthcare System, San Diego, CA 92161, USA
- Department of Psychiatry, University of California San Diego, La Jolla, CA 92093, USA
| | - Andre Y. Sanavi
- Department of Psychiatry, University of California San Diego, La Jolla, CA 92093, USA
| | - Neal Doran
- Mental Health Care Line, VA San Diego Healthcare System, San Diego, CA 92161, USA
- Department of Psychiatry, University of California San Diego, La Jolla, CA 92093, USA
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3
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Young JW, Barback CV, Stolz LA, Groman SM, Vera DR, Hoh C, Kotta KK, Minassian A, Powell SB, Brody AL. MicroPET evidence for a hypersensitive neuroinflammatory profile of gp120 mouse model of HIV. Psychiatry Res Neuroimaging 2022; 321:111445. [PMID: 35101828 DOI: 10.1016/j.pscychresns.2022.111445] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 01/19/2022] [Accepted: 01/24/2022] [Indexed: 02/07/2023]
Abstract
Despite increased survivability for people living with HIV (PLWH), HIV-related cognitive deficits persist. Determining biological mechanism(s) underlying abnormalities is critical to minimize the long-term impact of HIV. Positron emission tomography (PET) studies reveal that PLWH exhibit elevated neuroinflammation, potentially contributing to these problems. PLWH are hypersensitive to environmental insults that drive elevated inflammatory profiles. Gp120 is an envelope glycoprotein exposed on the surface of the HIV envelope which enables HIV entry into a cell contributing to HIV-related neurotoxicity. In vivo evidence for mice overexpressing gp120 (transgenic) mice exhibiting neuroinflammation remains unclear. Here, we conducted microPET imaging in gp120 transgenic and wildtype mice, using the radiotracer [(18)F]FEPPA (binds to the translocator protein expressed by activated microglial serving as a neuroinflammatory marker). Imaging was performed at baseline and 24 h after lipopolysaccharide (LPS; 5 mg/kg) treatment (endotoxin that triggers an immune response). Gp120 transgenic mice exhibited elevated [(18F)]FEPPA in response to LPS vs. wildtype mice throughout the brain including dorsal and ventral striata, hypothalamus, and hippocampus. Gp120 transgenic mice are hypersensitive to environmental inflammatory insults, consistent with PLWH, measurable in vivo. It remains to-be-determined whether this heightened sensitivity is connected to the behavioral abnormalities of these mice or sensitive to any treatments.
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Affiliation(s)
- Jared W Young
- Department of Psychiatry, University of California San Diego, 9500 Gilman Drive MC 0804, La Jolla, CA 92093-0804, USA; Research Service, VA San Diego Healthcare System, San Diego, CA, USA.
| | - Christopher V Barback
- Department of Radiology, University of California, San Diego, La Jolla California; UCSD In Vivo Cancer and Molecular Imaging Program
| | - Louise A Stolz
- Department of Psychiatry, University of California San Diego, 9500 Gilman Drive MC 0804, La Jolla, CA 92093-0804, USA
| | - Stephanie M Groman
- Department of Neuroscience, Medical Discovery Team on Addiction, University of Minnesota
| | - David R Vera
- Department of Radiology, University of California, San Diego, La Jolla California; UCSD In Vivo Cancer and Molecular Imaging Program
| | - Carl Hoh
- Department of Radiology, University of California, San Diego, La Jolla California; UCSD In Vivo Cancer and Molecular Imaging Program
| | - Kishore K Kotta
- Department of Radiology, University of California, San Diego, La Jolla California; UCSD In Vivo Cancer and Molecular Imaging Program
| | - Arpi Minassian
- Department of Psychiatry, University of California San Diego, 9500 Gilman Drive MC 0804, La Jolla, CA 92093-0804, USA; Research Service, VA San Diego Healthcare System, San Diego, CA, USA
| | - Susan B Powell
- Department of Psychiatry, University of California San Diego, 9500 Gilman Drive MC 0804, La Jolla, CA 92093-0804, USA; Research Service, VA San Diego Healthcare System, San Diego, CA, USA
| | - Arthur L Brody
- Department of Psychiatry, University of California San Diego, 9500 Gilman Drive MC 0804, La Jolla, CA 92093-0804, USA; Research Service, VA San Diego Healthcare System, San Diego, CA, USA
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London ED, Okita K, Kinney KR, Dean AC, McClintick MN, Rizor EJ, Johnson MC, Mahmoudie T, Brody AL, Nurmi EL, Seaman LC, Farahi J, Ginder N, Mandelkern MA. No significant elevation of translocator protein binding in the brains of recently abstinent methamphetamine users. Drug Alcohol Depend 2020; 213:108104. [PMID: 32570138 PMCID: PMC9059651 DOI: 10.1016/j.drugalcdep.2020.108104] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 05/22/2020] [Accepted: 05/26/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND Radioligands for the translocator protein (TSPO) 18 kDa have been used with positron emission tomography (PET) to assess neuroinflammation and microglial activation in psychiatric disorders. One study using this approach showed substantial TSPO elevation throughout the brain in chronic methamphetamine users following long-term abstinence (0.5-4 years), but clients typically present for treatment earlier in abstinence. METHODS We used PET with [11C]DAA1106 to compare standardized uptake values (SUVs) as an index of TSPO binding in the brains of methamphetamine-dependent participants who were abstinent for < 6 months (n = 11) and healthy controls (n = 12). We also assayed other typical correlates of Methamphetamine Dependence (e.g., striatal D2-type dopamine receptor deficits, depressed mood, anxiety and impaired emotion regulation). RESULTS Methamphetamine users exhibited depression (p < 0.0001), anxiety (p = 0.002), difficulties in emotional regulation (p = 0.01), and lower striatal dopamine D2-type receptor availability vs. controls (p = 0.02). SUVs for [11C]DAA1106 were larger in all brain regions of methamphetamine-dependent participants vs. controls, but the effect size was small to medium and not statistically significant. CONCLUSIONS The discrepancy between the lack of significant difference in TSPO binding in early-abstinent methamphetamine users vs. controls in this study and a previous report of elevated binding in longer-abstinent methamphetamine users may reflect methodological differences or limitations of TSPO binding as an index of neuroinflammation. It also seems possible that gliosis increases over time during the first 6 months of abstinence; longitudinal studies could clarify this possibility.
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Affiliation(s)
- Edythe D. London
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles (UCLA), Los Angeles, CA, 90024, USA,Department of Molecular and Medical Pharmacology, University of California Los Angeles (UCLA), Los Angeles, CA, 90024, USA,Brain Research Institute, University of California Los Angeles (UCLA), Los Angeles, CA, 90024, USA,Department of Research, Veterans Administration Greater Los Angeles Healthcare System (VAGLAHS), Los Angeles, CA, 90073, USA,Corresponding author at: Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, 760 Westwood Plaza, PO Box 175919, Los Angeles, CA, 90095, USA. (E.D. London)
| | - Kyoji Okita
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles (UCLA), Los Angeles, CA, 90024, USA,Department of Research, Veterans Administration Greater Los Angeles Healthcare System (VAGLAHS), Los Angeles, CA, 90073, USA,Department of Clinical Neuroimaging, Integrative Brain Imaging Center, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, 187-8551, Japan,Department of Drug Dependence, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, 187-8551, Japan
| | - Kaitlin R. Kinney
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles (UCLA), Los Angeles, CA, 90024, USA,Department of Research, Veterans Administration Greater Los Angeles Healthcare System (VAGLAHS), Los Angeles, CA, 90073, USA
| | - Andrew C. Dean
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles (UCLA), Los Angeles, CA, 90024, USA
| | - Megan N. McClintick
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles (UCLA), Los Angeles, CA, 90024, USA,Department of Research, Veterans Administration Greater Los Angeles Healthcare System (VAGLAHS), Los Angeles, CA, 90073, USA
| | - Elizabeth J. Rizor
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles (UCLA), Los Angeles, CA, 90024, USA,Department of Research, Veterans Administration Greater Los Angeles Healthcare System (VAGLAHS), Los Angeles, CA, 90073, USA
| | - Maritza C. Johnson
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles (UCLA), Los Angeles, CA, 90024, USA,Department of Research, Veterans Administration Greater Los Angeles Healthcare System (VAGLAHS), Los Angeles, CA, 90073, USA
| | - Tarannom Mahmoudie
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles (UCLA), Los Angeles, CA, 90024, USA,Department of Research, Veterans Administration Greater Los Angeles Healthcare System (VAGLAHS), Los Angeles, CA, 90073, USA
| | - Arthur L. Brody
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles (UCLA), Los Angeles, CA, 90024, USA,Department of Research, Veterans Administration Greater Los Angeles Healthcare System (VAGLAHS), Los Angeles, CA, 90073, USA
| | - Erika L. Nurmi
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles (UCLA), Los Angeles, CA, 90024, USA
| | - Lauren C. Seaman
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles (UCLA), Los Angeles, CA, 90024, USA
| | - Judah Farahi
- Department of Research, Veterans Administration Greater Los Angeles Healthcare System (VAGLAHS), Los Angeles, CA, 90073, USA
| | - Nathaniel Ginder
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles (UCLA), Los Angeles, CA, 90024, USA
| | - Mark A. Mandelkern
- Department of Research, Veterans Administration Greater Los Angeles Healthcare System (VAGLAHS), Los Angeles, CA, 90073, USA,Department of Physics, University of California Irvine, Irvine, CA, 92697, USA
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5
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Zorick T, Okita K, Mandelkern MA, London ED, Brody AL. Effects of Citalopram on Cue-Induced Alcohol Craving and Thalamic D2/3 Dopamine Receptor Availability. Int J Neuropsychopharmacol 2019; 22:286-291. [PMID: 30753467 PMCID: PMC6441125 DOI: 10.1093/ijnp/pyz010] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Revised: 01/13/2019] [Accepted: 02/07/2019] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Selective serotonin reuptake inhibitors are often used in alcohol use disorders. Clinical trials with selective serotonin reuptake inhibitors for alcohol use disorders, however, have yielded mixed results. The goal of this project was to assess whether a single i.v. dose of a selective serotonin reuptake inhibitor reduces craving for alcohol and/or simultaneously increases striatal dopamine concentration in individuals with alcohol dependence. METHODS Alcohol-dependent (DSM-IV-TR criteria) volunteers and matched controls (n = 10/group) underwent a double-blind, placebo-controlled, within-subjects study. Participants received i.v. citalopram (40 mg) or saline (counter-balanced) followed by a cue-induced craving assessment and [18F]-fallypride positron emission tomography scanning. RESULTS In the alcohol-dependent individuals, the citalopram (compared with saline) resulted in decreased cue-induced craving for alcohol. For the whole study group, cue-induced alcohol craving was inversely correlated with thalamic (but not striatal) dopamine D2/3 receptor availability. CONCLUSIONS Acute serotonin reuptake inhibition reduces cue-induced alcohol craving. Furthermore, thalamic dopamine abnormalities and the striatal hyperdopaminergic hypothesis of alcohol use disorder are supported.
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Affiliation(s)
- Todd Zorick
- Department of Psychiatry, Harbor-UCLA Medical Center, Los Angeles, California,Department of Psychiatry and Biobehavioral Science, UCLA, Los Angeles, California,Correspondence: Todd Zorick, MD, PhD, Department of Psychiatry, Harbor-UCLA Medical Center, 1000 W. Carson Blvd, Torrance, CA 90509 ()
| | - Kyoji Okita
- Department of Psychiatry and Biobehavioral Science, UCLA, Los Angeles, California
| | - Mark A Mandelkern
- Department of Psychiatry, Harbor-UCLA Medical Center, Los Angeles, California,Department of Physics, University of California, Irvine, California
| | - Edythe D London
- Department of Psychiatry, Harbor-UCLA Medical Center, Los Angeles, California,Department of Psychiatry and Biobehavioral Science, UCLA, Los Angeles, California,Department of Molecular and Medical Pharmacology, UCLA, Los Angeles, California
| | - Arthur L Brody
- Department of Psychiatry, Harbor-UCLA Medical Center, Los Angeles, California,Department of Psychiatry and Biobehavioral Science, UCLA, Los Angeles, California,UCSD/VA San Diego Departments of Psychiatry, San Diego, California
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Sultzer DL, Melrose RJ, Riskin‐Jones H, Narvaez TA, Veliz J, Ando TK, Juarez KO, Brody AL, Mandelkern MA. [P2–392]: CHOLINERGIC RECEPTOR BINDING IN VIVO AND COGNITIVE SKILLS IN HEALTHY AGING, MCI, AND ALZHEIMER'S DISEASE. Alzheimers Dement 2017. [DOI: 10.1016/j.jalz.2017.06.1047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- David L. Sultzer
- David Geffen School of Medicine at UCLALos AngelesCAUSA
- VA Greater Los Angeles Healthcare SystemLos AngelesCAUSA
| | - Rebecca J. Melrose
- David Geffen School of Medicine at UCLALos AngelesCAUSA
- VA Greater Los Angeles Healthcare SystemLos AngelesCAUSA
| | - Hannah Riskin‐Jones
- David Geffen School of Medicine at UCLALos AngelesCAUSA
- VA Greater Los Angeles Healthcare SystemLos AngelesCAUSA
| | | | - Joseph Veliz
- VA Greater Los Angeles Healthcare SystemLos AngelesCAUSA
| | | | | | - Arthur L. Brody
- University of California, San DiegoSan DiegoCAUSA
- VA San Diego Healthcare SystemSan DiegoCAUSA
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Sultzer DL, Melrose RJ, Riskin-Jones H, Narvaez TA, Veliz J, Ando TK, Juarez KO, Harwood DG, Brody AL, Mandelkern MA. Cholinergic Receptor Binding in Alzheimer Disease and Healthy Aging: Assessment In Vivo with Positron Emission Tomography Imaging. Am J Geriatr Psychiatry 2017; 25:342-353. [PMID: 28162919 DOI: 10.1016/j.jagp.2016.11.011] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2016] [Revised: 11/17/2016] [Accepted: 11/18/2016] [Indexed: 01/29/2023]
Abstract
OBJECTIVE To compare regional nicotinic cholinergic receptor binding in older adults with Alzheimer disease (AD) and healthy older adults in vivo and to assess relationships between receptor binding and clinical symptoms. METHODS Using cross-sectional positron emission tomography (PET) neuroimaging and structured clinical assessment, outpatients with mild to moderate AD (N = 24) and healthy older adults without cognitive complaints (C group; N = 22) were studied. PET imaging of α4β2* nicotinic cholinergic receptor binding using 2-[18F]fluoro-3-(2(S)azetidinylmethoxy)pyridine (2FA) and clinical measures of global cognition, attention/processing speed, verbal memory, visuospatial memory, and neuropsychiatric symptoms were used. RESULTS 2FA binding was lower in the AD group compared with the C group in the medial thalamus, medial temporal cortex, anterior cingulate, insula/opercula, inferior caudate, and brainstem (p < 0.05, corrected cluster), but binding was not associated with cognition. The C group had significant inverse correlations between 2FA binding in the thalamus (left: rs = -0.55, p = 0.008; right: rs = -0.50, p = 0.02; N = 22) and hippocampus (left: rs = -0.65, p = 0.001; right: rs = -0.55, p = 0.009; N = 22) and the Trails A score. The AD group had inverse correlation between 2FA binding in anterior cingulate (left: rs = -0.50, p = 0.01; right: rs = -0.50, p = 0.01; N = 24) and Neurobehavioral Rating Scale agitation/disinhibition factor score. CONCLUSION Cholinergic receptor binding is reduced in specific brain regions in mild to moderate AD and is related to neuropsychiatric symptoms. Among healthy older adults, lower receptor binding may be associated with slower processing speed. Cholinergic receptor binding in vivo may reveal links to other key brain changes associated with aging and AD and may provide a potential molecular treatment target.
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Affiliation(s)
- David L Sultzer
- Psychiatry/Mental Health Service, VA Greater Los Angeles Healthcare System, Los Angeles, CA; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, CA.
| | - Rebecca J Melrose
- Psychiatry/Mental Health Service, VA Greater Los Angeles Healthcare System, Los Angeles, CA; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, CA
| | - Hannah Riskin-Jones
- Psychiatry/Mental Health Service, VA Greater Los Angeles Healthcare System, Los Angeles, CA
| | - Theresa A Narvaez
- Psychiatry/Mental Health Service, VA Greater Los Angeles Healthcare System, Los Angeles, CA
| | - Joseph Veliz
- Psychiatry/Mental Health Service, VA Greater Los Angeles Healthcare System, Los Angeles, CA
| | - Timothy K Ando
- Psychiatry/Mental Health Service, VA Greater Los Angeles Healthcare System, Los Angeles, CA
| | - Kevin O Juarez
- Psychiatry/Mental Health Service, VA Greater Los Angeles Healthcare System, Los Angeles, CA
| | - Dylan G Harwood
- Psychiatry/Mental Health Service, VA Greater Los Angeles Healthcare System, Los Angeles, CA; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, CA
| | - Arthur L Brody
- Psychiatry/Mental Health Service, VA Greater Los Angeles Healthcare System, Los Angeles, CA; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, CA
| | - Mark A Mandelkern
- Imaging Service, VA Greater Los Angeles Healthcare Center, Los Angeles, CA; Department of Physics, University of California-Irvine, Irvine, CA
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Xie J, Douglas PK, Wu YN, Brody AL, Anderson AE. Decoding the encoding of functional brain networks: An fMRI classification comparison of non-negative matrix factorization (NMF), independent component analysis (ICA), and sparse coding algorithms. J Neurosci Methods 2017; 282:81-94. [PMID: 28322859 DOI: 10.1016/j.jneumeth.2017.03.008] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2016] [Revised: 03/07/2017] [Accepted: 03/07/2017] [Indexed: 11/18/2022]
Abstract
BACKGROUND Brain networks in fMRI are typically identified using spatial independent component analysis (ICA), yet other mathematical constraints provide alternate biologically-plausible frameworks for generating brain networks. Non-negative matrix factorization (NMF) would suppress negative BOLD signal by enforcing positivity. Spatial sparse coding algorithms (L1 Regularized Learning and K-SVD) would impose local specialization and a discouragement of multitasking, where the total observed activity in a single voxel originates from a restricted number of possible brain networks. NEW METHOD The assumptions of independence, positivity, and sparsity to encode task-related brain networks are compared; the resulting brain networks within scan for different constraints are used as basis functions to encode observed functional activity. These encodings are then decoded using machine learning, by using the time series weights to predict within scan whether a subject is viewing a video, listening to an audio cue, or at rest, in 304 fMRI scans from 51 subjects. RESULTS AND COMPARISON WITH EXISTING METHOD The sparse coding algorithm of L1 Regularized Learning outperformed 4 variations of ICA (p<0.001) for predicting the task being performed within each scan using artifact-cleaned components. The NMF algorithms, which suppressed negative BOLD signal, had the poorest accuracy compared to the ICA and sparse coding algorithms. Holding constant the effect of the extraction algorithm, encodings using sparser spatial networks (containing more zero-valued voxels) had higher classification accuracy (p<0.001). Lower classification accuracy occurred when the extracted spatial maps contained more CSF regions (p<0.001). CONCLUSION The success of sparse coding algorithms suggests that algorithms which enforce sparsity, discourage multitasking, and promote local specialization may capture better the underlying source processes than those which allow inexhaustible local processes such as ICA. Negative BOLD signal may capture task-related activations.
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Affiliation(s)
- Jianwen Xie
- Department of Statistics, University of California, Los Angeles, United States
| | - Pamela K Douglas
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, United States
| | - Ying Nian Wu
- Department of Statistics, University of California, Los Angeles, United States
| | - Arthur L Brody
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, United States
| | - Ariana E Anderson
- Department of Statistics, University of California, Los Angeles, United States; Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, United States.
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Brody AL, Zorick T, Hubert R, Hellemann GS, Balali S, Kawasaki SS, Garcia LY, Enoki R, Abraham P, Young P, McCreary C. Combination Extended Smoking Cessation Treatment Plus Home Visits for Smokers With Schizophrenia: A Randomized Controlled Trial. Nicotine Tob Res 2016; 19:68-76. [PMID: 27613888 DOI: 10.1093/ntr/ntw190] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Accepted: 07/18/2016] [Indexed: 11/12/2022]
Abstract
INTRODUCTION The majority of people with schizophrenia have a diagnosis of tobacco dependence during their lifetime. A major obstacle to reducing the burden of cigarette smoking in this population is that these smokers have lower quit rates when undergoing standard treatment compared to smokers with no mental illness. We sought to determine if combination extended treatment (COMB-EXT) and home visits (HV) would lead to improved outcomes in smokers with schizophrenia. METHODS Thirty-four cigarette smokers with schizophrenia completed either COMB-EXT with HV, COMB-EXT without HV, or treatment as usual (TAU) (random assignment). COMB-EXT consisted of group cognitive-behavioral therapy (CBT), bupropion, nicotine patch, and nicotine lozenge, which were initiated within 2 weeks and continued for 26 weekly visits. HV consisted of biweekly visits to the home with assessment of secondhand smoke (SHS) exposure and brief behavioral therapy with participants and others in the home environment. TAU consisted of group CBT plus serial single or combination medication trials as per standard care. RESULTS Smokers with schizophrenia who received COMB-EXT (with or without HV) had greater reductions in cigarettes per day than those treated with TAU (both ps < .01). In addition, 7-day point prevalence abstinence rates for the three groups were 45%, 20%, and 8%, respectively, which was significantly higher for COMB-EXT plus HV than TAU (χ2(1) = 4.8, p = .03). Groups did not differ significantly in the number of adverse events, and HV were easily scheduled. CONCLUSION COMB-EXT improves outcomes for smokers with schizophrenia. HV appeared to provide additional benefit for smoking cessation in this treatment-resistant population. IMPLICATIONS The clear benefit found here of rapidly initiated, combination, extended treatment over TAU suggests that aggressive and extended treatment should be considered in clinical practice for smokers with schizophrenia. Furthermore, HV to address SHS exposure showed initial promise for assisting smokers with schizophrenia in maintaining abstinence, indicating that this intervention may be worthy of future research.
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Affiliation(s)
- Arthur L Brody
- Department of Psychiatry, VA Greater Los Angeles Healthcare System, Los Angeles, CA; .,Department of Psychiatry, University of California at San Diego, San Diego, CA
| | - Todd Zorick
- Department of Psychiatry, VA Greater Los Angeles Healthcare System, Los Angeles, CA
| | - Robert Hubert
- Department of Psychiatry, VA Greater Los Angeles Healthcare System, Los Angeles, CA
| | - Gerhard S Hellemann
- Department of Psychiatry, VA Greater Los Angeles Healthcare System, Los Angeles, CA
| | - Shabnam Balali
- Department of Psychiatry, VA Greater Los Angeles Healthcare System, Los Angeles, CA
| | - Sarah S Kawasaki
- Department of Primary Care, Health Care for the Homeless, Baltimore, MD
| | - Lizette Y Garcia
- Department of Psychiatry, VA Greater Los Angeles Healthcare System, Los Angeles, CA
| | - Ryutaro Enoki
- Department of Psychiatry, VA Greater Los Angeles Healthcare System, Los Angeles, CA
| | - Paul Abraham
- Department of Psychiatry, VA Greater Los Angeles Healthcare System, Los Angeles, CA
| | - Paulina Young
- Department of Psychiatry, VA Greater Los Angeles Healthcare System, Los Angeles, CA
| | - Charles McCreary
- Department of Psychiatry, VA Greater Los Angeles Healthcare System, Los Angeles, CA
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Zanchi D, Brody AL, Montandon ML, Kopel R, Emmert K, Preti MG, Van De Ville D, Haller S. Cigarette smoking leads to persistent and dose-dependent alterations of brain activity and connectivity in anterior insula and anterior cingulate. Addict Biol 2015; 20:1033-41. [PMID: 26303184 DOI: 10.1111/adb.12292] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Revised: 06/18/2015] [Accepted: 07/14/2015] [Indexed: 12/01/2022]
Abstract
Although many smokers try to quit smoking, only about 20-25 percent will achieve abstinence despite 6 months or more of gold-standard treatment. This low success rate suggests long-term changes in the brain related to smoking, which remain poorly understood. We compared ex-smokers to both active smokers and non-smokers using functional magnetic resonance imaging (fMRI) to explore persistent modifications in brain activity and network organization. This prospective and consecutive study includes 18 non-smokers (29.5 ± 6.7 years of age, 11 women), 14 smokers (≥10 cigarettes a day >2 years of smoking, 29.3 ± 6.0 years of age, 10 women) and 14 ex-smokers (>1 year of quitting 30.5 ± 5.7 years of age, 10 women). Participants underwent a block-design fMRI study contrasting smoking cue with control (neutral cue) videos. Data analyses included task-related general linear model, seed-based functional connectivity, voxel-based morphometry (VBM) of gray matter and tract-based spatial statistics (TBSS) of white matter. Smoking cue videos versus control videos activated the right anterior insula in ex-smokers compared with smokers, an effect correlating with cumulative nicotine intake (pack-years). Moreover, ex-smokers had a persistent decrease in functional connectivity between right anterior insula and anterior cingulate cortex (ACC) compared with control participants, but similar to active smokers. Potentially confounding alterations in gray or white matter were excluded in VBM and TBSS analyses. In summary, ex-smokers with long-term nicotine abstinence have persistent and dose-dependent brain network changes notably in the right anterior insula and its connection to the ACC.
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Affiliation(s)
- Davide Zanchi
- Department of Imaging and Medical Informatics; University Hospitals of Geneva and Faculty of Medicine of the University of Geneva; Switzerland
| | - Arthur L. Brody
- Department of Psychiatry; University of California at Los Angeles
- Departments of Psychiatry and Research; VA Greater Los Angeles Healthcare System
| | - Marie-Louise Montandon
- Department of Imaging and Medical Informatics; University Hospitals of Geneva and Faculty of Medicine of the University of Geneva; Switzerland
| | - Rotem Kopel
- Department of Imaging and Medical Informatics; University Hospitals of Geneva and Faculty of Medicine of the University of Geneva; Switzerland
- Institute of Bioengineering; Ecole Polytechnique Fédérale de Lausanne; Switzerland
| | - Kirsten Emmert
- Department of Imaging and Medical Informatics; University Hospitals of Geneva and Faculty of Medicine of the University of Geneva; Switzerland
| | - Maria Giulia Preti
- Department of Imaging and Medical Informatics; University Hospitals of Geneva and Faculty of Medicine of the University of Geneva; Switzerland
- Institute of Bioengineering; Ecole Polytechnique Fédérale de Lausanne; Switzerland
| | - Dimitri Van De Ville
- Department of Imaging and Medical Informatics; University Hospitals of Geneva and Faculty of Medicine of the University of Geneva; Switzerland
- Institute of Bioengineering; Ecole Polytechnique Fédérale de Lausanne; Switzerland
| | - Sven Haller
- Faculty of Medicine of the University of Geneva; Switzerland
- Department of Surgical Sciences, Radiology; Uppsala University; Uppsala Sweden
- Department of Neuroradiology; University Hospital Freiburg; Germany
- Affidea Centre de Diagnostic Radiologique de Carouge CDRC; Geneva Switzerland
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11
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Dubroff JG, Doot RK, Falcone M, Schnoll RA, Ray R, Tyndale RF, Brody AL, Hou C, Schmitz A, Lerman C. Decreased Nicotinic Receptor Availability in Smokers with Slow Rates of Nicotine Metabolism. J Nucl Med 2015; 56:1724-9. [PMID: 26272810 DOI: 10.2967/jnumed.115.155002] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Accepted: 07/14/2015] [Indexed: 11/16/2022] Open
Abstract
UNLABELLED The nicotine metabolite ratio (NMR), a stable measure of hepatic nicotine metabolism via the CYP2A6 pathway and total nicotine clearance, is a predictive biomarker of response to nicotine replacement therapy, with increased quit rates in slower metabolizers. Nicotine binds directly to nicotinic acetylcholine receptors (nAChRs) to exert its psychoactive effects. This study examined the relationship between NMR and nAChR (α4β2* subtype) availability using PET imaging of the radiotracer 2-(18)F-fluoro-3-(2(S)-azetidinylmethoxy)pyridine (2-(18)F-FA-85380, or 2-(18)F-FA). METHODS Twenty-four smokers-12 slow metabolizers (NMR < 0.26) and 12 normal metabolizers (NMR ≥ 0.26)-underwent 2-(18)F-FA-PET brain imaging after overnight nicotine abstinence (18 h before scanning), using a validated bolus-plus-infusion protocol. Availability of nAChRs was compared between NMR groups in a priori volumes of interest, with total distribution volume (VT/fP) being the measure of nAChR availability. Cravings to smoke were assessed before and after the scans. RESULTS Thalamic nAChR α4β2* availability was significantly reduced in slow nicotine metabolizers (P = 0.04). Slow metabolizers exhibited greater reductions in cravings after scanning than normal metabolizers; however, craving was unrelated to nAChR availability. CONCLUSION The rate of nicotine metabolism is associated with thalamic nAChR availability. Additional studies could examine whether altered nAChR availability underlies the differences in treatment response between slow and normal metabolizers of nicotine.
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Affiliation(s)
- Jacob G Dubroff
- Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Robert K Doot
- Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Mary Falcone
- Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Robert A Schnoll
- Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Riju Ray
- Global Medical Affairs, GlaxoSmithKline, Brussels, Belgium
| | - Rachel F Tyndale
- Department of Pharmacology and Toxicology, and Department of Psychiatry, CAMH, University of Toronto, Toronto, Canada
| | - Arthur L Brody
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, California; and Department of Psychiatry, Veterans Administration Greater Los Angeles Healthcare System, Los Angeles, California
| | - Catherine Hou
- Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Alexander Schmitz
- Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Caryn Lerman
- Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania
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12
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Affiliation(s)
- Arthur L Brody
- Department of Psychiatry, University of California at Los Angeles, Los Angeles, CA, USA
- Departments of Psychiatry and Research, VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA
| | - Francis Joseph McClernon
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA
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13
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Zorick T, Mandelkern MA, Brody AL. A naturalistic study of the association between antidepressant treatment and outcome of smoking cessation treatment. J Clin Psychiatry 2014; 75:e1433-8. [PMID: 25551240 PMCID: PMC4666295 DOI: 10.4088/jcp.14m09012] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2014] [Accepted: 05/21/2014] [Indexed: 10/24/2022]
Abstract
OBJECTIVE Psychiatric, medical, and substance use comorbidities are highly prevalent among smokers, and many of these comorbidities have been found to be associated with reduced rate of success in clinical trials for smoking cessation. While much has been established about the best available treatments from these clinical trials, little is known about the effect of concomitant psychiatric medications on quit rates in smoking cessation programs. On the basis of results in populations with tobacco dependence and other substance use disorders, we hypothesized that smokers taking antidepressants would have a lower rate of quitting in an outpatient smoking cessation program. METHOD We performed a naturalistic chart review of veterans (N = 144) enrolled in the Veterans Affairs Greater Los Angeles Mental Health Clinic Smoking Cessation Program from March 2011 through July 2013, who met DSM-IV-TR criteria for nicotine dependence. The primary outcome was smoking cessation with treatment, as evidenced by a patient report of at least 1 week of abstinence and an exhaled carbon monoxide level of ≤ 6 ppm (if available) at the end of acute treatment, with comparators including concomitant psychotropic medication treatment, psychiatric and medical comorbidities, and the presence of a substance use disorder history. We utilized stepwise binary logistic regression as the main statistical technique. RESULTS We found that current antidepressant treatment (P = .003) and history of substance use disorder (P = .01) (particularly cocaine [P = .02]) were associated with a lower rate of quitting smoking. Furthermore, the association between antidepressant treatment and reduced rate of smoking cessation was primarily seen in patients with a history of substance use disorder (P = .003). CONCLUSIONS While preliminary, these results suggest an important clinical interaction meriting future study. If these findings are confirmed, clinicians may want to consider the risk of reduced ability to quit smoking in patients with a history of substance use disorder who are taking antidepressants.
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Affiliation(s)
- Todd Zorick
- Department of Psychiatry, VA Greater Los Angeles Healthcare System, 11301 Wilshire Blvd, B210/2nd Floor, Los Angeles CA 90073
| | - Mark A. Mandelkern
- VA Greater Los Angeles Healthcare System, Departments of Psychiatry (TZ and AB) and Imaging (MM),Department of Physics, University of California, Irvine, USA
| | - Arthur L. Brody
- VA Greater Los Angeles Healthcare System, Departments of Psychiatry (TZ and AB) and Imaging (MM),Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, USA
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14
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Jasinska AJ, Zorick T, Brody AL, Stein EA. Dual role of nicotine in addiction and cognition: a review of neuroimaging studies in humans. Neuropharmacology 2014; 84:111-22. [PMID: 23474015 PMCID: PMC3710300 DOI: 10.1016/j.neuropharm.2013.02.015] [Citation(s) in RCA: 110] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2012] [Revised: 12/28/2012] [Accepted: 02/19/2013] [Indexed: 12/11/2022]
Abstract
Substantial evidence demonstrates both nicotine's addiction liability and its cognition-enhancing effects. However, the neurobiological mechanisms underlying nicotine's impact on brain function and behavior remain incompletely understood. Elucidation of these mechanisms is of high clinical importance and may lead to improved therapeutics for smoking cessation as well as for a number of cognitive disorders such as schizophrenia. Neuroimaging techniques such as positron emission tomography (PET), single photon emission computed tomography (SPECT), and functional magnetic resonance imaging (fMRI), which make it possible to study the actions of nicotine in the human brain in vivo, play an increasingly important role in identifying these dual mechanisms of action. In this review, we summarize the current state of knowledge and discuss outstanding questions and future directions in human neuroimaging research on nicotine and tobacco. This research spans from receptor-level PET and SPECT studies demonstrating nicotine occupancy at nicotinic acetylcholine receptors (nAChRs) and upregulation of nAChRs induced by chronic smoking; through nicotine's interactions with the mesocorticolimbic dopamine system believed to mediate nicotine's reinforcing effects leading to dependence; to functional activity and connectivity fMRI studies documenting nicotine's complex behavioral and cognitive effects manifest by its actions on large-scale brain networks engaged both during task performance and at rest. This article is part of the Special Issue Section entitled 'Neuroimaging in Neuropharmacology'.
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Affiliation(s)
- Agnes J Jasinska
- National Institute on Drug Abuse, Intramural Research Program, 251 Bayview Blvd, Baltimore, MD 21224, United States.
| | - Todd Zorick
- University of California at Los Angeles, Department of Psychiatry, 300 UCLA Medical Plaza, Los Angeles, CA 90095, United States; VA Greater Los Angeles Healthcare System, United States
| | - Arthur L Brody
- University of California at Los Angeles, Department of Psychiatry, 300 UCLA Medical Plaza, Los Angeles, CA 90095, United States; VA Greater Los Angeles Healthcare System, United States.
| | - Elliot A Stein
- National Institute on Drug Abuse, Intramural Research Program, 251 Bayview Blvd, Baltimore, MD 21224, United States.
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15
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Brody AL, Okita K, Shieh J, Liang L, Hubert R, Mamoun M, Farahi J, Mandelkern MA. Radiation dosimetry and biodistribution of the translocator protein radiotracer [(11)C]DAA1106 determined with PET/CT in healthy human volunteers. Nucl Med Biol 2014; 41:871-5. [PMID: 25156039 DOI: 10.1016/j.nucmedbio.2014.07.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2014] [Revised: 07/11/2014] [Accepted: 07/15/2014] [Indexed: 10/25/2022]
Abstract
INTRODUCTION When microglia become activated (an integral part of neuroinflammation), cellular morphology changes and expression of translocator protein (TSPO) 18 kDa is increased. Over the past several years, [(11)C]DAA1106 has emerged as a reliable radiotracer for labeling TSPO with high affinity during positron emission tomography (PET) scanning. While [(11)C]DAA1106 PET scanning has been used in several research studies, a radiation dosimetry study of this radiotracer in humans has not yet been published. METHODS Twelve healthy participants underwent full body dynamic [(11)C]DAA1106 PET scanning, with 8 sequential whole body scans (approximately 12 bed positions each), following a single injection. Regions of interest were drawn manually, and time activity curves (TACs) were obtained for 15 organs. OLINDA/EXM 1.1 was used to compute radiation absorbed doses to the target organs, as well as effective dose (ED) and effective dose equivalent (EDE). RESULTS The ED and EDE were 4.06 ± 0.58 μSv/MBq and 5.89 ± 0.83 μSv/MBq, respectively. The highest absorbed doses were to the heart wall, kidney, liver, pancreas, and spleen. TACs revealed that peak dose rates are during the first scan (at 6 min) for all organs other than the urinary bladder wall, which had its peak dose rate during the fourth scan (at 30 min). CONCLUSIONS The recently developed radiotracer [(11)C]DAA1106 has its EDE and target-organ absorbed dose such that, for a single administration, its radiation dosimetry is well within the U.S. FDA guidelines for basic research studies in adults. This dose level implies that the dosimetry for multiple [(11)C]DAA1106 scans within a given year also falls within FDA guidelines, and this favorable property makes this radiotracer suitable for examining microglial activation repeatedly over time, which may in the future be useful for longitudinal tracking of disease progression and monitoring of therapy response in conditions marked by neuroinflammation (e.g., head trauma and multiple sclerosis).
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Affiliation(s)
- Arthur L Brody
- Department of Research, VA Greater Los Angeles Healthcare System (VAGLAHS), 11301 Wilshire Blvd., Los Angeles, CA 90073; Department of Psychiatry, University of California at Los Angeles, 300 UCLA Medical Plaza, Suite 2200, Los Angeles, CA 90095.
| | - Kyoji Okita
- Department of Research, VA Greater Los Angeles Healthcare System (VAGLAHS), 11301 Wilshire Blvd., Los Angeles, CA 90073; UCLA Laboratory of Molecular Imaging, 760 Westwood Plaza C8-538, Los Angeles, CA 90095
| | - Jennifer Shieh
- Department of Research, VA Greater Los Angeles Healthcare System (VAGLAHS), 11301 Wilshire Blvd., Los Angeles, CA 90073
| | - Lidia Liang
- Department of Research, VA Greater Los Angeles Healthcare System (VAGLAHS), 11301 Wilshire Blvd., Los Angeles, CA 90073
| | - Robert Hubert
- Department of Research, VA Greater Los Angeles Healthcare System (VAGLAHS), 11301 Wilshire Blvd., Los Angeles, CA 90073
| | - Michael Mamoun
- Department of Research, VA Greater Los Angeles Healthcare System (VAGLAHS), 11301 Wilshire Blvd., Los Angeles, CA 90073
| | - Judah Farahi
- Department of Imaging, VAGLAHS, 11301 Wilshire Blvd., Los Angeles, CA 90073
| | - Mark A Mandelkern
- Department of Imaging, VAGLAHS, 11301 Wilshire Blvd., Los Angeles, CA 90073; Department of Physics, University of California at Irvine, 4129 Frederick Reines Hall, Irvine, CA 92697
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16
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Brody AL, Mukhin AG, Mamoun MS, Luu T, Neary M, Liang L, Shieh J, Sugar CA, Rose JE, Mandelkern MA. Brain nicotinic acetylcholine receptor availability and response to smoking cessation treatment: a randomized trial. JAMA Psychiatry 2014; 71:797-805. [PMID: 24850280 PMCID: PMC4634637 DOI: 10.1001/jamapsychiatry.2014.138] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
IMPORTANCE Cigarette smoking leads to upregulation of nicotinic acetylcholine receptors (nAChRs) in the human brain, including the common α4β2* nAChR subtype. While subjective aspects of tobacco dependence have been extensively examined as predictors of quitting smoking with treatment, no studies to our knowledge have yet reported the relationship between the extent of pretreatment upregulation of nAChRs and smoking cessation. OBJECTIVE To determine whether the degree of nAChR upregulation in smokers predicts quitting with a standard course of treatment. DESIGN, SETTING, AND PARTICIPANTS Eighty-one tobacco-dependent cigarette smokers (volunteer sample) underwent positron emission tomographic (PET) scanning of the brain with the radiotracer 2-FA followed by 10 weeks of double-blind, placebo-controlled treatment with nicotine patch (random assignment). Pretreatment specific binding volume of distribution (VS/fP) on PET images (a value that is proportional to α4β2* nAChR availability) was determined for 8 brain regions of interest, and participant-reported ratings of nicotine dependence, craving, and self-efficacy were collected. Relationships between these pretreatment measures, treatment type, and outcome were then determined. The study took place at academic PET and clinical research centers. MAIN OUTCOMES AND MEASURES Posttreatment quit status after treatment, defined as a participant report of 7 or more days of continuous abstinence and an exhaled carbon monoxide level of 3 ppm or less. RESULTS Smokers with lower pretreatment VS/fP values (a potential marker of less severe nAChR upregulation) across all brain regions studied were more likely to quit smoking (multivariate analysis of covariance, F8,69 = 4.5; P < .001), regardless of treatment group assignment. Furthermore, pretreatment average VS/fP values provided additional predictive power for likelihood of quitting beyond the self-report measures (stepwise binary logistic regression, likelihood ratio χ21 = 19.8; P < .001). CONCLUSIONS AND RELEVANCE Smokers with less upregulation of available α4β2* nAChRs have a greater likelihood of quitting with treatment than smokers with more upregulation. In addition, the biological marker studied here provided additional predictive power beyond subjectively rated measures known to be associated with smoking cessation outcome. While the costly, time-consuming PET procedure used here is not likely to be used clinically, simpler methods for examining α4β2* nAChR upregulation could be tested and applied in the future to help determine which smokers need more intensive and/or lengthier treatment. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT01526005.
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Affiliation(s)
- Arthur L. Brody
- Department of Research, VA Greater Los Angeles Healthcare System, Los Angeles, California2Department of Psychiatry, University of California, Los Angeles
| | - Alexey G. Mukhin
- Department of Psychiatry, Duke University, Durham, North Carolina
| | - Michael S. Mamoun
- Department of Research, VA Greater Los Angeles Healthcare System, Los Angeles, California
| | - Trinh Luu
- Department of Research, VA Greater Los Angeles Healthcare System, Los Angeles, California
| | - Meaghan Neary
- Department of Research, VA Greater Los Angeles Healthcare System, Los Angeles, California
| | - Lidia Liang
- Department of Research, VA Greater Los Angeles Healthcare System, Los Angeles, California
| | - Jennifer Shieh
- Department of Research, VA Greater Los Angeles Healthcare System, Los Angeles, California
| | - Catherine A. Sugar
- Department of Psychiatry, University of California, Los Angeles4Department of Biostatistics, University of California, Los Angeles
| | - Jed E. Rose
- Department of Psychiatry, Duke University, Durham, North Carolina
| | - Mark A. Mandelkern
- Department of Research, VA Greater Los Angeles Healthcare System, Los Angeles, California5Department of Physics, University of California, Irvine
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Storage S, Mandelkern MA, Phuong J, Kozman M, Neary MK, Brody AL. A positive relationship between harm avoidance and brain nicotinic acetylcholine receptor availability. Psychiatry Res 2013; 214:415-21. [PMID: 24148908 PMCID: PMC3851586 DOI: 10.1016/j.pscychresns.2013.07.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2012] [Revised: 06/22/2013] [Accepted: 07/25/2013] [Indexed: 01/28/2023]
Abstract
Prior research indicates that disturbance of cholinergic neurotransmission reduces anxiety, leading to the hypothesis that people with heightened cholinergic function have a greater tendency toward anxiety-like and/or harm-avoidant behavior. We sought to determine if people with elevated levels of harm avoidance (HA), a dimension of temperament from the Temperament and Character Inventory (TCI), have high α4β2* nicotinic acetylcholine receptor (nAChR) availability. Healthy adults (n=105; 47 non-smokers and 58 smokers) underwent bolus-plus-continuous infusion positron emission tomography (PET) scanning using the radiotracer 2-[18F]fluoro-3-(2(S)azetidinylmethoxy) pyridine (abbreviated as 2-FA). During the uptake period of 2-FA, participants completed the TCI. The central study analysis revealed a significant association between total HA and mean nAChR availability, with higher total HA scores being linked with greater nAChR availability. In examining HA subscales, both 'Fear of Uncertainty' and 'Fatigability' were significant, based on higher levels of these characteristics being associated with greater nAChR availabilities. This study adds to a growing body of knowledge concerning the biological basis of personality and may prove useful in understanding the pathophysiology of psychiatric disorders (such as anxiety disorders) that have similar characteristics to HA. Study findings may indicate that heightened cholinergic neurotransmission is associated with increased anxiety-like traits.
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Affiliation(s)
- Steven Storage
- UCLA School of Medicine, Los Angeles, California, USA,Department of Research, VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA
| | - Mark A. Mandelkern
- Department of Research, VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA,Department of Physics, University of California at Irvine, California, USA
| | - Jonathan Phuong
- Department of Research, VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA
| | - Maggie Kozman
- Department of Research, VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA
| | - Meaghan K. Neary
- Department of Research, VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA
| | - Arthur L. Brody
- UCLA School of Medicine, Los Angeles, California, USA,Department of Research, VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA,Department of Psychiatry, VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA,Corresponding author at: UCLA Department of Psychiatry & Biobehavioral Sciences 300 UCLA Medical Plaza, Suite 2200 Los Angeles, CA 90095. Tel.: +310 268 4778; fax: +310 206 2802.
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18
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Affiliation(s)
- Marc N. Potenza
- Departments of Psychiatry, Child Study, and Neurobiology, Yale University School of Medicine, Connecticut Mental Health Center, New Haven, CT 6519, USA
| | - Arthur L. Brody
- Departments of Psychiatry, UCLA School of Medicine and VA Greater Los Angeles Healthcare System, Los Angeles, CA CA 90095, USA
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19
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Jarcho JM, Feier NA, Bert A, Labus JA, Lee M, Stains J, Ebrat B, Groman SM, Tillisch K, Brody AL, London ED, Mandelkern MA, Mayer EA. Diminished neurokinin-1 receptor availability in patients with two forms of chronic visceral pain. Pain 2013; 154:987-96. [PMID: 23582152 DOI: 10.1016/j.pain.2013.02.026] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2012] [Revised: 02/08/2013] [Accepted: 02/22/2013] [Indexed: 12/29/2022]
Abstract
Central sensitization and dysregulation of peripheral substance P and neurokinin-1 receptor (NK-1R) signaling are associated with chronic abdominal pain in inflammatory bowel disease (IBD) and irritable bowel syndrome (IBS). Although positron emission tomography (PET) has demonstrated that patients with injury-related chronic pain have diminished NK-1R availability in the brain, it is unknown whether these deficits are present in IBD and IBS patients, who have etiologically distinct forms of non-injury-related chronic pain. This study's aim was to determine if patients with IBD or IBS exhibit deficits in brain expression of NK-1Rs relative to healthy controls (HCs), the extent to which expression patterns differ across patient populations, and if these patterns differentially relate to clinical parameters. PET with [(18)F]SPA-RQ was used to measure NK-1R availability by quantifying binding potential (BP) in the 3 groups. Exploratory correlation analyses were performed to detect associations between NK-1R BP and physical symptoms. Compared to HCs, IBD patients had NK-1R BP deficits across a widespread network of cortical and subcortical regions. IBS patients had similar, but less pronounced deficits. BP in a subset of these regions was robustly related to discrete clinical parameters in each patient population. Widespread deficits in NK-1R BP occur in IBD and, to a lesser extent, IBS; however, discrete clinical parameters relate to NK-1R BP in each patient population. This suggests that potential pharmacological interventions that target NK-1R signaling may be most effective for treating distinct symptoms in IBD and IBS.
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Affiliation(s)
- Johanna M Jarcho
- Section on Developmental and Affective Neuroscience, National Institute of Mental Health, Bethesda, MD, USA
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20
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Xu J, Fregni F, Brody AL, Rahman AS. Transcranial direct current stimulation reduces negative affect but not cigarette craving in overnight abstinent smokers. Front Psychiatry 2013; 4:112. [PMID: 24065930 PMCID: PMC3778370 DOI: 10.3389/fpsyt.2013.00112] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2013] [Accepted: 09/04/2013] [Indexed: 12/25/2022] Open
Abstract
Transcranial direct current stimulation (tDCS) can enhance cognitive control functions including attention and top-down regulation over negative affect and substance craving in both healthy and clinical populations, including early abstinent (∼1.5 h) smokers. The aim of this study was to assess whether tDCS modulates negative affect, cigarette craving, and attention of overnight abstinent tobacco dependent smokers. In this study, 24 smokers received a real and a sham session of tDCS after overnight abstinence from smoking on two different days. We applied anode to the left dorsolateral prefrontal cortex and cathode to the right supra-orbital area for 20 min with a current of 2.0 mA. We used self-report questionnaires Profile of Mood States (POMS) to assess negative affect and Urge to Smoke (UTS) Scale to assess craving for cigarette smoking, and a computerized visual target identification task to assess attention immediately before and after each tDCS. Smokers reported significantly greater reductions in POMS scores of total mood disturbance and scores of tension-anxiety, depression-dejection, and confusion-bewilderment subscales after real relative to sham tDCS. Furthermore, this reduction in negative affect positively correlated with the level of nicotine dependence as assessed by Fagerström scale. However, reductions in cigarette craving after real vs. sham tDCS did not differ, nor were there differences in reaction time or hit rate change on the visual task. Smokers did not report significant side effects of tDCS. This study demonstrates the safety of tDCS and its promising effect in ameliorating negative affect in overnight abstinent smokers. Its efficacy in treating tobacco dependence deserves further investigation.
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Affiliation(s)
- Jiansong Xu
- Department of Psychiatry, Yale Medical School , New Haven, CT , USA
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Culbertson CS, Shulenberger S, De La Garza R, Newton TF, Brody AL. VIRTUAL REALITY CUE EXPOSURE THERAPY FOR THE TREATMENT OF TOBACCO DEPENDENCE. J Cyber Ther Rehabil 2012; 5:57-64. [PMID: 25342999 PMCID: PMC4204479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Researchers and clinicians have recently begun using Virtual Reality (VR) to create immersive and interactive cue exposure paradigms. The current study aimed to assess the effectiveness of individual cue exposure therapy (CET), using smoking-related VR cues (smoking-VR) as a smoking cessation treatment compared to a placebo-VR (neutral cue) treatment. The sample consisted of healthy treatment-seeking cigarette smokers, who underwent bi-weekly cognitive behavioral group therapy (CBT) plus either smoking-VR CET or placebo-VR CET (random assignment). Smoking-VR CET participants had a higher quit rate than placebo-VR CET participants (P = 0.015). Smoking-VR CET treated participants also reported smoking significantly fewer cigarettes per day at the end of treatment than placebo-VR CET treated participants (P = 0.034). These data indicate that smoking-related VR CET may prove useful in enhancing the efficacy of CBT treatment for tobacco dependence.
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Affiliation(s)
- Christopher S. Culbertson
- Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, CA
- Departments of Research and Psychiatry, VA Greater Los Angeles Healthcare System, Los Angeles, CA
| | - Stephanie Shulenberger
- Departments of Research and Psychiatry, VA Greater Los Angeles Healthcare System, Los Angeles, CA
| | - Richard De La Garza
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX
| | - Thomas F. Newton
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX
| | - Arthur L. Brody
- Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, CA
- Departments of Research and Psychiatry, VA Greater Los Angeles Healthcare System, Los Angeles, CA
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Liao Y, Tang J, Deng Q, Deng Y, Luo T, Wang X, Chen H, Liu T, Chen X, Brody AL, Hao W. Bilateral fronto-parietal integrity in young chronic cigarette smokers: a diffusion tensor imaging study. PLoS One 2011; 6:e26460. [PMID: 22069452 PMCID: PMC3206030 DOI: 10.1371/journal.pone.0026460] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2011] [Accepted: 09/27/2011] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Cigarette smoking continues to be the leading cause of preventable morbidity and mortality in China and other countries. Previous studies have demonstrated gray matter loss in chronic smokers. However, only a few studies assessed the changes of white matter integrity in this group. Based on those previous reports of alterations in white matter integrity in smokers, the aim of this study was to examine the alteration of white matter integrity in a large, well-matched sample of chronic smokers and non-smokers. METHODOLOGY/PRINCIPAL FINDINGS Using in vivo diffusion tensor imaging (DTI) to measure the differences of whole-brain white matter integrity between 44 chronic smoking subjects (mean age, 28.0±5.6 years) and 44 healthy age- and sex-matched comparison non-smoking volunteers (mean age, 26.3±5.8 years). DTI was performed on a 3-Tesla Siemens scanner (Allegra; Siemens Medical System). The data revealed that smokers had higher fractional anisotropy (FA) than healthy non-smokers in almost symmetrically bilateral fronto-parietal tracts consisting of a major white matter pathway, the superior longitudinal fasciculus (SLF). CONCLUSION/SIGNIFICANCE We found the almost symmetrically bilateral fronto-parietal whiter matter changes in a relatively large sample of chronic smokers. These findings support the hypothesis that chronic cigarette smoking involves alterations of bilateral fronto-parietal connectivity.
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Affiliation(s)
- Yanhui Liao
- Mental Health Institute, The Second Xiangya Hospital, Central South University, Changsha, People's Republic of China
| | - Jinsong Tang
- Mental Health Institute, The Second Xiangya Hospital, Central South University, Changsha, People's Republic of China
| | - Qijian Deng
- Mental Health Institute, The Second Xiangya Hospital, Central South University, Changsha, People's Republic of China
| | - Yongwen Deng
- Department of Neurosurgery, People's Hospital of Hunan Province, Changsha, People's Republic of China
| | - Tao Luo
- Mental Health Institute, The Second Xiangya Hospital, Central South University, Changsha, People's Republic of China
| | - Xuyi Wang
- Mental Health Institute, The Second Xiangya Hospital, Central South University, Changsha, People's Republic of China
| | - Hongxian Chen
- Mental Health Institute, The Second Xiangya Hospital, Central South University, Changsha, People's Republic of China
| | - Tieqiao Liu
- Mental Health Institute, The Second Xiangya Hospital, Central South University, Changsha, People's Republic of China
| | - Xiaogang Chen
- Mental Health Institute, The Second Xiangya Hospital, Central South University, Changsha, People's Republic of China
| | - Arthur L. Brody
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles School of Medicine, Los Angeles, California, United States of America
- Departments of Psychiatry and Research, Greater Los Angeles VA Healthcare System, Los Angeles, California, United States of America
| | - Wei Hao
- Mental Health Institute, The Second Xiangya Hospital, Central South University, Changsha, People's Republic of China
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23
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Affiliation(s)
- Arthur L Brody
- Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, Los Angeles, California; Department of Psychiatry, Greater Los Angeles Veterans Affairs Healthcare System, Los Angeles, California.
| | - Ian A Cook
- Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, Los Angeles, California
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Anderson A, Bramen J, Douglas PK, Lenartowicz A, Cho A, Culbertson C, Brody AL, Yuille AL, Cohen MS. Large Sample Group Independent Component Analysis of Functional Magnetic Resonance Imaging Using Anatomical Atlas-Based Reduction and Bootstrapped Clustering. Int J Imaging Syst Technol 2011; 21:223-231. [PMID: 22049263 PMCID: PMC3204794 DOI: 10.1002/ima.20286] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Independent component analysis (ICA) is a popular method for the analysis of functional magnetic resonance imaging (fMRI) signals that is capable of revealing connected brain systems of functional significance. To be computationally tractable, estimating the independent components (ICs) inevitably requires one or more dimension reduction steps. Whereas most algorithms perform such reductions in the time domain, the input data are much more extensive in the spatial domain, and there is broad consensus that the brain obeys rules of localization of function into regions that are smaller in number than the number of voxels in a brain image. These functional units apparently reorganize dynamically into networks under different task conditions. Here we develop a new approach to ICA, producing group results by bagging and clustering over hundreds of pooled single-subject ICA results that have been projected to a lower-dimensional subspace. Averages of anatomically based regions are used to compress the single subject-ICA results prior to clustering and resampling via bagging. The computational advantages of this approach make it possible to perform group-level analyses on datasets consisting of hundreds of scan sessions by combining the results of within-subject analysis, while retaining the theoretical advantage of mimicking what is known of the functional organization of the brain. The result is a compact set of spatial activity patterns that are common and stable across scan sessions and across individuals. Such representations may be used in the context of statistical pattern recognition supporting real-time state classification.
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Affiliation(s)
- Ariana Anderson
- Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, Los Angeles, CA
| | - Jennifer Bramen
- Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, Los Angeles, CA
| | - Pamela K. Douglas
- Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, Los Angeles, CA
| | - Agatha Lenartowicz
- Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, Los Angeles, CA
| | - Andrew Cho
- Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, Los Angeles, CA
| | - Chris Culbertson
- Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, Los Angeles, CA
| | - Arthur L. Brody
- Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, Los Angeles, CA
- Department of Psychiatry, Greater Los Angeles VA Healthcare System, Los Angeles, CA
- Department of Radiology, Greater Los Angeles VA Healthcare System, Los Angeles, CA
| | - Alan L. Yuille
- Department of Statistics, University of California at Los Angeles, Los Angeles, CA
- Department of Brain and Cognitive Engineering, Korea University, Anam-dong, Seongbuk-gu, Seoul 136–713, Korea
| | - Mark S. Cohen
- Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, Los Angeles, CA
- Department of Biomedical Engineering, Neurology, Psychology, Biomedical Physics and Radiology, University of California at Los Angeles, Los Angeles, CA
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Brody AL, Mandelkern MA, London ED, Khan A, Kozman D, Costello MR, Vellios EE, Archie MM, Bascom R, Mukhin AG. Effect of secondhand smoke on occupancy of nicotinic acetylcholine receptors in brain. ACTA ACUST UNITED AC 2011; 68:953-60. [PMID: 21536968 DOI: 10.1001/archgenpsychiatry.2011.51] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
CONTEXT Despite progress in tobacco control, secondhand smoke (SHS) exposure remains prevalent worldwide and is implicated in the initiation and maintenance of cigarette smoking. OBJECTIVE To determine whether moderate SHS exposure results in brain α(4)β(2)* nicotinic acetylcholine receptor (nAChR) occupancy. DESIGN, SETTING, AND PARTICIPANTS Positron emission tomography scanning and the radiotracer 2-[18F]fluoro-3-(2(S)azetidinylmethoxy) pyridine (also known as 2-[(18)F]fluoro-A-85380, or 2-FA) were used to determine α(4)β(2)* nAChR occupancy from SHS exposure in 24 young adult participants (11 moderately dependent cigarette smokers and 13 nonsmokers). Participants underwent two bolus-plus-continuous-infusion 2-FA positron emission tomography scanning sessions during which they sat in the passenger's seat of a car for 1 hour and either were exposed to moderate SHS or had no SHS exposure. The study took place at an academic positron emission tomography center. Main Outcome Measure Changes induced by SHS in 2-FA specific binding volume of distribution as a measure of α(4)β(2)* nAChR occupancy. RESULTS An overall multivariate analysis of variance using specific binding volume of distribution values revealed a significant main effect of condition (SHS vs control) (F(1,22) = 42.5, P < .001) but no between-group (smoker vs nonsmoker) effect. Exposure to SHS led to a mean 19% occupancy of brain α(4)β(2)* nAChRs (1-sample t test, 2-tailed, P < .001). Smokers had both a mean 23% increase in craving with SHS exposure and a correlation between thalamic α(4)β(2)* nAChR occupancy and craving alleviation with subsequent cigarette smoking (Spearman ρ = -0.74, P = .01). CONCLUSIONS Nicotine from SHS exposure results in substantial brain α(4)β(2)* nAChR occupancy in smokers and nonsmokers. Study findings suggest that such exposure delivers a priming dose of nicotine to the brain that contributes to continued cigarette use in smokers. This study has implications for both biological research into the link between SHS exposure and cigarette use and public policy regarding the need to limit SHS exposure in cars and other enclosed spaces.
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Affiliation(s)
- Arthur L Brody
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, USA.
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Lotfipour S, Mandelkern M, Brody AL. Quantitative Molecular Imaging of Neuronal Nicotinic Acetylcholine Receptors in the Human Brain with A-85380 Radiotracers. Curr Med Imaging 2011; 7:107-112. [PMID: 22773924 DOI: 10.2174/157340511795445676] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Neuronal nicotinic acetylcholine receptors (nAChRs) have been implicated in a spectrum of cognitive functions as well as psychiatric and neurodegenerative disorders, including tobacco addiction and Alzheimer's Disease. The examination of neuronal nAChRs in living humans is a relatively new field. Researchers have developed brain-imaging radiotracers for nAChRs, with radiolabeled A-85380 compounds having the most widespread use. We provide a brief background on nAChRs, followed by a discussion of the development and application of A-85380 radiotracers in human imaging studies. We describe potential future studies using nicotinic receptor radioligands for the study of tobacco addiction, including the mechanism of action of the smoking-cessation therapy varenicline. Throughout this review, we focus on the significant potential that resides in the identification and quantification of nAChRs in the living human brain.
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Affiliation(s)
- Shahrdad Lotfipour
- Department of Psychiatry, David Geffen School of Medicine, University of California, Los Angeles, California, USA
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Culbertson CS, Bramen J, Cohen MS, London ED, Olmstead RE, Gan JJ, Costello MR, Shulenberger S, Mandelkern MA, Brody AL. Effect of bupropion treatment on brain activation induced by cigarette-related cues in smokers. ACTA ACUST UNITED AC 2011; 68:505-15. [PMID: 21199957 DOI: 10.1001/archgenpsychiatry.2010.193] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
CONTEXT Nicotine-dependent smokers exhibit craving and brain activation in the prefrontal and limbic regions when presented with cigarette-related cues. Bupropion hydrochloride treatment reduces cue-induced craving in cigarette smokers; however, the mechanism by which bupropion exerts this effect has not yet been described. OBJECTIVE To assess changes in regional brain activation in response to cigarette-related cues from before to after treatment with bupropion (vs placebo). DESIGN Randomized, double-blind, before-after controlled trial. SETTING Academic brain imaging center. PARTICIPANTS Thirty nicotine-dependent smokers (paid volunteers). INTERVENTIONS Participants were randomly assigned to receive 8 weeks of treatment with either bupropion or a matching placebo pill (double-blind). MAIN OUTCOME MEASURES Subjective cigarette craving ratings and regional brain activations (blood oxygen level-dependent response) in response to viewing cue videos. RESULTS Bupropion-treated participants reported less craving and exhibited reduced activation in the left ventral striatum, right medial orbitofrontal cortex, and bilateral anterior cingulate cortex from before to after treatment when actively resisting craving compared with placebo-treated participants. When resisting craving, reduction in self-reported craving correlated with reduced regional brain activation in the bilateral medial orbitofrontal and left anterior cingulate cortices in all participants. CONCLUSIONS Treatment with bupropion is associated with improved ability to resist cue-induced craving and a reduction in cue-induced activation of limbic and prefrontal brain regions, while a reduction in craving, regardless of treatment type, is associated with reduced activation in prefrontal brain regions.
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28
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Brody AL, London ED, Olmstead RE, Allen-Martinez Z, Shulenberger S, Costello MR, Abrams AL, Scheibal D, Farahi J, Shoptaw S, Mandelkern MA. Smoking-induced change in intrasynaptic dopamine concentration: effect of treatment for Tobacco Dependence. Psychiatry Res 2010; 183:218-24. [PMID: 20682457 PMCID: PMC2947623 DOI: 10.1016/j.pscychresns.2009.06.004] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2008] [Revised: 06/12/2009] [Accepted: 06/17/2009] [Indexed: 11/29/2022]
Abstract
The aim of this study was to determine whether standard treatments for Tobacco Dependence affect smoking-induced changes in intrasynaptic dopamine (DA) concentration. Forty-three otherwise healthy adult cigarette smokers (10 to 40 cigarettes per day) were treated with either practical group counseling (PGC) psychotherapy (n=14), bupropion HCl (n=14), or matching pill placebo (n=15) (random assignment) for 8 weeks. Before and after treatment, each subject underwent a bolus-plus-continuous-infusion (11)C-raclopride positron emission tomography (PET) scanning session, during which he or she smoked a regular cigarette. The PET scanning outcome measure of interest was percent change in smoking-induced (11)C-raclopride binding potential (BP(ND)) in the ventral caudate/nucleus accumbens (VCD/NAc), as an indirect measure of DA release. Although the entire study sample had a smaller mean smoking-induced reduction in VCD/NAc BP(ND) after treatment (compared to before treatment), this change was highly correlated with smaller total cigarette puff volumes (and not other treatment variables). These data indicate that smoking-induced DA release is dose-dependent, and is not significantly affected by reductions in daily smoking levels or treatment type.
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Affiliation(s)
- Arthur L Brody
- Department of Psychiatry, UCLA, Los Angeles, CA 90095, USA.
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Culbertson C, Nicolas S, Zaharovits I, London ED, De La Garza R, Brody AL, Newton TF. Methamphetamine craving induced in an online virtual reality environment. Pharmacol Biochem Behav 2010; 96:454-60. [PMID: 20643158 DOI: 10.1016/j.pbb.2010.07.005] [Citation(s) in RCA: 77] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2010] [Revised: 06/21/2010] [Accepted: 07/05/2010] [Indexed: 11/29/2022]
Abstract
The main aim of this study was to assess self-reported craving and physiological reactivity in a methamphetamine virtual reality (METH-VR) cue model created using Second Life, a freely available online gaming platform. Seventeen, non-treatment seeking, individuals that abuse methamphetamine (METH) completed this 1-day, outpatient, within-subjects study. Participants completed four test sessions: 1) METH-VR, 2) neutral-VR, 3) METH-video, and 4) neutral-video in a counterbalanced (Latin square) fashion. The participants provided subjective ratings of urges to use METH, mood, and physical state throughout each cue presentation. Measures of physiological reactivity (heart rate variability) were also collected during each cue presentation and at rest. The METH-VR condition elicited the greatest change in subjective reports of "crave METH", "desire METH", and "want METH" at all time points. The "high craving" participants displayed more high frequency cardiovascular activity while the "low craving" participants displayed more low frequency cardiovascular activity during the cue conditions, with the greatest difference seen during the METH-VR and METH-video cues. These findings reveal a physiological divergence between high and low craving METH abusers using heart rate variability, and demonstrate the usefulness of VR cues for eliciting subjective craving in METH abusers, as well as the effectiveness of a novel VR drug cue model created within an online virtual world.
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Azizian A, Nestor LJ, Payer D, Monterosso JR, Brody AL, London ED. Smoking reduces conflict-related anterior cingulate activity in abstinent cigarette smokers performing a Stroop task. Neuropsychopharmacology 2010; 35:775-82. [PMID: 19907418 PMCID: PMC2813980 DOI: 10.1038/npp.2009.186] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Prior research suggests that abrupt initiation of abstinence from cigarette smoking reduces neural cognitive efficiency. When cognitive efficiency is high, processing speed and accuracy are maximized with minimal allocation of cognitive resources. The study presented here tested the effects of resumption of smoking on cognitive response conflict after overnight abstinence from smoking, hypothesizing that smoking would enhance cognitive efficiency. Twenty paid research volunteers who were chronic cigarette smokers abstained from smoking overnight (>12 h) before undergoing fMRI while performing a color-word Stroop task during two separate test sessions: one that did not include smoking before testing and another one that did. Statistical analyses were performed by modeling the Stroop effect (incongruent >congruent) BOLD response within a collection of a priori regions of interest that have consistently been associated with cognitive control. Behavioral assessment alone did not reveal any significant differences in the Stroop effect between the two sessions. BOLD activations, however, indicated that in the right anterior cingulate cortex (ACC), smokers had significantly less task-related activity following smoking (p<0.02). In contrast, the right middle frontal gyrus exhibited significantly greater activity after smoking as compared to the no-smoking session (p<0.003). Exaggerated neural activity in the ACC during nicotine withdrawal may reflect a compensatory mechanism by which cognitive control networks expend excessive energy to support selective attention processes. Resumption of smoking may enhance cognitive control in smokers, involving a reduction in ACC response conflict activity together with improvement in conflict resolution involving the dorsolateral prefrontal cortex.
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Affiliation(s)
- Allen Azizian
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA,Department of Psychology, University of Southern California, Los Angeles, CA, USA
| | - Liam J Nestor
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
| | - Doris Payer
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
| | - John R Monterosso
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA,Department of Psychology, University of Southern California, Los Angeles, CA, USA
| | - Arthur L Brody
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA,Brain Research Institute, University of California, Los Angeles, CA, USA
| | - Edythe D London
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA,Brain Research Institute, University of California, Los Angeles, CA, USA,Molecular and Medical Pharmacology, David Geffen School of Medicine, University of California, Los Angeles, CA, USA,UCLA Semel Institute, 740 Westwood Plaza, Room C8-831, Los Angeles, CA 90095, USA, Tel: +310 825 0606, Fax: +310 825 0812, E-mail:
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31
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Costello MR, Mandelkern MA, Shoptaw S, Shulenberger S, Baker SK, Abrams AL, Xia C, London ED, Brody AL. Effects of treatment for tobacco dependence on resting cerebral glucose metabolism. Neuropsychopharmacology 2010; 35:605-12. [PMID: 19865076 PMCID: PMC2813904 DOI: 10.1038/npp.2009.165] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
While bupropion HCl and practical group counseling (PGC) are commonly used treatments for tobacco dependence, the effects of these treatments on brain function are not well established. For this study, 54 tobacco-dependent cigarette smokers underwent resting (18)F-fluorodeoxyglucose-positron emission tomography (FDG-PET) scanning before and after 8 weeks of treatment with bupropion HCl, PGC, or pill placebo. Using Statistical Parametric Mapping (SPM 2), changes in cerebral glucose metabolism from before to after treatment were compared between treatment groups and correlations were determined between amount of daily cigarette usage and cerebral glucose metabolism. Compared with placebo, the two active treatments (bupropion HCl and PGC) had reductions in glucose metabolism in the posterior cingulate gyrus. Further analysis suggested that PGC had a greater effect than bupropion HCl on glucose metabolism in this region. We also found positive correlations between daily cigarette use and glucose metabolism in the left occipital gyrus and parietal-temporal junction. There were no significant negative correlations between daily cigarette use and glucose metabolism. Our findings suggest that bupropion HCl and PGC reduce neural activity much as the performance of a goal-oriented task does in the default mode network of the brain, including the posterior cingulate gyrus. Thus, this study supports the theory that active treatments for tobacco dependence move the brain into a more goal-oriented state.
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Affiliation(s)
- Matthew R Costello
- Greater Los Angeles Veterans Administration Healthcare System, Los Angeles, CA 90095, USA.
| | - Mark A Mandelkern
- Greater Los Angeles Veterans Administration Healthcare System, Los Angeles, CA, USA,UCI Department of Physics, Irvine, CA, USA
| | - Stephen Shoptaw
- UCLA Department of Psychiatry and Biobehavioral Sciences, Los Angeles, CA, USA
| | | | - Stephanie K Baker
- Greater Los Angeles Veterans Administration Healthcare System, Los Angeles, CA, USA
| | - Anna L Abrams
- Greater Los Angeles Veterans Administration Healthcare System, Los Angeles, CA, USA
| | - Catherine Xia
- Greater Los Angeles Veterans Administration Healthcare System, Los Angeles, CA, USA
| | - Edythe D London
- UCLA Department of Psychiatry and Biobehavioral Sciences, Los Angeles, CA, USA,UCLA Brain Research Institute, Los Angeles, CA, USA,UCLA Department of Molecular and Medical Pharmacology, Los Angeles, CA, USA
| | - Arthur L Brody
- Greater Los Angeles Veterans Administration Healthcare System, Los Angeles, CA, USA,UCLA Department of Psychiatry and Biobehavioral Sciences, Los Angeles, CA, USA,UCLA Brain Research Institute, Los Angeles, CA, USA,Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, 300 UCLA Medical Plaza, Suite 2200, Los Angeles, CA 90095, USA, Tel: +1 310 268 4778, Fax: +1 310 206 2802, E-mail:
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Brody AL, Olmstead RE, Abrams AL, Costello MR, Khan A, Kozman D, Saxena S, Farahi J, London ED, Mandelkern MA. Effect of a history of major depressive disorder on smoking-induced dopamine release. Biol Psychiatry 2009; 66:898-901. [PMID: 19640507 PMCID: PMC2763050 DOI: 10.1016/j.biopsych.2009.06.011] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2009] [Revised: 05/30/2009] [Accepted: 06/10/2009] [Indexed: 11/30/2022]
Abstract
BACKGROUND Dopamine (DA) system dysfunction is implicated in the pathophysiology of major depressive disorder (MDD). We sought to determine if cigarette smokers with a history of MDD and current mild depressive symptoms have abnormal smoking-induced DA release (measured indirectly as change in (11)C-raclopride binding potential [BP(ND)]). METHODS Fifty-six cigarette smokers either with (n = 10) or without (n = 46) a history of MDD (MDD+ and MDD-, respectively) underwent bolus-plus-continuous-infusion (11)C-raclopride positron emission tomography, during which they smoked a regular cigarette. Presmoking to postsmoking changes in (11)C-raclopride BP(ND) were compared between groups. Also, correlations were determined between change in BP(ND) and depression, anxiety, and withdrawal rating scale scores for the MDD+ group. RESULTS The MDD+ group had a significantly greater reduction in (11)C-raclopride BP(ND) (-16.3%) than the MDD- group (-8.4%) (analysis of covariance [ANCOVA], p = .03). Significant negative correlations were found between depression/anxiety and change in (11)C-raclopride BP(ND) (r = -.77, p < .01 and r = -.74, p = .01, respectively). CONCLUSIONS MDD+ smokers have greater smoking-induced DA release than MDD- smokers, and higher depression/anxiety levels are associated with greater smoking-induced DA release. These findings support the theory that MDD+ smokers have DA system dysfunction, including heightened smoking-induced DA release.
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Affiliation(s)
- Arthur L Brody
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, California 90095, USA.
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Abstract
While most cigarette smokers endorse a desire to quit smoking, only 14-49% will achieve abstinence after 6 months or more of treatment. A greater understanding of the effects of smoking on brain function may result in improved pharmacological and behavioral interventions for this condition. Research groups have examined the effects of acute and chronic nicotine/cigarette exposure on brain activity using functional imaging; the purpose of this chapter is to synthesize findings from such studies and present a coherent model of brain function in smokers. Responses to acute administration of nicotine/smoking include reduced global brain activity; activation of the prefrontal cortex, thalamus, and visual system; activation of the thalamus and visual cortex during visual cognitive tasks; and increased dopamine (DA) concentration in the ventral striatum/nucleus accumbens. Responses to chronic nicotine/cigarette exposure include decreased monoamine oxidase (MAO) A and B activity in the basal ganglia and a reduction in alpha4beta2 nicotinic acetylcholine receptor (nAChR) availability in the thalamus and putamen (accompanied by an overall upregulation of these receptors). These findings indicate that smoking enhances neurotransmission through cortico-basal ganglia-thalamic circuits by direct stimulation of nAChRs, indirect stimulation via DA release or MAO inhibition, or a combination of these and possibly other factors. Activation of this circuitry may be responsible for the effects of smoking seen in tobacco-dependent smokers, such as improvements in attentional performance, mood, anxiety, and irritability.
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Affiliation(s)
- Anil Sharma
- Department of Psychiatry and Biobehavioral Sciences, UCLA School of Medicine, Greater Los Angeles VA Healthcare System, 11301 Wilshire Blvd. Bldg 256 Suite 221, Los Angeles, CA 90073, USA.
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Xu J, Azizian A, Monterosso J, Domier CP, Brody AL, Fong TW, London ED. Gender effects on mood and cigarette craving during early abstinence and resumption of smoking. Nicotine Tob Res 2009; 10:1653-61. [PMID: 18988078 DOI: 10.1080/14622200802412929] [Citation(s) in RCA: 73] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Women are more likely than men to relapse after initiating abstinence from cigarette smoking. The reasons for this phenomenon are unclear but may relate to negative mood, cigarette craving, or other symptoms of nicotine withdrawal. We addressed this issue in a study of 26 female and 38 male smokers. The Profile of Mood States, Shiffman-Jarvik Withdrawal Scale, and Urge to Smoke Scale were administered twice in each of two test sessions on different days. One session began within 1 hr after smoking ad libitum and the other followed overnight abstinence (>13 hr). On each test day, the two assessment blocks were separated by a 5-10-min break, during which each participant smoked one cigarette. In the first test block, both men and women reported higher scores after >13 hr abstinence than after <1 hr abstinence on the tension-anxiety and anger-hostility subscales of the Profile of Mood States, and for the craving and psychological symptoms of the Shiffman-Jarvik Withdrawal Scale. Scores of female subjects showed significantly larger differences between sessions on the tension-anxiety subscale and a trend toward significance (p = .050) on the anger-hostility subscale of Profile of Mood States than those of males. Moreover, on the tension-anxiety subscale, women also reported a greater reduction than men from smoking one cigarette after overnight abstinence. The findings indicate that overnight abstinence produces more negative mood symptoms and cigarette craving in female smokers than in males, and that resumption of smoking produces greater relief from these symptoms in female smokers. These differences may contribute to the greater likelihood of relapse when women try to quit smoking.
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Affiliation(s)
- Jiansong Xu
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angles, Los Angeles, CA, USA
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Azizian A, Monterosso JR, Brody AL, Simon SL, London ED. Severity of nicotine dependence moderates performance on perceptual-motor tests of attention. Nicotine Tob Res 2008; 10:599-606. [PMID: 18418782 PMCID: PMC2773663 DOI: 10.1080/14622200801979159] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Acute abstinence from cigarette smoking by nicotine-dependent smokers has been linked with cognitive deficits, but the role of nicotine dependence per se in these effects is not known. We therefore tested the relationships of nicotine dependence and smoking history with performance in perceptual-motor, timed tests of attention. Nicotine-dependent smokers (n = 37) and nonsmokers (n = 48), 18-55 years old, took both the d2 Test of Attention and the Digit Symbol Test on each of 2 test days. For smokers, testing on one day began after ad libitum smoking (<45 min since last cigarette); and on the other day, it began after overnight abstinence (>13 hr since last cigarette). On each test day, there were two test blocks with an intervening break, when only the smokers each smoked one cigarette. There were no significant effects of abstinence or of smoking one cigarette on the performance of smokers; however, across conditions, the smokers' performance on both tests correlated negatively with severity of nicotine dependence but not lifetime cigarette consumption or cigarette craving. Smokers with high nicotine dependence performed more slowly on both tests than less dependent smokers or nonsmokers. The findings suggest that severity of nicotine dependence and slowness in perceptual-motor tasks of attention share an underlying basis.
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Affiliation(s)
- Allen Azizian
- Department of Psychiatry and Biobehavioral Sciences, Laboratory of Molecular Neuroimaging, UCLA Semel Institute for Neuroscience and Human Behavior, Los Angeles, CA 90024, USA
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Domier CP, Monterosso JR, Brody AL, Simon SL, Mendrek A, Olmstead R, Jarvik ME, Cohen MS, London ED. Effects of cigarette smoking and abstinence on Stroop task performance. Psychopharmacology (Berl) 2007; 195:1-9. [PMID: 17634928 PMCID: PMC2796691 DOI: 10.1007/s00213-007-0869-x] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2007] [Accepted: 06/21/2007] [Indexed: 11/25/2022]
Abstract
RATIONALE Smokers report enhanced concentration after cigarette smoking and difficulty concentrating when abstinent from smoking. These perceived effects may contribute to smoking cessation failures, and if so, clarification of their cognitive bases could inform treatment strategies. Selective attention may be important in this regard, but earlier literature presents inconsistent findings on how smoking abstinence and resumption of smoking influence this cognitive function. OBJECTIVES We aimed to compare smokers and nonsmokers on selective attention, and in smokers, to test the effects of overnight abstinence from smoking and of acute smoking on selective attention. MATERIALS AND METHODS Smokers and nonsmokers (n = 43) performed a Stroop test (two test days, two test blocks per day). Smokers participated after overnight abstinence and also within 1-h of ad libitum smoking. Smokers each smoked a cigarette between test blocks on each day; nonsmokers did not. RESULTS Smokers demonstrated longer response latencies for both congruent and incongruent stimuli after overnight than brief abstinence, but no deficit specifically related to selective attention. Whereas nonsmokers showed no changes in performance in the second test block, smoking between blocks reduced the Stroop effect when smokers were abstinent overnight. CONCLUSIONS These data are consistent with the hypothesis that abstinence from smoking among nicotine-dependent individuals has deleterious effects on cognitive performance, but do not indicate that selective attention is adversely effected. Improvement in selective attention after terminating abstinence with one cigarette may also contribute to smokers' perceived enhanced ability to concentrate after smoking.
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Affiliation(s)
- Catherine P Domier
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, Los Angeles, CA, USA
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Brody AL, Mandelkern MA, Olmstead RE, Jou J, Tiongson E, Allen V, Scheibal D, London ED, Monterosso JR, Tiffany ST, Korb A, Gan JJ, Cohen MS. Neural substrates of resisting craving during cigarette cue exposure. Biol Psychiatry 2007; 62:642-51. [PMID: 17217932 PMCID: PMC1992815 DOI: 10.1016/j.biopsych.2006.10.026] [Citation(s) in RCA: 220] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2006] [Revised: 08/22/2006] [Accepted: 10/13/2006] [Indexed: 10/23/2022]
Abstract
BACKGROUND In cigarette smokers, the most commonly reported areas of brain activation during visual cigarette cue exposure are the prefrontal, anterior cingulate, and visual cortices. We sought to determine changes in brain activity in response to cigarette cues when smokers actively resist craving. METHODS Forty-two tobacco-dependent smokers underwent functional magnetic resonance imaging, during which they were presented with videotaped cues. Three cue presentation conditions were tested: cigarette cues with subjects allowing themselves to crave (cigarette cue crave), cigarette cues with the instruction to resist craving (cigarette cue resist), and matched neutral cues. RESULTS Activation was found in the cigarette cue resist (compared with the cigarette cue crave) condition in the left dorsal anterior cingulate cortex (ACC), posterior cingulate cortex (PCC), and precuneus. Lower magnetic resonance signal for the cigarette cue resist condition was found in the cuneus bilaterally, left lateral occipital gyrus, and right postcentral gyrus. These relative activations and deactivations were more robust when the cigarette cue resist condition was compared with the neutral cue condition. CONCLUSIONS Suppressing craving during cigarette cue exposure involves activation of limbic (and related) brain regions and deactivation of primary sensory and motor cortices.
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Affiliation(s)
- Arthur L Brody
- Department of Psychiatry and Biobehavioral Sciences, University of California-Los Angeles, 300 UCLA Medical Plaza, Los Angeles, CA 90095, USA.
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Abstract
OBJECTIVE Compulsive hoarding, found in many patients with obsessive-compulsive disorder (OCD), has been associated with poor response to serotonin reuptake inhibitor (SRI) medications in some reports. However, no prior study has quantitatively measured response to standardized pharmacotherapy in compulsive hoarders. We sought to determine whether compulsive hoarders would respond as well as non-hoarding OCD patients to the SRI, paroxetine. METHODS Seventy-nine patients with OCD (32 patients with the compulsive hoarding syndrome and 47 patients without prominent hoarding symptoms) were treated openly with paroxetine (mean dose 41.6+/-12.8 mg/day; mean duration 80.4+/-23.5 days) according to a standardized protocol, from 3/1993 to 7/2005. All subjects were free of psychotropic medication for at least four weeks prior to study entry. No psychotherapy or psychotropic medications except paroxetine were allowed during the study period. Subjects were assessed before and after treatment with the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), Hamilton Depression Rating Scale (HDRS), Hamilton Anxiety Scale (Ham-A), Global Assessment Scale (GAS), and Clinical Global Impression/Improvement (CGI) scale. RESULTS Both compulsive hoarders and non-hoarding OCD patients improved significantly with treatment (p<0.001), with nearly identical changes in Y-BOCS, HDRS, Ham-A, and GAS scores. There were no significant differences between groups in the proportions of patients who completed or responded to treatment. Hoarding symptoms improved as much as other OCD symptoms. CONCLUSIONS Compulsive hoarders responded as well to paroxetine treatment as non-hoarding OCD patients, suggesting that SRI medications are effective for compulsive hoarding. Controlled trials of SRI medications for compulsive hoarding are now warranted.
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Affiliation(s)
- Sanjaya Saxena
- UCSD Department of Psychiatry, VA San Diego Healthcare System, 3350 La Jolla Village Drive, San Diego, CA 92161, United States
- Corresponding author. Tel.: +1 858 642 3472; fax: +1 858 642 6442. (S. Saxena)
| | - Arthur L. Brody
- UCLA Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, Los Angeles, CA, United States
| | - Karron M. Maidment
- UCLA Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, Los Angeles, CA, United States
| | - Lewis R. Baxter
- University of Florida, Department of Psychiatry, Gainesville, FL, United States
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Grand RBG, Hwang S, Han J, George T, Brody AL. Short-term naturalistic treatment outcomes in cigarette smokers with substance abuse and/or mental illness. J Clin Psychiatry 2007; 68:892-8; quiz 980-1. [PMID: 17592914 PMCID: PMC2893593 DOI: 10.4088/jcp.v68n0611] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE The majority of cigarette smokers have a lifetime diagnosis of substance abuse and/or mental illness, and treatment outcomes for smokers with these comorbidities are generally reported to be worse than for smokers without comorbidities. We sought to examine the effect of specific substance abuse/mental illness diagnoses compared to one another on treatment outcomes. METHOD A retrospective chart review of naturalistic treatment for nicotine dependence was performed on male smokers (N = 231) who enrolled in the Greater Los Angeles Veterans Affairs Mental Health Clinic Smoking Cessation Program (Los Angeles, Calif.) over a 1.5-year period (January 2004 to June 2005). Subjects in this program, who were diagnosed with nicotine dependence on the basis of a DSM-IV-based interview and a Fagerström Test for Nicotine Dependence score of > or = 3, underwent comprehensive treatment for nicotine dependence (including, but not limited to, group psychotherapy, nicotine replacement therapy, and bupropion hydrochloride). Quitting smoking was defined as a report of at least 1 week of abstinence and an exhaled carbon monoxide less than or equal to 8 parts per million at the final clinic visit. RESULTS Of the total group, 36.4% (84/231) quit smoking at the end of treatment. Quit rates were affected by the presence of specific diagnoses, with smokers with a history of alcohol abuse/dependence or schizophrenia/schizoaffective disorder having poorer response rates than smokers without such diagnoses. Other substance abuse and mental illness diagnoses did not affect quit rates. CONCLUSION Lower quit rates among patients with alcohol abuse/dependence or schizophrenia/schizoaffective disorder may be due to the severity of these conditions and suggest that specialized treatment is needed for these populations of smokers. Smokers with most comorbid diagnoses are successfully treated with standard treatment methods.
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Affiliation(s)
- Risa B. Gershon Grand
- UCLA Department of Psychiatry & Biobehavioral Sciences and Greater Los Angeles Veterans Affairs Healthcare System, Los Angeles, California, USA
| | - Sun Hwang
- UCLA Department of Psychiatry & Biobehavioral Sciences, Los Angeles, California, USA
| | - Juliette Han
- Greater Los Angeles Veterans Affairs Healthcare System, Los Angeles, California, USA
| | - Tony George
- Yale University School of Medicine, New Haven, Connecticut, USA
| | - Arthur L. Brody
- Corresponding Author: Arthur L. Brody UCLA Department of Psychiatry & Biobehavioral Sciences 300 UCLA Medical Plaza, Suite 2200 Los Angeles, CA 90095 Phone: 310-825-6541 Fax: 310-206-2802
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Xu J, Mendrek A, Cohen MS, Monterosso J, Simon S, Jarvik M, Olmstead R, Brody AL, Ernst M, London ED. Effect of cigarette smoking on prefrontal cortical function in nondeprived smokers performing the Stroop Task. Neuropsychopharmacology 2007; 32:1421-8. [PMID: 17164821 PMCID: PMC2876092 DOI: 10.1038/sj.npp.1301272] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Some reports indicate that cigarette smoking can help smokers focus attention, even when they have not abstained from smoking for a substantial period of time (eg, >1 h). Understanding the mechanisms by which smoking affects attention may help in designing smoking cessation treatments. Thirteen nonsmokers and nine smokers participated in two tests of blood oxygen level dependent (BOLD) functional magnetic resonance imaging (fMRI). During fMRI, the participants performed the Stroop Task. There was a 15-min break between the two tests. During the break, each smoker smoked one cigarette. For smokers, the first test began 45-60 min after the last cigarette of ad libitum smoking. The differences in BOLD signal changes between Stroop conditions (ie, incongruent minus congruent) showed a group x test interaction in the right precentral sulcus, including the putative human frontal eye field (FEF). Smokers, but not nonsmokers, showed greater changes (relative to rest) in BOLD signal in the incongruent than in the congruent condition in the first fMRI test but not in the second. Even after brief abstinence from smoking, therefore, smokers exhibit compromised functional efficiency in the right FEF and adjacent precentral sulcus in a test of selective attention; and smoking ameliorates this condition.
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Affiliation(s)
- Jiansong Xu
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Adrianna Mendrek
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Mark S Cohen
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
- Department of Neurology, Radiological Sciences, and Biomedical Physics, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
- Brain Research Institute, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - John Monterosso
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Sara Simon
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Murray Jarvik
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Richard Olmstead
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Arthur L Brody
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Monique Ernst
- Mood and Anxiety Disorders Program, National Institute of Mental Health, Bethesda, MD, USA
| | - Edythe D London
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
- Brain Research Institute, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
- Department of Molecular and Medical Pharmacology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
- Correspondence: Dr ED London, NPI-Semel Institute for Neuroscience, University of California Los Angeles, 760 Westwood Plaza, C8-528, Los Angeles, CA 90024, USA, Tel: + 1 310 825 0606, Fax: + 1 310 825 0812,
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Xu J, Mendrek A, Cohen MS, Monterosso J, Simon S, Brody AL, Jarvik M, Rodriguez P, Ernst M, London ED. Effects of acute smoking on brain activity vary with abstinence in smokers performing the N-Back task: a preliminary study. Psychiatry Res 2006; 148:103-9. [PMID: 17088048 PMCID: PMC1817900 DOI: 10.1016/j.pscychresns.2006.09.005] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2006] [Revised: 08/09/2006] [Accepted: 09/11/2006] [Indexed: 11/19/2022]
Abstract
We previously reported that compared with a non-deprivation state, overnight abstinence from cigarette smoking was associated with higher brain activity in the left dorsolateral prefrontal cortex (L-DLPFC) during a low demanding working memory challenge, and little increase beyond this activity level during more taxing working memory conditions. In the present study, we aimed to assess how recent smoking (overnight abstinence vs. smoking ad libitum) influenced the effect of smoking a cigarette on brain activity related to a working memory challenge. Six smokers performed the N-Back working memory task during functional magnetic resonance imaging (fMRI) both before and after smoking a cigarette in each of two test sessions: one following overnight abstinence from smoking ( approximately 13 h) and the other following ad libitum smoking. Task-related activity in L-DLPFC showed a significant interaction between the effects of acute smoking, test session, and task load. After overnight abstinence, post-smoking brain activity in L-DLPFC was lower than before smoking at low task load and higher at high task load; corresponding activity on a day of ad libitum smoking was higher at low load and lower at high task load after smoking during the session. These data suggest that the effect of acute smoking on working memory processing depends on recent prior smoking and task load. In particular, they provide preliminary evidence that functional efficiency of working memory is improved by smoking a cigarette during abstinence, while the effect of a cigarette in a non-deprived state varies with the nature and difficulty of the working memory challenge. This interaction merits further examination in larger studies specifically designed to consider this issue.
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Affiliation(s)
- Jiansong Xu
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA 90024
| | - Adrianna Mendrek
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA 90024
| | - Mark S. Cohen
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA 90024
- Department of Neurology, Radiological Sciences, Psychology, and Biomedical Physics, University of California Los Angeles, Los Angeles, CA 90024
- Brain Research Institute, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90024
| | - John Monterosso
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA 90024
| | - Sara Simon
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA 90024
| | - Arthur L. Brody
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA 90024
| | - Murray Jarvik
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA 90024
| | - Paul Rodriguez
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA 90024
| | - Monique Ernst
- Mood and Anxiety Disorders Research Program, National Institute of Mental Health, Bethesda, MD
| | - Edythe D. London
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA 90024
- Department of Molecular and Medical Pharmacology, University of California Los Angeles, Los Angeles, CA 90024
- Brain Research Institute, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90024
- *Corresponding author: ,, Fax: (310) 825-0812, Telephone: (310) 825-0606
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Brody AL, Mandelkern MA, London ED, Olmstead RE, Farahi J, Scheibal D, Jou J, Allen V, Tiongson E, Chefer SI, Koren AO, Mukhin AG. Cigarette smoking saturates brain alpha 4 beta 2 nicotinic acetylcholine receptors. ACTA ACUST UNITED AC 2006; 63:907-15. [PMID: 16894067 PMCID: PMC2773659 DOI: 10.1001/archpsyc.63.8.907] [Citation(s) in RCA: 265] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
CONTEXT 2-[18F]fluoro-3-(2(S)-azetidinylmethoxy) pyridine (2-F-A-85380, abbreviated as 2-FA) is a recently developed radioligand that allows for visualization of brain alpha 4 beta 2* nicotinic acetylcholine receptors (nAChRs) with positron emission tomography (PET) scanning in humans. OBJECTIVE To determine the effect of cigarette smoking on alpha 4 beta 2* nAChR occupancy in tobacco-dependent smokers. DESIGN Fourteen 2-FA PET scanning sessions were performed. During the PET scanning sessions, subjects smoked 1 of 5 amounts (none, 1 puff, 3 puffs, 1 full cigarette, or to satiety [2(1/2) to 3 cigarettes]). SETTING Academic brain imaging center. PARTICIPANTS Eleven tobacco-dependent smokers (paid volunteers). Main Outcome Measure Dose-dependent effect of smoking on occupancy of alpha 4 beta 2* nAChRs, as measured with 2-FA and PET in nAChR-rich brain regions. RESULTS Smoking 0.13 (1 to 2 puffs) of a cigarette resulted in 50% occupancy of alpha 4 beta 2* nAChRs for 3.1 hours after smoking. Smoking a full cigarette (or more) resulted in more than 88% receptor occupancy and was accompanied by a reduction in cigarette craving. A venous plasma nicotine concentration of 0.87 ng/mL (roughly 1/25th of the level achieved in typical daily smokers) was associated with 50% occupancy of alpha 4 beta 2* nAChRs. CONCLUSIONS Cigarette smoking in amounts used by typical daily smokers leads to nearly complete occupancy of alpha 4 beta 2* nAChRs, indicating that tobacco-dependent smokers maintain alpha 4 beta 2* nAChR saturation throughout the day. Because prolonged binding of nicotine to alpha 4 beta 2* nAChRs is associated with desensitization of these receptors, the extent of receptor occupancy found herein suggests that smoking may lead to withdrawal alleviation by maintaining nAChRs in the desensitized state.
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Affiliation(s)
- Arthur L Brody
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA 90095, USA.
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Brody AL, Mandelkern MA, Olmstead RE, Scheibal D, Hahn E, Shiraga S, Zamora-Paja E, Farahi J, Saxena S, London ED, McCracken JT. Gene variants of brain dopamine pathways and smoking-induced dopamine release in the ventral caudate/nucleus accumbens. ACTA ACUST UNITED AC 2006; 63:808-16. [PMID: 16818870 PMCID: PMC2873693 DOI: 10.1001/archpsyc.63.7.808] [Citation(s) in RCA: 168] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
CONTEXT Preclinical studies demonstrate that nicotine administration leads to dopamine release in the ventral striatum. However, human studies reveal considerable interindividual variability in the extent of smoking-induced dopamine release. OBJECTIVE To determine whether common gene variants of the brain dopamine pathway explain this observed phenotypic variability in humans. DESIGN Blood samples were drawn to determine gene variants of dopamine system components, and positron emission tomography scanning with the radiotracer raclopride labeled with radioactive carbon (11C) was performed to measure smoking-induced dopamine release. SETTING Academic brain imaging center. PARTICIPANTS Forty-five tobacco-dependent smokers. INTERVENTIONS Subjects either smoked a cigarette (n = 35) or did not smoke (n = 10) during positron emission tomography scanning. MAIN OUTCOME MEASURES Gene variants of dopamine system components (the dopamine transporter variable nucleotide tandem repeat, D2 receptor Taq A1/A2, D4 receptor variable nucleotide tandem repeat, and catechol-O-methyltransferase Val158Met polymorphisms) and change in [11C]raclopride binding potential in the ventral caudate/nucleus accumbens on positron emission tomography scans. RESULTS For subjects who smoked during scanning, those with at least one 9 allele of the dopamine transporter variable nucleotide tandem repeat, fewer than 7 repeats of the D4 variable nucleotide tandem repeat, and the Val/Val catechol-O-methyltransferase genotype had greater decreases in binding potential (an indirect measure of dopamine release) with smoking than those with the alternate genotypes. An overall decrease in ventral caudate/nucleus accumbens binding potential in those who smoked compared with those who did not smoke was also found but was smaller in magnitude than previously reported. CONCLUSIONS Smokers with genes associated with low resting dopamine tone have greater smoking-induced (phasic) dopamine release than those with alternate genotypes. These findings suggest that dopamine system genotype variabilities explain a significant proportion of the interindividual variability in smoking-induced dopamine release and indicate that smoking-induced dopamine release has a genetic predisposition.
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Affiliation(s)
- Arthur L Brody
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA 90095, USA.
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Abstract
While most cigarette smokers endorse a desire to quit smoking, only about 14% to 49% will achieve abstinence after 6 months or more of treatment. A greater understanding of the effects of smoking on brain function may (in conjunction with other lines of research) result in improved pharmacological (and behavioral) interventions. Many research groups have examined the effects of acute and chronic nicotine/cigarette exposure on brain activity using functional imaging; the purpose of this paper is to synthesize findings from such studies and present a coherent model of brain function in smokers. Responses to acute administration of nicotine/smoking include: a reduction in global brain activity; activation of the prefrontal cortex, thalamus, and visual system; activation of the thalamus and visual cortex during visual cognitive tasks; and increased dopamine (DA) concentration in the ventral striatum/nucleus accumbens. Responses to chronic nicotine/cigarette exposure include decreased monoamine oxidase (MAO) A and B activity in the basal ganglia and a reduction in alpha4beta2 nicotinic acetylcholine receptor (nAChR) availability in the thalamus and putamen. Taken together, these findings indicate that smoking enhances neurotransmission through cortico-basal ganglia-thalamic circuits either by direct stimulation of nAChRs, indirect stimulation via DA release or MAO inhibition, or a combination of these factors. Activation of this circuitry may be responsible for the effects of smoking seen in tobacco dependent subjects, such as improvements in attentional performance, mood, anxiety, and irritability.
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Affiliation(s)
- Arthur L Brody
- Department of Psychiatry and Biobehavioral Sciences, UCLA School of Medicine, 300 UCLA Medical Plaza, Suite 2200, Los Angeles, CA 90095, United States.
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London ED, Berman SM, Voytek B, Simon SL, Mandelkern MA, Monterosso J, Thompson PM, Brody AL, Geaga JA, Hong MS, Hayashi KM, Rawson RA, Ling W. Cerebral metabolic dysfunction and impaired vigilance in recently abstinent methamphetamine abusers. Biol Psychiatry 2005; 58:770-8. [PMID: 16095568 DOI: 10.1016/j.biopsych.2005.04.039] [Citation(s) in RCA: 105] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2004] [Revised: 04/07/2005] [Accepted: 04/21/2005] [Indexed: 11/27/2022]
Abstract
BACKGROUND Methamphetamine (MA) abusers have cognitive deficits, abnormal metabolic activity and structural deficits in limbic and paralimbic cortices, and reduced hippocampal volume. The links between cognitive impairment and these cerebral abnormalities are not established. METHODS We assessed cerebral glucose metabolism with [F-18]fluorodeoxyglucose positron emission tomography in 17 abstinent (4 to 7 days) methamphetamine users and 16 control subjects performing an auditory vigilance task and obtained structural magnetic resonance brain scans. Regional brain radioactivity served as a marker for relative glucose metabolism. Error rates on the task were related to regional radioactivity and hippocampal morphology. RESULTS Methamphetamine users had higher error rates than control subjects on the vigilance task. The groups showed different relationships between error rates and relative activity in the anterior and middle cingulate gyrus and the insula. Whereas the MA user group showed negative correlations involving these regions, the control group showed positive correlations involving the cingulate cortex. Across groups, hippocampal metabolic and structural measures were negatively correlated with error rates. CONCLUSIONS Dysfunction in the cingulate and insular cortices of recently abstinent MA abusers contribute to impaired vigilance and other cognitive functions requiring sustained attention. Hippocampal integrity predicts task performance in methamphetamine users as well as control subjects.
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Affiliation(s)
- Edythe D London
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California 90024-1759, USA.
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Obrzut SL, Koren AO, Mandelkern MA, Brody AL, Hoh CK, London ED. Whole-body radiation dosimetry of 2-[18F]Fluoro-A-85380 in human PET imaging studies. Nucl Med Biol 2005; 32:869-74. [PMID: 16253812 DOI: 10.1016/j.nucmedbio.2005.06.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2005] [Revised: 06/07/2005] [Accepted: 06/10/2005] [Indexed: 11/16/2022]
Abstract
2-[18F]Fluoro-A-85380 (2-[18F]fluoro-3-(2(S)-azetidinylmethoxy)pyridine, 2-[18F]FA) is a recently developed PET radioligand for noninvasive imaging of nicotinic acetylcholine receptors. Previous radiation absorbed dose estimates for 2-[18F]FA were limited to evaluation of activity in only several critical organs. Here, we performed 2-[18F]FA radiation dosimetry studies on two healthy human volunteers to obtain data for all important body organs. Intravenous injection of 2.9 MBq/kg of 2-[18F]FA was followed by dynamic PET imaging. Regions of interest were placed over images of each organ to generate time-activity curves, from which we computed residence times. Radiation absorbed doses were calculated from the residence times using the MIRDOSE 3.0 program (version 3.0, ORISE, Oak Ridge, TN). The urinary bladder wall receives the highest radiation absorbed dose (0.153 mGy/MBq, 0.566 rad/mCi, for a 2.4-h voiding interval), followed by the liver (0.0496 mGy/MBq, 0.184 rad/mCi) and the kidneys (0.0470 mGy/MBq, 0.174 rad/mCi). The mean effective dose equivalent is estimated to be 0.0278 mSv/MBq (0.103 rem/mCi), indicating that radiation dosimetry associated with 2-[18F]FA is within acceptable limits.
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Affiliation(s)
- Sebastian L Obrzut
- Department of Radiology, Division of Nuclear Medicine, University of California San Diego, La Jolla, CA 92093, USA
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Voytek B, Berman SM, Hassid BD, Simon SL, Mandelkern MA, Brody AL, Monterosso J, Ling W, London ED. Differences in regional brain metabolism associated with marijuana abuse in methamphetamine abusers. Synapse 2005; 57:113-5. [PMID: 15906384 DOI: 10.1002/syn.20155] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Bradley Voytek
- Department of Psychiatry, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California 90024, USA
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Baicy K, Bearden CE, Monterosso J, Brody AL, Isaacson AJ, London ED. Common Substrates of Dysphoria in Stimulant Drug Abuse and Primary Depression: Therapeutic Targets. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2005; 65:117-45. [PMID: 16140055 DOI: 10.1016/s0074-7742(04)65005-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Affiliation(s)
- Kate Baicy
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles California 90024, USA
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Abstract
OBJECTIVE Substantial evidence from animal models demonstrates that dopamine release in the ventral striatum underlies the reinforcing properties of nicotine. The authors used [(11)C]raclopride bolus-plus-continuous-infusion positron emission tomography (PET) to determine smoking-induced ventral striatum dopamine release in humans. METHOD Twenty nicotine-dependent smokers (who smoked > or =15 cigarettes/day) underwent a [(11)C]raclopride bolus-plus-continuous-infusion PET session. During the session, subjects had a 10-minute break outside the PET apparatus during which 10 subjects smoked a cigarette and 10 did not smoke (as a control condition). RESULTS The group that smoked had greater reductions in [(11)C]raclopride binding potential in ventral striatum regions of interest than the group that did not smoke, particularly in the left ventral caudate/nucleus accumbens and left ventral putamen (range for smoking group=-25.9% to -36.6% reduction). Significant correlations were found between change from before to after the smoking break in craving ratings and change from before to after the break in binding potential for these two regions. CONCLUSIONS Nicotine-dependent subjects who smoked during a break in PET scanning had greater reductions in [(11)C]raclopride binding potential (an indirect measure of dopamine release) than nicotine-dependent subjects who did not smoke. The magnitude of binding potential changes was comparable to that found in studies that used similar methods to examine the effects of other addictive drugs.
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Affiliation(s)
- Arthur L Brody
- Veterans Affairs Greater Los Angeles Healthcare, 300 UCLA Medical Plaza, Suite 2200, Los Angeles, CA 90095, USA.
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Abstract
OBJECTIVE Compulsive hoarding and saving symptoms, found in many patients with obsessive-compulsive disorder (OCD), are part of a discrete clinical syndrome that includes indecisiveness, disorganization, perfectionism, procrastination, and avoidance and has been associated with poor response to medications and cognitive behavior therapy. The authors sought to identify cerebral metabolic patterns specifically associated with the compulsive hoarding syndrome using positron emission tomography (PET). METHOD [(18)F]Fluorodeoxyglucose PET scans were obtained for 45 adult subjects who met DSM-IV criteria for OCD (12 of whom had compulsive hoarding as their most prominent OCD symptom factor) and 17 normal comparison subjects. All subjects had been free of psychotropic medication for at least 4 weeks. Regional cerebral glucose metabolism was compared between the groups. RESULTS In relation to the comparison subjects, the patients with compulsive hoarding syndrome had significantly lower glucose metabolism in the posterior cingulate gyrus and cuneus, whereas the nonhoarding OCD patients had significantly higher glucose metabolism in the bilateral thalamus and caudate. In relation to nonhoarding OCD patients, compulsive hoarders had significantly lower metabolism in the dorsal anterior cingulate gyrus. Across all OCD patients, hoarding severity was negatively correlated with glucose metabolism in the dorsal anterior cingulate gyrus. CONCLUSIONS OCD patients with the compulsive hoarding syndrome had a different pattern of cerebral glucose metabolism than nonhoarding OCD patients and comparison subjects. Obsessive-compulsive hoarding may be a neurobiologically distinct subgroup or variant of OCD whose symptoms and poor response to anti-obsessional treatment are mediated by lower activity in the cingulate cortex.
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Affiliation(s)
- Sanjaya Saxena
- UCLA Neuropsychiatric Institute, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, USA.
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