Neural substrates of abstinence-induced cigarette cravings in chronic smokers - PubMed (original) (raw)

Comparative Study

Neural substrates of abstinence-induced cigarette cravings in chronic smokers

Ze Wang et al. J Neurosci. 2007.

Abstract

Craving is a hallmark of drug dependence, including dependence on nicotine. Many studies have examined the neural substrates of cravings elicited by smoking-related cues. Less is known about the neural basis of unprovoked, abstinence-induced cravings, despite the contributions of such cravings to smoking relapse. To fill this gap, we used arterial spin labeled (ASL) perfusion magnetic resonance imaging to characterize the neural substrates of abstinence-induced cravings to smoke. Fifteen chronic smokers were scanned during a resting state on two separate occasions: (1) smoking satiety and (2) abstinence (after > or = 12 h of smoking deprivation), in counterbalanced order. Smoking abstinence state (vs satiety) was associated with increased cerebral blood flow (CBF) in anterior cingulate cortex (ACC)/medial orbitofrontal cortex (OFC) and left OFC. Abstinence-induced cravings to smoke were predicted by CBF increases (abstinence minus satiety) in the right OFC, right dorsolateral prefrontal cortex, occipital cortex, ACC, ventral striatum/nucleus accumbens, thalamus, amygdala, bilateral hippocampus, left caudate, and right insula. These data suggest that increased activation in the brain's visuospatial and reward circuitry underlies abstinence-induced cravings to smoke, and thereby, may be important in relapse.

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Figures

Figure 1.

Figure 1.

Statistical map of the regional CBF changes caused by abstinence (vs satiety). Yellow regions indicate greater CBF during abstinence; the blue region indicates a CBF decrease. The voxelwise statistical significance threshold is p < 0.005 (_t_ >3.17, two tailed, uncorrected) and the color bar indicates the range of t values displayed. The two blue lines superposed on the medial sagittal slice indicate the locations of the two left axial slices.

Figure 2.

Figure 2.

Association of abstinence-induced craving with regional CBF changes. The five coronal slices (4 in top row; 1 in bottom row) show suprathreshold craving-correlated CBF changes in bilateral thalamus, bilateral nucleus accumbens, right insula, bilateral medial temporal cortex, left caudate/putamen, bilateral dorsolateral prefrontal cortex, anterior cingulate cortex, and the orbitofrontal cortex. An axial slice (bottom row) shows suprathreshold clusters in the amygdala and the hippocampus. Suprathreshold correlation clusters in the occipital cortex, midbrain, and the anterior cingulate were also shown in the sagittal slice (bottom row). The voxelwise statistical significance threshold is p < 0.005 (_t_ >3.17, two tailed, uncorrected) and the color bar indicates the range of t values displayed.

Figure 3.

Figure 3.

Association of abstinence-induced global withdrawal scores with regional CBF changes. Significant correlations of CBF change with change in withdrawal symptoms were found in the right dorsolateral prefrontal cortex, caudate, right hippocampus, and the right medial temporal gyrus. The voxelwise statistical significance threshold is p < 0.005 (_t_ >3.17, two tailed, uncorrected) and the color bar indicates the range of t values displayed.

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