@article{efd281966a164f8bba5c4abcd8ba52d5,
title = "Brain Reactivity to Smoking Cues Prior to Smoking Cessation Predicts Ability to Maintain Tobacco Abstinence",
abstract = "Background: Developing the means to identify smokers at high risk for relapse could advance relapse prevention therapy. We hypothesized that functional magnetic resonance imaging (fMRI) reactivity to smoking-related cues, measured before a quit attempt, could identify smokers with heightened relapse vulnerability. Methods: Before quitting smoking, 21 nicotine-dependent women underwent fMRI during which smoking-related and neutral images were shown. These smokers also were tested for possible attentional biases to smoking-related words using a computerized emotional Stroop (ES) task previously found to predict relapse. Smokers then made a quit attempt and were grouped based on outcomes (abstinence vs. slip: smoking ≥ 1 cigarette after attaining abstinence). Prequit fMRI and ES measurements in these groups were compared. Results: Slip subjects had heightened fMRI reactivity to smoking-related images in brain regions implicated in emotion, interoceptive awareness, and motor planning and execution. Insula and dorsal anterior cingulate cortex (dACC) reactivity induced by smoking images correlated with an attentional bias to smoking-related words. A discriminant analysis of ES and fMRI data predicted outcomes with 79% accuracy. Additionally, smokers who slipped had decreased fMRI functional connectivity between an insula-containing network and brain regions involved in cognitive control, including the dACC and dorsal lateral prefrontal cortex, possibly reflecting reduced top-down control of cue-induced emotions. Conclusions: These findings suggest that the insula and dACC are important substrates of smoking relapse vulnerability. The data also suggest that relapse-vulnerable smokers can be identified before quit attempts, which could enable personalized treatment, improve tobacco-dependence treatment outcomes, and reduce smoking-related morbidity and mortality.",
keywords = "Dorsal anterior cingulate cortex, emotional Stroop task, fMRI, insula, relapse, smoking cessation, tobacco",
author = "Janes, {Amy C.} and Pizzagalli, {Diego A.} and Sarah Richardt and Frederick, {Blaise de B.} and Sarah Chuzi and Gladys Pachas and Culhane, {Melissa A.} and Holmes, {Avram J.} and Maurizio Fava and Evins, {A. Eden} and Kaufman, {Marc J.}",
note = "Funding Information: The following authors reported no biomedical financial interests or potential conflicts of interest. ACJ, BBF, SR, SC, GP, MC, AH. DAP has received research support from GlaxoSmithKline and ANT North America, Inc. (Advanced Neuro Technology), consulting fees from ANT North America, Inc. (Advanced Neuro Technology) and AstraZeneca for projects unrelated to the current study, and honoraria from AstraZeneca. AEE has received research product support from Pfizer and speaker honoraria from Reed Medical Education. MF has received research support from Abbott Laboratories , Alkermes , Aspect Medical Systems , AstraZeneca , Bio Research , BrainCells, Inc. , Bristol-Myers Squibb Company , Cephalon , Clinical Trial Solutions , Eli Lilly and Company , Forest Pharmaceuticals, Inc. , Ganeden , GlaxoSmithKline (GSK) , J and J Pharmaceuticals , Lichtwer Pharma , GmbH , Lorex Pharmaceuticals , National Alliance for Research on Schizophrenia and Depression , National Center for Complementary and Alternative Medicine , National Institute on Drug Abuse , National Institute of Mental Health , Novartis , Organon, Inc. , PamLab , LLC , Pfizer, Inc. , Pharmavite , Roche , Sanofi-Aventis , Shire, Solvay Pharmaceuticals, Inc. , Synthelabo , Wyeth-Ayerst Laboratories . MF has performed advisory and consulting for Abbott Laboratories, Amarin, Aspect Medical Systems, AstraZeneca, Auspex Pharmaceuticals, Bayer AG, Best Practice Project Management, Inc, BioMarin Pharmaceuticals, Inc., Biovail Pharmaceuticals, Inc., BrainCells, Inc., Bristol-Myers Squibb Company, Cephalon, Clinical Trials Solutions, CNS Response, Compellis, Cypress Pharmaceuticals, Dov Pharmaceuticals, EISAI, Inc., Eli Lilly and Company, EPIX Pharmaceuticals, Euthymics Bioscience, Inc., Fabre-Kramer, Pharmaceuticals, Inc., Forest Pharmaceuticals, Inc., GSK, Grunenthal, GmbH Janssen Pharmaceutica, Jazz Pharmaceuticals, J and J Pharmaceuticals, Knoll Pharmaceutical Company, Labopharm, Lorex Pharmaceuticals, Lundbeck, MedAvante, Inc., Merck, Methylation Sciences, Neuronetics, Novartis, Nutrition 21, Organon, Inc., PamLab, LLC, Pfizer, Inc., PharmaStar, Pharmavite, Precision Human Biolaboratory, PsychoGenics, Psylin Neurosciences, Inc., Ridge Diagnostics, Inc., Roche, Sanofi-Aventis, Sepracor, Schering-Plough, Solvay Pharmaceuticals, Inc., Somaxon, Somerset Pharmaceuticals, Synthelabo, Takeda, Tetragenex, Trancept Pharmaceuticals, TransForm Pharmaceuticals, Vanda Pharmaceuticals, Inc., Wyeth-Ayerst Laboratories. MF has had speaking/publishing engagements with Adamed Co., Advanced Meeting Partners, American Psychiatric Association, American Society of Clinical Psychopharmacology, AstraZeneca, Belvoir, Boehringer-Ingelheim, Bristol-Myers Squibb Company, Cephalon, Eli Lilly and Company, Forest Pharmaceuticals, Inc., GlaxoSmithKline, Imedex, Novartis, Organon, Inc., Pfizer, Inc., PharmaStar, Massachusetts General Hospital (MGH) Psychiatry Academy/Primedia, MGH Psychiatry Academy/Reed-Elsevier, United BioSource Corporation, Wyeth-Ayerst Laboratories. MF has equity holdings in Compellis and royalty/patent, other income as follows: patent applications for Sequential Parallel Comparison Design and for a combination of azapirones and bupropion in MDD, copyright royalties for the MGH Cognitive and Physical Functioning Questionnaire, Sexual Function Inventory, Antidepressant Treatment Response Questionnaire, Discontinuation Emergent Signs and Symptoms, and SAFER Criteria Inventory. MJK has received research support from GSK, Organon, Varian, Inc., BioPAL, has done advisory/consulting for Amgen, and Novartis. Funding Information: This research was supported in part by National Institute on Drug Abuse Grant Nos. U01DA019378 , R01DA022276 , R01DA014674 , R01DA09448 , K02DA017324 , and T32DA015036 ; by funding from the Counter-Drug Technology Assessment Center (CTAC) , an office within the Office of National Drug Control Policy (ONDCP) via Army Contracting Agency Contract BK39-03-C-0075; and by research support from GlaxoSmithKline . We thank Dr. David Schoenfeld (Massachusetts General Hospital) for his contributions to this study. We thank Drs. Robert S. Ross, Bruce M. Cohen, and Elizabeth Quattrocki-Knight for comments on the original manuscript. ",
year = "2010",
month = apr,
day = "15",
doi = "10.1016/j.biopsych.2009.12.034",
language = "English (US)",
volume = "67",
pages = "722--729",
journal = "Biological Psychiatry",
issn = "0006-3223",
publisher = "Elsevier USA",
number = "8",
}