Dorsolateral prefrontal and orbitofrontal cortex interactions during self-control of cigarette craving

Abstract

Drug-related cues induce craving, which may perpetuate drug use or trigger relapse in addicted individuals. Craving is also under the influence of other factors in daily life, such as drug availability and self-control. Neuroimaging studies using drug cue paradigms have shown frontal lobe involvement in this contextual influence on cue reactivity, but have not clarified how and which frontal area accounts for this phenomenon. We explored frontal lobe contributions to cue-induced drug craving under different intertemporal drug availability conditions by combining transcranial magnetic stimulation and functional magnetic resonance imaging in smokers. We hypothesized that the dorsolateral prefrontal cortex (DLPFC) regulates craving during changes in intertemporal availability. Subjective craving was greater when cigarettes were immediately available, and this effect was eliminated by transiently inactivating the DLPFC with transcranial magnetic stimulation. Functional magnetic resonance imaging demonstrated that the signal most proportional to subjective craving was located in the medial orbitofrontal cortex across all contexts, whereas the DLPFC most strongly encoded intertemporal availability information. The craving-related signal in the medial orbitofrontal cortex was attenuated by inactivation of the DLPFC, particularly when cigarettes were immediately available. Inactivation of the DLPFC also reduced craving-related signals in the anterior cingulate and ventral striatum, areas implicated in transforming value signals into action. These findings indicate that DLPFC builds up value signals based on knowledge of drug availability, and support a model wherein aberrant circuitry linking dorsolateral prefrontal and orbitofrontal cortices may underlie addiction.decision making | smoking | nicotine | expectancy | temporal discounting

Changes in Executive Function Following Short-Term Tobacco Cessation Therapy in College Students

“…Consistent with the above literature, studies suggest chronic cigarette use is also associated with altered structure [24][25][26] and function [13,27] of the prefrontal cortex.…”

Addiction and embodiment

“…Addiction has also been described as a disorder of disrupted self--control over automatically triggered impulses to use (Baler & Volkow, 2006). The dorsolateral prefrontal cortex (dlPFC) has been shown to be structurally and functionally impaired in drug--dependent individuals, which makes it an important region for the theorized lack of cognitive control (Baler & Volkow, 2006;Bechara, 2005;Hayashi, Ko, Strafella, & Dagher, 2013;Jentsch & Taylor, 1999;Kalivas, 2004;Park et al, 2010;Volkow et al, 2010). Dual process models of addiction are focused on the interaction between top--down and bottom--up processes.…”

Cigarette Exposure, Dependence, and Craving Are Related to Insula Thickness in Young Adult Smokers

“…Based on these studies, we predicted that cigarette exposure and dependence would be negatively correlated with insula thickness. As the ventral and dorsal anterior insula are structurally and functionally connected to the orbitofrontal cortex, anterior cingulate (ACC), and dorsolateral prefrontal cortex (Deen et al, 2011;Mesulam and Mufson, 1982b), regions commonly implicated in craving and in the ability to control the urge to smoke (Hayashi et al, 2013;Kober et al, 2010;Li et al, 2013), we hypothesized that thickness of the anterior insula would be negatively correlated with the urge to smoke.…”