IMAGING STUDY: Selectively reduced responses to smoking cues in amygdala following extinction‐based smoking cessation: results of a preliminary functional magnetic resonance imaging study

Abstract

Preliminary studies suggest an extinction-based smoking cessation treatment using reduced nicotine content (RNC) cigarettes decreases self-report craving for cigarettes prior to quitting and may be an effective smoking cessation treatment. The aims of this study was to evaluate the effect of an extinction-based smoking cessation treatment on brain responses to smoking cues using blood-oxygen level-dependent (BOLD) functional magnetic resonance imaging (fMRI). Sixteen (n = 16) dependent smokers were scanned using BOLD fMRI at baseline, following 2-4 weeks of smoking RNC cigarettes while wearing a 21-mg nicotine patch, and 2-4 weeks following quitting smoking. During scanning, participants viewed smoking-related pictures (e.g. lit cigarette) and pictures of people engaged in everyday activities (e.g. using a stapler). Event-related BOLD responses to smoking and control cues were analyzed in regions of interest (ROIs) known to subserve reward, attention, motivation and emotion. The extinction-based treatment simultaneously attenuated responses to smoking cues in amygdala while potentiating responses to control cues. Exploratory analysis indicated that this pattern was also observed in the thalamus of future abstinent but not relapsing smokers. The results of this preliminary study suggest that an extinction-based treatment for smoking cessation alters brain responses to smoking and control cues in amygdala--a region previously associated with drug cue reactivity and extinction.

Individual Differences in Nicotine Dependence, Withdrawal Symptoms, and Sex Predict Transient fMRI-BOLD Responses to Smoking Cues

“…The sample consisted of adult smokers drawn from two previous imaging studies (McClernon et al, 2005b(McClernon et al, , 2007 in which the same task, scanner, and scanning parameters were used. In our analyses we examined the effects of each individual difference factor and withdrawal symptom while controlling for all other variables to evaluate the unique relation of each with brain responses.…”

“…The goal of the study was to evaluate the effects of acute abstinence on reactivity to smoking cues; smokers in study 1 did not indicate an intention to quit smoking. In study 2 (McClernon et al, 2007) smokers completed three scanning sessions: (1) at baseline, (2) following 2-4 weeks of a treatment designed to devalue the conditioned aspects of smoking, and (3) 4 weeks following quitting smoking. The goal of the study was to evaluate the effects of smoking cessation treatment and abstinence on brain responses to smoking cues.…”

“…Photographic smoking, control, and target cues were presented during functional imaging using previously established methods (McClernon et al, 2005a(McClernon et al, , 2007. Smoking cues (n ¼ 60) consisted of full-color pictures of smoking-related objects (eg lit cigarettes) and people smoking cigarettes.…”

Hippocampal and Insular Response to Smoking-Related Environments: Neuroimaging Evidence for Drug-Context Effects in Nicotine Dependence

“…Bilateral aHPC and pHPC ROIs were defined following a prior study of aHPC and pHPC connectivity (Chen and Etkin, 2013), taking the anterior-most third and posterior-most third of an HPC ROI consisting of voxels with a 460% likelihood of being in HPC (as defined by the Harvard-Oxford probabilistic structural axis). The following additional ROIs, chosen a priori based on preclinical research (Bossert et al, 2011;Fuchs et al, 2005;McLaughlin and See, 2003;Otis et al, 2014), our previous neuroimaging studies (McClernon et al, 2005(McClernon et al, , 2007(McClernon et al, , 2009) and metaanalysis (Engelmann et al, 2012;Kuhn and Gallinat, 2011;Tang et al, 2012) of cue-reactivity, were created in PickAtlas (Maldjian et al, 2003): (1) ventral striatum (5 mm radius sphere centered on ± 6,4, − 5); (2) amygdala (anatomical); (3) insula (5 mm radius sphere centered on ± 38,10,6); (4) mPFC inclusive of portions of rostral anterior cingulate cortex (5 × 10 × 10 mm box centered on ± 5, 40, 10); and (5) PCC (5 × 5 × 10 mm box centered on ± 5, − 60,20). See Supplementary Figure S3 for visual depictions of the ROIs selected for analyses.…”

Marijuana craving in the brain

“…Other reward-related areas, including the insula (29)(30)(31) and cingulate gyrus (8,14,15,29,(32)(33)(34)(35)(36), show increased activity with the presentation of drug-related stimuli. Presentation of these stimuli is also associated with increased activity in brain structures that underlie reward and emotion regulation, such as the thalamus (9,30,(37)(38)(39)(40) and amygdala (32,39).…”