Insular lesions and smoking cessation after first-ever ischemic stroke: A 3-month follow-up

Bieńkowski, Przemysław; Zatorski, Paweł; Baranowska, Anna; Ryglewicz, Danuta; Sienkiewicz-Jarosz, Halina

doi:10.1016/j.neulet.2010.05.008

Cited by 30 publications

(29 citation statements)

References 33 publications

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“…16,19,25,35 At 1 year, lower percentages have been reported to those in the present study (30%) 34 as well as similar percentages (41.1%). 16 In the present study, smoking cessation has not been associated to female sex as was the case in other cited studies 16,19 nor to worse functional dependence.…”

Section: Discussionsupporting

confidence: 79%

“…Naqvi et al 21 in an earlier retrospective study of 69 patients found a greater incidence of cessation in patients with insular damage, but without statistical significance, and significantly greater "disruption of smoking addiction" in patients with insular lesions. Bienkowski et al 25 have investigated the same phenomenon more recently in 87 patients with ischemic stroke and did not find an association between smoking cessation and the insular cortex lesion.…”

Section: Discussionmentioning

confidence: 93%

“…However, a more recent prospective study with patients with ischemic stroke failed to find the same association. 25 The present study analyzes sociodemographic, psychological, and lesion-related variables to identify associated factors for smoking cessation during the first year after stroke.…”

mentioning

confidence: 99%

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Smoking Cessation 1 Year Poststroke and Damage to the Insular Cortex

Soler

Grau²,

Gras³

et al. 2012

Stroke

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Background and Purpose-Hospitalization as a result of stroke provides an opportunity to stop smoking that is often not taken up. The present study analyzes sociodemographic, psychological, and lesion-related variables to identify associated factors for smoking cessation during the first year after stroke. Methods-We conducted a prospective longitudinal study with a 1-year follow-up of a cohort of 110 patients with acute stroke who were smokers at the time of diagnosis and were admitted consecutively between January 2005 and July 2007. Results-On hospital release, 69.1% had given up smoking but at 1 year, only 40% had stopped smoking. Of the 110 patients, 27 (24.5%) had an acute stroke lesion in the insular cortex, of which 19 (70.3%) were nonsmokers at 1 year. Strongly associated factors in giving up smoking were the location of the lesion in the insular cortex (OR, 5.42; 95% CI, 1.95-15.01; Pϭ0.001) and having the intention of giving up before the stroke, comparing precontemplating patients (without intention of giving up in the near future) with contemplating and prepared patients (intention of stopping in the near future; OR, 7.29; 95% CI, 1.89 -28.07; Pϭ0.004). Conclusions-Of patients with stroke who were smokers, only 4 of 10 patients had stopped smoking 1 year after admission. Our results show that the variables best predicting smoking cessation in patients with a stroke diagnosis 1 year after hospital discharge are insular damage and the prestroke intention to stop. (Stroke. 2012;43:131-136.)

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Section: Discussionsupporting

confidence: 79%

Section: Discussionmentioning

confidence: 93%

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Smoking Cessation 1 Year Poststroke and Damage to the Insular Cortex

Soler

Grau²,

Gras³

et al. 2012

Stroke

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“…Another study [36] found that strokes that involved the IC increased odds of quitting smoking within a year of the stroke fivefold compared to strokes that spared the IC. We note that one study that examined the effects of brain lesions on smoking behavior reported that increased likelihood of smoking cessation after insula lesion was not significant[37]. However, given that this study was conducted in a non-American culture, it was suggested [9] that a likely explanation for this discrepancy could relate to cultural differences in the perception of the long-term harms of smoking.…”

Section: Evidence From Lesionsmentioning

confidence: 87%

Revisiting the role of the insula in addiction

Droutman¹,

Read²,

Bechara³

2015

Trends in Cognitive Sciences

279

180

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Brain lesions that damage the insular cortex interrupt addictive behaviors, suggesting that drug addiction sensitizes the insula. However, neuroimaging studies seem to lead to an opposite picture: structural neuroimaging studies show reduced grey matter volume of the insular cortex (IC) of drug users, and functional neuroimaging studies show reduced IC activity when drug users perform decision-making tasks. These results have been interpreted as indicating that addictive behaviors are associated with reduced interoceptive signaling within the IC. We use this apparent contradiction to examine possible roles of the insula in addiction, identify open questions, and explore ways to address them.

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“…Although this effect of insular damage was not observed in another publication (Bienkowski et al, 2010), others have gone as far as to suggest that unintentional abrupt smoking cessation may be a unique lesion localizer (Hefzy et al, 2011). Subsequent work utilizing animal models has shown insular involvement in different aspects of addictive behavior for various addictive substances (Contreras et al, 2007(Contreras et al, , 2012Forget et al, 2010a;Hollander et al, 2008;Scott and Hiroi, 2011).…”

Section: Introductionmentioning

confidence: 95%

Electrical Stimulation of the Insular Region Attenuates Nicotine-Taking and Nicotine-Seeking Behaviors

Pushparaj

Hamani

et al. 2012

Neuropsychopharmacol

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Pharmacological inactivation of the granular insular cortex is able to block nicotine-taking and -seeking behaviors in rats. In this study, we explored the potential of modulating activity in the insular region using electrical stimulation. Animals were trained to self-administer nicotine (0.03 mg/kg per infusion) under a fixed ratio-5 (FR-5) schedule of reinforcement followed by a progressive ratio (PR) schedule. Evaluation of the effect of stimulation in the insular region was performed on nicotine self-administration under FR-5 and PR schedules, as well on reinstatement of nicotine-seeking behavior induced by nicotine-associated cues or nicotine-priming injections. The effect of stimulation was also examined in brain slices containing insular neurons. Stimulation significantly attenuated nicotine-taking, under both schedules of reinforcement, as well as nicotine-seeking behavior induced by cues and priming. These effects appear to be specific to nicotine-associated behaviors, as stimulation did not have any effect on food-taking behavior. They appear to be anatomically specific, as stimulation surrounding the insular region had no effect on behavior. Stimulation of brain slices containing the insular region was found to inactivate insular neurons. Our results suggest that deep brain stimulation to modulate insular activity should be further explored.

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Insular lesions and smoking cessation after first-ever ischemic stroke: A 3-month follow-up

Cited by 30 publications

References 33 publications

Smoking Cessation 1 Year Poststroke and Damage to the Insular Cortex

Smoking Cessation 1 Year Poststroke and Damage to the Insular Cortex

Revisiting the role of the insula in addiction

Electrical Stimulation of the Insular Region Attenuates Nicotine-Taking and Nicotine-Seeking Behaviors

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