Neural substrates of resisting craving during cigarette cue exposure.
BACKGROUND
In cigarette smokers, the most commonly reported areas of brain activation during visual cigarette cue exposure are the prefrontal, anterior cingulate, and visual cortices. We sought to determine changes in brain activity in response to cigarette cues when smokers actively resist craving.


METHODS
Forty-two tobacco-dependent smokers underwent functional magnetic resonance imaging, during which they were presented with videotaped cues. Three cue presentation conditions were tested: cigarette cues with subjects allowing themselves to crave (cigarette cue crave), cigarette cues with the instruction to resist craving (cigarette cue resist), and matched neutral cues.


RESULTS
Activation was found in the cigarette cue resist (compared with the cigarette cue crave) condition in the left dorsal anterior cingulate cortex (ACC), posterior cingulate cortex (PCC), and precuneus. Lower magnetic resonance signal for the cigarette cue resist condition was found in the cuneus bilaterally, left lateral occipital gyrus, and right postcentral gyrus. These relative activations and deactivations were more robust when the cigarette cue resist condition was compared with the neutral cue condition.


CONCLUSIONS
Suppressing craving during cigarette cue exposure involves activation of limbic (and related) brain regions and deactivation of primary sensory and motor cortices.
Brody
Arthur L
AL
Department of Psychiatry and Biobehavioral Sciences, University of California-Los Angeles, 300 UCLA Medical Plaza, Los Angeles, CA 90095, USA. abrody@ucla.edu
Mandelkern
Mark A
MA
Olmstead
Richard E
RE
Jou
Jennifer
J
Tiongson
Emmanuelle
E
Allen
Valerie
V
Scheibal
David
D
London
Edythe D
ED
Monterosso
John R
JR
Tiffany
Stephen T
ST
Korb
Alex
A
Gan
Joanna J
JJ
Cohen
Mark S
MS
D000328:Adult; D016739:Behavior, Addictive / Q000523:psychology* / Q000628:therapy*; D001921:Brain / Q000502:physiology*; D001931:Brain Mapping; D003463:Cues; D005260:Female; D007839:Functional Laterality / Q000502:physiology; D006179:Gyrus Cinguli / Q000502:physiology; D006801:Humans; D008032:Limbic System / Q000502:physiology; D008279:Magnetic Resonance Imaging; D008297:Male; D008959:Models, Neurological; D009044:Motor Cortex / Q000502:physiology; D009434:Neural Pathways / Q000502:physiology; D012907:Smoking / Q000523:psychology / Q000628:therapy*; D016540:Smoking Cessation / Q000523:psychology*; D014029:Tobacco Use Disorder / Q000523:psychology / Q000628:therapy; D014796:Visual Perception / Q000502:physiology*; D062789:Tobacco Products