title: Regional brain activity correlates of nicotine dependence.
abstract: Fifteen smokers participated in a study investigating brain correlates of nicotine dependence. Dependence was reduced by having subjects switch to denicotinized cigarettes for 2 weeks while wearing nicotine skin patches. Positron emission tomography (PET) scans assessed regional cerebral metabolic rate for glucose (rCMRglc) after overnight nicotine abstinence on three occasions: (1) at baseline; (2) after 2 weeks of exposure to denicotinized cigarettes+nicotine patches; and (3) 2 weeks after returning to smoking the usual brands of cigarettes. Craving for cigarettes and scores on the Fagerström Test of Nicotine Dependence (FTND) questionnaire decreased at the second session relative to the first and last sessions. Regional brain metabolic activity (normalized to whole brain values) at session 2 also showed a significant decrease in the right hemisphere anterior cingulate cortex. Exploratory post hoc analyses showed that the change in craving across sessions was negatively correlated with the change in rCMRglc in several structures within the brain reward system, including the ventral striatum, orbitofrontal cortex and pons. The between-session difference in thalamus activity (right hemisphere) was positively correlated with the difference in FTND scores. Correlational analyses also revealed that reported smoking for calming effects was associated with a decrease (at session 2) in thalamus activity (bilaterally) and with an increase in amygdala activity (left hemisphere). Reported smoking to enhance pleasurable relaxation was associated with an increase in metabolic activity of the dorsal striatum (caudate, putamen) at session 2. These findings suggest that reversible changes in regional brain metabolic activity occur in conjunction with alterations in nicotine dependence. The results also highlight the likely role of thalamic gating processes as well as striatal reward and corticolimbic regulatory pathways in the maintenance of cigarette addiction.
authors.affiliation: Department of Psychiatry, Duke University Medical Center, Durham, NC 27705, USA. rose0003@mc.duke.edu
authors.forename: Jed E
authors.initials: JE
authors.lastname: Rose
authors.forename: Frederique M
authors.initials: FM
authors.lastname: Behm
authors.forename: Alfred N
authors.initials: AN
authors.lastname: Salley
authors.forename: James E
authors.initials: JE
authors.lastname: Bates
authors.forename: R Edward
authors.initials: RE
authors.lastname: Coleman
authors.forename: Thomas C
authors.initials: TC
authors.lastname: Hawk
authors.forename: Timothy G
authors.initials: TG
authors.lastname: Turkington
mesh_terms: D000328:Adult; D016739:Behavior, Addictive / Q000503:physiopathology; D001921:Brain / Q000098:blood supply / Q000000981:diagnostic imaging / Q000473:pathology*; D001931:Brain Mapping; D005260:Female; D019788:Fluorodeoxyglucose F18; D007839:Functional Laterality; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D018722:Nicotinic Agonists / Q000627:therapeutic use; D049268:Positron-Emission Tomography / Q000379:methods; D013223:Statistics as Topic; D013375:Substance Withdrawal Syndrome / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000378:metabolism* / Q000473:pathology; D011795:Surveys and Questionnaires; D013647:Task Performance and Analysis; D013997:Time Factors; D014029:Tobacco Use Disorder / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000378:metabolism* / Q000473:pathology* / Q000523:psychology
chemical_list: D018722:Nicotinic Agonists; D019788:Fluorodeoxyglucose F18