title: Insula-specific H magnetic resonance spectroscopy reactions in heavy smokers under acute nicotine withdrawal and after oral nicotine substitution.
abstract: The aim of this study was to clarify whether addiction-specific neurometabolic reaction patterns occur in the insular cortex during acute nicotine withdrawal in tobacco smokers in comparison to nonsmokers. Fourteen male smokers and 10 male nonsmokers were included. Neurometabolites of the right and the left insular cortices were quantified by magnetic resonance spectroscopy (MRS) on a 3-Tesla scanner. Three separate MRS measurements were performed in each subject: among the smokers, the first measurement was done during normal smoking behavior, the second measurement during acute withdrawal (after 24 h of smoking abstinence), and the third shortly after administration of an oral nicotine substitute. Simultaneously, craving, withdrawal symptoms, and CO levels in exhaled air were determined during the three phases. The participants in the control group underwent the same MR protocol. In the smokers, during withdrawal, the insular cortex showed a significant increase in glutamine (Gln; p = 0.023) as well as a slight increase not reaching significance for glutamine/glutamate (Glx; p = 0.085) and a nonsignificant drop in myoinositol (mI; p = 0.381). These values tended to normalize after oral nicotine substitution treatment, even though differences were not significant: Gln (p = 0.225), Glx (p = 0.107) and mI (p = 0.810). Overall, the nonsmokers (control group) did not show any metabolic changes over all three phases (p > 0.05). In smokers, acute nicotine withdrawal produces a neurometabolic reaction pattern that is partly reversed by the administration of an oral nicotine substitute. The results are consistent with the expression of an addiction-specific neurometabolic shift in the brain and confirm the fact that the insular cortex seems to play a possible role in nicotine dependence.
authors.affiliation: Department of Radiology, Cantonal Hospital Winterthur, CH–8401Winterthur, Switzerland. Andreas.Gutzeit@ksw.ch
authors.forename: Andreas
authors.initials: A
authors.lastname: Gutzeit
authors.forename: Johannes M
authors.initials: JM
authors.lastname: Froehlich
authors.forename: Klaus
authors.initials: K
authors.lastname: Hergan
authors.forename: Nicole
authors.initials: N
authors.lastname: Graf
authors.forename: Christoph A
authors.initials: CA
authors.lastname: Binkert
authors.forename: Dieter
authors.initials: D
authors.lastname: Meier
authors.forename: Mike
authors.initials: M
authors.lastname: Brügger
authors.forename: Carolin
authors.initials: C
authors.lastname: Reischauer
authors.forename: Reto
authors.initials: R
authors.lastname: Sutter
authors.forename: Marcus
authors.initials: M
authors.lastname: Herdener
authors.forename: Tillmann
authors.initials: T
authors.lastname: Schubert
authors.forename: Sebastian
authors.initials: S
authors.lastname: Kos
authors.forename: Martin
authors.initials: M
authors.lastname: Grosshans
authors.forename: Matus
authors.initials: M
authors.lastname: Straka
authors.forename: Jochen
authors.initials: J
authors.lastname: Mutschler
mesh_terms: D000284:Administration, Oral; D000328:Adult; D016739:Behavior, Addictive / Q000378:metabolism; D002248:Carbon Monoxide / Q000378:metabolism; D016022:Case-Control Studies; D002540:Cerebral Cortex / Q000187:drug effects* / Q000378:metabolism*; D059907:Functional Neuroimaging; D018698:Glutamic Acid / Q000378:metabolism; D005973:Glutamine / Q000378:metabolism; D006801:Humans; D007294:Inositol / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D009538:Nicotine / Q000008:administration & dosage* / Q000009:adverse effects / Q000494:pharmacology; D012907:Smoking / Q000378:metabolism*; D013375:Substance Withdrawal Syndrome / Q000378:metabolism*; D061485:Tobacco Use Cessation Devices
chemical_list: D005973:Glutamine; D018698:Glutamic Acid; D007294:Inositol; D009538:Nicotine; D002248:Carbon Monoxide