title: Prequit fMRI responses to pleasant cues and cigarette-related cues predict smoking cessation outcome.
abstract: BACKGROUND
  The reasons that some smokers find it harder to quit than others are unclear. Understanding how individual differences predict smoking cessation outcomes may allow the development of more successful personalized treatments for nicotine dependence. Theoretical models suggest that drug users might be characterized by increased sensitivity to drug cues and by reduced sensitivity to nondrug-related natural rewards. We hypothesized that baseline differences in brain sensitivity to natural rewards and cigarette-related cues would predict the outcome of a smoking cessation attempt.
  
  
  METHODS
  Using functional magnetic resonance imaging, we recorded prequit brain responses to neutral, emotional (pleasant and unpleasant), and cigarette-related cues from 55 smokers interested in quitting. We then assessed smoking abstinence, mood, and nicotine withdrawal symptoms during the course of a smoking cessation attempt.
  
  
  RESULTS
  Using cluster analysis, we identified 2 groups of smokers who differed in their baseline responses to pleasant cues and cigarette-related cues in the posterior visual association areas, the dorsal striatum, and the medial and dorsolateral prefrontal cortex. Smokers who showed lower prequit levels of brain reactivity to pleasant stimuli than to cigarette-related cues were less likely to be abstinent 6 months after their quit attempt, and they had higher levels of negative affect during the course of the quit attempt.
  
  
  CONCLUSIONS
  Smokers with blunted brain responses to pleasant stimuli, relative to cigarette-related stimuli, had more difficulty quitting smoking. For these individuals, the lack of alternative forms of reinforcement when nicotine deprived might be an important factor underlying relapse. Normalizing these pathological neuroadaptations may help them achieve abstinence.
authors.affiliation: University of Texas MD Anderson Cancer Center, Houston, TX;
authors.forename: Francesco
authors.initials: F
authors.lastname: Versace
authors.forename: Jeffrey M
authors.initials: JM
authors.lastname: Engelmann
authors.forename: Jason D
authors.initials: JD
authors.lastname: Robinson
authors.forename: Edward F
authors.initials: EF
authors.lastname: Jackson
authors.forename: Charles E
authors.initials: CE
authors.lastname: Green
authors.forename: Cho Y
authors.initials: CY
authors.lastname: Lam
authors.forename: Jennifer A
authors.initials: JA
authors.lastname: Minnix
authors.forename: Maher A
authors.initials: MA
authors.lastname: Karam-Hage
authors.forename: Victoria L
authors.initials: VL
authors.lastname: Brown
authors.forename: David W
authors.initials: DW
authors.lastname: Wetter
authors.forename: Paul M
authors.initials: PM
authors.lastname: Cinciripini
mesh_terms: D000328:Adult; D001921:Brain / Q000502:physiology*; D003463:Cues; D004644:Emotions / Q000502:physiology; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D016032:Randomized Controlled Trials as Topic; D012201:Reward; D012907:Smoking / Q000523:psychology; D016540:Smoking Cessation / Q000523:psychology*; D013375:Substance Withdrawal Syndrome / Q000523:psychology; D062789:Tobacco Products; D014029:Tobacco Use Disorder / Q000523:psychology