title: Cigarette smoking leads to persistent and dose-dependent alterations of brain activity and connectivity in anterior insula and anterior cingulate.
abstract: Although many smokers try to quit smoking, only about 20-25 percent will achieve abstinence despite 6 months or more of gold-standard treatment. This low success rate suggests long-term changes in the brain related to smoking, which remain poorly understood. We compared ex-smokers to both active smokers and non-smokers using functional magnetic resonance imaging (fMRI) to explore persistent modifications in brain activity and network organization. This prospective and consecutive study includes 18 non-smokers (29.5 ± 6.7 years of age, 11 women), 14 smokers (≥10 cigarettes a day >2 years of smoking, 29.3 ± 6.0 years of age, 10 women) and 14 ex-smokers (>1 year of quitting 30.5 ± 5.7 years of age, 10 women). Participants underwent a block-design fMRI study contrasting smoking cue with control (neutral cue) videos. Data analyses included task-related general linear model, seed-based functional connectivity, voxel-based morphometry (VBM) of gray matter and tract-based spatial statistics (TBSS) of white matter. Smoking cue videos versus control videos activated the right anterior insula in ex-smokers compared with smokers, an effect correlating with cumulative nicotine intake (pack-years). Moreover, ex-smokers had a persistent decrease in functional connectivity between right anterior insula and anterior cingulate cortex (ACC) compared with control participants, but similar to active smokers. Potentially confounding alterations in gray or white matter were excluded in VBM and TBSS analyses. In summary, ex-smokers with long-term nicotine abstinence have persistent and dose-dependent brain network changes notably in the right anterior insula and its connection to the ACC.
authors: Department of Imaging and Medical Informatics, University Hospitals of Geneva and Faculty of Medicine of the University of Geneva, Switzerland.
authors: Davide
authors: D
authors: Zanchi
authors: Department of Psychiatry, University of California at Los Angeles.|Departments of Psychiatry and Research, VA Greater Los Angeles Healthcare System.
authors: Arthur L
authors: AL
authors: Brody
authors: Department of Imaging and Medical Informatics, University Hospitals of Geneva and Faculty of Medicine of the University of Geneva, Switzerland.
authors: Marie-Louise
authors: ML
authors: Montandon
authors: Department of Imaging and Medical Informatics, University Hospitals of Geneva and Faculty of Medicine of the University of Geneva, Switzerland.|Institute of Bioengineering, Ecole Polytechnique Fédérale de Lausanne, Switzerland.
authors: Rotem
authors: R
authors: Kopel
authors: Department of Imaging and Medical Informatics, University Hospitals of Geneva and Faculty of Medicine of the University of Geneva, Switzerland.
authors: Kirsten
authors: K
authors: Emmert
authors: Department of Imaging and Medical Informatics, University Hospitals of Geneva and Faculty of Medicine of the University of Geneva, Switzerland.|Institute of Bioengineering, Ecole Polytechnique Fédérale de Lausanne, Switzerland.
authors: Maria Giulia
authors: MG
authors: Preti
authors: Department of Imaging and Medical Informatics, University Hospitals of Geneva and Faculty of Medicine of the University of Geneva, Switzerland.|Institute of Bioengineering, Ecole Polytechnique Fédérale de Lausanne, Switzerland.
authors: Dimitri
authors: D
authors: Van De Ville
authors: Faculty of Medicine of the University of Geneva, Switzerland.|Department of Surgical Sciences, Radiology, Uppsala University, Uppsala, Sweden.|Department of Neuroradiology, University Hospital Freiburg, Germany.|Affidea Centre de Diagnostic Radiologique de Carouge CDRC, Geneva, Switzerland.
authors: Sven
authors: http://orcid.org/0000-0001-7433-0203
authors: S
authors: Haller
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D001927:Brain Diseases / Q000209:etiology* / Q000503:physiopathology; D002540:Cerebral Cortex / Q000502:physiology; D066249:Craving / Q000502:physiology; D004305:Dose-Response Relationship, Drug; D005260:Female; D006179:Gyrus Cinguli / Q000502:physiology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D011446:Prospective Studies; D012907:Smoking / Q000009:adverse effects* / Q000503:physiopathology; D014741:Video Recording
keywords: Craving; nicotine; smoking