title: Increased ventro-medial prefrontal activations in schizophrenia smokers during cigarette cravings.
abstract: BACKGROUND
  Highly prevalent in schizophrenia, tobacco smoking substantially increases the risk of cardiac-related death. Compared to the general population, tobacco smoking cessation rates are lower in schizophrenia. Unfortunately, the reasons for these low cessation rates remain poorly understood. Recently, it has been shown that tobacco cravings are increased in schizophrenia smokers compared to smokers with no comorbid psychiatric disorder. In view of these results, we sought to examine - for the first time - the neurophysiologic responses elicited by cigarette cues in schizophrenia smokers. We hypothesized that cigarettes cues would elicit increased activations in brain regions involved in drug cravings in schizophrenia smokers relative to control smokers.
  
  
  METHODS
  Smokers with (n=18) and without (n=24) schizophrenia (DSM-IV criteria) were scanned using functional magnetic resonance imaging (fMRI) while viewing appetitive cigarette images.
  
  
  RESULTS
  Schizophrenia smokers and smokers with no psychiatric comorbidity did not differ in subjective cravings in response to appetitive smoking cues. However, in schizophrenia smokers relative to control smokers, we found that appetitive cigarette cues triggered increased activations of the bilateral ventro-medial prefrontal cortex, a core region of the brain reward system. Moreover, a negative correlation was observed between cigarette cravings and activations of the right ventro-medial prefrontal cortex in schizophrenia smokers.
  
  
  CONCLUSIONS
  The current results highlight a key role of the brain reward system in cigarette craving in schizophrenia, and suggest that the neurophysiologic mechanisms involved in the regulation of cue-induced cigarette craving are impaired in this population.
authors.affiliation: Centre de recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montréal, Canada; Department of Psychiatry, University of Montreal, Montreal, Canada. Electronic address: stephane.potvin@umontreal.ca.
authors.forename: Stéphane
authors.initials: S
authors.lastname: Potvin
authors.affiliation: Department of Psychiatry, University of Montreal, Montreal, Canada; Institut de Gériatrie de l'Université de Montréal, Montreal, Canada; Centre for Research in Aging, Donald Berman Maimonides Geriatric Centre, Montreal, Canada.
authors.forename: Ovidiu
authors.initials: O
authors.lastname: Lungu
authors.affiliation: Department of Psychiatry, University of Montreal, Montreal, Canada; Institut Universitaire en Santé Mentale de Montréal, Montreal, Canada.
authors.forename: Olivier
authors.initials: O
authors.lastname: Lipp
authors.affiliation: Department of Psychiatry, University of Montreal, Montreal, Canada; Institut Universitaire en Santé Mentale de Montréal, Montreal, Canada.
authors.forename: Pierre
authors.initials: P
authors.lastname: Lalonde
authors.affiliation: Centre de recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montréal, Canada.
authors.forename: Vessela
authors.initials: V
authors.lastname: Zaharieva
authors.affiliation: Department of Psychiatry, University of Montreal, Montreal, Canada; Centre Hospitalier de l'Université de Montréal, Montreal, Canada.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Stip
authors.affiliation: Department of Psychiatry, University of Montreal, Montreal, Canada; Institut Universitaire en Santé Mentale de Montréal, Montreal, Canada.
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Melun
authors.affiliation: Centre de recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montréal, Canada; Department of Psychology, Bishop's University, Lennoxville, Canada.
authors.forename: Adrianna
authors.initials: A
authors.lastname: Mendrek
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D001931:Brain Mapping; D058999:Drug-Seeking Behavior / Q000502:physiology*; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000097:blood; D012559:Schizophrenia / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology; D012565:Schizophrenic Psychology; D013223:Statistics as Topic; D014029:Tobacco Use Disorder / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology* / Q000523:psychology*; D055815:Young Adult
chemical_list: D010100:Oxygen
keywords: Brain reward system; Cigarette; Cravings; Functional magnetic resonance imaging; Schizophrenia