title: Increased network centrality as markers of relapse risk in nicotine-dependent individuals treated with varenicline.
abstract: Identifying smokers at high risk of relapse could improve the effectiveness of cessation therapies. Although altered regional brain function in smokers has been reported, whether the whole-brain functional organization differs smokers with relapse vulnerability from others remains unclear. Thus, the goal of this study is to investigate the baseline functional connectivity differences between relapsers and quitters. Using resting-state fMRI, we acquired images from 57 smokers prior to quitting attempts. After 12-week treatment with varenicline, smokers were divided into relapsers (n=36) and quitters (n=21) (quitter: continuously abstinent for weeks 9-12). The smoking cessation outcomes were cross-validated by self-reports and expired carbon monoxide. We then used eigenvector centrality (EC) mapping to identify the functional connectivity differences between relapsers and quitters. When compared to quitters, increased EC in the right dorsolateral prefrontal cortex (DLPFC), left middle temporal gyrus (MTG) and cerebellum anterior lobe was observed in relapsers. In addition, a logistic regression analysis of EC data (with DLPFC, MTG and cerebellum included) predicted relapse with 80.7% accuracy. These findings suggest that the DLPFC, MTG and cerebellum may be important substrates of smoking relapse vulnerability. The data also suggest that relapse-vulnerable smokers can be identified before quit attempts, which could enable personalized treatment and improve smoking cessation outcomes.
authors.affiliation: Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
authors.forename: Zhujing
authors.initials: Z
authors.lastname: Shen
authors.affiliation: Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
authors.forename: Peiyu
authors.initials: P
authors.lastname: Huang
authors.affiliation: Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
authors.forename: Chao
authors.initials: C
authors.lastname: Wang
authors.affiliation: Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Qian
authors.affiliation: Neuroimaging Research Branch, National Institute on Drug Abuse, National Institutes of Health, Baltimore, MD, United States.
authors.forename: Yihong
authors.initials: Y
authors.lastname: Yang
authors.affiliation: Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China. Electronic address: zhangminming@zju.edu.cn.
authors.forename: Minming
authors.initials: M
authors.lastname: Zhang
mesh_terms: D000328:Adult; D001921:Brain / Q000000981:diagnostic imaging / Q000187:drug effects*; D001931:Brain Mapping; D017352:Echo-Planar Imaging; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009434:Neural Pathways / Q000000981:diagnostic imaging / Q000187:drug effects; D018722:Nicotinic Agonists / Q000627:therapeutic use*; D010100:Oxygen / Q000097:blood; D012008:Recurrence; D014029:Tobacco Use Disorder / Q000000981:diagnostic imaging / Q000188:drug therapy*; D000068580:Varenicline / Q000627:therapeutic use*
chemical_list: D018722:Nicotinic Agonists; D010100:Oxygen; D000068580:Varenicline
keywords: Cerebellum; Dorsolateral prefrontal cortex; Eigenvector centrality mapping; Functional connectivity; Middle temporal gyrus; Smoking cessation