title: Default mode network deactivation to smoking cue relative to food cue predicts treatment outcome in nicotine use disorder.
abstract: Identifying predictors of treatment outcome for nicotine use disorders (NUDs) may help improve efficacy of established treatments, like varenicline. Brain reactivity to drug stimuli predicts relapse risk in nicotine and other substance use disorders in some studies. Activity in the default mode network (DMN) is affected by drug cues and other palatable cues, but its clinical significance is unclear. In this study, 143 individuals with NUD (male n = 91, ages 18-55 years) received a functional magnetic resonance imaging scan during a visual cue task during which they were presented with a series of smoking-related or food-related video clips prior to randomization to treatment with varenicline (n = 80) or placebo. Group independent components analysis was utilized to isolate the DMN, and temporal sorting was used to calculate the difference between the DMN blood-oxygen-level dependent signal during smoke cues and that during food cues for each individual. Food cues were associated with greater deactivation compared with smoke cues in the DMN. In correcting for baseline smoking and other clinical variables, which have been shown to be related to treatment outcome in previous work, a less positive Smoke - Food difference score predicted greater smoking at 6 and 12 weeks when both treatment groups were combined (P = 0.005, β = -0.766). An exploratory analysis of executive control and salience networks demonstrated that a more positive Smoke - Food difference score for executive control network predicted a more robust response to varenicline relative to placebo. These findings provide further support to theories that brain reactivity to palatable cues, and in particular in DMN, may have a direct clinical relevance in NUD.
authors.affiliation: Department of Psychiatry, University of New Mexico, Albuquerque, NM, USA.
authors.forename: Claire E
authors.initials: CE
authors.lastname: Wilcox
authors.affiliation: Mind Research Network and Lovelace Biomedical and Environmental Research Institute, Albuquerque, NM, USA.
authors.forename: Eric D
authors.initials: ED
authors.lastname: Claus
authors.affiliation: Mind Research Network and Lovelace Biomedical and Environmental Research Institute, Albuquerque, NM, USA.
authors.forename: Vince D
authors.initials: VD
authors.lastname: Calhoun
authors.affiliation: Mind Research Network and Lovelace Biomedical and Environmental Research Institute, Albuquerque, NM, USA.
authors.forename: Srinivas
authors.initials: S
authors.lastname: Rachakonda
authors.affiliation: Mind Research Network and Lovelace Biomedical and Environmental Research Institute, Albuquerque, NM, USA.
authors.forename: Rae A
authors.initials: RA
authors.lastname: Littlewood
authors.affiliation: Mind Research Network and Lovelace Biomedical and Environmental Research Institute, Albuquerque, NM, USA.
authors.forename: Jessica
authors.initials: J
authors.lastname: Mickey
authors.affiliation: Department of Psychiatry, University of New Mexico, Albuquerque, NM, USA.
authors.forename: Pamela B
authors.initials: PB
authors.lastname: Arenella
authors.affiliation: Mind Research Network and Lovelace Biomedical and Environmental Research Institute, Albuquerque, NM, USA.
authors.forename: Natalie
authors.initials: N
authors.lastname: Goodreau
authors.affiliation: Mind Research Network and Lovelace Biomedical and Environmental Research Institute, Albuquerque, NM, USA.|Department of Psychology, University of Colorado Boulder, Boulder, CO, USA.
authors.forename: Kent E
authors.initials: KE
authors.lastname: Hutchison
mesh_terms: D000293:Adolescent; D000328:Adult; D001921:Brain / Q000000981:diagnostic imaging*; D000073865:Cigarette Smoking / Q000188:drug therapy*; D003463:Cues; D005260:Female; D005502:Food; D059907:Functional Neuroimaging; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016540:Smoking Cessation; D000077444:Smoking Cessation Agents / Q000627:therapeutic use*; D014029:Tobacco Use Disorder / Q000000981:diagnostic imaging* / Q000188:drug therapy; D016896:Treatment Outcome; D000068580:Varenicline / Q000627:therapeutic use*; D055815:Young Adult
chemical_list: D000077444:Smoking Cessation Agents; D000068580:Varenicline
keywords: default mode network; functional MRI; nicotine use disorder; smoking; treatment outcome; varenicline