title: Restructuring Reward Mechanisms in Nicotine Addiction: A Pilot fMRI Study of Mindfulness-Oriented Recovery Enhancement for Cigarette Smokers.
abstract: The primary goal of this pilot feasibility study was to examine the effects of Mindfulness-Oriented Recovery Enhancement (MORE), a behavioral treatment grounded in dual-process models derived from cognitive science, on frontostriatal reward processes among cigarette smokers. Healthy adult (N= 13; mean (SD) age 49 ± 12.2) smokers provided informed consent to participate in a 10-week study testing MORE versus a comparison group (CG). All participants underwent two fMRI scans: pre-tx and after 8-weeks of MORE. Emotion regulation (ER), smoking cue reactivity (CR), and resting-state functional connectivity (rsFC) were assessed at each fMRI visit; smoking and mood were assessed throughout. As compared to the CG, MORE significantly reduced smoking (d= 2.06) and increased positive affect (d= 2.02). MORE participants evidenced decreased CR-BOLD response in ventral striatum (VS;d= 1.57) and ventral prefrontal cortex (vPFC;d= 1.7) and increased positive ER-BOLD in VS (dVS= 2.13) and vPFC (dvmPFC= 2.66). Importantly, ER was correlated with smoking reduction (r's = .68 to .91) and increased positive affect (r's = .52 to .61). These findings provide preliminary evidence that MORE may facilitate the restructuring of reward processes and play a role in treating the pathophysiology of nicotine addiction.
authors.affiliation: Department of Neuroscience, Medical University of South Carolina, Charleston, SC, USA; Department of Psychiatry, Medical University of South Carolina, Charleston, SC, USA; Hollings Cancer Center, Medical University of South Carolina, Charleston, SC, USA; Center for Biomedical Imaging, Medical University of South Carolina, Charleston, SC, USA.
authors.forename: B
authors.identifier: 0000-0002-4357-1626
authors.initials: B
authors.lastname: Froeliger
authors.affiliation: Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
authors.forename: A R
authors.initials: AR
authors.lastname: Mathew
authors.affiliation: Department of Neuroscience, Medical University of South Carolina, Charleston, SC, USA.
authors.forename: P A
authors.initials: PA
authors.lastname: McConnell
authors.affiliation: Department of Neuroscience, Medical University of South Carolina, Charleston, SC, USA.
authors.forename: C
authors.initials: C
authors.lastname: Eichberg
authors.affiliation: Department of Health Sciences and Research, Medical University of South Carolina, Charleston, SC, USA.
authors.forename: M E
authors.initials: ME
authors.lastname: Saladin
authors.affiliation: Department of Psychiatry, Medical University of South Carolina, Charleston, SC, USA; Hollings Cancer Center, Medical University of South Carolina, Charleston, SC, USA.
authors.forename: M J
authors.initials: MJ
authors.lastname: Carpenter
authors.affiliation: College of Social Work, University of Utah, Salt Lake City, UT, USA; Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA.
authors.forename: E L
authors.initials: EL
authors.lastname: Garland