Brody Arthur L, Mandelkern Mark A, London Edythe D, Childress Anna Rose, Lee Grace S, Bota Robert G, Ho Matthew L, Saxena Sanjaya, Baxter Lewis R, Madsen Damian, Jarvik Murray E
Department of Psychiatry and Biobehavioral Sciences, University of California-Los Angeles, 300 UCLA Medical Plaza, Suite 2200, Los Angeles, CA 90095, USA.
Arch Gen Psychiatry. 2002 Dec;59(12):1162-72. doi: 10.1001/archpsyc.59.12.1162.
In functional brain imaging studies, exposure to cues related to cocaine, opiates, and alcohol in dependent individuals is associated with activation of the anterior cingulate gyrus, amygdala, orbitofrontal cortex, and dorsolateral prefrontal cortex. Craving for these substances positively correlates with activity in the orbitofrontal cortex, dorsolateral prefrontal cortex, and anterior insula. The objective of this study was to determine changes in regional cerebral glucose metabolism and correlations between craving and regional metabolism in heavy cigarette smokers exposed to cigarette-related cues.
Twenty heavy smokers (who smoked > or =20 cigarettes per day) and 20 nonsmoking control subjects underwent 2 fluorine 18-fluorodeoxyglucose positron emission tomography scans 10 days apart in randomized order: one while watching a videotape that presented cigarette-related cues and handling a cigarette, and the other while watching an educational (nature) videotape and handling a neutral object (pen).
From the neutral to the cigarette cue scan, heavy smokers had greater increases than nonsmoking controls in relative glucose metabolism in the perigenual anterior cingulate gyrus spanning the midline. Significant positive correlations were found between intensity of craving and metabolism in the orbitofrontal cortex, dorsolateral prefrontal cortex, and anterior insula bilaterally. An unexpected positive association was found between craving and metabolism in the right sensorimotor cortex.
Brain regions associated with arousal, compulsive repetitive behaviors, sensory integration, and episodic memory are activated during exposure to cigarette-related cues and cigarette craving. These regional brain activations and associations with craving are similar to findings with other addictive substances.
在功能性脑成像研究中，依赖个体暴露于与可卡因、阿片类药物和酒精相关的线索时，前扣带回、杏仁核、眶额皮质和背外侧前额叶皮质会被激活。对这些物质的渴望与眶额皮质、背外侧前额叶皮质和前岛叶的活动呈正相关。本研究的目的是确定重度吸烟者在暴露于与香烟相关的线索时，局部脑葡萄糖代谢的变化以及渴望与局部代谢之间的相关性。
20名重度吸烟者（每天吸烟≥20支）和20名非吸烟对照者，以随机顺序在10天内接受两次氟代脱氧葡萄糖正电子发射断层扫描：一次是观看展示与香烟相关线索并手持香烟的录像带时进行扫描，另一次是观看教育（自然）录像带并手持中性物品（笔）时进行扫描。
从观看中性录像带到观看与香烟相关线索的录像带扫描过程中，重度吸烟者在跨越中线的膝周前扣带回的相对葡萄糖代谢增加幅度大于非吸烟对照者。在双侧眶额皮质、背外侧前额叶皮质和前岛叶，发现渴望强度与代谢之间存在显著正相关。在右侧感觉运动皮质，发现渴望与代谢之间存在意外的正相关。
在暴露于与香烟相关的线索和香烟渴望期间，与唤醒、强迫性重复行为、感觉整合和情景记忆相关的脑区被激活。这些脑区的激活以及与渴望的关联与其他成瘾物质的研究结果相似。
