Moran-Santa Maria Megan M, Hartwell Karen J, Hanlon Colleen A, Canterberry Melanie, Lematty Todd, Owens Max, Brady Kathleen T, George Mark S
Department of Psychiatry and Behavioral Sciences, Clinical Neuroscience Division, Medical University of South Carolina, Charleston, SC, USA.
Addict Biol. 2015 Mar;20(2):407-14. doi: 10.1111/adb.12124. Epub 2014 Feb 13.
The insula has been implicated in cue-induced craving and relapse in nicotine-dependent tobacco cigarette smokers. The aims of the present study were to identify brain regions that exhibit greater functional connectivity with the right anterior insula in response to smoking cues than to neutral cues and the role of functional connectivity between these regions in mediating cue-induced craving in healthy (free of axis I psychiatric disorders) nicotine-dependent tobacco cigarette smokers. Functional magnetic resonance imaging data were collected from 63 healthy nicotine-dependent smokers viewing blocks of smoking and neutral cues. Craving ratings were obtained after each block. A psychophysiologic interaction approach was used to identify regions that exhibited significantly greater functional connectivity with the right anterior insula (seed) during the smoking cues than during the neutral (corrected cluster thresholding, Z > 2.3, P = 0.05). Parameter estimates of the interaction effects from each region were regressed against the mean cue-induced craving scores. Significant task by seed interactions were observed in two clusters centered in the bilateral precuneus and left angular gyrus. The strength of connectivity between the right anterior insula and the precuneus, which is involved interoceptive processing and self-awareness, was positively correlated with the magnitude of the craving response to the smoking cues (r(2) = 0.15; P < 0.01). These data suggest that among smokers, cue-induced craving may be a function of connectivity between two regions involved in interoception and self-awareness. Moreover, treatment strategies that incorporate mindful attention may be effective in attenuating cue-induced craving and relapse in nicotine-dependent smokers.
脑岛与尼古丁依赖的吸烟者因线索诱发的渴望及复吸有关。本研究的目的是确定在对吸烟线索而非中性线索做出反应时，与右侧前脑岛表现出更强功能连接的脑区，以及这些脑区之间的功能连接在介导健康（无轴I精神障碍）尼古丁依赖的吸烟者线索诱发的渴望中的作用。收集了63名健康尼古丁依赖吸烟者观看吸烟和中性线索组块时的功能磁共振成像数据。每个组块后获取渴望评分。采用心理生理交互作用方法来确定在吸烟线索期间比在中性线索期间与右侧前脑岛（种子区）表现出显著更强功能连接的区域（校正聚类阈值，Z>2.3，P=0.05）。将每个区域交互效应的参数估计值与平均线索诱发的渴望评分进行回归分析。在以双侧楔前叶和左侧角回为中心的两个簇中观察到显著的任务与种子区交互作用。右侧前脑岛与楔前叶之间的连接强度与对吸烟线索的渴望反应程度呈正相关，楔前叶参与内感受处理和自我意识（r(2)=0.15；P<0.01）。这些数据表明，在吸烟者中，线索诱发的渴望可能是两个参与内感受和自我意识的区域之间连接的一种功能。此外，纳入正念注意力的治疗策略可能有效减轻尼古丁依赖吸烟者线索诱发的渴望及复吸。
