Versace Francesco, Engelmann Jeffrey M, Deweese Menton M, Robinson Jason D, Green Charles E, Lam Cho Y, Minnix Jennifer A, Karam-Hage Maher A, Wetter David W, Schembre Susan M, Cinciripini Paul M
Oklahoma Tobacco Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK.
Department of Behavioral Science, University of Texas MD Anderson Cancer Center, Houston, TX.
Nicotine Tob Res. 2017 Jun 1;19(6):663-669. doi: 10.1093/ntr/ntx002.
Neurobiological models of addiction posit that drug use can alter reward processes in two ways: (1) by increasing the motivational relevance of drugs and drug-related cues and (2) by reducing the motivational relevance of non-drug-related rewards. Here, we discuss the results from a series of neuroimaging studies in which we assessed the extent to which these hypotheses apply to nicotine dependence. In these studies, we recorded smokers’ and nonsmokers’ brain responses to a wide array of motivationally relevant visual stimuli that included pleasant, unpleasant, cigarette-related, and neutral images. Based on these findings, we highlight the flaws of the traditional cue reactivity paradigm and we conclude that responses to non-drug-related motivationally relevant stimuli should be used to appropriately gauge the motivational relevance of cigarette-related cues and to identify smokers attributing higher motivational relevance to drug-related cues than to non-drug-related rewards. Identifying these individuals is clinically relevant as they achieve lower rates of long-term smoking abstinence when attempting to quit. Finally, we show how this approach may be extended beyond nicotine dependence to inform theoretical and clinical research in the study of obesity.
The cue reactivity paradigm (ie, comparing responses evoked by drug-related cues to those evoked by neutral cues) cannot provide conclusive information about the motivational relevance of drug-related cues. Responses to non-drug-related motivationally relevant stimuli should be used to appropriately gauge the level of motivational relevance that substance-dependent individuals attribute to drug-related cues.
成瘾的神经生物学模型认为，药物使用可通过两种方式改变奖赏过程：（1）增加药物及与药物相关线索的动机相关性；（2）降低与非药物相关奖赏的动机相关性。在此，我们讨论了一系列神经影像学研究的结果，在这些研究中，我们评估了这些假设在多大程度上适用于尼古丁依赖。在这些研究中，我们记录了吸烟者和非吸烟者对一系列具有动机相关性的视觉刺激的大脑反应，这些刺激包括愉悦、不悦、与香烟相关和中性的图像。基于这些发现，我们强调了传统线索反应范式的缺陷，并得出结论，对与非药物相关的具有动机相关性的刺激的反应应用于适当衡量与香烟相关线索的动机相关性，并识别那些将与药物相关线索的动机相关性归因于高于与非药物相关奖赏的吸烟者。识别这些个体具有临床相关性，因为他们在试图戒烟时长期戒烟率较低。最后，我们展示了这种方法如何可以扩展到尼古丁依赖之外，为肥胖研究中的理论和临床研究提供信息。
线索反应范式（即比较药物相关线索引发的反应与中性线索引发的反应）无法提供关于药物相关线索动机相关性的决定性信息。对与非药物相关的具有动机相关性的刺激的反应应用于适当衡量物质依赖个体赋予药物相关线索的动机相关性水平。
