Garrison Kathleen A, Yip Sarah W, Balodis Iris M, Carroll Kathleen M, Potenza Marc N, Krishnan-Sarin Suchitra
Department of Psychiatry, Yale School of Medicine, United States.
Department of Psychiatry, Yale School of Medicine, United States; The National Center on Addiction and Substance Abuse, Yale School of Medicine, United States.
Drug Alcohol Depend. 2017 Aug 1;177:268-276. doi: 10.1016/j.drugalcdep.2017.03.035. Epub 2017 Jun 3.
Tobacco use is often initiated during adolescence and continued into adulthood despite desires to quit. A better understanding of the neural correlates of abstinence from smoking in adolescents may inform more effective smoking cessation interventions. Neural reward systems are implicated in tobacco use disorder, and adolescent smokers have shown reduced reward-related ventral striatal activation related to increased smoking.
The current study evaluated nondrug reward anticipation in adolescent smokers using a monetary incentive delay task in fMRI pre- and post- smoking cessation treatment (n=14). This study tested how changes in neural responses to reward anticipation pre- to post-treatment were related to reduced smoking. An exploratory analysis in a larger sample of adolescents with only pre-treatment fMRI (n=28) evaluated how neural responses to reward anticipation were related to behavioral inhibition and behavioral activation scales.
Adolescent smokers showed pre- to post-treatment increases in reward anticipation-related activity in the bilateral nucleus accumbens and insula, and medial prefrontal cortex, and greater increases in reward anticipation-related activity were correlated with larger percent days of smoking abstinence during treatment.
These findings suggest that reduced smoking during smoking cessation treatment is associated with a "recovery of function" in frontostriatal responses to nondrug reward anticipation in adolescent smokers, although comparison with a developmental control group of adolescent nonsmokers is warranted.
尽管有戒烟意愿,但吸烟行为通常始于青少年时期并持续至成年。更好地理解青少年戒烟的神经关联因素可能有助于制定更有效的戒烟干预措施。神经奖赏系统与烟草使用障碍有关,青少年吸烟者与吸烟增加相关的奖赏相关腹侧纹状体激活减少。
本研究使用功能磁共振成像(fMRI)货币激励延迟任务,对14名青少年吸烟者在戒烟治疗前后进行评估,以评价非药物奖赏预期。本研究测试了治疗前到治疗后奖赏预期神经反应的变化与吸烟减少之间的关系。在仅进行治疗前fMRI的更大样本青少年(n = 28)中进行的探索性分析,评估了奖赏预期神经反应与行为抑制和行为激活量表之间的关系。
青少年吸烟者在双侧伏隔核、岛叶和内侧前额叶皮质中,与奖赏预期相关的活动在治疗前到治疗后有所增加,并且与治疗期间吸烟戒断天数百分比的更大增加相关的奖赏预期相关活动增加幅度更大。
这些发现表明,戒烟治疗期间吸烟减少与青少年吸烟者对非药物奖赏预期的额纹状体反应的“功能恢复”有关,尽管有必要与青少年非吸烟者的发育对照组进行比较。