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尼古丁和烟草使用对大脑奖赏功能的影响:与尼古丁依赖严重程度的相互作用。

The Effects of Nicotine and Tobacco Use on Brain Reward Function: Interaction With Nicotine Dependence Severity.

机构信息

Department of Psychiatry, University of Arkansas for Medical Science, Little Rock, AR.

Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, University of Arkansas for Medical Sciences, Durham, NC.

出版信息

Nicotine Tob Res. 2019 May 21;21(6):764-771. doi: 10.1093/ntr/nty059.

Abstract

INTRODUCTION

This study investigated the effects of nicotine/tobacco on neural activation during performance of a monetary incentive delay task.

AIMS AND METHODS

Prior to each scan, nonsmokers received nicotine or placebo nasal spray, and smokers were smoking satiated or 24-hour withdrawn. During the scan, participants made timed responses to reward-related cues and received feedback. Parameter estimates from cue- and feedback-related activation in medial prefrontal regions and the nucleus accumbens were extracted and underwent within- and between-group analyses. Smokers' nicotine dependence severity was included as a continuous predictor variable for neural activation.

RESULTS

Among smokers (n = 21), withdrawal decreased cue-related activation in the supplementary motor area and ventromedial prefrontal cortex, and the difference in activation (satiety > withdrawal) in these regions negatively correlated with nicotine dependence severity (Fagerström Test for Nicotine Dependence). Among nonsmokers (n = 22), nicotine increased the difference in nucleus accumbens activation between rewarded and nonrewarded feedback phases. Tobacco withdrawal and acute nicotine also had widespread effects on activation throughout the brain during the feedback phase.

CONCLUSIONS

Acute nicotine in nonsmokers may have increased the salience of feedback information, but produced few effects on reward-related activation overall, perhaps reflecting nicotine's modest, indirect effects on reward processing. Conversely, tobacco withdrawal decreased activation compared with satiety, and this difference between conditions correlated with nicotine dependence severity. This suggests that as smokers become more dependent on nicotine, tobacco withdrawal has a more pronounced effect on reward processing.

IMPLICATIONS

Relative to the acute effects of nicotine in nonsmokers, withdrawal from daily tobacco use had more significant effects on reward-related brain activation. This study suggests that the effects of tobacco withdrawal on reward-related brain function interact with subjects' level of nicotine dependence severity. These are potentially important sources of variability that could contribute to smoking cessation outcomes.

摘要

简介

本研究旨在探讨尼古丁/烟草对执行金钱奖励延迟任务时神经激活的影响。

目的和方法

在每次扫描前,非吸烟者接受尼古丁或安慰剂鼻喷剂,吸烟者则处于吸烟满足或 24 小时戒断状态。在扫描过程中,参与者对与奖励相关的线索做出定时反应并接收反馈。从中提取内侧前额叶区域和伏隔核与线索和反馈相关的激活的参数估计,并进行组内和组间分析。将吸烟者的尼古丁依赖严重程度作为神经激活的连续预测变量。

结果

在吸烟者(n = 21)中,戒断降低了补充运动区和腹内侧前额叶皮层与线索相关的激活,并且这些区域的激活差异(满足感>戒断)与尼古丁依赖严重程度(尼古丁依赖测试)呈负相关。在非吸烟者(n = 22)中,尼古丁增加了奖赏和非奖赏反馈阶段之间伏隔核激活的差异。烟草戒断和急性尼古丁也对反馈阶段大脑的广泛激活产生影响。

结论

非吸烟者中的急性尼古丁可能增加了反馈信息的显著性,但总体上对奖赏相关激活的影响较小,这可能反映了尼古丁对奖赏处理的适度、间接影响。相反,与满足感相比,烟草戒断降低了激活,而这两种状态之间的差异与尼古丁依赖严重程度相关。这表明,随着吸烟者对尼古丁的依赖程度增加,烟草戒断对奖赏处理的影响更为显著。

意义

与非吸烟者急性尼古丁的影响相比,每日吸烟的戒断对奖赏相关大脑激活的影响更为显著。本研究表明,烟草戒断对奖赏相关大脑功能的影响与受试者的尼古丁依赖严重程度相互作用。这些可能是导致戒烟结果出现差异的重要来源。

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