Department of Psychiatry, Christiana Care Health System, Newark, DE, USA.
Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA.
Addict Biol. 2020 Mar;25(2):e12750. doi: 10.1111/adb.12750. Epub 2019 May 8.
Obesity and cigarette smoking are two of the leading preventable causes of death in the United States. Research suggests that overlapping pathophysiology may contribute to obesity and nicotine use disorder (NUD), yet no studies have investigated the effect of obesity on neural response to reward stimuli in NUD. This study used arterial spin-labeled perfusion functional magnetic resonance imaging (fMRI) to examine neural responses during exposure to smoking versus nonsmoking cues in 79 treatment-seeking participants with NUD, 26 with normal weight, 28 with overweight, and 25 with obesity. Given that deficits in behavioral inhibitory control have been associated with both obesity and NUD, participants completed an affect-congruent Go/NoGo task to assess the effect of body mass index (BMI) on this construct in NUD. Analyses revealed that BMI was negatively associated with activation in the right dorsolateral prefrontal cortex (dlPFC) in response to smoking cues, with significantly reduced response in smokers with overweight and smokers with obesity compared with normal-weight smokers. In addition, greater commission errors on the Go/NoGo task were correlated with reduced neural response to smoking cues in the right dlPFC only among those with obesity. Together, these findings provide evidence that obesity in treatment-seeking NUDs is related to neurobiological alterations in inhibitory control over cue-potentiated behaviors, suggesting that smoking cessation may be more difficult in individuals with comorbid NUD and obesity than in those without, requiring treatment strategies tailored to meet their unique needs.
肥胖和吸烟是美国两大可预防的主要死亡原因。研究表明，重叠的病理生理学可能导致肥胖和尼古丁使用障碍（NUD），但尚无研究调查肥胖对 NUD 中对奖励刺激的神经反应的影响。本研究使用动脉自旋标记灌注功能磁共振成像（fMRI），在 79 名寻求治疗的 NUD 参与者、26 名体重正常者、28 名超重者和 25 名肥胖者中，检查了吸烟与非吸烟线索暴露时的神经反应。鉴于行为抑制控制缺陷与肥胖和 NUD 均有关，参与者完成了与情绪一致的 Go/NoGo 任务，以评估 BMI 在 NUD 中对该结构的影响。分析显示，BMI 与对吸烟线索的右背外侧前额叶皮层（dlPFC）的激活呈负相关，与超重和肥胖的吸烟者相比，正常体重的吸烟者的反应明显减少。此外，在 Go/NoGo 任务中的更多错误反应与右 dlPFC 中对吸烟线索的神经反应减少相关，仅在肥胖者中如此。这些发现共同证明，在寻求治疗的 NUD 中肥胖与对线索增强行为的抑制控制的神经生物学改变有关，这表明患有共病 NUD 和肥胖的个体戒烟可能比没有共病的个体更困难，需要量身定制的治疗策略来满足他们的独特需求。
