Montemitro Chiara, Ossola Paolo, Ross Thomas J, Huys Quentin J M, Fedota John R, Salmeron Betty Jo, di Giannantonio Massimo, Stein Elliot A
Neuroimaging Research Branch, National Institute on Drug Abuse-Intramural Research Program, National Institutes of Health, Baltimore, MD, USA.
Department of Neuroscience, Imaging and Clinical Sciences, "G. d'Annunzio" University, Chieti, Italy.
Sci Rep. 2024 Dec 31;14(1):32171. doi: 10.1038/s41598-024-84091-y.
Despite progress in smoking reduction in the past several decades, cigarette smoking remains a significant public health concern world-wide, with many smokers attempting but ultimately failing to maintain abstinence. However, little is known about how decision-making evolves in quitting smokers. Based on preregistered hypotheses and analysis plan ( https://osf.io/yq5th ), we examined the evolution of reinforcement learning (RL), a key component of decision-making, in smokers during acute and extended nicotine abstinence. In a longitudinal, within-subject design, we used a probabilistic reward task (PRT) to assess RL in twenty smokers who successfully refrained from smoking for at least 30 days. We evaluated changes in reward-based decision-making using signal-detection analysis and five RL models across three sessions during 30 days of nicotine abstinence. Contrary to our preregistered hypothesis, punishment sensitivity emerged as the only parameter that changed during smoking cessation. While it is plausible that some changes in task performance could be attributed to task repetition effects, we observed a clear impact of the Nicotine Withdrawal Syndrome (NWS) on RL, and a dynamic relationship between craving and reward and punishment sensitivity over time, suggesting a significant recalibration of cognitive processes during abstinence. In this context, the heightened sensitivity to negative outcomes observed at the last session (30 days after quitting) compared to the previous sessions, may be interpreted as a cognitive adaptation aimed at fostering long-term abstinence. While further studies are needed to clarify the mechanisms underlying punishment sensitivity during nicotine abstinence, these results highlight the need for personalized treatment approaches tailored to individual needs.
尽管在过去几十年中吸烟率有所下降，但吸烟仍然是全球重大的公共卫生问题，许多吸烟者试图戒烟但最终未能保持戒烟状态。然而，对于戒烟者的决策过程如何演变却知之甚少。基于预先注册的假设和分析计划（https://osf.io/yq5th），我们研究了强化学习（RL）这一决策关键组成部分在吸烟者急性和长期尼古丁戒断期间的演变。在一项纵向的、受试者内设计中，我们使用概率奖励任务（PRT）来评估20名成功戒烟至少30天的吸烟者的强化学习。我们在尼古丁戒断的30天内，通过信号检测分析和五个强化学习模型，在三个阶段评估基于奖励的决策变化。与我们预先注册的假设相反，惩罚敏感性成为戒烟期间唯一发生变化的参数。虽然任务表现的一些变化可能归因于任务重复效应，但我们观察到尼古丁戒断综合征（NWS）对强化学习有明显影响，以及随着时间推移渴望与奖励和惩罚敏感性之间的动态关系，这表明在戒断期间认知过程发生了重大重新校准。在这种情况下，与前几个阶段相比，在最后一个阶段（戒烟30天后）观察到的对负面结果的更高敏感性，可能被解释为一种旨在促进长期戒烟的认知适应。虽然需要进一步研究来阐明尼古丁戒断期间惩罚敏感性的潜在机制，但这些结果凸显了针对个体需求制定个性化治疗方法的必要性。
