Neural correlates of craving and resisting craving for tobacco in nicotine dependent smokers.
Neural correlates of craving and resisting craving for tobacco in nicotine dependent smokers.
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DOI：
10.1111/j.1369-1600.2011.00340.x
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发表时间：
2011-10
影响因子：
3.4
通讯作者：
Brady KT
中科院分区：
文献类型：
--
作者：
Hartwell KJ;Johnson KA;Li X;Myrick H;LeMatty T;George MS;Brady KT
渴望是一个重要的因素，可以导致在戒烟尝试复吸。在暗示引发的渴望中，试图抵制吸烟的冲动已经被证明可以激活大脑中与决策，焦虑调节和视觉处理相关的区域。在这项研究中，32名寻求治疗的尼古丁依赖性吸烟者在3T西门子扫描仪中进行MRI扫描期间观察了吸烟和中性线索与休息时间交替的区块。在观看线索或控制图像时，参与者被指示“允许自己渴望”或“抵制渴望”。用FSL 4.1.5分析数据，集中于吸烟线索与中性线索对比，在个体和组水平上使用聚类阈值（Z>2.3和校正的聚类阈值p=0.05）。在渴求条件下，左前扣带回（LACC），内侧前额叶皮层，左中扣带回，双侧后扣带回和双侧楔前叶，与注意力，决策和情节记忆相关的区域被激活。LACC和与高级执行功能相关的前额叶皮层区域在抵抗条件下被激活。在不考虑用于抵制吸烟冲动的具体策略的情况下，群体渴望和抵制分析作为一个整体没有明显的区别，支持渴望与一定程度的抵制吸烟冲动有关的想法，并且试图抵制几乎总是伴随着一定程度的渴望。不同的抵抗策略，如分散注意力，激活了不同的区域。了解抵抗吸烟渴望的潜在神经生物学可能会发现新的治疗焦点。
Craving is a significant factor which can lead to relapse during smoking quit attempts. Attempts to resist urges to smoke during cue-elicited craving have been shown to activate regions in the brain associated with decision-making, anxiety regulation, and visual processing. In this study, 32 treatment-seeking, nicotine-dependent smokers viewed blocks of smoking and neutral cues alternating with rest periods during MRI scanning in a 3T Siemens scanner. While viewing cues or control images, participants were instructed either to “allow yourself to crave” or “resist craving.” Data were analyzed with FSL 4.1.5, focused on the smoking cues versus neutral cues contrast, using cluster thresholding (Z>2.3 and corrected cluster threshold of p=0.05) at the individual and group levels. During the Crave Condition activation was seen the left anterior cingulated cortex (LACC), medial prefrontal cortex, left middle cingulate gyrus, bilateral posterior cingulated gyrus and bilateral precuneus, areas associated with attention, decision-making and episodic memory. The LACC and areas of the prefrontal cortex associated with higher executive functioning were activated during the Resist Condition. No clear distinctions between group crave and resist analyses as a whole were seen without taking into account specific strategies used to resist the urge to smoke, supporting the idea that craving is associated with some degree of resisting the urge to smoke, and trying to resist is almost always accompanied by some degree of craving. Different strategies for resisting, such as distraction, activated different regions. Understanding the underlying neurobiology of resisting craving to smoke may identify new foci for treatments.
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