Blunted striatal response to monetary reward anticipation during smoking abstinence predicts lapse during a contingency-managed quit attempt.
Blunted striatal response to monetary reward anticipation during smoking abstinence predicts lapse during a contingency-managed quit attempt.
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DOI：
10.1007/s00213-015-4152-2
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发表时间：
2016-03
影响因子：
3.4
通讯作者：
Donny EC
中科院分区：
文献类型：
--
作者：
Sweitzer MM;Geier CF;Denlinger R;Forbes EE;Raiff BR;Dallery J;McClernon FJ;Donny EC
吸烟与纹状体内的奖励加工失调有关，其特征是对吸烟奖励过敏，而对非吸烟奖励不敏感。这种以牺牲其他奖励为代价的对吸烟奖励的偏爱，由于无法吸烟而进一步加剧，这可能会导致在戒烟尝试期间难以保持戒断。我们研究了戒断诱导的纹状体奖励处理的变化是否预测了在应急管理（CM）支持的戒烟尝试中失败的可能性，在CM中，金钱加强了戒断。36名不寻求治疗的吸烟者参加了两次功能磁共振成像，一次是24小时戒烟，另一次是照常吸烟。在每次扫描过程中，参与者完成一项奖励猜测任务，该任务旨在激发纹状体的激活，他们可以在扫描后获得吸烟和金钱奖励。然后，参与者进行了为期3周的cm支持戒烟尝试。如前所述，24小时的戒断与预期吸烟奖励时纹状体激活增加和预期金钱奖励时纹状体激活减少有关。在禁欲期间，表现出对金钱奖励的右侧纹状体激活更大下降的个体（控制非禁欲期间的激活）更有可能在CM期间失效（p< 0.05），即使在控制失效结果的其他预测因素（例如，渴望）时也是如此；吸烟奖励没有关联。这些结果与越来越多的研究一致，这些研究表明，在尼古丁依赖中，非药物奖励的纹状体加工被破坏具有特殊的重要性，并强调了戒烟诱导的纹状体功能缺陷的个体差异的重要性。
Tobacco smoking is associated with dysregulated reward processing within the striatum, characterized by hypersensitivity to smoking rewards and hyposensitivity to non-smoking rewards. This bias toward smoking reward at the expense of alternative rewards is further exacerbated by deprivation from smoking, which may contribute to difficulty maintaining abstinence during a quit attempt. We examined whether abstinence-induced changes in striatal processing of rewards predicted lapse likelihood during a quit attempt supported by contingency management (CM), in which abstinence from smoking was reinforced with money. Thirty-six non-treatment seeking smokers participated in two fMRI sessions, one following 24-hr abstinence and one following smoking as usual. During each scan, participants completed a rewarded guessing task designed to elicit striatal activation in which they could earn smoking and monetary rewards delivered after the scan. Participants then engaged in a 3-week CM-supported quit attempt. As previously reported, 24-hr abstinence was associated with increased striatal activation in anticipation of smoking reward and decreased activation in anticipation of monetary reward. Individuals exhibiting greater decrements in right striatal activation to monetary reward during abstinence (controlling for activation during non-abstinence) were more likely to lapse during CM (p<.05), even when controlling for other predictors of lapse outcome (e.g., craving); no association was seen for smoking reward. These results are consistent with a growing number of studies indicating the specific importance of disrupted striatal processing of non-drug reward in nicotine dependence, and highlight the importance of individual differences in abstinence-induced deficits in striatal function for smoking cessation.