Nicotine Acutely Enhances Reinforcement from Non-Drug Rewards in Humans.
Nicotine Acutely Enhances Reinforcement from Non-Drug Rewards in Humans.
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DOI：
10.3389/fpsyt.2017.00065
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发表时间：
2017
影响因子：
4.7
通讯作者：
Boldry MC
中科院分区：
文献类型：
--
作者：
Perkins KA;Karelitz JL;Boldry MC
临床前研究表明，除了尼古丁摄入本身的主要和次要强化作用外，尼古丁还能显著增强非药物增强剂（“奖励”）的强化功效。对人类这些影响的研究在很大程度上被忽视了，但最近的研究结果表明，它们可能对更充分地理解烟草依赖的持续性具有临床意义。本综述首先概述了这一主题，并指出了最近一些间接涉及尼古丁对相关反应影响的人体研究（例如，主观评级），解释了为什么这些发现不能直接证实尼古丁本身对行为强化的增强作用。然后，在随后提出的研究中使用的方法进行了描述，展示了这些研究如何具体证明了增强非药物奖励的强化反应。主要部分集中在有限的对照研究，到目前为止，直接评估尼古丁在人类中的急性增强作用，特别是因为它涉及到非人类动物模型中非药物奖励的强化行为反应。在详细介绍了现有的几项人类研究之后，我们讨论了这些影响对依赖和戒烟努力的潜在后果，然后为未来的研究提出了方向。这项研究表明，尼古丁本身会增加人类的反应，这种反应会被一些奖励（通过音乐的听觉刺激，通过视频的视觉刺激）所加强，但可能不会被其他奖励（例如，钱）。吸烟者的这些增强效果不是由于依赖或戒断缓解，可以通过少量尼古丁（类似于吸烟失效）恢复，包括来自电子烟的尼古丁产品。未来的临床研究应检查决定尼古丁增强（或不增强）哪种类型的奖励的因素，戒烟后尼古丁效应丧失的后果，这些效应的潜在个体差异，以及尼古丁通过尼古丁替代疗法和非尼古丁戒烟药物可能减轻戒烟后这些效应丧失的可能性。对尼古丁增强戒烟效果的人类进一步研究可能会提供对吸烟持续性的更完整理解，并增加戒烟药物疗效的机制。
Preclinical research documents that, aside from the primary and secondary reinforcing effects of nicotine intake itself, nicotine also acutely enhances the reinforcing efficacy of non-drug reinforcers (“rewards”). Study of these effects in humans has largely been overlooked, but very recent findings suggest they may have clinical implications for more fully understanding the persistence of tobacco dependence. This overview first outlines the topic and notes some recent human studies indirectly addressing nicotine effects on related responses (e.g., subjective ratings), explaining why those findings do not directly confirm enhancement of behavioral reinforcement per se due to nicotine. Then, the methodology used in the subsequently presented studies is described, demonstrating how those studies specifically did demonstrate enhancement of reinforced responding for non-drug rewards. The main section focuses on the limited controlled research to date directly assessing nicotine’s acute reinforcement-enhancing effects in humans, particularly as it relates to reinforced behavioral responding for non-drug rewards in non-human animal models. After detailing those few existing human studies, we address potential consequences of these effects for dependence and tobacco cessation efforts and then suggest directions for future research. This research indicates that nicotine per se increases responding in humans that is reinforced by some rewards (auditory stimuli via music, visual stimuli via video), but perhaps not by others (e.g., money). These reinforcement-enhancing effects in smokers are not due to dependence or withdrawal relief and can be restored by a small amount of nicotine (similar to a smoking lapse), including from e-cigarettes, a non-tobacco nicotine product. Future clinical research should examine factors determining which types of rewards are (or are not) enhanced by nicotine, consequences of the loss of these nicotine effects after quitting smoking, potential individual differences in these effects, and the possibility that nicotine via nicotine replacement therapy and non-nicotine quit medications may attenuate loss of these effects upon quitting. Further study with humans of nicotine’s reinforcement-enhancing effects may provide a more complete understanding of smoking persistence and added mechanisms of cessation medication efficacy.