Smoking cessation behaviors three months following acute insular damage from stroke
Smoking cessation behaviors three months following acute insular damage from stroke
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DOI：
10.1016/j.addbeh.2015.07.001
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发表时间：
2015-12-01
影响因子：
4.4
通讯作者：
van Wijngaarden, Edwin
中科院分区：
文献类型：
--
作者：
Abdolahi, Amir;Williams, Geoffrey C.;van Wijngaarden, Edwin
背景资料：最近的证据表明，岛叶皮层可能在促进药物使用的认知和情感过程中发挥重要作用，但尚不清楚岛叶皮层的变化是否会导致持续的戒断。为了更好地理解大脑皮层在维持戒烟中的作用，我们研究了相对于其他区域大脑皮层急性损伤的吸烟者的戒烟模式。设计：前瞻性队列研究，随访3个月，从2013年6月开始，到2014年5月结束。38与岛叶梗死和118与非岛叶梗死，评估由3 neuroradiologist.Measurements：自我报告的吸烟状态（7天的点患病率和连续戒烟），完全戒除任何尼古丁产品，并中断吸烟成瘾（定义标准吸烟状态，戒烟困难，并敦促）进行了评估，在中风后3个月。结果：岛叶损伤与3个月连续戒烟（OR = 3.71，95% CI：1.59，8.65）和完全停止使用任何尼古丁产品（OR = 2.72，95% CI：1.19，622）的几率增加相关。岛叶损伤组的平均复发时间（17.50天，SD = 19.82）长于非岛叶损伤组（10.42天，SD = 18.49）。戒烟者中，岛叶损伤也与较高的相对几率经历了中断的成瘾相比，非岛叶损伤（调整OR = 5.60，95%CI：1.52，20.56）。结论：这些研究结果支持的潜在作用，岛叶皮层在维持吸烟和尼古丁戒断。需要进一步的研究来确定吸烟是否可能成为戒烟干预的新目标。(C)2015爱思唯尔有限公司版权所有。
Background: Recent evidence suggests that the insular cortex may play an important role in cognitive and emotional processes that facilitate drug use but it is unclear whether changes to the insula would result in sustained abstinence. To better understand the role of the insula in maintaining abstinence, we examined quitting patterns in smokers with acute damage to their insula relative to other regions.Design: Prospective cohort study with 3 month follow-up, beginning June 2013 and ending May 2014.Setting: Three acute care hospitals in Rochester, NY.Participants: One-hundred-fifty-six current smokers hospitalized for acute ischemic stroke; 38 with insular infarctions and 118 with non-insular infarctions, assessed by 3 neuroradiologists.Measurements: Self-reported smoking status (seven-day point prevalence and continuous abstinence), complete abstinence from any nicotine product, and disruption of smoking addiction (defined by criteria on smoking status, difficulty of quitting, and urge) were assessed at three months post-stroke. Time to relapse (in days) after discharge was also assessed.Results: Insular damage was associated with increased odds of three-month continuous abstinence (OR = 3.71, 95% CI: 1.59, 8.65) and complete cessation from any nicotine product (OR = 2.72,95% CI: 1.19, 622). Average time to relapse was longer in the insular-damaged group (17.50 days, SD = 19.82) relative to non-insular damage (10.42 days, SD = 18.49). Among quitters, insular damage was also associated with higher relative odds of experiencing a disruption of addiction compared to non-insular damage (adjusted OR = 5.60, 95% CI: 1.52, 20.56).Conclusions: These findings support the potential role of the insular cortex in maintaining smoking and nicotine abstinence. Further research is needed to establish whether the insula may be a novel target for smoking cessation interventions. (C) 2015 Elsevier Ltd. All rights reserved.