Reversing the Atypical Valuation of Drug and Nondrug Rewards in Smokers Using Multimodal Neuroimaging
Reversing the Atypical Valuation of Drug and Nondrug Rewards in Smokers Using Multimodal Neuroimaging
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DOI：
10.1016/j.biopsych.2017.01.015
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发表时间：
2017-12-01
影响因子：
10.6
通讯作者：
Conrod, Patricia
中科院分区：
文献类型：
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作者：
Baker, Travis E.;Lesperance, Paul;Conrod, Patricia
背景：慢性物质使用可以破坏前扣带皮层（ACC）的奖励功能，使ACC偏向于倾向于目标导向的行为，这些行为集中在药物使用上。在这里，我们使用多模态神经成像方法来研究在前扣带皮层调节奖励相关信号是否可以逆转戒烟者对非药物和药物奖励的非典型评价。方法：我们首先记录了20名中度依赖吸烟者（平均年龄5 - 25岁，无神经精神疾病史）的功能磁共振成像数据，在一晚的戒烟期后，确定与药物相关奖励预期（吸烟）相关的左背外侧前额叶皮层区域。接下来，我们记录了奖励的积极性——一种被认为是衡量前扣带皮层对奖励敏感度的电生理信号——当参与者参与两项反馈任务时，他们分别获得金钱奖励或香烟奖励。最后，在功能磁共振成像数据的指导下，机械臂将一个重复的经颅磁刺激线圈放置在受试者特定的背外侧前额叶皮层目标上，并在10次金钱条件试验前立即以10 Hz（兴奋性刺激）和1 Hz（抑制性刺激）的频率传递50个重复的经颅磁刺激脉冲。结果：我们的研究结果表明，与金钱奖励相比，戒烟者对香烟奖励表现出更高的奖励积极性，并且通过对受试者特异性额扣带奖励通路施加兴奋性或抑制性重复经颅磁刺激，这种结果模式被逆转。结论：通过调节大脑将价值与药物和非药物奖励联系起来的方式，新的基于大脑的治疗方法可能最终会出现。
BACKGROUND: Chronic substance use can disrupt the reward function of the anterior cingulate cortex (ACC), biasing the ACC to favor goal-directed behaviors that converge on drug use. Here we used multimodal neuroimaging methods to ask whether modulating reward-related signaling in the ACC can reverse the atypical valuation of nondrug and drug rewards in abstinent smokers.METHODS: We first recorded functional magnetic resonance imaging data from 20 moderately dependent cigarette smokers (mean age 5 25 years; no history of neuropsychiatric disorders), following an overnight period of abstinence, to identify regions of the left dorsal lateral prefrontal cortex associated with the anticipation of drug-related rewards (cigarette puff). Next, we recorded the reward positivity-an electrophysiological signal believed to index sensitivity of the ACC to rewards-while participants engaged in two feedback tasks to gain either monetary or cigarette rewards. Lastly, guided by functional magnetic resonance imaging data, a robotic arm positioned a repetitive transcranial magnetic stimulation coil over a subject-specific dorsal lateral prefrontal cortex target, and 50 repetitive transcranial magnetic stimulation pulses were delivered at 10 Hz (excitatory stimulation) immediately before each block of 10 trials of the money condition and at 1 Hz (inhibitory stimulation) before each block of 10 trials of the cigarette condition.RESULTS: Our findings show that abstained smokers exhibited a heightened reward positivity to cigarette rewards relative to monetary rewards, and by applying excitatory or inhibitory repetitive transcranial magnetic stimulation to a subject-specific frontal-cingulate reward pathway, this pattern of results was reversed.CONCLUSIONS: By modulating how the brain links value to drug and nondrug rewards, novel brain-based treatments may finally be on the horizon.