Neural correlates of distress tolerance in tobacco addiction

摘要 烟草成瘾是一个代价高昂且往往致命的问题。即使有咨询和尼古丁替代疗法， 大多数吸烟者在尝试戒烟后又复吸。对于许多吸烟者和戒烟者来说，吸烟是 由包括烟瘾在内的情感困扰引起的。科普这种痛苦的能力， 保持禁欲取决于一个人对痛苦的容忍程度，这是一种坚持目标导向的能力。 活动，同时经历身体或情感不适。然而，在知识方面存在差距， 神经机制是痛苦耐受的基础。识别这些神经机制并理解 痛苦耐受力的个体差异为新疗法的开发和治疗提供了希望。 通过个性化干预提高戒烟成功率。 过去的研究表明，烟瘾和其他形式的情感困扰会激活大脑皮层， 它可能是连接情感痛苦意识和运动及认知控制的神经中枢 确定后续行为反应的区域（例如，抽支烟来缓解烟瘾）。 然而，先前测量大脑区域内功能活动的研究并没有提供具体的结果。 关于大脑皮层和其他大脑区域之间的功能连接的信息。这些信息对于 理解复杂的行为。根据我们的初步数据，我们的中心假设是， 连接性是戒烟后痛苦耐受行为的基础。 为了研究这一假设，我们将研究三个目标：目标1）研究 痛苦耐受性和基于胰岛的连接，目的2）确定吸烟者和前吸烟者之间的差异， 吸烟者，目的3）使用多模态融合分析探索痛苦耐受的脑相关性。这些数据- 驱动的方法将补充我们关于基于岛的连接的假设。 据我们所知，这是第一项研究，以探讨神经机制的痛苦耐受，在 戒烟服务。此外，这项研究将大大增加我们对为什么有些人 吸烟者成功戒烟。这项措施可以在未来用于识别和治疗吸烟者， 增加与痛苦相关的复发风险。因此，成功完成本研究将告知 制定个性化的吸烟干预措施，以及确定可以 通过新的治疗技术。

ABSTRACT Tobacco addiction is a costly and often fatal problem. Even with counseling and nicotine replacement therapy, most smokers relapse following a quit attempt. For many smokers and ex-smokers, cigarette smoking is provoked by affective distress, which includes cigarette cravings. The ability to cope with this distress and remain abstinent depends on one's level of distress tolerance, which is the ability to persist in a goal-directed activity while experiencing physical or affective discomfort. However, a gap in knowledge exists regarding the neural mechanisms that underlie distress tolerance. Identifying these neural mechanisms and understanding individual differences in distress tolerance holds promise for the development of new therapies and the improvement of cessation success through personalized interventions. Past research has shown that cigarette cravings and other forms of affective distress activate the insula, which may be the neural hub that connects the awareness of affective distress to motor and cognitive control regions that determine the subsequent behavioral response (e.g., smoking a cigarette to relieve cravings). However, previous studies that measured functional activity within brain regions have not provided specific information about functional connectivity between the insula and other brain regions. This information is vital to understanding complex behaviors. Based on our preliminary data, our central hypothesis is that insula-based connectivity underlies distress tolerance behavior in relation to smoking cessation. To investigate this hypothesis, we will investigate three Aims: Aim 1) examine the relationship between distress tolerance and insula-based connectivity, Aim 2) identify differences between smokers and ex- smokers, Aim 3) explore brain correlates of distress tolerance using multimodal fusion analysis. This data- driven approach will complement our hypotheses regarding insula-based connectivity. To our knowledge, this is the first study to investigate the neural mechanisms of distress tolerance in the service of smoking cessation. Furthermore, this study will greatly increase our understanding of why some smokers succeed in quitting. This measure could be used in the future to identify and treat smokers at increased risk for distress-related relapse. Thus, successful completion of this study will inform the development of personalized smoking interventions, as well as identify neural mechanisms that can be targeted by novel therapeutic techniques.