Large-scale brain network coupling predicts acute nicotine abstinence effects on craving and cognitive function.
- Authors
- Lerman, Caryn; Gu, Hong; Loughead, James; Ruparel, Kosha; Yang, Yihong; Stein, Elliot A
- Year
- 2014
- Journal
- JAMA psychiatry
- PMID
- 24622915
- DOI
- 10.1001/jamapsychiatry.2013.4091
- PMCID
- PMC4097018
IMPORTANCE: Interactions of large-scale brain networks may underlie cognitive dysfunctions in psychiatric and addictive disorders. OBJECTIVES: To test the hypothesis that the strength of coupling among 3 large-scale brain networks--salience, executive control, and default mode--will reflect the state of nicotine withdrawal (vs smoking satiety) and will predict abstinence-induced craving and cognitive deficits and to develop a resource allocation index (RAI) that reflects the combined strength of interactions among the 3 large-scale networks. DESIGN, SETTING, AND PARTICIPANTS: A within-subject functional magnetic resonance imaging study in an academic medical center compared resting-state functional connectivity coherence strength after 24 hours of abstinence and after smoking satiety. We examined the relationship of abstinence-induced changes in the RAI with alterations in subjective, behavioral, and neural functions. We included 37 healthy smoking volunteers, aged 19 to 61 years, for analyses. INTERVENTIONS: Twenty-four hours of abstinence vs smoking satiety. MAIN OUTCOMES AND MEASURES: Inter-network connectivity strength (primary) and the relationship with subjective, behavioral, and neural measures of nicotine withdrawal during abstinence vs smoking satiety states (secondary). RESULTS: The RAI was significantly lower in the abstinent compared with the smoking satiety states (left RAI, Pβ=β.002; right RAI, Pβ=β.04), suggesting weaker inhibition between the default mode and salience networks. Weaker inter-network connectivity (reduced RAI) predicted abstinence-induced cravings to smoke (rβ=β-0.59; Pβ=β.007) and less suppression of default mode activity during performance of a subsequent working memory task (ventromedial prefrontal cortex, rβ=β-0.66, Pβ=β.003; posterior cingulate cortex, rβ=β-0.65, Pβ=β.001). CONCLUSIONS AND RELEVANCE: Alterations in coupling of the salience and default mode networks and the inability to disengage from the default mode network may be critical in cognitive/affective alterations that underlie nicotine dependence.
Functional Magnetic Resonance Images Demonstrating Results of Independent Component Analysis (ICA)Four networks generated from group ICA of the resting state data were identified as the salience network (SN), default mode network (DMN), and left and right executive control network (ECN). Spatial maps were converted to z score images and then thresholded at z = 3.5 via a mixture model fit. Network maps are displayed in red-yellow overlaid onto the Talairach standard brain map based on neurological (left = left) convention. Slice coordinates are given in millimeters. The key SN regions included the dorsal anterior cingulate cortex (ACC)/paracingulate gyrus (Talairach coordinates: 3, 21, 33), bilateral anterior insula (left, β39, 9, 3; right, 51, 15, 0), dorsolateral prefrontal cortex (DLPFC) (left, β30, 45, 30; right, 30, 48, 30), supramarginal gyrus (left, β57, β45, 30; right, 57, β42, 33), and precuneus (12, β69, 36). Together, the left and right ECN covered the bilateral DLPFC (Talairach coordinates: left, β42, 45, 6; right, 45, 33, 25), parietal cortices (left, β39, β51, 42; right, 39, β57, 48), middle temporal gyrus (left, β51, β54, β9; right, 51, β57, β9), and dorsal medial frontal gyrus (left, β6, 27, 45; right, 6, 30, 45). The DMN included the posterior cingulate cortex (Talairach coordinates: 6, β57, 27), bilateral angular gyrus (left, β42, β69, 33; right, 48, β63, 30), ventromedial prefrontal cortex/rostral ACC (3, 54, 3), and temporal gyrus (left, β57, β9, β15; right, 60, β18, β15).
LLM interpretation
This figure presents functional MRI (fMRI) spatial maps generated from group Independent Component Analysis (ICA) of resting-state data. Four distinct networksβthe salience network (SN), left executive control network (Left ECN), right executive control network (Right ECN), and default mode network (DMN)βare displayed as red-yellow overlays on a Talairach standard brain map across multiple axial slices (z = -10 to 46 mm) and one sagittal view. A color scale indicates z-score values ranging from a threshold of 3.5 to 10.0.
Resource Allocation Index (RAI) in the Abstinence vs Smoking StatesRendered brain figures present network components identified by group independent component analysis. Compared with the smoking state, the RAI for the left hemisphere (mL) decreased in abstinence (P = .002); the RAI for the right hemisphere (mR) showed a decreasing trend (P = .04). A thinner path connecting the salience network (SN) and executive control network (ECN) and the path connecting the SN and default mode network (DMN) in the abstinence (vs smoking) states illustrates decreased coupling between the networks. β Indicates negative correlation; +, positive correlation.aDifferences were significant.
LLM interpretation
This figure combines a bar chart with brain network diagrams to compare the Resource Allocation Index (RAI) between smoking and abstinence states. The bar chart shows a significant decrease in RAI for the left hemisphere ($m_L$, $P = .002$) and a decreasing trend for the right hemisphere ($m_R$, $P = .04$) during abstinence compared to smoking. Accompanying diagrams illustrate the salience network (SN) connecting to the executive control network (ECN, positive correlation) and default mode network (DMN, negative correlation), with thinner paths in the abstinence state indicating decreased coupling.
Between-Network Coupling in the Abstinence vs Smoking StatesSignificant reduction in correlation between the salience network (SN) and default mode network (DMN) (P = .02) in the abstinence vs smoking states. LECN indicates left executive control network; RECN, right executive control network. Whiskers indicate SD.aDifferences were significant.
LLM interpretation
This bar chart compares between-network correlations in the smoking state (light blue) versus the abstinence state (dark blue) across three network couplings: SN-LECN, SN-RECN, and SN-DMN. The y-axis measures "Between-Network Correlation," with error bars representing standard deviation. Statistically significant reductions in correlation during the abstinence state are observed for SN-LECN ($P = .04$) and SN-DMN ($P = .02$), while the difference for SN-RECN is not significant ($P = .45$).
Resource Allocation Index (RAI) Correlation With Smoking Urge ScorePartial regression plots of the difference of brief Questionnaire on Smoking Urges score between the abstinence and smoking states (ΞQSUa β s) against the difference of the RAI in the right hemisphere between states (ΞmRa β s).
LLM interpretation
This is a scatter plot with a linear regression line showing the correlation between the difference in Resource Allocation Index ($\Delta m_{Ra-s}$) on the x-axis and the difference in Questionnaire on Smoking Urges score ($\Delta QSU_{a-s}$) on the y-axis. The data points exhibit a negative correlation, indicating that as the difference in RAI increases, the difference in smoking urge scores generally decreases. The x-axis ranges from approximately -0.70 to 0.50, and the y-axis ranges from -10 to 60.
Resource Allocation Index (RAI) Correlations With Working Memory (WM) Task ActivationPartial regression plots of the difference between the abstinence vs smoking states of the WM task-induced blood oxygenation levelβdependent change ([dS/S0]a β s) averaged across memory load in the ventromedial prefrontal cortex (A) and posterior cingulate cortex regions (B) against the difference of the RAI in the left hemisphere (ΞmL,a β s). Markers indicate individual participants.
LLM interpretation
This figure consists of two partial regression scatter plots (A and B) showing the correlation between the difference in Resource Allocation Index ($\Delta m_{La-s}$) and the difference in BOLD signal change during a working memory task between abstinence and smoking states. Plot A represents the ventromedial prefrontal cortex and Plot B represents the posterior cingulate cortex. Both plots display a negative linear trend, with individual participants represented by open circles.
Schematic of Changes in the Association of the Resource Allocation Index (RAI) Between the Abstinence vs Smoking SessionsChanges in the working memory (WM)βinduced signal percentage change between states (dS/S)a β s, the RAI in the right and left hemispheres between states (ΞmR,a β s and ΞmL,a β s, respectively), and the brief Questionnaire on Smoking Urges (QSU) score between states (ΞQSUa β s) are depicted. PCC indicates posterior cingulate cortex; VMPFC, ventromedial prefrontal cortex. Upward arrow indicates increase; downward arrows, decrease.
LLM interpretation
This figure is a schematic diagram illustrating changes in the Resource Allocation Index (RAI) between abstinence and smoking sessions. It shows a decrease in working memory-induced deactivation in the VMPFC and PCC, which is associated with a decrease in the left hemisphere RAI ($\Delta m_{La-s}$). This sequence, along with a decrease in the right hemisphere RAI ($\Delta m_{Ra-s}$), is linked to an increase in the urge score ($\Delta \text{QSU-brief}_{a-s}$).
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|---|---|---|
| A protocadherin gene cluster regulatory variant is associated with nicotine withdrawal and the urge to smoke. | 2017 | 27067016 |
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