Neural Substrates of Resisting Craving During Cigarette Cue Exposure
Received 7 April 2006; received in revised form 22 August 2006; accepted 13 October 2006. published online 11 January 2007.
Background
In cigarette smokers, the most commonly reported areas of brain activation during visual cigarette cue exposure are the prefrontal, anterior cingulate, and visual cortices. We sought to determine changes in brain activity in response to cigarette cues when smokers actively resist craving.
Methods
Forty-two tobacco-dependent smokers underwent functional magnetic resonance imaging, during which they were presented with videotaped cues. Three cue presentation conditions were tested: cigarette cues with subjects allowing themselves to crave (cigarette cue crave), cigarette cues with the instruction to resist craving (cigarette cue resist), and matched neutral cues.
Results
Activation was found in the cigarette cue resist (compared with the cigarette cue crave) condition in the left dorsal anterior cingulate cortex (ACC), posterior cingulate cortex (PCC), and precuneus. Lower magnetic resonance signal for the cigarette cue resist condition was found in the cuneus bilaterally, left lateral occipital gyrus, and right postcentral gyrus. These relative activations and deactivations were more robust when the cigarette cue resist condition was compared with the neutral cue condition.
Conclusions
Suppressing craving during cigarette cue exposure involves activation of limbic (and related) brain regions and deactivation of primary sensory and motor cortices.
aDepartment of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles.
bDepartment of Molecular and Medical Pharmacology, University of California, Los Angeles.
cGreater Los Angeles VA Healthcare System Positron Emission Tomography Center, Los Angeles, California.
dDepartment of Physics, University of California, Irvine, Irvine, California.
eUniversity of Utah School of Medicine, Salt Lake City, Utah.
Address reprint requests to Arthur L. Brody, M.D., UCLA School of Medicine, Department of Psychiatry & Biobehavioral Sciences, 300 UCLA Medical Plaza, Suite 2200, Los Angeles, CA 90095
ABSTRACT