Increased functional connectivity in an insula-based network is associated with improved smoking cessation outcomes
Open accessAbstract
Little is known regarding the underlying neurobiology of smoking cessation. Neuroimaging studies indicate a role for the insula in connecting the interoceptive awareness of tobacco craving with a larger brain network that motivates smoking. We investigated differences in insula-based functional connectivity between smokers who did not relapse during a quit attempt vs those who relapsed. Smokers (n=85) underwent a resting-state functional connectivity scan and were then randomized into two groups (either smoking usual brand cigarettes or smoking very low nicotine cigarettes plus nicotine replacement therapy) for 30 days before their target quit date. Following the quit date, all participants received nicotine replacement therapy and their smoking behavior was observed for 10 weeks. Participants were subsequently classified as nonrelapsed (n=44) or relapsed (i.e., seven consecutive days of smoking ⩾1 cigarette/day; n=41). The right and left insula, as well as insula subdivisions (posterior, ventroanterior, and dorsoanterior) were used as seed regions of interest in the connectivity analysis. Using the right and left whole-insula seed regions, the nonrelapsed group had greater functional connectivity than the relapsed group with the bilateral pre- and postcentral gyri. This effect was isolated to the right and left posterior insula seed regions. Our results suggest that relapse vulnerability is associated with weaker connectivity between the posterior insula and primary sensorimotor cortices. Perhaps greater connectivity in this network improves the ability to inhibit a motor response to cigarette cravings when those cravings conflict with a goal to remain abstinent. These results are consistent with recent studies demonstrating a positive relationship between insula-related functional connectivity and cessation likelihood among neurologically intact smokers.
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In smokers, decreased functional connectivity between the insula and the primary sensorimotor cortices was found in those who relapsed.
“In smokers, researchers found a decreased functional connectivity between the insula and the primary sensorimotor cortices (Addicott et al., 2015), as well as the insula, dACC, and dlPFC (Janes et al., 2010), in those who relapsed.”
From The Insula: A Brain Stimulation Target for the Treatment of Addiction (2019) · cites this paper as Addicott et al., 2015
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The Insula: A Brain Stimulation Target for the Treatment of Addiction
Ibrahim, C., Rubin-Kahana, D. S., Pushparaj, A., Musiol, M., Blumberger, D. M., Daskalakis, Z. J., Zangen, A., & Le Foll, B. (2019) · Frontiers in Pharmacology · doi:10.3389/fphar.2019.00720 · Cited by 133 · see citing works
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- Authors
- Addicott, M. A., Sweitzer, M. M., Froeliger, B., Rose, J. E., & McClernon, F. J.
- Affiliations
- Duke University (US)
- Medical University of South Carolina (US)
- Corresponding author
- Addicott, Merideth A
- Venue
- Neuropsychopharmacology
- Published
- 2015-04-21
- Volume
- 40
- Issue
- 11
- Pages
- 2648-2656
- ISSN
- 0893-133X (ISSN-L)
- 1740-634X
- PMC
- PMC4569957
- OpenAlex
- W2101633223
- Cited by
- 85
- References
- 47
- Citations by year
- 2026: 4 · 2025: 6 · 2024: 5 · 2023: 8 · 2022: 4 · 2021: 10 · 2020: 5 · 2019: 11 · 2018: 8 · 2017: 14 · 2016: 9 · 2015: 1
- FWCI
- 7.86
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Neuropsychopharmacology (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute on Drug Abuse (R01DA025876, K01DA033347)
- Topics
- Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
- Life Sciences › Neuroscience › Cognitive Neuroscience › Functional Brain Connectivity Studies
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Nicotinic Acetylcholine Receptors Study
- Keywords
- smoking cessation, insula, functional connectivity, relapse, nicotine replacement therapy, posterior insula, primary motor cortex, precentral gyrus, postcentral gyrus, cigarette craving, interoception, goal-directed behavior
- MeSH terms
- Adolescent, Adult, Brain Mapping, Cerebral Cortex, Female, Follow-Up Studies, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Neural Pathways, Random Allocation, Recurrence, Rest, Smoking, Tobacco Use Disorder, Smoking Cessation, Treatment Outcome, Young Adult, Tobacco Use Cessation Devices
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