An exploratory pilot study of the relationship between neural correlates of cognitive control and reduction in cigarette use among treatment-seeking adolescent smokers

Abstract

Despite high rates of tobacco use during adolescence, few empirically validated smoking cessation strategies exist for adolescent smokers. Developing an understanding of the neural underpinnings of cognitive control processes in adolescent smokers, and their relationship to quit behaviors, may help advance the development of enhanced behavioral and pharmacological therapies. The current pilot study explored the relationship between brain responses during performance of the Stroop color-word interference task and reduction in tobacco use (as measured by changes in cotinine levels) in treatment-seeking adolescent smokers participating in a high school-based smoking-cessation program. Eleven adolescent daily smokers participated in a prequit session during which neural activity in response to congruent and incongruent events in a Stroop task was examined using functional MRI (fMRI). Changes in urine cotinine levels from prequit baseline to end of treatment were calculated and correlated with brain activity. Adolescents with greater activation in the inferior frontal gyrus, insula, thalamus, and anterior cingulate had greater reductions in cotinine levels. The preliminary observation of a relationship between treatment outcome and neural correlates of cognitive control prior to treatment onset provides insight into individual differences in adolescent brain function that might relate importantly to treatment outcome.

Figure 1

Significant correlations between Stroop related activation and percent changes in cotinine levels (left side of figure). Orange/yellow indicates areas of positive correlations between % decrease in cotinine levels and increased % BOLD signal changes in the incongruent versus congruent contrast. Axial slices demonstrate the correlation with a cluster in the right insula (z=−9), ACC (z=6) and dorsal mPFC (z=33). Numbers indicate z-axis MNI coordinates. Right side of the brain is on the right. Scatterplots (right side of figure) demonstrate the distribution of individual scores in the correlation between % change in cotinine levels and % BOLD signal change in A) Insula, B) ACC, and C) medal prefrontal cortex, during Stroop task performance in the adolescent smoking group (n = 11). BOLD = blood-oxygenation-level-dependent MNI = Montreal Neurological Institute ACC=anterior cingulate cortex mPFC= medial prefrontal cortex r = Pearson correlation coefficient