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. 2015 Mar;20(2):407-14.
doi: 10.1111/adb.12124. Epub 2014 Feb 13.

Right anterior insula connectivity is important for cue-induced craving in nicotine-dependent smokers

Megan M Moran-Santa Maria  1 , Karen J Hartwell, Colleen A Hanlon, Melanie Canterberry, Todd Lematty, Max Owens, Kathleen T Brady, Mark S George
Affiliations

Right anterior insula connectivity is important for cue-induced craving in nicotine-dependent smokers

Megan M Moran-Santa Maria et al. Addict Biol. 2015 Mar.

Abstract

The insula has been implicated in cue-induced craving and relapse in nicotine-dependent tobacco cigarette smokers. The aims of the present study were to identify brain regions that exhibit greater functional connectivity with the right anterior insula in response to smoking cues than to neutral cues and the role of functional connectivity between these regions in mediating cue-induced craving in healthy (free of axis I psychiatric disorders) nicotine-dependent tobacco cigarette smokers. Functional magnetic resonance imaging data were collected from 63 healthy nicotine-dependent smokers viewing blocks of smoking and neutral cues. Craving ratings were obtained after each block. A psychophysiologic interaction approach was used to identify regions that exhibited significantly greater functional connectivity with the right anterior insula (seed) during the smoking cues than during the neutral (corrected cluster thresholding, Z > 2.3, P = 0.05). Parameter estimates of the interaction effects from each region were regressed against the mean cue-induced craving scores. Significant task by seed interactions were observed in two clusters centered in the bilateral precuneus and left angular gyrus. The strength of connectivity between the right anterior insula and the precuneus, which is involved interoceptive processing and self-awareness, was positively correlated with the magnitude of the craving response to the smoking cues (r(2) = 0.15; P < 0.01). These data suggest that among smokers, cue-induced craving may be a function of connectivity between two regions involved in interoception and self-awareness. Moreover, treatment strategies that incorporate mindful attention may be effective in attenuating cue-induced craving and relapse in nicotine-dependent smokers.

Keywords: Craving; cues; functional connectivity; insula; nicotine-dependence; tobacco cigarettes.

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Figures

Figure 1
Figure 1
Mean (se) craving responses to the smoking and neutral cues. *Denotes a significant difference from neutral cues.
Figure 2
Figure 2
A significant main effect of task was observed in the right occipital cortex and sub-threshold activation was observed in the right anterior insula.
Figure 3
Figure 3
Significant task × seed interactions were observed in in the left angular gyrus and bilateral precuneus. Association between cue-induced craving and functional connectivity between the right anterior insula and the left angular gyrus (p>0.05) and the precuneus (p<0.01).
See this image and copyright information in PMC

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