Research from Penn Medicine has discovered that quitting smoking sets off changes in the brain that may indicate whether or not a smoker will start smoking again.
Published in the journal Neuropsychopharmacology, the research was led by James Loughead, Ph.D., a psychiatry assistant professor, and Caryn Lerman, Ph.D., also a psychiatry professor and the director for the Center for Interdisciplinary Research on Nicotine Addiction at Penn. According to their work with colleagues, those who started smoking again within seven days of their targeted quit day displayed specific brain disruptions, particularly in the working memory system, separating them from those who successfully quit.
Appearing as reductions in the area of the brain responsible for supporting self-control and increases in a part that promotes "introspective states," the disruptions are believed to be crucial in identifying successful quitters so those who will fail will be distinguished earlier and provided more novel treatment which will increase their rates of success.
For the study, researchers enlisted 80 smokers looking to quit, all between the ages of 18 and 65 and have reported puffing on over 10 cigarettes a day for over half a year. They used functional magnetic resonance imaging to focus on the impact of brief abstinence on the brain's working memory and the area's associated neural activation.
For every subject, two fMRIs were done: one immediately after smoking and another set for 24 hours after they began abstaining. After going to smoking cessation counseling, the subjects designated target quit dates on their own. A monitoring visit was completed seven days after the set quit dates during which a urine test and smoking behavior assessment was carried out.
Researchers were left with 19 successful quitters and 61 who relapsed.
Those who relapsed exhibited reduced activity in their left dorsolateral prefrontal cortex, affecting working memory which is responsible for staying focused, completing tasks and blocking out distractions. They also showed reduced suppression in the posterior cingulate cortex which put people in an introspective state.
Behavioral and clinical predictors for relapse are currently in use today but the study shows there is room for improvement. Neuroimaging assessment might not be feasible economically or clinically at this time but it shows how working memory may be targeted by assessment instruments to improve early detection for smoking relapse.
The study received funding support from the Pennsylvania Department of Health, National Institutes of Drug Abuse, and the National Cancer Institute. Other authors include: Ruben Gur, Ph.D.; Ryan Hopson; Mary Falcone, Ph.D.; Kosha Ruparel, M.D.; and E. Paul Wileyto, Ph.D.
