Effects of Treatment for Tobacco Dependence on Resting Cerebral Glucose Metabolism

Abstract

While bupropion HCl and practical group counseling (PGC) are commonly used treatments for tobacco dependence, the effects of these treatments on brain function are not well established. For this study, 54 tobacco-dependent cigarette smokers underwent resting 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) scanning before and after 8 weeks of treatment with bupropion HCl, PGC, or pill placebo. Using Statistical Parametric Mapping (SPM 2), changes in cerebral glucose metabolism from before to after treatment were compared between treatment groups and correlations were determined between amount of daily cigarette usage and cerebral glucose metabolism. Compared with placebo, the two active treatments (bupropion HCl and PGC) had reductions in glucose metabolism in the posterior cingulate gyrus. Further analysis suggested that PGC had a greater effect than bupropion HCl on glucose metabolism in this region. We also found positive correlations between daily cigarette use and glucose metabolism in the left occipital gyrus and parietal-temporal junction. There were no significant negative correlations between daily cigarette use and glucose metabolism. Our findings suggest that bupropion HCl and PGC reduce neural activity much as the performance of a goal-oriented task does in the default mode network of the brain, including the posterior cingulate gyrus. Thus, this study supports the theory that active treatments for tobacco dependence move the brain into a more goal-oriented state.

Cognitive interventions for addiction medicine

“…We identified two studies that used neuroimaging to investigate its effects. Both studies, performed in smokers and a mixed population of drug users prior to and after 2 months of CBT, reported a reduction in drug use and an improvement on relevant behavioral measures (Costello et al, 2010; DeVito et al, 2012; Table 1). Both employed a pre–post design to compare brain activation before and after treatment in a within-subjects design, while controlling for treatment-unrelated changes over time by including a control group.…”

“…Both employed a pre–post design to compare brain activation before and after treatment in a within-subjects design, while controlling for treatment-unrelated changes over time by including a control group. The first study investigated PET resting glucose metabolism, comparing the CBT group (nicotine smokers) to another group of smokers receiving placebo treatment (Costello et al, 2010). The PET resting data analysis revealed reduced glucose metabolism in the posterior cingulate cortex (PCC) in the CBT group compared to the placebo group after treatment.…”

Effect of Bupropion Treatment on Brain Activation Induced by Cigarette-Related Cues in Smokers

“…56,57 Human studies using positron emission tomography have shown that bupropion treatment attenuates cue-induced increases in glucose metabolism in the anterior and posterior cingulate gyri. 58,59 Furthermore, recently abstinent smokers treated with bupropion and group therapy display lower levels of craving and less increase in glucose metabolism in the striatum, thalamus, and midbrain while viewing smoking-related cues compared with identically treated nonabstinent smokers. 60 Taken together, these studies establish that smoking cessation treatments not only attenuate self-reported cue-induced craving but also attenuate cueinduced neural activation within the limbic system and associated prefrontal brain regions.…”

A Study of the Feasibility of FDG-PET/CT to Systematically Detect and Quantify Differential Metabolic Effects of Chronic Tobacco Use in Organs of the Whole Body—A Prospective Pilot Study

“…Furthermore, studies using magnetic resonance spectroscopy (MRS) have reported alterations in regional brain metabolite levels due to chronic tobacco use [44, 47]. Costello et al reported in a prospective study of 54 tobacco-dependent cigarette smokers (≥ 10 cigarettes/day) that there was a positive correlation between the number of cigarettes smoked per day and glucose metabolism in the left posterior occipital gyrus and left parietal-temporal junction extending to the left superior temporal gyrus based on FDG-PET using statistical parametric mapping [48]. …”