Brain Responses to Cigarette-Related and Emotional Images in Smokers During Smoking Cessation: No Effect of Varenicline or Bupropion on the Late Positive Potential. Nicotine Tob Res 2019 Jan 04;21(2):234-240
Date
12/09/2017Pubmed ID
29220524Pubmed Central ID
PMC6329398DOI
10.1093/ntr/ntx264Scopus ID
2-s2.0-85059500007 (requires institutional sign-in at Scopus site) 11 CitationsAbstract
INTRODUCTION: Varenicline and bupropion are two effective smoking cessation pharmacotherapies. Researchers have hypothesized that they might be effective, in part, because they reduce cue reactivity and cue-induced cravings. Here, we used event-related potentials (ERPs) to directly measure brain responses to cigarette-related and other motivationally relevant images during a pharmacologically aided quit attempt.
METHODS: Smokers involved in a 12-week placebo-controlled double-blind clinical trial of smoking cessation medications (varenicline, bupropion, placebo) took part in the study. We assessed participants at two time points: 24 h (n = 140) and 4 weeks (n = 176) after the quit date. At both sessions, we measured the amplitude of the late positive potential (LPP), an ERP component reliably associated with motivational relevance, and self-reported tonic craving using the brief version of the Questionnaire of Smoking Urges (QSU-Brief).
RESULTS: At both sessions, emotional and cigarette-related images evoked significantly larger LPPs than neutral images. Neither drug type nor smoking abstinence altered this effect at either session. At both sessions, varenicline and bupropion significantly reduced self-reported tonic craving relative to the placebo condition.
CONCLUSIONS: While both varenicline and bupropion reduced self-reported tonic craving, neither medication altered the amplitude of the LPP to cigarette-related or emotional pictures in smokers attempting to quit. These medications may influence abstinence by means other than by reducing neuroaffective responses to cigarette-related cues. Smokers should be prepared for the likelihood that even after several weeks of successful abstinence, once treatment ends, cigarette-related cues may remain motivationally relevant and trigger cravings that might lead to relapse.
IMPLICATIONS: Bupropion and varenicline do not alter electrophysiological responses, as measured by the LPP, to cigarette-related and emotional images. These findings help explain why cigarette-related cues can trigger relapse when smoking cessation medication treatments end.
Author List
Versace F, Stevens EM, Robinson JD, Cui Y, Deweese MM, Engelmann JM, Green CE, Karam-Hage M, Lam CY, Minnix JA, Wetter DW, Cinciripini PMMESH terms used to index this publication - Major topics in bold
AdultBrain
Bupropion
Cigarette Smoking
Double-Blind Method
Emotions
Female
Humans
Male
Middle Aged
Photic Stimulation
Smokers
Smoking Cessation
Treatment Outcome
Varenicline
