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Davidov A, Greer TL. Pathology-Congruent Biases as Biomarkers for Psychopathology. Psychiatr Ann 2020. [DOI: 10.3928/00485713-20200504-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Janes AC, Datko M, Roy A, Barton B, Druker S, Neal C, Ohashi K, Benoit H, van Lutterveld R, Brewer JA. Quitting starts in the brain: a randomized controlled trial of app-based mindfulness shows decreases in neural responses to smoking cues that predict reductions in smoking. Neuropsychopharmacology 2019; 44:1631-1638. [PMID: 31039580 PMCID: PMC6785102 DOI: 10.1038/s41386-019-0403-y] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Revised: 04/19/2019] [Accepted: 04/22/2019] [Indexed: 12/13/2022]
Abstract
Current treatments for smoking yield suboptimal outcomes, partly because of an inability to reduce cue-induced smoking. Mindfulness training (MT) has shown preliminary efficacy for smoking cessation, yet its neurobiological target remains unknown. Our prior work with nonsmokers indicates that MT reduces posterior cingulate cortex (PCC) activity. In individuals who smoke, the PCC, consistently a main hub of the "default mode network," activates in response to smoking cues. In this randomized controlled trial, we tested the effects of app-delivered MT on PCC reactivity to smoking cues and whether individual differences in MT-mediated PCC changes predicted smoking outcomes. Smoking cue-induced PCC reactivity was measured using functional magnetic resonance imaging at baseline and 1 month after receiving smartphone app-based MT (n = 33) vs. an active control (National Cancer Institute's QuitGuide, n = 34). Whether individual differences in treatment-related changes in PCC activity predicted smoking behavior was assessed. The MT group demonstrated a significant correlation between a reduction in PCC reactivity to smoking cues and a decline in cigarette consumption (r = 0.39, p = 0.02). No association was found in the control group (r = 0.08, p = 0.65). No effects of group alone were found in PCC or cigarette reduction. Post hoc analysis revealed this association is sex specific (women, r = 0.49, p = 0.03; men: r = -0.08, p = 0.79). This initial report indicates that MT specifically reduces smoking cue-induced PCC activity in a subject-specific manner, and the reduction in PCC activity predicts a concurrent decline in smoking. These findings link the hypothesized behavioral effects of MT for smoking to neural mechanisms particularly in women. This lays the groundwork for identifying individuals who may benefit from targeted digital therapeutic treatments such as smartphone-based MT, yielding improved clinical outcomes.
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Affiliation(s)
- Amy C. Janes
- 0000 0000 8795 072Xgrid.240206.2McLean Imaging Center, McLean Hospital, Belmont, MA 02478 USA ,000000041936754Xgrid.38142.3cHarvard Medical School, Boston, MA 02115 USA
| | - Michael Datko
- 0000 0004 0386 9924grid.32224.35Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, 149 Thirteenth St. #2301, Charlestown, MA 02129 USA ,0000 0000 9419 3149grid.239475.eCenter for Mindfulness and Compassion, Cambridge Health Alliance, 1035 Cambridge St. #21, Cambridge, MA 02141 USA
| | - Alexandra Roy
- 0000 0004 1936 9094grid.40263.33Mindfulness Center, Brown University School of Public Health and Warren Alpert School of Medicine, 121S Main St, Providence, RI 02903 USA
| | - Bruce Barton
- 0000 0001 0742 0364grid.168645.8Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, 55 Lake Ave North, Worcester, MA 01655 USA
| | - Susan Druker
- 0000 0001 0742 0364grid.168645.8Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, 55 Lake Ave North, Worcester, MA 01655 USA
| | - Carolyn Neal
- 0000 0004 0447 0018grid.266900.bUniversity of Oklahoma-Tulsa School of Community Medicine, Tulsa, OK 74135 USA
| | - Kyoko Ohashi
- 0000 0000 8795 072Xgrid.240206.2McLean Imaging Center, McLean Hospital, Belmont, MA 02478 USA ,000000041936754Xgrid.38142.3cHarvard Medical School, Boston, MA 02115 USA
| | - Hanif Benoit
- 0000 0001 0742 0364grid.168645.8Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, 55 Lake Ave North, Worcester, MA 01655 USA
| | - Remko van Lutterveld
- 0000 0004 1936 9094grid.40263.33Mindfulness Center, Brown University School of Public Health and Warren Alpert School of Medicine, 121S Main St, Providence, RI 02903 USA
| | - Judson A. Brewer
- 0000 0004 1936 9094grid.40263.33Mindfulness Center, Brown University School of Public Health and Warren Alpert School of Medicine, 121S Main St, Providence, RI 02903 USA
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