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Guo Y, Xu X, Li T, Chen H, Wang X, Huang W, Liu T, Kong Q, Chen F. Dynamic functional connectivity changes associated with decreased memory performance in betel quid dependence. Addict Biol 2023; 28:e13329. [PMID: 37753571 DOI: 10.1111/adb.13329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 07/17/2023] [Accepted: 08/15/2023] [Indexed: 09/28/2023]
Abstract
The temporal variability of the dynamic functional connectivity (dFC) has been suggested as a useful metric for studying abnormal cognitive function. This study aimed to explore the associations between the temporal properties of dFC and memory performance in betel quid dependence (BQD). Sixty-four BQD individuals and 47 gender- and age-matched healthy controls (HCs) underwent functional magnetic resonance imaging and a series of neuropsychological assessments. The dFC was constructed by calculating the Pearson correlation coefficients within a sliding window and was clustered into three functional connectivity states using k-means clustering. The dFC temporal properties derived from the cluster results were compared between the BQD and HC groups. The results showed that States 1 and 3 featured more frequent and weak connectivity, and State 2 featured less frequent and strong connectivity. There were significant differences for mean dwell time (MDT) in State 3 (p = 0.022) and fraction of time in State 2 (p = 0.018) between the BQD and HC groups. Pearson correlation analyses showed that the MDT in State 1 was negatively correlated with long delay free recall and short delay free recall, and the MDT in State 3 was positively correlated with false positive of long delay recall. Our findings provide strong evidence that MDT match the memory performance and suggest new insights into the pathophysiological mechanism of memory disorders in BQD individuals.
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Affiliation(s)
- Yihao Guo
- Department of Radiology, Hainan General Hospital (Hainan Affiliated Hospital of Hainan Medical University), Haikou, Hainan, China
| | - Xiaoling Xu
- Department of Radiology, Hainan General Hospital (Hainan Affiliated Hospital of Hainan Medical University), Haikou, Hainan, China
| | - Tiansheng Li
- Department of Radiology, Hainan General Hospital (Hainan Affiliated Hospital of Hainan Medical University), Haikou, Hainan, China
| | - Huijuan Chen
- Department of Radiology, Hainan General Hospital (Hainan Affiliated Hospital of Hainan Medical University), Haikou, Hainan, China
| | - Xiaoyi Wang
- Department of Radiology, Hainan General Hospital (Hainan Affiliated Hospital of Hainan Medical University), Haikou, Hainan, China
| | - Weiyuan Huang
- Department of Radiology, Hainan General Hospital (Hainan Affiliated Hospital of Hainan Medical University), Haikou, Hainan, China
| | - Tao Liu
- Department of Geriatric Center, Hainan General Hospital (Hainan Affiliated Hospital of Hainan Medical University), Haikou, Hainan, China
| | - Qingle Kong
- MR Collaboration, Siemens Healthineers Ltd., Beijing, China
| | - Feng Chen
- Department of Radiology, Hainan General Hospital (Hainan Affiliated Hospital of Hainan Medical University), Haikou, Hainan, China
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Muthukrishnan A, Nagi R, Ashok L, Sujatha GP, Rao RS, Lakshminarayana S, Pandarathodiyil AK, Patil S. Behavioral and Psychosocial Risk Factors that Lead Individuals to Initiate and/or Maintain Betel Quid Chewing in Developed and Developing Countries: A Systematic Review. J Contemp Dent Pract 2022; 23:1267-1279. [PMID: 37125526 DOI: 10.5005/jp-journals-10024-3450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
BACKGROUND Betel quid (BQ) is the fourth most commonly used psychoactive substance and its use is highly prevalent among southeast Asian countries due to the influence of psychosocial, behavioral, and environmental factors. As a result, even young children and women are becoming addicted and find it difficult to achieve long-term abstinence. Systematic research addressing the influence of behavioral and psychosocial factors on BQ chewing is scarce, hence pointing to the need for understanding the interplay of these factors to develop tailored intervention strategies for BQ cessation. OBJECTIVE The objective of this systematic review is to assess various behavioral and psychosocial risk factors from pre-existing literature that lead individuals to initiate and/or maintain BQ chewing in developed and developing countries. MATERIALS AND METHODS The electronic retrieval systems and databases PUBMED [MEDLINE], EMBASE, SCOPUS, WEB OF SCIENCE, GOOGLE SCHOLAR, and SCIENCE DIRECT were searched independently by two authors for relevant articles from January 2011 to July 2021 using combinations of keywords. Primary studies published in English focusing on the behavioral and psychosocial risk factors for BQ chewing were included. RESULTS Out of the initial 264 articles searched, 12 articles met the selection criteria. Included studies addressed the influence of behavioral and psychosocial factors toward the initiation and/or maintenance of BQ chewing. Included studies reported that dependent BQ was not able to quit BQ chewing due to habituation, addiction, and withdrawal symptoms. Few social BQ chewers in Southeast Asian countries were not willing to initiate quitting as they considered AN as an important social and cultural identifier and claimed that they could not resist chewing in a peer group, and it has become part of their social life. CONCLUSION In the future, studies should take into consideration behavioral and psychosocial risk factors, which are major barriers toward successful quitting. These factors should be integrated into areca nut cessation guidelines, and there is a need to develop more comprehensive culture-specific intervention approaches to achieve long-term abstinence.
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Affiliation(s)
- Arvind Muthukrishnan
- Department of Oral Medicine and Radiology and Special Care Dentistry, Saveetha Dental College and Hospital, Chennai, Tamil Nadu, India
| | - Ravleen Nagi
- Department of Oral Medicine and Radiology, Saveetha Dental College and Hospital, Chennai, Tamil Nadu, India
| | - L Ashok
- Department of Oral Medicine and Radiology, Bapuji Dental College and Hospital, Davanagere, Karnataka, India
| | - G P Sujatha
- Department of Oral Medicine and Radiology, Bapuji Dental College and Hospital, Davanagere, Karnataka, India
| | - Roopa S Rao
- Department of Oral Pathology and Microbiology, Faculty of Dental Sciences, Ramaiah University of Applied Sciences, Bengaluru, Karnataka, India
| | - Surendra Lakshminarayana
- Department of Oral Pathology and Microbiology, Faculty of Dental Sciences, Ramaiah University of Applied Sciences, Bengaluru, Karnataka, India
| | | | - Shankargouda Patil
- Department of Maxillofacial Surgery and Diagnostic Sciences, Division of Oral Pathology, College of Dentistry, Jazan University, Jazan, Saudi Arabia, e-mail:
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Sumithrarachchi SR, Jayasinghe R, Warnakulasuriya S. Betel Quid Addiction: A Review of Its Addiction Mechanisms and Pharmacological Management as an Emerging Modality for Habit Cessation. Subst Use Misuse 2021; 56:2017-2025. [PMID: 34396897 DOI: 10.1080/10826084.2021.1963990] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Areca-nut (AN) and added smokeless-tobacco (SLT) are considered agents that may cause addiction to betel-quid (BQ). However, the primary addictive substance in AN is not clearly understood. Objective: The present review evaluates possible addictive chemicals in AN with their mechanisms of action for progression to BQ dependence, as it is essential to overcome barriers in BQ cessation. It also identifies innovative treatment modalities in BQ cessation including the scope for research on pharmacotherapy using Monoamine-oxidase Inhibitors, Selective Serotonin Re-uptake Inhibitors and Norepinephrine Dopamine Reuptake Inhibitors. Methods: This is a narrative review on addictive properties of BQ and trials undertaken to promote cessation of SLT or AN use. Results: Twenty interventional studies, three by behavioral therapy and seventeen using pharmacotherapy were reviewed. There was heterogeneity in reported follow up times, most studies reporting data at 12 weeks with abstinence rates of 45-55% for SLT cessation and at 8 weeks with abstinence rates around 35% for AN cessation. Conclusion: Even though literature reveals a few cessation programs through behavioral support for BQ addiction, its success has been limited in certain instances mainly due to addictive properties of AN, resulting in withdrawal and relapse. Hence, in line with pharmacotherapy in tobacco smoking cessation, potential pharmacological agents to assist in cessation of SLT and AN require more attention. Several clinical trials for SLT cessation have been carried out with varying levels of success using Nicotine Replacement Therapy and Varenicline while trials on antidepressants for SLT and AN cessation are also emerging.
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Affiliation(s)
| | - Ruwan Jayasinghe
- Centre for Research in Oral Cancer, Faculty of Dental Sciences, University of Peradeniya, Kandy, Sri Lanka.,Department of Oral Medicine and Periodontology, Faculty of Dental Sciences, University of Peradeniya, Kandy, Sri Lanka
| | - Saman Warnakulasuriya
- Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK.,WHO Collaborating Centre for Oral Cancer, London, UK
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Huang X, Wu Z, Liu Z, Liu D, Huang D, Long Y. Acute Effect of Betel Quid Chewing on Brain Network Dynamics: A Resting-State Functional Magnetic Resonance Imaging Study. Front Psychiatry 2021; 12:701420. [PMID: 34504445 PMCID: PMC8421637 DOI: 10.3389/fpsyt.2021.701420] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 08/02/2021] [Indexed: 12/12/2022] Open
Abstract
Betel quid (BQ) is one of the most popular addictive substances in the world. However, the neurophysiological mechanism underlying BQ addiction remains unclear. This study aimed to investigate whether and how BQ chewing would affect brain function in the framework of a dynamic brain network model. Resting-state functional magnetic resonance imaging scans were collected from 24 male BQ-dependent individuals and 26 male non-addictive healthy individuals before and promptly after chewing BQ. Switching rate, a measure of temporal stability of functional brain networks, was calculated at both global and local levels for each scan. The results showed that BQ-dependent and healthy groups did not significantly differ on switching rate before BQ chewing (F = 0.784, p = 0.381, analysis of covariance controlling for age, education, and head motion). After chewing BQ, both BQ-dependent (t = 2.674, p = 0.014, paired t-test) and healthy (t = 2.313, p = 0.029, paired t-test) individuals showed a significantly increased global switching rate compared to those before chewing BQ. Significant corresponding local-level effects were observed within the occipital areas for both groups, and within the cingulo-opercular, fronto-parietal, and cerebellum regions for BQ-dependent individuals. Moreover, in BQ-dependent individuals, switching rate was significantly correlated with the severity of BQ addiction assessed by the Betel Quid Dependence Scale scores (Spearman's rho = 0.471, p = 0.020) before BQ chewing. Our study provides preliminary evidence for the acute effects of BQ chewing on brain functional dynamism. These findings may provide insights into the neural mechanisms of substance addictions.
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Affiliation(s)
- Xiaojun Huang
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China.,Department of Clinical Psychology, Jiangxi Provincial People's Hospital Affiliated to Nanchang University, Nanchang, China
| | - Zhipeng Wu
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Zhening Liu
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Dayi Liu
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Danqing Huang
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Yicheng Long
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China
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Ko AMS, Lee CH, Ko AMJ, Ko YC. Betel quid dependence mechanism and potential cessation therapy. Prog Neuropsychopharmacol Biol Psychiatry 2020; 103:109982. [PMID: 32454163 DOI: 10.1016/j.pnpbp.2020.109982] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 05/22/2020] [Accepted: 05/22/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND Global reports estimate the number of betel quid (BQ) chewers up to 600 million. The proportion of betel quid dependence (BQD) is 20%-90% among current users. BQD mechanisms are not fully understood, and no pharmacological solution exists for its cessation therapy. METHODS We present a systematic review on BQD mechanisms and examine potential cessation therapeutic drugs. We conducted a systematic literature search in PubMed and Web of Science databases and identified the latest 10 years' relevant articles for reviews. RESULTS Functional magnetic resonance imaging results demonstrate that neurological mechanisms link the brain reward, cognitive, and impulsive systems in BQ or BQD users. The use of the areca nut increases both brain serotonin and noradrenaline levels, whereas arecoline, a potentially addictive areca nut component, has monoamine oxidase-A (MAO-A) inhibitor-like properties. MAO-A inhibitors prevent neurotransmitter breakdown and increase dopamine and serotonin concentrations in the brain. A reduction of daily BQ use was observed among patients with depression after antidepressant therapy, including MAO-A inhibitor and selective serotonin reuptake inhibitor (SSRI). Arecoline is a nicotinic acetylcholine receptor agonist expressed in Xenopus oocytes. However, relatively negligible amounts of nicotine are detected in the areca nut. CONCLUSION In conclusion, the current evidence provides a better understanding of the neurological and pharmacological mechanisms behind BQD. Arecoline, an MAO-A inhibitor, may account for BQD. Future translational studies are needed to verify the efficacy of potential BQD cessation drugs. MAO-A inhibitor and SSRI would thus be potentially promising targets for clinical trials.
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Affiliation(s)
- Albert Min-Shan Ko
- Key Laboratory of Vertebrate Evolution and Human Origins of Chinese Academy of Sciences, Institute of Vertebrate Paleontology and Paleoanthropology, Chinese Academy of Sciences, Beijing, China
| | - Chien-Hung Lee
- Department of Public Health and Research Center for Environment Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Allen Min-Jen Ko
- Medical Imaging and Radiology, Alpenglow Australia, Sydney, New South Wales, Australia
| | - Ying-Chin Ko
- Environment-Omics-Disease Research Center, China Medical University Hospital, China Medical University, Taichung, Taiwan; Graduate Institute of Toxicology, College of Medicine, National Taiwan University, Taipei, Taiwan.
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Qian Z, Liu S, Zhu X, Kong L, Liu N, Wang D, Jiang C, Zhan Z, Yuan F. Higher Trait Impulsivity and Altered Frontostriatal Connectivity in Betel-Quid Dependent Individuals. Front Hum Neurosci 2020; 14:578913. [PMID: 33192412 PMCID: PMC7658367 DOI: 10.3389/fnhum.2020.578913] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 09/22/2020] [Indexed: 12/17/2022] Open
Abstract
Objective: Betel quid dependency (BQD) is characterized by functional and structural brain alterations. Trait impulsivity may influence substance dependence by impacting its neurobiological underpinnings in the frontostriatal circuit. However, little is known about the trait impulsivity and its neural correlates in individuals with BQD. Methods: Forty-eight participants with BQD and 22 normal controls (NCs) were recruited and scanned on a 3T MRI scanner. Barratt impulsiveness scale (BIS) was used to measure trait impulsivity: motor, attention, and no plan impulsivity. We used voxel-based morphometry (VBM) to assess the relationship between trait impulsivity and gray matter volumes. The relevant clusters identified were served as regions of interest (ROI) seeds. The whole-volume psycho-physiological interactions (PPI) analysis was used to investigate the changes of functional connectivity related to ROI seeds in the cue-reactivity task condition (BQ and control images). Results: Behaviorally, the BQD group showed significantly higher trait impulsivity including motor and no plan impulsivity than the NCs group. VBM analyses showed that motor impulsivity was negatively associated with gray matter volume of right caudate in the whole sample. No difference in gray matter volume between the two groups was observed. PPI analyses showed that there was a significantly decreased functional connectivity between the right caudate and right dorsolateral prefrontal cortex (DLPFC) when watching BQ related images than control images in individuals with BQD. Furthermore, functional connectivity between the right caudate and right DLPFC was negatively correlated with BQ dependency scores. Conclusions: Our study demonstrated the structural basis of trait impulsivity in the caudate and provided evidence for abnormal interactions within frontostriatal circuitsin individuals with BQD, which may provide insight into the selection of potential novel therapeutic targets for the treatment of BQ dependency.
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Affiliation(s)
- Zhaoxin Qian
- Department of Emergency, Xiangya Hospital, Central South University, Changsha, China
| | - Shaohui Liu
- Health Management Center, Xiangya Hospital, Central South University, Changsha, China
| | - Xueling Zhu
- Department of Radiology, Xiangya Hospital, Central South University, Changsha, China
| | - Lingyu Kong
- Department of Radiology, Xiangya Hospital, Central South University, Changsha, China
| | - Neng Liu
- Department of Nursing, Xiangya Hospital, Central South University, Changsha, China
| | - Dongcui Wang
- Department of Radiology, Xiangya Hospital, Central South University, Changsha, China
| | - Canhua Jiang
- Department of Oral and Maxillofacial Surgery, Xiangya Hospital, Central South University, Changsha, China
| | - Zhongyuan Zhan
- Department of Oral and Maxillofacial Surgery, Xiangya Hospital, Central South University, Changsha, China
| | - Fulai Yuan
- Health Management Center, Xiangya Hospital, Central South University, Changsha, China
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Huang BS, Chung CF, Chang YL, Lee LY, Peng HL, Chen SC. Body mass index and self-care behaviors related to oral health-related quality of life in patients with oral squamous cell carcinoma within three months posttreatment. Support Care Cancer 2020; 29:2239-2248. [PMID: 32910290 DOI: 10.1007/s00520-020-05737-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 09/04/2020] [Indexed: 11/29/2022]
Abstract
PURPOSE Oral dysfunction is a common adverse event of treatment and may affect oral health-related quality of life (OHRQoL). This study aimed to identify factors associated with OHRQoL in patients with oral squamous cell carcinoma (OSCC) within the first three months posttreatment. METHODS This cross-sectional study examined OSCC patients who received treatment from the outpatient radiation department of a single cancer center in northern Taiwan. Demographic and clinical characteristics were recorded, and patients were assessed using the Self-Care Behaviors Scale (SCB), Oral Health Impact Profile (OHIP), and Karnofsky Performance Status (KPS) questionnaires. RESULTS Among 148 OSCC patients, 11.5% reported being underweight and 70.3% reported normal weight. The most common self-care factors associated with adverse effects were decreased appetite and fatigue. Psychological disability, functional limitation, and physical pain were the most negative OHRQoL factors. Poor OHRQoL was associated with more severe adverse effects after self-care behaviors, using feeding tubes during treatment, and having BMI less than 25, which together explained 33.5% of the variance in OHRQoL. CONCLUSIONS The severity of adverse effects after self-care behaviors and using feeding tubes during treatment strongly influenced overall OHRQoL and seven specific dimensions of OHRQoL.
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Affiliation(s)
- Bing-Shen Huang
- Department of Radiation Oncology and Proton and Radiation Therapy Center, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.,Department of Medical Imaging and Radiological Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Ching-Fang Chung
- Department of Nursing, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Ya-Lan Chang
- Department of Nursing, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Li-Yun Lee
- Department of Nursing, College of Nursing and Health Sciences, Da-Yeh University, Changhua, Taiwan
| | - Hsi-Ling Peng
- Department of Nursing, Oriental Institute of Technology, Taipei, Taiwan
| | - Shu-Ching Chen
- Department of Radiation Oncology and Proton and Radiation Therapy Center, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan. .,School of Nursing and Geriatric and Long-Term Care Research Center, College of Nursing, Chang Gung University of Science and Technology, 261, Wen-Hua 1st Road, Kweishan, Taoyuan, 333, Taiwan. .,School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
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Liang F, Jiang C, Feng T, Li D, Zhou B. Associations between Work Experience and Betel Nut, Alcohol, or Tobacco Use among Low-Income Taiwanese Students from Middle School to University. Subst Use Misuse 2020; 55:1493-1500. [PMID: 32569531 DOI: 10.1080/10826084.2020.1747083] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Background: Research suggests that young working students are at higher risk for substance use. However, most studies have focused on students from middle-class families, with few investigations conducted on substance use by students from low-income families. Objective: To examine the associations between work experience and betel nut, alcohol, or tobacco (BAT) use among Taiwanese students from low-income families. Methods: The data for this cross-sectional study were derived from the fourth wave of the Taiwan Panel Study of Children and Youth survey which provides primary data on low-income families. A total of 3,350 low-income students aged 12-25 years old from middle school to university participated. The χ2 test was performed to examine differences in sociodemographic characteristics and BAT use between employed and unemployed students. Multivariate logistic regression was used to examine the associations between work status, work intensity, monthly income, occupation, and BAT use. Results: Employed students displayed higher BAT use than those who were unemployed. Increased BAT use was also associated with higher work intensity (except for betel nut use), higher monthly income, and specific occupations (such as service or manual work). Conclusions: Employment is independently associated with a higher risk of BAT use among low-income Taiwanese students. Work intensity and specific occupational fields may offer insights into formulating relevant preventive measures for these students.
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Affiliation(s)
- Fengjuan Liang
- Medical department, the First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | | | - Tienan Feng
- Clinical Research Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Dongxu Li
- Medical department, the First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Baosong Zhou
- School of Data Science, Fudan University, Shanghai, China
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Kong L, Zeng C, Yuan F, Liu S, Wang D, Jiang C, Zhan Z, Qian Z, Zhu X. Dysfunction of the Prefrontal Cortex in Betel-Quid-Dependent Chewers. Front Psychiatry 2020; 11:558367. [PMID: 33192673 PMCID: PMC7541958 DOI: 10.3389/fpsyt.2020.558367] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Accepted: 08/27/2020] [Indexed: 11/29/2022] Open
Abstract
Betel quid is the fourth most popular psychoactive agent worldwide. Imaging studies have found altered brain structure in prefrontal cortex (PFC) in betel-quid dependent (BQD) chewers. However, the brain function in PFC associated with BQ use still remains unclear. The present study aimed to examine brain functional activity in PFC in individuals with BQD. This study recruited 48 participants with BQD and 22 normal controls (NCs). Both BQ-specific cue reactivity and Go/NoGo tasks were administered with functional magnetic resonance imaging (fMRI). Behavioral results showed a deficit in the choice reaction time task in BQD group. The fMRI results of the cue reactivity task suggested that, individuals with BQD exhibited responses in right ventromedial PFC, left posterior cingulate cortex (PCC), left lateral parietal lobe (LPL), left middle temporal gyrus and left visual cortex, when seeing BQ images compared with control images. In the Go/NoGo task, relative to NCs group, individuals with BQD showed higher activity in right dorsolateral PFC, right PCC and bilateral LPL between NoGo and Go trials. Across these two tasks, we consistently found disrupted function in PFC in individuals with BQD, which might lead to impaired craving and response inhibition in BQ addiction. Results of current study might shed light on the neural mechanisms involved in BQ use, which could be used as potential guidelines for diagnosis and treatment of BQ dependence.
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Affiliation(s)
- Lingyu Kong
- Department of Radiology, Xiangya Hospital, Central South University, Changsha, China
| | - Chang Zeng
- Health Management Center, Xiangya Hospital, Central South University, Changsha, China
| | - Fulai Yuan
- Health Management Center, Xiangya Hospital, Central South University, Changsha, China
| | - Shaohui Liu
- Health Management Center, Xiangya Hospital, Central South University, Changsha, China
| | - Dongcui Wang
- Department of Radiology, Xiangya Hospital, Central South University, Changsha, China
| | - Canhua Jiang
- Department of Oral and Maxillofacial Surgery, Xiangya Hospital, Central South University, Changsha, China
| | - Zhongyuan Zhan
- Department of Oral and Maxillofacial Surgery, Xiangya Hospital, Central South University, Changsha, China
| | - Zhaoxin Qian
- Department of Emergency, Xiangya Hospital, Central South University, Changsha, China
| | - Xueling Zhu
- Department of Radiology, Xiangya Hospital, Central South University, Changsha, China
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Chen CC, Wu WC, Chang SS, Chang CB, Yang CTJ, Su HK, Chan DCD. Common mental disorders in Taiwanese consumers of commercial low-dose computed tomography lung cancer screening: Comparison with a nationally representative sample. J Formos Med Assoc 2019; 119:1274-1282. [PMID: 31787488 DOI: 10.1016/j.jfma.2019.11.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Revised: 09/04/2019] [Accepted: 11/12/2019] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND/PURPOSE We examined the prevalence of probable common mental disorders (CMDs) in commercial low-dose computed tomography (LDCT) lung cancer screening consumers relative to the general population and to determine the correlates of probable CMDs among screening participants. METHODS Commercial LDCT lung cancer screening consumers (N = 1323) were compared with a nationally representative sample from the Taiwan Social Change Survey (TSCS) (N = 2034). Respondents scoring ≥3 on the Chinese Health Questionnaire were classified as having a probable CMD. Logistic regression was used to investigate differences between the two groups and correlates of probable CMDs among LDCT lung cancer screening participants. RESULTS The prevalence of probable CMDs was higher among LDCT lung cancer screening participants (25.47%) than among TSCS adults (21.56%). Compared with the TSCS sample, the screening participants had a higher probability of CMDs (OR = 1.40, 95% CI = 1.13-1.73), higher education levels (OR = 7.95, 95% CI = 6.00-10.53), and a history of drinking (OR = 11.85, 95% CI = 9.45-14.85) or betel-quid use (OR = 5.43, 95% CI = 3.98-7.42) but were less likely to smoke (OR = 0.52, 95% CI = 0.40-0.68). Among the screening participants, being female (OR = 1.37, 95% CI = 1.02-1.84) and a current smoker (OR = 1.74, 1.19-2.54) and living near ≥2 smoking family members (OR = 2.30, 95% CI 1.57-3.38) were associated with an increased likelihood of having CMDs. CONCLUSION Commercial LDCT lung cancer screening users may have a positive association with probable CMDs compared to the general population. Screening programs should consider including criteria and providing psychoeducation to improve the physical and mental outcomes of participants. CLINICAL TRIAL REGISTRATION Purely observational studies (those in which the assignment of the medical intervention is not at the discretion of the investigator) do not require registration.
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Affiliation(s)
- Cheng-Che Chen
- Department of Psychiatry, National Taiwan University Hospital Chu-Tung Branch, No. 52, Zhishan Rd., Zhudong Township, Hsinchu County, Taiwan; Center for Medical Education and Research, National Taiwan University Hospital Chu-Tung Branch, No. 52, Zhishan Rd., Zhudong Township, Hsinchu County, Taiwan
| | - Wen-Chi Wu
- Department of Health Promotion and Health Education, National Taiwan Normal University, No. 162, Section 1, Heping E. Rd., Taipei 106, Taiwan
| | - Shu-Sen Chang
- Institute of Health Behaviors and Community Sciences, Department of Public Health, College of Public Health, National Taiwan University, No. 17, Xu-Zhou Road, Taipei 10055, Taiwan
| | - Chirn-Bin Chang
- Department of Internal Medicine, National Taiwan University Hospital Chu-Tung Branch, No. 52, Zhishan Rd., Zhudong Township, Hsinchu County, Taiwan; Department of Geriatrics and Gerontology, National Taiwan University Hospital, No. 1, Changde St., Zhongzheng Dist., Taipei 10048, Taiwan; Department of Internal Medicine, National Taiwan University Hospital, No. 1, Changde St., Zhongzheng Dist., Taipei 10048, Taiwan
| | - Cheng-Ta Justin Yang
- Department of Radiology, National Taiwan University Hospital Chu-Tung Branch, No. 52, Zhishan Rd., Zhudong Township, Hsinchu County, Taiwan
| | - Hung-Kuang Su
- Department of Psychiatry, National Taiwan University Hospital, No. 1, Changde St., Zhongzheng Dist., Taipei 10048, Taiwan
| | - Ding-Cheng Derrick Chan
- Department of Geriatrics and Gerontology, National Taiwan University Hospital, No. 1, Changde St., Zhongzheng Dist., Taipei 10048, Taiwan; Department of Internal Medicine, National Taiwan University Hospital, No. 1, Changde St., Zhongzheng Dist., Taipei 10048, Taiwan; Superintendent Office, National Taiwan University Hospital Chu-Tung Branch, No. 52, Zhishan Rd., Zhudong Township, Hsinchu County, Taiwan.
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Abstract
Problem Areca nut (AN) chewing is common among Southeast Asian population. Use of AN products (with or without tobacco) have a multifaceted effect on physical health, especially on cardiovascular, nervous, gastrointestinal, metabolic, respiratory, and reproductive systems. AN is a known group 1 carcinogen and carries addictive potential. Varying degrees of AN-related substance use disorder (SUD) have been reported among AN chewers. There is a lacuna in awareness of the health risk of AN use, prevention, and cessation programs among AN users, particularly in those who have developed SUD. Existing Lacunae The dynamic interaction of factors that promote AN use and later the risk of developing SUD at individual and community level has not been studied in depth. Understanding of the bio-psycho-socio-economic-cultural factors is necessary to identify the factors that prelude, promote, and reinforce AN usage. For managing AN-related conditions, including the several systemic disorders, there is a knowledge lacunae, among health care providers with respect to the pathophysiology of AN-related health issues, SUD, and nonavailability of structured, evidence-based cessation protocols. Solutions/Recommendations This manuscript presents a model-map to study the dynamics of AN use and the impact of AN on health and health care system at individual as well as community level. The model proposed can help the health policymakers to create evidence-based awareness and cessation protocols for AN.
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Affiliation(s)
- Rooban Thavarajah
- Department of Oral and Maxillofacial Pathology, Ragas Dental College and Hospital, Affiliated to the Tamil Nadu Dr. MGR Medical University, Chennai, Tamil Nadu, India
| | - Kannan Ranganathan
- Department of Oral and Maxillofacial Pathology, Ragas Dental College and Hospital, Affiliated to the Tamil Nadu Dr. MGR Medical University, Chennai, Tamil Nadu, India
| | - Elizabeth Joshua
- Department of Oral and Maxillofacial Pathology, Ragas Dental College and Hospital, Affiliated to the Tamil Nadu Dr. MGR Medical University, Chennai, Tamil Nadu, India
| | - Umadevi Krishnamohan Rao
- Department of Oral and Maxillofacial Pathology, Ragas Dental College and Hospital, Affiliated to the Tamil Nadu Dr. MGR Medical University, Chennai, Tamil Nadu, India
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Zhu X, Liu S, Liao W, Kong L, Jiang C, Yuan F. Executive function deficit in betel-quid-dependent chewers: Mediating role of prefrontal cortical thickness. J Psychopharmacol 2018; 32:1362-1368. [PMID: 30379118 DOI: 10.1177/0269881118806299] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
BACKGROUND Betel quid is the fourth most popular psychoactive agent worldwide. Neuroimaging studies have suggested betel-quid dependence is accompanied by abnormality in brain structure and function. However, the neural correlates of executive function deficit and prefrontal cortical thickness associated with betel-quid chewing still remain unclear. OBJECTIVE The present study aimed to examine the relationship between executive function deficit and prefrontal cortical thickness in chronic betel-quid chewers. METHODS Twenty-three betel-quid-dependent chewers and 26 healthy controls were recruited to participate in this study. Executive function was tested using three tasks. Cortical thickness analysis was analyzed with the FreeSurfer software package. RESULTS Behavioral results suggested a profound deficit of executive function in betel-quid-dependent chewers. Cortical thickness analysis revealed thinner cortex in the bilateral dorsolateral prefrontal cortex in betel-quid-dependent chewers. Further analysis suggested that cortical thickness of the bilateral dorsolateral prefrontal cortex mediated the correlation of betel-quid chewing and executive function. CONCLUSIONS These results suggest the important role of executive function and cortical thickness of the dorsolateral prefrontal cortex with betel-quid chewing. Our findings provide evidence that executive function deficit may be mediated by the cortical thickness of the dorsolateral prefrontal cortex. These results could potentially help us develop novel ways to diagnose and prevent betel-quid dependence.
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Affiliation(s)
- Xueling Zhu
- 1 Department of Radiology, Xiangya Hospital, Central South University, Changsha, China
| | - Shaohui Liu
- 2 Health Management Center, Xiangya Hospital, Central South University, Changsha, China
| | - Weihua Liao
- 1 Department of Radiology, Xiangya Hospital, Central South University, Changsha, China
| | - Lingyu Kong
- 1 Department of Radiology, Xiangya Hospital, Central South University, Changsha, China
| | - Canhua Jiang
- 3 Department of Oral and Maxillofacial Surgery, Xiangya Hospital, Central South University, Changsha, China
| | - Fulai Yuan
- 2 Health Management Center, Xiangya Hospital, Central South University, Changsha, China
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