Brain Marker Links Stress and Nicotine Abstinence.

Abstract

BACKGROUND\nSubjective stress is a well-documented predictor of early smoking relapse, yet our understanding of stress and tobacco use is limited by reliance on self-reported measures of stress. We utilized a validated functional neuroimaging paradigm to examine whether stress exposure during early abstinence alters objective measures of brain function.\n\n\nMETHODS\n75 participants underwent blood oxygen level dependent (BOLD) functional magnetic resonance imaging (FMRI) during the Montreal Imaging Stress Task (MIST) on two occasions: once during smoking satiety and once following biochemically confirmed 24-hour abstinence (order counter-balanced). The primary outcome measure was brain response during stress (vs. control) blocks of the MIST, assessed using whole-brain analysis corrected for multiple comparisons using clusters determined by Z≥3.1.\n\n\nRESULTS\nAbstinence (vs. satiety) was associated with significantly increased activation in the left inferior frontal gyrus, a brain region associated with inhibitory control. Abstinence-induced change in brain response to stress was positively associated with change in self-reported stress.\n\n\nCONCLUSIONS\nThis study provides objective evidence that the brain response to stress is altered during the first 24 hours of a quit attempt compared to smoking satiety.\n\n\nIMPLICATIONS\nThese results point to the potential value of inoculating smokers with stress management training prior to a quit attempt.