O-Seok Kang

Individual differences in smoking-related cue reactivity in smokers: An eye-tracking and fMRI study

Measures of cue reactivity provide a means of studying and understanding addictive behavior. We wanted to examine the relationship between different cue reactivity measures, such as attentional bias and subjective craving, and functional brain responses toward smoking-related cues in smokers. We used eye-tracking measurements, a questionnaire for smoking urges-brief and functional magnetic resonance imaging to assess the responses to smoking-related and neutral visual cues from 25 male smokers after 36 h of smoking abstinence. Regression analyses were conducted to determine the correlation between cue-evoked brain responses and the attentional bias to smoking-related cues. The eye gaze dwell time percentage was longer in response to smoking-related cues than neutral cues, indicating significant differences in attentional bias towards smoking-related cues. The attentional bias to smoking-related cues correlated with subjective craving ratings (r=0.660, p<0.001). The dorsolateral prefrontal cortex, the putamen, the posterior cingulate cortex and the primary motor cortex were associated with the attentional bias to smoking-related cues, whereas the orbitofrontal cortex, the insula and the superior temporal gyrus were associated with smoking-related cue-induced craving and smoking urges. These results suggest that attentional mechanisms in combination with motivational and reward-related mechanisms play a role in smoking-related cue reactivity. We confirmed a positive correlation between different smoking-related cue reactivities, such as attentional bias and subjective craving, and functional brain responses in various individuals. Further studies in this field might contribute to a better individualized understanding of addictive behavior.

Autonomic and subjective responses to real and sham acupuncture stimulation

This study compared verum acupuncture (VA) and sham acupuncture (SA) stimulation by assessing autonomic and subjective responses. Autonomic responses such as skin conductance response (SCR) and heart rate (HR) were measured. Subjective pain ratings were collected and evaluated. A correlation analysis was performed for SCR and HR changes and subjective pain ratings. In both VA and SA sessions, SCR increased, and HR decreased. Subjective responses were different for VA and SA. The SCR changes correlated with subjective responses for VA, but not SA. The present results suggest that VA and SA do not fundamentally differ in their autonomic response patterns.

Acupuncture attenuates autonomic responses to smoking-related visual cues

OBJECTIVES In smokers, smoking-associated cues produce smoking urges and cravings, which are accompanied by autonomic dysfunction in response to these cues. We investigated whether or not acupuncture ameliorated cigarette withdrawal symptoms, as well as attenuated the autonomic responses to smoking-related visual cues in smokers using a power spectrum analysis of heart rate variability (HRV). INTERVENTIONS Fifteen subjects were treated with real acupuncture (RA) at HT7 and 14 subjects received sham acupuncture (SA) at LI10 using the Park Sham Device. MAIN OUTCOME MEASURE The cigarette withdrawal scale (CWS) was measured on the third day after the subjects had quit smoking. We compared the low-frequency/high-frequency (HF/LF) ratio in the HRV of the RA and SA groups during a distraction task using neutral and smoking visual cues. RESULTS The CWS of the RA group was significantly lower than that of the SA group. The increase in the LF/HF ratio of HRV induced by the smoking-related visual cues was also significantly lower in the RA group when compared with the SA group. Acupuncture not only ameliorated cigarette withdrawal, but also weakened the autonomic responses to smoking cues during withdrawal. CONCLUSIONS These findings suggest that acupuncture might help in smoking cessation by attenuating withdrawal symptoms and smoking cues-induced autonomic responses.

Subjective and Autonomic Responses to Smoking-Related Visual Cues

Nicotine, like several other abused drugs, is known to act on the reward system in the brain. Smoking-associated cues produce smoking urges and cravings accompanied by autonomic dysfunction to these cues in smokers. The present study was aimed at investigating whether cues related to smoking elicit the autonomic response in smokers. The subjective and physiological reactivity of 7 smokers and 12 nonsmokers in a supine position to smoking-related visual cues was assessed under indirect dim light using a self-assessment manikin and a specially designed pupillometer. The experimental procedure consisted of the elicitation and measurement of pupil size (PS) while the subjects viewed a smoking image and images from three valence-defined categories (i.e., pleasant, unpleasant, and neutral), based on normative affective ratings selected from the International Affective Picture System. Both groups produced significantly larger PS increases in response to pleasant or unpleasant images compared to neutral images. Smokers, viewing smoking-related visual cues but no other affective images, produced significantly larger PSs compared to nonsmokers. Moreover, smokers rated the smoking image with more pleasure and arousal than nonsmokers. These findings suggest that cues related to smoking induce not only a subjective emotional alteration, but also sympathetic activation, measured by the time-series PS data in smokers.

Short term effects by acupuncture to SP3 on the autonomic blood flow control

Abstract Objectives: In this study, we investigated the short term effects of acupuncture on autonomic control of blood flow in healthy subjects. We also studied whether deqi (obtaining qi) sensations are correlated with these autonomic hemodynamic changes. Methods: The experiment had a randomized, crossover design. Five healthy volunteers (age: 18–26 years) participated in this study. Acupuncture (2 Hz rotations for 10 seconds to 20 mm deep) was applied either to the acupuncture point SP3 or KI2 for 5 minutes. Non-invasively obtained continuous hemodynamic measurements of ultrasound Dopplerography were recorded at the radial artery before, during and after acupuncture stimulation. Cardiovascular autonomic tone was also recorded using power spectral analysis of heart rate variability. After acupuncture stimulation, the participants completed the acupuncture perception scales to measure the degree of deqi or pain they had experienced. Results: Acupuncture stimulation to the acupuncture point SP3, when compared to the acupuncture point KI2, decreased the maximum systolic velocity. It also decreased low frequency component and increased high frequency component of heart rate variability, indicating that the decrease in systolic blood flow velocity was due to the increased parasympathetic response. Interestingly, warm, radiating and energetic feeling, which are related to deqi, had close correlations with the decrease in blood flow velocity. Discussion: Acupuncture stimulation to the acupuncture point SP3 modulates the autonomic cardiovascular responses by enhancing parasympathetic function, and this may help to understand the therapeutic effects of acupuncture.

Effect of acupuncture on selective attention for smoking-related visual cues in smokers

Abstract Objectives: Cue reactivity is a key factor that modulates motivational goal directed behavior associated with compulsive drug intake and relapse. We investigated the effect of acupuncture on the selective attention to smoking-related visual cues in smokers, as an index of the severity of drug dependence. Methods: Twenty-nine smokers received real acupuncture (n=15) or sham acupuncture (n=14) to the acupuncture point HT7 (Sinmun) for 2 consecutive days after quitting smoking. A visual probe task was used to measure the attentional bias using neutral or smoking visual cues after the second acupuncture stimulation. The cigarette withdrawal scale was also measured on the same day. Results: The real acupuncture group showed markedly attenuated attentional bias towards smoking cues. The real acupuncture group exhibited significant decrease in withdrawal symptoms compared to the sham acupuncture group. The attentional bias revealed a significant positive correlation with the smoking withdrawal symptoms (r=0.430, p<0.05). Discussion: Acupuncture treatment ameliorated the smoking withdrawal symptoms as well as the selective attention to smoking-related visual cues in smokers. The selective attention to smoking cues was associated with the degree of the cigarette withdrawal symptoms.

Pre-existing beliefs and expectations influence judgments of novel health information

The present study examined whether health information is judged differently depending on pre-existing beliefs and expectations. People’s initial beliefs and expectations were assessed by a questionnaire about acupuncture and a trustworthiness and preference rating task of doctors’ faces. Then, newspaper headlines about novel acupuncture treatment were shown and rated for their feasibility in a normal and framed condition. The judged feasibility of the newspaper headlines correlated strongly with initial beliefs about acupuncture in the normal condition, and with initial expectations towards a doctor’s face in the framed condition. Thus, as suggested by Bayes Theorem, pre-existing beliefs and expectations influence judgments of novel health information.

Deqi Is Double-Faced: The Acupuncture Practitioner's and the Subject's Perspective.

Background. While therapeutic acupuncture perception (deqi) has recently been investigated only for the subjects perception, classical acupuncture discussed acupuncture perception for both the practitioner and the subject. The aim of this study was to explore the practitioners and the subjects acupuncture perception during acupuncture. Methods. Explorative crossover study to quantitatively document acupuncture perception of both the practitioner and the subject. Eighty-one participants acted as a practitioner or a subject. The practitioners and the subjects acupuncture perceptions were collected using self-report type checklists. Acupuncture needles were inserted to LI4 or ST36, adopting a four-phase method: insertion into shallow, middle, and deep depths, followed by twirling manipulation. Pain, transmission, dullness, and soreness feelings of the subject and thick, tangled, solid, and empty feelings of the practitioner were analyzed for their correlation. Results. The practitioners and the subjects perception showed a significant correlation. Acupuncture perception varied over four phases of needling, with a tendency to be rated higher when inserted deep. Perception for LI4 was generally higher than those for ST36. Conclusion. The practitioners acupuncture perception was successfully documented and analyzed in relation to the subjects acupuncture perception and different needling conditions.

Do not judge according to appearance: patients’ preference of a doctor's face does not influence their assessment of the patient–doctor relationship

Objectives The aim of this study was to investigate whether a patients preference for a doctors face is associated with better assessments of relational empathy in the patient–doctor relationship after the first clinical consultation. Methods A total of 110 patients enrolled in a traditional Korean medical clinic participated in the study. Patients’ preference for doctors’ faces was assessed by a two alternative forced choice (2AFC) task, with 60 different pairs of six different Asian male doctors’ faces. One of the six doctors then carried out the initial clinical consultation for these patients. The patient–doctor relationship was assessed using the Consultation and Relational Empathy (CARE) measure. Results The data of all patients’ simulated preferences for a doctors face and their assessment values of a doctors relational empathy was compared, and no significant correlation was found between both values (r=−0.024, p>0.809). Conclusions These findings suggest that the perceived empathy in the patient–doctor relationship is not influenced by the patients preference for a certain doctors face. The first impression of a doctor is often determined by his appearance and look. However, whether or not the patient particularly prefers a doctors face does not seem to matter in developing a good patient–doctor relationship.

What Factors Are Influencing Preferences Toward Conventional Versus Complementary and Alternative Medical Clinic Advertisements

OBJECTIVES The present study aimed to determine whether health service advertisements are perceived differently depending on advertising conventional or complementary and alternative medicine clinics. METHODS A total of 42 adults (male=21, female=21) recruited through advertisements in Seoul, South Korea participated in this study. A standardized health service advertisement was designed with three controlled visual components such as (1) medical treatment information, (2) medical practitioner, and (3) medical facilities and it was shown to subjects while their eye movements were tracked and they were asked to rate their preferences for the different advertisements and their separate components. A multiple regression analysis was performed to see the correlation of the preferences for each of the three visual components with the overall preference rating of each health service advertisement. RESULTS Preferences for the advertisement depended mostly on the preference for the medical treatment information, whereas advertisements for complementary and alternative medical clinics depended also on the preference for the medical practitioner. CONCLUSIONS These results imply that the same health service advertisement will be perceived differently depending on whether it advertises Western or Oriental medical clinics.