Brain Responses to Cigarette-Related and Emotional Images in Smokers During Smoking Cessation: No Effect of Varenicline or Bupropion on the Late Positive Potential. Issue 2 (6th December 2017)

• Record Type: Journal Article
• Authors: Versace, Francesco; Stevens, Elise M; Robinson, Jason D; Cui, Yong; Deweese, Menton M; Engelmann, Jeffrey M; Green, Charles E; Karam-Hage, Maher; Lam, Cho Y; Minnix, Jennifer A; Wetter, David W; Cinciripini, Paul M
• Is Part Of: Nicotine & tobacco research. Volume 21:Issue 2(2019)
• Page Start: 234
• Page End: 240
• Publication Date: 2017-12-06
• Subjects: Nicotine -- Periodicals; Tobacco -- Research -- Periodicals; Tobacco habit -- Periodicals; Nicotine -- Periodicals; Tobacco -- Periodicals; Smoking -- Periodicals; 613.85
• DOI: 10.1093/ntr/ntx264
• Languages: English
• ISSNs: 1462-2203

Abstract

Abstract: 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.