Title

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

UMMS Affiliation

Department of Population and Quantitative Health Sciences

Publication Date

2019-04-30

Document Type

Article

Disciplines

Movement and Mind-Body Therapies | Neuroscience and Neurobiology | Psychiatry and Psychology | Substance Abuse and Addiction | Telemedicine

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.

Keywords

Neuroscience, Predictive markers

DOI of Published Version

10.1038/s41386-019-0403-y

Source

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 Aug;44(9):1631-1638. doi: 10.1038/s41386-019-0403-y. Epub 2019 Apr 30. PMID: 31039580; PMCID: PMC6785102. Link to article on publisher's site

Journal/Book/Conference Title

Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology

PubMed ID

31039580

Related Resources

Link to Article in PubMed

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