Brain Responses to Cigarette-Related and Emotional Images in Smokers During Smoking Cessation: No Effect of Varenicline or Bupropion on the Late Positive Potential

Francesco Versace, Elise M. Stevens, Jason D. Robinson, Yong Cui, Menton M. Deweese, Jeffrey M. Engelmann, Charles Green, Maher Karam-Hage, Cho Y. Lam, Jennifer A. Minnix, David W. Wetter, Paul M. Cinciripini

Research output: Contribution to journalArticle

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.

LanguageEnglish
Pages234-240
Number of pages7
JournalNicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco
Volume21
Issue number2
DOIs
StatePublished - Jan 4 2019
Externally publishedYes

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Bupropion
Smoking Cessation
Tobacco Products
Cues
Brain
Placebos
Evoked Potentials
Smoking
Recurrence
Withholding Treatment
Varenicline
Research Personnel
Craving
Clinical Trials
Drug Therapy
Pharmaceutical Preparations

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

Cite this

Brain Responses to Cigarette-Related and Emotional Images in Smokers During Smoking Cessation : No Effect of Varenicline or Bupropion on the Late Positive Potential. / Versace, Francesco; Stevens, Elise M.; Robinson, Jason D.; Cui, Yong; Deweese, Menton M.; Engelmann, Jeffrey M.; Green, Charles; Karam-Hage, Maher; Lam, Cho Y.; Minnix, Jennifer A.; Wetter, David W.; Cinciripini, Paul M.

In: Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco, Vol. 21, No. 2, 04.01.2019, p. 234-240.

Research output: Contribution to journalArticle

Versace, Francesco ; Stevens, Elise M. ; Robinson, Jason D. ; Cui, Yong ; Deweese, Menton M. ; Engelmann, Jeffrey M. ; Green, Charles ; Karam-Hage, Maher ; Lam, Cho Y. ; Minnix, Jennifer A. ; Wetter, David W. ; Cinciripini, Paul M. / Brain Responses to Cigarette-Related and Emotional Images in Smokers During Smoking Cessation : No Effect of Varenicline or Bupropion on the Late Positive Potential. In: Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco. 2019 ; Vol. 21, No. 2. pp. 234-240.
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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.",
author = "Francesco Versace and Stevens, {Elise M.} and Robinson, {Jason D.} and Yong Cui and Deweese, {Menton M.} and Engelmann, {Jeffrey M.} and Charles Green and Maher Karam-Hage and Lam, {Cho Y.} and Minnix, {Jennifer A.} and Wetter, {David W.} and Cinciripini, {Paul M.}",
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AU - Cui, Yong

AU - Deweese, Menton M.

AU - Engelmann, Jeffrey M.

AU - Green, Charles

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AU - Minnix, Jennifer A.

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