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Insular and anterior cingulate circuits in smokers with schizophrenia.

Abstract
Schizophrenia (SZ) is associated with high rates of smoking. We previously found that resting state functional connectivity (rsFC) between the dorsal anterior cingulate (dACC) and striatum is independently associated with nicotine addiction and psychiatric illness. Since the insula is implicated in nicotine dependence, we hypothesized that SZ smokers will have greater dysfunction in smoking-related insular and dACC circuits than normal control smokers (NC) independent of smoking severity, consistent with an inherent disease-related weakening of smoking-related circuits. Nicotine challenge was used to demonstrate that decreased rsFC in identified circuits reflects addiction trait and is not affected by pharmacological state. Twenty-four NC smokers and 20 smokers with SZ matched on nicotine addiction severity participated in a resting state fMRI study and were scanned during two separate sessions while receiving a placebo or nicotine patch, in a randomized, cross-over design. Using individualized, anatomically defined anterior and posterior insula and dACC as regions of interest (ROI), whole brain rsFC was performed using each ROI as a seed. Significant negative correlations between smoking severity and rsFC between insula, dACC and striatum were found for both groups. Furthermore, smokers with SZ demonstrated additive reductions in circuit strength between the dACC and insula compared to NC smokers independent of smoking severity. Nicotine challenge did not significantly alter rsFC in insula-dACC-striatal circuits. Reduced rsFC strength between the insula, dACC and striatum is associated with nicotine addiction severity in both non-psychiatrically ill and in SZ smokers. Decreased insula-dACC rsFC may index overlapping circuitry associated with smoking and SZ.
AuthorsLauren V Moran, Hemalatha Sampath, Elliot A Stein, L Elliot Hong
JournalSchizophrenia research (Schizophr Res) Vol. 142 Issue 1-3 Pg. 223-9 (Dec 2012) ISSN: 1573-2509 [Electronic] Netherlands
PMID23021898 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, N.I.H., Extramural, Research Support, N.I.H., Intramural, Research Support, Non-U.S. Gov't)
CopyrightCopyright © 2012 Elsevier B.V. All rights reserved.
Chemical References
  • Nicotine
  • Oxygen
Topics
  • Adolescent
  • Adult
  • Brain Mapping
  • Cross-Over Studies
  • Double-Blind Method
  • Female
  • Gyrus Cinguli (blood supply, drug effects, pathology)
  • Humans
  • Image Processing, Computer-Assisted
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Nicotine (pharmacology)
  • Oxygen (blood)
  • Psychiatric Status Rating Scales
  • Schizophrenia (pathology)
  • Schizophrenic Psychology
  • Smoking (physiopathology, psychology)
  • Young Adult

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