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Neuroimaging to detect brain network differences among heavy drinking smokers treated with different cessation aids

Institution: University of California, Los Angeles
Investigator(s): Aaron Lim,
Award Cycle: 2019 (Cycle 29) Grant #: T29DT0371 Award: $45,058
Subject Area: Neuroscience of Nicotine Addiction and Treatment
Award Type: Dissertation Awards

Initial Award Abstract
Heavy drinking smokers are a sizeable group of smokers who experience significant difficulties in quitting smoking and reducing drinking. Varenicline (VAR) and Naltrexone (NTX) are effective smoking cessation and drinking reduction aids, respectively. There is emerging evidence that a combination of Varenicline and Naltrexone (VAR+NTX) may be an effective smoking cessation treatment for heavy drinking smokers. No large clinical trials, however, have examined this combination medication.

There is also little known about the neural effects of these medications. We will employ an advanced imaging technique, dynamic functional connectivity (dFC) analyses, to capture acute temporal changes in connectivity between brain networks. This helps overcome limitations of commonly used methods in neuroscience of addiction, which rely on averaged, static connectivity analyses. Recent work suggests that static connectivity of three brain networks called the salience (SN), default mode (DMN) and executive control (ECN) networks are predictive of cessation outcome. Little is known how predictions based on such static connectivity patterns compare to those based on dFC. Further, no studies have examined the potential effects of alcohol and smoking cessation medications on such dynamic predictive patterns. Examination of dFC may identify a neural signature of brain connectivity response to VAR and VAR+NTX.

The proposed project will examine whether heavy drinking smokers assigned to VAR or VAR+NTX exhibit differences in brain connectivity, and whether such differences are predictive of smoking cessation. This proposal adds a functional magnetic resonance imaging component to an ongoing R01 clinical trial comparing effects of VAR versus VAR+NTX on smoking cessation milestones through 6-month post-quit. The proposed study will recruit 50 participants from this parent study for one imaging session to occur once target medication dose is reached. Analyses will compare the effects of medication conditions on dFC states, focusing on brain networks connectivity within the salience network, and test whether medication differences in dFC predict differences in cessation outcomes.