Elsevier

Biological Psychiatry

Volume 67, Issue 8, 15 April 2010, Pages 745-752
Biological Psychiatry

Archival Report
Nicotine Dependence Is Characterized by Disordered Reward Processing in a Network Driving Motivation

https://doi.org/10.1016/j.biopsych.2009.10.029Get rights and content

Background

Drug addiction is characterized by an unhealthy priority for drug consumption with a compulsive, uncontrolled drug-intake pattern due to a disordered motivational system. However, only some individuals become addicted, whereas others maintain regular but controlled drug use. Whether the transition occurs might depend on how individuals process drug relative to nondrug reward.

Methods

We applied functional magnetic resonance imaging to measure mesocorticolimbic activity to stimuli predicting monetary or cigarette reward, together with behavioral assessment of subsequent motivation to obtain the respective reward on a trial-by-trial basis, in 21 nicotine-dependent and 21 nondependent, occasional smokers.

Results

Occasional smokers showed increased reactivity of the mesocorticolimbic system to stimuli predicting monetary reward relative to cigarette reward and subsequently spent more effort to obtain money. In the group of dependent smokers, we found equivalent anticipatory activity and subsequent instrumental response rates for both reward types. Additionally, anticipatory mesocorticolimbic activation predicted subsequent motivation to obtain reward.

Conclusions

This imbalance in the incentive salience of drug relative to nondrug reward-predicting cues, in a network that drives motivation to obtain reward, could represent a central mechanism of drug addiction.

Section snippets

Subjects

We recruited 51 participants. Three occasional and six dependent smokers were excluded because of noncompliance with study requirements. The final sample consisted of 21 dependent and 21 occasional smokers with comparable age and smoking onset (for details, see Table S1 in Supplement 1). Inclusion criteria for dependent smokers were a score in the Fagerström Test for Nicotine Dependence (FTND) (13) greater than 5 and a diagnosis of nicotine dependence according to DSM-IV (14). Smokers were not

Results

Subject data, physiologic measures, and ratings on the subjective importance of reward are presented in Table S1 in Supplement 1.

Discussion

In line with our hypothesis, mesocorticolimbic activity data during performance of an instrumental motivation task suggest that the incentive salience of drug- relative to nondrug-reward-predicting stimuli differed between dependent and nondependent, occasional smokers. Nondrug-reward-predicting stimuli possessed higher incentive salience only for the group of nondependent, occasional smokers, reflected in higher reactivity of the mesocorticolimbic system to stimuli predicting monetary reward

Conclusion

This imbalance in the incentive salience of drug- relative to nondrug-reward-predicting stimuli in dependent compared with nondependent smokers in a network that drives subsequent motivation to obtain the respective reward could represent a central mechanism of nicotine addiction. Our results suggest that preventive approaches and therapeutic treatments that aim to enhance the salience of nondrug-reward-predicting stimuli in addicts could be effective in relapse prevention. Prospective studies

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