Anterior cingulate proton spectroscopy glutamate levels differ as a function of smoking cessation outcome

BackgroundCigarette smoking is the leading preventable cause of death. Unfortunately, the majority of smokers who attempt to quit smoking relapse within weeks. Abnormal dorsal anterior cingulate cortex (dACC) function may contribute to tobacco smoking relapse vulnerability. Growing evidence suggests that glutamate neurotransmission is involved in mediating nicotine dependence. We hypothesized that prior to a cessation attempt, dACC glutamate levels would be lower in relapse vulnerable smokers.MethodsProton magnetic resonance spectra (MRS) were obtained from dACC and a control region, the parieto-occipital cortex (POC), using two-dimensional J-resolved MRS at 4 T and analyzed using LCModel. Nine nicotine-dependent women were scanned prior to making a quit attempt. Subjects then were divided into two groups; those able to maintain subsequent abstinence aided by nicotine replacement therapy (NRT) and those who slipped while on NRT (smoked any part of a cigarette after attaining at least 24 h of abstinence).ResultsSlip subjects exhibited significantly reduced dACC MRS glutamate (Glu/Cr) levels (p < 0.03) compared to abstinent subjects. This effect was not observed in the POC control region.ConclusionsOur preliminary findings suggest that dACC Glu levels as measured with MRS may help identify and/or be a biomarker for relapse vulnerable smokers. Future research following up on these findings may help clarify the role of dACC Glu in smoking dependence that may lead to new treatment strategies.

Research highlights►Used MRS to assess smoker dACC Glu/Cr ratios based on smoking cessation outcome. ►Lower dACC Glu/Cr in relapse-vulnerable smokers vs. abstinent smokers. ►Control region POC Glu/Cr ratios did not differ between groups. ►dACC Glu/Cr may be a neurobiological marker of smoking relapse vulnerability.