12 h abstinence-induced right anterior insula network pattern changes in young smokers

Background: The strong craving to smoke is a core factor of smoking abstinence that precipitates relapse. Insula plays critical roles in maintaining nicotine dependence, especially in the interoceptive awareness of craving. Despite evidence indicating a link between insula and abstinence-induced craving, less is known about the neural basis of abstinence-induced craving from the circuit level of insula. Methods: The present study examined the effects of 12 h of abstinence from smoking on the resting state functional connectivity (RSFC) of anterior (AI) and posterior insula in young smokers using a within-subject design. Thirty-three young male smokers underwent functional magnetic resonance imaging scanning on two separate sessions: (1) smoking satiety and (2) abstinence (after 12 h of smoking deprivation), in counterbalanced order. Multiple regression analysis was applied to investigate the possible relationships between the RSFC changes of insula (abstinence minus satiety) and the abstinence-induced craving changes. Results: Smoking abstinence state (versus satiety) was associated with increased RSFC between right AI and right medial orbitofrontal cortex (OFC), ventromedial prefrontal cortex as well as anterior cingulate cortex. The abstinence-induced RSFC changes between right AI and right lateral OFC was significantly correlated with the craving changes. Conclusions: These findings improve the understanding of the effects of short-term smoking abstinence on insula circuit connectivity and may contribute new insights into the neural basis of abstinence-induced craving to smoke.