Abstract

Abstract Objective: Smoking is a leading cause of avoidable death, with the best cessation treatments yielding only 10-30% abstinence. Limited neurocognitive research is available on the best predictor of cessation: addiction severity. We investigated whether smoking severity is associated with stronger resting functional connectivity and cognitive functioning. Method: A community sample of 33 adult smokers (mean age=40.77, 72.73% female, 27.27% Black, >10 cigarettes per day [CPD]) completed 8-minutes of resting state functional MRI and the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). Default network (DN) functional connectivity was conducted using four seed/target regions. RBANS total score was operationalized as overall cognitive function. Smoking severity was operationalized as CPD. Results: Mean RBANS scores were in the average range (mean=89.76, SD=11.68) and predicted CPD (mean=20.14, SD=9.33), accounting for 20.30% of the variance (see Table). Associations between RBANS and CPD were significantly moderated by mean target region synchrony with three of four seed regions: posterior cingulate cortex (PCC), left posterior precuneus (LPP), and right posterior precuneus (RPP). Medial prefrontal cortex (MPFC) synchrony did not add to the prediction. Repeating these regressions, controlling for age, yielded the same pattern. The three DN seeds continued to yield mean target region effects that exhibited strong interactions with the RBANS to predict severity (see Table). Conclusions: DN synchrony moderates the association between cognitive function and smoking severity, such that the negative relationship between overall cognitive functioning and smoking severity is only present for those with lower levels of DN synchrony. These markers may improve understanding of neurocognitive mechanisms of smoking severity.

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