Abstract
Smoking and stress cooccur in different stages of a nicotine addiction cycle, affecting brain function and showing additive impact on different physiological responses. Resting-state functional connectivity has shown potential in identifying these alterations. Nicotine addiction has been associated with detrimental effects on functional integrity of the central nervous system, including the organization of resting-state networks. Prolonged stress may result in enhanced activation of the default mode network (DMN). Considering that biofeedback has shown promise in alleviating physiological manifestations of stress, we aimed to explore the possible neuroplastic effects of biofeedback training on smokers. Clinical, behavioral, and neurophysiological (resting-state EEG) data were collected from twenty-seven subjects before and after five sessions of skin temperature training. DMN functional cortical connectivity was investigated. While clinical status remained unaltered, the degree of nicotine dependence and psychiatric symptoms were significantly improved. Significant changes in DMN organization and network properties were not observed, except for a significant increase of information flow from the right ventrolateral prefrontal cortex and right temporal pole cortex towards other DMN components. Biofeedback aiming at stress alleviation in smokers could play a protective role against maladaptive plasticity of connectivity. Multiple sessions, individualized interventions and more suitable methods to promote brain plasticity, such as neurofeedback training, should be considered.
Highlights
Resting-state brain activity involves the recruitment and activation of a number of subcomponents of the brain, such as the visual (VN), salience (SN), ventral and dorsal attention (VAN and DAN), sensorimotor (SMN), frontoparietal control (FPCN), and cinguloopercular control networks (COCN) [1, 2]
The goal of the present study was to investigate whether a biofeedback intervention that aims to alleviate the stress induced during a smoking-cessation attempt might play a protective role, affecting the reorganization of the resting-state cortical networks
The behavioral data showed mixed results; while depressive and anxiety symptomatology were not significantly reduced, significant improvement was observed in the degree of nicotine dependence and the psychiatric symptomatology of the subjects
Summary
Resting-state brain activity involves the recruitment and activation of a number of subcomponents of the brain, such as the visual (VN), salience (SN), ventral and dorsal attention (VAN and DAN), sensorimotor (SMN), frontoparietal control (FPCN), and cinguloopercular control networks (COCN) [1, 2]. A chronic smoking habit has been associated with negative functional and structural effects on the central nervous system These effects include decreased neurocognitive capacity, as well as the atrophy of grey and white matter of the brain in frontal, prefrontal, cingulate, temporal, and frontoparietal sites, among others [6]. Heavy smokers showed lower global efficiency of both whole-brain network and DMN, as well as increased clustering and greater path lengths [7] These changes were associated with the severity and duration of smoking-habit abuse. DMN connectivity appears to show some impairment and decrease in smokers [4, 5, 9] but other functional brain networks, especially those involved in executive functions and cognition, are affected by the addiction [9, 10]
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