Abstract
Introduction: Impairments in the multifaceted neuropsychological construct of cognitive impulsivity are a main feature of chronic tobacco smokers. According to the literature, these cognitive impairments are relevant for the initiation and maintenance of the smoking behavior. However, the neuroanatomical correlates of cognitive impulsivity in chronic smokers remain under-investigated.Methods: A sample of 28 chronic smokers (mean age = 28 years) not affected by polysubstance dependence and 24 matched non-smoker controls was recruited. Voxel Based Morphometry (VBM) was employed to assess Gray Matter (GM) volume differences between smokers and non-smokers. The relationships between GM volume and behavioral manifestations of impulsive choices (5 trial adjusting delay discounting task, ADT-5) and risky decision making (Cambridge Gambling Task, CGT) were also investigated.Results: VBM results revealed GM volume reductions in cortical and striatal brain regions of chronic smokers compared to non-smokers. Additionally, smokers showed heightened impulsive choices (p < 0.01, Cohen's f = 0.50) and a riskier decision- making process (p < 0.01, Cohen's f = 0.40) compared to non-smokers. GM volume reductions in the left Anterior Cingulate Cortex (ACC) correlated with impaired impulsive and risky choices, while GM volume reductions in the left Ventrolateral Prefrontal Cortex (VLPFC) and Caudate correlated with heightened impulsive choices. Reduced GM volume in the left VLPFC correlated with younger age at smoking initiation (mean = 16 years).Conclusion: Smokers displayed significant GM volume reductions and related cognitive impulsivity impairments compared to non-smoker individuals. Longitudinal studies would be required to assess whether these impairments underline neurocognitive endophenotypes or if they are a consequence of tobacco exposure on the adolescent brain.
Highlights
Impairments in the multifaceted neuropsychological construct of cognitive impulsivity are a main feature of chronic tobacco smokers
The current study provides support to the findings of Durazzo et al [21] by revealing a correlation between GM volume reductions in the left ACC and risky decision making in chronic smokers
The current study revealed a positive association between GM volume reductions in the left ACC and the inability to delay gratification displayed by chronic smokers (ED50 values)
Summary
Impairments in the multifaceted neuropsychological construct of cognitive impulsivity are a main feature of chronic tobacco smokers. Choice impulsivity refers to the tendency to opt for immediate pleasures/rewards (e.g., drug of abuse) over long- term gains (e.g., long-term health) [4], while “risky decision making” refers to a type of decisional process occurring when a an individual engages in decisions despite the risk of suffering known adverse consequences. Both cognitive impaired processes are strongly predictive of treatment outcomes for substance use and dependence, including tobacco smoking cessation treatments [8, 9]. Tobacco smokers displaying heightened impulsive choices (high delay discounting rates) are likely to relapse and to jeopardize cessation attempts [10, 11]
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