Increased Functional Connectivity in an Insula-Based Network is Associated with Improved Smoking Cessation Outcomes

Area of Science:

• Neuroscience
• Addiction Research
• Neuroimaging

Background:

• Smoking cessation neurobiology is poorly understood.
• The insula plays a key role in linking tobacco craving awareness to brain networks motivating smoking.

Purpose of the Study:

• To investigate differences in insula-based functional connectivity between smokers who relapsed and those who did not during a quit attempt.

Main Methods:

• 85 smokers underwent resting-state functional connectivity scans.
• Participants were randomized into two groups for 30 days before a quit date.
• Insula subdivisions served as seed regions for connectivity analysis.

Main Results:

• The nonrelapsed group exhibited greater functional connectivity between the whole insula and bilateral pre/postcentral gyri compared to the relapsed group.
• This effect was specifically localized to the posterior insula seed regions.
• Weaker posterior insula connectivity was associated with relapse vulnerability.

Conclusions:

• Relapse vulnerability in smoking cessation is linked to reduced functional connectivity between the posterior insula and sensorimotor cortices.
• Enhanced connectivity may improve the ability to inhibit motor responses to cravings.
• Findings support a positive relationship between insula connectivity and smoking cessation success.