Auricular electro-acupuncture for smoking cravings in young smokers with nicotine dependence: A pilot fMRI study

This pilot study aims to evaluate the efficacy of auricular electro-acupuncture (AEA) for smoking cravings induced by quitting in young smokers and to investigate the underlying neural mechanism using functional magnetic resonance imaging (fMRI).

We recruited 16 young participants with nicotine dependence (ND) and 15 matched healthy non-smoking controls (HCs). ND participants were treated with AEA for 4 weeks, and underwent brain fMRI scanning following 24-hour abstinence, 20 min of smoking satisfaction, after 1 week, and 4 weeks of AEA treatment. HCs underwent a single fMRI scanning. Fractional Amplitude of Low-Frequency Fluctuations (fALFF) was assessed.

Compared with HCs, fALFF values in ND participants following 24-hour abstinence decreased in the bilateral anterior cerebellar lobes (ACL), anterior cingulate cortex (ACC) and central tegmental area (CTA) /insula (P < 0.05). However, after 20 min of smoking satisfaction, fALFF values for ACC and bilateral ACL significantly increased (P < 0.05). Compared to 24-hour abstinence, the fALFF value of ACC and cerebellum in ND group significantly increased after 4 weeks of AEA treatment (P < 0.05). Compared to baseline, both smoking cravings (t = 3.87, P < 0.01) and nicotine dependence levels (t = 3.83, P < 0.01) showed significant reductions after 4 weeks of AEA treatment.

The results of this pilot study indicate that AEA may be effective in suppressing smoking cravings and alleviating nicotine dependence. ACC, cerebellum, CTA, and insula may be involved in modulating smoking cravings. AEA may inhibit cravings through regulating the functional activity of ACC and cerebellum.