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Effects of varenicline and cognitive bias modification on neural response to smoking-related cues: a randomised control trial

View ORCID ProfileAngela S. Attwood, Tim M. Williams, F. Joseph McClernon, Rachel Kozink, Sally Adams, Karl Scheeres, Amy Green, David Christmas, Marcus R. Munafò
doi: https://doi.org/10.1101/480566
Angela S. Attwood
1MRC Integrative Epidemiology Unit at the University of Bristol, United Kingdom
2UK Centre for Tobacco and Alcohol Studies, University of Bristol, United Kingdom
3School of Psychological Science, University of Bristol, United Kingdom
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  • ORCID record for Angela S. Attwood
  • For correspondence: angela.attwood@bristol.ac.uk
Tim M. Williams
4Population Health Sciences, University of Bristol, United Kingdom
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F. Joseph McClernon
5Psychiatry and Behavioral Sciences, Duke University School of Medicine, USA
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Rachel Kozink
5Psychiatry and Behavioral Sciences, Duke University School of Medicine, USA
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Sally Adams
6Department of Psychology, University of Bath, United Kingdom
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Karl Scheeres
7Avon and Wiltshire Mental Health Partnership NHS Trust, United Kingdom
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Amy Green
4Population Health Sciences, University of Bristol, United Kingdom
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David Christmas
8Cambridge and Peterborough NHS Foundation Trust, United Kingdom
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Marcus R. Munafò
1MRC Integrative Epidemiology Unit at the University of Bristol, United Kingdom
2UK Centre for Tobacco and Alcohol Studies, University of Bristol, United Kingdom
3School of Psychological Science, University of Bristol, United Kingdom
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Abstract

Drug-related cognitive biases have been positively associated with drug-craving and increased likelihood of relapse. Cognitive bias modification paradigms have been developed to attenuate cognitive biases but there have been few studies that examined neural responses to these paradigms. This study compared neural responses following CBM and explored whether CBM effects were potentiated by varenicline administration. This was a double-blind placebo-controlled study with two between subject factors of drug (varenicline, placebo) and CBM (attend towards smoking cues, train away from smoking cues, control training) that recruited daily (≥ 10 cigarettes per day) non-treatment seeking smokers. Participants (n = 67, 53% female) were randomised to one-week of drug administration (varenicline or placebo) before attending a study session at which they were randomised to CBM condition, and underwent an fMRI scan were they were presented with smoking and neutral cues. Neural response to smoking (vs. neutral) cues, cognitive bias, craving and mood were assessed. There was no evidence of CBM effects on any outcomes. There was evidence of effects of varenicline on craving, with greater reductions in craving in the week preceding the study session in the varencline group (p = 0.04, ηp2 = .06). There was also evidence of a drug by CBM interaction for neural responses (z = 3.78, p <0.001). Compared to placebo, varenicline was associated with greater activation in the right temporal middle gyrus in the CBM control condition, compared to an opposite effect in the CBM “attend towards” condition. These data suggest that CBM does not modify cognitive bias, subjective craving and mood, or neural response to smoking cues. There was also no evidence that CBM effects were potentiated by varenicline.

Footnotes

  • Author email addresses: Tim Williams - tim.williams6{at}nhs.net, F. Joseph McClernon - francis.mcclernon{at}duke.edu, Rachel Kozink – rachel.kozink{at}duke.edu, Sally Adams - s.adams{at}bath.ac.uk, Karl Scheeres – karlscheeres{at}nhs.net, Amy Green – amy.green{at}bristol.ac.uk, David Christmas – david.christmas{at}cpft.nhs.uk, Marcus R. Munafò - marcus.munafo{at}bristol.ac.uk.

  • Funding: Investigator Initiated Research Grant, Pfizer Ltd. Grant number WS676950.

  • Trial Registration: Current Controlled Trials ISRCTN65690030. Date of registration: 41 30 January 2014.

  • Abbreviations

    CBM
    Cognitive bias modification
    PEQ-R
    Eysenck Personality Questionnaire-Revised
    MNWS
    Minnesota Nicotine Withdrawal Scale
    RT
    reaction time
    VAS
    visual analogue scales
  • Copyright 
    The copyright holder for this preprint is the author/funder, who has granted bioRxiv a license to display the preprint in perpetuity. It is made available under a CC-BY 4.0 International license.
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    Posted December 21, 2018.
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    Effects of varenicline and cognitive bias modification on neural response to smoking-related cues: a randomised control trial
    Angela S. Attwood, Tim M. Williams, F. Joseph McClernon, Rachel Kozink, Sally Adams, Karl Scheeres, Amy Green, David Christmas, Marcus R. Munafò
    bioRxiv 480566; doi: https://doi.org/10.1101/480566
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    Effects of varenicline and cognitive bias modification on neural response to smoking-related cues: a randomised control trial
    Angela S. Attwood, Tim M. Williams, F. Joseph McClernon, Rachel Kozink, Sally Adams, Karl Scheeres, Amy Green, David Christmas, Marcus R. Munafò
    bioRxiv 480566; doi: https://doi.org/10.1101/480566

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