3 - (OP2) Neuroimaging Study of Cbt-based Smoking Cessation

Dynamic lateralization is closely related to cognitive function and affective states; however, research investigating brain dynamic lateralization specifically in individuals with tobacco use disorder remains absent. Cognitive Behavioral Therapy (CBT)-based smoking cessation interventions are considered among the most empirically supported and efficacious psychological treatments, yet their precise neural mechanisms are not well understood. A detailed investigation into the treatment efficacy and neuroimaging correlates of CBT-based cessation interventions is crucial for reducing relapse rates. This study therefore aims to explore the intervention's efficacy and its underlying neuroimaging signatures by examining dynamic brain lateralization in individuals with tobacco use disorder in conjunction with a CBT-based intervention.
The study enrolled 87 individuals diagnosed with tobacco use disorder and 48 healthy control participants. All participants completed clinical assessments, neuroimaging data acquisition, and biochemical verification of smoking status. Following the baseline assessment, 47 individuals with tobacco use disorder, based on their stated willingness to quit, were enrolled in a 4-week online CBT-based smoking cessation intervention. A follow-up assessment was conducted at the end of the fourth week post the designated quit day. A sliding time-window approach was applied to map time-varying lateralization patterns and assess brain functional activity. Independent samples t-tests were used to compare differences in dynamic lateralization indices between the intervention group and healthy controls, while paired t-tests were used for pre- versus post-intervention comparisons within the intervention group. Pearson correlation analysis was performed to examine relationships between changes in dynamic lateralization metrics and clinical characteristics.
The 4-week continuous abstinence rate following the CBT-based intervention was 42.6%. At baseline, individuals with tobacco use disorder exhibited widespread abnormalities in dynamic lateralization across multiple brain regions, primarily characterized by reduced laterality fluctuations (LF). Affected regions included the left anterior cingulate cortex, medial prefrontal cortex, sensorimotor area, inferior frontal area, primary auditory cortex, frontal operculum/orbitofrontal cortex, and dorsolateral prefrontal cortex, as well as the right sensorimotor area and visual association area. Furthermore, LF in the right sensorimotor area was negatively correlated with daily cigarette consumption and craving scores; LF in the right auditory association area correlated negatively with craving; LF in the dorsolateral prefrontal cortex correlated negatively with craving; and LF in the left sensorimotor area correlated negatively with daily cigarette consumption. Post-intervention, compared to healthy controls, the intervention group exhibited significantly abnormal LF only in the right primary auditory cortex and the left premotor cortex.
Individuals with tobacco use disorder exhibit altered dynamic lateralization involving multiple brain regions.