Abstract Objective: Compared to the general population, tobacco smoking cessation rates are lower in populations with schizophrenia. Unfortunately, the potential neurophysiologic mechanisms underlying these low cessation rates in schizophrenia have been seldom studied using functional neuroimaging. Recently, it has been shown that tobacco cravings are increased in smokers with schizophrenia compared to smokers with no comorbid psychiatric disorder. Given the critical role of the brain reward system in the neurobiology of addiction, we sought to examine the functional connectivity of core regions of this system in smokers with schizophrenia during the viewing of appetitive smoking cues. Methods: Smokers with (n = 18) and without (n = 24) schizophrenia were scanned using functional magnetic resonance imaging while viewing appetitive cigarette images. Functional connectivity analyses were performed using the bilateral nucleus accumbens as the seed regions. Results: Smokers with schizophrenia and smokers with no psychiatric comorbidity did not differ in subjective cravings in response to appetitive smoking cues. However, in smokers with schizophrenia relative to control smokers, we found an increased connectivity between the nucleus accumbens and regions involved in the default mode network (e.g., middle temporal gyrus and precuneus), which are involved in self-referential processes. Moreover, a positive correlation was observed between the left nucleus accumbens and left middle temporal gyrus connectivity and cigarette cravings across both groups of smokers. Conclusions: These results highlight a key role of the nucleus accumbens in cigarette craving in schizophrenia and suggest that the subjective valuation of cigarette cues is increased in this population. Similar neurofunctional studies on cravings for other psychoactive substances in schizophrenia are warranted.

中文翻译：

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精神分裂症患者在吸烟渴望期间伏隔核和默认模式网络之间的连接增加

摘要 目的：与一般人群相比，精神分裂症人群的戒烟率较低。不幸的是，很少使用功能性神经影像学研究精神分裂症这些低戒断率背后的潜在神经生理机制。最近，已经表明，与没有共存精神疾病的吸烟者相比，患有精神分裂症的吸烟者对烟草的渴望增加。鉴于大脑奖励系统在成瘾神经生物学中的关键作用，我们试图在观察食欲吸烟线索期间检查精神分裂症吸烟者该系统核心区域的功能连通性。方法：使用功能性磁共振成像扫描有（n = 18）和没有（n = 24）精神分裂症的吸烟者，同时查看有食欲的香烟图像。使用双侧伏隔核作为种子区域进行功能连接分析。结果：患有精神分裂症的吸烟者和没有精神共病的吸烟者在对食欲吸烟线索的主观渴望方面没有差异。然而，在精神分裂症吸烟者中，相对于对照组吸烟者，我们发现伏隔核和参与默认模式网络（例如，颞中回和楔前叶）的区域之间的连接增加，这些区域参与自我参照过程。此外，在两组吸烟者中观察到左侧伏隔核和左侧颞中回连通性与对香烟的渴望之间存在正相关。结论：这些结果突出了伏隔核在精神分裂症患者对香烟的渴望中的关键作用，并表明该人群对香烟线索的主观评价有所增加。有必要对精神分裂症患者对其他精神活性物质的渴望进行类似的神经功能研究。