Table_4_Neuroanatomical Correlates of Impulsive Choices and Risky Decision Making in Young Chronic Tobacco Smokers: A Voxel-Based Morphometry Study.docx

Introduction: Impairments in the multifaceted neuropsychological construct of cognitive impulsivity are a main feature of chronic tobacco smokers. According to the literature, these cognitive impairments are relevant for the initiation and maintenance of the smoking behavior. However, the neuroanatomical correlates of cognitive impulsivity in chronic smokers remain under-investigated.
Methods: A sample of 28 chronic smokers (mean age = 28 years) not affected by polysubstance dependence and 24 matched non-smoker controls was recruited. Voxel Based Morphometry (VBM) was employed to assess Gray Matter (GM) volume differences between smokers and non-smokers. The relationships between GM volume and behavioral manifestations of impulsive choices (5 trial adjusting delay discounting task, ADT-5) and risky decision making (Cambridge Gambling Task, CGT) were also investigated.
Results: VBM results revealed GM volume reductions in cortical and striatal brain regions of chronic smokers compared to non-smokers. Additionally, smokers showed heightened impulsive choices (p < 0.01, Cohen's f = 0.50) and a riskier decision- making process (p < 0.01, Cohen's f = 0.40) compared to non-smokers. GM volume reductions in the left Anterior Cingulate Cortex (ACC) correlated with impaired impulsive and risky choices, while GM volume reductions in the left Ventrolateral Prefrontal Cortex (VLPFC) and Caudate correlated with heightened impulsive choices. Reduced GM volume in the left VLPFC correlated with younger age at smoking initiation (mean = 16 years).
Conclusion: Smokers displayed significant GM volume reductions and related cognitive impulsivity impairments compared to non-smoker individuals. Longitudinal studies would be required to assess whether these impairments underline neurocognitive endophenotypes or if they are a consequence of tobacco exposure on the adolescent brain.

引言：认知冲动性这一多维度神经心理学构念的损伤，是慢性烟草吸烟者的典型特征之一。已有研究表明，此类认知损伤与吸烟行为的启动及维持紧密相关。然而，慢性吸烟者认知冲动性的神经解剖学关联仍未得到充分研究。
研究方法：本研究招募了28名无多物质依赖史的慢性吸烟者（平均年龄28岁），以及24名人口学特征匹配的非吸烟对照。采用基于体素的形态测量学（Voxel Based Morphometry, VBM）评估吸烟者与非吸烟者的灰质（Gray Matter, GM）体积差异。同时探究了灰质体积与冲动性选择行为表现（5试次调整延迟折扣任务，5 trial adjusting delay discounting task, ADT-5）及风险决策行为（剑桥赌博任务，Cambridge Gambling Task, CGT）之间的关联。
研究结果：基于体素的形态测量学分析结果显示，与非吸烟者相比，慢性吸烟者的皮层及纹状体脑区存在灰质体积减少现象。此外，与非吸烟者相比，吸烟者表现出更显著的冲动性选择行为（p < 0.01，科恩f值=0.50）及风险决策倾向（p < 0.01，科恩f值=0.40）。左侧前扣带回皮层（Anterior Cingulate Cortex, ACC）的灰质体积减少与冲动性及风险选择损伤相关；左侧腹外侧前额叶皮层（Ventrolateral Prefrontal Cortex, VLPFC）及尾状核的灰质体积减少与冲动性选择行为增强相关。左侧腹外侧前额叶皮层的灰质体积减少与更早的吸烟启动年龄（平均16岁）呈显著相关。
研究结论：与非吸烟者相比，慢性吸烟者存在显著的灰质体积减少及相关的认知冲动性损伤。未来需开展纵向研究，以明确此类损伤是否为神经认知内表型，或是烟草暴露对青少年大脑造成的后果。