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In the present study, we aimed to investigate the difference in white matter between smokers and nonsmokers. In addition, we examined relationships between white matter integrity and nicotine dependence parameters in smoking subjects. Nineteen male smokers were enrolled in this study. Eighteen age-matched non-smokers with no current or past psychiatric history were included as controls. Diffusion tensor imaging scans were performed, and the analysis was conducted using a tract-based special statistics approach. Compared with nonsmokers, smokers exhibited a significant decrease in fractional anisotropy FA throughout the whole corpus callosum. There were no significant differences in radial diffusivity or axial diffusivity between the two groups. These results suggest that the corpus callosum may be one of the key areas influenced by chronic smoking. This is an open-access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Ltd in The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Competing interests: The authors have the following interests: This study was supported by Dainippon Sumitomo Pharma Co. There are no patents, products in development or marketed products to declare. The most prevalent substance dependence issue worldwide is tobacco smoking. Smoking leads to serious public health problems and preventable early deaths \[1\]. In neuroimaging researches, smoking has been associated with large-scale structural brain alterations \[2\] , \[3\] , \[4\]. Particularly, recent voxel-based morphometry VBM study, smoking was associated with reductions in cerebral grey matter in the prefrontal, anterior cingulate, parietal, and temporal cortices and the cerebellum \[3\] \[4\]. There was an inverse relationship between cortical volume or cortical thickness and exposure to smoking \[3\] \[5\]. Furthermore, lower gray matter density in the prefrontal cortex and higher density in the insula have also been observed in smokers \[6\]. In short, the results of previous studied were consistent. Diffusion tensor imaging DTI is sensitive to water diffusion characteristics and has been developed as a tool for investigating the local properties of brain white matter \[7\]. There are three diffusion metrics derived from DTI data: fractional anisotropy FA , which reflects the directionality of water diffusion and the coherence of white matter fiber tracts; axial diffusivity AD , which measures the magnitude of diffusivity along the principle diffusion direction; and radial diffusivity RD , which reflects the magnitude of diffusivity perpendicular to the principle diffusion direction \[8\] \[9\]. In a previous study, higher FA was measured in the corpus callosum of smokers compared with age-matched nonsmokers \[10\]. Jacobsen et al. In this study, both prenatal exposure and adolescent exposure to tobacco smoke was associated with increased FA in the anterior cortical white matter. Adolescent smoking was also associated with increased FA in regions of the internal capsule that contain auditory thalamocortical and corticofugal fibers. Thus, the effect of smoking on FA was inconsistent, and the regions affected were various. The novel voxel-wise approach of tract-based spatial statistics TBSS was recently introduced \[12\] , restricting the evaluation of diffusion parameters to a white matter skeleton common to all subjects. Therefore, there has not been a consensus about the method to spatially normalize FA images and the size of the smoothing kernel. To overcome these problems TBSS has been proposed \[12\]. To date, only two studies existed investigated white matter in smokers using TBSS. First, Zhang et al. Second, Lin et al. The results of two former studies were controversial, and the influence of smoking on white matter still remains unclear. The objectives of the current study were 1 to investigate differences between smokers and nonsmokers in white matter, and 2 to examine relationships between white matter integrity and nicotine dependence parameters in the smokers. Twenty smokers met the DSM-IV criteria for nicotine dependence; the score on the Tobacco Dependence Screener Scale TDS was used to diagnose nicotine dependence \[15\] The exclusion criteria included a current or past history of any comorbid neurological disorder, significant medical conditions, abnormal results on laboratory screening tests, or addiction to alcohol or other substances with the exception of nicotine. Finally, nineteen males were enrolled of this study. As part of the initial clinical evaluation, all smokers were asked to complete baseline questionnaires that assessed detailed demographic information and smoking-related clinical variables. The expiratory carbon monoxide CO levels of the smokers were measured using the Smokerlyzer system Bedfont Scientific Ltd. Twenty age-matched nonsmokers with no current or past psychiatric history were included as controls. Finally, eighteen males were enrolled of this study. All the participants gave written informed consent to participate in the study. The diffusion properties were measured along 25 noncollinear directions. Image processing for VBM, a fully automatic technique for the computational analysis of differences in regional brain volume throughout the entire brain, was conducted using SPM8. Age was treated as confounding covariates. In an intensity modulation step, the voxel values of the segmented images were multiplied by the measure of warped and unwarped structures derived from the nonlinear step of the spatial normalization. This step converted the relative regional GM and WM density into absolute volume, expressed as the amount of per-unit volume of brain tissue before spatial normalization. An analysis of covariance model was used to examine group differences in GM and WM, with age as a covariate. Topological false discovery rate FDR correction was applied. Brain extraction was performed using the Brain Extraction Tool 2. The FA data for all the subjects were aligned into a common space via nonlinear registration \[27\]. Next, a mean FA image was created and thinned to create a mean FA skeleton representing the centers of all tracts common to the group. The number of permutations was set to 20, in all voxel-wise analyses. Diffusion tensors were computed, and fiber tracts were created by interpolation along the z-axis to obtain data voxel size 2. Fiber tracts were based on a fiber assignment that was made using the continuous tracking approach \[29\] to obtain a three-dimensional tract reconstruction. The fiber tracts were initiated by placing a seed area in the anatomical regions through which the particular fibers were expected to course \[26\]. Tract measurements of the corpus callosum were performed by one of the authors K. Voxelization along the corpus callosum was then performed. To reduce the partial volume effect of the peripheral portion of the tract and to eliminate small incidental artifactual lines, we used a shape-processing technique based on mathematical morphology \[28\]. In this shape-processing technique, we dilated the voxels once and eroded them twice. The FA values in coregistered voxels were calculated. All statistical analyses were conducted using SAS Version 9. The Mann-Whitney U test and the chi-squared test were used to compare the variables between the smokers and nonsmokers. All were males and there was no significant difference in the distributions of age Smokers: The mean AUDIT score for the smokers was significantly higher compared to that of the nonsmokers smokers: 9. There was no significant difference in the global brain volume total gray matter and total white matter between the smokers and the nonsmokers Table 1. The regional volumetric analysis showed no significant group difference in any regions. Compared with the nonsmokers, the smokers exhibited a significant decrease in FA throughout the corpus callosum Figure 1. There were no significant differences in AD or RD. The red voxels represent the areas where the fractional anisotropy FA levels of smokers were significantly reduced with respect to those of nonsmokers. Compared with nonsmokers, the smokers exhibited a significant decrease in FA throughout the whole corpus callosum. The current study provides novel evidence of decreased FA throughout the whole corpus callosum in smokers. Based on this result, we evaluated the relationship between FA levels of corpus callosum and smoking-related clinical variables using tract-specific analysis. This analysis has the advantage of detecting abnormalities in specific white matter tracts, whereas TBSS can influence the outcome by multiple comparisons \[30\]. We found a significant inverse correlation between FA levels and the amount of tobacco consumptions. Our finding is concordant with the results of Lin et al. It is generally believed that AD mainly reflects axonal integrity \[31\] and RD is more related to the integrity and thickness of the myelin sheaths covering the axons \[32\]. And the decreased FA in corpus callosum of smokers is likely the manifestation of axonal damage and disrupted myelin integrity in the region. In other words, not much amount of smoking might influence only in FA. Zhang et al. This inconsistency may arise from the comorbidity of psychiatry disorder in a part of our samples both smokers and healthy controls. The corpus callosum connects the brain hemispheres and facilitates communication between left- and right-side brain structures; it is the largest white matter fiber tract connecting the neocortex of the two hemispheres \[34\]. The anterior parts of the corpus callosum connect the frontal cortices, while the body and the splenium connect the parietal, temporal, and occipital homotopic regions \[35\]. Compromised fiber connectivity within the corpus callosum has been previously reported in subjects with substance addictions \[36\]. Decreased FA in the genu, body and splenium of the corpus callosum has been associated with alcohol-dependent subjects \[37\]. Significant reductions in FA in the genu and rostral body \[38\] and in the body and splenium of the corpus callosum \[39\] have been reported in cocaine-dependent subjects. Methamphetamine abusers showed reduced white matter integrity in the genu \[40\] and the rostral body \[41\] of the corpus callosum. There was a significant reduction in FA in the genu and the isthmus of the corpus callosum in opiate-dependent subjects \[42\]. Qiu et al. Taken together, these findings suggest that substance abuse may be associated with reduced FA levels that reflect less microstructural integrity. In contrast, Paul et al. The authors hypothesized that either nicotine-induced cytotoxic cell swelling secondary to nicotine-induced osmotic imbalances or vasogenic swelling characterized by plasma fluid leaking into the parenchymal interstitial space might lead to alterations in the white matter. According to Hudkins et al. Negative correlations between the age at which the subjects began smoking and FA have been observed \[41\]. Our finding in the present study is in accordance with that of Hudkins et al. The subjects of Lin et al. The reason of discrepancy about location of corpus callosum between whole corpus callosum in this study and anterior corpus callosum in Lin et al. There were several limitations to our study. First, the sample size was small and this might lead absence of finding a change in the frontal cortex in the RD and AD Second, we did not evaluate healthy controls using any structured interviewed. Therefore, we might not completely exclude comorbidity psychiatric disorders among both samples. Taking together, it is not ruled out that cigarette smoking increases alcohol consumptions, which might influence the results. Forth, we did not measure plasma levels of nicotine and cotinine, a metabolite of nicotine. We are currently undergoing the new study taking account of above problems. In conclusion, we found that FA in smokers was significantly decreased compared with that of nonsmokers. Moreover, an inverse correlation between the amount of cigarette smoking and FA throughout the whole corpus callosum, which may shed light on the vulnerability of the region after long-term exposure in nicotine. Browse Subject Areas? Click through the PLOS taxonomy to find articles in your field. Abstract In the present study, we aimed to investigate the difference in white matter between smokers and nonsmokers. Introduction The most prevalent substance dependence issue worldwide is tobacco smoking. Methods Participants Twenty smokers met the DSM-IV criteria for nicotine dependence; the score on the Tobacco Dependence Screener Scale TDS was used to diagnose nicotine dependence \[15\] The exclusion criteria included a current or past history of any comorbid neurological disorder, significant medical conditions, abnormal results on laboratory screening tests, or addiction to alcohol or other substances with the exception of nicotine. Download: PPT. Total Volumes There was no significant difference in the global brain volume total gray matter and total white matter between the smokers and the nonsmokers Table 1. Figure 2. Discussion The current study provides novel evidence of decreased FA throughout the whole corpus callosum in smokers. References 1. Benowitz NL Clinical pharmacology of nicotine: implications for understanding, preventing, and treating tobacco addiction. Clin Pharmacol Ther — View Article Google Scholar 2. Handb Exp Pharmacol: — Biol Psychiatry 77— View Article Google Scholar 4. Eur J Neurosci — View Article Google Scholar 5. Biol Psychiatry — View Article Google Scholar 6. Neuroimage 42— View Article Google Scholar 7. Nat Rev Neurosci 4: — View Article Google Scholar 8. J Magn Reson B — View Article Google Scholar 9. Neuroimage — View Article Google Scholar Nicotine Tob Res — J Neurosci — Zhang X, Stein EA, Hong LE Smoking and schizophrenia independently and additively reduce white matter integrity between striatum and frontal cortex. Lin F, Wu G, Zhu L, Lei H Heavy smokers show abnormal microstructural integrity in the anterior corpus callosum: a diffusion tensor imaging study with tract-based spatial statistics. Drug Alcohol Depend 82— Addict Behav — J Clin Psychiatry 59 Suppl 22—33;quiz 34— Br J Addict — Alcohol Clin Exp Res — Nihon Arukoru Yakubutsu Igakkai Zasshi — Haselgrove JC, Moore JR Correction for distortion of echo-planar images used to calculate the apparent diffusion coefficient. Magn Reson Med — Magn Reson Imaging — Ashburner J A fast diffeomorphic image registration algorithm. Neuroimage 95— Neuroimage 23 Suppl 1S— Smith SM Fast robust automated brain extraction. Hum Brain Mapp — Eur J Radiol 53— Mori S. Elisevier, Amsterdam. Eur Radiol — J Neuropathol Exp Neurol — J Comput Assist Tomogr — Neuropsychobiology — Neuropsychopharmacology — Drug Alcohol Depend — Am J Drug Alcohol Abuse — Addict Biol — PLoS One 8: e Psychopharmacology Berl — View Article Google Scholar.
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