Functional brain activation changes associated with practice in delaying smoking among moderate to heavy smokers: study protocol and rationale of a randomized trial (COPE)

Andrew T Fox, Delwyn Catley, Kimber P Richter, Edward F Ellerbeck, Morgan G Brucks, Vlad B Papa, Laura E Martin, Andrew T Fox, Delwyn Catley, Kimber P Richter, Edward F Ellerbeck, Morgan G Brucks, Vlad B Papa, Laura E Martin

Abstract

Background: Most smokers struggle to overcome tobacco addiction. Neuroscientific models of addiction emphasize the importance of brain regions associated with cognitive control and reward to understand the cycle of addiction and relapse. During an attempt at abstinence, the cognitive control system appears to be underpowered to override the heightened reward system of the addicted brain. Thus, one neural target for treatment is to strengthen the cognitive control system. It may be possible to improve the functioning of the cognitive control system via deliberate practice.

Methods/design: This study will determine the effects of practicing delaying smoking on brain and behavioral measures of cognitive control. Smoking patterns will be monitored for 1 week and then smokers (N = 80) will be randomized to either practice cognitive control by delaying their first cigarette of the day for 2 weeks (practice group) or they will continue monitoring only (no practice group). Functional magnetic resonance imaging will be performed while smokers regulate their responses to smoking images (i) at baseline and (ii) after 2 weeks of practice (or no practice).

Discussion: The primary aim of this study will be to identify the impact of practicing cognitive control on functional brain activation changes in response to smoking cues. If successful, this project will establish a neurobiological biomarker for increasing cognitive control and demonstrate the feasibility of neuroimaging methods to predict the efficacy of an intervention without a large clinical trial.

Trial registration: ClinicalTrials.gov, NCT03080844 . Registered March 15, 2017.

Keywords: Functional magnetic resonance imaging; Randomized trial; Smoking; Study protocol.

Conflict of interest statement

Ethics approval and consent to participate

All study procedures will be conducted in accordance with the Code of Ethics of the World Medical Association (Declaration of Helsinki) and have been approved by the institutional review board of the University of Kansas (protocol STUDY00004095, version 0.01).

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Flow chart of enrollment, interventions, and assessments
Fig. 2
Fig. 2
Study measures and timing (SPIRIT Figure). Cigs cigarettes, MRI magnetic resonance imaging, QSU Questionnaire of Smoking Urges, UPPS-P Urgency, Premeditation, Perserverance, Sesation-Seeking, and Positive Urgencey
Fig. 3
Fig. 3
Diagram depicting scanner task

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