ArticlePsychopharmacology2013
Insula's functional connectivity with ventromedial prefrontal cortex mediates the impact of trait alexithymia on state tobacco craving.
Article in Psychopharmacology, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 62 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
62 citing papers in PubMed, 1 synthesis or guideline pooled it, 87 citations in OpenAlex.
- Sleep disorders and structural alterations in brain regions linked with motivation: a neuroimaging meta-analysis.Scientific reports · 2026Pooled it
- Transcranial Direct Current Stimulation Applied to the Dorsolateral and Ventromedial Prefrontal Cortices in Smokers Modifies Cognitive Circuits Implicated in the Nicotine Withdrawal Syndrome.Biological psychiatry. Cognitive neuroscience and neuroimaging · 2020Trial
- Functional network connectivity predicts treatment outcome during treatment of nicotine use disorder.Psychiatry research. Neuroimaging · 2017Trial
- Neural Signatures of Cognitive Flexibility and Reward Sensitivity Following Nicotinic Receptor Stimulation in Dependent Smokers: A Randomized Trial.JAMA psychiatry · 2017Trial
- Repetitive transcranial magnetic stimulation (rTMS) of the dorsolateral prefrontal cortex reduces resting-state insula activity and modulates functional connectivity of the orbitofrontal cortex in cigarette smokers.Drug and alcohol dependence · 2017Trial
- Effects of Varenicline on Neural Correlates of Alcohol Salience in Heavy Drinkers.The international journal of neuropsychopharmacology · 2015Trial
- Resting-state functional connectivity and alexithymia: Preliminary predictive evidence.Journal of affective disorders · 2026Article
- Determinants of Repetitive Transcranial Magnetic Stimulation Efficacy in Tobacco Use Disorder: A Pre-Registered Study.medRxiv : the preprint server for health sciences · 2026Article
- Modulating cue-induced craving in alcohol dependence syndrome: A functional magnetic resonance imaging blood oxygen level-dependent activation study of adjunctive cathodal high-definition transcranial direct current stimulation over the insula.Indian journal of psychiatry · 2026Article
- How alexithymia shapes functional networks: Insights from a general population study.European psychiatry : the journal of the Association of European Psychiatrists · 2026Article
- Positive Emotion Regulation in Addiction: A New Frontier for Recovery Science.Current addiction reports · 2026Review
- Psychosomatic Profiles and Their Association with Health Behaviors in Patients with Inflammatory Bowel Disease (IBD) and Low Disease Activity.Journal of clinical medicine · 2025Article
- Regulation of craving and underlying resting-state neural circuitry predict hazard of smoking lapse.Translational psychiatry · 2025Article
- Childhood abuse and craving in methamphetamine-dependent individuals: the mediating role of alexithymia.European archives of psychiatry and clinical neuroscience · 2025Article
- Insular cortex subregions have distinct roles in cued heroin seeking after extinction learning and prolonged withdrawal in rats.Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology · 2024Article
- Childhood Trauma, Emotional Awareness, and Neural Correlates of Long-Term Nicotine Smoking.JAMA network open · 2024Article
- Still a "hidden island"? The rodent insular cortex in drug seeking, reward, and risk.Neuroscience and biobehavioral reviews · 2023Review
- Altered neuronal activity in the ventromedial prefrontal cortex drives nicotine intake escalation.Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology · 2023Article
- Right inferior frontal gyrus theta-burst stimulation reduces smoking behaviors and strengthens fronto-striatal-limbic resting-state functional connectivity: a randomized crossover trial.Frontiers in psychiatry · 2023Article
- Are empathic processes mechanisms of pregnancy's protective effect on smoking? Identification of a novel target for preventive intervention.Social science & medicine (1982) · 2022Article
2 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 2 institutions in 1 country.
Funding
Abstract
rationaleAlexithymia is a personality trait characterized by difficulty indentifying and describing subjective emotional experiences. Decreased aptitude in the perception, evaluation, and communication of affectively laden mental states has been associated with reduced emotion regulation, more severe drug craving in addicts, and structural/functional alterations in insula and anterior cingulate cortex (ACC). The insula and ACC represent sites of convergence between the putative neural substrates of alexithymia and those perpetuating cigarette smoking.
objectivesWe examined the interrelations between alexithymia, tobacco craving, and insula/ACC neurocircuitry using resting-state functional connectivity (rsFC).
methodsOvernight-deprived smokers (n = 24) and nonsmokers (n = 20) completed six neuroimaging assessments on different days both in the absence of, and following, varenicline and/or nicotine administration. In this secondary analysis of data from a larger study, we assessed trait alexithymia and state tobacco craving using self-reports and examined the rsFC of bilateral insular subregions (anterior, middle, posterior) and dorsal ACC.
resultsHigher alexithymia in smokers predicted reduced rsFC strength between the right anterior insula (aI) and ventromedial prefrontal cortex (vmPFC). Higher alexithymia also predicted more severe tobacco craving during nicotine withdrawal. Critically, the identified aI-vmPFC circuit fully mediated this alexithymia-craving relation. That is, elevated alexithymia predicted decreased aI-vmPFC rsFC and, in turn, decreased aI-vmPFC rsFC predicted increased craving during withdrawal. A moderated mediation analysis indicated that this aI-vmPFC mediational effect was not observed following drug administration.
conclusionsThese results suggest that a weakened right aI-vmPFC functional circuit confers increased liability for tobacco craving during smoking abstinence. Individual differences in alexithymia and/or aI-vmPFC functional coupling may be relevant factors for smoking cessation success.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.