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Brain function associated with craving for cigarettes fluctuates across the menstrual cycle in women smokers, according to a new study.1 These findings indicate that women need gender-specific programs to quit smoking, along with consideration of their menstrual cycle phase during addiction treatment.
The research was published in Psychiatry Journal.
“Our data reveal that incontrollable urges to smoke are stronger at the beginning of the follicular phase that begins after menstruation. Hormonal decreases of estrogen and progesterone possibly deepen the withdrawal syndrome and increase activity of neural circuits associated with craving,” study researcher Adrianna Mendrek, PhD, of the University of Montreal, said in a press release.
In the study, Dr. Mendrek and colleagues found that cigarette cravings caused different patterns of activations in women during the follicular phase of their menstrual cycle compared with the luteal phase.
The researchers used functional magnetic resonance imaging (fMRI) to examine craving-associated cerebral activations of 15 tobacco-smoking men and 19 tobacco-smoking women. No sex differences were revealed by this study in the cerebral activations associated with craving.
The women were tested by fMRI twice, with one test occurring during early follicular phase and the other during the midluteal phase of their menstrual cycle. The men were tested once.
The pattern of activations varied during the menstrual cycles of the women examined. Significant activations occurred in the frontal, temporal and parietal lobe during the follicular phase, whereas only limited activations occurred in the right hippocampus during the luteal phase.
Further, the angular gyrus had increased activations in the follicular phase compared with the luteal phase. The authors stated that introspective and self-referential thoughts have been implicated with the functional coupling of the inferior parietal cortex, or angular gyrus, with other regions.
While this study assessed hormone levels and correlated them with subjective cravings and neuroimaging data, no positive associations were observed, but they noted the authors noted that the small sample size may have played a role. They also suggested that psychological and sociocultural factors may be more important than hormonal influences and biological forces in drug use and addiction.
“A greater knowledge of the neurobiological mechanisms governing addiction should enable us to better target treatment according to the smoker’s profile,” Dr. Mendrek said.
The limitations of this study include its relatively small sample size, involving smokers who were not abstinent vs. those who were satiated and its use of a liberal statistical threshold. The authors noted that their use of a cluster size correction, after which most of the fMRI results remained significant.
