Negative affect and craving during abstinence from smoking are both linked to default mode network connectivity.

Background: Negative affect and craving during abstinence from cigarettes predict resumption of smoking. Therefore, understanding their neural substrates may guide development of new interventions. Negative affect and craving have traditionally been linked to functions of the brain's threat and reward networks, respectively. However, given the role of default mode network (DMN), particularly the posterior cingulate cortex (PCC), in self-related thought, we examined whether DMN activity underlies both craving and negative affective states in adults who smoke.

Methods: 46 adults who smoke abstained from smoking overnight and underwent resting-state fMRI, after self-reporting their psychological symptoms (negative affect) and craving on the Shiffman-Jarvik Withdrawal Scale and state anxiety (negative affect) on the Spielberger State-Trait Anxiety Inventory. Within-DMN functional connectivity using 3 different anterior PCC seeds was tested for correlations with self-report measures. Additionally, independent component analysis with dual regression was performed to measure associations of self-report with whole-brain connectivity of the DMN component.

Results: Craving correlated positively with connectivity of all three anterior PCC seeds with posterior PCC clusters (p<0.04). The measures of negative affective states correlated positively with connectivity of the DMN component to various brain regions, including posterior PCC (p=0.02) and striatum (p<0.008). Craving and state anxiety were correlated with connectivity of an overlapping region of PCC (p=0.003). Unlike the state measures, nicotine dependence and trait anxiety were not associated with PCC connectivity within DMN.

Conclusions: Although negative affect and craving are distinct subjective states, they appear to share a common neural pathway within the DMN, particularly involving the PCC.