Deep in the brain may lie the secret of why some smokers quit easily and some find it nearly impossible

When a person tries to quit smoking, the cravings, headaches and lethargy that come from the nicotine withdrawal makes it near impossible for many to be successful. But this lack of success could also be a result of how a smoker’s brain is wired, according to a study from Duke University.

The study, published in the journal Neuropsychopharmacology, used magnetic resonance imaging to look at the brain activity of 85 smokers who smoked at least 10 cigarettes a day.

Image from CNN (Click on it to see a larger version)

MRI revealed that “people who had stronger connections between two regions of the brain — one involved in reward and the other in controlling impulsive behavior– were more likely to be successful at giving up smoking, at least for 10 weeks,” Carina Storrs reports for CNN.

“This is the largest study to date where we’ve attempted to identify neural markers, or predictors, of later success in quitting smoking,” Joseph McClernon, associate professor of psychiatry and behavioral sciences at Duke, who led the current study, told Storrs.

The scans were taken one month before the quit date. Then, on their quit date, participants were given nicotine patches and were asked to check in with the researchers to report any relapses over the following 10 weeks.

The study found that the “key difference” was that those who were able to quit had more activity in the insula, a prune-sized section that lies deep in the brain, than those who did not quit.

Researchers can’t explain why,but speculate that the insula “acts like a bridge, connecting the reward region with the behavior control regions,” Storrs reports, noting that it has also been linked to other types of drug addictions such as alcoholism.

This study offers hope that doctors might come to identify smokers who have poor connectivity in their insula and offer them treatment to strengthen this connectivity. That could be good news for Kentucky, where almost 30 percent of adults smoke and many are trying to quit. Forty-five percent of Kentuckians reported in the CDC’s Behavioral Risk Factor Surveillance System that they had tried to quit in 2012.

Jonathan Foulds, professor of public health sciences and psychiatry at Penn State, was not so hopeful, telling Storrs that not enough is known about specific treatments to tell whether they will increase insula connectivity, and that any such treatments will likely “not be affordable options anyway.”

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