BACKGROUND AND AIMS: Current pharmacotherapies for @entity286 @entity734 are generally well tolerated, but have relatively high rates of relapse. They target primarily the brains' mesocorticolimbic 'reward' pathway. However, recent evidence suggests that the insular cortex, a central cerebral hemispheric region historically overlooked in addiction models, may also play an important role in cognitive and emotional processes that facilitate drug use. We examined whether insular versus @entity16 from @entity385 attenuated acute withdrawal from cigarette smoking and reduced the likelihood of @entity1239 replacement therapy (NRT) use during hospitalization. DESIGN: Data were derived from a longitudinal study with 3   months' follow-up, beginning June 2013 and ending May 2014. SETTING: Three acute care hospitals in Rochester, NY, USA. @entity1 : One-hundred and fifty-six current smokers hospitalized for acute @entity385 (38 with insular @entity1188 and 118 with non-insular @entity1188 , assessed by three neuroradiologists). MEASUREMENTS: The @entity3347 ( @entity3347 ) and Minnesota @entity1239 Withdrawal Scale (MNWS) were administered during hospitalization (a period of forced abstinence) to assess the frequency and severity of @entity3347 . NRT use was also assessed during hospitalization. FINDINGS: On average, smokers with @entity16 had a lower @entity3347 score during admission [mean   =   5.89, standard deviation (SD)   =   4.72] compared with those with @entity16 (mean   =   9.20, SD   =   4.71; P   <   0.001) [covariate-adjusted difference in means of -3.12, 95% confidence interval (CI)   =   -4.97, -1.27]. A similar difference was also noted when the MNWS was used (P   =   0.02). Furthermore, @entity1 with @entity75 appeared to be less likely to use NRT during admission compared with those with @entity75 [odds ratio (OR)   =   0.72, 95% CI   =   0.32, 1.64]. CONCLUSIONS: Current smokers with damage to their insular cortex brain region appear to experience fewer and less severe @entity286 @entity3347 , and appear to be less likely to require @entity1239 replacement therapy during hospitalization, compared with smokers with @entity16 . These findings support the potential role of the insular cortex in regulating withdrawal during abstinence, a motivator responsible for the maintenance of @entity146 .

@entity16 leads to decreased XXXX withdrawal during abstinence.

@entity1 :: ('9606', 'Species') :: ['participants', 'PARTICIPANTS'] @entity286 :: ('4097', 'Species') :: ['tobacco'] @entity3347 :: ('MESH:D013375', 'Disease') :: ['Wisconsin Smoking Withdrawal Scale', 'WSWS', 'withdrawal symptoms'] @entity146 :: ('MESH:D001523', 'Disease') :: ['addictive behaviors'] @entity75 :: ('MESH:D001927', 'Disease') :: ['non-insular lesions', 'insular lesions'] @entity16 :: ('MESH:D009422', 'Disease') :: ['non-insular damage', 'insular damage'] @entity1239 :: ('MESH:D009538', 'Chemical') :: ['Nicotine', 'nicotine'] @entity1188 :: ('MESH:D007238', 'Disease') :: ['infarctions'] @entity734 :: ('MESH:D019966', 'Disease') :: ['dependence'] @entity385 :: ('MESH:D002544', 'Disease') :: ['ischemic stroke']
@entity1239 :: (MESH:D009538,Chemical) :: ['nicotine']
