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Arthur L. Brody, MD; Mark A. Mandelkern, MD, PhD; Richard E. Olmstead, PhD; David Scheibal, BS; Emily Hahn, BA; Sharon Shiraga, BS; Eleanor Zamora-Paja, BS; Judah Farahi, PhD; Sanjaya Saxena, MD; Edythe D. London, PhD; James T. McCracken, MD

Arch Gen Psychiatry. 2006;63:808-816.

Context  Preclinical studies demonstrate that nicotine administration leads to dopamine release in the ventral striatum. However, human studies reveal considerable interindividual variability in the extent of smoking-induced dopamine release.

Objective  To determine whether common gene variants of the brain dopamine pathway explain this observed phenotypic variability in humans.

Design  Blood samples were drawn to determine gene variants of dopamine system components, and positron emission tomography scanning with the radiotracer raclopride labeled with radioactive carbon (¹¹C) was performed to measure smoking-induced dopamine release.

Setting  Academic brain imaging center.

Participants  Forty-five tobacco-dependent smokers.

Interventions  Subjects either smoked a cigarette (n = 35) or did not smoke (n = 10) during positron emission tomography scanning.

Main Outcome Measures  Gene variants of dopamine system components (the dopamine transporter variable nucleotide tandem repeat, D₂ receptor Taq A₁/A₂, D₄ receptor variable nucleotide tandem repeat, and catechol-O-methyltransferase Val158Met polymorphisms) and change in [¹¹C]raclopride binding potential in the ventral caudate/nucleus accumbens on positron emission tomography scans.

Results  For subjects who smoked during scanning, those with at least one 9 allele of the dopamine transporter variable nucleotide tandem repeat, fewer than 7 repeats of the D₄ variable nucleotide tandem repeat, and the Val/Val catechol-O-methyltransferase genotype had greater decreases in binding potential (an indirect measure of dopamine release) with smoking than those with the alternate genotypes. An overall decrease in ventral caudate/nucleus accumbens binding potential in those who smoked compared with those who did not smoke was also found but was smaller in magnitude than previously reported.

Conclusions  Smokers with genes associated with low resting dopamine tone have greater smoking-induced (phasic) dopamine release than those with alternate genotypes. These findings suggest that dopamine system genotype variabilities explain a significant proportion of the interindividual variability in smoking-induced dopamine release and indicate that smoking-induced dopamine release has a genetic predisposition.

Author Affiliations: Department of Psychiatry and Biobehavioral Sciences (Drs Brody, Saxena, London, and McCracken and Mr Scheibal and Mss Hahn, Shiraga, and Zamora-Paja) and Department of Molecular and Medical Pharmacology (Dr London), University of California, Los Angeles; Positron Emission Tomography Center, Greater Los Angeles VA Healthcare System, Los Angeles (Drs Brody, Mandelkern, Olmstead, and Farahi and Mr Scheibal and Ms Hahn); and Department of Physics, University of California, Irvine (Dr Mandelkern).