Associations between working memory, brain activation, and e-cigarette use: A functional magnetic resonance imaging (fMRI) study

Nicotine improves withdrawal-related executive dysfunction and enhances task performance in chronic users, regardless of the delivery method. Research on combustible cigarette users shows that nicotine boosts performance by increasing activity in prefrontal and parietal brain regions. It remains unclear whether e-cigarettes offer the same improvements and involve similar neurobiological mechanisms. Nicotine-abstinent (14 hr) regular e-cigarette users completed working memory tasks (i.e., Rapid Visual Information Processing, n-back) before and after a 10-min e-cigarette protocol, with the n-back completed while fMRI measurements were taken. Whole-brain voxel-wise analyses were used to assess BOLD activation during an n-back task before and after e-cigarette use, examining the association between activation and nicotine boost (serum nicotine changes) and craving. Participants were 55% female, 87% White, and had a mean age of 36 years (N = 18). There were increases in Rapid Visual Information Processing accuracy after (M = 17.79, SD = 7.78) compared to before e-cigarette use (M = 14.41, SD = 7.76; t[16] = -4.35, p < .001). Rapid Visual Information Processing reaction time increased after (M = 412.33, SD = 47.53) compared to before (M = 380.64, SD = 67.16; t[16] = -2.69, p = .02). During the n-back task, there was increased activation in task-positive executive and attention networks and decreased activation in task-negative networks (e.g., the default mode network) after e-cigarette use. Although e-cigarette use did not alter BOLD signal during the task, higher nicotine boost was linked to reduced task-negative activity, and reduced craving following e-cigarette use was tied to increased task-positive activity. This pilot study supports that e-cigarette use improves target detection and alters brain function for e-cigarette users through nicotine exposure, with craving reductions potentially contributing to these effects. (PsycInfo Database Record (c) 2025 APA, all rights reserved).