Brain morphometry in electronic cigarette and traditional cigarette users: an MRI-based analysis
Neurotoxicity, brain morphometric and structural changes associated with electronic cigarette (vaping) and traditional cigarette use in young adults.
Participant Selection and Grouping Participants will be screened and classified into three distinct groups (n=25 per group, total N=75) based on specialized dependency scales and explicit inclusion/exclusion criteria: Electronic Cigarette (EC) group, Traditional Cigarette (TC) group, and a Healthy Control group. The classification and characterization will be performed using the Fagerström Test for Nicotine Dependence, the Penn State Electronic Cigarette Dependence Index, the E-Cigarette Dependence Scale, and the Sensory E-Cigarette Expectations Scale. Written informed consent will be obtained from all individuals prior to enrollment. MRI Acquisition Protocol All cranial imaging will be performed using a 3.0 Tesla superconducting MRI scanner (Ingenia, Philips) equipped with a 16-channel head coil. Participants will be scanned in the supine position without sedation and without the administration of contrast agents. The total scan duration will be approximately 30–40 minutes per participant, utilizing the following sequences: T1-Weighted 3D Volumetric Data: Field of View (FOV) = 240 mm, slice thickness = 1 mm, spacing between slices = 0.5 mm, Number of Averages = 2, repetition time (TR) = 6.7 ms, and echo time (TE) = 3.0 ms. Diffusion Tensor Imaging (DTI): Axial acquisition, TR = 3260 ms, TE = 85 ms, FOV = 240 mm, slice thickness = 2.5 mm, spacing between slices = 2.5 mm, Number of Averages = 2, b-value = 1000 s/mm², acquired along 32 non-collinear diffusion-sensitizing directions. Image Processing and Volumetric Analysis Raw MRI data in DICOM format will be converted using Radiant DICOM Viewer and MRIcroGL software into NIfTI format (.nii.gz). For brain volumetry, NIfTI files will be uploaded to the vol2brain (volBrain) cloud-based, artificial intelligence-driven automated pipeline. This pipeline will automatically segment and calculate the volumes of 135 distinct brain regions, alongside macrostructural estimations of hippocampal subfields, brain structures age
1. Aged between 18 years and 30 years (both sexes included) 2. No known history of central nervous system disease 3. No known chronic systemic diseases (e.g., hypertension, diabetes, metabolic syndrome) 4. No contraindications for MRI scanning (e.g., metallic implants, cardiac pacemakers, neurostimulators, or severe claustrophobia) 5. Capable of giving written informed consent 6. Good MRI image quality without severe motion artifacts 7. Group-specific criteria: 7.1. Minimum 1 year of continuous exclusive use for the EC or TC groups 7.2. Absolute non-use of any nicotine or tobacco products, alcohol, or illicit substances for the healthy control group
1. History of serious neurological disease (e.g., epilepsy, cerebrovascular events) 2. Severe or unstable psychiatric disorders (e.g., major depressive disorder, schizophrenia, bipolar disorder) 3. Diagnoses affecting brain structure or development, such as ADHD 4. Alcohol or illicit substance use disorder, or active use within the past year 5. Dependence on substances other than nicotine 6. Extremely high or low body mass index (BMI) that could independently influence brain volume 7. Metabolic or chronic inflammatory diseases (e.g., uncontrolled diabetes) 8. Regular use of medications affecting central nervous system activity or structure (e.g., psychotropics, chronic steroids) 9. Pregnancy or lactation 10. Dual users (simultaneous users of both electronic and traditional cigarettes)