, Volume 235, Issue 4, pp 1257–1271 | Cite as

Mapping brain functional alterations in betel-quid chewers using resting-state fMRI and network analysis

  • Jun-Cheng Weng
  • Yu-Syuan Chou
  • Guo-Joe Huang
  • Yeu-Sheng Tyan
  • Ming-Chou Ho
Original Investigation



The World Health Organization regards betel quid (BQ) as a human carcinogen, and DSM-IV and ICD-10 dependence symptoms may develop with its heavy use. BQ’s possible effects of an enhanced reward system and disrupted inhibitory control may increase the likelihood of habitual substance use.


The current study aimed to employ resting-state fMRI to examine the hypothesized enhanced reward system (e.g., the basal forebrain system) and disrupted inhibitory control (e.g., the prefrontal system) in BQ chewers.


The current study recruited three groups of 48 male participants: 16 BQ chewers, 15 tobacco- and alcohol-user controls, and 17 healthy controls. We used functional connectivity (FC), mean fractional amplitude of low-frequency fluctuations (mfALFF), and mean regional homogeneity (mReHo) to evaluate functional alternations in BQ chewers. Graph theoretical analysis (GTA) and network-based statistical (NBS) analysis were also performed to identify the functional network differences among the three groups.


Our hypothesis was partially supported: the enhanced reward system for the BQ chewers (e.g., habitual drug-seeking behavior) was supported; however, their inhibitory control was relatively preserved. In addition, we reported that the BQ chewers may have enhanced visuospatial processing and decreased local segregation.


The current results (showing an enhanced reward system in the chewers) provided the clinicians with important insight for the future development of an effective abstinence treatment.


Betel quid Resting-state functional MRI (rs-fMRI) Functional connectome Graph theoretical analysis (GTA) Network-based statistical (NBS) analysis 



The authors would like to thank Jau-Yang Lin for his assistance in experimental preparation.

Funding information

This study was supported by the research programs NSC103-2420-H-040-001-MY2, MOST105-2410-H-040-001-MY3, and MOST106-2221-E-182-079, which were sponsored by the Ministry of Science and Technology, Taipei, Taiwan.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Jun-Cheng Weng
    • 1
    • 2
  • Yu-Syuan Chou
    • 3
  • Guo-Joe Huang
    • 4
  • Yeu-Sheng Tyan
    • 3
    • 5
  • Ming-Chou Ho
    • 4
    • 6
  1. 1.Department of Medical Imaging and Radiological SciencesChang Gung UniversityTaoyuanTaiwan
  2. 2.Department of PsychiatryChang Gung Memorial HospitalChiayiTaiwan
  3. 3.Department of Medical Imaging and Radiological SciencesChung Shan Medical UniversityTaichungTaiwan
  4. 4.Department of PsychologyChung Shan Medical UniversityTaichungTaiwan
  5. 5.Department of Medical ImagingChung Shan Medical University HospitalTaichungTaiwan
  6. 6.Clinical Psychological RoomChung Shan Medical University HospitalTaichungTaiwan

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