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Belnap MA, McManus KR, Grodin EN, Ray LA. Endpoints for Pharmacotherapy Trials for Alcohol Use Disorder. Pharmaceut Med 2024; 38:291-302. [PMID: 38967906 PMCID: PMC11272707 DOI: 10.1007/s40290-024-00526-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/20/2024] [Indexed: 07/06/2024]
Abstract
Alcohol use disorder (AUD) is a debilitating disorder, yet currently approved pharmacotherapies to treat AUD are under-utilized. The three medications approved by the US Food and Drug Administration (FDA) for the indication of AUD are disulfiram, acamprosate, and naltrexone. The current landscape of pharmacotherapies for AUD suggests opportunities for improvement. Clinical trials investigating novel pharmacotherapies for AUD traditionally use abstinence-based drinking outcomes or no heavy drinking days as trial endpoints to determine the efficacy of pharmacotherapies. These outcomes are typically measured through patient self-report endorsements of their drinking. Apart from these traditional outcomes, there have been recent developments in novel endpoints for AUD pharmacotherapies. These novel endpoints include utilizing the World Health Organization (WHO) risk drinking level reductions to promote a harm-reduction endpoint rather than an abstinence-based endpoint. Additionally, in contrast to patient self-report measurements, biological markers of alcohol use may serve as objective endpoints in AUD pharmacotherapy trials. Lastly, the National Institute on Alcohol Abuse and Alcoholism (NIAAA) definition of recovery from AUD and patient-oriented outcomes offer new frameworks to consider endpoints associated with more than alcohol consumption itself, such as the provider-patient experiences with novel pharmacotherapies. These recent developments in new endpoints for AUD pharmacotherapies offer promising future opportunities for pharmacotherapy development, so long as validity and reliability measures are demonstrated for the endpoints. A greater breadth of endpoint utilization may better capture the complexity of AUD symptomatology.
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Affiliation(s)
- Malia A Belnap
- Neuroscience Interdepartmental Program, University of California, Los Angeles, Los Angeles, CA, USA
| | - Kaitlin R McManus
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA
| | - Erica N Grodin
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
| | - Lara A Ray
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA.
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA.
- Brain Research Institute, University of California, Los Angeles, Los Angeles, CA, USA.
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McCurdy LY, DeVito EE, Loya JM, Nich C, Zhai ZW, Kiluk BD, Potenza MN. Structural brain changes associated with cocaine use and digital cognitive behavioral therapy in cocaine use disorder treatment. DRUG AND ALCOHOL DEPENDENCE REPORTS 2024; 11:100246. [PMID: 38966567 PMCID: PMC11222934 DOI: 10.1016/j.dadr.2024.100246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/22/2024] [Accepted: 05/28/2024] [Indexed: 07/06/2024]
Abstract
Background Few studies have investigated changes in brain structure and function associated with recovery from cocaine use disorder (CUD), and fewer still have identified brain changes associated with specific CUD treatments, which could inform treatment development and optimization. Methods In this longitudinal study, T1-weighted magnetic resonance imaging scans were acquired from 41 methadone-maintained individuals with CUD (15 women) at the beginning of and after 12 weeks of outpatient treatment. As part of a larger randomized controlled trial, these participants were randomly assigned to receive (or not) computer-based training for cognitive behavioral therapy (CBT4CBT), and galantamine (or placebo). Results Irrespective of treatment condition, whole-brain voxel-based morphometry analyses revealed a significant decrease in right caudate body, bilateral cerebellum, and right middle temporal gyrus gray matter volume (GMV) at post-treatment relative to the start of treatment. Subsequent region of interest analyses found that greater reductions in right caudate and bilateral cerebellar GMV were associated with higher relative and absolute levels of cocaine use during treatment, respectively. Participants who completed more CBT4CBT modules had a greater reduction in right middle temporal gyrus GMV. Conclusions These results extend previous findings regarding changes in caudate and cerebellar GMV as a function of cocaine use and provide the first evidence of a change in brain structure as a function of engagement in digital CBT for addiction. These data suggest a novel potential mechanism underlying how CBT4CBT and CBT more broadly may exert therapeutic effects on substance-use-related behaviors through brain regions implicated in semantic knowledge.
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Affiliation(s)
- Li Yan McCurdy
- Department of Psychiatry, Yale School of Medicine, New Haven, CT 06511, USA
- Department of Radiology & Biomedical Imaging, Yale School of Medicine, New Haven, CT 06520, USA
| | - Elise E. DeVito
- Department of Psychiatry, Yale School of Medicine, New Haven, CT 06511, USA
| | - Jennifer M. Loya
- Department of Psychiatry, Yale School of Medicine, New Haven, CT 06511, USA
| | - Charla Nich
- Department of Psychiatry, Yale School of Medicine, New Haven, CT 06511, USA
| | - Zu Wei Zhai
- Program in Neuroscience, Middlebury College, Middlebury, VT 05753, USA
| | - Brian D. Kiluk
- Department of Psychiatry, Yale School of Medicine, New Haven, CT 06511, USA
| | - Marc N. Potenza
- Department of Psychiatry, Yale School of Medicine, New Haven, CT 06511, USA
- Department of Neuroscience, Yale School of Medicine, New Haven, CT 06510, USA
- Child Study Center, Yale School of Medicine, New Haven, CT 06520, USA
- The Connecticut Mental Health Center, New Haven, CT 06519, USA
- The Connecticut Council on Problem Gambling, Wethersfield, CT 06109, USA
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3
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Beheshti I. Cocaine Destroys Gray Matter Brain Cells and Accelerates Brain Aging. BIOLOGY 2023; 12:biology12050752. [PMID: 37237564 DOI: 10.3390/biology12050752] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 05/16/2023] [Accepted: 05/18/2023] [Indexed: 05/28/2023]
Abstract
Introduction: Cocaine use disorder (CUD) is a substance use disorder characterized by a strong desire to obtain, consume, and misuse cocaine. Little is known about how cocaine affects the structure of the brain. In this study, we first investigated the anatomical brain changes in individuals with CUD compared to their matched healthy controls, and then explored whether these anatomical brain abnormalities contribute to considerably accelerated brain aging among this population. Methods: At the first stage, we used anatomical magnetic resonance imaging (MRI) data, voxel-based morphometry (VBM), and deformation-based morphometry techniques to uncover the morphological and macroscopic anatomical brain changes in 74 CUD patients compared to 62 age- and sex-matched healthy controls (HCs) obtained from the SUDMEX CONN dataset, the Mexican MRI dataset of patients with CUD. Then, we computed brain-predicted age difference (i.e., brain-PAD: the brain-predicted age minus the actual age) in CUD and HC groups using a robust brain age estimation framework. Using a multiple regression analysis, we also investigated the regional gray matter (GM) and white matter (WM) changes associated with the brain-PAD. Results: Using a whole-brain VBM analysis, we observed widespread gray matter atrophy in CUD patients located in the temporal lobe, frontal lobe, insula, middle frontal gyrus, superior frontal gyrus, rectal gyrus, and limbic lobe regions compared to the HCs. In contrast, we did not observe any swelling in the GM, changes in the WM, or local brain tissue atrophy or expansion between the CUD and HC groups. Furthermore, we found a significantly higher brain-PAD in CUD patients compared to matched HCs (mean difference = 2.62 years, Cohen's d = 0.54; t-test = 3.16, p = 0.002). The regression analysis showed significant negative changes in GM volume associated with brain-PAD in the CUD group, particularly in the limbic lobe, subcallosal gyrus, cingulate gyrus, and anterior cingulate regions. Discussion: The results of our investigation reveal that chronic cocaine use is linked to significant changes in gray matter, which hasten the process of structural brain aging in individuals who use the drug. These findings offer valuable insights into the impact of cocaine on the composition of the brain.
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Affiliation(s)
- Iman Beheshti
- Department of Human Anatomy and Cell Science, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB R3E 0J9, Canada
- Neuroscience Research Program, Kleysen Institute for Advanced Medicine, Health Sciences Centre, Winnipeg, MB R3E 3J7, Canada
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4
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Versace F, Robinson JD, Cinciripini PM. Toward neuromarkers for tailored smoking cessation treatments. ADDICTION NEUROSCIENCE 2023; 6. [PMID: 37034180 PMCID: PMC10081511 DOI: 10.1016/j.addicn.2023.100075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
Vulnerability to compulsive drug use stems from dysregulated activity within the neural networks that underlie reward and executive functions. Empirical evidence suggests that a) attributing high motivational salience to drug-related stimuli leads to compulsive drug seeking and b) cognitive control deficits lead to compulsive drug taking. Noninvasive neuroimaging techniques enable brain activity monitoring during affective and cognitive processing and are paving the way to precision medicine for substance use disorders. Identifying robust neuromarkers of affective and cognitive dysregulation would allow clinicians to personalize treatments by targeting individual psychophysiological vulnerabilities. However, methodological choices have biased the field toward experimental paradigms that cannot optimally assess individual differences in the motivational salience of drug-related cues and in the ability to control drug-related decisions, choices which have hindered the identification of clinically relevant neuromarkers. Here, we show that once these shortcomings are amended, replicable neuromarkers of the tendency to attribute motivational salience to drug-related cues and the ability to control drug-related decisions emerge. While we use tobacco use disorder as a model, we also show that the methodological issues highlighted here are relevant to other disorders characterized by maladaptive appetitive behaviors.
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Gancz NN, Forster SE. Threats to external validity in the neuroprediction of substance use treatment outcomes. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2023; 49:5-20. [PMID: 36099534 PMCID: PMC9974755 DOI: 10.1080/00952990.2022.2116712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Revised: 08/09/2022] [Accepted: 08/21/2022] [Indexed: 10/14/2022]
Abstract
Background: Tools predicting individual relapse risk would invaluably inform clinical decision-making (e.g. level-of-care) in substance use treatment. Studies of neuroprediction - use of neuromarkers to predict individual outcomes - have the dual potential to create such tools and inform etiological models leading to new treatments. However, financial limitations, statistical power demands, and related factors encourage restrictive selection criteria, yielding samples that do not fully represent the target population. This problem may be further compounded by a lack of statistical optimism correction in neuroprediction research, resulting in predictive models that are overfit to already-restricted samples.Objectives: This systematic review aims to identify potential threats to external validity related to restrictive selection criteria and underutilization of optimism correction in the existing neuroprediction literature targeting substance use treatment outcomes.Methods: Sixty-seven studies of neuroprediction in substance use treatment were identified and details of sample selection criteria and statistical optimism correction were extracted.Results: Most publications were found to report restrictive selection criteria (e.g. excluding psychiatric (94% of publications) and substance use comorbidities (69% of publications)) that would rule-out a considerable portion of the treatment population. Furthermore, only 21% of publications reported optimism correction.Conclusion: Restrictive selection criteria and underutilization of optimism correction are common in the existing literature and may limit the generalizability of identified neural predictors to the target population whose treatment they would ultimately inform. Greater attention to the inclusivity and generalizability of addiction neuroprediction research, as well as new opportunities provided through open science initiatives, have the potential to address this issue.
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Affiliation(s)
- Naomi N. Gancz
- VA Pittsburgh Healthcare System, VISN 4 Mental Illness Research, Education, & Clinical Center (MIRECC)
- University of California, Los Angeles, Department of Psychology
| | - Sarah E. Forster
- VA Pittsburgh Healthcare System, VISN 4 Mental Illness Research, Education, & Clinical Center (MIRECC)
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Chen YH, Yang J, Wu H, Beier KT, Sawan M. Challenges and future trends in wearable closed-loop neuromodulation to efficiently treat methamphetamine addiction. Front Psychiatry 2023; 14:1085036. [PMID: 36911117 PMCID: PMC9995819 DOI: 10.3389/fpsyt.2023.1085036] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 02/03/2023] [Indexed: 02/25/2023] Open
Abstract
Achieving abstinence from drugs is a long journey and can be particularly challenging in the case of methamphetamine, which has a higher relapse rate than other drugs. Therefore, real-time monitoring of patients' physiological conditions before and when cravings arise to reduce the chance of relapse might help to improve clinical outcomes. Conventional treatments, such as behavior therapy and peer support, often cannot provide timely intervention, reducing the efficiency of these therapies. To more effectively treat methamphetamine addiction in real-time, we propose an intelligent closed-loop transcranial magnetic stimulation (TMS) neuromodulation system based on multimodal electroencephalogram-functional near-infrared spectroscopy (EEG-fNIRS) measurements. This review summarizes the essential modules required for a wearable system to treat addiction efficiently. First, the advantages of neuroimaging over conventional techniques such as analysis of sweat, saliva, or urine for addiction detection are discussed. The knowledge to implement wearable, compact, and user-friendly closed-loop systems with EEG and fNIRS are reviewed. The features of EEG and fNIRS signals in patients with methamphetamine use disorder are summarized. EEG biomarkers are categorized into frequency and time domain and topography-related parameters, whereas for fNIRS, hemoglobin concentration variation and functional connectivity of cortices are described. Following this, the applications of two commonly used neuromodulation technologies, transcranial direct current stimulation and TMS, in patients with methamphetamine use disorder are introduced. The challenges of implementing intelligent closed-loop TMS modulation based on multimodal EEG-fNIRS are summarized, followed by a discussion of potential research directions and the promising future of this approach, including potential applications to other substance use disorders.
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Affiliation(s)
- Yun-Hsuan Chen
- CenBRAIN Neurotech Center of Excellence, School of Engineering, Westlake University, Hangzhou, China.,Institute of Advanced Technology, Westlake Institute for Advanced Study, Hangzhou, China
| | - Jie Yang
- CenBRAIN Neurotech Center of Excellence, School of Engineering, Westlake University, Hangzhou, China.,Institute of Advanced Technology, Westlake Institute for Advanced Study, Hangzhou, China
| | - Hemmings Wu
- Department of Neurosurgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Kevin T Beier
- Department of Physiology and Biophysics, University of California, Irvine, Irvine, CA, United States.,Department of Neurobiology and Behavior, University of California, Irvine, Irvine, CA, United States.,Department of Biomedical Engineering, University of California, Irvine, Irvine, CA, United States.,Department of Pharmaceutical Sciences, University of California, Irvine, Irvine, CA, United States.,Center for the Neurobiology of Learning and Memory, University of California, Irvine, Irvine, CA, United States
| | - Mohamad Sawan
- CenBRAIN Neurotech Center of Excellence, School of Engineering, Westlake University, Hangzhou, China.,Institute of Advanced Technology, Westlake Institute for Advanced Study, Hangzhou, China
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Dieterich R, Endrass T. Neural Correlates of Cue Reactivity and the Regulation of Craving in Substance Use Disorders. ZEITSCHRIFT FUR KLINISCHE PSYCHOLOGIE UND PSYCHOTHERAPIE 2022. [DOI: 10.1026/1616-3443/a000680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Abstract. Theoretical background: Considerable progress has been made in illuminating the neural basis of the compulsive use patterns characterizing substance use disorders. It has been suggested to utilize these findings to alleviate the health burden associated with substance use. Objective: We address how neuroimaging research can provide these benefits. Methods: Based on neurobiological models of addiction, we highlight neuroimaging research elucidating neural predictors of relapse and how treatments modify these markers. Results: With the focus on cue reactivity, brain activity related to the motivational salience of drugs and automatized use behaviors can predict relapse. Cue reactivity changes with abstinence, and it remains to be determined whether such changes confer periods of critical relapse susceptibility. Conclusions: Several established and emerging interventions modulate brain activity associated with drug value. However, executive deficits in addiction may compromise interventions targeting control-related prefrontal brain areas. Lastly, it remains more difficult to change the brain responses mediating habitual behaviors.
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Affiliation(s)
- Raoul Dieterich
- Addiction Research, Institute of Clinical Psychology and Psychotherapy, Faculty of Psychology, Technische Universität Dresden (TU Dresden), Germany
| | - Tanja Endrass
- Addiction Research, Institute of Clinical Psychology and Psychotherapy, Faculty of Psychology, Technische Universität Dresden (TU Dresden), Germany
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8
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Vamvakopoulou IA, Fonville L, Hayes A, McGonigle J, Elliott R, Ersche KD, Flechais R, Orban C, Murphy A, Smith DG, Suckling J, Taylor EM, Deakin B, Robbins TW, Nutt DJ, Lingford-Hughes AR, Paterson LM. Selective D3 receptor antagonism modulates neural response during negative emotional processing in substance dependence. Front Psychiatry 2022; 13:998844. [PMID: 36339857 PMCID: PMC9627287 DOI: 10.3389/fpsyt.2022.998844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 09/20/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction Negative affective states contribute to the chronic-relapsing nature of addiction. Mesolimbic dopamine D3 receptors are well placed to modulate emotion and are dysregulated in substance dependence. Selective antagonists might restore dopaminergic hypofunction, thus representing a potential treatment target. We investigated the effects of selective D3 antagonist, GSK598809, on the neural response to negative emotional processing in substance dependent individuals and healthy controls. Methodology Functional MRI BOLD response was assessed during an evocative image task, 2 h following acute administration of GSK598809 (60 mg) or placebo in a multi-site, double-blind, pseudo-randomised, cross-over design. Abstinent drug dependent individuals (DD, n = 36) comprising alcohol-only (AO, n = 19) and cocaine-alcohol polydrug (PD, n = 17) groups, and matched controls (n = 32) were presented with aversive and neutral images in a block design (contrast of interest: aversive > neutral). Whole-brain mixed-effects and a priori ROI analyses tested for group and drug effects, with identical models exploring subgroup effects. Results No group differences in task-related BOLD signal were identified between DD and controls. However, subgroup analysis revealed greater amygdala/insular BOLD signal in PD compared with AO groups. Following drug administration, GSK598809 increased BOLD response across HC and DD groups in thalamus, caudate, putamen, and pallidum, and reduced BOLD response in insular and opercular cortices relative to placebo. Multivariate analyses in a priori ROIs revealed differential effects of D3 antagonism according to subgroup in substantia nigra; GSK598809 increased BOLD response in AO and decreased response in PD groups. Conclusion Acute GSK598809 modulates the BOLD response to aversive image processing, providing evidence that D3 antagonism may impact emotional regulation. Enhanced BOLD response within D3-rich mesolimbic regions is consistent with its pharmacology and with attenuation of substance-related hypodopaminergic function. However, the lack of group differences in task-related BOLD response and the non-specific effect of GSK598809 between groups makes it difficult to ascertain whether D3 antagonism is likely to be normalising or restorative in our abstinent populations. The suggestion of differential D3 modulation between AO and PD subgroups is intriguing, raising the possibility of divergent treatment responses. Further study is needed to determine whether D3 antagonism should be recommended as a treatment target in substance dependence.
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Affiliation(s)
- Ioanna A. Vamvakopoulou
- Division of Psychiatry, Department of Brain Sciences, Imperial College London, London, United Kingdom
| | - Leon Fonville
- Division of Psychiatry, Department of Brain Sciences, Imperial College London, London, United Kingdom
| | - Alexandra Hayes
- Division of Psychiatry, Department of Brain Sciences, Imperial College London, London, United Kingdom
| | - John McGonigle
- Division of Psychiatry, Department of Brain Sciences, Imperial College London, London, United Kingdom
| | - Rebecca Elliott
- Neuroscience and Psychiatry Unit, Institute of Brain, Behaviour and Mental Health, The University of Manchester, Manchester, United Kingdom
| | - Karen D. Ersche
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, United Kingdom
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
| | - Remy Flechais
- Division of Psychiatry, Department of Brain Sciences, Imperial College London, London, United Kingdom
| | - Csaba Orban
- Division of Psychiatry, Department of Brain Sciences, Imperial College London, London, United Kingdom
| | - Anna Murphy
- Neuroscience and Psychiatry Unit, Institute of Brain, Behaviour and Mental Health, The University of Manchester, Manchester, United Kingdom
| | - Dana G. Smith
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, United Kingdom
- Department of Psychology, University of Cambridge, Cambridge, United Kingdom
| | - John Suckling
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, United Kingdom
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
| | - Eleanor M. Taylor
- Neuroscience and Psychiatry Unit, Institute of Brain, Behaviour and Mental Health, The University of Manchester, Manchester, United Kingdom
| | - Bill Deakin
- Neuroscience and Psychiatry Unit, Institute of Brain, Behaviour and Mental Health, The University of Manchester, Manchester, United Kingdom
| | - Trevor W. Robbins
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, United Kingdom
- Department of Psychology, University of Cambridge, Cambridge, United Kingdom
| | - David J. Nutt
- Division of Psychiatry, Department of Brain Sciences, Imperial College London, London, United Kingdom
| | - Anne R. Lingford-Hughes
- Division of Psychiatry, Department of Brain Sciences, Imperial College London, London, United Kingdom
| | - Louise M. Paterson
- Division of Psychiatry, Department of Brain Sciences, Imperial College London, London, United Kingdom
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Beard SJ, Yoon L, Venticinque JS, Shepherd NE, Guyer AE. The brain in social context: A systematic review of substance use and social processing from adolescence to young adulthood. Dev Cogn Neurosci 2022; 57:101147. [PMID: 36030675 PMCID: PMC9434028 DOI: 10.1016/j.dcn.2022.101147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 08/08/2022] [Accepted: 08/10/2022] [Indexed: 11/19/2022] Open
Abstract
Substance use escalates between adolescence and young adulthood, and most experimentation occurs among peers. To understand underlying mechanisms, research has focused on neural response during relevant psychological processes. Functional magnetic resonance imaging (fMRI) research provides a wealth of information about brain activity when processing monetary rewards; however, most studies have used tasks devoid of social stimuli. Given that adolescent neurodevelopment is sculpted by the push-and-pull of peers and emotions, identifying neural substrates is important for intervention. We systematically reviewed 28 fMRI studies examining substance use and neural responses to stimuli including social reward, emotional faces, social influence, and social stressors. We found substance use was positively associated with social-reward activity (e.g., in the ventral striatum), and negatively with social-stress activity (e.g., in the amygdala). For emotion, findings were mixed with more use linked to heightened response (e.g., in amygdala), but also with decreased response (e.g., in insula). For social influence, evidence supported both positive (e.g., cannabis and nucleus accumbens during conformity) and negative (e.g., polydrug and ventromedial PFC during peers' choices) relations between activity and use. Based on the literature, we offer recommendations for future research on the neural processing of social information to better identify risks for substance use.
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Affiliation(s)
- Sarah J Beard
- Center for Mind and Brain, University of California, Davis, 267 Cousteau Pl, Davis, CA 95618, USA; Department of Human Ecology, University of California, Davis, 301 Shields Ave, Davis, CA 95616, USA.
| | - Leehyun Yoon
- Center for Mind and Brain, University of California, Davis, 267 Cousteau Pl, Davis, CA 95618, USA.
| | - Joseph S Venticinque
- Center for Mind and Brain, University of California, Davis, 267 Cousteau Pl, Davis, CA 95618, USA; Department of Human Ecology, University of California, Davis, 301 Shields Ave, Davis, CA 95616, USA.
| | - Nathan E Shepherd
- Center for Mind and Brain, University of California, Davis, 267 Cousteau Pl, Davis, CA 95618, USA.
| | - Amanda E Guyer
- Center for Mind and Brain, University of California, Davis, 267 Cousteau Pl, Davis, CA 95618, USA; Department of Human Ecology, University of California, Davis, 301 Shields Ave, Davis, CA 95616, USA.
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Gibson BC, Claus ED, Sanguinetti J, Witkiewitz K, Clark VP. A review of functional brain differences predicting relapse in substance use disorder: Actionable targets for new methods of noninvasive brain stimulation. Neurosci Biobehav Rev 2022; 141:104821. [PMID: 35970417 DOI: 10.1016/j.neubiorev.2022.104821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Revised: 08/03/2022] [Accepted: 08/06/2022] [Indexed: 11/17/2022]
Abstract
Neuroimaging studies have identified a variety of brain regions whose activity predicts substance use (i.e., relapse) in patients with substance use disorder (SUD), suggesting that malfunctioning brain networks may exacerbate relapse. However, this knowledge has not yet led to a marked improvement in treatment outcomes. Noninvasive brain stimulation (NIBS) has shown some potential for treating SUDs, and a new generation of NIBS technologies offers the possibility of selectively altering activity in both superficial and deep brain structures implicated in SUDs. The goal of the current review was to identify deeper brain structures involved in relapse to SUD and give an account of innovative methods of NIBS that might be used to target them. Included studies measured fMRI in currently abstinent SUD patients and tracked treatment outcomes, and fMRI results were organized with the framework of the Addictions Neuroclinical Assessment (ANA). Four brain structures were consistently implicated: the anterior and posterior cingulate cortices, ventral striatum and insula. These four deeper brain structures may be appropriate future targets for the treatment of SUD using these innovative NIBS technologies.
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Affiliation(s)
- Benjamin C Gibson
- Psychology Clinical Neuroscience Center, Department of Psychology, University of New Mexico, Albuquerque, NM 87131, USA; Department of Psychology, University of New Mexico, Albuquerque, NM 87131, USA; The Mind Research Network/Lovelace Biomedical and Environmental Research Institute, Albuquerque, NM 87106, USA
| | - Eric D Claus
- Department of Biobehavioral Health, The Pennsylvania State University, University Park, PA 16802, USA
| | - Jay Sanguinetti
- The Center for Consciousness Studies, University of Arizona, Tucson, AZ 85719, USA
| | - Katie Witkiewitz
- Department of Psychology, University of New Mexico, Albuquerque, NM 87131, USA
| | - Vincent P Clark
- Psychology Clinical Neuroscience Center, Department of Psychology, University of New Mexico, Albuquerque, NM 87131, USA; Department of Psychology, University of New Mexico, Albuquerque, NM 87131, USA; The Mind Research Network/Lovelace Biomedical and Environmental Research Institute, Albuquerque, NM 87106, USA.
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11
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Dakhili A, Sangchooli A, Jafakesh S, Zare-Bidoky M, Soleimani G, Batouli SAH, Kazemi K, Faghiri A, Oghabian MA, Ekhtiari H. Cue-induced craving and negative emotion disrupt response inhibition in methamphetamine use disorder: Behavioral and fMRI results from a mixed Go/No-Go task. Drug Alcohol Depend 2022; 233:109353. [PMID: 35249000 DOI: 10.1016/j.drugalcdep.2022.109353] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Revised: 02/07/2022] [Accepted: 02/09/2022] [Indexed: 11/15/2022]
Abstract
BACKGROUND Drug-related cue-reactivity, dysfunctional negative emotion processing, and response-disinhibition constitute three core aspects of methamphetamine use disorder (MUD). These phenomena have been studied independently, but the neuroscientific literature on their interaction in addictive disorders remains scant. METHODS 62 individuals with MUD were scanned when responding to the geometric Go or No-Go cues superimposed over blank, neutral, negative-emotional and drug-related background images. Neural correlates of drug and negative-emotional cue-reactivity, response-inhibition and their interactions were estimated, and methamphetamine cue-reactivity was compared between individuals with MUD and 23 healthy controls. Relationships between behavioral characteristics and observed activations were investigated. RESULTS Individuals with MUD had longer reaction times and more errors in drug and negative-emotional compared to blank blocks, and more omission errors in drug compared to neutral blocks. They showed higher drug cue-reactivity than controls across prefrontal, fusiform, and visual regions (Z > 3.1, p-corrected<0.05). Response-inhibition was associated with precuneal, inferior parietal, anterior cingulate, temporal, and inferior frontal activations (Z > 3.1, p-corrected<0.05). Response-inhibition in drug cue blocks coincided with higher activations in the visual cortex and lower activations in the paracentral lobule and superior and inferior frontal gyri, while inhibition during negative-emotional blocks led to higher superior parietal, fusiform, and lateral occipital activations (Z > 3.1, p-corrected<0.05). CONCLUSION Drug cue-reactivity may impair response inhibition partly through activating dis-inhibitory regions, while temporal and parietal activations associated with response-inhibition in negative blocks suggest compensatory activity. Results suggest that drug and negative-emotional cue-reactivity influence response-inhibition, and the study of these interactions may aid mechanistic understanding of methamphetamine use disorder.
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Affiliation(s)
- Amirhossein Dakhili
- Neuroimaging and Analysis Group. (NIAG), Research Center for Molecular and Cellular Imaging, Tehran University of Medical Sciences, Tehran Iran; Medical Physics Department, Iran University of Medical Sciences, Tehran, Iran
| | - Arshiya Sangchooli
- Iranian National Center for Addiction Studies (INCAS), Tehran University of Medical Science, Tehran, Iran
| | - Sara Jafakesh
- Department of Electrical and Electronics Engineering, Shiraz University of Technology, Shiraz, Iran
| | - Mehran Zare-Bidoky
- Iranian National Center for Addiction Studies (INCAS), Tehran University of Medical Science, Tehran, Iran; School of Medicine, Shahid-Sadoughi University of Medical Sciences, Yazd, Iran
| | - Ghazaleh Soleimani
- Department of Biomedical Engineering, Amirkabir University of Technology (Tehran Polytechnic), Tehran, Iran
| | - Seyed Amir Hossein Batouli
- Department of Neuroscience and Addiction Studies, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Kamran Kazemi
- Department of Electrical and Electronics Engineering, Shiraz University of Technology, Shiraz, Iran
| | - Ashkan Faghiri
- Tri-Institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia State University, Georgia Institute of Technology, and Emory University, Atlanta, GA 30303, USA
| | - Mohammad Ali Oghabian
- Neuroimaging and Analysis Group. (NIAG), Research Center for Molecular and Cellular Imaging, Tehran University of Medical Sciences, Tehran Iran; Medical Physics and Biomedical Engineering Department, Tehran University of Medical Sciences, Tehran Iran
| | - Hamed Ekhtiari
- Laureate Institute for Brain Research (LIBR), Tulsa, OK, USA.
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12
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Roberts W, Zhao Y, Verplaetse T, Moore KE, Peltier MR, Burke C, Zakiniaeiz Y, McKee S. Using machine learning to predict heavy drinking during outpatient alcohol treatment. Alcohol Clin Exp Res 2022; 46:657-666. [PMID: 35420710 PMCID: PMC9180421 DOI: 10.1111/acer.14802] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 02/15/2022] [Accepted: 02/22/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND Accurate clinical prediction supports the effective treatment of alcohol use disorder (AUD) and other psychiatric disorders. Traditional statistical techniques have identified patient characteristics associated with treatment outcomes. However, less work has focused on systematically leveraging these associations to create optimal predictive models. The current study demonstrates how machine learning can be used to predict clinical outcomes in people completing outpatient AUD treatment. METHOD We used data from the COMBINE multisite clinical trial (n = 1383) to develop and test predictive models. We identified three priority prediction targets, including (1) heavy drinking during the first month of treatment, (2) heavy drinking during the last month of treatment, and (3) heavy drinking between weekly/bi-weekly sessions. Models were generated using the random forest algorithm. We used "leave sites out" partitioning to externally validate the models in trial sites that were not included in the model training. Stratified model development was used to test for sex differences in the relative importance of predictive features. RESULTS Models predicting heavy alcohol use during the first and last months of treatment showed internal cross-validation area under the curve (AUC) scores ranging from 0.67 to 0.74. AUC was comparable in the external validation using data from held-out sites (AUC range = 0.69 to 0.72). The model predicting between-session heavy drinking showed strong classification accuracy in internal cross-validation (AUC = 0.89) and external test samples (AUC range = 0.80 to 0.87). Stratified analyses showed substantial sex differences in optimal feature sets. CONCLUSION Machine learning techniques can predict alcohol treatment outcomes using routinely collected clinical data. This technique has the potential to greatly improve clinical prediction accuracy without requiring expensive or invasive assessment methods. More research is needed to understand how best to deploy these models.
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Affiliation(s)
- Walter Roberts
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA.,Department of Psychology, East Tennessee State University, Johnson City, Tennessee, USA
| | - Yize Zhao
- Department of Biostatistics, Yale University School of Public Health, New Haven, Connecticut, USA
| | - Terril Verplaetse
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Kelly E Moore
- Department of Psychology, East Tennessee State University, Johnson City, Tennessee, USA
| | - MacKenzie R Peltier
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA.,Veterans Affairs Connecticut Healthcare System, West Haven, Connecticut, USA
| | - Catherine Burke
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Yasmin Zakiniaeiz
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Sherry McKee
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
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13
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The Mexican magnetic resonance imaging dataset of patients with cocaine use disorder: SUDMEX CONN. Sci Data 2022; 9:133. [PMID: 35361781 PMCID: PMC8971535 DOI: 10.1038/s41597-022-01251-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 03/10/2022] [Indexed: 01/16/2023] Open
Abstract
Cocaine use disorder (CUD) is a substance use disorder (SUD) characterized by compulsion to seek, use and abuse of cocaine, with severe health and economic consequences for the patients, their families and society. Due to the lack of successful treatments and high relapse rate, more research is needed to understand this and other SUD. Here, we present the SUDMEX CONN dataset, a Mexican open dataset of 74 CUD patients (9 female) and matched 64 healthy controls (6 female) that includes demographic, cognitive, clinical, and magnetic resonance imaging (MRI) data. MRI data includes: 1) structural (T1-weighted), 2) multishell high-angular resolution diffusion-weighted (DWI-HARDI) and 3) functional (resting state fMRI) sequences. The repository contains unprocessed MRI data available in brain imaging data structure (BIDS) format with corresponding metadata available at the OpenNeuro data sharing platform. Researchers can pursue brain variability between these groups or use a single group for a larger population sample. Measurement(s) | functional brain measurement • Diffusion Weighted Imaging • Abnormality of brain morphology • Alteration Of Cognitive Function • Clinical Study | Technology Type(s) | Functional Magnetic Resonance Imaging • Diffusion Weighted Imaging • Turbo Field Echo MRI • neuropsychological test • Clinical Evaluation | Factor Type(s) | Cocaine Dependence | Sample Characteristic - Organism | Homo | Sample Characteristic - Location | Mexico City |
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14
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Navarrete F, García-Gutiérrez MS, Gasparyan A, Navarro D, López-Picón F, Morcuende Á, Femenía T, Manzanares J. Biomarkers of the Endocannabinoid System in Substance Use Disorders. Biomolecules 2022; 12:biom12030396. [PMID: 35327588 PMCID: PMC8946268 DOI: 10.3390/biom12030396] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 02/21/2022] [Accepted: 02/28/2022] [Indexed: 02/04/2023] Open
Abstract
Despite substance use disorders (SUD) being one of the leading causes of disability and mortality globally, available therapeutic approaches remain ineffective. The difficulty in accurately characterizing the neurobiological mechanisms involved with a purely qualitative diagnosis is an obstacle to improving the classification and treatment of SUD. In this regard, identifying central and peripheral biomarkers is essential to diagnosing the severity of drug dependence, monitoring therapeutic efficacy, predicting treatment response, and enhancing the development of safer and more effective pharmacological tools. In recent years, the crucial role that the endocannabinoid system (ECS) plays in regulating the reinforcing and motivational properties of drugs of abuse has been described. This has led to studies characterizing ECS alterations after exposure to various substances to identify biomarkers with potential diagnostic, prognostic, or therapeutic utility. This review aims to compile the primary evidence available from rodent and clinical studies on how the ECS components are modified in the context of different substance-related disorders, gathering data from genetic, molecular, functional, and neuroimaging experimental approaches. Finally, this report concludes that additional translational research is needed to further characterize the modifications of the ECS in the context of SUD, and their potential usefulness in the necessary search for biomarkers.
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Affiliation(s)
- Francisco Navarrete
- Instituto de Neurociencias, Universidad Miguel Hernández-CSIC, Avda. de Ramón y Cajal s/n, San Juan de Alicante, 03550 Alicante, Spain; (F.N.); (M.S.G.-G.); (A.G.); (D.N.); (Á.M.); (T.F.)
- Departamento de Medicina Clínica, Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Universidad Miguel Hernández, 03010 Alicante, Spain
- Redes de Investigación Cooperativa Orientada a Resultados en Salud (RICORS), Red de Investigación en Atención Primaria de Adicciones (RIAPAd), Instituto de Salud Carlos III, MICINN and FEDER, 28029 Madrid, Spain
| | - María S. García-Gutiérrez
- Instituto de Neurociencias, Universidad Miguel Hernández-CSIC, Avda. de Ramón y Cajal s/n, San Juan de Alicante, 03550 Alicante, Spain; (F.N.); (M.S.G.-G.); (A.G.); (D.N.); (Á.M.); (T.F.)
- Departamento de Medicina Clínica, Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Universidad Miguel Hernández, 03010 Alicante, Spain
- Redes de Investigación Cooperativa Orientada a Resultados en Salud (RICORS), Red de Investigación en Atención Primaria de Adicciones (RIAPAd), Instituto de Salud Carlos III, MICINN and FEDER, 28029 Madrid, Spain
| | - Ani Gasparyan
- Instituto de Neurociencias, Universidad Miguel Hernández-CSIC, Avda. de Ramón y Cajal s/n, San Juan de Alicante, 03550 Alicante, Spain; (F.N.); (M.S.G.-G.); (A.G.); (D.N.); (Á.M.); (T.F.)
- Departamento de Medicina Clínica, Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Universidad Miguel Hernández, 03010 Alicante, Spain
- Redes de Investigación Cooperativa Orientada a Resultados en Salud (RICORS), Red de Investigación en Atención Primaria de Adicciones (RIAPAd), Instituto de Salud Carlos III, MICINN and FEDER, 28029 Madrid, Spain
| | - Daniela Navarro
- Instituto de Neurociencias, Universidad Miguel Hernández-CSIC, Avda. de Ramón y Cajal s/n, San Juan de Alicante, 03550 Alicante, Spain; (F.N.); (M.S.G.-G.); (A.G.); (D.N.); (Á.M.); (T.F.)
- Departamento de Medicina Clínica, Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Universidad Miguel Hernández, 03010 Alicante, Spain
- Redes de Investigación Cooperativa Orientada a Resultados en Salud (RICORS), Red de Investigación en Atención Primaria de Adicciones (RIAPAd), Instituto de Salud Carlos III, MICINN and FEDER, 28029 Madrid, Spain
| | - Francisco López-Picón
- PET Preclinical Imaging Laboratory, Turku PET Centre, University of Turku, 20520 Turku, Finland;
| | - Álvaro Morcuende
- Instituto de Neurociencias, Universidad Miguel Hernández-CSIC, Avda. de Ramón y Cajal s/n, San Juan de Alicante, 03550 Alicante, Spain; (F.N.); (M.S.G.-G.); (A.G.); (D.N.); (Á.M.); (T.F.)
| | - Teresa Femenía
- Instituto de Neurociencias, Universidad Miguel Hernández-CSIC, Avda. de Ramón y Cajal s/n, San Juan de Alicante, 03550 Alicante, Spain; (F.N.); (M.S.G.-G.); (A.G.); (D.N.); (Á.M.); (T.F.)
- Redes de Investigación Cooperativa Orientada a Resultados en Salud (RICORS), Red de Investigación en Atención Primaria de Adicciones (RIAPAd), Instituto de Salud Carlos III, MICINN and FEDER, 28029 Madrid, Spain
| | - Jorge Manzanares
- Instituto de Neurociencias, Universidad Miguel Hernández-CSIC, Avda. de Ramón y Cajal s/n, San Juan de Alicante, 03550 Alicante, Spain; (F.N.); (M.S.G.-G.); (A.G.); (D.N.); (Á.M.); (T.F.)
- Departamento de Medicina Clínica, Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Universidad Miguel Hernández, 03010 Alicante, Spain
- Redes de Investigación Cooperativa Orientada a Resultados en Salud (RICORS), Red de Investigación en Atención Primaria de Adicciones (RIAPAd), Instituto de Salud Carlos III, MICINN and FEDER, 28029 Madrid, Spain
- Correspondence: ; Tel.: +34-965-919-248
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15
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Shi Z, Langleben DD, O'Brien CP, Childress AR, Wiers CE. Multivariate pattern analysis links drug use severity to distributed cortical hypoactivity during emotional inhibitory control in opioid use disorder. Neuroimage Clin 2021; 32:102806. [PMID: 34525436 PMCID: PMC8436158 DOI: 10.1016/j.nicl.2021.102806] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 08/17/2021] [Accepted: 08/20/2021] [Indexed: 11/22/2022]
Abstract
Opioid use disorder (OUD) is characterized by emotional and cognitive impairements that are associated with poor treatment outcomes. The present study investigated the neural mechanism underlying emotion evaluation and inhibitory control using an affective go/no-go (AGN) task and its association with drug use severity and craving in patients with OUD. Twenty-six recently detoxified patients with OUD underwent functional magnetic resonance imaging (fMRI) while performing the AGN task that required response to frequently presented appetitive stimuli ("go") and inhibition of response to infrequently presented aversive stimuli ("no-go"). The fMRI session was immediately followed by an injection of extended-release opioid antagonist naltrexone (XR-NTX). Participants' opioid craving was assessed immediately before fMRI and 10 ± 2 days after XR-NTX injection. Multivariate pattern analysis (MVPA) showed that drug use severity was associated with distributed brain hypoactivity in response to aversive no-go stimuli, with particularly large negative contributions from the cognitive control and dorsal attention brain networks. While drug use severity and its associated MVPA brain response pattern were both correlated with opioid craving at baseline, only the brain response pattern predicted craving during XR-NTX treatment. Our findings point to widespread functional hypoactivity in the brain networks underlying emotional inhibitory control in OUD. Such a distributed pattern is consistent with the multifaceted nature of OUD, which affects multiple brain networks. It also highlights the utility of the multivariate approach in uncovering large-scale cortical substrates associated with clinical severity in complex psychiatric disorders and in predicting treatment response.
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Affiliation(s)
- Zhenhao Shi
- Center for Studies of Addiction, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, 3535 Market St Ste 500, Philadelphia, PA 19104, USA.
| | - Daniel D Langleben
- Center for Studies of Addiction, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, 3535 Market St Ste 500, Philadelphia, PA 19104, USA
| | - Charles P O'Brien
- Center for Studies of Addiction, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, 3535 Market St Ste 500, Philadelphia, PA 19104, USA
| | - Anna Rose Childress
- Center for Studies of Addiction, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, 3535 Market St Ste 500, Philadelphia, PA 19104, USA
| | - Corinde E Wiers
- Center for Studies of Addiction, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, 3535 Market St Ste 500, Philadelphia, PA 19104, USA
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16
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Abu Y, Roy S. Prenatal opioid exposure and vulnerability to future substance use disorders in offspring. Exp Neurol 2021; 339:113621. [PMID: 33516730 PMCID: PMC8012222 DOI: 10.1016/j.expneurol.2021.113621] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 01/21/2021] [Accepted: 01/22/2021] [Indexed: 01/06/2023]
Abstract
The heightened incidence of opioid use during pregnancy has resulted in unprecedented rates of neonates prenatally exposed to opioids. Prenatal opioid exposure (POE) results in significantly adverse medical, developmental, and behavioral outcomes in offspring. Of growing interest is whether POE contributes to future vulnerability to substance use disorders. The effects of POE on brain development is difficult to assess in humans, as the timing, dose, and route of drug exposure together with complex genetic and environmental factors affect susceptibility to addiction. Preclinical models of POE have allowed us to avoid methodological difficulties and confounding factors of POE in humans. Here, we review the effects of maternal opioid exposure on the developing brain with an emphasis on the neurobiological basis of drug addiction and on preclinical models of POE and their limitations. These studies have indicated that POE increases self-administration of drugs, reward-driven behaviors in the conditioned place paradigm, and locomotor sensitization. While addiction is multifaceted and vulnerability to drug addiction is still inconclusive in human studies of prenatally exposed infants, animal studies do provide a noteworthy corroboration of negative behavioral outcomes.
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Affiliation(s)
- Yaa Abu
- Medical Scientist Training Program, University of Miami Miller School of Medicine, Miami, FL 33136, USA; Department of Microbiology and Immunology, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - Sabita Roy
- Department of Microbiology and Immunology, University of Miami Miller School of Medicine, Miami, FL 33136, USA; Department of Surgery, University of Miami Miller School of Medicine, Miami, FL 33136, USA.
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17
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Tripathi R, Singh S, Bhad R. The need, scope, challenges, and potential solutions for enhancing addiction psychiatry training in India. Indian J Psychiatry 2020; 62:728-731. [PMID: 33896982 PMCID: PMC8052883 DOI: 10.4103/psychiatry.indianjpsychiatry_355_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Revised: 10/27/2019] [Accepted: 01/19/2020] [Indexed: 11/04/2022] Open
Abstract
Addictive disorders have become increasingly common in India. The health consequences of addictive disorders are immense, and the need for specialized addiction treatment and training far exceeds the capacity and human resources that currently exist. At the same time, increasing demand and treatment gap, need for specialized care, and the emerging sector of medical tourism in the country open avenues for superspecialty training in addiction psychiatry as an attractive career option for Indian psychiatrists. Human resource development and capacity building in the addiction psychiatry field in India is the need of the hour. In the present article, we describe the existing scenario and challenges related to addiction psychiatry training among postgraduate psychiatry trainees and psychiatrists in India and scope for the future.
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Affiliation(s)
- Richa Tripathi
- Department of Psychiatry and National Drug Dependence Treatment Centre (NDDTC), All India Institute of Medical Sciences, New Delhi, India
| | - Shalini Singh
- Department of Psychiatry and National Drug Dependence Treatment Centre (NDDTC), All India Institute of Medical Sciences, New Delhi, India
| | - Roshan Bhad
- Department of Psychiatry and National Drug Dependence Treatment Centre (NDDTC), All India Institute of Medical Sciences, New Delhi, India
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18
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Chye Y, Mackey S, Gutman BA, Ching CR, Batalla A, Blaine S, Brooks S, Caparelli EC, Cousijn J, Dagher A, Foxe JJ, Goudriaan AE, Hester R, Hutchison K, Jahanshad N, Kaag AM, Korucuoglu O, Li CR, London ED, Lorenzetti V, Luijten M, Martin‐Santos R, Meda SA, Momenan R, Morales A, Orr C, Paulus MP, Pearlson G, Reneman L, Schmaal L, Sinha R, Solowij N, Stein DJ, Stein EA, Tang D, Uhlmann A, Holst R, Veltman DJ, Verdejo‐Garcia A, Wiers RW, Yücel M, Thompson PM, Conrod P, Garavan H. Subcortical surface morphometry in substance dependence: An ENIGMA addiction working group study. Addict Biol 2020; 25:e12830. [PMID: 31746534 DOI: 10.1111/adb.12830] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Revised: 07/25/2019] [Accepted: 08/26/2019] [Indexed: 11/27/2022]
Abstract
While imaging studies have demonstrated volumetric differences in subcortical structures associated with dependence on various abused substances, findings to date have not been wholly consistent. Moreover, most studies have not compared brain morphology across those dependent on different substances of abuse to identify substance-specific and substance-general dependence effects. By pooling large multinational datasets from 33 imaging sites, this study examined subcortical surface morphology in 1628 nondependent controls and 2277 individuals with dependence on alcohol, nicotine, cocaine, methamphetamine, and/or cannabis. Subcortical structures were defined by FreeSurfer segmentation and converted to a mesh surface to extract two vertex-level metrics-the radial distance (RD) of the structure surface from a medial curve and the log of the Jacobian determinant (JD)-that, respectively, describe local thickness and surface area dilation/contraction. Mega-analyses were performed on measures of RD and JD to test for the main effect of substance dependence, controlling for age, sex, intracranial volume, and imaging site. Widespread differences between dependent users and nondependent controls were found across subcortical structures, driven primarily by users dependent on alcohol. Alcohol dependence was associated with localized lower RD and JD across most structures, with the strongest effects in the hippocampus, thalamus, putamen, and amygdala. Meanwhile, nicotine use was associated with greater RD and JD relative to nonsmokers in multiple regions, with the strongest effects in the bilateral hippocampus and right nucleus accumbens. By demonstrating subcortical morphological differences unique to alcohol and nicotine use, rather than dependence across all substances, results suggest substance-specific relationships with subcortical brain structures.
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Affiliation(s)
- Yann Chye
- Turner Institute for Brain and Mental Health, School of Psychological Sciences Monash University Clayton Victoria Australia
| | - Scott Mackey
- Departments of Psychiatry University of Vermont Burlington VT USA
| | - Boris A. Gutman
- Biomedical Engineering Illinois Institute of Technology Chicago IL USA
| | - Christopher R.K. Ching
- Department of Neurology, Keck School of Medicine, Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute University of Southern California Los Angeles CA USA
| | - Albert Batalla
- Department of Psychiatry University Medical Centre Utrecht Brain Center, Utrecht University Utrecht The Netherlands
- Department of Psychiatry and Psychology, Hospital Clinic, IDIBAPS, CIBERSAM, Institute of Neuroscience University of Barcelona Barcelona Spain
| | - Sara Blaine
- Departments of Psychiatry and Neuroscience Yale University School of Medicine CT USA
| | - Samantha Brooks
- Faculty of Health, School of Psychology Liverpool John Moores University L3 3AF Liverpool UK
- Department of Neuroscience, Section of Functional Pharmacology Uppsala University 75240 Sweden
| | - Elisabeth C. Caparelli
- Neuroimaging Research Branch, Intramural Research Program National Institute of Drug Abuse Baltimore MD USA
| | - Janna Cousijn
- Department of Developmental Psychology University of Amsterdam The Netherlands
| | - Alain Dagher
- McConnell Brain Imaging Center, Montreal Neurological Institute McGill University Montreal Quebec Canada
| | - John J. Foxe
- Department of Neuroscience & The Ernest J. Del Monte Institute for Neuroscience University of Rochester School of Medicine and Dentistry Rochester NY USA
| | - Anna E. Goudriaan
- Amsterdam UMC, Department of Psychiatry, Amsterdam Institute for Addiction Research University of Amsterdam Amsterdam The Netherlands
- Department of Research and Quality of Care Arkin Mental Health Care Amsterdam The Netherlands
| | - Robert Hester
- Melbourne School of Psychological Sciences University of Melbourne Melbourne Victoria Australia
| | - Kent Hutchison
- Department of Psychology and Neuroscience University of Colorado Boulder Boulder CO USA
| | - Neda Jahanshad
- Department of Neurology, Keck School of Medicine, Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute University of Southern California Los Angeles CA USA
| | - Anne M. Kaag
- Department of Developmental Psychology University of Amsterdam The Netherlands
| | - Ozlem Korucuoglu
- Department of Psychiatry Washington University School of Medicine Saint Louis MO USA
| | - Chiang‐Shan R. Li
- Departments of Psychiatry and Neuroscience Yale University School of Medicine CT USA
| | - Edythe D. London
- Jane and Terry Semel Institute of Neuroscience and Human Behavior, David Geffen School of Medicine Universityof California at Los Angeles Los Angeles CA USA
| | - Valentina Lorenzetti
- Turner Institute for Brain and Mental Health, School of Psychological Sciences Monash University Clayton Victoria Australia
- School of Psychology, Faculty of Health Sciences Australian Catholic University Melbourne Victoria Australia
| | - Maartje Luijten
- Behavioural Science Institute Radboud University Nijmegen The Netherlands
| | - Rocio Martin‐Santos
- Department of Psychiatry and Psychology, Hospital Clinic, IDIBAPS, CIBERSAM, Institute of Neuroscience University of Barcelona Barcelona Spain
| | - Shashwath A. Meda
- Olin Neuropsychiatry Research Center Hartford Hospital/IOL Hartford CT USA
| | - Reza Momenan
- Clinical NeuroImaging Research Core, Division of Intramural Clinical and BiologicalResearch National Institute of Alcohol Abuse and Alcoholism Bethesda MD USA
| | - Angelica Morales
- Jane and Terry Semel Institute of Neuroscience and Human Behavior, David Geffen School of Medicine Universityof California at Los Angeles Los Angeles CA USA
| | - Catherine Orr
- Departments of Psychiatry University of Vermont Burlington VT USA
| | - Martin P. Paulus
- VA San Diego Healthcare System and Department of Psychiatry University of California San Diego CA USA
- Laureate Institute for Brain Research Tulsa OK USA
| | - Godfrey Pearlson
- Departments of Psychiatry and Neuroscience Yale University School of Medicine CT USA
| | - Liesbeth Reneman
- Department of Radiology and Nuclear Medicine Amsterdam UMC, location AMC Amsterdam The Netherlands
| | - Lianne Schmaal
- Orygen The National Centre of Excellence in Youth Mental Health Parkville Australia
- Centre for Youth Mental Health The University of Melbourne Parkville Australia
| | - Rajita Sinha
- Departments of Psychiatry and Neuroscience Yale University School of Medicine CT USA
| | - Nadia Solowij
- School of Psychology and Illawarra Health and Medical Research Institute University of Wollongong Wollongong New South Wales Australia
- The Australian Centre for Cannabinoid Clinical and Research Excellence (ACRE) New Lambton Heights New South Wales Australia
| | - Dan J. Stein
- SA MRC Unit on Risk & Resilience in Mental Disorders, Department of Psychiatry and Neuroscience Institute University of Cape Town Cape Town South Africa
| | - Elliot A. Stein
- Neuroimaging Research Branch, Intramural Research Program National Institute of Drug Abuse Baltimore MD USA
| | - Deborah Tang
- McConnell Brain Imaging Center, Montreal Neurological Institute McGill University Montreal Quebec Canada
| | - Anne Uhlmann
- Department of Psychiatry and Mental Health Faculty of Health Sciences University of Cape Town South Africa
| | - Ruth Holst
- Department of Psychiatry University of Amsterdam Amsterdam The Netherlands
| | - Dick J. Veltman
- Department of Psychiatry VU University Medical Center Amsterdam The Netherlands
| | - Antonio Verdejo‐Garcia
- Turner Institute for Brain and Mental Health, School of Psychological Sciences Monash University Clayton Victoria Australia
| | - Reinout W. Wiers
- Addiction Development and Psychopathology (ADAPT) Lab University of Amsterdam Amsterdam The Netherlands
| | - Murat Yücel
- Turner Institute for Brain and Mental Health, School of Psychological Sciences Monash University Clayton Victoria Australia
| | - Paul M. Thompson
- Department of Neurology, Keck School of Medicine, Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute University of Southern California Los Angeles CA USA
| | - Patricia Conrod
- Department of Psychiatry Université de Montreal, CHU Ste Justine Hospital Canada
| | - Hugh Garavan
- Departments of Psychiatry University of Vermont Burlington VT USA
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19
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Abstract
Abstract
Purpose of Review
Gaming disorder (GD), meanwhile classified as a mental disorder in both DSM-5 and ICD-11, is a current public health issue. Theoretical models assume core psychological processes, such as cue reactivity, craving, reward processing, decision-making, cognitive biases, inhibitory control, and stress relief, to be crucially involved in the development and maintenance of GD. This review summarizes neuroscientific findings on these processes in the context of GD as well as treatments and intervention programs addressing these processes.
Recent Findings
We identified overlaps regarding the involvement of neural structures and networks related to psychological processes which may be targeted by public health programs. Complex interactions between executive control, salience, reward, and habit networks are crucially linked to processes involved in GD and public health programs respectively.
Summary
We point at the difficulties of making one to one assignments of neural networks to psychological processes or interventions. Furthermore, new treatment and prevention programs of GD are discussed pointing at possible future directions for neuroscientific research and treatment programs for GD.
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20
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Throuvala MA, Griffiths MD, Rennoldson M, Kuss DJ. Mind over Matter: Testing the Efficacy of an Online Randomized Controlled Trial to Reduce Distraction from Smartphone Use. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E4842. [PMID: 32635650 PMCID: PMC7369880 DOI: 10.3390/ijerph17134842] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Revised: 06/29/2020] [Accepted: 06/30/2020] [Indexed: 02/07/2023]
Abstract
Evidence suggests a growing call for the prevention of excessive smartphone and social media use and the ensuing distraction that arises affecting academic achievement and productivity. A ten-day online randomized controlled trial with the use of smartphone apps, engaging participants in mindfulness exercises, self-monitoring and mood tracking, was implemented amongst UK university students (n = 143). Participants were asked to complete online pre- and post-intervention assessments. Results indicated high effect sizes in reduction of smartphone distraction and improvement scores on a number of self-reported secondary psychological outcomes. The intervention was not effective in reducing habitual behaviours, nomophobia, or time spent on social media. Mediation analyses demonstrated that: (i) emotional self-awareness but not mindful attention mediated the relationship between intervention effects and smartphone distraction, and (ii) online vigilance mediated the relationship between smartphone distraction and problematic social media use. The present study provides preliminary evidence of the efficacy of an intervention for decreased smartphone distraction and highlights psychological processes involved in this emergent phenomenon in the smartphone literature. Online interventions may serve as complementary strategies to reduce distraction levels and promote insight into online engagement. More research is required to elucidate the mechanisms of digital distraction and assess its implications in problematic use.
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Affiliation(s)
- Melina A. Throuvala
- International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham NG1 4FQ, UK; (M.D.G.); (D.J.K.)
| | - Mark D. Griffiths
- International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham NG1 4FQ, UK; (M.D.G.); (D.J.K.)
| | - Mike Rennoldson
- Psychology Department, Nottingham Trent University, Nottingham NG1 4FQ, UK;
| | - Daria J. Kuss
- International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham NG1 4FQ, UK; (M.D.G.); (D.J.K.)
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21
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Solingapuram Sai JKK, Hurley RA, Dodda M, Taber KH. Positron Emission Tomography: Updates on Imaging of Addiction. J Neuropsychiatry Clin Neurosci 2020; 31:A6-288. [PMID: 31613195 DOI: 10.1176/appi.neuropsych.19080169] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Ja Kiran Kumar Solingapuram Sai
- The Department of Radiology, Wake Forest School of Medicine, Winston-Salem, N.C. (Sai, Dodda, Hurley); The Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center, and the Research and Academic Affairs Service Line at the W.G. Hefner Veterans Affairs Medical Center, Salisbury, N.C. (Hurley, Taber); the Department of Psychiatry, Wake Forest School of Medicine, Winston-Salem, N.C. (Hurley); the Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston (Hurley); the Division of Biomedical Sciences, Via College of Osteopathic Medicine, Blacksburg, Va. (Taber); and the Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston (Taber)
| | - Robin A Hurley
- The Department of Radiology, Wake Forest School of Medicine, Winston-Salem, N.C. (Sai, Dodda, Hurley); The Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center, and the Research and Academic Affairs Service Line at the W.G. Hefner Veterans Affairs Medical Center, Salisbury, N.C. (Hurley, Taber); the Department of Psychiatry, Wake Forest School of Medicine, Winston-Salem, N.C. (Hurley); the Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston (Hurley); the Division of Biomedical Sciences, Via College of Osteopathic Medicine, Blacksburg, Va. (Taber); and the Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston (Taber)
| | - Meghana Dodda
- The Department of Radiology, Wake Forest School of Medicine, Winston-Salem, N.C. (Sai, Dodda, Hurley); The Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center, and the Research and Academic Affairs Service Line at the W.G. Hefner Veterans Affairs Medical Center, Salisbury, N.C. (Hurley, Taber); the Department of Psychiatry, Wake Forest School of Medicine, Winston-Salem, N.C. (Hurley); the Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston (Hurley); the Division of Biomedical Sciences, Via College of Osteopathic Medicine, Blacksburg, Va. (Taber); and the Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston (Taber)
| | - Katherine H Taber
- The Department of Radiology, Wake Forest School of Medicine, Winston-Salem, N.C. (Sai, Dodda, Hurley); The Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center, and the Research and Academic Affairs Service Line at the W.G. Hefner Veterans Affairs Medical Center, Salisbury, N.C. (Hurley, Taber); the Department of Psychiatry, Wake Forest School of Medicine, Winston-Salem, N.C. (Hurley); the Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston (Hurley); the Division of Biomedical Sciences, Via College of Osteopathic Medicine, Blacksburg, Va. (Taber); and the Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston (Taber)
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22
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Ma S, Zhang C, Yuan TF, Steele D, Voon V, Sun B. Neurosurgical treatment for addiction: lessons from an untold story in China and a path forward. Natl Sci Rev 2019; 7:702-712. [PMID: 34692088 PMCID: PMC8288968 DOI: 10.1093/nsr/nwz207] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2019] [Revised: 11/15/2019] [Accepted: 12/13/2019] [Indexed: 12/11/2022] Open
Abstract
Addiction is a major public-health crisis associated with significant disability and mortality. Although various pharmacological and behavioral treatments are currently available, the clinical efficacy of these treatments is limited. Given this situation, there is a growing interest in finding an effective neurosurgical treatment for addiction. First, we discuss the use of ablative surgery in treating addiction. We focus on the rise and fall of nucleus accumbens ablation for addiction in China. Subsequently, we review recent studies that have explored the efficacy and safety of deep-brain-stimulation treatment for addiction. We conclude that neurosurgical procedures, particularly deep-brain stimulation, have a potentially valuable role in the management of otherwise intractable addictive disorders. Larger well-controlled clinical trials, however, are needed to assess clinical efficacy and safety. We end by discussing several key issues involved in this clinical field and identifying some areas of progress.
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Affiliation(s)
- Shuo Ma
- Department of Functional Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Chencheng Zhang
- Department of Functional Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Ti-fei Yuan
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
- Co-innovation Center of Neuroregeneration, Nantong University, Nantong 226001, China
| | - Douglas Steele
- Division of Imaging Science and Technology, Medical School, University of Dundee, Dundee DD1 4HN, UK
| | - Valerie Voon
- Department of Functional Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
- Department of Psychiatry, University of Cambridge, Cambridge CB2 0SZ, UK
| | - Bomin Sun
- Department of Functional Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
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23
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Reese ED, Yi JY, McKay KG, Stein EA, Ross TJ, Daughters SB. Triple Network Resting State Connectivity Predicts Distress Tolerance and Is Associated with Cocaine Use. J Clin Med 2019; 8:jcm8122135. [PMID: 31817047 PMCID: PMC6947426 DOI: 10.3390/jcm8122135] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Revised: 11/21/2019] [Accepted: 11/25/2019] [Indexed: 01/28/2023] Open
Abstract
Distress tolerance (DT), a predictor of substance use treatment retention and post-treatment relapse, is associated with task based neural activation in regions located within the salience (SN), default mode (DMN), and executive control networks (ECN). The impact of network connectivity on DT has yet to be investigated. The aim of the present study was to test within and between network resting-state functional connectivity (rsFC) associations with DT, and the impact of cocaine use on this relationship. Twenty-nine adults reporting regular cocaine use (CU) and 28 matched healthy control individuals (HC), underwent resting-state functional magnetic resonance imaging followed by the completion of two counterbalanced, computerized DT tasks. Dual-regression analysis was used to derive within and between network rsFC of the SN, DMN, and lateralized (left and right) ECN. Cox proportional-hazards survival models were used to test the interactive effect of rsFC and group on DT. The association between cocaine use severity, rsFC, and DT was tested within the CU group. Lower LECN and higher DMN-SN rsFC were associated with DT impairment. Greater amount of cocaine use per using day was associated with greater DMN-SN rsFC. The findings emphasize the role of neural resource allocation within the ECN and between DMN-SN on distress tolerance.
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Affiliation(s)
- Elizabeth D. Reese
- Department of Psychology and Neuroscience, University of North Carolina, Chapel Hill, NC 27514, USA; (E.D.R.); (J.Y.Y.); (K.G.M.)
| | - Jennifer Y. Yi
- Department of Psychology and Neuroscience, University of North Carolina, Chapel Hill, NC 27514, USA; (E.D.R.); (J.Y.Y.); (K.G.M.)
| | - Katlyn G. McKay
- Department of Psychology and Neuroscience, University of North Carolina, Chapel Hill, NC 27514, USA; (E.D.R.); (J.Y.Y.); (K.G.M.)
| | - Elliot A. Stein
- Neuroimaging Research Branch, Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, Baltimore, MD 21224, USA; (E.A.S.); (T.J.R.)
| | - Thomas J. Ross
- Neuroimaging Research Branch, Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, Baltimore, MD 21224, USA; (E.A.S.); (T.J.R.)
| | - Stacey B. Daughters
- Department of Psychology and Neuroscience, University of North Carolina, Chapel Hill, NC 27514, USA; (E.D.R.); (J.Y.Y.); (K.G.M.)
- Correspondence:
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24
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Is (poly-) substance use associated with impaired inhibitory control? A mega-analysis controlling for confounders. Neurosci Biobehav Rev 2019; 105:288-304. [DOI: 10.1016/j.neubiorev.2019.07.006] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Revised: 06/10/2019] [Accepted: 07/07/2019] [Indexed: 12/25/2022]
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25
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Ceccarini J, Leurquin-Sterk G, Crunelle CL, de Laat B, Bormans G, Peuskens H, Van Laere K. Recovery of Decreased Metabotropic Glutamate Receptor 5 Availability in Abstinent Alcohol-Dependent Patients. J Nucl Med 2019; 61:256-262. [PMID: 31481578 DOI: 10.2967/jnumed.119.228825] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Accepted: 07/19/2019] [Indexed: 12/21/2022] Open
Abstract
Animal models of alcohol dependence and relapse demonstrate an important role of the glutamatergic system, in particular, cerebral metabotropic glutamate receptor 5 (mGluR5). 18F-3-fluoro-5-[(pyridin-3-yl)ethynyl]benzonitrile (18F-FPEB) PET has revealed that chronic alcohol use leads to decreased limbic mGluR5 availability, which was associated with less craving. Here, we tested whether the state of decreased mGluR5 availability in alcohol-dependent patients normalizes during abstinence (at 2 and 6 mo of detoxification) and whether initial mGluR5 imaging parameters can predict individual relapse. Methods: 18F-FPEB scans were performed for 16 recently detoxified alcohol-dependent patients (baseline condition), 2 mo after detoxification (n = 10), and 6 mo after detoxification (n = 8); 32 age- and sex-matched controls were included for comparison. mGluR5 availability was quantified by the 18F-FPEB total distribution volume using both voxel-by-voxel and volume-of-interest analyses. During follow-up, craving was assessed using the Desire for Alcohol Questionnaire, and alcohol consumption was assessed using the timeline follow-back method and monitored by hair ethyl glucuronide analysis. Results: During abstinence, alcohol-dependent patients showed sustained recovered mGluR5 availability in cortical and subcortical regions compared with the baseline, up to the levels observed in controls, after 6 mo in most areas except for the hippocampus, nucleus accumbens, and thalamus. Higher striatopallidal mGluR5 availability was observed at the baseline in patients who had a relapse during the 6-mo follow-up period (+25.1%). Also, normalization of striatal mGluR5 to control levels was associated with reduced craving ("desire and intention to drink" and "negative reinforcement"; r = 0.72-0.94). Conclusion: Reduced cerebral mGluR5 availability in alcohol-dependent patients recovers during abstinence and is associated with reduced craving. Higher striatal mGluR5 availability in alcohol-dependent users may be associated with long-term relapse.
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Affiliation(s)
- Jenny Ceccarini
- Department of Nuclear Medicine and Molecular Imaging, UZ Leuven, Leuven, Belgium .,Department of Imaging and Pathology, KU Leuven, Leuven, Belgium
| | - Gil Leurquin-Sterk
- Department of Nuclear Medicine and Molecular Imaging, UZ Leuven, Leuven, Belgium.,Department of Imaging and Pathology, KU Leuven, Leuven, Belgium
| | - Cleo Lina Crunelle
- Toxicological Center, University of Antwerp, Wilrijk, Belgium.,Department of Psychiatry, Universitair Ziekenhuis Brussel, Brussels, Belgium
| | - Bart de Laat
- Department of Nuclear Medicine and Molecular Imaging, UZ Leuven, Leuven, Belgium.,Department of Imaging and Pathology, KU Leuven, Leuven, Belgium.,MoSAIC, Molecular Small Animal Imaging Center, KU Leuven, Leuven, Belgium
| | - Guy Bormans
- Laboratory for Radiopharmacy, KU Leuven, Leuven, Belgium
| | - Hendrik Peuskens
- University Psychiatric Center, KU Leuven, Kortenberg, Belgium; and.,Kliniek Broeders Alexianen, Tienen, Belgium
| | - Koen Van Laere
- Department of Nuclear Medicine and Molecular Imaging, UZ Leuven, Leuven, Belgium.,Department of Imaging and Pathology, KU Leuven, Leuven, Belgium.,MoSAIC, Molecular Small Animal Imaging Center, KU Leuven, Leuven, Belgium
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26
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Ekhtiari H, Tavakoli H, Addolorato G, Baeken C, Bonci A, Campanella S, Castelo-Branco L, Challet-Bouju G, Clark VP, Claus E, Dannon PN, Del Felice A, den Uyl T, Diana M, di Giannantonio M, Fedota JR, Fitzgerald P, Gallimberti L, Grall-Bronnec M, Herremans SC, Herrmann MJ, Jamil A, Khedr E, Kouimtsidis C, Kozak K, Krupitsky E, Lamm C, Lechner WV, Madeo G, Malmir N, Martinotti G, McDonald WM, Montemitro C, Nakamura-Palacios EM, Nasehi M, Noël X, Nosratabadi M, Paulus M, Pettorruso M, Pradhan B, Praharaj SK, Rafferty H, Sahlem G, Salmeron BJ, Sauvaget A, Schluter RS, Sergiou C, Shahbabaie A, Sheffer C, Spagnolo PA, Steele VR, Yuan TF, van Dongen JDM, Van Waes V, Venkatasubramanian G, Verdejo-García A, Verveer I, Welsh JW, Wesley MJ, Witkiewitz K, Yavari F, Zarrindast MR, Zawertailo L, Zhang X, Cha YH, George TP, Frohlich F, Goudriaan AE, Fecteau S, Daughters SB, Stein EA, Fregni F, Nitsche MA, Zangen A, Bikson M, Hanlon CA. Transcranial electrical and magnetic stimulation (tES and TMS) for addiction medicine: A consensus paper on the present state of the science and the road ahead. Neurosci Biobehav Rev 2019; 104:118-140. [PMID: 31271802 PMCID: PMC7293143 DOI: 10.1016/j.neubiorev.2019.06.007] [Citation(s) in RCA: 171] [Impact Index Per Article: 34.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Revised: 05/30/2019] [Accepted: 06/08/2019] [Indexed: 12/21/2022]
Abstract
There is growing interest in non-invasive brain stimulation (NIBS) as a novel treatment option for substance-use disorders (SUDs). Recent momentum stems from a foundation of preclinical neuroscience demonstrating links between neural circuits and drug consuming behavior, as well as recent FDA-approval of NIBS treatments for mental health disorders that share overlapping pathology with SUDs. As with any emerging field, enthusiasm must be tempered by reason; lessons learned from the past should be prudently applied to future therapies. Here, an international ensemble of experts provides an overview of the state of transcranial-electrical (tES) and transcranial-magnetic (TMS) stimulation applied in SUDs. This consensus paper provides a systematic literature review on published data - emphasizing the heterogeneity of methods and outcome measures while suggesting strategies to help bridge knowledge gaps. The goal of this effort is to provide the community with guidelines for best practices in tES/TMS SUD research. We hope this will accelerate the speed at which the community translates basic neuroscience into advanced neuromodulation tools for clinical practice in addiction medicine.
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Affiliation(s)
| | - Hosna Tavakoli
- Institute for Cognitive Science Studies (ICSS), Iran; Iranian National Center for Addiction Studies (INCAS), Iran
| | - Giovanni Addolorato
- Alcohol Use Disorder Unit, Division of Internal Medicine, Gastroenterology and Hepatology Unit, Catholic University of Rome, A. Gemelli Hospital, Rome, Italy; Fondazione Policlinico Universitario A Gemelli IRCCS, Rome, Italy
| | - Chris Baeken
- Department of Psychiatry and Medical Psychology, University Hospital Ghent, Ghent, Belgium
| | - Antonello Bonci
- Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, Baltimore, MD, USA; Solomon H. Snyder Department of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | | | | | | | - Vincent P Clark
- University of New Mexico, USA; The Mind Research Network, USA
| | | | | | - Alessandra Del Felice
- University of Padova, Department of Neuroscience, Padova, Italy; Padova Neuroscience Center (PNC), University of Padova, Padova, Italy
| | | | - Marco Diana
- 'G. Minardi' Laboratory of Cognitive Neuroscience, Department of Chemistry and Pharmacy, University of Sassari, Italy
| | | | - John R Fedota
- Neuroimaging Research Branch, National Institute on Drug Abuse, Intramural Research Program, National Institutes of Health, Baltimore, MD, USA
| | | | - Luigi Gallimberti
- Novella Fronda Foundation, Human Science and Brain Research, Padua, Italy
| | | | - Sarah C Herremans
- Department of Psychiatry and Medical Psychology, University Hospital Ghent, Ghent, Belgium
| | - Martin J Herrmann
- Center of Mental Health, Department of Psychiatry, Psychosomatics, and Psychotherapy, University Hospital of Würzburg, Würzburg, Germany
| | - Asif Jamil
- Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany
| | | | | | - Karolina Kozak
- University of Toronto, Canada; Centre for Addiction and Mental Health (CAMH), Canada
| | - Evgeny Krupitsky
- V. M. Bekhterev National Medical Research Center for Psychiatry and Neurology, St.-Petersburg, Russia; St.-Petersburg First Pavlov State Medical University, Russia
| | - Claus Lamm
- Department of Basic Psychological Research and Research Methods, Faculty of Psychology, University of Vienna, Austria
| | | | - Graziella Madeo
- Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, Baltimore, MD, USA
| | | | | | - William M McDonald
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Chiara Montemitro
- Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, Baltimore, MD, USA; University G.d'Annunzio of Chieti-Pescara, Italy
| | | | - Mohammad Nasehi
- Cognitive and Neuroscience Research Center (CNRC), Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Xavier Noël
- Université Libre de Bruxelles (ULB), Belgium
| | | | | | | | | | - Samir K Praharaj
- Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, India
| | - Haley Rafferty
- Spaulding Rehabilitation Hospital, Harvard Medical School, USA
| | | | - Betty Jo Salmeron
- Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, Baltimore, MD, USA
| | - Anne Sauvaget
- Laboratory «Movement, Interactions, Performance» (E.A. 4334), University of Nantes, 25 Bis Boulevard Guy Mollet, BP 72206, 44322, Nantes Cedex 3, France; CHU de Nantes Addictology and Liaison Psychiatry Department, University Hospital Nantes, Nantes Cedex 3, France
| | - Renée S Schluter
- Laureate Institute for Brain Research, USA; Institute for Cognitive Science Studies (ICSS), Iran
| | | | - Alireza Shahbabaie
- Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany
| | | | | | - Vaughn R Steele
- Neuroimaging Research Branch, National Institute on Drug Abuse, Intramural Research Program, National Institutes of Health, Baltimore, MD, USA
| | - Ti-Fei Yuan
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, China
| | | | - Vincent Van Waes
- Laboratoire de Neurosciences Intégratives et Cliniques EA481, Université Bourgogne Franche-Comté, Besançon, France
| | | | | | | | - Justine W Welsh
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | | | | | - Fatemeh Yavari
- Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany
| | - Mohammad-Reza Zarrindast
- Department of Pharmacology School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Laurie Zawertailo
- University of Toronto, Canada; Centre for Addiction and Mental Health (CAMH), Canada
| | - Xiaochu Zhang
- University of Science and Technology of China, China
| | | | - Tony P George
- University of Toronto, Canada; Centre for Addiction and Mental Health (CAMH), Canada
| | | | - Anna E Goudriaan
- Department of Psychiatry, Amsterdam Institute for Addiction Research, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, The Netherlands; Arkin, Department of Research and Quality of Care, Amsterdam, The Netherlands
| | | | | | - Elliot A Stein
- Neuroimaging Research Branch, National Institute on Drug Abuse, Intramural Research Program, National Institutes of Health, Baltimore, MD, USA
| | - Felipe Fregni
- Spaulding Rehabilitation Hospital, Harvard Medical School, USA
| | - Michael A Nitsche
- Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany; University Medical Hospital Bergmannsheil, Dept. Neurology, Bochum, Germany
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27
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Anastasio NC, Stutz SJ, Price AE, Davis-Reyes BD, Sholler DJ, Ferguson SM, Neumaier JF, Moeller FG, Hommel JD, Cunningham KA. Convergent neural connectivity in motor impulsivity and high-fat food binge-like eating in male Sprague-Dawley rats. Neuropsychopharmacology 2019; 44:1752-1761. [PMID: 31003231 PMCID: PMC6785029 DOI: 10.1038/s41386-019-0394-8] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2019] [Revised: 04/05/2019] [Accepted: 04/13/2019] [Indexed: 12/27/2022]
Abstract
Food intake is essential for survival, but maladaptive patterns of intake, possibly encoded by a preexisting vulnerability coupled with the influence of environmental variables, can modify the reward value of food. Impulsivity, a predisposition toward rapid unplanned reactions to stimuli, is one of the multifaceted determinants underlying the etiology of dysregulated eating and its evolving pathogenesis. The medial prefrontal cortex (mPFC) is a major neural director of reward-driven behavior and impulsivity. Compromised signaling between the mPFC and nucleus accumbens shell (NAcSh) is thought to underlie the cognitive inability to withhold prepotent responses (motor impulsivity) and binge intake of high-fat food (HFF) seen in binge eating disorder. To explore the relationship between motor impulsivity and binge-like eating in rodents, we identified high (HI) and low impulsive (LI) rats in the 1-choice serial reaction time task and employed a rat model of binge-like eating behavior. HFF binge rats consumed significantly greater calories relative to control rats maintained on continual access to standard food or HFF. HI rats repeatedly exhibited significantly higher bingeing on HFF vs. LI rats. Next, we employed dual viral vector chemogenetic technology which allows for the targeted and isolated modulation of ventral mPFC (vmPFC) neurons that project to the NAcSh. Chemogenetic activation of the vmPFC to NAcSh pathway significantly suppressed motor impulsivity and binge-like intake for high-fat food. Thus, inherent motor impulsivity and binge-like eating are linked and the vmPFC to NAcSh pathway serves as a 'brake' over both behaviors.
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Affiliation(s)
- Noelle C. Anastasio
- 0000 0001 1547 9964grid.176731.5Center for Addiction Research and Department of Pharmacology and Toxicology, University of Texas Medical Branch, Galveston, TX USA
| | - Sonja J. Stutz
- 0000 0001 1547 9964grid.176731.5Center for Addiction Research and Department of Pharmacology and Toxicology, University of Texas Medical Branch, Galveston, TX USA
| | - Amanda E. Price
- 0000 0001 1547 9964grid.176731.5Center for Addiction Research and Department of Pharmacology and Toxicology, University of Texas Medical Branch, Galveston, TX USA
| | - Brionna D. Davis-Reyes
- 0000 0001 1547 9964grid.176731.5Center for Addiction Research and Department of Pharmacology and Toxicology, University of Texas Medical Branch, Galveston, TX USA
| | - Dennis J. Sholler
- 0000 0001 1547 9964grid.176731.5Center for Addiction Research and Department of Pharmacology and Toxicology, University of Texas Medical Branch, Galveston, TX USA
| | - Susan M. Ferguson
- 0000 0000 9026 4165grid.240741.4Center for Integrative Brain Research, Seattle Children’s Research Institute, Seattle, WA USA ,0000000122986657grid.34477.33Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA USA
| | - John F. Neumaier
- 0000000122986657grid.34477.33Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA USA
| | - F. Gerard Moeller
- 0000 0004 0458 8737grid.224260.0Department of Psychiatry and Institute for Drug and Alcohol Studies, Virginia Commonwealth University, Richmond, VA USA
| | - Jonathan D. Hommel
- 0000 0001 1547 9964grid.176731.5Center for Addiction Research and Department of Pharmacology and Toxicology, University of Texas Medical Branch, Galveston, TX USA
| | - Kathryn A. Cunningham
- 0000 0001 1547 9964grid.176731.5Center for Addiction Research and Department of Pharmacology and Toxicology, University of Texas Medical Branch, Galveston, TX USA
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Lima DR, Gonçalves PD, Ometto M, Malbergier A, Amaral RA, Dos Santos B, Cavallet M, Chaim-Avancini T, Serpa MH, Ferreira LRK, Duran FLDS, Zanetti MV, Nicastri S, Busatto GF, Andrade AG, Cunha PJ. The role of neurocognitive functioning, substance use variables and the DSM-5 severity scale in cocaine relapse: A prospective study. Drug Alcohol Depend 2019; 197:255-261. [PMID: 30875646 DOI: 10.1016/j.drugalcdep.2019.01.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Revised: 12/19/2018] [Accepted: 01/19/2019] [Indexed: 01/02/2023]
Abstract
BACKGROUND The severity of substance use disorder (SUD) is currently defined by the sum of DSM-5 criteria. However, little is known about the validity of this framework or the role of additional severity indicators in relapse prediction. This study aimed to investigate the relationship between DSM-5 criteria, neurocognitive functioning, substance use variables and cocaine relapse among inpatients with cocaine use disorder (CUD). METHODS 128 adults aged between 18 and 45 years were evaluated; 68 (59 males, 9 females) had CUD and 60 (52 males, 8 females) were healthy controls. For the group with CUD, the use of other substances was not an exclusion criterion. Participants were tested using a battery of neurocognitive tests. Cocaine relapse was evaluated 3 months after discharge. RESULTS Scores for attention span and working memory were worse in patients compared to controls. Earlier onset and duration of cocaine use were related to poorer inhibitory control and global executive functioning, respectively; recent use was related to worse performance in inhibitory control, attention span and working memory. More DSM-5 criteria at baseline were significantly associated with relapse. CONCLUSIONS Recent cocaine use was the most predictive variable for neurocognitive impairments, while DSM-5 criteria predicted cocaine relapse at three months post treatment. The integration of neurocognitive measures, DSM-5 criteria and cocaine use variables in CUD diagnosis could improve severity differentiation. Longitudinal studies using additional biomarkers are needed to disentangle the different roles of severity indicators in relapse prediction and to achieve more individualized and effective treatment strategies for these patients.
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Affiliation(s)
- Danielle Ruiz Lima
- Grupo Interdisciplinar de Estudos de Álcool e Drogas GREA, Instituto de Psiquiatria IPq, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, R. Dr. Ovídio Pires de Campos, 785, Cerqueira César, 01060-970, Sao Paulo, SP, Brazil; Laboratorio de Neuroimagem em Psiquiatria (LIM 21), Instituto de Psiquiatria IPq, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, R. Dr. Ovídio Pires de Campos, 785, Cerqueira César, 01060-970, Sao Paulo, SP, Brazil.
| | - Priscila Dib Gonçalves
- Grupo Interdisciplinar de Estudos de Álcool e Drogas GREA, Instituto de Psiquiatria IPq, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, R. Dr. Ovídio Pires de Campos, 785, Cerqueira César, 01060-970, Sao Paulo, SP, Brazil; Laboratorio de Neuroimagem em Psiquiatria (LIM 21), Instituto de Psiquiatria IPq, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, R. Dr. Ovídio Pires de Campos, 785, Cerqueira César, 01060-970, Sao Paulo, SP, Brazil
| | - Mariella Ometto
- Grupo Interdisciplinar de Estudos de Álcool e Drogas GREA, Instituto de Psiquiatria IPq, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, R. Dr. Ovídio Pires de Campos, 785, Cerqueira César, 01060-970, Sao Paulo, SP, Brazil; Laboratorio de Neuroimagem em Psiquiatria (LIM 21), Instituto de Psiquiatria IPq, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, R. Dr. Ovídio Pires de Campos, 785, Cerqueira César, 01060-970, Sao Paulo, SP, Brazil
| | - Andre Malbergier
- Grupo Interdisciplinar de Estudos de Álcool e Drogas GREA, Instituto de Psiquiatria IPq, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, R. Dr. Ovídio Pires de Campos, 785, Cerqueira César, 01060-970, Sao Paulo, SP, Brazil
| | - Ricardo Abrantes Amaral
- Grupo Interdisciplinar de Estudos de Álcool e Drogas GREA, Instituto de Psiquiatria IPq, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, R. Dr. Ovídio Pires de Campos, 785, Cerqueira César, 01060-970, Sao Paulo, SP, Brazil
| | - Bernardo Dos Santos
- Escola de Enfermagem, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Av. Dr. Enéas de Carvalho Aguiar, 419, Cerqueira César, 05403-000, Sao Paulo, SP, Brazil
| | - Mikael Cavallet
- Laboratorio de Neuroimagem em Psiquiatria (LIM 21), Instituto de Psiquiatria IPq, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, R. Dr. Ovídio Pires de Campos, 785, Cerqueira César, 01060-970, Sao Paulo, SP, Brazil
| | - Tiffany Chaim-Avancini
- Laboratorio de Neuroimagem em Psiquiatria (LIM 21), Instituto de Psiquiatria IPq, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, R. Dr. Ovídio Pires de Campos, 785, Cerqueira César, 01060-970, Sao Paulo, SP, Brazil
| | - Mauricio Henriques Serpa
- Laboratorio de Neuroimagem em Psiquiatria (LIM 21), Instituto de Psiquiatria IPq, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, R. Dr. Ovídio Pires de Campos, 785, Cerqueira César, 01060-970, Sao Paulo, SP, Brazil
| | - Luiz Roberto Kobuti Ferreira
- Laboratorio de Neuroimagem em Psiquiatria (LIM 21), Instituto de Psiquiatria IPq, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, R. Dr. Ovídio Pires de Campos, 785, Cerqueira César, 01060-970, Sao Paulo, SP, Brazil
| | - Fabio Luis de Souza Duran
- Laboratorio de Neuroimagem em Psiquiatria (LIM 21), Instituto de Psiquiatria IPq, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, R. Dr. Ovídio Pires de Campos, 785, Cerqueira César, 01060-970, Sao Paulo, SP, Brazil
| | - Marcus Vinicius Zanetti
- Laboratorio de Neuroimagem em Psiquiatria (LIM 21), Instituto de Psiquiatria IPq, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, R. Dr. Ovídio Pires de Campos, 785, Cerqueira César, 01060-970, Sao Paulo, SP, Brazil
| | - Sergio Nicastri
- Grupo Interdisciplinar de Estudos de Álcool e Drogas GREA, Instituto de Psiquiatria IPq, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, R. Dr. Ovídio Pires de Campos, 785, Cerqueira César, 01060-970, Sao Paulo, SP, Brazil; Laboratorio de Neuroimagem em Psiquiatria (LIM 21), Instituto de Psiquiatria IPq, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, R. Dr. Ovídio Pires de Campos, 785, Cerqueira César, 01060-970, Sao Paulo, SP, Brazil
| | - Geraldo Filho Busatto
- Laboratorio de Neuroimagem em Psiquiatria (LIM 21), Instituto de Psiquiatria IPq, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, R. Dr. Ovídio Pires de Campos, 785, Cerqueira César, 01060-970, Sao Paulo, SP, Brazil
| | - Arthur Guerra Andrade
- Grupo Interdisciplinar de Estudos de Álcool e Drogas GREA, Instituto de Psiquiatria IPq, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, R. Dr. Ovídio Pires de Campos, 785, Cerqueira César, 01060-970, Sao Paulo, SP, Brazil; Departmento de Neurociencias, Escola de Medicina do ABC, Av. Lauro Gomes, 2000, Vila Sacadura Cabral, 09060-870, Santo Andre, SP, Brazil
| | - Paulo Jannuzzi Cunha
- Grupo Interdisciplinar de Estudos de Álcool e Drogas GREA, Instituto de Psiquiatria IPq, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, R. Dr. Ovídio Pires de Campos, 785, Cerqueira César, 01060-970, Sao Paulo, SP, Brazil; Laboratorio de Neuroimagem em Psiquiatria (LIM 21), Instituto de Psiquiatria IPq, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, R. Dr. Ovídio Pires de Campos, 785, Cerqueira César, 01060-970, Sao Paulo, SP, Brazil
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Mackey S, Algaier N, Chaarani B, Spechler P, Orr C, Bunn J, Allen NB, Alia-Klein N, Batalla A, Blaine S, Brooks S, Caparelli E, Chye YY, Cousijn J, Dagher A, Desrivieres S, Feldstein-Ewing S, Foxe JJ, Goldstein RZ, Goudriaan AE, Heitzeg MM, Hester R, Hutchison K, Korucuoglu O, Li CSR, London E, Lorenzetti V, Luijten M, Martin-Santos R, May A, Momenan R, Morales A, Paulus MP, Pearlson G, Rouseau ME, Salmeron BJ, Schluter R, Schmaal L, Schumann G, Sjoerds Z, Stein DJ, Stein EA, Sinha R, Solowij N, Tapert S, Uhlmann A, Veltman D, van Holst R, Wittle S, Wright MJ, Yucel M, Zhang S, Yurgelun-Todd D, Hibar DP, Jahanshad N, Evans A, Thompson PM, Glahn DC, Conrod P, Garavan H. Mega-Analysis of Gray Matter Volume in Substance Dependence: General and Substance-Specific Regional Effects. Am J Psychiatry 2019; 176:119-128. [PMID: 30336705 PMCID: PMC6427822 DOI: 10.1176/appi.ajp.2018.17040415] [Citation(s) in RCA: 170] [Impact Index Per Article: 34.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Although lower brain volume has been routinely observed in individuals with substance dependence compared with nondependent control subjects, the brain regions exhibiting lower volume have not been consistent across studies. In addition, it is not clear whether a common set of regions are involved in substance dependence regardless of the substance used or whether some brain volume effects are substance specific. Resolution of these issues may contribute to the identification of clinically relevant imaging biomarkers. Using pooled data from 14 countries, the authors sought to identify general and substance-specific associations between dependence and regional brain volumes. METHOD Brain structure was examined in a mega-analysis of previously published data pooled from 23 laboratories, including 3,240 individuals, 2,140 of whom had substance dependence on one of five substances: alcohol, nicotine, cocaine, methamphetamine, or cannabis. Subcortical volume and cortical thickness in regions defined by FreeSurfer were compared with nondependent control subjects when all sampled substance categories were combined, as well as separately, while controlling for age, sex, imaging site, and total intracranial volume. Because of extensive associations with alcohol dependence, a secondary contrast was also performed for dependence on all substances except alcohol. An optimized split-half strategy was used to assess the reliability of the findings. RESULTS Lower volume or thickness was observed in many brain regions in individuals with substance dependence. The greatest effects were associated with alcohol use disorder. A set of affected regions related to dependence in general, regardless of the substance, included the insula and the medial orbitofrontal cortex. Furthermore, a support vector machine multivariate classification of regional brain volumes successfully classified individuals with substance dependence on alcohol or nicotine relative to nondependent control subjects. CONCLUSIONS The results indicate that dependence on a range of different substances shares a common neural substrate and that differential patterns of regional volume could serve as useful biomarkers of dependence on alcohol and nicotine.
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Affiliation(s)
- Scott Mackey
- Department of Psychiatry, University of Vermont, Burlington VT, USA
| | - Nicholas Algaier
- Department of Psychiatry, University of Vermont, Burlington VT, USA
| | - Bader Chaarani
- Department of Psychiatry, University of Vermont, Burlington VT, USA
| | - Philip Spechler
- Department of Psychiatry, University of Vermont, Burlington VT, USA
| | - Catherine Orr
- Department of Psychiatry, University of Vermont, Burlington VT, USA
| | - Janice Bunn
- Department of Mathematics and Statistics, University of Vermont, Burlington VT, USA
| | - Nicholas B. Allen
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Australia,Department of Psychology, University of Oregon, Eugene OR, USA,Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Australia
| | - Nelly Alia-Klein
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York City NY, USA
| | - Albert Batalla
- Department of Psychiatry and Psychology, University of Barcelona, Barcelona, Spain,Department of Psychiatry, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Sara Blaine
- Department of Psychiatry, Yale University School of Medicine, New Haven CT, USA
| | - Samantha Brooks
- Department of Psychiatry and MRC Unit on Anxiety & Stress Disorders, University of Cape Town, Cape Town, South Africa
| | - Elisabeth Caparelli
- Neuroimaging Research Branch, Intramural Research Program, National Institute on Drug Abuse, Baltimore, USA
| | - Yann Ying Chye
- Monash Institute of Cognitive and Clinical Neurosciences & School of Psychological Sciences, Monash University, Melbourne, Australia
| | - Janna Cousijn
- Departments of Developmental and Experimental Psychology, Utrecht University, Utrecht, the Netherlands
| | - Alain Dagher
- Brain Imaging Center, Montreal Neurological Institute, McGill University, Montreal QC, Canada
| | - Sylvane Desrivieres
- Centre for Population Neuroscience and Precision Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | | | - John J. Foxe
- Department of Neuroscience & The Ernest J. Del Monte Institute for Neuroscience, University of Rochester School of Medicine and Dentistry, Rochester NY, USA
| | - Rita Z. Goldstein
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York City NY, USA
| | - Anna E. Goudriaan
- Department of Psychiatry, University of Amsterdam, Amsterdam, the Netherlands,Amsterdam Institute for Addiction Research & Arkin Mental Health Care, Amsterdam, The Netherlands
| | - Mary M. Heitzeg
- Department of Psychiatry, University of Michigan, Ann Arbor MI, USA
| | - Robert Hester
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia
| | - Kent Hutchison
- Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, USA
| | - Ozlem Korucuoglu
- Department of Psychiatry, Washington University School of Medicine, St. Louis MO, USA
| | - Chiang-Shan R. Li
- Department of Psychiatry, Yale University School of Medicine, New Haven CT, USA
| | - Edythe London
- David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, USA
| | - Valentina Lorenzetti
- Monash Institute of Cognitive and Clinical Neurosciences & School of Psychological Sciences, Monash University, Melbourne, Australia,School of Psychology, Faculty of Health Sciences, Australian Catholic University, Melbourne, Australia,Department of Psycological Sciences, the University of Liverpool, Liverpool, UK
| | - Maartje Luijten
- Behavioural Science Institute, Radboud University, Nijmegen, the Netherlands
| | - Rocio Martin-Santos
- Department of Psychiatry and Psychology, University of Barcelona, Barcelona, Spain
| | - April May
- Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California, San Diego, USA
| | - Reza Momenan
- Clinical NeuroImaging Research Core, Division of Intramural Clinical and Biological Research, National Institute on Alcohol Abuse and Alcoholism, Bethesda MD, USA
| | - Angelica Morales
- David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, USA
| | - Martin P. Paulus
- VA San Diego Healthcare System and Department of Psychiatry, University of California San Diego, La Jolla, USA,Laureate Institute for Brain Research, Tulsa OK, USA
| | - Godfrey Pearlson
- Department of Psychiatry, Yale University School of Medicine, New Haven CT, USA
| | - Marc-Etienne Rouseau
- Brain Imaging Center, Montreal Neurological Institute, McGill University, Montreal QC, Canada
| | - Betty Jo Salmeron
- Neuroimaging Research Branch, Intramural Research Program, National Institute on Drug Abuse, Baltimore, USA
| | - Renée Schluter
- Department of Psychiatry, University of Amsterdam, Amsterdam, the Netherlands
| | - Lianne Schmaal
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Australia,Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
| | - Gunter Schumann
- Centre for Population Neuroscience and Precision Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Zsuzsika Sjoerds
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany,Institute of Psychology, Cognitive Psychology Unit & Leiden Institute for Brain and Cognition, Leiden University, Leiden, Netherlands
| | - Dan J. Stein
- Department of Psychiatry and MRC Unit on Anxiety & Stress Disorders, University of Cape Town, Cape Town, South Africa
| | - Elliot A. Stein
- Neuroimaging Research Branch, Intramural Research Program, National Institute on Drug Abuse, Baltimore, USA
| | - Rajita Sinha
- Department of Psychiatry, Yale University School of Medicine, New Haven CT, USA
| | - Nadia Solowij
- School of Psychology and Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, Australia
| | - Susan Tapert
- Department of Psychiatry, University of California San Diego, La Jolla, USA
| | - Anne Uhlmann
- Department of Psychiatry and MRC Unit on Anxiety & Stress Disorders, University of Cape Town, Cape Town, South Africa
| | - Dick Veltman
- Department of Psychiatry, VU University Medical Center, Amsterdam, the Netherlands
| | - Ruth van Holst
- Department of Psychiatry, University of Amsterdam, Amsterdam, the Netherlands
| | - Sarah Wittle
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Australia,Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Melbourne, Australia
| | | | - Murat Yucel
- Monash Institute of Cognitive and Clinical Neurosciences & School of Psychological Sciences, Monash University, Melbourne, Australia,Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Melbourne, Australia
| | - Sheng Zhang
- Department of Psychiatry, Yale University School of Medicine, New Haven CT, USA
| | - Deborah Yurgelun-Todd
- Department of Psychiatry, University of Utah School of Medicine, Salt Lake City UT, USA
| | - Derrek P. Hibar
- Imaging Genetics Center, Department of Neurology Keck School of Medicine, University of Southern California, Marina del Rey, USA
| | - Neda Jahanshad
- Imaging Genetics Center, Department of Neurology Keck School of Medicine, University of Southern California, Marina del Rey, USA
| | - Alan Evans
- Brain Imaging Center, Montreal Neurological Institute, McGill University, Montreal QC, Canada
| | - Paul M. Thompson
- Imaging Genetics Center, Department of Neurology Keck School of Medicine, University of Southern California, Marina del Rey, USA
| | - David C. Glahn
- Department of Psychiatry, Yale University School of Medicine, New Haven CT, USA
| | - Patricia Conrod
- Department of Psychiatry, Université de Montreal, CHU Ste Justine Hospital, Montreal QC, Canada
| | - Hugh Garavan
- Department of Psychiatry, University of Vermont, Burlington VT, USA
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Kearney-Ramos TE, Dowdle LT, Mithoefer OJ, Devries W, George MS, Hanlon CA. State-Dependent Effects of Ventromedial Prefrontal Cortex Continuous Thetaburst Stimulation on Cocaine Cue Reactivity in Chronic Cocaine Users. Front Psychiatry 2019; 10:317. [PMID: 31133897 PMCID: PMC6517551 DOI: 10.3389/fpsyt.2019.00317] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Accepted: 04/24/2019] [Indexed: 12/21/2022] Open
Abstract
Cue-induced craving is a significant barrier to obtaining abstinence from cocaine. Neuroimaging research has shown that cocaine cue exposure evokes elevated activity in a network of frontal-striatal brain regions involved in drug craving and drug seeking. Prior research from our laboratory has demonstrated that when targeted at the medial prefrontal cortex (mPFC), continuous theta burst stimulation (cTBS), an inhibitory form of non-invasive brain stimulation, can decrease drug cue-related activity in the striatum in cocaine users and alcohol users. However, it is known that there are individual differences in response to repetitive transcranial magnetic stimulation (rTMS), with some individuals being responders and others non-responders. There is some evidence that state-dependent effects influence response to rTMS, with baseline neural state predicting rTMS treatment outcomes. In this single-blind, active sham-controlled crossover study, we assess the striatum as a biomarker of treatment response by determining if baseline drug cue reactivity in the striatum influences striatal response to mPFC cTBS. The brain response to cocaine cues was measured in 19 cocaine-dependent individuals immediately before and after real and sham cTBS (110% resting motor threshold, 3600 total pulses). Group independent component analysis (ICA) revealed a prominent striatum network comprised of bilateral caudate, putamen, and nucleus accumbens, which was modulated by the cocaine cue reactivity task. Baseline drug cue reactivity in this striatal network was inversely related to change in striatum reactivity after real (vs. sham) cTBS treatment (ρ = -.79; p < .001; R 2 Adj = .58). Specifically, individuals with a high striatal response to cocaine cues at baseline had significantly attenuated striatal activity after real but not sham cTBS (t 9 = -3.76; p ≤ .005). These data demonstrate that the effects of mPFC cTBS on the neural circuitry of craving are not uniform and may depend on an individual's baseline frontal-striatal reactivity to cues. This underscores the importance of assessing individual variability as we develop brain stimulation treatments for addiction.
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Affiliation(s)
- Tonisha E Kearney-Ramos
- Division on Substance Use Disorders, Columbia University Irving Medical Center, New York, NY, United States
| | - Logan T Dowdle
- Department of Psychiatry, Medical University of South Carolina, Charleston, SC, United States.,Department of Neurosciences, Medical University of South Carolina, Charleston, SC, United States
| | - Oliver J Mithoefer
- Department of Psychiatry, Medical University of South Carolina, Charleston, SC, United States
| | - William Devries
- Department of Psychiatry, Medical University of South Carolina, Charleston, SC, United States
| | - Mark S George
- Department of Psychiatry, Medical University of South Carolina, Charleston, SC, United States.,Department of Neurosciences, Medical University of South Carolina, Charleston, SC, United States.,Center for Biomedical Imaging, Medical University of South Carolina, Charleston, SC, United States.,Ralph S. Johnson VA Medical Center, Charleston, SC, United States
| | - Colleen A Hanlon
- Department of Psychiatry, Medical University of South Carolina, Charleston, SC, United States.,Department of Neurosciences, Medical University of South Carolina, Charleston, SC, United States.,Center for Biomedical Imaging, Medical University of South Carolina, Charleston, SC, United States
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31
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Zhang WH, Cao KX, Ding ZB, Yang JL, Pan BX, Xue YX. Role of prefrontal cortex in the extinction of drug memories. Psychopharmacology (Berl) 2019; 236:463-477. [PMID: 30392133 DOI: 10.1007/s00213-018-5069-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Accepted: 10/04/2018] [Indexed: 12/30/2022]
Abstract
It has been recognized that drug addiction engages aberrant process of learning and memory, and substantial studies have focused on developing effective treatment to erase the enduring drug memories to reduce the propensity to relapse. Extinction, a behavioral intervention exposing the individuals to the drug-associated cues repeatedly, can weaken the craving and relapse induced by drug-associated cues, but its clinic efficacy is limited. A clear understanding of the neuronal circuitry and molecular mechanism underlying extinction of drug memory will facilitate the successful use of extinction therapy in clinic. As a key component of mesolimbic system, medial prefrontal cortex (mPFC) has received particular attention largely in that PFC stands at the core of neural circuits for memory extinction and manipulating mPFC influences extinction of drug memories and subsequent relapse. Here, we review the recent advances in both animal models of drug abuse and human addicted patients toward the understanding of the mechanistic link between mPFC and drug memory, with particular emphasis on how mPFC contributes to the extinction of drug memory at levels ranging from neuronal architecture, synaptic plasticity to molecular signaling and epigenetic regulation, and discuss the clinic relevance of manipulating the extinction process of drug memory to prevent craving and relapse through enhancing mPFC function.
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Affiliation(s)
- Wen-Hua Zhang
- Laboratory of Fear and Anxiety Disorders, Institute of Life Science, Nanchang University, Nanchang, 330031, China
| | - Ke-Xin Cao
- Tianjin General Hospital, Tianjin Medical University, Tianjin, 300052, China.,National Institute on Drug Dependence, and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, 100191, China
| | - Zeng-Bo Ding
- National Institute on Drug Dependence, and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, 100191, China
| | - Jian-Li Yang
- Tianjin General Hospital, Tianjin Medical University, Tianjin, 300052, China
| | - Bing-Xing Pan
- Laboratory of Fear and Anxiety Disorders, Institute of Life Science, Nanchang University, Nanchang, 330031, China.
| | - Yan-Xue Xue
- National Institute on Drug Dependence, and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, 100191, China. .,Key Laboratory for Neuroscience of Ministry of Education and Neuroscience, National Health and Family Planning Commision, Peking University, Beijing, 100191, China.
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32
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Colledge F, Ludyga S, Mücke M, Pühse U, Gerber M. The effects of an acute bout of exercise on neural activity in alcohol and cocaine craving: study protocol for a randomised controlled trial. Trials 2018; 19:713. [PMID: 30594237 PMCID: PMC6310988 DOI: 10.1186/s13063-018-3062-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Accepted: 11/20/2018] [Indexed: 12/16/2022] Open
Abstract
Background Numerous studies suggest that exercise may be an effective adjunct treatment for substance use disorders. It has been suggested that exercise-induced improvements in inhibitory control may reduce craving for the substance of abuse. However, this potential mechanism has seldom been researched. Objectives The aim of the ExAlCo Study is to examine how acute bouts of exercise, at varying intensities, impact on craving for cocaine or alcohol. Cerebral haemodynamic responses during cognitive tests of inhibitory control, and exposure to substance-related cue imagery, will also be assessed using functional near-infrared spectroscopy. Design The study is a crossover randomised controlled trial. Participants will be recruited from inpatient and outpatient psychiatric treatment centres, on the approval of their treating physician. A healthy control group will be recruited using online advertising. All participants will undergo each of three conditions in randomised order: 20 min of cycle ergometry at 50–60% of maximum heart rate; 20 min of exercise at 70–80% of maximum heart rate; and 20 min of quiet reading. Immediately before and after each condition, participants will be asked to complete a computerised Stroop test, watch a film containing substance-related images and self-report craving levels. During the Stroop test and film viewing, participants’ neural activity will be measured via functional near-infrared spectroscopy. Outcomes The primary outcome measures are self-reported craving, inhibitory control and cerebral haemodynamic response to the Stroop test and a substance-related film. It is hoped that the findings from this study will shed more light on the role of exercise in the treatment of substance use disorders, particularly its scope in preventing relapse through reduced craving severity. Trial registration ClinicalTrials.gov, NCT03502486. Registered retrospectively on 5 April 2018. Electronic supplementary material The online version of this article (10.1186/s13063-018-3062-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Flora Colledge
- Department of Sport, Exercise and Health, University of Basel, Birsstrasse 320b, 4052, Basel, Switzerland.
| | - Sebastian Ludyga
- Department of Sport, Exercise and Health, University of Basel, Birsstrasse 320b, 4052, Basel, Switzerland
| | - Manuel Mücke
- Department of Sport, Exercise and Health, University of Basel, Birsstrasse 320b, 4052, Basel, Switzerland
| | - Uwe Pühse
- Department of Sport, Exercise and Health, University of Basel, Birsstrasse 320b, 4052, Basel, Switzerland
| | - Markus Gerber
- Department of Sport, Exercise and Health, University of Basel, Birsstrasse 320b, 4052, Basel, Switzerland
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McCready H, Kohno M, Kolessar M, Dennis L, Kriz D, Luber H, Anderson R, Chang M, Sasaki A, Flora K, Vandenbark A, Mitchell SH, Loftis JM, Hoffman WF, Huckans M. Functional MRI and delay discounting in patients infected with hepatitis C. J Neurovirol 2018; 24:738-751. [PMID: 30298201 PMCID: PMC6279508 DOI: 10.1007/s13365-018-0670-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Revised: 04/23/2018] [Accepted: 08/15/2018] [Indexed: 02/06/2023]
Abstract
Hepatitis C virus-infected (HCV+) adults evidence increased rates of psychiatric and cognitive difficulties. This is the first study to use functional magnetic resonance imaging (fMRI) to examine brain activation in untreated HCV+ adults. To determine whether, relative to non-infected controls (CTLs), HCV+ adults exhibit differences in brain activation during a delay discounting task (DDT), a measure of one's tendency to choose smaller immediate rewards over larger delayed rewards-one aspect of impulsivity. Twenty adults with HCV and 26 CTLs completed an fMRI protocol during the DDT. Mixed effects regression analyses of hard versus easy trials of the DDT showed that, compared with CTLs, the HCV+ group exhibited less activation in the left lateral occipital gyrus, precuneus, and superior frontal gyrus. There were also significant interactive effects for hard-easy contrasts in the bilateral medial frontal gyrus, left insula, left precuneus, left inferior parietal lobule, and right temporal occipital gyrus; the CTL group evidenced a positive relationship between impulsivity and activation, while the HCV+ group exhibited a negative relationship. Within the HCV+ group, those with high viral load chose immediate rewards more often than those with low viral load, regardless of choice difficulty; those with low viral load chose immediate rewards more often on hard choices relative to easy choices. Results show that HCV+ patients exhibit greater impulsive behavior when presented with difficult choices, and impulsivity is negatively related to activation in regions important for cognitive control. Thus, interventions that decrease impulsive choice may be warranted with some HCV+ patients.
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Affiliation(s)
- Holly McCready
- Research and Development, VA Portland Health Care System, 3710 SW US Veteran's Hospital Road, Portland, OR, 97239, USA
- Department of Behavioral Neuroscience, School of Medicine, Oregon Health and Science University, Portland, OR, USA
- Department of Psychiatry, School of Medicine, Oregon Health and Science University, Portland, OR, USA
| | - Milky Kohno
- Research and Development, VA Portland Health Care System, 3710 SW US Veteran's Hospital Road, Portland, OR, 97239, USA
- Department of Behavioral Neuroscience, School of Medicine, Oregon Health and Science University, Portland, OR, USA
- Department of Psychiatry, School of Medicine, Oregon Health and Science University, Portland, OR, USA
| | - Michael Kolessar
- Research and Development, VA Portland Health Care System, 3710 SW US Veteran's Hospital Road, Portland, OR, 97239, USA
- Department of PM&R and Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Laura Dennis
- Research and Development, VA Portland Health Care System, 3710 SW US Veteran's Hospital Road, Portland, OR, 97239, USA
- Department of Behavioral Neuroscience, School of Medicine, Oregon Health and Science University, Portland, OR, USA
- Department of Psychiatry, School of Medicine, Oregon Health and Science University, Portland, OR, USA
| | - Daniel Kriz
- Research and Development, VA Portland Health Care System, 3710 SW US Veteran's Hospital Road, Portland, OR, 97239, USA
| | - Hannah Luber
- Research and Development, VA Portland Health Care System, 3710 SW US Veteran's Hospital Road, Portland, OR, 97239, USA
| | - Renee Anderson
- Research and Development, VA Portland Health Care System, 3710 SW US Veteran's Hospital Road, Portland, OR, 97239, USA
| | - Michael Chang
- Research and Development, VA Portland Health Care System, 3710 SW US Veteran's Hospital Road, Portland, OR, 97239, USA
- The Northwest Hepatitis C Resource Center, VA Portland Health Care System, 3710 SW US Veteran's Hospital Road, Portland, OR, 97239, USA
| | - Anna Sasaki
- Research and Development, VA Portland Health Care System, 3710 SW US Veteran's Hospital Road, Portland, OR, 97239, USA
- The Northwest Hepatitis C Resource Center, VA Portland Health Care System, 3710 SW US Veteran's Hospital Road, Portland, OR, 97239, USA
| | - Kenneth Flora
- Department of Gastroenterology, The Oregon Clinic, Portland, OR, USA
| | - Arthur Vandenbark
- Research and Development, VA Portland Health Care System, 3710 SW US Veteran's Hospital Road, Portland, OR, 97239, USA
- Department of Neurology, School of Medicine, Oregon Health and Science University, Portland, OR, USA
- Department of Molecular Microbiology and Immunology, School of Medicine, Oregon Health and Science University, Portland, OR, USA
| | - Suzanne H Mitchell
- Department of Behavioral Neuroscience, School of Medicine, Oregon Health and Science University, Portland, OR, USA
- Department of Psychiatry, School of Medicine, Oregon Health and Science University, Portland, OR, USA
- Oregon Institute of Occupational Health Sciences, School of Medicine, Oregon Health and Science University, Portland, OR, USA
| | - Jennifer M Loftis
- Research and Development, VA Portland Health Care System, 3710 SW US Veteran's Hospital Road, Portland, OR, 97239, USA
- Department of Psychiatry, School of Medicine, Oregon Health and Science University, Portland, OR, USA
- The Northwest Hepatitis C Resource Center, VA Portland Health Care System, 3710 SW US Veteran's Hospital Road, Portland, OR, 97239, USA
| | - William F Hoffman
- Research and Development, VA Portland Health Care System, 3710 SW US Veteran's Hospital Road, Portland, OR, 97239, USA
- Department of Behavioral Neuroscience, School of Medicine, Oregon Health and Science University, Portland, OR, USA
- Department of Psychiatry, School of Medicine, Oregon Health and Science University, Portland, OR, USA
- Behavioral Health & Clinical Neurosciences Division, VA Portland Health Care System, 3710 SW US Veteran's Hospital Road, Portland, OR, 97239, USA
| | - Marilyn Huckans
- Research and Development, VA Portland Health Care System, 3710 SW US Veteran's Hospital Road, Portland, OR, 97239, USA.
- Department of Psychiatry, School of Medicine, Oregon Health and Science University, Portland, OR, USA.
- The Northwest Hepatitis C Resource Center, VA Portland Health Care System, 3710 SW US Veteran's Hospital Road, Portland, OR, 97239, USA.
- Behavioral Health & Clinical Neurosciences Division, VA Portland Health Care System, 3710 SW US Veteran's Hospital Road, Portland, OR, 97239, USA.
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Hanlon CA, Shannon EE, Porrino LJ. Brain activity associated with social exclusion overlaps with drug-related frontal-striatal circuitry in cocaine users: A pilot study. Neurobiol Stress 2018; 10:100137. [PMID: 30937344 PMCID: PMC6430184 DOI: 10.1016/j.ynstr.2018.10.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Revised: 09/24/2018] [Accepted: 10/29/2018] [Indexed: 12/31/2022] Open
Abstract
Background Exposure to various types of stress can elevate craving for cocaine and hasten relapse among substance dependent individuals. This investigation evaluated the effects of social exclusion on brain activity in cocaine dependent individuals. Method Forty three individuals (18 crack-cocaine users, 25 controls) were recruited from the community to participate in functional neuroimaging study in which they performed a simulated 3 person ball-tossing game (Cyberball). Each participant was told that the other 2 players were in nearby MRI scanners. Task blocks included: Inclusion (likelihood of our participant receiving the ball = 50%), Exclusion (likelihood gradually decreases to 0%), and Rest. Self-worth variables (e.g self-esteem, locus of control) were measured before and after the ball-tossing game. General linear model-based statistics were used to measure the brain response to inclusion and exclusion within and between the groups with respect to rest. Results Relative to controls, cocaine users had significantly more activity during Exclusion versus Inclusion in 3 areas: the right medial frontal gyrus (Brodmann Area 9,10), left ventral lateral frontal gyrus (Brodmann Area 10,47) and right caudate. This was driven by a higher response to social exclusion in the cocaine users. There was no difference between groups in the brain reactivity to social inclusion. Conclusion Cocaine dependent individuals have an amplified brain response to social exclusion stress in cortical regions associated with emotional regulation, arousal, craving and perception of physical pain. These data suggest that there may be a neurological basis for the well-established relationship between social stress and addiction.
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Affiliation(s)
- Colleen A Hanlon
- Department of Physiology and Pharmacology, Wake Forest University School of Medicine, Winston-Salem, NC, 27157, USA.,Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, 29425, USA
| | - Erin E Shannon
- Department of Physiology and Pharmacology, Wake Forest University School of Medicine, Winston-Salem, NC, 27157, USA
| | - Linda J Porrino
- Department of Physiology and Pharmacology, Wake Forest University School of Medicine, Winston-Salem, NC, 27157, USA
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Aharonovich E, Hasin DS, Nunes EV, Stohl M, Cannizzaro D, Sarvet A, Bolla K, Carroll KM, Genece KG. Modified cognitive behavioral therapy (M-CBT) for cocaine dependence: Development of treatment for cognitively impaired users and results from a Stage 1 trial. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2018; 32:800-811. [PMID: 30346186 DOI: 10.1037/adb0000398] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Cognitive impairments are associated with poor outcomes when treating cocaine dependent patients, but behavioral interventions to mitigate this impact have not been developed. In this Stage 1A/1B treatment development study, several compensatory strategies (e.g., content repetition, daily logs, diaries, visual presentation) were combined to create a modified cognitive behavioral therapy (M-CBT) for treating cocaine dependence. Initially, a select group of therapists, neuropsychology experts, and patients were asked to provide input on early drafts of the treatment manual and companion patient workbook. After an uncontrolled small trial (N = 15) and two rounds of manual development (Stage 1A), a pilot randomized clinical trial (N = 102) of cocaine dependent outpatients with and without cognitive impairments was conducted (Stage 1B). Participants were randomized to M-CBT (N = 52) or CBT (N = 50). Both treatments were individually delivered over 12 weeks with assessments conducted at baseline, end-of-treatment, and 3-month follow-up. The primary outcome was frequency of cocaine use, measured by number of days used in the prior 7 days. Participants in the two treatment groups did not differ significantly on drug use reduction or retention in treatment. However, among participants who completed at least 9 weeks of treatment, those in M-CBT showed a trend toward greater reduction in cocaine use compared to those in the CBT group. M-CBT is feasible for impaired and nonimpaired cocaine dependent participants. However, M-CBT treatment did not show significant superiority over standard CBT in the present sample. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
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Affiliation(s)
| | | | | | | | | | | | - Karen Bolla
- Department of Neurology, Bayview Medical Center, Johns Hopkins University
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Elias D, Kleber HD. Minding the brain: the role of pharmacotherapy in substance-use disorder treatment. DIALOGUES IN CLINICAL NEUROSCIENCE 2018. [PMID: 29302226 PMCID: PMC5741112 DOI: 10.31887/dcns.2017.19.3/hkleber] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
With its medicalization as a brain-based disease, addiction has come to be regarded as amenable to biomedical treatment approaches, most commonly pharmacotherapy. Various vulnerabilities are recognized to contribute to maladaptive substance use, and have been linked to diverse neurobiological alterations that may be targeted with pharmacotherapy: withdrawal, craving and cue reactivity, and aberrant reward processing are the most significant. Here, we summarize current thinking regarding pharmacotherapy for substance-use disorders, grouping medications by the type of vulnerability they propose to address and providing insight into their neurobiological mechanisms. We also examine the limitations of the brain-based disease model in addiction treatment, especially as these shortcomings pertain to the place of pharmacotherapy in recovery. We conclude by sketching a framework whereby medications might be integrated fruitfully with other interventions, such as behavioral, existential, or peer-based treatments, targeting aspects of addiction beyond neurobiological deficits.
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Affiliation(s)
- Dakwar Elias
- New York State Psychiatric Institute, Columbia University Medical Center, New York, New York, USA
| | - Herbert D Kleber
- New York State Psychiatric institute, Columbia University Medical Center, New York, New York, USA
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A Multilevel Computational Characterization of Endophenotypes in Addiction. eNeuro 2018; 5:eN-TNC-0151-18. [PMID: 30073199 PMCID: PMC6071202 DOI: 10.1523/eneuro.0151-18.2018] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Revised: 06/06/2018] [Accepted: 06/12/2018] [Indexed: 02/06/2023] Open
Abstract
Addiction is characterized by a profound intersubject (phenotypic) variability in the expression of addictive symptomatology and propensity to relapse following treatment. However, laboratory investigations have primarily focused on common neural substrates in addiction and have not yet been able to identify mechanisms that can account for the multifaceted phenotypic behaviors reported in the literature. To fill this knowledge gap theoretically, here we simulated phenotypic variations in addiction symptomology and responses to putative treatments, using both a neural model, based on cortico-striatal circuit dynamics, and an algorithmic model of reinforcement learning (RL). These simulations rely on the widely accepted assumption that both the ventral, model-based, goal-directed system and the dorsal, model-free, habitual system are vulnerable to extra-physiologic dopamine reinforcements triggered by addictive rewards. We found that endophenotypic differences in the balance between the two circuit or control systems resulted in an inverted-U shape in optimal choice behavior. Specifically, greater unbalance led to a higher likelihood of developing addiction and more severe drug-taking behaviors. Furthermore, endophenotypes with opposite asymmetrical biases among cortico-striatal circuits expressed similar addiction behaviors, but responded differently to simulated treatments, suggesting personalized treatment development could rely on endophenotypic rather than phenotypic differentiations. We propose our simulated results, confirmed across neural and algorithmic levels of analysis, inform on a fundamental and, to date, neglected quantitative method to characterize clinical heterogeneity in addiction.
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Forster SE, Dickey MW, Forman SD. Regional cerebral blood flow predictors of relapse and resilience in substance use recovery: A coordinate-based meta-analysis of human neuroimaging studies. Drug Alcohol Depend 2018; 185:93-105. [PMID: 29428325 DOI: 10.1016/j.drugalcdep.2017.12.009] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Revised: 11/29/2017] [Accepted: 12/01/2017] [Indexed: 12/11/2022]
Abstract
BACKGROUND Predicting relapse vulnerability can inform level-of-care and personalized substance use treatment. Few reliable predictors of relapse risk have been identified from traditional clinical, psychosocial, and demographic variables. However, recent neuroimaging findings highlight the potential prognostic import of brain-based signals, indexing the degree to which neural systems have been perturbed by addiction. These proposed "neuromarkers" forecast the likelihood, severity, and timing of relapse but the reliability and generalizability of such effects remains to be established. METHODS Activation likelihood estimation was used to conduct a preliminary quantitative, coordinate-based meta-analysis of the addiction neuroprediction literature; specifically, studies wherein baseline measures of regional cerebral blood flow were prospectively associated with substance use treatment outcomes. Consensus patterns of activation associated with relapse vulnerability (greater activation predicts poorer outcomes) versus resilience (greater activation predicts improved outcomes) were specifically investigated. RESULTS Twenty-four eligible studies yielded 134 foci, representing 923 subjects. Consensus activation was identified in right putamen and claustrum (p < .05, cluster-corrected) in relation to positive and negative treatment outcomes - likely reflecting variability in measurement context (e.g., task, sample characteristics) across datasets. A single cluster in rostral-ventral anterior cingulate cortex (rACC) was associated with relapse resilience, specifically (p < .05, cluster-corrected); no significant vulnerability-related clusters were identified. CONCLUSIONS Right putamen activation has been associated with relapse vulnerability and resilience, while increased baseline rACC activation has been consistently associated with improved treatment outcomes. Methodological heterogeneity within the existing literature, however, limits firm conclusions and future work will be necessary to confirm and clarify these results.
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Affiliation(s)
- Sarah E Forster
- VA Pittsburgh Healthcare System, United States; University of Pittsburgh, Department of Psychiatry, United States.
| | - Michael Walsh Dickey
- VA Pittsburgh Healthcare System, United States; University of Pittsburgh, Department of Psychology, United States; University of Pittsburgh, Department of Communication Science and Disorders, United States
| | - Steven D Forman
- VA Pittsburgh Healthcare System, United States; University of Pittsburgh, Department of Psychiatry, United States
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de Laat B, Weerasekera A, Leurquin-Sterk G, Bormans G, Himmelreich U, Casteels C, Van Laere K. Glutamatergic Biomarkers for Cocaine Addiction: A Longitudinal Study Using MR Spectroscopy and mGluR5 PET in Self-Administering Rats. J Nucl Med 2018; 59:952-959. [DOI: 10.2967/jnumed.117.202614] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Accepted: 12/15/2017] [Indexed: 12/15/2022] Open
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Toward biomarkers of the addicted human brain: Using neuroimaging to predict relapse and sustained abstinence in substance use disorder. Prog Neuropsychopharmacol Biol Psychiatry 2018; 80:143-154. [PMID: 28322982 PMCID: PMC5603350 DOI: 10.1016/j.pnpbp.2017.03.003] [Citation(s) in RCA: 78] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Revised: 02/17/2017] [Accepted: 03/01/2017] [Indexed: 01/23/2023]
Abstract
The ability to predict relapse is a major goal of drug addiction research. Clinical and diagnostic measures are useful in this regard, but these measures do not fully and consistently identify who will relapse and who will remain abstinent. Neuroimaging approaches have the potential to complement these standard clinical measures to optimize relapse prediction. The goal of this review was to survey the existing drug addiction literature that either used a baseline functional or structural neuroimaging phenotype to longitudinally predict a clinical outcome, or that examined test-retest of a neuroimaging phenotype during a course of abstinence or treatment. Results broadly suggested that, relative to individuals who sustained abstinence, individuals who relapsed had (1) enhanced activation to drug-related cues and rewards, but reduced activation to non-drug-related cues and rewards, in multiple corticolimbic and corticostriatal brain regions; (2) weakened functional connectivity of these same corticolimbic and corticostriatal regions; and (3) reduced gray and white matter volume and connectivity in prefrontal regions. Thus, beyond these regions showing baseline group differences, reviewed evidence indicates that function and structure of these regions can prospectively predict - and normalization of these regions can longitudinally track - important clinical outcomes including relapse and adherence to treatment. Future clinical studies can leverage this information to develop novel treatment strategies, and to tailor scarce therapeutic resources toward individuals most susceptible to relapse.
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Yip SW, Worhunsky PD, Xu J, Morie KP, Constable RT, Malison RT, Carroll KM, Potenza MN. Gray-matter relationships to diagnostic and transdiagnostic features of drug and behavioral addictions. Addict Biol 2018; 23:394-402. [PMID: 28150390 DOI: 10.1111/adb.12492] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2016] [Revised: 12/03/2016] [Accepted: 01/03/2017] [Indexed: 11/27/2022]
Abstract
Alterations in neural structure have been reported in both cocaine-use disorder and gambling disorder, separately, suggesting similarities across addiction diagnoses. Individual variation in neural structure has also been associated with impulsivity, a dimensional construct implicated in addictions. This study combines categorical (diagnosis-based) and dimensional (transdiagnostic) approaches to identify neural structural alterations linked to addiction subtypes and trait impulsivity, respectively, across individuals with gambling disorder (n = 35), individuals with cocaine-use disorder (n = 37) and healthy comparison individuals (n = 37). High-resolution T1-weighted data were analyzed using modulated voxel-based morphometry (VBM). Statistical analyses were conducted using whole-brain general-linear models, corrected for family-wise error (pFWE < .05). Categorical analyses indicated a main effect of diagnostic group on prefrontal (dorsal anterior cingulate and ventromedial prefrontal cortex) gray matter volumes (GMVs), involving decreased GMVs among cocaine-use disorder participants only. Dimensional analyses indicated a negative association between trait impulsivity and cortical (insula) and subcortical (amygdala and hippocampus) GMVs across all participants. Conjunction analysis indicated little anatomical overlap between regions identified as differentiating diagnostic groups and regions covarying with impulsivity. These data provide first evidence of neural structural differences between gambling disorder and an illicit substance-use disorder. They further indicate dissociable effects of diagnostic groupings and trait impulsivity on neural structure among individuals with behavioral and drug addictions. Study findings highlight the importance of considering both categorical and dimensional (e.g. Research Domain Criteria; RDoC) analysis approaches within the context of addictions research.
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Affiliation(s)
- Sarah W. Yip
- The National Center on Addiction and Substance Abuse, Department of Psychiatry; Yale University School of Medicine; New Haven CT USA
- Department of Psychiatry; Yale University School of Medicine; New Haven CT USA
| | - Patrick D. Worhunsky
- Department of Diagnostic Radiology; Yale University School of Medicine; New Haven CT USA
| | - Jiansong Xu
- Department of Psychiatry; Yale University School of Medicine; New Haven CT USA
| | - Kristen P. Morie
- Department of Psychiatry; Yale University School of Medicine; New Haven CT USA
| | - R. Todd Constable
- Department of Diagnostic Radiology; Yale University School of Medicine; New Haven CT USA
| | - Robert T. Malison
- Department of Psychiatry; Yale University School of Medicine; New Haven CT USA
- Connecticut Mental Health Center; New Haven CT USA
| | - Kathleen M. Carroll
- Department of Psychiatry; Yale University School of Medicine; New Haven CT USA
| | - Marc N. Potenza
- The National Center on Addiction and Substance Abuse, Department of Psychiatry; Yale University School of Medicine; New Haven CT USA
- Connecticut Mental Health Center; New Haven CT USA
- Department of Neurobiology; Yale University School of Medicine; New Haven CT USA
- Yale Child Study Center; Yale University School of Medicine; New Haven CT USA
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Houston RJ, Schlienz NJ. Event-Related Potentials as Biomarkers of Behavior Change Mechanisms in Substance Use Disorder Treatment. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2017; 3:30-40. [PMID: 29397076 DOI: 10.1016/j.bpsc.2017.09.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Revised: 09/15/2017] [Accepted: 09/16/2017] [Indexed: 12/21/2022]
Abstract
Substance use disorders (SUDs) are one of the most prevalent psychiatric conditions and represent a significant public health concern. Substantial research has identified key processes related to reinforcement and cognition for the development and maintenance of SUDs, and these processes represent viable treatment targets for psychosocial and pharmacological interventions. Research on SUD treatments has suggested that most approaches are comparable in effectiveness. As a result, recent work has focused on delineating the underlying mechanisms of behavior change that drive SUD treatment outcome. Given the rapid fluctuations associated with the key neurocognitive processes associated with SUDs, high-temporal-resolution measures of human brain processing, namely event-related potentials (ERPs), are uniquely suited to expand our understanding of the underlying neural mechanisms of change during and after SUD treatment. The value of ERPs in the context of SUD treatment are discussed along with work demonstrating the predictive validity of ERPs as biomarkers of SUD treatment response. Example associations between multiple ERP components and psychosocial and/or pharmacological treatment outcome include the P3a and P3b (in response to neutral and substance-related cues), the attention-related negativities (e.g., N170, N200), the late positive potential, and the error-related negativity. Also addressed are limitations of the biomarker approach to underscore the need for research programs evaluating mechanisms of change. Finally, we emphasize the advantages of ERPs as indices of behavior change in SUD treatment and outline issues relevant for future directions in this context.
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Affiliation(s)
- Rebecca J Houston
- Health and Addictions Research Center, Department of Psychology, Rochester Institute of Technology, Rochester, New York.
| | - Nicolas J Schlienz
- Behavioral Pharmacology Research Unit, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
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Liu XL, Li L, Li JN, Tang JH, Rong JH, Liu B, Hu ZX. Quantifying absolute glutamate concentrations in nucleus accumbens of prescription opioid addicts by using 1H MRS. Brain Behav 2017; 7:e00769. [PMID: 28828225 PMCID: PMC5561325 DOI: 10.1002/brb3.769] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Revised: 06/07/2017] [Accepted: 06/13/2017] [Indexed: 02/06/2023] Open
Abstract
INTRODUCTION The diagnosis of psychoactive substance use disorders has been based primarily on descriptive, symptomatic checklist criteria. In opioid addiction, there are no objective biological indicators specific enough to guide diagnosis, monitor disease status, and evaluate efficacy of therapeutic interventions. Proton magnetic resonance spectroscopy (1H MRS) of the brain has potential to identify and quantify biomarkers for the diagnosis of opioid dependence. The purpose of this study was to detect the absolute glutamate concentration in the nucleus accumbens (NAc) of patients with prescription opioid dependence using 1H MRS, and to analyze its clinical associations. METHODS Twenty patients with clinically diagnosed definitive prescription opioid dependent (mean age = 26.5 ± 4.3 years) and 20 matched healthy controls (mean age = 26.1 ± 3.8 years) participated in this study. Patients were evaluated with the Barratt Impulsiveness Scale (BIS-11), the Self-Rating Anxiety Scale (SAS), and the opiate Addiction Severity Inventory (ASI). We used point-resolved spectroscopy to quantify the absolute concentrations of metabolites (glutamate, choline, N-acetylaspartate, glutamine, creatine) within the NAc. The difference between metabolite levels of groups and Pearson's correlation between glutamate levels and psychometric scores in patients were analyzed statistically. RESULTS Glutamate concentrations in the NAc were significantly higher in prescription opiate addicts than in controls (t = 3.84, p = .001). None of the other metabolites differed significantly between the two groups (all ps > .05). The glutamate concentrations correlated positively with BIS-11 scores in prescription opiate addicts (r = .671, p = .001), but not with SAS score and ASI index. CONCLUSIONS Glutamate levels in the NAc measured quantitatively with in vivo 1H MRS could be used as a biomarker to evaluate disease condition in opioid-dependent patients.
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Affiliation(s)
- Xi-Long Liu
- Department of Radiology Guangdong Provincial Corps Hospital of Chinese People's Armed Police Forces Guangzhou Medical University Guangzhou China
| | - Long Li
- Department of Radiology Guangdong Provincial Corps Hospital of Chinese People's Armed Police Forces Guangzhou Medical University Guangzhou China
| | - Jian-Neng Li
- Department of Radiology Guangdong Provincial Corps Hospital of Chinese People's Armed Police Forces Guangzhou Medical University Guangzhou China
| | - Ji-Hua Tang
- Department of Psychology and Addiction Medicine Guangdong Provincial Corps Hospital of Chinese People's Armed Police Forces Guangzhou Medical University Guangzhou China
| | - Jia-Hui Rong
- Department of Radiology Guangdong Provincial Corps Hospital of Chinese People's Armed Police Forces Guangzhou Medical University Guangzhou China
| | - Bo Liu
- Department of Radiology Guangdong Provincial Corps Hospital of Chinese People's Armed Police Forces Guangzhou Medical University Guangzhou China
| | - Ze-Xuan Hu
- Department of Radiology Guangdong Provincial Corps Hospital of Chinese People's Armed Police Forces Guangzhou Medical University Guangzhou China
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Neurofeedback in Substance Use and Overeating: Current Applications and Future Directions. CURRENT ADDICTION REPORTS 2017. [DOI: 10.1007/s40429-017-0137-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Schuch-Goi SB, Goi PD, Bermudez M, Fara LS, Kessler FP, Pechansky F, Gama CS, Massuda R, von Diemen L. Accumbens volumes are reduced among crack-cocaine users. Neurosci Lett 2017; 645:86-89. [DOI: 10.1016/j.neulet.2017.02.073] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2016] [Revised: 02/26/2017] [Accepted: 02/27/2017] [Indexed: 11/28/2022]
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Murphy A, Nestor LJ, McGonigle J, Paterson L, Boyapati V, Ersche KD, Flechais R, Kuchibatla S, Metastasio A, Orban C, Passetti F, Reed L, Smith D, Suckling J, Taylor E, Robbins TW, Lingford-Hughes A, Nutt DJ, Deakin JFW, Elliott R. Acute D3 Antagonist GSK598809 Selectively Enhances Neural Response During Monetary Reward Anticipation in Drug and Alcohol Dependence. Neuropsychopharmacology 2017; 42:1049-1057. [PMID: 28042871 PMCID: PMC5423526 DOI: 10.1038/npp.2016.289] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Revised: 12/09/2016] [Accepted: 12/19/2016] [Indexed: 01/16/2023]
Abstract
Evidence suggests that disturbances in neurobiological mechanisms of reward and inhibitory control maintain addiction and provoke relapse during abstinence. Abnormalities within the dopamine system may contribute to these disturbances and pharmacologically targeting the D3 dopamine receptor (DRD3) is therefore of significant clinical interest. We used functional magnetic resonance imaging to investigate the acute effects of the DRD3 antagonist GSK598809 on anticipatory reward processing, using the monetary incentive delay task (MIDT), and response inhibition using the Go/No-Go task (GNGT). A double-blind, placebo-controlled, crossover design approach was used in abstinent alcohol dependent, abstinent poly-drug dependent and healthy control volunteers. For the MIDT, there was evidence of blunted ventral striatal response to reward in the poly-drug-dependent group under placebo. GSK598809 normalized ventral striatal reward response and enhanced response in the DRD3-rich regions of the ventral pallidum and substantia nigra. Exploratory investigations suggested that the effects of GSK598809 were mainly driven by those with primary dependence on alcohol but not on opiates. Taken together, these findings suggest that GSK598809 may remediate reward deficits in substance dependence. For the GNGT, enhanced response in the inferior frontal cortex of the poly-drug group was found. However, there were no effects of GSK598809 on the neural network underlying response inhibition nor were there any behavioral drug effects on response inhibition. GSK598809 modulated the neural network underlying reward anticipation but not response inhibition, suggesting that DRD3 antagonists may restore reward deficits in addiction.
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Affiliation(s)
- Anna Murphy
- Neuroscience and Psychiatry Unit, University of Manchester, Manchester, UK
| | - Liam J Nestor
- Centre for Neuropsychopharmacology, Division of Brain Sciences, Imperial College London, London, UK
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - John McGonigle
- Centre for Neuropsychopharmacology, Division of Brain Sciences, Imperial College London, London, UK
| | - Louise Paterson
- Centre for Neuropsychopharmacology, Division of Brain Sciences, Imperial College London, London, UK
| | | | - Karen D Ersche
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- Department of Psychology, University of Cambridge, Cambridge, UK
| | - Remy Flechais
- Centre for Neuropsychopharmacology, Division of Brain Sciences, Imperial College London, London, UK
| | - Shankar Kuchibatla
- Neuroscience and Psychiatry Unit, University of Manchester, Manchester, UK
| | - Antonio Metastasio
- Neuroscience and Psychiatry Unit, University of Manchester, Manchester, UK
| | - Csaba Orban
- Centre for Neuropsychopharmacology, Division of Brain Sciences, Imperial College London, London, UK
| | - Filippo Passetti
- Centre for Neuropsychopharmacology, Division of Brain Sciences, Imperial College London, London, UK
| | - Laurence Reed
- Centre for Neuropsychopharmacology, Division of Brain Sciences, Imperial College London, London, UK
| | - Dana Smith
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- Department of Psychology, University of Cambridge, Cambridge, UK
| | - John Suckling
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Eleanor Taylor
- Neuroscience and Psychiatry Unit, University of Manchester, Manchester, UK
| | - Trevor W Robbins
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- Department of Psychology, University of Cambridge, Cambridge, UK
| | - Anne Lingford-Hughes
- Centre for Neuropsychopharmacology, Division of Brain Sciences, Imperial College London, London, UK
| | - David J Nutt
- Centre for Neuropsychopharmacology, Division of Brain Sciences, Imperial College London, London, UK
| | - John FW Deakin
- Neuroscience and Psychiatry Unit, University of Manchester, Manchester, UK
| | - Rebecca Elliott
- Neuroscience and Psychiatry Unit, University of Manchester, Manchester, UK
| | - ICCAM Platform
- Neuroscience and Psychiatry Unit, University of Manchester, Manchester, UK
- Centre for Neuropsychopharmacology, Division of Brain Sciences, Imperial College London, London, UK
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- Department of Psychology, University of Cambridge, Cambridge, UK
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Cannella N, Cosa-Linan A, Roscher M, Takahashi TT, Vogler N, Wängler B, Spanagel R. [18F]-Fluorodeoxyglucose-Positron Emission Tomography in Rats with Prolonged Cocaine Self-Administration Suggests Potential Brain Biomarkers for Addictive Behavior. Front Psychiatry 2017; 8:218. [PMID: 29163237 PMCID: PMC5671955 DOI: 10.3389/fpsyt.2017.00218] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Accepted: 10/17/2017] [Indexed: 12/14/2022] Open
Abstract
The DSM5-based dimensional diagnostic approach defines substance use disorders on a continuum from recreational drug use to habitual and ultimately addicted behavior. Biomarkers that are indicative of recreational drug use and addicted behavior are lacking. We performed a translational [18F]-fluorodeoxyglucose-positron emission tomography (FDG-PET) study in the multi-dimensional 0/3crit model of cocaine addiction. Addict-like (3crit) and non-addict-like (0crit) rats, which shared identical life conditions and levels of cocaine self-administration, were acquired for FDG-PET under baseline conditions and following cocaine and yohimbine challenges. Compared to cocaine-naïve control rats, 0crit animals showed higher glucose uptake in the caudate putamen (CPu) and medial prefrontal cortex (mPFC) respect to naïve controls. 3crit animals did not show this adaptive higher glucose utilization, but had lower uptake in several cortical areas. Both cocaine and yohimbine challenges affected glucose uptake in control rats in several brain sites, but not in 0crit and 3crit rats, indicating that impaired glucose mobilization in response to these challenges is not specifically associated with addictive behavior. Compared to 0crit, 3crit rats showed higher reinstatement responses, which were negatively associated with glucose uptake in the ventral tegmental area. Data indicate that cocaine non-addict- and addict-like phenotypes are associated with several potential biomarkers. Specifically, we propose that increased glucose uptake in the CPu and mPFC is a function of controlled drug use, whereas a loss of striatal and prefrontal metabolic activity and reduced uptake in cortical areas are indicative of addictive behavior.
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Affiliation(s)
- Nazzareno Cannella
- Medical Faculty Mannheim, Institute of Psychopharmacology, Central Institute of Mental Health, Heidelberg University, Mannheim, Germany
| | - Alejandro Cosa-Linan
- Medical Faculty Mannheim, Institute of Psychopharmacology, Central Institute of Mental Health, Heidelberg University, Mannheim, Germany
| | - Mareike Roscher
- Medical Faculty Mannheim, Department of Clinical Radiology and Nuclear Medicine, Heidelberg University, Mannheim, Germany
| | - Tatiane T Takahashi
- Medical Faculty Mannheim, Institute of Psychopharmacology, Central Institute of Mental Health, Heidelberg University, Mannheim, Germany
| | - Nils Vogler
- Medical Faculty Mannheim, Department of Clinical Radiology and Nuclear Medicine, Heidelberg University, Mannheim, Germany
| | - Björn Wängler
- Medical Faculty Mannheim, Department of Clinical Radiology and Nuclear Medicine, Heidelberg University, Mannheim, Germany
| | - Rainer Spanagel
- Medical Faculty Mannheim, Institute of Psychopharmacology, Central Institute of Mental Health, Heidelberg University, Mannheim, Germany
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Herremans SC, De Raedt R, Van Schuerbeek P, Marinazzo D, Matthys F, De Mey J, Baeken C. Accelerated HF-rTMS Protocol has a Rate-Dependent Effect on dACC Activation in Alcohol-Dependent Patients: An Open-Label Feasibility Study. Alcohol Clin Exp Res 2016; 40:196-205. [PMID: 26727534 DOI: 10.1111/acer.12937] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Accepted: 10/19/2015] [Indexed: 12/26/2022]
Abstract
BACKGROUND The application of accelerated high-frequency (HF) repetitive transcranial magnetic stimulation (rTMS) could be a potential treatment option for alcohol-dependent patients and may result in a faster clinical response. In this open-label HF-rTMS feasibility study, we wanted to replicate previous findings of baseline brain activation as a predictor of relapse, and to evaluate how this intervention influences the relapse neurocircuit of "treatment-seeking" alcohol-dependent patients, by means of functional magnetic resonance imaging (fMRI) cue-exposure paradigms. Because relapsing patients have a diminished resilience of the emotion regulation/cognitive control system, before HF-rTMS treatment, we expected lower neuronal activation of especially the ventromedial prefrontal cortex and anterior cingulate cortex (ACC) during the presentation of alcohol-related cues in these patients. The relapse neurocircuit should be modified after accelerated HF-rTMS treatment, only in those patients who did not relapse. METHODS After being administered a single sham-controlled HF-rTMS session (20 Hz to 110% motor threshold), 19 alcohol-dependent patients received an accelerated HF-rTMS protocol, consisting of 14 right dorsolateral prefrontal cortical sessions spread over 3 days. Before and after stimulation, during fMRI patients were confronted with a block and an event-related alcoholic cue-exposure paradigm. Relapse was defined as the consumption of any amount of alcohol within 4 weeks after the stimulation. A region of interest analysis was performed to evaluate how HF-rTMS exerts its effect. RESULTS After 4 weeks, 13 of 19 patients had already consumed alcohol. When abstainers were compared to patients who had relapsed, we found higher dorsal ACC (dACC) activation at baseline, but only during the blocked cue-exposure paradigm. The effects of HF-rTMS on dACC blood oxygen level-dependent response were negatively correlated with the baseline dACC activation. Due to susceptibility artifacts located at the ventral cortical aspects in 6 of our participants, reliable data were only obtained for the ACC. CONCLUSIONS Our data indicate that higher baseline dACC activation may serve as a protective mechanism regarding relapse. For the first time, it is demonstrated that accelerated HF-rTMS treatment influences dACC activation in a rate-dependent manner: the lower the baseline dACC activation, the more dACC activity was increased after HF-rTMS treatment.
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Affiliation(s)
- Sarah C Herremans
- Department of Psychiatry, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Rudi De Raedt
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Peter Van Schuerbeek
- Department of Radiology, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Daniele Marinazzo
- Department of Data Analysis, Faculty of Psychology and Physiological Sciences, Ghent University, Ghent, Belgium
| | - Frieda Matthys
- Department of Psychiatry, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Johan De Mey
- Department of Radiology, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Chris Baeken
- Department of Psychiatry, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel (VUB), Brussels, Belgium.,Department of Psychiatry and Medical Psychology, Ghent University, Ghent, Belgium
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Fedota JR, Stein EA. Resting-state functional connectivity and nicotine addiction: prospects for biomarker development. Ann N Y Acad Sci 2015; 1349:64-82. [PMID: 26348486 PMCID: PMC4563817 DOI: 10.1111/nyas.12882] [Citation(s) in RCA: 110] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Given conceptual frameworks of addiction as a disease of intercommunicating brain networks, examinations of network interactions may provide a holistic characterization of addiction-related dysfunction. One such methodological approach is the examination of resting-state functional connectivity, which quantifies correlations in low-frequency fluctuations of the blood oxygen level-dependent magnetic resonance imaging signal between disparate brain regions in the absence of task performance. Here, evidence of differentiated effects of chronic nicotine exposure, which reduces the efficiency of network communication across the brain, and acute nicotine exposure, which increases connectivity within specific limbic circuits, is discussed. Several large-scale resting networks, including the salience, default, and executive control networks, have also been implicated in nicotine addiction. The dynamics of connectivity changes among and between these large-scale networks during nicotine withdrawal and satiety provide a heuristic framework with which to characterize the neurobiological mechanism of addiction. The ability to simultaneously quantify effects of both chronic (trait) and acute (state) nicotine exposure provides a platform to develop a neuroimaging-based addiction biomarker. While such development remains in its early stages, evidence of coherent modulations in resting-state functional connectivity at various stages of nicotine addiction suggests potential network interactions on which to focus future addiction biomarker development.
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Affiliation(s)
- John R Fedota
- Neuroimaging Research Branch, National Institute on Drug Abuse, Intramural Research Program, National Institutes of Health, Baltimore, Maryland
| | - Elliot A Stein
- Neuroimaging Research Branch, National Institute on Drug Abuse, Intramural Research Program, National Institutes of Health, Baltimore, Maryland
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