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Kohler RJ, Zhornitsky S, Potenza MN, Yip SW, Worhunsky P, Angarita GA. Cocaine self-administration behavior is associated with subcortical and cortical morphometry measures in individuals with cocaine use disorder. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2024:1-12. [PMID: 38551365 DOI: 10.1080/00952990.2024.2318585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 02/10/2024] [Indexed: 05/24/2024]
Abstract
Background: Individual differences in gray-matter morphometry in the limbic system and frontal cortex have been linked to clinical features of cocaine use disorder (CUD). Self-administration paradigms can provide more direct measurements of the relationship between the regulation of cocaine use and gray-matter morphometry when compared to self-report assessments.Objectives: Our goal was to investigate associations with self-administration behavior in subcortical and cortical brain regions. We hypothesized the number of cocaine infusions self-administered would be correlated with gray-matter volumes (GMVs) in the striatum, amygdala, and hippocampus. Due to scarcity in human studies, we did not hypothesize subcortical directionality. In the frontal cortex, we hypothesized thickness would be negatively correlated with self-administered cocaine.Methods: We conducted an analysis of cocaine self-administration and structural MRI data from 33 (nFemales = 10) individuals with moderate-to-severe CUD. Self-administration lasted 60-minutes and cocaine (8, 16, or 32 mg/70 kg) was delivered on an FR1 schedule (5-minute lockout). Subcortical and cortical regression analyses were performed that included combined bilateral regions and age, experimental variables and use history as confounders.Results: Self-administered cocaine infusions were positively associated with caudal GMV (b = 0.18, p = 0.030) and negatively with putamenal GMV (b = -0.10, p = 0.041). In the cortical model, infusions were positively associated with insular thickness (b = 0.39, p = 0.008) and women appeared to self-administer cocaine more frequently (b = 0.23, p = 0.019).Conclusions: Brain morphometry features in the striatum and insula may contribute to cocaine consumption in CUD. These differences in morphometry may reflect consequences of prolonged use, predisposed vulnerability, or other possibilities.Clinical Trial Numbers: NCT01978431; NCT03471182.
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Affiliation(s)
- Robert J Kohler
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Simon Zhornitsky
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
- Connecticut Mental Health Center, New Haven, CT, USA
| | - Marc N Potenza
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
- Connecticut Mental Health Center, New Haven, CT, USA
- Child Study Center, Yale School of Medicine, New Haven, CT, USA
- Connecticut Council on Problem Gambling, Wethersfield, CT, USA
- Wu Tsai Institute, Yale University, New Haven, CT, USA
- Department of Neuroscience, Yale University, New Haven, CT, USA
| | - Sarah W Yip
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
- Child Study Center, Yale School of Medicine, New Haven, CT, USA
| | - Patrick Worhunsky
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
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Dacosta-Sánchez D, Díaz-Batanero C, Fernandez-Calderon F, Lozano ÓM. Impact of Cluster B Personality Disorders in Drugs Therapeutic Community Treatment Outcomes: A Study Based on Real World Data. J Clin Med 2021; 10:jcm10122572. [PMID: 34200750 PMCID: PMC8230360 DOI: 10.3390/jcm10122572] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Revised: 05/24/2021] [Accepted: 06/07/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND The impact of dual pathology on treatment outcomes is unclear, with the literature reporting both favorable and unfavorable evidence. The main aim of this study was to determine how dual pathology affects treatment outcomes using real world data obtained from inpatients that began treatment in therapeutic communities. METHOD The data of 2458 inpatients were used. Clinical information was obtained from electronic medical records. Reliability of diagnosis was checked and revealed a mean kappa value of 0.88. RESULTS Of the sample, 41.8% were discharged after achieving the therapeutic objectives. Patients diagnosed with Cluster B personality disorders were found to have a higher risk of dropping out of treatment (HR = 1.320; z = 2.61; p = 0.009). CONCLUSIONS Personality traits exhibited by Cluster B patients can interfere with treatment in therapeutic communities. There is a need to develop specific interventions for these inpatient groups, which could be implemented in therapeutic communities.
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Affiliation(s)
- Daniel Dacosta-Sánchez
- Department of Experimental and Clinical Psychology, University of Huelva, 21071 Huelva, Spain; (D.D.-S.); (C.D.-B.); (F.F.-C.)
- Research Center for Natural Resources, Health and Environment, University of Huelva, 21071 Huelva, Spain
| | - Carmen Díaz-Batanero
- Department of Experimental and Clinical Psychology, University of Huelva, 21071 Huelva, Spain; (D.D.-S.); (C.D.-B.); (F.F.-C.)
- Research Center for Natural Resources, Health and Environment, University of Huelva, 21071 Huelva, Spain
| | - Fermin Fernandez-Calderon
- Department of Experimental and Clinical Psychology, University of Huelva, 21071 Huelva, Spain; (D.D.-S.); (C.D.-B.); (F.F.-C.)
- Research Center for Natural Resources, Health and Environment, University of Huelva, 21071 Huelva, Spain
| | - Óscar M. Lozano
- Department of Experimental and Clinical Psychology, University of Huelva, 21071 Huelva, Spain; (D.D.-S.); (C.D.-B.); (F.F.-C.)
- Research Center for Natural Resources, Health and Environment, University of Huelva, 21071 Huelva, Spain
- Correspondence:
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