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Angarita GA, Pittman B, Nararajan A, Mayerson TF, Parate A, Marlin B, Gueorguieva RR, Potenza MN, Ganesan D, Malison RT. Discriminating cocaine use from other sympathomimetics using wearable electrocardiographic (ECG) sensors. Drug Alcohol Depend 2023; 250:110898. [PMID: 37523916 PMCID: PMC10905422 DOI: 10.1016/j.drugalcdep.2023.110898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 06/05/2023] [Accepted: 07/09/2023] [Indexed: 08/02/2023]
Abstract
BACKGROUND Our group has established the feasibility of using on-body electrocardiographic (ECG) sensors to detect cocaine use in the human laboratory. The purpose of the current study was to test whether ECG sensors and features are capable of discriminating cocaine use from other non-cocaine sympathomimetics. METHODS Eleven subjects with cocaine use disorder wore the Zephyr BioHarness™ 3 chest band under six experimental (drug and non-drug) conditions, including 1) laboratory, intravenous cocaine self-administration, 2) after a single oral dose of methylphenidate, 3) during aerobic exercise, 4) during tobacco use (N=7 who smoked tobacco), and 5) during routine activities of daily inpatient living (unit activity). Three ECG-derived feature sets served as primary outcome measures, including 1) the RR interval (i.e., heart rate), 2) a group of ECG interval proxies (i.e., PR, QS, QT and QTc intervals), and 3) the full ECG waveform. Discriminatory power between cocaine and non-cocaine conditions for each of the three outcomes measures was expressed as the area under the receiver operating characteristics (AUROC) curve. RESULTS All three outcomes successfully discriminated cocaine use from unit activity, exercise, tobacco, and methylphenidate conditions with a mean AUROC values ranging from 0.66 to 0.99 and with least squares means values all statistically different/higher than 0.5 among all subjects [F(3, 99) = 3.38, p =0.02] and among those with tobacco use [F(4, 84) = 5.39, p = 0.0007]. CONCLUSIONS These preliminary results support discriminatory power of wearable ECG sensors for detecting cocaine use.
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Affiliation(s)
- Gustavo A Angarita
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT06519, USA; Clinical Neuroscience Research Unit, Connecticut Mental Health Center, 34 Park Street, New Haven, CT06519, USA; Connecticut Mental Health Center, New Haven, CT06519, USA; Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, CT06510, USA.
| | - Brian Pittman
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT06519, USA; Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, CT06510, USA
| | - Annamalai Nararajan
- Philips Research North America, Cambridge, MA02141, USA; Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, CT06510, USA
| | - Talia F Mayerson
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT06519, USA; Clinical Neuroscience Research Unit, Connecticut Mental Health Center, 34 Park Street, New Haven, CT06519, USA; Connecticut Mental Health Center, New Haven, CT06519, USA; Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, CT06510, USA
| | - Abhinav Parate
- Manning College of Information and Computer Science, University of Massachusetts, Amherst, MA01003, USA; Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, CT06510, USA; Lumme Health Inc, Boston, MA02210, USA
| | - Benjamin Marlin
- Manning College of Information and Computer Science, University of Massachusetts, Amherst, MA01003, USA; Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, CT06510, USA
| | - Ralitza R Gueorguieva
- Department of Biostatistics, Yale University School of Public Health, New Haven, CT06510, USA; Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, CT06510, USA
| | - Marc N Potenza
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT06519, USA; Connecticut Mental Health Center, New Haven, CT06519, USA; Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, CT06510, USA; Child Study Center, Yale University School of Medicine, New Haven, CT06510, USA; Department of Neuroscience, Yale University, New Haven, CT06510, USA; Connecticut Council on Problem Gambling, Wethersfield, CT06109, USA; Wu Tsai Institute, New Haven, CT06510, USA
| | - Deepak Ganesan
- Manning College of Information and Computer Science, University of Massachusetts, Amherst, MA01003, USA; Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, CT06510, USA
| | - Robert T Malison
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT06519, USA; Clinical Neuroscience Research Unit, Connecticut Mental Health Center, 34 Park Street, New Haven, CT06519, USA; Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, CT06510, USA; Department of Neuroscience, Yale University, New Haven, CT06510, USA
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van Ruitenbeek P, Franzen L, Mason NL, Stiers P, Ramaekers JG. Methylphenidate as a treatment option for substance use disorder: a transdiagnostic perspective. Front Psychiatry 2023; 14:1208120. [PMID: 37599874 PMCID: PMC10435872 DOI: 10.3389/fpsyt.2023.1208120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 07/14/2023] [Indexed: 08/22/2023] Open
Abstract
A transition in viewing mental disorders from conditions defined as a set of unique characteristics to one of the quantitative variations on a collection of dimensions allows overlap between disorders. The overlap can be utilized to extend to treatment approaches. Here, we consider the overlap between attention-deficit/hyperactivity disorder and substance use disorder to probe the suitability to use methylphenidate as a treatment for substance use disorder. Both disorders are characterized by maladaptive goal-directed behavior, impaired cognitive control, hyperactive phasic dopaminergic neurotransmission in the striatum, prefrontal hypoactivation, and reduced frontal cortex gray matter volume/density. In addition, methylphenidate has been shown to improve cognitive control and normalize associated brain activation in substance use disorder patients and clinical trials have found methylphenidate to improve clinical outcomes. Despite the theoretical basis and promising, but preliminary, outcomes, many questions remain unanswered. Most prominent is whether all patients who are addicted to different substances may equally profit from methylphenidate treatment.
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Affiliation(s)
- Peter van Ruitenbeek
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands
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Graczyk MM, Sahakian BJ, Robbins TW, Ersche KD. Genotype-by-diagnosis interaction influences self-control in human cocaine addiction. Transl Psychiatry 2023; 13:51. [PMID: 36774338 PMCID: PMC9922269 DOI: 10.1038/s41398-023-02347-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 01/22/2023] [Accepted: 01/30/2023] [Indexed: 02/13/2023] Open
Abstract
Not everyone who uses drugs loses control over their intake, which is a hallmark of addiction. Although familial risk studies suggest significant addiction heritability, the genetic basis of vulnerability to drug addiction remains largely unknown. In the present study, we investigate the relationship between self-control, cocaine use, and the rs36024 single nucleotide polymorphism of the noradrenaline transporter gene (SLC6A2). We hypothesize that C-allele-carrying adults show impaired self-control, as measured by the stop-signal task and demonstrated previously in adolescents, and further exacerbated by chronic cocaine use. Patients with cocaine use disorder (CUD, n = 79) and healthy unrelated participants with no history of drug abuse (n = 54) completed the stop-signal task. All participants were genotyped for rs36024 allelic variants (CC/TT homozygotes, CT heterozygotes). We measured mean stop-signal reaction time, reflecting the ability to inhibit ongoing motor responses, reaction times to go stimuli, and the proportion of successful stops. CUD patients showed prolonged stop-signal reaction time, however, there was no main effect of rs36024 genotype. Importantly, there was a significant genotype-by-diagnosis interaction such that CUD patients with CC genotype had longer stop-signal reaction time and fewer successful stops compared with CC healthy controls and TT CUD patients. CT CUD patients showed an intermediate performance. Self-control deficits were associated with cocaine use disorder diagnosis, which interacts with the noradrenaline transporter rs36024 polymorphism. Our findings suggest that rs36024 may represent a potential genetic vulnerability marker, which facilitates the transition from first cocaine use to addiction by weakening the inhibitory control over behavior.
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Affiliation(s)
- Michal M Graczyk
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | | | - Trevor W Robbins
- Department of Psychology, University of Cambridge, Cambridge, UK
| | - Karen D Ersche
- Department of Psychiatry, University of Cambridge, Cambridge, UK.
- Department of Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
- Department of Addictive Behaviour and Addiction Medicine, Central Institute of Mental Health, University of Heidelberg, Mannheim, Germany.
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Schwartz EKC, Wolkowicz NR, De Aquino JP, MacLean RR, Sofuoglu M. Cocaine Use Disorder (CUD): Current Clinical Perspectives. Subst Abuse Rehabil 2022; 13:25-46. [PMID: 36093428 PMCID: PMC9451050 DOI: 10.2147/sar.s337338] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 08/22/2022] [Indexed: 11/29/2022] Open
Abstract
Cocaine use disorder (CUD) is a devastating disorder, impacting both individuals and society. Individuals with CUD face many barriers in accessing treatment for CUD, and most individuals with CUD never receive treatment. In this review, we provide an overview of CUD, including risk factors for CUD, common co-occurring disorders, acute and chronic effects of cocaine use, and currently available pharmacological and behavioral treatments. There are no FDA-approved pharmacological treatments for CUD. Future studies with larger sample sizes and testing treatment combinations are warranted. However, individuals with CUD and co-occurring disorders (eg, a mood or anxiety disorder) may benefit from medication treatments. There are behavioral interventions that have demonstrated efficacy in treating CUD – contingency management (CM) and cognitive-behavioral therapy for substance use disorders (CBT-SUD) in particular – however many barriers remain in delivering these treatments to patients. Following the discussion of current treatments, we highlight some promising emerging treatments, as well as offer a framework that can be used in building a treatment plan for individuals with CUD.
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Affiliation(s)
- Elizabeth K C Schwartz
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Department of Psychiatry, VA Connecticut Healthcare System, West Haven, CT, USA
- Correspondence: Elizabeth KC Schwartz, Tel +1-203-932-5711, Fax +1-203-937-3472, Email
| | - Noah R Wolkowicz
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Department of Psychiatry, VA Connecticut Healthcare System, West Haven, CT, USA
| | - Joao P De Aquino
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Department of Psychiatry, VA Connecticut Healthcare System, West Haven, CT, USA
| | - R Ross MacLean
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Department of Psychiatry, VA Connecticut Healthcare System, West Haven, CT, USA
| | - Mehmet Sofuoglu
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Department of Psychiatry, VA Connecticut Healthcare System, West Haven, CT, USA
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Cannabidiol effects on cognition in individuals with cocaine use disorder: Exploratory results from a randomized controlled trial. Pharmacol Biochem Behav 2022; 216:173376. [DOI: 10.1016/j.pbb.2022.173376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 02/16/2022] [Accepted: 03/25/2022] [Indexed: 11/22/2022]
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van Ruitenbeek P, Quaedflieg CWEM, Hernaus D, Hartogsveld B, Smeets T. Dopaminergic and noradrenergic modulation of stress-induced alterations in brain activation associated with goal-directed behaviour. J Psychopharmacol 2021; 35:1449-1463. [PMID: 34519561 PMCID: PMC8652367 DOI: 10.1177/02698811211044679] [Citation(s) in RCA: 6] [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] [Indexed: 11/21/2022]
Abstract
BACKGROUND Acute stress is thought to reduce goal-directed behaviour, an effect purportedly associated with stress-induced release of catecholamines. In contrast, experimentally increased systemic catecholamine levels have been shown to increase goal-directed behaviour. Whether experimentally increased catecholamine function can modulate stress-induced reductions in goal-directed behaviour and its neural substrates, is currently unknown. AIM To assess whether and how experimentally induced increases in dopamine and noradrenaline contribute to the acute stress effects on goal-directed behaviour and associated brain activation. METHODS One hundred participants underwent a stress induction protocol (Maastricht acute stress test; MAST) or a control procedure and received methylphenidate (MPH) (40 mg, oral) or placebo according to a 2 × 2 between-subjects design. In a well-established instrumental learning paradigm, participants learnt stimulus-response-outcome associations, after which rewards were selectively devalued. Participants' brain activation and associated goal-directed behaviour were assessed in a magnetic resonance imaging scanner at peak cortisol/MPH concentrations. RESULTS The MAST and MPH increased physiological measures of stress (salivary cortisol and blood pressure), but only MAST increased subjective measures of stress. MPH modulated stress effects on activation of brain areas associated with goal-directed behaviour, including insula, putamen, amygdala, medial prefrontal cortex, frontal pole and orbitofrontal cortex. However, MPH did not modulate the tendency of stress to induce a reduction in goal-directed behaviour. CONCLUSION Our neuroimaging data suggest that MPH-induced increases in dopamine and noradrenaline reverse stress-induced changes in key brain regions associated with goal-directed behaviour, while behavioural effects were absent. These effects may be relevant for preventing stress-induced maladaptive behaviour like in addiction or binge eating disorder.
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Affiliation(s)
- Peter van Ruitenbeek
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands,Peter van Ruitenbeek, Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Universiteitssingel 40, Maastricht 6229 ER, The Netherlands.
| | - Conny WEM Quaedflieg
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Dennis Hernaus
- Department of Psychiatry and Neuropsychology, Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands
| | - Bart Hartogsveld
- Department of Clinical Psychological Science, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Tom Smeets
- Department of Clinical Psychological Science, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands,CoRPS – Center of Research on Psychological and Somatic Diseases, Department of Medical and Clinical Psychology, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, Noord-Brabant, The Netherlands
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Distinct patterns of prefrontal cortical disengagement during inhibitory control in addiction: A meta-analysis based on population characteristics. Neurosci Biobehav Rev 2021; 127:255-269. [PMID: 33933507 DOI: 10.1016/j.neubiorev.2021.04.028] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 03/22/2021] [Accepted: 04/25/2021] [Indexed: 11/21/2022]
Abstract
Prefrontal cortical dysfunctions underlying inhibitory control deficits in addiction are complex and likely dependent on population characteristics. Here, we conducted a meta-analysis to examine alterations in brain activations during response inhibition in addicted individuals. We characterized imaging findings based on substance use status, diagnosis, substance classes, and task performance. Results revealed in those with active drug addiction hypoactivation of the left dorsal anterior cingulate cortex (dACC) and right middle frontal gyrus (MFG), compared with healthy controls. Weakening of the dACC and MFG activations was particularly pronounced in nicotine users, respectively. Impaired task performance was also associated with diminished MFG activation. In contrast, abstinent users did not exhibit any significant differences compared with healthy controls. Those with behavioral addictions were characterized by higher midcingulate cortical activation. Thus, the neural disengagement during response inhibition in active drug addiction was limited to a small number of prefrontal cortical regions and dependent on population characteristics. Finally, the evidence for potential normalization of hypofrontality following substance use cessation highlights the benefits of abstinence in restoring cerebral functions.
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Prefrontal Responses during Proactive and Reactive Inhibition Are Differentially Impacted by Stress in Anorexia and Bulimia Nervosa. J Neurosci 2021; 41:4487-4499. [PMID: 33846229 PMCID: PMC8152613 DOI: 10.1523/jneurosci.2853-20.2021] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 01/23/2021] [Accepted: 03/02/2021] [Indexed: 11/21/2022] Open
Abstract
Binge eating is a distressing, transdiagnostic eating disorder symptom associated with impulsivity, particularly in negative mood states. Neuroimaging studies of bulimia nervosa (BN) report reduced activity in frontostriatal regions implicated in self-regulatory control, and an influential theory posits that binge eating results from self-regulation failures under stress. However, there is no direct evidence that psychological stress impairs self-regulation in binge-eating disorders, or that any such self-regulatory deficits generalize to binge eating in underweight individuals (i.e., anorexia nervosa bingeing/purging subtype; AN-BP). We therefore determined the effect of acute stress on inhibitory control in 85 women (BN, 33 women; AN-BP, 22 women; 30 control participants). Participants underwent repeated functional MRI scanning during performance of the Stop-signal anticipation task, a validated measure of proactive (i.e., anticipation of stopping) and reactive (outright stopping) inhibition. Neural and behavioral responses to induced stress and a control task were evaluated on 2 consecutive days. Women with BN had reduced proactive inhibition, while prefrontal responses were increased in both AN-BP and BN. Reactive inhibition was neurally and behaviorally intact in both diagnostic groups. Both AN-BP and BN groups showed distinct stress-induced changes in inferior and superior frontal activity during both proactive and reactive inhibition. However, task performance was unaffected by stress. These results offer novel evidence of reduced proactive inhibition in BN, yet inhibitory control deficits did not generalize to AN-BP. Our findings identify intriguing alterations of stress responses and inhibitory function associated with binge eating, but they counsel against stress-induced failures of inhibitory control as a comprehensive explanation for loss-of-control eating. SIGNIFICANCE STATEMENT Binge eating is a common psychiatric syndrome that feels uncontrollable to the sufferer. Theoretically, it has been related to reduced self-regulation under stress, but there remains no direct evidence for this link in binge-eating disorders. Here, we examined how experimentally induced stress affected response inhibition in control participants and women with anorexia nervosa and bulimia nervosa. Participants underwent repeated brain scanning under stressful and neutral conditions. Although patient groups had intact action cancellation, the slowing of motor responses was impaired in bulimia nervosa, even when the likelihood of having to stop increased. Stress altered brain responses for both forms of inhibition in both groups, yet performance remained unimpaired. These findings counsel against a simple model of stress-induced disinhibition as an adequate explanation for binge eating.
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Alcorn JL, Strickland JC, Lile JA, Stoops WW, Rush CR. Acute methylphenidate administration reduces cocaine-cue attentional bias. Prog Neuropsychopharmacol Biol Psychiatry 2020; 103:109974. [PMID: 32454161 DOI: 10.1016/j.pnpbp.2020.109974] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Revised: 03/23/2020] [Accepted: 05/19/2020] [Indexed: 11/30/2022]
Abstract
Mechanistic research on behavioral processes underlying substance use disorder might help identify novel targets for interventions development. Drug-related attentional bias and response inhibition deficits have received a great deal of consideration in substance use research, broadly, and cocaine use research, specifically. Studies investigating pharmacological mechanisms that may ameliorate, or further impair, these behaviors relevant to cocaine use are relatively lacking. This study evaluated the impact of acute administration of methylphenidate, a dopamine-favoring reuptake inhibitor, on both gaze-related cocaine-cue-attentional bias and cocaine-cue related disruptions in response inhibition among individuals with cocaine use disorder. Participants (N = 12; 33% female) completed a within-subject, outpatient, acute dosing study. Two sessions were completed in which methylphenidate (60 mg) or placebo were administered followed by completion of an attentional bias task using eye-tracking technology and neutral-cue and cocaine-cue response inhibition tasks. Subjective and physiological effects were also recorded. Significant cocaine cue attentional bias and response inhibition failures were observed during placebo administration. Acute methylphenidate administration reduced cocaine-cue attentional bias as measured by cocaine-cue gaze fixations (dz = 1.04; Bayes Factor = 12.37). No statistically significant effects of methylphenidate were observed on response inhibition (Bayes Factors = 0.17-1.04). Methylphenidate produced prototypical subjective and physiological effects. Although the small sample should be considered, these findings indicate acute manipulation of dopaminergic activity reduced cue-related attentional allocation related to cocaine use disorder. Future research evaluating alternative dopaminergic agents and applications within a clinical setting are needed to determine the clinical significance of targeting this neurobehavioral mechanism.
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Affiliation(s)
- Joseph L Alcorn
- Department of Behavioral Science, University of Kentucky College of Medicine, 1110 Veterans Drive, Medical Behavioral Science Building Room 140, Lexington, KY 40536-0086, USA
| | - Justin C Strickland
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 5510 Nathan Shock Drive, Baltimore, MD 21224, USA
| | - Joshua A Lile
- Department of Behavioral Science, University of Kentucky College of Medicine, 1110 Veterans Drive, Medical Behavioral Science Building Room 140, Lexington, KY 40536-0086, USA; Department of Psychology, University of Kentucky College of Arts and Sciences, 110 Kastle Hall, Lexington, KY 40506-0044, USA; Department of Psychiatry, University of Kentucky College of Medicine, 245 Fountain Court, Lexington, KY 40509-1810, USA
| | - William W Stoops
- Department of Behavioral Science, University of Kentucky College of Medicine, 1110 Veterans Drive, Medical Behavioral Science Building Room 140, Lexington, KY 40536-0086, USA; Department of Psychology, University of Kentucky College of Arts and Sciences, 110 Kastle Hall, Lexington, KY 40506-0044, USA; Department of Psychiatry, University of Kentucky College of Medicine, 245 Fountain Court, Lexington, KY 40509-1810, USA; Center on Drug and Alcohol Research, University of Kentucky College of Medicine, 845 Angliana Ave, Lexington, KY 40508, USA
| | - Craig R Rush
- Department of Behavioral Science, University of Kentucky College of Medicine, 1110 Veterans Drive, Medical Behavioral Science Building Room 140, Lexington, KY 40536-0086, USA; Department of Psychology, University of Kentucky College of Arts and Sciences, 110 Kastle Hall, Lexington, KY 40506-0044, USA; Department of Psychiatry, University of Kentucky College of Medicine, 245 Fountain Court, Lexington, KY 40509-1810, USA.
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CHEN J, ZHOU Y, CHEN J. The relationship between musical training and inhibitory control: An ERPs study. ACTA PSYCHOLOGICA SINICA 2020. [DOI: 10.3724/sp.j.1041.2020.01365] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Narendran R, Mason NS, Himes ML, Frankle WG. Imaging Cortical Dopamine Transmission in Cocaine Dependence: A [ 11C]FLB 457-Amphetamine Positron Emission Tomography Study. Biol Psychiatry 2020; 88:788-796. [PMID: 32507390 PMCID: PMC7554061 DOI: 10.1016/j.biopsych.2020.04.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 03/24/2020] [Accepted: 04/02/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND Positron emission tomography studies have demonstrated less dopamine D2/3 receptor availability and blunted psychostimulant-induced dopamine release in cocaine-dependent subjects (CDSs). No studies in CDSs have reported the in vivo status of D2/3 and dopamine release in the cortex. Basic and functional imaging studies suggest a role for prefrontal cortical dopaminergic abnormalities in impaired executive function and relapse in cocaine dependence. We used [11C]FLB 457 positron emission tomography and amphetamine to measure cortical D2/3 receptors and dopamine release in CDSs. METHODS [11C]FLB 457 and positron emission tomography were used to measure D2/3 receptor binding potential in cortical regions of interest in recently abstinent CDSs (n = 24) and healthy control subjects (n = 36) both before and after 0.5 mg kg-1 of oral d-amphetamine. Binding potential relative to nondisplaceable uptake (BPND) and binding potential relative to total plasma concentration (BPP) were derived using an arterial input function-based kinetic analysis. Cortical dopamine release in regions of interest was measured as the change in BPND and BPP after amphetamine. RESULTS Baseline D2/3 receptor availability (BPP and BPND) and amphetamine-induced dopamine release (ΔBPND and ΔBPP) were significantly lower in the cortical regions in CDSs compared with healthy control subjects. Fewer D2/3 receptors and less dopamine release in CDSs were not associated with performance on working memory and attention tasks. CONCLUSIONS The results of this study suggest that deficits in dopamine D2/3 transmission involve the cortex in cocaine dependence. Further studies to understand the clinical relevance of these findings are warranted.
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Affiliation(s)
- Rajesh Narendran
- Department of Radiology, University of Pittsburgh, Pittsburgh, Pennsylvania; Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania.
| | | | - Michael L. Himes
- Department of Radiology, University of Pittsburgh, Pittsburgh, PA
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Edlow BL, Barra ME, Zhou DW, Foulkes AS, Snider SB, Threlkeld ZD, Chakravarty S, Kirsch JE, Chan ST, Meisler SL, Bleck TP, Fins JJ, Giacino JT, Hochberg LR, Solt K, Brown EN, Bodien YG. Personalized Connectome Mapping to Guide Targeted Therapy and Promote Recovery of Consciousness in the Intensive Care Unit. Neurocrit Care 2020; 33:364-375. [PMID: 32794142 PMCID: PMC8336723 DOI: 10.1007/s12028-020-01062-7] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Accepted: 04/18/2020] [Indexed: 01/05/2023]
Abstract
There are currently no therapies proven to promote early recovery of consciousness in patients with severe brain injuries in the intensive care unit (ICU). For patients whose families face time-sensitive, life-or-death decisions, treatments that promote recovery of consciousness are needed to reduce the likelihood of premature withdrawal of life-sustaining therapy, facilitate autonomous self-expression, and increase access to rehabilitative care. Here, we present the Connectome-based Clinical Trial Platform (CCTP), a new paradigm for developing and testing targeted therapies that promote early recovery of consciousness in the ICU. We report the protocol for STIMPACT (Stimulant Therapy Targeted to Individualized Connectivity Maps to Promote ReACTivation of Consciousness), a CCTP-based trial in which intravenous methylphenidate will be used for targeted stimulation of dopaminergic circuits within the subcortical ascending arousal network (ClinicalTrials.gov NCT03814356). The scientific premise of the CCTP and the STIMPACT trial is that personalized brain network mapping in the ICU can identify patients whose connectomes are amenable to neuromodulation. Phase 1 of the STIMPACT trial is an open-label, safety and dose-finding study in 22 patients with disorders of consciousness caused by acute severe traumatic brain injury. Patients in Phase 1 will receive escalating daily doses (0.5-2.0 mg/kg) of intravenous methylphenidate over a 4-day period and will undergo resting-state functional magnetic resonance imaging and electroencephalography to evaluate the drug's pharmacodynamic properties. The primary outcome measure for Phase 1 relates to safety: the number of drug-related adverse events at each dose. Secondary outcome measures pertain to pharmacokinetics and pharmacodynamics: (1) time to maximal serum concentration; (2) serum half-life; (3) effect of the highest tolerated dose on resting-state functional MRI biomarkers of connectivity; and (4) effect of each dose on EEG biomarkers of cerebral cortical function. Predetermined safety and pharmacodynamic criteria must be fulfilled in Phase 1 to proceed to Phase 2A. Pharmacokinetic data from Phase 1 will also inform the study design of Phase 2A, where we will test the hypothesis that personalized connectome maps predict therapeutic responses to intravenous methylphenidate. Likewise, findings from Phase 2A will inform the design of Phase 2B, where we plan to enroll patients based on their personalized connectome maps. By selecting patients for clinical trials based on a principled, mechanistic assessment of their neuroanatomic potential for a therapeutic response, the CCTP paradigm and the STIMPACT trial have the potential to transform the therapeutic landscape in the ICU and improve outcomes for patients with severe brain injuries.
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Affiliation(s)
- Brian L Edlow
- Department of Neurology, Center for Neurotechnology and Neurorecovery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, USA.
| | - Megan E Barra
- Department of Neurology, Center for Neurotechnology and Neurorecovery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Department of Pharmacy, Massachusetts General Hospital, Boston, MA, USA
| | - David W Zhou
- Department of Neurology, Center for Neurotechnology and Neurorecovery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Andrea S Foulkes
- Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Samuel B Snider
- Department of Neurology, Center for Neurotechnology and Neurorecovery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Zachary D Threlkeld
- Department of Neurology, Center for Neurotechnology and Neurorecovery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Department of Neurology and Neurological Sciences, Stanford School of Medicine, Stanford, CA, USA
| | - Sourish Chakravarty
- Department of Neurology, Center for Neurotechnology and Neurorecovery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA, USA
- The Picower Institute for Learning and Memory, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - John E Kirsch
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, USA
| | - Suk-Tak Chan
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, USA
| | - Steven L Meisler
- Department of Neurology, Center for Neurotechnology and Neurorecovery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Thomas P Bleck
- Davee Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Joseph J Fins
- Division of Medical Ethics and Consortium for the Advanced Study of Brain Injury (CASBI), Weill Cornell Medical College, New York, NY, USA
- The Rockefeller University, New York, NY, USA
- Solomon Center for Health Law and Policy, Yale Law School, New Haven, CT, USA
| | - Joseph T Giacino
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Boston, MA, USA
| | - Leigh R Hochberg
- Department of Neurology, Center for Neurotechnology and Neurorecovery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- School of Engineering and Carney Institute for Brain Science, Brown University, Providence, RI, USA
- Veterans Affairs RR&D Center for Neurorestoration and Neurotechnology, VA Medical Center, Providence, RI, USA
| | - Ken Solt
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Emery N Brown
- Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Cambridge, MA, USA
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA, USA
- The Picower Institute for Learning and Memory, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Yelena G Bodien
- Department of Neurology, Center for Neurotechnology and Neurorecovery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Boston, MA, USA
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13
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14
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Regier PS, Kampman KM, Childress AR. Clinical Trials for Stimulant Use Disorders: Addressing Heterogeneities That May Undermine Treatment Outcomes. Handb Exp Pharmacol 2020; 258:299-322. [PMID: 32193666 DOI: 10.1007/164_2019_303] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
In recent years, use of cocaine and amphetamines and deaths associated with stimulants have been on the rise, and there are still no FDA-approved medications for stimulant use disorders. One contributing factor may involve heterogeneity. At the neurobiological level, dual dopamine dysfunction may be undermining medication efficacy, suggesting a need for combination pharmacotherapies. At the population level, individual variability is expressed in a number of ways and, if left unaddressed, may interfere with medication efficacy. This chapter reviews studies investigating medications to address dopamine dysfunction, and it also identifies several prominent heterogeneities associated with stimulant (and other substance) use disorders. The chapter has implications for improving interventions to treat stimulant use disorders, and the theme of individual heterogeneity may have broader application across substance use disorders.
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Affiliation(s)
- Paul S Regier
- Department of Psychiatry, Perelman School of Medicine, Center for Studies of Addiction, University of Pennsylvania, Philadelphia, PA, USA.
| | - Kyle M Kampman
- Department of Psychiatry, Perelman School of Medicine, Center for Studies of Addiction, University of Pennsylvania, Philadelphia, PA, USA
| | - Anna Rose Childress
- Department of Psychiatry, Perelman School of Medicine, Center for Studies of Addiction, University of Pennsylvania, Philadelphia, PA, USA
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15
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Zhang R, Volkow ND. Brain default-mode network dysfunction in addiction. Neuroimage 2019; 200:313-331. [DOI: 10.1016/j.neuroimage.2019.06.036] [Citation(s) in RCA: 131] [Impact Index Per Article: 26.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Revised: 06/14/2019] [Accepted: 06/17/2019] [Indexed: 12/21/2022] Open
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16
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Sullivan RM, Perlman G, Moeller SJ. Meta-analysis of aberrant post-error slowing in substance use disorder: implications for behavioral adaptation and self-control. Eur J Neurosci 2019; 50:2467-2476. [PMID: 30383336 PMCID: PMC6494729 DOI: 10.1111/ejn.14229] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Revised: 09/28/2018] [Accepted: 10/08/2018] [Indexed: 11/30/2022]
Abstract
Individual with substance use disorders have well-recognized impairments in cognitive control, including in behavioral adaptation after mistakes. One way in which this impairment manifests is via diminished post-error slowing, the increase in reaction time following a task-related error that is posited to reflect cautionary or corrective behavior. Yet, in the substance use disorder literature, findings with regard to post-error slowing have been inconsistent, and thus could benefit from quantitative integration. Here, we conducted a meta-analysis of case-control studies examining post-error slowing in addiction. Twelve studies with 15 unique comparisons were identified, comprising 567 substance users and 384 healthy controls across three broad types of inhibitory control paradigms (go-no/go, conflict resolution, and stop signal tasks, respectively). Results of the random-effects meta-analysis revealed a moderate group difference across all studies (Cohen's d = 0.31), such that the individuals with substance use disorder had diminished post-error slowing compared with controls. Despite this omnibus effect, there was also large variability in the magnitude of the effects, explained in part by differences between studies in task complexity. These findings suggest that post-error slowing may serve as a promising and easy-to-implement measure of cognitive control impairment in substance use disorder, with potential links to aberrant brain function in cognitive control areas such as the anterior cingulate cortex.
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Affiliation(s)
- Ryan M. Sullivan
- Department of Psychiatry, Stony Brook University School of
Medicine
- Department of Psychology, University of
Wisconsin-Milwaukee
| | - Greg Perlman
- Department of Psychiatry, Stony Brook University School of
Medicine
| | - Scott J. Moeller
- Department of Psychiatry, Stony Brook University School of
Medicine
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17
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Wang GJ, Wiers CE, Shumay E, Tomasi D, Yuan K, Wong CT, Logan J, Fowler JS, Volkow ND. Expectation effects on brain dopamine responses to methylphenidate in cocaine use disorder. Transl Psychiatry 2019; 9:93. [PMID: 30770780 PMCID: PMC6377670 DOI: 10.1038/s41398-019-0421-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Accepted: 01/04/2019] [Indexed: 11/29/2022] Open
Abstract
The response to drugs of abuse is affected by expectation, which is modulated in part by dopamine (DA), which encodes for a reward prediction error. Here we assessed the effect of expectation on methylphenidate (MP)-induced striatal DA changes in 23 participants with an active cocaine use disorder (CUD) and 23 healthy controls (HC) using [11C]raclopride and PET both after placebo (PL) and after MP (0.5 mg/kg, i.v.). Brain dopamine D2 and D3 receptor availability (D2R: non-displaceable binding potential (BPND)) was measured under four conditions in randomized order: (1) expecting PL/receiving PL, (2) expecting PL/receiving MP, (3) expecting MP/receiving PL, and (4) expecting MP/receiving MP. Expecting MP increased pulse rate compared to expecting PL. Receiving MP decreased D2R in striatum compared to PL, indicating MP-induced striatal DA release, and this effect was significantly blunted in CUD versus HC consistent with prior findings of decreased striatal dopamine responses both in active and detoxified CUD. There was a group × challenge × expectation effect in caudate and midbrain, with expectation of MP increasing MP-induced DA release in HC but not in CUD, and expectation of PL showing a trend to increase MP-induced DA release in CUD but not in HC. These results are consistent with the role of DA in reward prediction error in the human brain: decreasing DA signaling when rewards are less than expected (blunted DA increases to MP in CUD) and increasing them when greater than expected (for PL in CUD reflecting conditioned responses to injection). Our findings also document disruption of the expectation of drug effects in dopamine signaling in participants with CUD compared to non-addicted individuals.
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Affiliation(s)
- Gene-Jack Wang
- Laboratory of Neuroimaging, National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, 20892-1013, USA.
| | - Corinde E. Wiers
- 0000 0004 0481 4802grid.420085.bLaboratory of Neuroimaging, National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD 20892-1013 USA
| | - Elena Shumay
- 0000 0004 0481 4802grid.420085.bLaboratory of Neuroimaging, National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD 20892-1013 USA
| | - Dardo Tomasi
- 0000 0004 0481 4802grid.420085.bLaboratory of Neuroimaging, National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD 20892-1013 USA
| | - Kai Yuan
- 0000 0004 0481 4802grid.420085.bLaboratory of Neuroimaging, National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD 20892-1013 USA ,0000 0001 0707 115Xgrid.440736.2School of Life Science and Technology, Xidian University, 710071 Xi’an, Shaanxi China
| | - Christopher T. Wong
- 0000 0004 0481 4802grid.420085.bLaboratory of Neuroimaging, National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD 20892-1013 USA
| | - Jean Logan
- 0000 0004 1936 8753grid.137628.9Department of Radiology, New York University, New York, NY 11793 USA
| | - Joanna S. Fowler
- 0000 0004 0481 4802grid.420085.bLaboratory of Neuroimaging, National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD 20892-1013 USA ,0000 0001 2188 4229grid.202665.5Brookhaven National Laboratory, Upton, NY 11973 USA
| | - Nora D. Volkow
- 0000 0004 0481 4802grid.420085.bLaboratory of Neuroimaging, National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD 20892-1013 USA ,0000 0001 2297 5165grid.94365.3dNational Institute on Drug Abuse, National Institutes of Health, Bethesda, MD 20892 USA
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18
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Konova AB, Parvaz MA, Bernstein V, Zilverstand A, Moeller SJ, Delgado MR, Alia-Klein N, Goldstein RZ. Neural mechanisms of extinguishing drug and pleasant cue associations in human addiction: role of the VMPFC. Addict Biol 2019; 24:88-99. [PMID: 28872745 PMCID: PMC5837898 DOI: 10.1111/adb.12545] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2017] [Revised: 06/30/2017] [Accepted: 07/15/2017] [Indexed: 01/23/2023]
Abstract
The neurobiological mechanisms that underlie the resistance of drug cue associations to extinction in addiction remain unknown. Fear extinction critically depends on the ventromedial prefrontal cortex (VMPFC). Here, we tested if this same region plays a role in extinction of non-fear, drug and pleasant cue associations. Eighteen chronic cocaine users and 15 matched controls completed three functional MRI scans. Participants first learned to associate an abstract cue (the conditioned stimulus, CS) with a drug-related (CSD+ ) or pleasant (CSP+ ) image. Extinction immediately followed where each CS was repeatedly presented without the corresponding image. Participants underwent a second identical session 24 hours later to assess retention of extinction learning. Results showed that like fear extinction, non-fear-based extinction relies on the VMPFC. However, extinction-related changes in the VMPFC differed by cue valence and diagnosis. In controls, VMPFC activation to the CSD+ (which was unpleasant for participants) gradually increased as in fear extinction, while it decreased to the CSP+ , consistent with a more general role of the VMPFC in flexible value updating. Supporting a specific role in extinction retention, we further observed a cross-day association between VMPFC activation and skin conductance, a classic index of conditioned responses. Finally, cocaine users showed VMPFC abnormalities for both CSs, which, in the case of the CSD+ , correlated with craving. These data suggest a global deficit in extinction learning in this group that may hinder extinction-based treatment efforts. More broadly, these data show that the VMPFC, when functionally intact, supports extinction learning in diverse contexts in humans.
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Affiliation(s)
- Anna B. Konova
- Center for Neural Science; New York University; New York NY USA
| | - Muhammad A. Parvaz
- Departments of Psychiatry and Neuroscience; Icahn School of Medicine at Mount Sinai; New York NY USA
| | - Vladimir Bernstein
- Departments of Psychiatry and Neuroscience; Icahn School of Medicine at Mount Sinai; New York NY USA
| | - Anna Zilverstand
- Departments of Psychiatry and Neuroscience; Icahn School of Medicine at Mount Sinai; New York NY USA
| | - Scott J. Moeller
- Department of Psychiatry; Stony Brook University School of Medicine; Stony Brook NY USA
| | | | - Nelly Alia-Klein
- Departments of Psychiatry and Neuroscience; Icahn School of Medicine at Mount Sinai; New York NY USA
| | - Rita Z. Goldstein
- Departments of Psychiatry and Neuroscience; Icahn School of Medicine at Mount Sinai; New York NY USA
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19
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Perugi G, Pallucchini A, Rizzato S, De Rossi P, Sani G, Maremmani AG, Pinzone V, Maremmani I. Pharmacotherapeutic strategies for the treatment of attention-deficit hyperactivity (ADHD) disorder with comorbid substance-use disorder (SUD). Expert Opin Pharmacother 2018; 20:343-355. [PMID: 30513231 DOI: 10.1080/14656566.2018.1551878] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
INTRODUCTION Substance use disorder (SUD) is very common amongst patients with attention deficit hyperactivity disorder (ADHD). The two disorders share partially overlapping features and SUD in ADHD is characterized by an early age of onset, high likelihood of poly-substance use, increased risk of suicide attempts, more hospitalizations, and scarce treatment adherence. AREAS COVERED This paper reviews randomized active comparator-controlled or placebo-controlled trials evaluating the use of pharmacotherapy in patients with ADHD and SUD. The authors include open label and observational studies. EXPERT OPINION Stimulant and non-stimulant treatments should be used to aid ADHD symptomatology in patients with SUD. SUD seems to be less responsive, suggesting a relative independence of the two conditions. For this reason, the association of ADHD-specific drugs and SUD-treatments should be recommended in a large proportion of patients suffering from both disorders. The rate and the quality of ADHD response to specific pharmacological treatments is highly variable, depending on the dose and the duration of the treatment, the age of the patient, and the severity and the chronicity of addiction. Further research is necessary to explore the divergences in treatment response of different ADHD subtypes in different subtypes of SUD.
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Affiliation(s)
- Giulio Perugi
- a Department of Experimental and Clinic Medicine, Section of Psychiatry , University of Pisa , Pisa , Italy
| | - Alessandro Pallucchini
- a Department of Experimental and Clinic Medicine, Section of Psychiatry , University of Pisa , Pisa , Italy
| | - Salvatore Rizzato
- b Psychiatry Residency Training Program, Faculty of Medicine and Psychology , Sapienza University of Rome , Rome , Italy
| | - Pietro De Rossi
- c NESMOS Department (Neurosciences, Mental Health, and Sensory Organs) , Sapienza University of Rome.,d School of Medicine and Psychology , Sant'Andrea Hospital , Rome , Italy.,e Department of Neurology and Psychiatry , Sapienza University of Rome , Rome , Italy.,f ASL Roma 5 , Rome , Italy
| | - Gabriele Sani
- c NESMOS Department (Neurosciences, Mental Health, and Sensory Organs) , Sapienza University of Rome.,d School of Medicine and Psychology , Sant'Andrea Hospital , Rome , Italy.,e Department of Neurology and Psychiatry , Sapienza University of Rome , Rome , Italy
| | - Angelo Gi Maremmani
- g Dipartimento di Psichiatria , Unità Sanitaria della Toscana nord-occidentale, Zona della Versilia , Viareggio , Italia
| | - Vito Pinzone
- b Psychiatry Residency Training Program, Faculty of Medicine and Psychology , Sapienza University of Rome , Rome , Italy
| | - Icro Maremmani
- a Department of Experimental and Clinic Medicine, Section of Psychiatry , University of Pisa , Pisa , Italy
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20
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Rae CL, Botan VE, Gould van Praag CD, Herman AM, Nyyssönen JAK, Watson DR, Duka T, Garfinkel SN, Critchley HD. Response inhibition on the stop signal task improves during cardiac contraction. Sci Rep 2018; 8:9136. [PMID: 29904123 PMCID: PMC6002409 DOI: 10.1038/s41598-018-27513-y] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Accepted: 05/31/2018] [Indexed: 12/04/2022] Open
Abstract
Motor actions can be facilitated or hindered by psychophysiological states of readiness, to guide rapid adaptive action. Cardiovascular arousal is communicated by cardiac signals conveying the timing and strength of individual heartbeats. Here, we tested how these interoceptive signals facilitate control of motor impulsivity. Participants performed a stop signal task, in which stop cues were delivered at different time points within the cardiac cycle: at systole when the heart contracts (T-wave peak, approximately 300 ms following the R-wave), or at diastole between heartbeats (R-wave peak). Response inhibition was better at systole, indexed by a shorter stop signal reaction time (SSRT), and longer stop signal delay (SSD). Furthermore, parasympathetic control of cardiovascular tone, and subjective sensitivity to interoceptive states, predicted response inhibition efficiency, although these cardiovascular and interoceptive correlations did not survive correction for multiple comparisons. This suggests that response inhibition capacity is influenced by interoceptive physiological cues, such that people are more likely to express impulsive actions during putative states of lower cardiovascular arousal, when frequency and strength of cardiac afferent signalling is reduced.
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Affiliation(s)
- Charlotte L Rae
- Sackler Centre for Consciousness Science, University of Sussex, Falmer, UK. .,Department of Neuroscience, Brighton & Sussex Medical School, Falmer, UK.
| | - Vanessa E Botan
- Sackler Centre for Consciousness Science, University of Sussex, Falmer, UK.,School of Psychology, University of Sussex, Falmer, UK
| | - Cassandra D Gould van Praag
- Sackler Centre for Consciousness Science, University of Sussex, Falmer, UK.,Department of Neuroscience, Brighton & Sussex Medical School, Falmer, UK
| | | | | | - David R Watson
- Department of Neuroscience, Brighton & Sussex Medical School, Falmer, UK
| | - Theodora Duka
- School of Psychology, University of Sussex, Falmer, UK
| | - Sarah N Garfinkel
- Sackler Centre for Consciousness Science, University of Sussex, Falmer, UK.,Department of Neuroscience, Brighton & Sussex Medical School, Falmer, UK.,Sussex Partnership NHS Foundation Trust, Brighton, UK
| | - Hugo D Critchley
- Sackler Centre for Consciousness Science, University of Sussex, Falmer, UK.,Department of Neuroscience, Brighton & Sussex Medical School, Falmer, UK.,Sussex Partnership NHS Foundation Trust, Brighton, UK
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21
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Structural changes in brain regions involved in executive-control and self-referential processing after sleeve gastrectomy in obese patients. Brain Imaging Behav 2018; 13:830-840. [DOI: 10.1007/s11682-018-9904-2] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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22
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Sun D. Development of New Diagnostic Techniques - Machine Learning. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2017; 1010:203-215. [PMID: 29098674 DOI: 10.1007/978-981-10-5562-1_10] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Traditional diagnoses on addiction reply on the patients' self-reports, which are easy to be dampened by false memory or malingering. Machine learning (ML) is a data-driven procedure that learns algorithms from training data and makes predictions. It is quickly developed and is more and more utilized into clinical applications including diagnoses of addiction. This chapter reviewed the basic concepts and processes of ML. Some studies utilizing ML to classify addicts and non-addicts, separate different types of addiction, and evaluate the effects of treatment are also reviewed. Both advantages and shortcomings of ML in diagnoses of addiction are discussed.
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Affiliation(s)
- Delin Sun
- Duke-UNC Brain Imaging and Analysis Center, Duke University Medical Center, Durham, NC, USA.
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23
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Manza P, Amandola M, Tatineni V, Li CSR, Leung HC. Response inhibition in Parkinson's disease: a meta-analysis of dopaminergic medication and disease duration effects. NPJ Parkinsons Dis 2017; 3:23. [PMID: 28702504 PMCID: PMC5501877 DOI: 10.1038/s41531-017-0024-2] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2016] [Revised: 06/07/2017] [Accepted: 06/16/2017] [Indexed: 12/24/2022] Open
Abstract
Parkinson's disease is a neurodegenerative disorder involving the basal ganglia that results in a host of motor and cognitive deficits. Dopamine-replacement therapy ameliorates some of the hallmark motor symptoms of Parkinson's disease, but whether these medications improve deficits in response inhibition, a critical executive function for behavioral control, has been questioned. Several studies of Parkinson's disease patients "on" and "off" (12-h withdrawal) dopaminergic medications suggested that dopamine-replacement therapy did not provide significant response inhibition benefits. However, these studies tended to include patients with moderate-to-advanced Parkinson's disease, when the efficacy of dopaminergic drugs is reduced compared to early-stage Parkinson's disease. In contrast, a few recent studies in early-stage Parkinson's disease report that dopaminergic drugs do improve response inhibition deficits. Based on these findings, we hypothesized that Parkinson's disease duration interacts with medication status to produce changes in cognitive function. To investigate this issue, we conducted a meta-analysis of studies comparing patients with Parkinson's disease and healthy controls on tests of response inhibition (50 comparisons from 42 studies). The findings supported the hypothesis; medication benefited response inhibition in patients with shorter disease duration, whereas "off" medication, moderate deficits were present that were relatively unaffected by disease duration. These findings support the role of dopamine in response inhibition and suggest the need to consider disease duration in research of the efficacy of dopamine-replacement therapy on cognitive function in Parkinson's disease.
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Affiliation(s)
- Peter Manza
- Department of Psychology, Stony Brook University, Stony Brook, NY 11790 USA
| | - Matthew Amandola
- Department of Psychology, Stony Brook University, Stony Brook, NY 11790 USA
| | | | - Chiang-shan R. Li
- Department of Psychiatry, Yale University, New Haven, CT 06519 USA
- Department of Neuroscience, Yale University, New Haven, CT 06520 USA
- Interdepartmental Neuroscience Program, Yale University, New Haven, CT 06520 USA
- Beijing Huilongguan Hospital, Beijing, China
| | - Hoi-Chung Leung
- Department of Psychology, Stony Brook University, Stony Brook, NY 11790 USA
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24
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Bosker WM, Neuner I, Shah NJ. The role of impulsivity in psychostimulant- and stress-induced dopamine release: Review of human imaging studies. Neurosci Biobehav Rev 2017; 78:82-90. [PMID: 28438467 DOI: 10.1016/j.neubiorev.2017.04.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Revised: 02/13/2017] [Accepted: 04/11/2017] [Indexed: 12/21/2022]
Abstract
Drug addiction is a debilitating disorder and its pivotal problem is the high relapse rate. To solve this problem, the aim is to prevent people from becoming addicted in the first place. One of the key questions that is still unanswered is why some people become addicted to drugs and others, who take drugs regularly, do not. In recent years extensive research has been done to untangle the many factors involved in this disorder. Here, we review some of the factors that are related to dopamine, i.e., impulsivity and stress (hormones), and aim to integrate this into a neurobiological model. Based on this, we draw two conclusions: (1) in order to understand the transition from recreational drug use to addiction, we need to focus more on these recreational users; and (2) research should be aimed at finding therapies that can restore inhibitory control/frontal functioning and improve stress resiliency in addicts.
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Affiliation(s)
- Wendy M Bosker
- Institute of Neuroscience and Medicine (INM-4/INM-11), Forschungszentrum Jülich GmbH, 52425 Jülich, Germany.
| | - Irene Neuner
- Institute of Neuroscience and Medicine (INM-4/INM-11), Forschungszentrum Jülich GmbH, 52425 Jülich, Germany; JARA - Translational Brain Medicine, RWTH Aachen University, 52074 Aachen, Germany; Department of Psychiatry, Psychotherapy and Psychosomatic Disorders, University Clinic Aachen, 52074 Aachen, Germany.
| | - N Jon Shah
- Institute of Neuroscience and Medicine (INM-4/INM-11), Forschungszentrum Jülich GmbH, 52425 Jülich, Germany; JARA - Translational Brain Medicine, RWTH Aachen University, 52074 Aachen, Germany; Department of Psychiatry, Psychotherapy and Psychosomatic Disorders, University Clinic Aachen, 52074 Aachen, Germany; Department of Neurology, University Clinic Aachen, 52074 Aachen, Germany; Department of Electrical and Computer Systems Engineering, and Monash Biomedical Imaging, School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia
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25
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Moeller SJ, Konova AB, Tomasi D, Parvaz MA, Goldstein RZ. Abnormal response to methylphenidate across multiple fMRI procedures in cocaine use disorder: feasibility study. Psychopharmacology (Berl) 2016; 233:2559-69. [PMID: 27150080 PMCID: PMC4916842 DOI: 10.1007/s00213-016-4307-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Accepted: 04/18/2016] [Indexed: 12/14/2022]
Abstract
RATIONALE The indirect dopamine agonist methylphenidate remediates cognitive deficits in psychopathology, but the individual characteristics that determine its effects on the brain are not known. OBJECTIVES We aimed to determine whether targeted dopaminergically modulated traits and individual differences could predict neural response to methylphenidate across multiple functional magnetic resonance imaging (fMRI) procedures. METHODS We combined neural measures from three separate procedures (two inhibitory control tasks differing in their degree of emotional salience and resting-state functional connectivity) during methylphenidate (20 mg oral, versus randomized and counterbalanced placebo) and correlated these aggregated responses with cocaine use disorder diagnosis (22 cocaine abusers, 21 controls), symptoms of attention deficit hyperactivity disorder, and working memory capacity. RESULTS Cocaine abusers, relative to controls, had a lower response in the dorsolateral prefrontal cortex to methylphenidate across all three procedures, driven by responses to the two inhibitory control tasks; reduced methylphenidate fMRI response in this region further correlated with more frequent cocaine use. CONCLUSIONS Cocaine abuse (and its frequency), associated with lower tonic dopamine levels, correlated with a reduction in activation to methylphenidate (versus placebo). These initial results provide feasibility to the idea that multimodal fMRI tasks can be meaningfully aggregated, and that these aggregated procedures show a common disruption in addiction in a highly anticipated region relevant to cognitive control. Results also suggest that drug use frequency may represent an important modulatory variable in interpreting the efficacy of pharmacologically enhanced cognitive interventions in addiction.
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Affiliation(s)
- Scott J. Moeller
- Departments of Psychiatry and Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY 10029,Correspondence may be addressed to: Scott J. Moeller, 1470 Madison Ave (Room 9-115), New York, NY 10029; Tel: 212-824-8973; Fax: 212-803-6743; . Or to: Rita Z. Goldstein, One Gustave L. Levy Place, Box 1230, New York, NY 10029; tel. (212) 824-9312; fax (212) 996-8931;
| | - Anna B. Konova
- Center for Neural Science, New York University, NY 10003
| | - Dardo Tomasi
- National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD 20892
| | - Muhammad A. Parvaz
- Departments of Psychiatry and Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY 10029
| | - Rita Z. Goldstein
- Departments of Psychiatry and Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY 10029,Correspondence may be addressed to: Scott J. Moeller, 1470 Madison Ave (Room 9-115), New York, NY 10029; Tel: 212-824-8973; Fax: 212-803-6743; . Or to: Rita Z. Goldstein, One Gustave L. Levy Place, Box 1230, New York, NY 10029; tel. (212) 824-9312; fax (212) 996-8931;
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Wang Q, Chen C, Cai Y, Li S, Zhao X, Zheng L, Zhang H, Liu J, Chen C, Xue G. Dissociated neural substrates underlying impulsive choice and impulsive action. Neuroimage 2016; 134:540-549. [DOI: 10.1016/j.neuroimage.2016.04.010] [Citation(s) in RCA: 69] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2015] [Revised: 03/23/2016] [Accepted: 04/04/2016] [Indexed: 12/01/2022] Open
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Reed SC, Evans SM. The effects of oral d-amphetamine on impulsivity in smoked and intranasal cocaine users. Drug Alcohol Depend 2016; 163:141-52. [PMID: 27114203 PMCID: PMC4880502 DOI: 10.1016/j.drugalcdep.2016.04.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Revised: 04/07/2016] [Accepted: 04/09/2016] [Indexed: 11/18/2022]
Abstract
BACKGROUND Effective treatments for cocaine use disorders remain elusive. Two factors that may be related to treatment failures are route of cocaine used and impulsivity. Smoked cocaine users are more likely to have poorer treatment outcomes compared to intranasal cocaine users. Further, cocaine users are impulsive and impulsivity is associated with poor treatment outcomes. While stimulants are used to treat Attention Deficit Hyperactivity Disorder (ADHD) and attenuate certain cocaine-related behaviors, few studies have comprehensively examined whether stimulants can reduce behavioral impulsivity in cocaine users, and none examined route of cocaine use as a factor. METHODS The effects of immediate release oral d-amphetamine (AMPH) were examined in 34 cocaine users (13 intranasal, 21 smoked). Participants had three separate sessions where they were administered AMPH (0, 10, or 20mg) and completed behavioral measures of impulsivity and risk-taking and subjective measures of abuse liability. RESULTS Smoked cocaine users were more impulsive on the Delayed Memory Task, the GoStop task and the Delay Discounting Task than intranasal cocaine users. Smoked cocaine users also reported more cocaine craving and negative mood than intranasal cocaine users. AMPH produced minimal increases on measures of abuse liability (e.g., Drug Liking). CONCLUSIONS Smoked cocaine users were more impulsive than intranasal cocaine users on measures of impulsivity that had a delay component. Additionally, although AMPH failed to attenuate impulsive responding, there was minimal evidence of abuse liability in cocaine users. These preliminary findings need to be confirmed in larger samples that control for route and duration of cocaine use.
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Affiliation(s)
- Stephanie Collins Reed
- Division on Substance Abuse, New York State Psychiatric Institute and Department of Psychiatry, Columbia University Medical Center, 1051 Riverside Drive, Unit 66, New York, NY 10032 USA.
| | - Suzette M Evans
- Division on Substance Abuse, New York State Psychiatric Institute and Department of Psychiatry, Columbia University Medical Center, 1051 Riverside Drive, Unit 66, New York, NY 10032 USA
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Manza P, Hu S, Ide JS, Farr OM, Zhang S, Leung HC, Li CSR. The effects of methylphenidate on cerebral responses to conflict anticipation and unsigned prediction error in a stop-signal task. J Psychopharmacol 2016; 30:283-93. [PMID: 26755547 PMCID: PMC4837899 DOI: 10.1177/0269881115625102] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
To adapt flexibly to a rapidly changing environment, humans must anticipate conflict and respond to surprising, unexpected events. To this end, the brain estimates upcoming conflict on the basis of prior experience and computes unsigned prediction error (UPE). Although much work implicates catecholamines in cognitive control, little is known about how pharmacological manipulation of catecholamines affects the neural processes underlying conflict anticipation and UPE computation. We addressed this issue by imaging 24 healthy young adults who received a 45 mg oral dose of methylphenidate (MPH) and 62 matched controls who did not receive MPH prior to performing the stop-signal task. We used a Bayesian Dynamic Belief Model to make trial-by-trial estimates of conflict and UPE during task performance. Replicating previous research, the control group showed anticipation-related activation in the presupplementary motor area and deactivation in the ventromedial prefrontal cortex and parahippocampal gyrus, as well as UPE-related activations in the dorsal anterior cingulate, insula, and inferior parietal lobule. In group comparison, MPH increased anticipation activity in the bilateral caudate head and decreased UPE activity in each of the aforementioned regions. These findings highlight distinct effects of catecholamines on the neural mechanisms underlying conflict anticipation and UPE, signals critical to learning and adaptive behavior.
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Affiliation(s)
- Peter Manza
- Integrative Neuroscience Program, Department of Psychology, Stony Brook University, Stony Brook, NY, USA Department of Psychiatry, Yale University, New Haven, CT, USA
| | - Sien Hu
- Department of Psychiatry, Yale University, New Haven, CT, USA
| | - Jaime S Ide
- Department of Psychiatry, Yale University, New Haven, CT, USA Department of Biomedical Engineering, Stony Brook University, Stony Brook, NY, USA
| | - Olivia M Farr
- Department of Psychiatry, Yale University, New Haven, CT, USA Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, MA, USA
| | - Sheng Zhang
- Department of Psychiatry, Yale University, New Haven, CT, USA
| | - Hoi-Chung Leung
- Integrative Neuroscience Program, Department of Psychology, Stony Brook University, Stony Brook, NY, USA
| | - Chiang-shan R Li
- Department of Psychiatry, Yale University, New Haven, CT, USA Department of Neuroscience, Yale University, New Haven, CT, USA Interdepartmental Neuroscience Program, Yale University, New Haven, CT, USA
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Lalanne L, Lutz PE, Trojak B, Lang JP, Kieffer BL, Bacon E. Medications between psychiatric and addictive disorders. Prog Neuropsychopharmacol Biol Psychiatry 2016; 65:215-23. [PMID: 26514592 DOI: 10.1016/j.pnpbp.2015.10.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Revised: 10/02/2015] [Accepted: 10/25/2015] [Indexed: 12/25/2022]
Abstract
INTRODUCTION Many epidemiological studies have revealed a frequent co-occurrence of psychiatric and substance use disorders. The term used in the literature to refer to this co-occurrence is dual diagnosis. The high prevalence of dual diagnosis has led physicians to observe the effects of medication prescribed to treat psychiatric disorders on the co-occurring substance use disorder and vice versa. The concept of medications between psychiatric and addictive disorders stems from these clinical observations, alongside which, however, it has developed from the observation that both psychiatric and substance use disorders share common neurobiological pathways and trigger common cognitive disorders. This has led researchers to develop medications on the basis of neurobiological and cognitive rationales. MATERIAL AND METHOD In our article, we review peculiar medications based on neurobiological and cognitive rationales and that have an impact in both psychiatric and addictive disorders. RESULTS We highlight how interesting these new prescriptions are for clinical observation and for the treatment of patients suffering from dual diagnosis. CONCLUSION We then go on to discuss the interest in them from the perspective of clinical practice and clinical research, in that the development of medications to treat dual diagnosis helps to further our knowledge of both psychiatric and substance use disorders.
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Affiliation(s)
- Laurence Lalanne
- Translational Medicine and Neurogenetics, Institut de Génétique et de Biologie Molé-culaire et Cellulaire, INSERM U-964, CNRS UMR-7104, Université de Strasbourg, France; CHRU de Strasbourg-INSERM1114, Department of Psychiatry, University of Strasbourg, France.
| | - Pierre-Eric Lutz
- McGill Group for Suicide Studies, Douglas Mental Health research Centre, McGill University, Montréal, Canada; Douglas Mental Health Research Centre, McGill University, Montréal, Canada.
| | - Benoit Trojak
- Department of Psychiatry and Addictology, University Hospital of Dijon, France, EA 4452, LPPM, University of Burgundy, France.
| | - Jean-Philippe Lang
- CHRU de Strasbourg-INSERM1114, Department of Psychiatry, University of Strasbourg, France.
| | - Brigitte L Kieffer
- Translational Medicine and Neurogenetics, Institut de Génétique et de Biologie Molé-culaire et Cellulaire, INSERM U-964, CNRS UMR-7104, Université de Strasbourg, France; Douglas Mental Health Research Centre, McGill University, Montréal, Canada.
| | - Elisabeth Bacon
- Inserm U-1114, Department of Psychiatry, University of Strasbourg, France.
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Sofuoglu M, DeVito EE, Waters AJ, Carroll KM. Cognitive Function as a Transdiagnostic Treatment Target in Stimulant Use Disorders. J Dual Diagn 2016; 12:90-106. [PMID: 26828702 PMCID: PMC4837011 DOI: 10.1080/15504263.2016.1146383] [Citation(s) in RCA: 69] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Stimulant use disorder is an important public health problem, with an estimated 2.1 million current users in the United States alone. No pharmacological treatments are approved by the U.S. Food and Drug Administration for stimulant use disorder and behavioral treatments have variable efficacy and limited availability. Most individuals with stimulant use disorder have other comorbidities, most with overlapping symptoms and cognitive impairments. The goal of this article is to present a rationale for cognition as a treatment target in stimulant use disorder and to outline potential treatment approaches. Rates of lifetime comorbid psychiatric disorders among people with stimulant use disorders are estimated at 65% to 73%, with the most common being mood disorders (13% to 64%) and anxiety disorders (21% to 50%), as well as non-substance-induced psychotic disorders (<10%). There are several models of addictive behavior, but the dual process model particularly highlights the relevance of cognitive impairments and biases to the development and maintenance of addiction. This model explains addictive behavior as a balance between automatic processes and executive control, which in turn are related to individual (genetics, comorbid disorders, psychosocial factors) and other (craving, triggers, drug use) factors. Certain cognitive impairments, such as attentional bias and approach bias, are most relevant to automatic processes, while sustained attention, response inhibition, and working memory are primarily related to executive control. These cognitive impairments and biases are also common in disorders frequently comorbid with stimulant use disorder and predict poor treatment retention and clinical outcomes. As such, they may serve as feasible transdiagnostic treatment targets. There are promising pharmacological, cognitive, and behavioral approaches that aim to enhance cognitive function. Pharmacotherapies target cognitive impairments associated with executive control and include cholinesterase inhibitors (e.g., galantamine, rivastigmine) and monoamine transporter inhibitors (e.g., modafinil, methylphenidate). Cognitive behavioral therapy and cognitive rehabilitation also enhance executive control, while cognitive bias modification targets impairments associated with automatic processes. Cognitive enhancement to improve treatment outcomes is a novel and promising strategy, but its clinical value for the treatment of stimulant use disorder, with or without other psychiatric comorbidities, remains to be determined in future studies.
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Affiliation(s)
- Mehmet Sofuoglu
- a Department of Psychiatry , Yale University School of Medicine , West Haven , Connecticut , USA.,b VA Connecticut Healthcare System , West Haven , Connecticut , USA
| | - Elise E DeVito
- a Department of Psychiatry , Yale University School of Medicine , West Haven , Connecticut , USA.,b VA Connecticut Healthcare System , West Haven , Connecticut , USA
| | - Andrew J Waters
- c Department of Medical and Clinical Psychology , Uniformed Services University of the Health Science , Bethesda , Maryland , USA
| | - Kathleen M Carroll
- a Department of Psychiatry , Yale University School of Medicine , West Haven , Connecticut , USA.,b VA Connecticut Healthcare System , West Haven , Connecticut , USA
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Morein-Zamir S, Robbins TW. Fronto-striatal circuits in response-inhibition: Relevance to addiction. Brain Res 2015; 1628:117-29. [PMID: 25218611 PMCID: PMC4686018 DOI: 10.1016/j.brainres.2014.09.012] [Citation(s) in RCA: 78] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2014] [Revised: 08/28/2014] [Accepted: 09/03/2014] [Indexed: 12/29/2022]
Abstract
Disruptions to inhibitory control are believed to contribute to multiple aspects of drug abuse, from preexisting vulnerability in at-risk individuals, through escalation to dependence, to promotion of relapse in chronic users. Paradigms investigating the suppression of actions have been investigated in animal and human research on drug addiction. Rodent research has focused largely on impulsive behaviors, often gauged by premature responding, as a viable model highlighting the relevant role of dopamine and other neurotransmitters primarily in the striatum. Human research on action inhibition in stimulant dependence has highlighted impaired performance and largely prefrontal cortical abnormalities as part of a broader pattern of cognitive abnormalities. Animal and human research implicate inhibitory difficulties mediated by fronto-striatal circuitry both preceding and as a result of excessive stimulus use. In this regard, response-inhibition has proven a useful cognitive function to gauge the integrity of fronto-striatal systems and their role in contributing to impulsive and compulsive features of drug dependence.
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Affiliation(s)
- Sharon Morein-Zamir
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge CB2 3EB, UK; Department of Psychology, University of Cambridge, Cambridge CB2 0SZ, UK.
| | - Trevor W Robbins
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge CB2 3EB, UK; Department of Psychology, University of Cambridge, Cambridge CB2 0SZ, UK
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Moeller SJ, Bederson L, Alia-Klein N, Goldstein RZ. Neuroscience of inhibition for addiction medicine: from prediction of initiation to prediction of relapse. PROGRESS IN BRAIN RESEARCH 2015; 223:165-88. [PMID: 26806776 DOI: 10.1016/bs.pbr.2015.07.007] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
A core deficit in drug addiction is the inability to inhibit maladaptive drug-seeking behavior. Consistent with this deficit, drug-addicted individuals show reliable cross-sectional differences from healthy nonaddicted controls during tasks of response inhibition accompanied by brain activation abnormalities as revealed by functional neuroimaging. However, it is less clear whether inhibition-related deficits predate the transition to problematic use, and, in turn, whether these deficits predict the transition out of problematic substance use. Here, we review longitudinal studies of response inhibition in children/adolescents with little substance experience and longitudinal studies of already addicted individuals attempting to sustain abstinence. Results show that response inhibition and its underlying neural correlates predict both substance use outcomes (onset and abstinence). Neurally, key roles were observed for multiple regions of the frontal cortex (e.g., inferior frontal gyrus, dorsal anterior cingulate cortex, and dorsolateral prefrontal cortex). In general, less activation of these regions during response inhibition predicted not only the onset of substance use, but interestingly also better abstinence-related outcomes among individuals already addicted. The role of subcortical areas, although potentially important, is less clear because of inconsistent results and because these regions are less classically reported in studies of healthy response inhibition. Overall, this review indicates that response inhibition is not simply a manifestation of current drug addiction, but rather a core neurocognitive dimension that predicts key substance use outcomes. Early intervention in inhibitory deficits could have high clinical and public health relevance.
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Affiliation(s)
- Scott J Moeller
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | - Lucia Bederson
- Department of Psychology, New York University, New York, NY, USA
| | - Nelly Alia-Klein
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Rita Z Goldstein
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
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Yu J, Tseng P, Hung DL, Wu SW, Juan CH. Brain stimulation improves cognitive control by modulating medial-frontal activity and preSMA-vmPFC functional connectivity. Hum Brain Mapp 2015; 36:4004-15. [PMID: 26248582 DOI: 10.1002/hbm.22893] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2015] [Revised: 06/13/2015] [Accepted: 06/27/2015] [Indexed: 01/24/2023] Open
Abstract
Previous research has demonstrated that brain stimulation can improve inhibitory control. However, the neural mechanisms underlying such artificially induced improvement remain unclear. In this study, by coupling anodal transcranial direct current stimulation (atDCS) with functional MRI, we found that atDCS over preSMA effectively improved stopping speed, which was associated with increased BOLD response in the preSMA and ventromedial prefrontal cortex (vmPFC). Furthermore, such atDCS-induced BOLD increase in vmPFC was positively correlated with participants' improvement in stopping efficiency, and the functional connectivity between preSMA and vmPFC increased during successful stop. These results suggest that the rapid behavioral improvement from preSMA brain stimulation involves modulated medial-frontal activity and preSMA-vmPFC functional connectivity.
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Affiliation(s)
- Jiaxin Yu
- Institute of Neuroscience, National Yang-Ming University, Taipei City, Taiwan.,Institute of Cognitive Neuroscience, National Central University, Taiwan
| | - Philip Tseng
- Graduate Institute of Humanities in Medicine, Taipei Medical University, Taipei, Taiwan.,Brain and Consciousness Research Center, Shuang-Ho Hospital, New Taipei City, Taiwan
| | - Daisy L Hung
- Institute of Cognitive Neuroscience, National Central University, Taiwan
| | - Shih-Wei Wu
- Institute of Neuroscience, National Yang-Ming University, Taipei City, Taiwan
| | - Chi-Hung Juan
- Institute of Cognitive Neuroscience, National Central University, Taiwan
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Dürsteler KM, Berger EM, Strasser J, Caflisch C, Mutschler J, Herdener M, Vogel M. Clinical potential of methylphenidate in the treatment of cocaine addiction: a review of the current evidence. Subst Abuse Rehabil 2015; 6:61-74. [PMID: 26124696 PMCID: PMC4476488 DOI: 10.2147/sar.s50807] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Background Cocaine use continues to be a public health problem, yet there is no proven effective pharmacotherapy for cocaine dependence. A promising approach to treating cocaine dependence may be agonist-replacement therapy, which is already used effectively in the treatment of opioid and tobacco dependence. The replacement approach for cocaine dependence posits that administration of a long-acting stimulant medication should normalize the neurochemical and behavioral perturbations resulting from chronic cocaine use. One potential medication to be substituted for cocaine is methylphenidate (MPH), as this stimulant possesses pharmacobehavioral properties similar to those of cocaine. Aim To provide a qualitative review addressing the rationale for the use of MPH as a cocaine substitute and its clinical potential in the treatment of cocaine dependence. Methods We searched MEDLINE for clinical studies using MPH in patients with cocaine abuse/dependence and screened the bibliographies of the articles found for pertinent literature. Results MPH, like cocaine, increases synaptic dopamine by inhibiting dopamine reuptake. The discriminative properties, reinforcing potential, and subjective effects of MPH and cocaine are almost identical and, importantly, MPH has been found to substitute for cocaine in animals and human volunteers under laboratory conditions. When taken orally in therapeutic doses, its abuse liability, however, appears low, which is especially true for extended-release MPH preparations. Though there are promising data in the literature, mainly from case reports and open-label studies, the results of randomized controlled trials have been disappointing so far and do not corroborate the use of MPH as a substitute for cocaine dependence in patients without attention deficit hyperactivity disorder. Conclusion Clinical studies evaluating MPH substitution for cocaine dependence have provided inconsistent findings. However, the negative findings may be explained by specific study characteristics, among them dosing, duration of treatment, or sample size. This needs to be considered when discussing the potential of MPH as replacement therapy for cocaine dependence. Finally, based on the results, we suggest possible directions for future research.
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Affiliation(s)
- Kenneth M Dürsteler
- Center for Addictive Disorders, Psychiatric University Clinics Basel, Basel, Switzerland ; Center for Addictive Disorders, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Eva-Maria Berger
- Center for Addictive Disorders, Psychiatric University Clinics Basel, Basel, Switzerland
| | - Johannes Strasser
- Center for Addictive Disorders, Psychiatric University Clinics Basel, Basel, Switzerland
| | - Carlo Caflisch
- Center for Addictive Disorders, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Jochen Mutschler
- Center for Addictive Disorders, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Marcus Herdener
- Center for Addictive Disorders, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Marc Vogel
- Center for Addictive Disorders, Psychiatric University Clinics Basel, Basel, Switzerland
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Ye Z, Altena E, Nombela C, Housden CR, Maxwell H, Rittman T, Huddleston C, Rae CL, Regenthal R, Sahakian BJ, Barker RA, Robbins TW, Rowe JB. Improving response inhibition in Parkinson's disease with atomoxetine. Biol Psychiatry 2015; 77:740-8. [PMID: 24655598 PMCID: PMC4384955 DOI: 10.1016/j.biopsych.2014.01.024] [Citation(s) in RCA: 81] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2013] [Revised: 12/10/2013] [Accepted: 01/06/2014] [Indexed: 11/28/2022]
Abstract
BACKGROUND Dopaminergic drugs remain the mainstay of Parkinson's disease therapy but often fail to improve cognitive problems such as impulsivity. This may be due to the loss of other neurotransmitters, including noradrenaline, which is linked to impulsivity and response inhibition. We therefore examined the effect of the selective noradrenaline reuptake inhibitor atomoxetine on response inhibition in a stop-signal paradigm. METHODS This pharmacological functional magnetic resonance imaging study used a double-blinded randomized crossover design with low-frequency inhibition trials distributed among frequent Go trials. Twenty-one patients received 40 mg atomoxetine or placebo. Control subjects were tested on no-drug. The effects of disease and drug on behavioral performance, regional brain activity, and functional connectivity were analyzed using general linear models. Anatomical connectivity was examined using diffusion-weighted imaging. RESULTS Patients with Parkinson's disease had longer stop-signal reaction times, less stop-related activation in the right inferior frontal gyrus (RIFG), and weaker functional connectivity between the RIFG and striatum compared with control subjects. Atomoxetine enhanced stop-related RIFG activation in proportion to disease severity. Although there was no overall behavioral benefit from atomoxetine, analyses of individual differences revealed that enhanced response inhibition by atomoxetine was associated with increased RIFG activation and functional frontostriatal connectivity. Improved performance was more likely in patients with higher structural frontostriatal connectivity. CONCLUSIONS This study suggests that enhanced prefrontal cortical activation and frontostriatal connectivity by atomoxetine may improve response inhibition in Parkinson's disease. These results point the way to new stratified clinical trials of atomoxetine to treat impulsivity in selected patients with Parkinson's disease.
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Affiliation(s)
- Zheng Ye
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, United Kingdom
| | - Ellemarije Altena
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, United Kingdom
| | - Cristina Nombela
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, United Kingdom
| | - Charlotte R Housden
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, United Kingdom; Cambridge Cognition Ltd, University of Cambridge, Cambridge, United Kingdom; Behavioural and Clinical Neuroscience Institute , University of Cambridge, Cambridge, United Kingdom
| | - Helen Maxwell
- Department of Experimental Psychology, University of Cambridge, Cambridge, United Kingdom
| | - Timothy Rittman
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, United Kingdom
| | - Chelan Huddleston
- Medical Research Council Cognition and Brain Sciences Unit, Cambridge, United Kingdom
| | - Charlotte L Rae
- Medical Research Council Cognition and Brain Sciences Unit, Cambridge, United Kingdom
| | - Ralf Regenthal
- Division of Clinical Pharmacology, Rudolf-Boehm-Institute of Pharmacology and Toxicology, University of Leipzig, Leipzig, Germany
| | - Barbara J Sahakian
- Behavioural and Clinical Neuroscience Institute, Cambridge, United Kingdom
| | - Roger A Barker
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, United Kingdom
| | - Trevor W Robbins
- Department of Experimental Psychology, University of Cambridge, Cambridge, United Kingdom; Behavioural and Clinical Neuroscience Institute, Cambridge, United Kingdom
| | - James B Rowe
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, United Kingdom; Medical Research Council Cognition and Brain Sciences Unit, Cambridge, United Kingdom; Behavioural and Clinical Neuroscience Institute, Cambridge, United Kingdom.
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36
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Kravitz AV, Tomasi D, LeBlanc KH, Baler R, Volkow ND, Bonci A, Ferré S. Cortico-striatal circuits: Novel therapeutic targets for substance use disorders. Brain Res 2015; 1628:186-98. [PMID: 25863130 DOI: 10.1016/j.brainres.2015.03.048] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2014] [Revised: 03/04/2015] [Accepted: 03/28/2015] [Indexed: 01/08/2023]
Abstract
It is widely believed that substance use disorder (SUD) results from both pre-alterations (vulnerability) and/or post-alterations (drug effects) on cortico-striatal circuits. These circuits are essential for cognitive control, motivation, reward dependent learning, and emotional processing. As such, dysfunctions in cortico-striatal circuits are thought to relate to the core features of SUD, which include compulsive drug use, loss of the ability to control drug intake, and the emergence of negative emotional states (Koob and Volkow, 2010. Neuropsychopharmacology 35(1), 217-238). While the brain circuits underlying SUD have been studied in human patients largely through imaging studies, experiments in animals have allowed researchers to examine the specific cell-types within these circuits to reveal their role in behavior relevant to SUD. Here, we will review imaging studies on cortico-striatal systems that are altered in SUD, and describe animal experiments that relate SUD to specific neural projections and cell types within this circuitry. We will end with a discussion of novel clinical approaches such as deep brain stimulation (DBS), repeated transcranial magnetic stimulation (rTMS), and pharmacological targeting of G protein-coupled receptor (GPCR) heteromers that may provide promising avenues for modulating these circuits to combat SUD in humans.
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Affiliation(s)
- Alexxai V Kravitz
- National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, USA; National Institute of Drug Abuse, Baltimore, MD, USA
| | - Dardo Tomasi
- National Institute on Alcoholism and Alcohol Abuse, Bethesda, MD, USA
| | - Kimberly H LeBlanc
- National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, USA
| | - Ruben Baler
- National Institute of Drug Abuse, Baltimore, MD, USA
| | - Nora D Volkow
- National Institute of Drug Abuse, Baltimore, MD, USA
| | - Antonello Bonci
- National Institute of Drug Abuse, Baltimore, MD, USA; Solomon H. Snyder Department of Neuroscience, The Johns Hopkins School of Medicine, Baltimore, MD, USA; Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
| | - Sergi Ferré
- National Institute of Drug Abuse, Baltimore, MD, USA
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Yu J, Tseng P, Muggleton NG, Juan CH. Being watched by others eliminates the effect of emotional arousal on inhibitory control. Front Psychol 2015; 6:4. [PMID: 25653635 PMCID: PMC4299288 DOI: 10.3389/fpsyg.2015.00004] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2014] [Accepted: 01/03/2015] [Indexed: 01/23/2023] Open
Abstract
The psychological effect of being watched by others has been proven a powerful tool in modulating social behaviors (e.g., charitable giving) and altering cognitive performance (e.g., visual search). Here we tested whether such awareness would affect one of the core elements of human cognition: emotional processing and impulse control. Using an emotion stop-signal paradigm, we found that viewing emotionally-arousing erotic images before attempting to inhibit a motor response impaired participants’ inhibition ability, but such an impairing effect was completely eliminated when participants were led to believe that their facial expressions were monitored by a webcam. Furthermore, there was no post-error slowing in any of the conditions, thus these results cannot be explained by a deliberate speed-accuracy tradeoff or other types of conscious shift in strategy. Together, these findings demonstrate that the interaction between emotional arousal and impulse control can be dependent on one’s state of self-consciousness. Furthermore, this study also highlights the effect that the mere presence of the experimenter may have on participants’ cognitive performance, even if it’s only a webcam.
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Affiliation(s)
- Jiaxin Yu
- Institute of Neuroscience, National Yang-Ming University , Taipei, Taiwan ; Institute of Cognitive Neuroscience, National Central University , Jhongli, Taiwan
| | - Philip Tseng
- Institute of Cognitive Neuroscience, National Central University , Jhongli, Taiwan
| | - Neil G Muggleton
- Institute of Cognitive Neuroscience, National Central University , Jhongli, Taiwan ; Brain and Consciousness Research Center, Taipei Medical University - Shuang Ho Hospital , New Taipei City, Taiwan ; Institute of Cognitive Neuroscience, University College London , London, UK
| | - Chi-Hung Juan
- Institute of Cognitive Neuroscience, National Central University , Jhongli, Taiwan
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38
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Voon V, Dalley JW. Translatable and Back-Translatable Measurement of Impulsivity and Compulsivity: Convergent and Divergent Processes. Curr Top Behav Neurosci 2015; 28:53-91. [PMID: 27418067 DOI: 10.1007/7854_2015_5013] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Impulsivity and compulsivity have emerged as important dimensional constructs that challenge traditional psychiatric classification systems. Both are present in normal healthy populations where the need to act quickly and repeatedly without hesitation can be highly advantageous. However, when excessively expressed, impulsive and compulsive behavior can lead to adverse consequences and spectrum disorders exemplified by attention-deficit/hyperactivity disorder (ADHD), obsessive compulsive disorder (OCD), autism, and drug addiction. Impulsive individuals have difficulty in deferring gratification and are inclined to 'jump the gun' and respond prematurely before sufficient information is gathered. Compulsivity involves repetitive behavior often motivated by the need to reduce or prevent anxiety, thus leading to the maladaptive perseveration of behavior. Defined in this way, impulsivity and compulsivity could be viewed as separate entities or 'traits' but overwhelming evidence indicates that both may be present in the same disorder, either concurrently or even separately at different time points. Herein we discuss the neural and cognitive heterogeneity of impulsive and compulsive endophenotypes. These constructs map onto distinct fronto-striatal neural and neurochemical structures interacting both at nodal convergent points and as opponent processes highlighting both the heterogeneity and the commonalities of function. We focus on discoveries made using both translational research methodologies and studies exclusively in humans, and implications for treatment intervention in disorders in which impulsive and compulsive symptoms prevail. We emphasize the relevance of these constructs for understanding dimensional psychiatry.
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Affiliation(s)
- Valerie Voon
- Behavioral and Clinical Neuroscience Institute, University of Cambridge, Cambridge, CB2 3EB, UK.
- Department of Psychiatry, University of Cambridge, Addenbrooke's Hospital, Cambridge, CB2 2QQ, UK.
- Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK.
| | - Jeffrey W Dalley
- Behavioral and Clinical Neuroscience Institute, University of Cambridge, Cambridge, CB2 3EB, UK
- Department of Psychiatry, University of Cambridge, Addenbrooke's Hospital, Cambridge, CB2 2QQ, UK
- Department of Psychology, University of Cambridge, Downing Street, Cambridge, CB2 3EB, UK
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Abstract
Neuroimaging studies have made a significant contribution to the efforts to identify measurable indices, or biomarkers, of addictions and their treatments. Biomarkers in addiction treatment are needed to provide targets for treatment, detect treatment subgroups, predict treatment response, and broadly improve outcomes. Neuroimaging is important to biomarkers research as it relates neural circuits to both molecular mechanisms and behavior. A focus of recent efforts in neuroimaging in addiction has been to elucidate the neural correlates associated with dimensions of functioning in substance-use and related disorders, such as cue-reactivity, impulsivity, and cognitive control, among others. These dimensions of functioning have been related to addiction treatment outcomes and relapse, and therefore, a better understanding of these dimensions and their neural correlates may help to identify brain-behavior biomarkers of treatment response. This paper reviews recent neuroimaging studies that report potential biomarkers in addiction treatment related to cue-reactivity, impulsivity, and cognitive control, as well as recent advances in neuroimaging that may facilitate efforts to determine reliable biomarkers. This important initial work has begun to identify possible mediators and moderators of treatment response, and multiple promising indices are being tested.
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Affiliation(s)
- Kathleen A. Garrison
- Department of Psychiatry, Yale University School of Medicine, 1 Church Street, Room 730, New Haven, CT 06510, USA
| | - Marc N. Potenza
- Department of Psychiatry, Yale University School of Medicine, 1 Church Street, Room 730, New Haven, CT 06510, USA,Department of Neurobiology and Child Study Center, Yale University School of Medicine, New Haven, CT, USA
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Grant JE, Chamberlain SR. Impulsive action and impulsive choice across substance and behavioral addictions: cause or consequence? Addict Behav 2014; 39:1632-1639. [PMID: 24864028 DOI: 10.1016/j.addbeh.2014.04.022] [Citation(s) in RCA: 147] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2013] [Revised: 01/02/2014] [Accepted: 04/28/2014] [Indexed: 11/28/2022]
Abstract
Substance use disorders are prevalent and debilitating. Certain behavioral syndromes ('behavioral addictions') characterized by repetitive habits, such as gambling disorder, stealing, shopping, and compulsive internet use, may share clinical, co-morbid, and neurobiological parallels with substance addictions. This review considers overlap between substance and behavioral addictions with a particular focus on impulsive action (inability to inhibit motor responses), and impulsive choice (preference for immediate smaller rewards to the detriment of long-term outcomes). We find that acute consumption of drugs with abuse potential is capable of modulating impulsive choice and action, although magnitude and direction of effect appear contingent on baseline function. Many lines of evidence, including findings from meta-analyses, show an association between chronic drug use and elevated impulsive choice and action. In some instances, elevated impulsive choice and action have been found to predate the development of substance use disorders, perhaps signifying their candidacy as objective vulnerability markers. Research in behavioral addictions is preliminary, and has mostly focused on impulsive action, finding this to be elevated versus controls, similar to that seen in chronic substance use disorders. Only a handful of imaging studies has explored the neural correlates of impulsive action and choice across these disorders. Key areas for future research are highlighted along with potential implications in terms of neurobiological models and treatment. In particular, future work should further explore whether the cognitive deficits identified are state or trait in nature: i.e. are evident before addiction perhaps signaling risk; or are a consequence of repetitive engagement in habitual behavior; and effects of novel agents known to modulate these cognitive abilities on various addictive disorders.
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Affiliation(s)
- Jon E Grant
- University of Chicago, Pritzker School of Medicine, 5841 South Maryland Ave., Chicago, IL 60637, USA.
| | - Samuel R Chamberlain
- Department of Psychiatry, University of Cambridge, UK; MRC/Wellcome Trust Behavioural and Clinical Neurosciences Institute, UK; Cambridge & Peterborough NHS Foundation Trust, Cambridge, UK
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41
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The effects of methylphenidate on resting-state striatal, thalamic and global functional connectivity in healthy adults. Int J Neuropsychopharmacol 2014; 17:1177-91. [PMID: 24825078 PMCID: PMC4506752 DOI: 10.1017/s1461145714000674] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
By blocking dopamine and norepinephrine transporters, methylphenidate affects cognitive performance and regional brain activation in healthy individuals as well as those with neuropsychiatric disorders. Resting-state connectivity evaluates the functional integrity of a network of brain regions. Here, we examined how methylphenidate effects resting-state functional connectivity of the dorsal striatum and thalamus, areas each with dense dopaminergic and noradrenergic innervations, as well as global cerebral connectivity. We administered a single, oral dose (45 mg) to 24 healthy adults and compared resting-state connectivity to 24 demographically matched adults who did not receive any medication. The results showed that methylphenidate alters seed-based and global connectivity between the thalamus/dorsal striatum with primary motor cortex, amygdala/hippocampus and frontal executive areas (p < 0.05, corrected). Specifically, while methylphenidate at this dosage enhances connectivity to the motor cortex and memory circuits, it dampens prefrontal cortical connectivity perhaps by increasing catecholaminergic signalling past the 'optimal' level. These findings advance our understanding of a critical aspect of the multifaceted effects of methylphenidate on brain functions. The results may also facilitate future studies of the aetiology and treatment of neurological and psychiatric disorders that implicate catecholaminergic dysfunction.
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42
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Mayse JD, Nelson GM, Park P, Gallagher M, Lin SC. Proactive and reactive inhibitory control in rats. Front Neurosci 2014; 8:104. [PMID: 24847204 PMCID: PMC4021122 DOI: 10.3389/fnins.2014.00104] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2014] [Accepted: 04/21/2014] [Indexed: 12/12/2022] Open
Abstract
Inhibiting actions inappropriate for the behavioral context, or inhibitory control, is essential for survival and involves both reactively stopping the current prepared action and proactively adjusting behavioral tendencies to increase future performance. A powerful paradigm widely used in basic and clinical research to study inhibitory control is the stop signal task (SST). Recent years have seen a surging interest in translating the SST to rodents to study the neural mechanisms underlying inhibitory control. However, significant differences in task designs and behavioral strategies between rodent and primate studies have made it difficult to directly compare the two literatures. In this study, we developed a rodent-appropriate SST and characterized both reactive and proactive control in rats. For reactive inhibitory control, we found that, unlike in primates, incorrect stop trials in rodents result from two independent types of errors: an initial failure-to-stop error or, after successful stopping, a subsequent failure-to-wait error. Conflating failure-to-stop and failure-to-wait errors systematically overestimates the covert latency of reactive inhibition, the stop signal reaction time (SSRT). To correctly estimate SSRT, we developed and validated a new method that provides an unbiased SSRT estimate independent of the ability to wait. For proactive inhibitory control, we found that rodents adjust both their reaction time and the ability to stop following failure-to-wait errors and successful stop trials, but not after failure-to-stop errors. Together, these results establish a valid rodent model that utilizes proactive and reactive inhibitory control strategies similar to primates, and highlight the importance of dissociating initial stopping from subsequent waiting in studying mechanisms of inhibitory control using rodents.
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Affiliation(s)
- Jeffrey D Mayse
- Department of Psychological and Brain Sciences, Johns Hopkins University Baltimore, MD, USA ; Neural Circuits and Cognition Unit, Laboratory of Behavioral Neuroscience, National Institute on Aging, National Institutes of Health Baltimore, MD, USA
| | - Geoffrey M Nelson
- Neural Circuits and Cognition Unit, Laboratory of Behavioral Neuroscience, National Institute on Aging, National Institutes of Health Baltimore, MD, USA
| | - Pul Park
- Neurocognitive Aging Section, Laboratory of Behavioral Neuroscience, National Institute on Aging, National Institutes of Health Baltimore, MD, USA
| | - Michela Gallagher
- Department of Psychological and Brain Sciences, Johns Hopkins University Baltimore, MD, USA
| | - Shih-Chieh Lin
- Neural Circuits and Cognition Unit, Laboratory of Behavioral Neuroscience, National Institute on Aging, National Institutes of Health Baltimore, MD, USA
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43
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Luijten M, Machielsen MW, Veltman DJ, Hester R, de Haan L, Franken IH. Systematic review of ERP and fMRI studies investigating inhibitory control and error processing in people with substance dependence and behavioural addictions. J Psychiatry Neurosci 2014; 39:149-69. [PMID: 24359877 PMCID: PMC3997601 DOI: 10.1503/jpn.130052] [Citation(s) in RCA: 250] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Several current theories emphasize the role of cognitive control in addiction. The present review evaluates neural deficits in the domains of inhibitory control and error processing in individuals with substance dependence and in those showing excessive addiction-like behaviours. The combined evaluation of event-related potential (ERP) and functional magnetic resonance imaging (fMRI) findings in the present review offers unique information on neural deficits in addicted individuals. METHODS We selected 19 ERP and 22 fMRI studies using stop-signal, go/no-go or Flanker paradigms based on a search of PubMed and Embase. RESULTS The most consistent findings in addicted individuals relative to healthy controls were lower N2, error-related negativity and error positivity amplitudes as well as hypoactivation in the anterior cingulate cortex (ACC), inferior frontal gyrus and dorsolateral prefrontal cortex. These neural deficits, however, were not always associated with impaired task performance. With regard to behavioural addictions, some evidence has been found for similar neural deficits; however, studies are scarce and results are not yet conclusive. Differences among the major classes of substances of abuse were identified and involve stronger neural responses to errors in individuals with alcohol dependence versus weaker neural responses to errors in other substance-dependent populations. LIMITATIONS Task design and analysis techniques vary across studies, thereby reducing comparability among studies and the potential of clinical use of these measures. CONCLUSION Current addiction theories were supported by identifying consistent abnormalities in prefrontal brain function in individuals with addiction. An integrative model is proposed, suggesting that neural deficits in the dorsal ACC may constitute a hallmark neurocognitive deficit under lying addictive behaviours, such as loss of control.
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Affiliation(s)
- Maartje Luijten
- Correspondence to: M. Luijten, Behavioural Science Institute, Radboud University Nijmegen, PO Box 9104, 6500 HE Nijmegen, the Netherlands;
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Farr OM, Hu S, Matuskey D, Zhang S, Abdelghany O, Li CSR. The effects of methylphenidate on cerebral activations to salient stimuli in healthy adults. Exp Clin Psychopharmacol 2014; 22:154-65. [PMID: 24188171 PMCID: PMC4105943 DOI: 10.1037/a0034465] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Detection of a salient stimulus is critical to cognitive functioning. A stimulus is salient when it appears infrequently, carries high motivational value, and/or when it dictates changes in behavior. Individuals with neurological conditions that implicate altered catecholaminergic signaling, such as those with attention deficit hyperactivity disorder, are impaired in detecting salient stimuli, a deficit that can be remediated by catecholaminergic medications. However, the effects of these catecholaminergic agents on cerebral activities during saliency processing within the context of the stop-signal task are not clear. Here, we examined the effects of a single oral dose (45 mg) of methylphenidate in 24 healthy adults performing the stop-signal task during functional MRI (fMRI). Compared to 92 demographically matched adults who did not receive any medications, the methylphenidate group showed higher activations in bilateral caudate head, primary motor cortex, and the right inferior parietal cortex during stop as compared to go trials (p < .05, corrected for family-wise error of multiple comparisons). These results show that methylphenidate enhances saliency processing by promoting specific cerebral regional activities. These findings may suggest a neural basis for catecholaminergic treatment of attention disorders.
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Affiliation(s)
- Olivia M. Farr
- Interdepartmental Neuroscience Program, Yale University School of Medicine, New Haven, CT 06520
| | - Sien Hu
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06519
| | - David Matuskey
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06519
| | - Sheng Zhang
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06519
| | - Osama Abdelghany
- Investigational Drug Service, Yale New Haven Hospital, New Haven, CT 06519
| | - Chiang-shan R. Li
- Interdepartmental Neuroscience Program, Yale University School of Medicine, New Haven, CT 06520,Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06519,Department of Neurobiology, Yale University School of Medicine, New Haven, CT 06520
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45
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Revealing the brain's adaptability and the transcranial direct current stimulation facilitating effect in inhibitory control by multiscale entropy. Neuroimage 2014; 90:218-34. [DOI: 10.1016/j.neuroimage.2013.12.048] [Citation(s) in RCA: 65] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2013] [Revised: 12/11/2013] [Accepted: 12/23/2013] [Indexed: 11/22/2022] Open
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46
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Albrecht DS, Kareken DA, Christian BT, Dzemidzic M, Yoder KK. Cortical dopamine release during a behavioral response inhibition task. Synapse 2014; 68:266-74. [PMID: 24677429 DOI: 10.1002/syn.21736] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2013] [Revised: 01/30/2013] [Accepted: 02/10/2013] [Indexed: 01/09/2023]
Abstract
Dopamine (DA) dysregulation within fronto-striatal circuitry may underlie impulsivity in alcohol and other substance use disorders. To date, no one has directly demonstrated DA release during a task requiring the control of impulsive behavior. The current study was conducted to determine whether a response inhibition task (stop signal task; SST) would elicit detectable extrastriatal DA release in healthy controls. We hypothesized that DA release would be detected in regions previously implicated in different aspects of inhibitory control. [(18) F]Fallypride (FAL) PET imaging was performed in nine healthy males (24.6 ± 4.1 y.o.) to assess changes in cortical DA during a SST relative to a baseline "Go" task. On separate days, subjects received one FAL scan during the SST, and one FAL scan during a "Go" control; task-order was counter-balanced across subjects. Parametric BPND images were generated and analyzed with SPM8. Voxel-wise analysis indicated significant SST-induced DA release in several cortical regions involved in inhibitory control, including the insula, cingulate cortex, orbitofrontal cortex, precuneus, and supplementary motor area. There was a significant positive correlation between stop signal reaction time and DA release in the left orbitofrontal cortex, right middle frontal gyrus, and right precentral gyrus. These data support the feasibility of using FAL PET to study DA release during response inhibition, enabling investigation of relationships between DA function and impulsive behavior.
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Affiliation(s)
- Daniel S Albrecht
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, Indiana, 46202; Stark Neurosciences Research Institute, Indiana University School of Medicine, Indianapolis, Indiana, 46202
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McHugh MJ, Demers CH, Salmeron BJ, Devous MD, Stein EA, Adinoff B. Cortico-amygdala coupling as a marker of early relapse risk in cocaine-addicted individuals. Front Psychiatry 2014; 5:16. [PMID: 24578695 PMCID: PMC3936467 DOI: 10.3389/fpsyt.2014.00016] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2013] [Accepted: 02/03/2014] [Indexed: 12/20/2022] Open
Abstract
Addiction to cocaine is a chronic condition characterized by high rates of early relapse. This study builds on efforts to identify neural markers of relapse risk by studying resting-state functional connectivity (rsFC) in neural circuits arising from the amygdala, a brain region implicated in relapse-related processes including craving and reactivity to stress following acute and protracted withdrawal from cocaine. Whole-brain resting-state functional magnetic resonance imaging connectivity (6 min) was assessed in 45 cocaine-addicted individuals and 22 healthy controls. Cocaine-addicted individuals completed scans in the final week of a residential treatment episode. To approximate preclinical models of relapse-related circuitry, separate seeds were derived for the left and right basolateral (BLA) and corticomedial (CMA) amygdala. Participants also completed the Iowa Gambling Task, Wisconsin Card Sorting Test, Cocaine Craving Questionnaire, Obsessive-Compulsive Cocaine Use Scale and Personality Inventory. Relapse within the first 30 days post-treatment (n = 24) was associated with reduced rsFC between the left CMA and ventromedial prefrontal cortex/rostral anterior cingulate cortex (vmPFC/rACC) relative to cocaine-addicted individuals who remained abstinent (non-relapse, n = 21). Non-relapse participants evidenced reduced rsFC between the bilateral BLA and visual processing regions (lingual gyrus/cuneus) compared to controls and relapsed participants. Early relapse was associated with fewer years of education but unrelated to trait reactivity to stress, neurocognitive and clinical characteristics or cocaine use history. Findings suggest that rsFC within neural circuits implicated in preclinical models of relapse may provide a promising marker of relapse risk in cocaine-addicted individuals. Future efforts to replicate the current findings and alter connectivity within these circuits may yield novel interventions and improve treatment outcomes.
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Affiliation(s)
- Meredith J. McHugh
- Neuroimaging Research Branch, Intramural Research Program, National Institute on Drug Abuse, Baltimore, MD, USA
| | - Catherine H. Demers
- Neuroimaging Research Branch, Intramural Research Program, National Institute on Drug Abuse, Baltimore, MD, USA
| | - Betty Jo Salmeron
- Neuroimaging Research Branch, Intramural Research Program, National Institute on Drug Abuse, Baltimore, MD, USA
| | | | - Elliot A. Stein
- Neuroimaging Research Branch, Intramural Research Program, National Institute on Drug Abuse, Baltimore, MD, USA
| | - Bryon Adinoff
- VA North Texas Health Care System, Dallas, TX, USA
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
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48
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Stevens L, Verdejo-García A, Goudriaan AE, Roeyers H, Dom G, Vanderplasschen W. Impulsivity as a vulnerability factor for poor addiction treatment outcomes: a review of neurocognitive findings among individuals with substance use disorders. J Subst Abuse Treat 2014; 47:58-72. [PMID: 24629886 DOI: 10.1016/j.jsat.2014.01.008] [Citation(s) in RCA: 199] [Impact Index Per Article: 19.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2013] [Revised: 12/20/2013] [Accepted: 01/21/2014] [Indexed: 01/10/2023]
Abstract
With the current review, we explore the hypothesis that individual differences in neurocognitive aspects of impulsivity (i.e., cognitive and motor disinhibition, delay discounting and impulsive decision-making) among individuals with a substance use disorder are linked to unfavorable addiction treatment outcomes, including high drop-out rates and difficulties in achieving and maintaining abstinence. A systematic review of the literature was carried out using PubMed, PsycINFO and Web of Knowledge searches. Twenty-five unique empirical papers were identified and findings were considered in relation to the different impulsivity dimensions. Although conceptual/methodological heterogeneity and lack of replication are key limitations of studies in this area, findings speak for a prominent role of cognitive disinhibition, delay discounting and impulsive decision-making in the ability to successfully achieve and maintain abstinence during and following addiction treatment. In contrast, indices of motor disinhibition appear to be unrelated to abstinence levels. Whereas the relationship between impulsivity and treatment retention needs to be examined more extensively, preliminary evidence suggests that impulsive/risky decision-making is unrelated to premature treatment drop-out among individuals with a substance use disorder. The reviewed findings are discussed in terms of their clinical implications.
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Affiliation(s)
- Laura Stevens
- Department of Orthopedagogics, Ghent University, Belgium.
| | - Antonio Verdejo-García
- Department of Clinical Psychology, Universidad de Granada, Spain; Institute of Neuroscience F. Olóriz, Universidad de Granada, Spain; School of Psychology and Psychiatry, Monash University, Melbourne, Victoria
| | - Anna E Goudriaan
- Department of Psychiatry, Academic Medical Center, University of Amsterdam, The Netherlands; Arkin Mental Health Care, Amsterdam, The Netherlands
| | - Herbert Roeyers
- Department of Experimental Clinical and Health Psychology, Ghent University, Belgium
| | - Geert Dom
- Psychiatric Centre Alexian Brothers, Boechout, Belgium; Collaborative Antwerp Psychiatry Research Institute (CAPRI), Antwerp, Belgium
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49
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Zhang S, Hu S, Bednarski SR, Erdman E, Li CSR. Error-related functional connectivity of the thalamus in cocaine dependence. NEUROIMAGE-CLINICAL 2014; 4:585-92. [PMID: 24936409 PMCID: PMC4053644 DOI: 10.1016/j.nicl.2014.01.015] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/21/2013] [Revised: 01/13/2014] [Accepted: 01/26/2014] [Indexed: 11/30/2022]
Abstract
Error processing is a critical component of cognitive control, an executive function that has been widely implicated in substance misuse. In previous studies we showed that error related activations of the thalamus predicted relapse to drug use in cocaine addicted individuals (Luo et al., 2013). Here, we investigated whether the error-related functional connectivity of the thalamus is altered in cocaine dependent patients (PCD, n = 54) as compared to demographically matched healthy individuals (HC, n = 54). The results of a generalized psychophysiological interaction analysis showed negative thalamic connectivity with the ventral medial prefrontal cortex (vmPFC), in the area of perigenual and subgenual anterior cingulate cortex, in HC but not PCD (p < 0.05, corrected, two-sample t test). This difference in functional connectivity was not observed for task-residual signals, suggesting that it is specific to task-related processes during cognitive control. Further, the thalamic-vmPFC connectivity is positively correlated with the amount of cocaine use in the prior month for female but not for male PCD. These findings add to recent literature and provide additional evidence for circuit-level biomarkers of cocaine dependence. Error-related thalamic-vmPFC connectivity is altered in cocaine misuse. This altered connectivity is associated with impaired self control. This deficit is associated with recent cocaine use in women but not men.
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Affiliation(s)
- Sheng Zhang
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06519, USA
| | - Sien Hu
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06519, USA
| | - Sarah R Bednarski
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06519, USA
| | - Emily Erdman
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06519, USA
| | - Chiang-Shan R Li
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06519, USA ; Inter-departmental Neuroscience Program, Yale University, New Haven, CT 06520, USA ; Department of Neurobiology, Yale University School of Medicine, New Haven, CT 06520, USA
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50
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Jan RK, Lin JC, McLaren DG, Kirk IJ, Kydd RR, Russell BR. The effects of methylphenidate on cognitive control in active methamphetamine dependence using functional magnetic resonance imaging. Front Psychiatry 2014; 5:20. [PMID: 24639656 PMCID: PMC3944404 DOI: 10.3389/fpsyt.2014.00020] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2013] [Accepted: 02/07/2014] [Indexed: 01/28/2023] Open
Abstract
Methamphetamine (MA) dependence is associated with cognitive deficits. Methylphenidate (MPH) has been shown to improve inhibitory control in healthy and cocaine-dependent subjects. This study aimed to understand the neurophysiological effects before and after acute MPH administration in active MA-dependent and control subjects. Fifteen MA-dependent and 18 control subjects aged 18-46 years were scanned using functional magnetic resonance imaging before and after either a single oral dose of MPH (18 mg) or placebo while performing a color-word Stroop task. Baseline accuracy was lower (p = 0.026) and response time (RT) was longer (p < 0.0001) for the incongruent compared to congruent condition, demonstrating the task probed cognitive control. Increased activation of the dorsolateral prefrontal cortex (DLPFC) and parietal cortex during the incongruent and Stroop effect conditions, respectively was observed in MA-dependent compared to control subjects (p < 0.05), suggesting the need to recruit neural resources within these regions for conflict resolution. Post- compared to pre-MPH treatment, increased RT and DLPFC activation for the Stroop effect were observed in MA-dependent subjects (p < 0.05). In comparison to MPH-treated controls and placebo-treated MA-dependent subjects, MPH-treated MA-dependent subjects showed decreased activation of parietal and occipital regions during the incongruent and Stroop effect conditions (p < 0.05). These findings suggest that in MA-dependent subjects, MPH facilitated increased recruitment of the DLPFC for Stroop conflict resolution, and a decreased need for recruitment of neural resources in parietal and occipital regions compared to the other groups, while maintaining a comparable level of task performance to that achieved pre-drug administration. Due to the small sample size, the results from this study are preliminary; however, they inform us about the effects of MPH on the neural correlates of cognitive control in active MA-dependent subjects.
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Affiliation(s)
- Reem K Jan
- School of Pharmacy, University of Auckland , Auckland , New Zealand ; Centre for Brain Research, University of Auckland , Auckland , New Zealand
| | - Joanne C Lin
- School of Pharmacy, University of Auckland , Auckland , New Zealand ; Centre for Brain Research, University of Auckland , Auckland , New Zealand
| | - Donald G McLaren
- Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital , Boston, MA , USA ; Department of Neurology, Massachusetts General Hospital , Boston, MA , USA ; Harvard Medical School , Boston, MA , USA
| | - Ian J Kirk
- Centre for Brain Research, University of Auckland , Auckland , New Zealand ; Department of Psychology, University of Auckland , Auckland , New Zealand
| | - Rob R Kydd
- Centre for Brain Research, University of Auckland , Auckland , New Zealand ; Department of Psychological Medicine, University of Auckland , Auckland , New Zealand
| | - Bruce R Russell
- School of Pharmacy, University of Auckland , Auckland , New Zealand ; Centre for Brain Research, University of Auckland , Auckland , New Zealand
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