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Ye J, Mehta S, Peterson H, Ibrahim A, Saeed G, Linsky S, Kreinin I, Tsang S, Nwanaji-Enwerem U, Raso A, Arora J, Tokoglu F, Yip SW, Alice Hahn C, Lacadie C, Greene AS, Constable RT, Barry DT, Redeker NS, Yaggi H, Scheinost D. Investigating brain dynamics and their association with cognitive control in opioid use disorder using naturalistic and drug cue paradigms. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.02.25.24303340. [PMID: 38464297 PMCID: PMC10925365 DOI: 10.1101/2024.02.25.24303340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/12/2024]
Abstract
Objectives Opioid use disorder (OUD) impacts millions of people worldwide. The prevalence and debilitating effects of OUD present a pressing need to understand its neural mechanisms to provide more targeted interventions. Prior studies have linked altered functioning in large-scale brain networks with clinical symptoms and outcomes in OUD. However, these investigations often do not consider how brain responses change over time. Time-varying brain network engagement can convey clinically relevant information not captured by static brain measures. Methods We investigated brain dynamic alterations in individuals with OUD by applying a new multivariate computational framework to movie-watching (i.e., naturalistic; N=76) and task-based (N=70) fMRI. We further probed the associations between cognitive control and brain dynamics during a separate drug cue paradigm in individuals with OUD. Results Compared to healthy controls (N=97), individuals with OUD showed decreased variability in the engagement of recurring brain states during movie-watching. We also found that worse cognitive control was linked to decreased variability during the rest period when no opioid-related stimuli were present. Conclusions These findings suggest that individuals with OUD may experience greater difficulty in effectively engaging brain networks in response to evolving internal or external demands. Such inflexibility may contribute to aberrant response inhibition and biased attention toward opioid-related stimuli, two hallmark characteristics of OUD. By incorporating temporal information, the current study introduces novel information about how brain dynamics are altered in individuals with OUD and their behavioral implications.
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Affiliation(s)
- Jean Ye
- Interdepartmental Neuroscience Program, Yale University
| | - Saloni Mehta
- Department of Radiology & Biomedical Imaging, Yale School of Medicine
| | | | - Ahmad Ibrahim
- Department of Internal Medicine, Yale School of Medicine
| | - Gul Saeed
- Department of Internal Medicine, Roger Williams Medical Center
| | | | - Iouri Kreinin
- Pulmonary, Critical Care and Sleep Medicine, Yale School of Medicine
| | | | | | - Anthony Raso
- Frank H. Netter M.D. School of Medicine, Quinnipiac University
| | - Jagriti Arora
- Department of Radiology & Biomedical Imaging, Yale School of Medicine
| | - Fuyuze Tokoglu
- Department of Radiology & Biomedical Imaging, Yale School of Medicine
| | - Sarah W Yip
- Interdepartmental Neuroscience Program, Yale University
- Department of Psychiatry, Yale School of Medicine
- Child Study Center, Yale School of Medicine
| | - C Alice Hahn
- Yale Center for Clinical Investigation, Yale School of Medicine
| | - Cheryl Lacadie
- Department of Radiology & Biomedical Imaging, Yale School of Medicine
| | | | - R Todd Constable
- Interdepartmental Neuroscience Program, Yale University
- Department of Radiology & Biomedical Imaging, Yale School of Medicine
- Department of Biomedical Engineering, Yale School of Engineering and Applied Science
- Department of Neurosurgery, Yale School of Medicine
| | - Declan T Barry
- Department of Psychiatry, Yale School of Medicine
- Child Study Center, Yale School of Medicine
- Department of Research, APT foundation
| | | | - Henry Yaggi
- Department of Internal Medicine, Yale School of Medicine
- Clinical Epidemiology Research Center, VA CT Healthcare System
| | - Dustin Scheinost
- Interdepartmental Neuroscience Program, Yale University
- Department of Radiology & Biomedical Imaging, Yale School of Medicine
- Child Study Center, Yale School of Medicine
- Department of Biomedical Engineering, Yale School of Engineering and Applied Science
- Department of Statistics & Data Science, Yale School of Medicine
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Pericot-Valverde I, Byrne KA, Ortiz EG, Davis S, Hammond E, Nahvi S, Thrasher JF, Sivaraj LB, Cumby S, Goodwin E, King AC, Arnsten J, Fernández-Artamendi S, Heo M, Litwin AH. Preliminary Evidence of the Association between Time on Buprenorphine and Cognitive Performance among Individuals with Opioid Use Disorder Maintained on Buprenorphine: A Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6610. [PMID: 37623193 PMCID: PMC10454026 DOI: 10.3390/ijerph20166610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Revised: 07/26/2023] [Accepted: 08/16/2023] [Indexed: 08/26/2023]
Abstract
People on buprenorphine maintenance treatment (BMT) commonly present cognitive deficits that have been associated with illicit drug use and dropout from buprenorphine treatment. This study has compared cognitive responses to the Stroop Task and the Continuous Performance Task (CPT) among individuals on BMT, with recent drug use, and healthy controls and explored the associations between cognitive responses and drug use, craving, and buprenorphine use among participants on BMT. The participants were 16 individuals on BMT and 23 healthy controls. All participants completed a 60 min laboratory session in which they completed the Stroop Task and the CPT, a saliva drug test, a brief clinical history that collected substance-use- and treatment-related information, and the Opioid Craving Scale. The results showed that the BMT participants presented more commission errors (MBMT participants = 2.49; Mhealthy controls = 1.38; p = 0.048) and longer reaction times (MBMT participants = 798.09; Mhealthy controls = 699.09; p = 0.047) in the Stroop Task than did the healthy controls. More days on buprenorphine were negatively associated with reaction time in the CPT (-0.52) and the number of commission errors (-0.53), simple reaction time (-0.54), and reaction time correct (-0.57) in the Stroop Task. Neither drug use nor craving was significantly associated with the results for the cognitive tasks. Relative to the control participants, the BMT individuals performed worse in terms of longer reaction times and more commission errors in the Stroop Task. Within the BMT participants, longer times on buprenorphine were associated with better cognitive results in terms of faster reaction times for both tasks and lower commission errors for the Stroop Task.
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Affiliation(s)
- Irene Pericot-Valverde
- Department of Psychology, College of Behavioral, Social, and Health Sciences, Clemson University, Clemson, SC 29634, USA; (K.A.B.); (E.H.); (A.H.L.)
- School of Health Research, Clemson University, Clemson, SC 29634, USA
| | - Kaileigh A. Byrne
- Department of Psychology, College of Behavioral, Social, and Health Sciences, Clemson University, Clemson, SC 29634, USA; (K.A.B.); (E.H.); (A.H.L.)
- School of Health Research, Clemson University, Clemson, SC 29634, USA
| | - Erik G. Ortiz
- Addiction Medicine Center, Prisma Health, Greenville, SC 29601, USA; (E.G.O.); (L.B.S.); (A.C.K.)
| | - Stephanie Davis
- Department of Psychology, College of Behavioral, Social, and Health Sciences, Clemson University, Clemson, SC 29634, USA; (K.A.B.); (E.H.); (A.H.L.)
| | - Ethan Hammond
- Department of Psychology, College of Behavioral, Social, and Health Sciences, Clemson University, Clemson, SC 29634, USA; (K.A.B.); (E.H.); (A.H.L.)
| | - Shadi Nahvi
- Department of Medicine, Albert Einstein College of Medicine/Montefiore Medical Center, New York, NY 10461, USA; (S.N.)
| | - James F. Thrasher
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA;
| | - Laksika B. Sivaraj
- Addiction Medicine Center, Prisma Health, Greenville, SC 29601, USA; (E.G.O.); (L.B.S.); (A.C.K.)
- Department of Medicine, University of South Carolina School of Medicine, Greenville, SC 29209, USA; (S.C.); (E.G.)
| | - Sam Cumby
- Department of Medicine, University of South Carolina School of Medicine, Greenville, SC 29209, USA; (S.C.); (E.G.)
| | - Eli Goodwin
- Department of Medicine, University of South Carolina School of Medicine, Greenville, SC 29209, USA; (S.C.); (E.G.)
| | - Ashley C. King
- Addiction Medicine Center, Prisma Health, Greenville, SC 29601, USA; (E.G.O.); (L.B.S.); (A.C.K.)
| | - Julia Arnsten
- Department of Medicine, Albert Einstein College of Medicine/Montefiore Medical Center, New York, NY 10461, USA; (S.N.)
| | | | - Moonseong Heo
- Department of Public Health Sciences, Clemson University, Clemson, SC 29634, USA;
| | - Alain H. Litwin
- Department of Psychology, College of Behavioral, Social, and Health Sciences, Clemson University, Clemson, SC 29634, USA; (K.A.B.); (E.H.); (A.H.L.)
- School of Health Research, Clemson University, Clemson, SC 29634, USA
- Addiction Medicine Center, Prisma Health, Greenville, SC 29601, USA; (E.G.O.); (L.B.S.); (A.C.K.)
- Department of Medicine, University of South Carolina School of Medicine, Greenville, SC 29209, USA; (S.C.); (E.G.)
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Weidacker K, Zhao Y, Zhang Y, Whiteford S, Ren Q, Zhang C, Voon V. Methadone maintenance treatment and impulsivity: premature responding. J Clin Exp Neuropsychol 2023; 45:606-617. [PMID: 37916529 DOI: 10.1080/13803395.2023.2276483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Accepted: 10/23/2023] [Indexed: 11/03/2023]
Abstract
INTRODUCTION Previous research showed that methadone maintenance treatment (MMT) is linked to impulsivity, with higher impulsivity levels being associated with for example, increased drug use. One aspect of impulsivity, most commonly studied in rodent research, is premature responding, the failure to wait for a starting signal. Premature responding is of high translational significance since it predicts the development of addiction-like behaviors in rodents. METHODS We assessed 45 MMT patients and 46 demographically matched (age, sex, education, and handedness) healthy volunteers (HVs) on premature responding alongside action and inhibition of instructed and intentional trials using the Intentional Hand Task (IHT). RESULTS The results showed markedly enhanced premature responses in the MMT vs. the HV group, which correlated positively with methadone dosage in the MMT patients. Throughout the task, MMT patients were faster across all trial parts and less accurate in response to instructed trials compared to HVs. CONCLUSIONS The increase in premature motor reactions during variable waiting periods alongside increased motion speed and lower accuracy might reflect a specific motor inhibition deficit in MMT, a subcomponent of impulsivity not previously assessed in MMT. Incorporating an experimentally defined measure of impulsivity, such as premature responding, into existing test batteries used by clinicians might enable more tailored treatments addressing the increased impulsivity levels and associated dysfunctional behaviors in MMT.
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Affiliation(s)
- Kathrin Weidacker
- School of Psychology, Swansea University, Wales, UK
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Yijie Zhao
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China
- Clinical Research Center for Mental Disorders, Shanghai Pudong New Area Mental Health Center, School of Medicine, Tongji University, Shanghai, China
| | - Yingying Zhang
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China
| | - Seb Whiteford
- School of Psychology, Swansea University, Wales, UK
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Qihuan Ren
- Department of Psychiatry, Shanghai Hongkou Mental Health Center, Shanghai, China
| | - Chencheng Zhang
- Department of Neurosurgery, Center for Functional Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Clinical Neuroscience Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Research Center for Brain Science and Brain-Inspired Technology, Shanghai, China
| | - Valerie Voon
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China
- Department of Neurosurgery, Center for Functional Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
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Bhatia G, Ganesh R, Kulkarni A. Cognitive impairment in opioid use disorders: Is there a case for use of nootropics? Psychiatry Res 2023; 326:115335. [PMID: 37459675 DOI: 10.1016/j.psychres.2023.115335] [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: 05/04/2023] [Revised: 07/03/2023] [Accepted: 07/04/2023] [Indexed: 08/02/2023]
Abstract
Opioid Use Disorders (OUDs) are often associated with cognitive impairments, which may lead to an increased risk of relapse. These cognitive deficits do not resolve with abstinence or medication-assisted treatment and may require targeted management. While psychotherapies and neuromodulation techniques have been studied for their effectiveness, they have certain limitations and challenges. Cognition enhancing prescription drugs like donepezil and memantine, which are used in dementias, have shown promise in a small number of studies examining their role in the reversal of opioid-induced cognitive deficits. The authors explore the potential role of nootropics in improvement of cognitive decline associated with OUDs.
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Affiliation(s)
- Gayatri Bhatia
- Department of Psychiatry, All India Institute of Medical Sciences, Rajkot, India.
| | - Ragul Ganesh
- Department of Psychiatry, All India Institute of Medical Sciences, Jammu, India
| | - Alok Kulkarni
- Department of Psychiatry, S. S. Institute of Medical Sciences, Davanagere, Karnataka, India
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5
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Wang D, Yin Y, Yuan W, Li B, Wang H, Hu J, Chen M, Gong Y, Yuan TF, Yu T. Post-error slowing predicts for relapse in individuals with alcohol use disorder. J Psychiatr Res 2023; 161:441-448. [PMID: 37059028 DOI: 10.1016/j.jpsychires.2023.03.039] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Revised: 03/09/2023] [Accepted: 03/27/2023] [Indexed: 04/16/2023]
Abstract
BACKGROUND Relapse characterizes addiction. The cognitive phenotype underlying relapse in individuals with alcohol use disorder (AUD) remain unelucidated. Here we aimed to investigate the potential changes in behavioral adjustment in AUD, and the association with relapse. METHOD Forty-seven subjects with AUD at Shandong Mental Health Center completed the stop-signal task, the PACS, the Beck Depression Inventory and the State-Trait anxiety questionnaires. Thirty age-matched male healthy subjects served as the control group (HC). In the follow-up, twenty-one subjects remained abstinent, while twenty-six subjects relapsed. Independent sample t-test was applied to measure differences between two groups and logistic regression analysis was conducted to explore the potential predictors on relapse. RESULTS The results showed that there were significant differences in stop signal reaction time (SSRT) and trigger failure between the AUD and HC groups. Relapsed group showed longer post-error slowing (PES) when compared to the non-relapsed group. The PES could predict relapse in alcohol use disorder. CONCLUSION Individuals with AUD showed impaired inhibitory control, which may predict relapse.
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Affiliation(s)
- Duanwei Wang
- Shandong Mental Health Center, Jinan, Shandong, China
| | - Yuanyuan Yin
- School of Mental Healthy, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Wei Yuan
- Shandong Mental Health Center, Jinan, Shandong, China
| | - Bin Li
- Shandong Mental Health Center, Jinan, Shandong, China
| | - Hairong Wang
- Shandong Mental Health Center, Jinan, Shandong, China
| | - Ji Hu
- School of Life Sciences, ShanghaiTech University, Shanghai, China
| | - Meng Chen
- Brain and Cognitive Neuroscience Research Center, Liaoning Normal University, Dalian, China
| | - Yuandong Gong
- Shandong Mental Health Center, Jinan, Shandong, China.
| | - Ti-Fei Yuan
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Co-Innovation Center of Neuroregeneration, Nantong University, Nantong, China.
| | - Tiangui Yu
- Shandong Mental Health Center, Jinan, Shandong, China.
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Psederska E, Vassileva J. Neurocognitive Impulsivity in Opiate Users at Different Lengths of Abstinence. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1236. [PMID: 36674000 PMCID: PMC9859339 DOI: 10.3390/ijerph20021236] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 01/06/2023] [Accepted: 01/07/2023] [Indexed: 06/17/2023]
Abstract
The aim of the current study was to examine the effects of length of abstinence on decision making (impulsive choice) and response inhibition (impulsive action) in former opiate users (OU). Participants included 45 OU in early remission [0−12 months of abstinence], 68 OU in sustained remission [>12 months of abstinence], and 68 control participants. Decision making was assessed with the Iowa Gambling Task (IGT), the Cambridge Gambling Task (CGT), and the Monetary Choice Questionnaire (MCQ). Response inhibition was examined with the Stop Signal Task (SST), and the Go/No-Go Task (GNG). Results revealed group differences in decision making under risk (CGT) and ambiguity (IGT), where control participants displayed better decision making compared to OU in early remission. Both groups of former OU were also characterized by higher discounting of delayed rewards (MCQ). Regression analyses revealed minimal effects of length of abstinence on performance on decision-making tasks and no effects on delay discounting. In addition, both OU groups showed reduced action inhibition (GNG) relative to controls and there were no group differences in action cancellation (SST). Length of abstinence had no effect on response inhibition. Overall, our findings suggest that neurocognitive function may not fully recover even with protracted abstinence, which should be addressed by relapse prevention and cognitive remediation programs for OU.
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Affiliation(s)
- Elena Psederska
- Bulgarian Addictions Institute, 93 Antim I Str., 1303 Sofia, Bulgaria
- Department of Cognitive Science and Psychology, New Bulgarian University, 1618 Sofia, Bulgaria
| | - Jasmin Vassileva
- Institute for Drug and Alcohol Studies, Virginia Commonwealth University, Richmond, VA 23219, USA
- Department of Psychiatry, Virginia Commonwealth University, Richmond, VA 23219, USA
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Ceceli AO, King SG, McClain N, Alia-Klein N, Goldstein RZ. The Neural Signature of Impaired Inhibitory Control in Individuals with Heroin Use Disorder. J Neurosci 2023; 43:173-182. [PMID: 36396402 PMCID: PMC9838696 DOI: 10.1523/jneurosci.1237-22.2022] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 09/26/2022] [Accepted: 09/28/2022] [Indexed: 11/18/2022] Open
Abstract
Heroin addiction imposes a devastating toll on society, with little known about its neurobiology. Excessive salience attribution to drug over nondrug cues/reinforcers, with concomitant inhibitory control decreases, are common mechanisms underlying drug addiction. Although inhibitory control alterations generally culminate in prefrontal cortex (PFC) hypoactivations across drugs of abuse, patterns in individuals with heroin addiction (iHUDs) remain unknown. We used a stop-signal fMRI task designed to meet recent consensus guidelines in mapping inhibitory control in 41 iHUDs and 24 age- and sex-matched healthy controls (HCs). Despite group similarities in the stop-signal response time (SSRT; the classic inhibitory control measure), compared with HCs, iHUDs exhibited impaired target detection sensitivity (proportion of hits in go vs false alarms in stop trials; p = 0.003). Additionally, iHUDs exhibited lower right anterior PFC (aPFC) and dorsolateral PFC (dlPFC) activity during successful versus failed stops (the hallmark inhibitory control contrast). Lower left dlPFC/supplementary motor area (SMA) activity was associated with slower SSRT specifically in iHUDs and lower left aPFC activity with worse target sensitivity across all participants (p < 0.05 corrected). Importantly, in iHUDs, lower left SMA and aPFC activity during inhibitory control was associated with shorter time since last use and higher severity of dependence, respectively (p < 0.05 corrected). Together, results revealed lower perceptual sensitivity and hypoactivations during inhibitory control in cognitive control regions (e.g., aPFC, dlPFC, SMA) as associated with task performance and heroin use severity measures in iHUDs. Such neurobehavioral inhibitory control deficits may contribute to self-control lapses in heroin addiction, constituting targets for prevention and intervention efforts to enhance recovery.SIGNIFICANCE STATEMENT Heroin addiction continues its deadly impact, with little known about the neurobiology of this disorder. Although behavioral and prefrontal cortical impairments in inhibitory control characterize addiction across drugs of abuse, these patterns remain underexplored in heroin addiction. Here, we illustrate a significant behavioral impairment in target discrimination in individuals with heroin addiction compared with matched healthy controls. We further show lower engagement during inhibitory control in the anterior and dorsolateral prefrontal cortex (key regions that regulate cognitive control) as associated with slower stopping, worse discrimination, and heroin use measures. Mapping the neurobiology of inhibitory control in heroin addiction for the first time, we identify potential treatment targets inclusive of prefrontal cortex-mediated cognitive control amenable for neuromodulation en route to recovery.
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Affiliation(s)
- Ahmet O Ceceli
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York 10029
| | - Sarah G King
- Department of Neuroscience, Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, New York 10029
| | - Natalie McClain
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York 10029
| | - Nelly Alia-Klein
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York 10029
- Department of Neuroscience, Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, New York 10029
| | - Rita Z Goldstein
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York 10029
- Department of Neuroscience, Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, New York 10029
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Giustiniani J, Rothen S, Penzenstadler L, Colombo L, Calzada G, Thorens G, Zullino D. Does slow release oral morphine have impact on craving and impulsivity in heroin dependent individuals? Int Clin Psychopharmacol 2023; 38:16-22. [PMID: 35833289 PMCID: PMC9722371 DOI: 10.1097/yic.0000000000000418] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Craving and impulsivity are addiction components which explain why heroin-dependant individuals (HDI), continue using heroin despite not wanting to do so. Opioid maintenance treatment (OMT), such as slow-release oral morphine (SROM), is the most effective treatment for opioid dependence. However, the impact of SROM on craving and impulsivity remains unclear. In this observational study, 23 HDI receiving SROM, their usual OMT, took part in the experiment. Each of the participants filled in the perceived level of craving with a visual analog scale. Their impulsivity was assessed via three laboratory tasks, the stop-signal reaction time, the Balloon Analogue Risk Task and delay discounting. Each evaluation was performed before and after SROM administration. Craving was significantly reduced after administration of SROM (difference 2.83; P = 0.0010), whereas there were no significant differences in performance in the three laboratory tasks. In the long term, we observed an improvement on delay discounting correlated with the duration and dosage of SROM. The acute impact of SROM appears to significantly reduce craving, without impacting impulsivity. Observation of the correlation between delay discounting and the duration and dosage of OMT is of great interest and should be studied further.
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Affiliation(s)
- Julie Giustiniani
- Addictology Division, Mental Health and Psychiatry Department, Geneva University Hospitals
| | - Stéphane Rothen
- Addictology Division, Mental Health and Psychiatry Department, Geneva University Hospitals
- Research Center for Statistics, University of Geneva, Geneva School of Management and Economics
| | - Louise Penzenstadler
- Addictology Division, Mental Health and Psychiatry Department, Geneva University Hospitals
| | - Laura Colombo
- Addictology Division, Mental Health and Psychiatry Department, Geneva University Hospitals
| | - Gérard Calzada
- Addictology Division, Mental Health and Psychiatry Department, Geneva University Hospitals
- Faculty of Medicine, Geneva University, Geneva, Switzerland
| | - Gabriel Thorens
- Addictology Division, Mental Health and Psychiatry Department, Geneva University Hospitals
- Faculty of Medicine, Geneva University, Geneva, Switzerland
| | - Daniele Zullino
- Addictology Division, Mental Health and Psychiatry Department, Geneva University Hospitals
- Faculty of Medicine, Geneva University, Geneva, Switzerland
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9
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Bjork JM, Keyser-Marcus L, Vassileva J, Ramey T, Houghton DC, Moeller FG. Attentional function and inhibitory control in different substance use disorders. Psychiatry Res 2022; 313:114591. [PMID: 35533472 PMCID: PMC9177751 DOI: 10.1016/j.psychres.2022.114591] [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: 11/24/2021] [Revised: 02/22/2022] [Accepted: 04/30/2022] [Indexed: 10/18/2022]
Abstract
Attentional function in substance use disorder (SUD) is not well understood. To probe attentional function in SUD as a function of primary substance of abuse, we administered the attentional network task (ANT) to 44 individuals with Cocaine Use Disorder (CoUD), 49 individuals with Cannabis Use Disorder (CaUD), 86 individuals with Opioid Use Disorder (OUD), and 107 controls with no SUD, along with the stop-signal task (SST). The ANT quantifies the effects of (temporal) alerting cues and (spatial) orienting cues to reduce reaction time (RT) to targets, as well as probing how conflicting (target-incongruent) stimuli slow RT. The SST quantifies individuals' ability to inhibit already-initiated motor responses. After controlling for sex representation and age, OUD and CaUD participants showed blunted alerting effects compared to controls, whereas CaUD and CoUD participants showed greater stimulus conflict (flanker) effects. Finally, CoUD participants showed a trend toward increased orienting ability. In SST performance, no SUD group showed a prolonged stop-signal reaction compared to controls. However, the OUD group (and CoUD group at trend level) showed prolonged "go" RT to targets and reduced hit rates. These data indicate differences in attentional function in persons with SUD as a function of the primary substance use.
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Affiliation(s)
- James M. Bjork
- Institute for Drug and Alcohol Studies, Virginia Commonwealth University, Richmond, Virginia, USA,Address correspondence to: James M. Bjork, Associate Professor, Institute for Drug and Alcohol Studies, Department of Psychiatry, Virginia Commonwealth University, 203 E Cary St, Room 202, Richmond, Virginia 23219, Phone: (301) 351-4143,
| | - Lori Keyser-Marcus
- Institute for Drug and Alcohol Studies, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Jasmin Vassileva
- Institute for Drug and Alcohol Studies, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Tatiana Ramey
- Division of Therapeutics and Medical Consequences, National Institute on Drug Abuse, Bethesda, Maryland, USA
| | - David C. Houghton
- Department of Psychiatry and Behavioral Sciences & Center for Addiction Research, University of Texas Medical Branch, Galveston, Texas, USA
| | - F. Gerard Moeller
- Institute for Drug and Alcohol Studies, Virginia Commonwealth University, Richmond, Virginia, USA
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Wu J, Xiao W, Yip J, Peng L, Zheng K, Takyi Bentil O, Ren Z. Effects of Exercise on Neural Changes in Inhibitory Control: An ALE Meta-Analysis of fMRI Studies. Front Hum Neurosci 2022; 16:891095. [PMID: 35814955 PMCID: PMC9265250 DOI: 10.3389/fnhum.2022.891095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 06/08/2022] [Indexed: 11/13/2022] Open
Abstract
It is widely known that exercise improves inhibitory control; however, the mechanisms behind the cognitive improvement remain unclear. This study analyzes the extant literature on the neuronal effects of exercise on inhibitory control functions. We searched four online databases (Pubmed, Scopus, PsycINFO, and Web of Science) for relevant peer-reviewed studies to identify eligible studies published before September 1, 2021. Among the 4,090 candidate studies identified, 14 meet the inclusion criteria, and the results of 397 participants in these 14 studies are subsequently analyzed. We quantify the neural effects on the entire brain by using GingerALE software and identify 10 clusters of exercise-induced neuronal with either increases/decreases in the superior temporal gyrus (BA 22), precuneus (BA 7), superior frontal gyrus (BA 10), cuneus (BA 19), precuneus (BA 19), caudate, posterior cingulate (BA 19), middle temporal gyrus (B 37), parahippocampal gyrus (BA 30), precentral gyrus (BA 6). Meta-analytic coactivation map (MACM) showed that multiple functional networks overlap with brain regions with activation likelihood estimation (ALE) results. We propose the effect of exercise on neural activity is related to inhibitory control in the extended frontoparietal, default mode network (DMN), visual network, and other pathways. These results provide preliminary evidence of the neural effects of exercise on inhibitory control.
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Affiliation(s)
- Jinlong Wu
- School of Physical Education, Shenzhen University, Shenzhen, China
- Institute of Textiles and Clothing, The Hong Kong Polytechnic University, Hong Kong, China
| | - Wen Xiao
- School of Physical Education, Shenzhen University, Shenzhen, China
| | - Joanne Yip
- Institute of Textiles and Clothing, The Hong Kong Polytechnic University, Hong Kong, China
| | - Li Peng
- College of Physical Education, Southwest University, Chongqing, China
| | - Kangyong Zheng
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
| | - Obed Takyi Bentil
- Civil and Environmental Engineering Department, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
| | - Zhanbing Ren
- School of Physical Education, Shenzhen University, Shenzhen, China
- *Correspondence: Zhanbing Ren
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11
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Samarghandian S, Ghasemi F, Aramjoo H, Samini F, Aschner M, Roshanravan B, Farkhondeh T. Effects of exposure in utero to buprenorphine on oxidative stress and apoptosis in the hippocampus of rat pups. Toxicol Rep 2022; 9:311-315. [PMID: 35284239 PMCID: PMC8908041 DOI: 10.1016/j.toxrep.2022.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 01/26/2022] [Accepted: 03/01/2022] [Indexed: 11/23/2022] Open
Abstract
The study investigated the effect of buprenorphine (BUP) on oxidative indices and gene expression of apoptotic molecules in the hippocampus of neonates during the fetal stage. BUP (1 or 0.5 mg/kg) was subcutaneously administrated to pregnant rat dams. After parturition, the pups were maintained to the end of breastfeeding period, then hippocampi were assessed for oxidative stress indices [glutathione (GSH), thiobarbituric acid reactive substances (TBARS), superoxide dismutase (SOD), total antioxidant capacity (TAC)] and mRNA expression of apoptotic markers (Bax, Bcl2 and caspase 3). Our data indicated that BUP (0.5 mg/kg) administration during gestation significantly increased GSH and TAC concentrations in the hippocampus of pups versus control group (p < 0.05). BUP (0.5 and 1 mg/kg) administration significantly elevated the expression levels of Bcl2 in the hippocampus of neonates compared with controls. BUP injection (0.5 and 1 mg/kg) to pregnant rats markedly reduced the expression levels of caspase 3 in the hippocampus of neonates in BUP 0.5 group (p < 0.01) and BUP 1 group (p < 0.05) versus the controls. Our study indicated that BUP may potentiate antioxidant system and inhibit apoptosis and oxidative stress in the hippocampus of neonates received this drug during the fetal stage. BUP at low doses may potentiate antioxidant system. BUP at low dose may inhibit oxidative stress. BUP at low dose may act as an anti-apoptotic agent.
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Affiliation(s)
- Saeed Samarghandian
- Noncommunicable Diseases Research Center, Neyshabur University of Medical Sciences, Neyshabur, Iran
| | - Fahimeh Ghasemi
- Cellular and Molecular Research Center, Birjand University of Medical Sciences, Birjand, Iran
- Department of Biotechnology, School of Medicine, Birjand University of Medical Sciences, Birjand, Iran
| | - Hamed Aramjoo
- Medical Toxicology and Drug Abuse Research Center (MTDRC), Birjand University of Medical Sciences (BUMS), Birjand, Iran
| | - Fariborz Samini
- Neuroscience Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Neurosurgery, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Michael Aschner
- Department of Molecular Pharmacology, Albert Einstein College of Medicine, Forchheimer 209, 1300 Morris Park Avenue, Bronx, NY 10461, USA
| | - Babak Roshanravan
- Student Research Committee, Birjand University of Medical Sciences, Birjand, Iran
| | - Tahereh Farkhondeh
- Medical Toxicology and Drug Abuse Research Center (MTDRC), Birjand University of Medical Sciences (BUMS), Birjand, Iran
- Faculty of Pharmacy, Birjand University of Medical Sciences, Birjand, Iran
- Correspondence to: Medical Toxicology and Drug Abuse Research Center (MTDRC), Birjand University of Medical Sciences, Birjand, Iran. Faculty of Pharmacy, Birjand University of Medical Sciences, Birjand, Iran.
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12
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Shukla R, Kar SK, Dalal PK, Arya A. Psychosocial functioning among current noninjecting opioid users: Is there any difference between methadone maintenance treatment and treatment as usual? Indian J Psychiatry 2022; 64:56-63. [PMID: 35400736 PMCID: PMC8992753 DOI: 10.4103/indianjpsychiatry.indianjpsychiatry_682_21] [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: 08/13/2021] [Revised: 11/23/2021] [Accepted: 12/19/2021] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Patients with opioid use disorder (OUD) have a significant problem in psychosocial functioning domains, which are not systematically studied in India. This study aimed to evaluate the psychosocial functioning in current noninjecting opioid users on Methadone Maintenance Treatment (MMT) versus Treatment as Usual (TaU: Chlordiazepoxide, Zolpidem, Trazodone, Tramadol, Tapentadol, and Buprenorphine). MATERIALS AND METHODS It is a cross-sectional study on patients of current noninjecting OUD on MMT or TaU for at least in the past month. Comorbidities and illness severity were assessed with the help of Mini-International Neuropsychiatric Interview 7.0.2 and World Health Organization-The Alcohol, Smoking, and Substance Involvement Screening Test 3.0, respectively. Social and occupational functioning assessment scale (SOFAS), WHO Quality of Life (WHOQoL-BREF), and Client Satisfaction Questionnaire (CSQ-8) assessed the sociooccupational functioning and QoL and client satisfaction. A total of 67 participants (37 on MMT and 30 on TaU) were included in the study. RESULTS A significant difference between the two groups (MMT better than TaU) was based on SOFAS scores, CSQ-8, and WHOQoL-BREF. In the TaU group, there was a significant negative correlation between risk of addiction severity with sociooccupational functioning (r = -0.5; P = 0.0046), physical health (r = -0.48; P = 0.0087) and social relationship (r = -0.47; P = 0.0087) domain of QoL. In the MMT group, the association between risk of addiction severity with sociooccupational functioning, domains of QoL, and client satisfaction were insignificant. CONCLUSION Sociooccupational Functioning, Client Satisfaction, and QoL of patients maintained on MMT are better than those on TaU.
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Affiliation(s)
- Richa Shukla
- Department of Psychiatry, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Sujita Kumar Kar
- Department of Psychiatry, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - P K Dalal
- Department of Psychiatry, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Amit Arya
- Department of Psychiatry, King George's Medical University, Lucknow, Uttar Pradesh, India
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13
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Mindt MR, Coulehan K, Aghvinian M, Scott TM, Olsen JP, Cunningham CO, Arias F, Arnsten JH. Underrepresentation of diverse populations and clinical characterization in opioid agonist treatment research: A systematic review of the neurocognitive effects of buprenorphine and methadone treatment. J Subst Abuse Treat 2021; 135:108644. [PMID: 34857427 DOI: 10.1016/j.jsat.2021.108644] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 08/27/2021] [Accepted: 10/05/2021] [Indexed: 10/20/2022]
Abstract
INTRODUCTION The relative neurocognitive effects of the two most common opioid agonist treatments (OAT; buprenorphine and methadone) for opioid use disorder (OUD) are poorly understood. The aim of this systematic review is to examine the neurocognitive effects of OAT (buprenorphine and methadone) and the clinical and sociodemographic characteristics of study samples. METHODS The research team queried PubMed, PsycINFO and Cochrane Reviews for articles (01/1980-01/2020) with terms related to neurocognitive testing in adults (age ≥ 18) prescribed OAT. The team extracted neurocognitive data and grouped them by domain (e.g., executive functioning, learning/memory), and assessed study quality. RESULTS The search retrieved 2341 abstracts, the team reviewed 278 full articles, and 32 met inclusion criteria. Of these, 31 were observational designs and one was an experimental design. Healthy controls performed better across neurocognitive domains than OAT-treated persons (buprenorphine or methadone). Compared to those with active OUD, OAT-treated persons had better neurocognition in various domains. However, in seven studies comparing buprenorphine- and methadone-treated persons, buprenorphine was associated with better neurocognition than was methadone, with moderate to large effect sizes in executive functioning, attention/working memory, and learning/memory. Additionally, OAT research underreports clinical characteristics and underrepresents Black and Latinx adults, as well as women. CONCLUSIONS Findings suggest that compared to active opioid use, both buprenorphine and methadone treatment are associated with better neurocognitive functioning, but buprenorphine is associated with better executive functioning, attention/working memory, and learning/memory. These findings should be interpreted with caution given widespread methodological heterogeneity, and limited representation of ethnoracially diverse adults and women. Rigorous longitudinal comparisons with more diverse, better characterized samples will help to inform treatment and policy recommendations for persons with OUD.
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Affiliation(s)
- Monica Rivera Mindt
- Fordham University, Department of Psychology, USA; Icahn School of Medicine at Mount Sinai, Department of Neurology, USA.
| | | | - Maral Aghvinian
- Fordham University, Department of Psychology, USA; Icahn School of Medicine at Mount Sinai, Department of Neurology, USA.
| | - Travis M Scott
- VA Palo Alto Health Care System, Sierra Pacific Mental Illness Research Education Clinical Center, USA; Stanford School of Medicine, Department of Psychiatry and Behavioral Sciences, USA.
| | | | - Chinazo O Cunningham
- Albert Einstein College of Medicine and Montefiore Medical Center, Department of Medicine, USA.
| | - Franchesca Arias
- The Aging Brain Center, Hebrew SeniorLife, USA; Harvard Medical School, Beth Israel Deaconess Medical Center, Department of Cognitive Neurology, USA.
| | - Julia H Arnsten
- Albert Einstein College of Medicine and Montefiore Medical Center, Department of Medicine, USA.
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14
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Motazedian S, Solat N, Banihashem SS, Kheradmand A, Mohammadi SD, Chalakinia N. Cognitive function in methadone maintenance patients compared with abstinent opioid users. J Addict Dis 2021; 39:537-544. [PMID: 33829960 DOI: 10.1080/10550887.2021.1907501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Opioid is the second most prevalent illicit drug worldwide, whose consumption is very high in Iran, due to Iran's geographical proximity to producing countries. Methadone maintenance therapy is one of the most prevalent and accepted methods of substance abuse treatment. Nevertheless, cognitive disorders have been reported as one of its complications. AIM This study was conducted to evaluate cognitive impairment in methadone maintenance patients (MMPs) and to compare it with abstinent opioid users (AOUs). MATERIALS AND METHODS This cross-sectional analytical study was performed on 25 MMPs and 25 AOUs. Samples were selected through convenience sampling method whereby a self-made questionnaire was distributed among them to assess demographic information, clinical variables such as methadone and opioid use history, underlying disease and medication history, as well as 13-item Beck depression inventory. Then, they were interviewed using the Montreal Cognitive Assessment (MoCA) questionnaire. RESULTS Significant differences were found in MoCA questionnaire total scores (p = 0.018) and orientation to time and place dimension (p = 0.008) between the two groups, with the mean scores being higher in AOU group. Duration of opioid use was the only factor influencing cognitive assessment score in both Groups. (p = 0.029). CONCLUSION We suggest monitoring and assessing cognition function in patients receiving methadone especially for those with a long history of opioid use.
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Affiliation(s)
- Somayeh Motazedian
- Department of Psychosomatic Medicine, Taleghani Hospital, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Niloofar Solat
- Department of Psychiatry, School of Medicine, Fasa University of Medical Sciences, Fasa, Shiraz, Iran
| | - Seyed Shahab Banihashem
- Department of Psychosomatic Medicine, Taleghani Hospital Research Development Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ali Kheradmand
- Department of Psychiatry, Taleghani Hospital Research Development Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Seyed Davood Mohammadi
- Department of Clinical Psychology, School of Medicine, Fasa University of Medical Sciences, Fasa, Shiraz, Iran
| | - Nasrin Chalakinia
- Department of Psychosomatic Medicine, Taleghani Hospital, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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15
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Ma SS, Li CSR, Zhang S, Worhunsky PD, Zhou N, Zhang JT, Liu L, Yao YW, Fang XY. Altered functional network activities for behavioral adjustments and Bayesian learning in young men with Internet gaming disorder. J Behav Addict 2021; 10:112-122. [PMID: 33704083 PMCID: PMC8969861 DOI: 10.1556/2006.2021.00010] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 11/02/2020] [Accepted: 02/06/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND AND AIMS Deficits in cognitive control represent a core feature of addiction. Internet Gaming Disorder (IGD) offers an ideal model to study the mechanisms underlying cognitive control deficits in addiction, eliminating the confounding effects of substance use. Studies have reported behavioral and neural deficits in reactive control in IGD, but it remains unclear whether individuals with IGD are compromised in proactive control or behavioral adjustment by learning from the changing contexts. METHODS Here, fMRI data of 21 male young adults with IGD and 21 matched healthy controls (HC) were collected during a stop-signal task. We employed group independent component analysis to investigate group differences in temporally coherent, large-scale functional network activities during post-error slowing, the typical type of behavioral adjustments. We also employed a Bayesian belief model to quantify the trial-by-trial learning of the likelihood of stop signal - P(Stop) - a broader process underlying behavioral adjustment, and identified the alterations in functional network responses to P(Stop). RESULTS The results showed diminished engagement of the fronto-parietal network during post-error slowing, and weaker activity in the ventral attention and anterior default mode network in response to P(Stop) in IGD relative to HC. DISCUSSION AND CONCLUSIONS These results add to the literatures by suggesting deficits in updating and anticipating conflicts as well as in behavioral adjustment according to contextual information in individuals with IGD.
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Affiliation(s)
- Shan-Shan Ma
- Institute of Developmental Psychology, Beijing Normal University, Beijing, China
| | - Chiang-Shan R. Li
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA,Department of Neuroscience, Yale University School of Medicine, New Haven, CT, USA
| | - Sheng Zhang
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Patrick D. Worhunsky
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Nan Zhou
- Faculty of Education, Beijing Normal University, Beijing, China
| | - Jin-Tao Zhang
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China,IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China,Beijing Key Lab of Applied Experimental Psychology, School of Psychology, Beijing Normal University, Beijing, China,Corresponding authors. E-mail: (J.-T. Zhang) (X.-Y. Fang)
| | - Lu Liu
- Institute of Developmental Psychology, Beijing Normal University, Beijing, China,German Institute of Human Nutrition Potsdam-Rehbruecke, 14558Nuthetal, Germany
| | - Yuan-Wei Yao
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China,Einstein Center for Neurosciences Berlin, Charitéplatz 1, 10117Berlin, Germany
| | - Xiao-Yi Fang
- Institute of Developmental Psychology, Beijing Normal University, Beijing, China,Corresponding authors. E-mail: (J.-T. Zhang) (X.-Y. Fang)
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16
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Yang W, Wang S, Shao Z, Yang R, Tang F, Luo J, Yan C, Zhang J, Chen J, Liu J, Yuan K. Novel circuit biomarker of impulsivity and craving in male heroin-dependent individuals. Drug Alcohol Depend 2021; 219:108485. [PMID: 33360853 DOI: 10.1016/j.drugalcdep.2020.108485] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 11/14/2020] [Accepted: 11/17/2020] [Indexed: 01/12/2023]
Abstract
INTRODUCTION The striatum mediates reward processing in addiction, and previous fMRI (functional Magnetic Resonance Imaging) studies have revealed abnormal striatofrontal functional connectivity in heroin addiction. However, little is known about whether there is abnormal structural connectivity of the striatal circuit in heroin addiction. This study investigated the structural connectivity of striatal circuits in abstinent heroin-dependent individuals (HDIs) without methadone treatment. METHODS Forty-three (age: 38.8 ± 7.1) male HDIs and twenty-one (age: 42.4 ± 7.9) matched healthy controls underwent high-resolution T1 and whole-brain diffusion tensor imaging (64 directions) magnetic resonance imaging. Connectivity-based seed classification probabilistic tractography was used to detect the tract strengths of striatal circuits with 10 a priori target masks. Tract strengths were compared between groups and correlated with impulsivity behavior, evaluated using the Barratt Impulsivity Scale (BIS), and craving, measured on visual analogue scale (VAS). RESULTS HDIs showed significantly weaker tract strength of the left striatum-medial orbitofrontal cortex (mOFC) (Bonferroni corrected, p < 0.05/20 = 0.0025) and significantly higher BIS total, attention, motor, and non-planning scores (Bonferroni corrected, p < 0.05/4 = 0.0125) than controls. In HDIs, negative correlations were observed between the left striatum- mOFC tract strengths and the BIS total, attention and non-planning scores (r1=-0.410, p1 = 0.005; r2=-0.432, p2 = 0.003; r3=-0.506, p3<0.001) and between the right striatum-posterior cingulate cortex (PCC) tract strengths and craving scores (r=-0.433, p = 0.009) in HDIs. CONCLUSION HDIs displayed decreased structural connectivity of the striatum-mOFC circuit and higher impulsivity. Higher impulsive behavior was associated with decreased left striatal circuit connectivity. These findings suggest that the striatal circuit tract strengths might be a novel potential biomarker in heroin and, potentially, general opioid addiction.
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Affiliation(s)
- Wenhan Yang
- Department of Radiology, Second Xiangya Hospital of Central South University, Changsha, China
| | - Shicong Wang
- School of Life Science and Technology, Xidian University, Xi'an, 710071, China
| | - Ziqiang Shao
- School of Life Science and Technology, Xidian University, Xi'an, 710071, China
| | - Ru Yang
- Department of Radiology, Second Xiangya Hospital of Central South University, Changsha, China
| | - Fei Tang
- Department of Radiology, Second Xiangya Hospital of Central South University, Changsha, China
| | - Jing Luo
- Department of Radiology, Second Xiangya Hospital of Central South University, Changsha, China
| | - Cui Yan
- Department of Radiology, Second Xiangya Hospital of Central South University, Changsha, China
| | - Jun Zhang
- Hunan Judicial Police Academy, Changsha, China
| | - Jiyuan Chen
- Hunan Judicial Police Academy, Changsha, China
| | - Jun Liu
- Department of Radiology, Second Xiangya Hospital of Central South University, Changsha, China.
| | - Kai Yuan
- School of Life Science and Technology, Xidian University, Xi'an, 710071, China; Engineering Research Center of Molecular and Neuroimaging, Ministry of Education, Xi'an, China.
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Li J, Weidacker K, Mandali A, Zhang Y, Whiteford S, Ren Q, Zhou Z, Zhou H, Jiang H, Du J, Zhang C, Sun B, Voon V. Impulsivity and craving in subjects with opioid use disorder on methadone maintenance treatment. Drug Alcohol Depend 2021; 219:108483. [PMID: 33385690 DOI: 10.1016/j.drugalcdep.2020.108483] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 11/07/2020] [Accepted: 11/27/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Methadone maintenance treatment (MMT) is effective in decreasing opioid use or facilitating abstinence. Previous studies using small opioid use disorder samples suggest that cognitive impairments including impulsivity and executive functions may partially improve on MMT, but a range of deficits may persist. However, systematic assessments with larger samples are needed to confirm the profile of cognitive functions on MMT. METHODS We assessed four types of impulsivity (delay discounting, reflection impulsivity, risk taking and motoric impulsivity), executive functioning (spatial working memory, paired associative learning and strategic planning) and drug cue-induced craving in a relatively large population (115 MMT patients, 115 healthy controls). The relationships between impulsivity, drug cue-induced craving and addiction-related variables were also assessed. RESULTS Delay discounting, as well as drug cue-induced craving was increased in patients, while motoric impulsivity was lower than in controls. Paired associative learning was additionally impaired, which was explained by increased depression and anxiety levels in patients. Within the MMT group, the delay discounting and drug-cue induced craving scores were positively correlated with self-reported urgency, but unrelated to methadone dosage, duration on methadone, withdrawal symptoms, or presence of nicotine dependence. CONCLUSIONS Our findings highlight increased delay discounting and cue-induced craving in MMT patients suggesting a potential role for trait effects in delay discounting. Although previous smaller studies have shown impaired executive function, in our large sample size on chronic MMT we only observed impaired associative learning related to depressive and anxiety symptoms highlighting a role for managing comorbid symptoms to further optimize cognitive function.
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Affiliation(s)
- Jun Li
- Department of Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Center for Functional Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Kathrin Weidacker
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
| | - Alekhya Mandali
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
| | - Yingying Zhang
- Department of Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Center for Functional Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Seb Whiteford
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
| | - Qihuan Ren
- Department of Psychiatry, Shanghai Hongkou Mental Health Center, Shanghai, China
| | - Zhirong Zhou
- Department of Functional Clinic of the Community Based Methadone Maintenance Therapy in Xuhui District, Shanghai, China
| | - Huijing Zhou
- Department of Drug Dependence, Yangpu District Mental Health Center, Shanghai, China
| | - Haifeng Jiang
- Department of Substance Abuse and Addiction, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jiang Du
- Department of Substance Abuse and Addiction, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chencheng Zhang
- Department of Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Center for Functional Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Bomin Sun
- Department of Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Center for Functional Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Valerie Voon
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom.
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18
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Prior cocaine self-administration impairs attention signals in anterior cingulate cortex. Neuropsychopharmacology 2020; 45:833-841. [PMID: 31775158 PMCID: PMC7075947 DOI: 10.1038/s41386-019-0578-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 11/04/2019] [Accepted: 11/15/2019] [Indexed: 01/11/2023]
Abstract
Although maladaptive decision-making is a defining feature of drug abuse and addiction, we have yet to ascertain how cocaine self-administration disrupts neural signals in anterior cingulate cortex (ACC), a brain region thought to contribute to attentional control. To address this issue, rats were trained on a reward-guided decision-making task; reward value was manipulated by independently varying the size of or the delay to reward over several trial blocks. Subsequently, rats self-administered either a cocaine (experimental group) or sucrose (control) during 12 consecutive days, after which they underwent a 1-month withdrawal period. Upon completion of this period, rats performed the previously learned reward-guided decision-making task while we recorded from single neurons in ACC. We demonstrate that prior cocaine self-administration attenuates attention and attention-related ACC signals in an intake-dependent manner, and that changes in attention are decoupled from ACC firing. These effects likely contribute to the impaired decision-making-typified by chronic substance abuse and relapse-observed after drug use.
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19
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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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Elkana O, Adelson M, Doniger GM, Sason A, Peles E. Cognitive function is largely intact in methadone maintenance treatment patients. World J Biol Psychiatry 2019; 20:219-229. [PMID: 28610451 DOI: 10.1080/15622975.2017.1342047] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVES To confirm our previous findings of less cognitive impairments (based on cognitive screening tools) among methadone maintenance treatment (MMT) patients who achieved take-home dose (THD) privileges. METHODS a random sample of 65 Israeli MMT patients were studied using computerised, age and education standardised, cognitive domains (attention, executive function, memory, motor skills), and non-computerised phonetic and semantic verbal fluency. RESULTS Cognitive scores were within ±1 standard deviation (SD) of average for most domains, including non-verbal IQ, attention and motor skills. Verbal fluency and memory were >1 SD below average (mean = 84; z = -1.1 for both). Females were younger than the males and had poorer motor skills (P = 0.005) but better verbal memory (P < 0.0005). Opiate usage duration correlated with reaction time (P = 0.05) and inversely with verbal memory (P = 0.01). Overall cognitive function was poorest among 25 (38.5%) current drug users, and 6 (9.2%) lifetime schizophrenia patients. Cognitive domains were comparable between THD privileges subgroups. CONCLUSIONS Despite heterogeneity in MMT duration, abuse duration, substance use and psychiatric comorbidity, all performed within ±1 SD of average for age and education in most cognitive domains. Our findings challenge the notion of MMT as being synonymous with compromised cognition and may lead to reduced bias regarding cognitive function of MMT patients.
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Affiliation(s)
- Odelia Elkana
- a Behavioral Sciences , Academic College of Tel Aviv-Yaffo , Tel Aviv , Israel
| | - Miriam Adelson
- b Dr. Miriam and Sheldon G. Adelson Clinic for Drug Abuse, Treatment and Research , Tel Aviv Sourasky Medical Center , Tel Aviv , Israel
| | - Glen M Doniger
- c Department of Clinical Research , NeuroTrax Corporation , Modiin , Israel.,d Sagol Neuroscience Center & Center of Advanced Technologies in Rehabilitation , Sheba Medical Center , Ramat-Gan , Israel
| | - Anat Sason
- b Dr. Miriam and Sheldon G. Adelson Clinic for Drug Abuse, Treatment and Research , Tel Aviv Sourasky Medical Center , Tel Aviv , Israel
| | - Einat Peles
- b Dr. Miriam and Sheldon G. Adelson Clinic for Drug Abuse, Treatment and Research , Tel Aviv Sourasky Medical Center , Tel Aviv , Israel.,e Sackler Faculty of Medicine , Tel Aviv University , Tel Aviv , Israel.,f Sagol School of Neuroscience , Tel Aviv University , Tel Aviv , Israel
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Butler K, Le Foll B. Impact of Substance Use Disorder Pharmacotherapy on Executive Function: A Narrative Review. Front Psychiatry 2019; 10:98. [PMID: 30881320 PMCID: PMC6405638 DOI: 10.3389/fpsyt.2019.00098] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Accepted: 02/11/2019] [Indexed: 12/20/2022] Open
Abstract
Substance use disorders are chronic, relapsing, and harmful conditions characterized by executive dysfunction. While there are currently no approved pharmacotherapy options for stimulant and cannabis use disorders, there are several evidence-based options available to help reduce symptoms during detoxification and aid long-term cessation for those with tobacco, alcohol and opioid use disorders. While these medication options have shown clinical efficacy, less is known regarding their potential to enhance executive function. This narrative review aims to provide a brief overview of research that has investigated whether commonly used pharmacotherapies for these substance use disorders (nicotine, bupropion, varenicline, disulfiram, acamprosate, nalmefene, naltrexone, methadone, buprenorphine, and lofexidine) effect three core executive function components (working memory, inhibitory control and cognitive flexibility). While pharmacotherapy-induced enhancement of executive function may improve cessation outcomes in dependent populations, there are limited and inconsistent findings regarding the effects of these medications on executive function. We discuss possible reasons for the mixed findings and suggest some future avenues of work that may enhance the understanding of addiction pharmacotherapy and cognitive training interventions and lead to improved patient outcomes.
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Affiliation(s)
- Kevin Butler
- Translational Addiction Research Laboratory, Centre for Addiction and Mental Health, University of Toronto, Toronto, ON, Canada
| | - Bernard Le Foll
- Translational Addiction Research Laboratory, Centre for Addiction and Mental Health, University of Toronto, Toronto, ON, Canada.,Alcohol Research and Treatment Clinic, Acute Care Program, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada.,Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada.,Division of Brain and Therapeutics, Department of Psychiatry, University of Toronto, Toronto, ON, Canada.,Institute of Medical Sciences, University of Toronto, Toronto, ON, Canada
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Hsieh SS, Huang CJ, Wu CT, Chang YK, Hung TM. Acute Exercise Facilitates the N450 Inhibition Marker and P3 Attention Marker during Stroop Test in Young and Older Adults. J Clin Med 2018; 7:E391. [PMID: 30373181 PMCID: PMC6262533 DOI: 10.3390/jcm7110391] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Revised: 10/23/2018] [Accepted: 10/24/2018] [Indexed: 12/15/2022] Open
Abstract
While considerable evidence supporting the positive influence of acute exercise on cognitive inhibition, little is known regarding the underlying cognitive processes. There is also little neuroelectric evidence regarding the effects on older adults of acute exercise-elicited cognitive benefits. Thus, our objective was to explore the possible neural markers underlying improved cognitive inhibition, with particular attention to the N450 and P3 components, following acute exercise. Another aim was to investigate whether cognitive gains seen in young adults are replicated in older adults. Twenty-four young males and 20 older males underwent either a single bout of aerobic exercise or video-watching in counterbalanced order. Afterwards, cognitive inhibition was assessed by the Stroop test. Results revealed that acute exercise resulted in shorter response time regardless of age or congruency. Regarding the neuroeletric data, acute exercise resulted in larger P3 amplitude and smaller N450 amplitude regardless of congruency or age. Further, following exercise, changes in response time interference were correlated with changes in incongruent N450 amplitude. Collectively, acute exercise-facilitated conflict monitoring and attention control, as signified by the N450 and P3 components, may be the underlying processes leading to better Stroop performance, with conflict monitoring having a stronger association with task performance. Further, cognitive gains resulting from acute exercise were found to the same extent in both young and older adults.
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Affiliation(s)
- Shu-Shih Hsieh
- Department of Physical Education, National Taiwan Normal University, Taipei 106, Taiwan.
| | - Chung-Ju Huang
- Graduate Institute of Sports Pedagogy, University of Taipei, Taipei 106, Taiwan.
| | - Chien-Ting Wu
- Department of Exercise and Sport Science, University of South Carolina Upstate, 800 University Way, Spartanburg, SC 29303, USA.
| | - Yu-Kai Chang
- Department of Physical Education, National Taiwan Normal University, Taipei 106, Taiwan.
| | - Tsung-Min Hung
- Department of Physical Education & Institute for Research Excellence in Learning Science, National Taiwan Normal University, Taipei 106, Taiwan.
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Ye JJ, Li W, Zhang DS, Li Q, Zhu J, Chen JJ, Li YB, Yan XJ, Liu JR, Wei X, Wang YR, Wang W. Longitudinal behavioral and fMRI-based assessment of inhibitory control in heroin addicts on methadone maintenance treatment. Exp Ther Med 2018; 16:3202-3210. [PMID: 30214543 DOI: 10.3892/etm.2018.6571] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2016] [Accepted: 06/05/2017] [Indexed: 11/05/2022] Open
Abstract
The objective of the present study was to determine whether methadone maintenance treatment (MMT) in heroin-dependent patients affects inhibitory control, whether any MMT-induced changes correlate with methadone dose and MMT duration, and whether these changes depend on the psychological characteristics of patients, such as depression, anxiety and impulsivity. Response inhibition in the GO/NO-GO test was combined with functional magnetic resonance imaging (fMRI) scanning data to examine whether MMT affects inhibitory control in 21 heroin-addicted patients who had already undergone at least three months of MMT. Patients were evaluated one year prior to and after the MMT period. Participants exhibited no difference in their GO/NO-GO reaction time and accuracy rate, or in their false alarm rate under NO-GO conditions. However, increased activation was detected in numerous brain regions in their 12-month fMRI scans, although these were not in the frontal-striatal loop. Increased fMRI activation in the left precentral gyrus and superior temporal gyrus were negatively correlated with the daily methadone dose and total methadone dose during the one-year study period. In conclusion, these results suggested that MMT over one year does not significantly change the behavioral indicators of inhibitory control function in heroin-dependent patients. The increase in activation leads to the hypothesis that MMT over one year may increase cognitive inhibitory control, which may be the result of the combined negative effect of methadone and the positive effect of functional recovery after withdrawal of heroin.
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Affiliation(s)
- Jian-Jun Ye
- Department of Radiology, Tangdu Hospital, The Fourth Military Medical University, Xi'an, Shaanxi 710038, P.R. China
| | - Wei Li
- Department of Radiology, Tangdu Hospital, The Fourth Military Medical University, Xi'an, Shaanxi 710038, P.R. China
| | - Dong-Sheng Zhang
- Department of Radiology, Tangdu Hospital, The Fourth Military Medical University, Xi'an, Shaanxi 710038, P.R. China
| | - Qiang Li
- Department of Radiology, Tangdu Hospital, The Fourth Military Medical University, Xi'an, Shaanxi 710038, P.R. China
| | - Jia Zhu
- Department of Radiology, Tangdu Hospital, The Fourth Military Medical University, Xi'an, Shaanxi 710038, P.R. China
| | - Jia-Jie Chen
- Department of Radiology, Tangdu Hospital, The Fourth Military Medical University, Xi'an, Shaanxi 710038, P.R. China
| | - Yong-Bin Li
- Department of Radiology, Tangdu Hospital, The Fourth Military Medical University, Xi'an, Shaanxi 710038, P.R. China
| | - Xue-Jiao Yan
- Department of Radiology, Tangdu Hospital, The Fourth Military Medical University, Xi'an, Shaanxi 710038, P.R. China
| | - Jie-Rong Liu
- Department of Radiology, Tangdu Hospital, The Fourth Military Medical University, Xi'an, Shaanxi 710038, P.R. China
| | - Xuan Wei
- Department of Radiology, Tangdu Hospital, The Fourth Military Medical University, Xi'an, Shaanxi 710038, P.R. China
| | - Ya-Rong Wang
- Department of Radiology, Tangdu Hospital, The Fourth Military Medical University, Xi'an, Shaanxi 710038, P.R. China
| | - Wei Wang
- Department of Radiology, Tangdu Hospital, The Fourth Military Medical University, Xi'an, Shaanxi 710038, P.R. China
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Pujol CN, Paasche C, Laprevote V, Trojak B, Vidailhet P, Bacon E, Lalanne L. Cognitive effects of labeled addictolytic medications. Prog Neuropsychopharmacol Biol Psychiatry 2018; 81:306-332. [PMID: 28919445 DOI: 10.1016/j.pnpbp.2017.09.008] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Revised: 09/11/2017] [Accepted: 09/11/2017] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Alcohol, tobacco, and illegal drug usage is pervasive throughout the world, and abuse of these substances is a major contributor to the global disease burden. Many pharmacotherapies have been developed over the last 50years to target addictive disorders. While the efficacy of these pharmacotherapies is largely recognized, their cognitive impact is less known. However, all substance abuse disorders are known to promote cognitive disorders like executive dysfunction and memory impairment. These impairments are critical for the maintenance of addictive behaviors and impede cognitive behavioral therapies that are regularly administered in association with pharmacotherapies. It is also unknown if addictolytic medications have an impact on preexisting cognitive disorders, and if this impact is modulated by the indication of prescription, i.e. abstinence, reduction or substitution, or by the specific action of the medication. METHOD We reviewed the cognitive effects of labeled medications for tobacco addiction (varenicline, bupropion, nicotine patch and nicotine gums), alcohol addiction (naltrexone, nalmefene, baclofen, disulfiram, sodium oxybate, acamprosate), and opioid addiction (methadone, buprenorphine) in human studies. Studies were selected following MOOSE guidelines for systematic reviews of observational studies, using the keywords [Cognition] and [Cognitive disorders] and [treatment] for each medication. RESULTS 971 articles were screened and 77 studies met the inclusion criteria and were reported in this review (for alcohol abuse, n=21, for tobacco n=22, for opioid n=34. However, very few comparative clinical trials have explored the chronic effects of addictolytic medications on cognition in addictive behaviors, and there are no clinical trials on the cognitive impact of nalmefene in patients suffering from alcohol use disorders. DISCUSSION Although some medications seem to enhance cognition in patients suffering from cognitive disorders, others could promote cognitive impairments, and our work highlights a lack of literature on this subject. In conclusion, more comparative clinical trials are needed to better understand the cognitive impact of addictolytic medications.
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Affiliation(s)
- Camille Noélie Pujol
- Department of Neurosciences, Institute for Functional Genomics, INSERM U-661, CNRS UMR-5203, 34094 Montpellier, France
| | - Cecilia Paasche
- INSERM 1114, Department of Psychiatry and Addictology, University Hospital of Strasbourg, Fédération de Médecine Translationnelle de Strasbourg (FMTS), 67000 Strasbourg, France
| | - Vincent Laprevote
- Centre Psychothérapique de Nancy, Laxou, F-54520, France.; EA 7298, INGRES, Université de Lorraine, Vandoeuvre-lès-, Nancy F-54000, France; CHU Nancy, Maison des Addictions, Nancy, F-54000, France.
| | - Benoit Trojak
- Department of Psychiatry and Addictology, University Hospital of Dijon, France; EA 4452, LPPM, University of Burgundy, France.
| | - Pierre Vidailhet
- INSERM 1114, Department of Psychiatry and Addictology, University Hospital of Strasbourg, Fédération de Médecine Translationnelle de Strasbourg (FMTS), 67000 Strasbourg, France; Department of Psychiatry and Addictology, University Hospital of Strasbourg, Fédération de Médecine Translationnelle de Strasbourg (FMTS), 67000 Strasbourg, France..
| | - Elisabeth Bacon
- INSERM 1114, Department of Psychiatry and Addictology, University Hospital of Strasbourg, Fédération de Médecine Translationnelle de Strasbourg (FMTS), 67000 Strasbourg, France.
| | - Laurence Lalanne
- INSERM 1114, Department of Psychiatry and Addictology, University Hospital of Strasbourg, Fédération de Médecine Translationnelle de Strasbourg (FMTS), 67000 Strasbourg, France; Department of Psychiatry and Addictology, University Hospital of Strasbourg, Fédération de Médecine Translationnelle de Strasbourg (FMTS), 67000 Strasbourg, France..
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25
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Age and impulsive behavior in drug addiction: A review of past research and future directions. Pharmacol Biochem Behav 2017; 164:106-117. [PMID: 28778737 DOI: 10.1016/j.pbb.2017.07.013] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Revised: 07/10/2017] [Accepted: 07/31/2017] [Indexed: 11/20/2022]
Abstract
Impulsive behavior is implicated in the initiation, maintenance, and relapse of drug-seeking behaviors involved in drug addiction. Research shows that changes in impulsive behavior across the lifespan contribute to drug use and addiction. The goal of this review is to examine existing research on the relationship between impulsive behavior and drug use across the lifespan and to recommend directions for future research. Three domains of impulsive behavior are explored in this review: impulsive behavior-related personality traits, delay discounting, and prepotent response inhibition. First, we present previous research on these three domains of impulsive behavior and drug use across developmental stages. Then, we discuss how changes in impulsive behavior across the lifespan are implicated in the progression of drug use and addiction. Finally, we discuss the relatively limited attention given to middle-to-older adults in the current literature, consider the validity of the measures used to assess impulsive behavior in middle-to-older adulthood, and suggest recommendations for future research.
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Fauth-Bühler M, Mann K, Potenza MN. Pathological gambling: a review of the neurobiological evidence relevant for its classification as an addictive disorder. Addict Biol 2017; 22:885-897. [PMID: 26935000 DOI: 10.1111/adb.12378] [Citation(s) in RCA: 91] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2015] [Revised: 12/09/2015] [Accepted: 01/26/2016] [Indexed: 01/13/2023]
Abstract
In light of the upcoming eleventh edition of the International Classification of Diseases (ICD-11), the question arises as to the most appropriate classification of 'Pathological Gambling' ('PG'). Some academic opinion favors leaving PG in the 'Impulse Control Disorder' ('ICD') category, as in ICD-10, whereas others argue that new data especially from the neurobiological area favor allocating it to the category of 'Substance-related and Addictive Disorders' ('SADs'), following the decision in the fifth revision of the Diagnostic and Statistical Manual of Mental Disorders. The current review examines important findings in relation to PG, with the aim of enabling a well-informed decision to be made with respect to the classification of PG as a SAD or ICD in ICD-11. Particular attention is given to cognitive deficits and underlying neurobiological mechanisms that play a role in SADs and ICDs. These processes are impulsivity, compulsivity, reward/punishment processing and decision-making. In summary, the strongest arguments for subsuming PG under a larger SAD category relate to the existence of similar diagnostic characteristics; the high co-morbidity rates between the disorders; their common core features including reward-related aspects (positive reinforcement: behaviors are pleasurable at the beginning which is not the case for ICDs); the findings that the same brain structures are involved in PG and SADs, including the ventral striatum. Research on compulsivity suggests a relationship with PG and SAD, particularly in later stages of the disorders. Although research is limited for ICDs, current data do not support continuing to classify PG as an ICD.
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Affiliation(s)
- Mira Fauth-Bühler
- Department of Addictive Behavior and Addiction Medicine; Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University; Mannheim Germany
| | - Karl Mann
- Department of Addictive Behavior and Addiction Medicine; Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University; Mannheim Germany
| | - Marc N. Potenza
- Departments of Psychiatry, Neurobiology and Child Study Center and CASAColumbia; Yale University School of Medicine; New Haven CT USA
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Meyer HC, Bucci DJ. Neural and behavioral mechanisms of proactive and reactive inhibition. ACTA ACUST UNITED AC 2016; 23:504-14. [PMID: 27634142 PMCID: PMC5026209 DOI: 10.1101/lm.040501.115] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Accepted: 07/19/2016] [Indexed: 01/19/2023]
Abstract
Response inhibition is an important component of adaptive behavior. Substantial prior research has focused on reactive inhibition, which refers to the cessation of a motor response that is already in progress. More recently, a growing number of studies have begun to examine mechanisms underlying proactive inhibition, whereby preparatory processes result in a response being withheld before it is initiated. It has become apparent that proactive inhibition is an essential component of the overall ability to regulate behavior and has implications for the success of reactive inhibition. Moreover, successful inhibition relies on learning the meaning of specific environmental cues that signal when a behavioral response should be withheld. Proactive inhibitory control is mediated by stopping goals, which reflect the desired outcome of inhibition and include information about how and when inhibition should be implemented. However, little is known about the circuits and cellular processes that encode and represent features in the environment that indicate the necessity for proactive inhibition or how these representations are implemented in response inhibition. In this article, we will review the brain circuits and systems involved in implementing inhibitory control through both reactive and proactive mechanisms. We also comment on possible cellular mechanisms that may contribute to inhibitory control processes, noting that substantial further research is necessary in this regard. Furthermore, we will outline a number of ways in which the temporal dynamics underlying the generation of the proactive inhibitory signal may be particularly important for parsing out the neurobiological correlates that contribute to the learning processes underlying various aspects of inhibitory control.
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Affiliation(s)
- Heidi C Meyer
- Department of Psychological and Brain Sciences, Dartmouth College, Hanover, New Hampshire 03755, USA
| | - David J Bucci
- Department of Psychological and Brain Sciences, Dartmouth College, Hanover, New Hampshire 03755, USA
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A dual but asymmetric role of the dorsal anterior cingulate cortex in response inhibition and switching from a non-salient to salient action. Neuroimage 2016; 134:466-474. [PMID: 27126003 DOI: 10.1016/j.neuroimage.2016.04.055] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Revised: 04/20/2016] [Accepted: 04/24/2016] [Indexed: 11/21/2022] Open
Abstract
Response inhibition and salience detection are among the most studied psychological constructs of cognitive control. Despite a growing body of work, how inhibition and salience processing interact and engage regional brain activations remains unclear. Here, we examined this issue in a stop signal task (SST), where a prepotent response needs to be inhibited to allow an alternative, less dominant response. Sixteen adult individuals performed two versions of the SST each with 25% (SST25) and 75% (SST75) of stop trials. We posited that greater regional activations to the infrequent trial type in each condition (i.e., to stop as compared to go trials in SST25 and to go as compared to stop trials in SST75) support salience detection. Further, successful inhibition in stop trials requires attention to the stop signal to trigger motor inhibition, and the stop signal reaction time (SSRT) has been used to index the efficiency of motor response inhibition. Therefore, greater regional activations to stop as compared to go success trials in association with the stop signal reaction time (SSRT) serve to expedite response inhibition. In support of an interactive role, the dorsal anterior cingulate cortex (dACC) increases activation to salience detection in both SST25 and SST75, but only mediates response inhibition in SST75. Thus, infrequency response in the dACC supports motor inhibition only when stopping has become a routine. In contrast, although the evidence is less robust, the pre-supplementary motor area (pre-SMA) increases activity to the infrequent stimulus and supports inhibition in both SST25 and SST75. These findings clarify a unique role of the dACC and add to the literature that distinguishes dACC and pre-SMA functions in cognitive control.
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Impulsivity in abstinent alcohol and polydrug dependence: a multidimensional approach. Psychopharmacology (Berl) 2016; 233:1487-99. [PMID: 26911382 PMCID: PMC4819593 DOI: 10.1007/s00213-016-4245-6] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2015] [Accepted: 02/10/2016] [Indexed: 12/17/2022]
Abstract
RATIONALE Dependence on drugs and alcohol is associated with impaired impulse control, but deficits are rarely compared across individuals dependent on different substances using several measures within a single study. OBJECTIVES We investigated impulsivity in abstinent substance-dependent individuals (AbD) using three complementary techniques: self-report, neuropsychological and neuroimaging. We hypothesised that AbDs would show increased impulsivity across modalities, and that this would depend on length of abstinence. METHODS Data were collected from the ICCAM study: 57 control and 86 AbDs, comprising a group with a history of dependence on alcohol only (n = 27) and a group with history of dependence on multiple substances ("polydrug", n = 59). All participants completed self-report measures of impulsivity: Barratt Impulsiveness Scale, UPPS Impulsive Behaviour Scale, Behaviour Inhibition/Activation System and Obsessive-Compulsive Inventory. They also performed three behavioural tasks: Stop Signal, Intra-Extra Dimensional Set-Shift and Kirby Delay Discounting; and completed a Go/NoGo task during fMRI. RESULTS AbDs scored significantly higher than controls on self-report measures, but alcohol and polydrug dependent groups did not differ significantly from each other. Polydrug participants had significantly higher discounting scores than both controls and alcohol participants. There were no group differences on the other behavioural measures or on the fMRI measure. CONCLUSIONS The results suggest that the current set of self-report measures of impulsivity is more sensitive in abstinent individuals than the behavioural or fMRI measures of neuronal activity. This highlights the importance of developing behavioural measures to assess different, more relevant, aspects of impulsivity alongside corresponding cognitive challenges for fMRI.
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Hu S, Ide JS, Zhang S, Li CSR. Anticipating conflict: Neural correlates of a Bayesian belief and its motor consequence. Neuroimage 2015; 119:286-95. [PMID: 26095091 DOI: 10.1016/j.neuroimage.2015.06.032] [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: 04/10/2015] [Revised: 06/02/2015] [Accepted: 06/10/2015] [Indexed: 02/05/2023] Open
Abstract
Previous studies have examined the neural correlates of proactive control using a variety of behavioral paradigms; however, the neural network relating the control process to its behavioral consequence remains unclear. Here, we applied a dynamic Bayesian model to a large fMRI data set of the stop signal task to address this issue. By estimating the probability of the stop signal - p(Stop) - trial by trial, we showed that higher p(Stop) is associated with prolonged go trial reaction time (RT), indicating proactive control of motor response. In modeling fMRI signals at trial and target onsets, we distinguished activities of proactive control, prediction error, and RT slowing. We showed that the anterior pre-supplementary motor area (pre-SMA) responds specifically to increased stop signal likelihood, and its activity is correlated with activations of the posterior pre-SMA and bilateral anterior insula during prolonged response times. This directional link is also supported by Granger causality analysis. Furthermore, proactive control, prediction error, and time-on-task are each mapped to distinct areas in the medial prefrontal cortex. Together, these findings dissect regional functions of the medial prefrontal cortex in cognitive control and provide system level evidence associating conflict anticipation with its motor consequence.
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Affiliation(s)
- Sien Hu
- Department of Psychiatry, Yale University, New Haven, CT 06519, USA.
| | - Jaime S Ide
- Department of Biomedical Engineering, Stony Brook University, Stony Brook, NY 11794, USA
| | - Sheng Zhang
- Department of Psychiatry, Yale University, New Haven, CT 06519, USA
| | - Chiang-Shan R Li
- Department of Psychiatry, Yale University, New Haven, CT 06519, USA; Department of Neurobiology, Yale University, New Haven, CT 06520, USA; Interdepartmental Neuroscience Program, Yale University, New Haven, CT 06520, USA.
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Willens JS, Bucior I, Bujanover S, Mehta N. Assessment of rescue opioid use in patients with post-bunionectomy pain treated with diclofenac potassium liquid-filled capsules. J Pain Res 2015; 8:53-62. [PMID: 25678812 PMCID: PMC4322883 DOI: 10.2147/jpr.s75234] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
When used in multimodal analgesia for acute pain, nonsteroidal anti-inflammatory drugs (NSAIDs) may reduce the requirement for opioids during the perioperative period. To provide more insight into pain treatment during the outpatient period, we examined the use of opioid rescue medication (RM) and described the relationship between pain intensity and RM use in patients with acute pain after bunionectomy. Patients received placebo or 25 mg of a liquid-filled capsule version of the NSAID diclofenac potassium (DPLFC; n=188 patients/group) every 6 hours during the 48-hour inpatient period through the end of outpatient dosing on day 4. Opioid RM (hydrocodone/acetaminophen tablets, 5 mg/500 mg) was available as needed, but taken at least 1 hour post-study medication. Fewer patients taking DPLFC versus placebo requested opioid RM during the inpatient period (4.8%-44.7% versus 25.0%-90.4%) and also during the outpatient period (3.7%-16.0% versus 13.1%-46.4%). Moderate or severe pain after surgery (P=0.0307 and P=0.0002, respectively) or at second dose (P=0.0006 and P=0.0002, respectively) was predictive of RM use. Patients taking RM (placebo/DPLFC) reported more adverse events (RM 55.7%/40.6%; no RM 29.4%/26.0%). Most adverse events in the RM group were opioid-related. In summary, this study shows that DPLFC lowers the requirement for opioids, which is associated with a reduction in the occurrence of treatment side effects, while maintaining adequate analgesia for patients with moderate acute pain in both the outpatient and outpatient periods. Patients with more severe pain are more likely to use RM, but they still use fewer opioids when treated with DPLFC. This suggests that multimodal treatment using DPLFC and an opioid may offer an important clinical benefit in the treatment of acute pain, including in the home environment.
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Affiliation(s)
| | | | | | - Neel Mehta
- Weill-Cornell Pain Medicine Center, New York, NY, USA
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Abstract
Impulsivity is associated with various psychopathologies, and elevated impulsivity is typically disadvantageous. This manuscript reviews recent investigations into the neurobiology of impulsivity using human imaging techniques and animal models. Both human imaging and preclinical pharmacological manipulations have yielded important insights into the neurobiological underpinnings of impulsivity. A more thorough understanding of the complex neurobiology underlying aspects of impulsivity may provide insight into new treatment options that target elevated impulsivity and psychopathologies such as addictions.
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Affiliation(s)
- Marci R Mitchell
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT
| | - Marc N Potenza
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT ; Department of Neurobiology, Yale University School of Medicine, New Haven, CT ; Child Study Center, Yale University School of Medicine, New Haven, CT
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33
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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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