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Hsu LM, Cerri DH, Lee SH, Shnitko TA, Carelli RM, Shih YYI. Intrinsic Functional Connectivity between the Anterior Insular and Retrosplenial Cortex as a Moderator and Consequence of Cocaine Self-Administration in Rats. J Neurosci 2024; 44:e1452232023. [PMID: 38233216 PMCID: PMC10869158 DOI: 10.1523/jneurosci.1452-23.2023] [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: 07/31/2023] [Revised: 12/21/2023] [Accepted: 12/22/2023] [Indexed: 01/19/2024] Open
Abstract
While functional brain imaging studies in humans suggest that chronic cocaine use alters functional connectivity (FC) within and between key large-scale brain networks, including the default mode network (DMN), the salience network (SN), and the central executive network (CEN), cross-sectional studies in humans are challenging to obtain brain FC prior to cocaine use. Such information is critical to reveal the relationship between individual's brain FC and the subsequent development of cocaine dependence and brain changes during abstinence. Here, we performed a longitudinal study examining functional magnetic resonance imaging (fMRI) data in male rats (n = 7), acquired before cocaine self-administration (baseline), on 1 d of abstinence following 10 d of cocaine self-administration, and again after 30 d of experimenter-imposed abstinence. Using repeated-measures analysis of variance (ANOVA) with network-based statistics (NBS), significant connectivity changes were found between anterior insular cortex (AI) of the SN, retrosplenial cortex (RSC) of the DMN, somatosensory cortex, and caudate-putamen (CPu), with AI-RSC FC showing the most robust changes between baseline and 1 d of abstinence. Additionally, the level of escalated cocaine intake is associated with AI-RSC and AI-CPu FC changes between 1 d and 30 d of abstinence; further, the subjects' AI-RSC FC prior to cocaine intake is a significant moderator for the AI-RSC changes during abstinence. These results provide novel insights into the roles of AI-RSC FC before and after cocaine intake and suggest this circuit to be a potential target to modulate large-scale network and associated behavioral changes in cocaine use disorders.
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Affiliation(s)
- Li-Ming Hsu
- Center for Animal Magnetic Resonance Imaging, The University of North Carolina at Chapel Hill, Chapel Hill 27599, North Carolina
- Biomedical Research Imaging Center, The University of North Carolina at Chapel Hill, Chapel Hill 27599, North Carolina
- Departments of Neurology, The University of North Carolina at Chapel Hill, Chapel Hill 27599, North Carolina
| | - Domenic H Cerri
- Center for Animal Magnetic Resonance Imaging, The University of North Carolina at Chapel Hill, Chapel Hill 27599, North Carolina
- Biomedical Research Imaging Center, The University of North Carolina at Chapel Hill, Chapel Hill 27599, North Carolina
- Departments of Neurology, The University of North Carolina at Chapel Hill, Chapel Hill 27599, North Carolina
| | - Sung-Ho Lee
- Center for Animal Magnetic Resonance Imaging, The University of North Carolina at Chapel Hill, Chapel Hill 27599, North Carolina
- Biomedical Research Imaging Center, The University of North Carolina at Chapel Hill, Chapel Hill 27599, North Carolina
- Departments of Neurology, The University of North Carolina at Chapel Hill, Chapel Hill 27599, North Carolina
| | - Tatiana A Shnitko
- Center for Animal Magnetic Resonance Imaging, The University of North Carolina at Chapel Hill, Chapel Hill 27599, North Carolina
- Biomedical Research Imaging Center, The University of North Carolina at Chapel Hill, Chapel Hill 27599, North Carolina
- Departments of Neurology, The University of North Carolina at Chapel Hill, Chapel Hill 27599, North Carolina
| | - Regina M Carelli
- Psychology and Neuroscience, The University of North Carolina at Chapel Hill, Chapel Hill 27599, North Carolina
| | - Yen-Yu Ian Shih
- Center for Animal Magnetic Resonance Imaging, The University of North Carolina at Chapel Hill, Chapel Hill 27599, North Carolina
- Biomedical Research Imaging Center, The University of North Carolina at Chapel Hill, Chapel Hill 27599, North Carolina
- Departments of Neurology, The University of North Carolina at Chapel Hill, Chapel Hill 27599, North Carolina
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2
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Zilverstand A, Parvaz MA, Moeller SJ, Kalayci S, Kundu P, Malaker P, Alia-Klein N, Gümüş ZH, Goldstein RZ. Whole-brain resting-state connectivity underlying impaired inhibitory control during early versus longer-term abstinence in cocaine addiction. Mol Psychiatry 2023; 28:3355-3364. [PMID: 37528227 PMCID: PMC10731999 DOI: 10.1038/s41380-023-02199-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Revised: 07/18/2023] [Accepted: 07/21/2023] [Indexed: 08/03/2023]
Abstract
Lapses in inhibitory control have been linked to relapse in human drug addiction. Evidence suggests differences in inhibitory control depending on abstinence duration, but the underlying neural mechanisms remain unknown. We hypothesized that early abstinence (2-5 days) would be characterized by the strongest impairments of inhibitory control and most wide-spread deviations in resting-state functional connectivity of brain networks, while longer-term abstinence (>30 days) would be characterized by weaker impairments as compared to healthy controls. In this laboratory-based cross-sectional study, we compared individuals with Cocaine Use Disorder (iCUD) during early (cocaine urine-positive: N = 19, iCUD+; 32% female; mean age: 46.8 years) and longer-term abstinence (cocaine urine-negative: N = 29, iCUD-; 15% female; mean age: 46.6 years) to healthy controls (N = 33; 24% female; mean age: 40.9 years). We compared the groups on inhibitory control performance (Stop-Signal Task) and, using a whole-brain graph theory analysis (638 region parcellation) of functional magnetic resonance imaging (fMRI) data, we tested for group differences in resting-state brain function (local/global efficiency). We characterized how resting-state brain function was associated with inhibitory control performance within iCUD. Inhibitory control performance was worst in the early abstinence group, and intermediate in the longer-term abstinence group, as compared to the healthy control group (P < 0.01). More recent use of cocaine (CUD+ > CUD- > healthy controls) was characterized by decreased efficiency in fronto-temporal and subcortical networks (primarily in the salience, semantic, and basal ganglia networks) and increased efficiency in visual networks. Importantly, a similar functional connectivity pattern characterized impaired inhibitory control performance within iCUD (all brain analyses P < 0.05, FWE-corrected). Together, we demonstrated that a similar pattern of systematic and widespread deviations in resting-state brain efficiency, extending beyond the networks commonly investigated in human drug addiction, is linked to both abstinence duration and inhibitory control deficits in iCUD.
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Affiliation(s)
- Anna Zilverstand
- Department of Psychiatry & Behavioral Sciences, University of Minnesota, Minneapolis, MN, USA
| | - Muhammad A Parvaz
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Artificial Intelligence and Human Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Scott J Moeller
- Department of Psychiatry, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA
| | - Selim Kalayci
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Prantik Kundu
- Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Ceretype Neuromedicine, Cambridge, MA, USA
| | - Pias Malaker
- Tom and Anne Smith MD-PhD Program, School of Medicine, University of Missouri, Columbia, MO, USA
| | - Nelly Alia-Klein
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Zeynep H Gümüş
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Rita Z Goldstein
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
- Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
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Soleimani G, Conelea CA, Kuplicki R, Opitz A, Lim KO, Paulus MP, Ekhtiari H. Optimizing Individual Targeting of Fronto-Amygdala Network with Transcranial Magnetic Stimulation (TMS): Biophysical, Physiological and Behavioral Variations in People with Methamphetamine Use Disorder. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.04.02.23288047. [PMID: 37066153 PMCID: PMC10104226 DOI: 10.1101/2023.04.02.23288047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/18/2023]
Abstract
Background Previous studies in people with substance use disorders (SUDs) have implicated both the frontopolar cortex and amygdala in drug cue reactivity and craving, and amygdala-frontopolar coupling is considered a marker of early relapse risk. Accumulating data highlight that the frontopolar cortex can be considered a promising therapeutic target for transcranial magnetic stimulation (TMS) in SUDs. However, one-size-fits-all approaches to TMS targets resulted in substantial variation in both physiological and behavioral outcomes. Individualized TMS approaches to target cortico-subcortical circuits like amygdala-frontopolar have not yet been investigated in SUDs. Objective Here, we (1) defined individualized TMS target location based on functional connectivity of the amygdala-frontopolar circuit while people were exposed to drug-related cues, (2) optimized coil orientation based on maximizing electric field (EF) perpendicular to the individualized target, and (3) harmonized EF strength in targeted brain regions across a population. Method MRI data including structural, resting-state, and task-based fMRI data were collected from 60 participants with methamphetamine use disorders (MUDs). Craving scores based on a visual analog scale were collected immediately before and after the MRI session. We analyzed inter-subject variability in the location of TMS targets based on the maximum task-based connectivity between the left medial amygdala (with the highest functional activity among subcortical areas during drug cue exposure) and frontopolar cortex using psychophysiological interaction (PPI) analysis. Computational head models were generated for all participants and EF simulations were calculated for fixed vs. optimized coil location (Fp1/Fp2 vs. individualized maximal PPI location), orientation (AF7/AF8 vs. orientation optimization algorithm), and stimulation intensity (constant vs. adjusted intensity across the population). Results Left medial amygdala with the highest (mean ± SD: 0.31±0.29) functional activity during drug cue exposure was selected as the subcortical seed region. Amygdala-to-whole brain PPI analysis showed a significant cluster in the prefrontal cortex (cluster size: 2462 voxels, cluster peak in MNI space: [25 39 35]) that confirms cortico-subcortical connections. The location of the voxel with the most positive amygdala-frontopolar PPI connectivity in each participant was considered as the individualized TMS target (mean ± SD of the MNI coordinates: [12.6 64.23 -0.8] ± [13.64 3.50 11.01]). Individual amygdala-frontopolar PPI connectivity in each participant showed a significant correlation with VAS scores after cue exposure (R=0.27, p=0.03). Averaged EF strength in a sphere with r = 5mm around the individualized target location was significantly higher in the optimized (mean ± SD: 0.99 ± 0.21) compared to the fixed approach (Fp1: 0.56 ± 0.22, Fp2: 0.78 ± 0.25) with large effect sizes (Fp1: p = 1.1e-13, Hedges'g = 1.5, Fp2: p = 1.7e-5, Hedges'g = 1.26). Adjustment factor to have identical 1 V/m EF strength in a 5mm sphere around the individualized targets ranged from 0.72 to 2.3 (mean ± SD: 1.07 ± 0.29). Conclusion Our results show that optimizing coil orientation and stimulation intensity based on individualized TMS targets led to stronger electric fields in the targeted brain regions compared to a one-size-fits-all approach. These findings provide valuable insights for refining TMS therapy for SUDs by optimizing the modulation of cortico-subcortical circuits.
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Affiliation(s)
- Ghazaleh Soleimani
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, MN, USA
| | - Christine A. Conelea
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, MN, USA
| | | | - Alexander Opitz
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, MN, USA
| | - Kelvin O Lim
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, MN, USA
| | | | - Hamed Ekhtiari
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, MN, USA
- Laureate Institute for Brain Research (LIBR), OK, USA
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Biomarkers of Relapse in Cocaine Use Disorder: A Narrative Review. Brain Sci 2022; 12:brainsci12081013. [PMID: 36009076 PMCID: PMC9405750 DOI: 10.3390/brainsci12081013] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 07/21/2022] [Accepted: 07/27/2022] [Indexed: 12/10/2022] Open
Abstract
Introduction: Cocaine use disorder is a chronic disease with severe consequences and a high relapse rate. There is a critical need to explore the factors influencing relapse in order to achieve more efficient treatment outcomes. Furthermore, there is a great need for easy-to-measure, repeatable, and valid biomarkers that can predict treatment response or relapse. Methods: We reviewed the available literature on the Pubmed database concerning the biomarkers associated with relapse in CUD, including central nervous system-derived, genetic, immune, oxidative stress, and “other” biomarkers. Results: Fifty-one articles were included in our analysis. Twenty-five imaging brain anatomic and function assessment studies, mostly using fMRI, examined the role of several structures such as the striatum activity in abstinence prediction. There were fewer studies assessing the use of neuropsychological factors, neurotrophins, or genetic/genomic factors, immune system, or oxidative stress measures to predict abstinence. Conclusion: Several biomarkers have been shown to have predictive value. Prospective studies using combined multimodal assessments are now warranted.
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Taebi A, Becker B, Klugah-Brown B, Roecher E, Biswal B, Zweerings J, Mathiak K. Shared network-level functional alterations across substance use disorders: A multi-level kernel density meta-analysis of resting-state functional connectivity studies. Addict Biol 2022; 27:e13200. [PMID: 35754101 DOI: 10.1111/adb.13200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 04/21/2022] [Accepted: 06/02/2022] [Indexed: 11/30/2022]
Abstract
An increasing number of neuroimaging studies indicate functional alterations in cortico-striatal loops in individuals with substance use disorders (SUD). Dysregulations in these circuits may contribute to drug-seeking and drug-consuming behaviour by impeding inhibitory control, habit formation, and reward processing. Despite evidence of network-level changes in SUD, a shared pattern of functional alterations within and between spatially distributed brain networks has not been systematically investigated. The present meta-analytic investigation aims at identifying common alterations in resting-state functional connectivity patterns across different SUD, including stimulant, heroin, alcohol, cannabis, and nicotine use. To this aim, seed-based whole-brain connectivity maps for different functional networks were extracted and subjected to multi-level kernel density analysis to identify dysfunctional networks in individuals with SUD compared with healthy controls. In addition, an exploratory analysis examined substance-specific effects as well as the influence of drug use status on the main findings. Our findings indicate a hypoconnectivity pattern for the limbic, salience, and frontoparietal networks in individuals with SUD as compared with healthy controls. The default mode network additionally exhibited a complex pattern of hypo- and hyperconnectivity across the studies. The observed disrupted connectivity between networks in SUD may associate with deficient inhibitory control mechanisms that are thought to contribute to excessive craving and automatic drug-related behaviour as well as failure in substance use cessation. The identified network-based alterations in SUD represent potential treatment targets for neuromodulation, for example, network-based real-time functional magnetic resonance imaging (fMRI) neurofeedback. Such interventions can evaluate the behavioural relevance of the identified neural circuits.
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Affiliation(s)
- Arezoo Taebi
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine, RWTH Aachen, Aachen, Germany
| | - Benjamin Becker
- The Clinical Hospital of the Chengdu Brain Science Institute, School of Life Science and Technology, Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China
| | - Benjamin Klugah-Brown
- The Clinical Hospital of the Chengdu Brain Science Institute, School of Life Science and Technology, Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China
| | - Erik Roecher
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine, RWTH Aachen, Aachen, Germany
| | - Bharat Biswal
- Department of Biomedical Engineering, New Jersey Institute of Technology, Newark, New Jersey, USA
| | - Jana Zweerings
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine, RWTH Aachen, Aachen, Germany
| | - Klaus Mathiak
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine, RWTH Aachen, Aachen, Germany.,Institute of Neuroscience and Medicine: JARA-Institute Brain Structure Function Relationship (INM 10), Research Center Jülich, Jülich, Germany
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6
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Tolomeo S, Yu R. Brain network dysfunctions in addiction: a meta-analysis of resting-state functional connectivity. Transl Psychiatry 2022; 12:41. [PMID: 35091540 PMCID: PMC8799706 DOI: 10.1038/s41398-022-01792-6] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 01/05/2022] [Accepted: 01/12/2022] [Indexed: 11/16/2022] Open
Abstract
Resting-state functional connectivity (rsFC) provides novel insights into variabilities in neural networks associated with the use of addictive drugs or with addictive behavioral repertoire. However, given the broad mix of inconsistent findings across studies, identifying specific consistent patterns of network abnormalities is warranted. Here we aimed at integrating rsFC abnormalities and systematically searching for large-scale functional brain networks in substance use disorder (SUD) and behavioral addictions (BA), through a coordinate-based meta-analysis of seed-based rsFC studies. A total of fifty-two studies are eligible in the meta-analysis, including 1911 SUD and BA patients and 1580 healthy controls. In addition, we performed multilevel kernel density analysis (MKDA) for the brain regions reliably involved in hyperconnectivity and hypoconnectivity in SUD and BA. Data from fifty-two studies showed that SUD was associated with putamen, caudate and middle frontal gyrus hyperconnectivity relative to healthy controls. Eight BA studies showed hyperconnectivity clusters within the putamen and medio-temporal lobe relative to healthy controls. Altered connectivity in salience or emotion-processing areas may be related to dysregulated affective and cognitive control-related networks, such as deficits in regulating elevated sensitivity to drug-related stimuli. These findings confirm that SUD and BA might be characterized by dysfunctions in specific brain networks, particularly those implicated in the core cognitive and affective functions. These findings might provide insight into the development of neural mechanistic biomarkers for SUD and BA.
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Affiliation(s)
- Serenella Tolomeo
- Institute of High Performance Computing, Agency for Science, Technology and Research (A*STAR), Singapore, Singapore.
| | - Rongjun Yu
- Department of Management, Hong Kong Baptist University, Hong Kong, China.
- Department of Sport, Physical Education and Health, Hong Kong Baptist University, Hong Kong, China.
- Department of Physics, Hong Kong Baptist University, Hong Kong, China.
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7
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Matto HC, Seshaiyer P, Carmack S, Peixoto N, Scherbel M. When Triggers Become Tigers: Taming the Autonomic Nervous System via Sensory Support System Modulation. JOURNAL OF SOCIAL WORK PRACTICE IN THE ADDICTIONS 2021; 21:382-395. [PMID: 34621139 PMCID: PMC8491990 DOI: 10.1080/1533256x.2021.1973833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 07/27/2020] [Accepted: 09/06/2020] [Indexed: 06/13/2023]
Abstract
Personalized recovery technologies may enable individuals with Substance Use Disorder (SUD) to monitor and manage acute craving and drug use urges in ways that improve drug-seeking decisions in real-time. Direct and indirect regulation of the autonomic nervous system through sensory input monitoring and modulation may enhance control over behavioral decisions and prevent relapse. A personalized sensory support system that monitors neurophysiological reactivity and offers non-pharmacological point-in-time personalized digital interventions may increase awareness of and control over craving reactivity. It is critical to be able to detect these warning signs and intervene early and effectively. The use of wearable technologies that assess point-in-time neurophysiological escalation and shape behavioral response through personalized interventions could be transformative in allowing individuals to better manage their recovery as they transition out of institutions and move back into community settings.
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Affiliation(s)
- Holly C Matto
- Department of Social Work ∣ Center for Adaptive Systems of Brain-Body Interactions, George Mason University, Fairfax, VA, USA
| | - Padmanabhan Seshaiyer
- Department of Mathematical Sciences ∣ ∣ Center for Adaptive Systems of Brain-Body Interactions, George Mason University, Fairfax, VA, USA
| | - Stephanie Carmack
- Research Operations, Center for Adaptive Systems of Brain-Body Interactions, George Mason University, Fairfax, VA, USA
| | - Nathalia Peixoto
- Electrical and Computer Engineering ∣ Center for Adaptive Systems of Brain-Body Interactions, George Mason University, Fairfax, VA, USA
| | - Matthew Scherbel
- Department of Social Work, George Mason University, Fairfax, VA, USA
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Zhai T, Salmeron BJ, Gu H, Adinoff B, Stein EA, Yang Y. Functional connectivity of dorsolateral prefrontal cortex predicts cocaine relapse: implications for neuromodulation treatment. Brain Commun 2021; 3:fcab120. [PMID: 34189458 PMCID: PMC8226190 DOI: 10.1093/braincomms/fcab120] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 04/27/2021] [Accepted: 05/03/2021] [Indexed: 11/13/2022] Open
Abstract
Relapse is one of the most perplexing problems of addiction. The dorsolateral prefrontal cortex is crucially involved in numerous cognitive and affective processes that are implicated in the phenotypes of both substance use disorders and other neuropsychiatric diseases and has become the principal site to deliver transcranial magnetic stimulation for their treatment. However, the dorsolateral prefrontal cortex is an anatomically large and functionally heterogeneous region, and the specific dorsolateral prefrontal cortex locus and dorsolateral prefrontal cortex-based functional circuits that contribute to drug relapse and/or treatment outcome remain unknown. We systematically investigated the relationship of cocaine relapse with functional circuits from 98 dorsolateral prefrontal cortex regions-of-interest defined by evenly sampling the entire surface of bilateral dorsolateral prefrontal cortex in a cohort of cocaine dependent patients (n = 43, 5 Fr) following a psychosocial treatment intervention. Cox regression models were utilized to predict relapse likelihood based on dorsolateral prefrontal cortex functional connectivity strength. Functional connectivity from only 3 of the 98 dorsolateral prefrontal cortex loci, one in the left and two in the right hemisphere, significantly predicted cocaine relapse with an accuracy of 83.9%, 84.6% and 85.4%, respectively. Combining all three loci significantly improved prediction validity to 87.5%. Protective and risk circuits related to these dorsolateral prefrontal cortex loci were identified that have previously been implicated to support 'bottom up' drive to use drug and 'top down' control over behaviour together with social emotional, learning and memory processing. Three dorsolateral prefrontal cortex-centric circuits were identified that predict relapse to cocaine use with high accuracy. These functionally distinct dorsolateral prefrontal cortex-based circuits provide insights into the multiple roles played by the dorsolateral prefrontal cortex in cognitive and affective functioning that affects treatment outcome. The identified dorsolateral prefrontal cortex loci may serve as potential neuromodulation targets to be tested in subsequent clinical studies for addiction treatment and as clinically relevant biomarkers of its efficacy. Zhai et al. identify three dorsolateral prefrontal cortex (dlPFC)-centric circuits that predict cocaine relapse with high accuracy, providing insights into the multiple roles of the dlPFC in brain functioning that affects treatment outcome and suggesting the dlPFC loci as potential neuromodulation targets for addiction treatment.
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Affiliation(s)
- Tianye Zhai
- Neuroimaging Research Branch, Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, Baltimore, MD 21224, USA
| | - Betty Jo Salmeron
- Neuroimaging Research Branch, Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, Baltimore, MD 21224, USA
| | - Hong Gu
- Neuroimaging Research Branch, Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, Baltimore, MD 21224, USA
| | - Bryon Adinoff
- Veterans Affairs North Texas Health Care System, Dallas, TX 75216, USA.,Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA.,Department of Psychiatry-Residency, School of Medicine, University of Colorado, Aurora, CO 80045, USA
| | - Elliot A Stein
- Neuroimaging Research Branch, Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, Baltimore, MD 21224, USA
| | - Yihong Yang
- Neuroimaging Research Branch, Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, Baltimore, MD 21224, USA
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Kroll DS, Feldman DE, Wang SYA, Zhang R, Manza P, Wiers CE, Volkow ND, Wang GJ. The associations of comorbid substance use disorders and psychiatric conditions with adolescent brain structure and function: A review. J Neurol Sci 2020; 418:117099. [PMID: 32866814 PMCID: PMC9003866 DOI: 10.1016/j.jns.2020.117099] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2019] [Revised: 07/15/2020] [Accepted: 08/14/2020] [Indexed: 12/30/2022]
Abstract
Adolescence is a period of rapid neural and behavioral development that often precipitates substance use, substance use disorders (SUDs), and other psychopathology. While externalizing disorders have been closely linked to SUD epidemiologically, the comorbidity of internalizing disorders and SUD is less well understood. Neuroimaging studies can be used to measure structural and functional developments in the brain that mediate the relationship between psychopathology and SUD in adolescence. Externalizing disorders and SUD are both associated with structural and functional changes in the basal ganglia and prefrontal cortex in adolescence. The neural mechanisms underlying internalizing disorders and SUD are less clear, but evidence points to involvement of the amygdala and prefrontal cortex. We also highlight independent contributions of SUD, which may vary in certain ways by the substances assessed. A deeper understanding of the neural basis of the relationship between psychopathology and SUD will allow for more informed interventions in this critical developmental stage.
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Affiliation(s)
- Danielle S Kroll
- National Institute on Alcohol Abuse and Alcoholism, 10 Center Dr, Rm B2L124, Bethesda, MD 20892-1013, USA
| | - Dana E Feldman
- National Institute on Alcohol Abuse and Alcoholism, 10 Center Dr, Rm B2L124, Bethesda, MD 20892-1013, USA
| | - Szu-Yung Ariel Wang
- National Institute on Alcohol Abuse and Alcoholism, 10 Center Dr, Rm B2L124, Bethesda, MD 20892-1013, USA
| | - Rui Zhang
- National Institute on Alcohol Abuse and Alcoholism, 10 Center Dr, Rm B2L124, Bethesda, MD 20892-1013, USA
| | - Peter Manza
- National Institute on Alcohol Abuse and Alcoholism, 10 Center Dr, Rm B2L124, Bethesda, MD 20892-1013, USA
| | - Corinde E Wiers
- National Institute on Alcohol Abuse and Alcoholism, 10 Center Dr, Rm B2L124, Bethesda, MD 20892-1013, USA
| | - Nora D Volkow
- National Institute on Alcohol Abuse and Alcoholism, 10 Center Dr, Rm B2L124, Bethesda, MD 20892-1013, USA; National Institute on Drug Abuse, National Institutes of Health, 6001 Executive Blvd., Suite 5274, Bethesda, MD 20892-9581, USA
| | - Gene-Jack Wang
- National Institute on Alcohol Abuse and Alcoholism, 10 Center Dr, Rm B2L124, Bethesda, MD 20892-1013, USA.
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Back SE, Gray K, Santa Ana E, Jones JL, Jarnecke AM, Joseph JE, Prisciandaro J, Killeen T, Brown DG, Taimina L, Compean E, Malcolm R, Flanagan JC, Kalivas PW. N-acetylcysteine for the treatment of comorbid alcohol use disorder and posttraumatic stress disorder: Design and methodology of a randomized clinical trial. Contemp Clin Trials 2020; 91:105961. [PMID: 32087337 PMCID: PMC7333883 DOI: 10.1016/j.cct.2020.105961] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Revised: 02/06/2020] [Accepted: 02/17/2020] [Indexed: 12/11/2022]
Abstract
Alcohol use disorder (AUD) and posttraumatic stress disorder (PTSD) are two prevalent psychiatric conditions in the U.S. The co-occurrence of AUD and PTSD is also common, and associated with a more severe clinical presentation and worse treatment outcomes across the biopsychosocial spectrum (e.g., social and vocational functioning, physical health) as compared to either disorder alone. Despite the high co-occurrence and negative outcomes, research on effective medications for AUD/PTSD is sparse and there is little empirical evidence to guide treatment decisions. The study described in this paper addresses this knowledge gap by testing the efficacy of N-acetylcysteine (NAC) in reducing alcohol use and PTSD symptoms. Animal studies and prior clinical research suggest a role for NAC in the treatment of substance use disorders and PTSD via glutamate modulation. NAC is a cysteine pro-drug that stimulates the cystine-glutamate exchanger, normalizes glial glutamate transporters, and restores glutamatergic tone on presynaptic receptors in reward regions of the brain. Moreover, NAC is available over-the-counter, has a long-established safety record, and does not require titration to achieve the target dose. This paper describes the rationale, study design, and methodology of a 12-week, randomized, double-blind, placebo-controlled trial of NAC (2400 mg/day) among adults with co-occurring AUD and PTSD. Functional magnetic resonance imaging (fMRI) and proton magnetic resonance spectroscopy (1H-MRS) are utilized to investigate the neural circuitry and neurochemistry underlying comorbid AUD/PTSD and identify predictors of treatment outcome. This study is designed to determine the efficacy of NAC in the treatment of co-occurring AUD/PTSD and provide new information regarding mechanisms of action implicated in co-occurring AUD/PTSD.
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Affiliation(s)
- Sudie E Back
- Department of Psychiatry and Behavioral Sciences, College of Medicine, Medical University of South Carolina, Charleston, SC, USA; Ralph H. Johnson Veterans Affairs Medical Center, Charleston, SC, USA.
| | - Kevin Gray
- Department of Psychiatry and Behavioral Sciences, College of Medicine, Medical University of South Carolina, Charleston, SC, USA.
| | - Elizabeth Santa Ana
- Department of Psychiatry and Behavioral Sciences, College of Medicine, Medical University of South Carolina, Charleston, SC, USA; Ralph H. Johnson Veterans Affairs Medical Center, Charleston, SC, USA.
| | - Jennifer L Jones
- Department of Psychiatry and Behavioral Sciences, College of Medicine, Medical University of South Carolina, Charleston, SC, USA.
| | - Amber M Jarnecke
- Department of Psychiatry and Behavioral Sciences, College of Medicine, Medical University of South Carolina, Charleston, SC, USA.
| | - Jane E Joseph
- Department of Psychiatry and Behavioral Sciences, College of Medicine, Medical University of South Carolina, Charleston, SC, USA.
| | - James Prisciandaro
- Department of Psychiatry and Behavioral Sciences, College of Medicine, Medical University of South Carolina, Charleston, SC, USA.
| | - Therese Killeen
- Department of Psychiatry and Behavioral Sciences, College of Medicine, Medical University of South Carolina, Charleston, SC, USA.
| | - Delisa G Brown
- Department of Psychiatry and Behavioral Sciences, College of Medicine, Medical University of South Carolina, Charleston, SC, USA.
| | - Linda Taimina
- Department of Psychiatry and Behavioral Sciences, College of Medicine, Medical University of South Carolina, Charleston, SC, USA.
| | - Ebele Compean
- Department of Psychiatry and Behavioral Sciences, College of Medicine, Medical University of South Carolina, Charleston, SC, USA
| | - Robert Malcolm
- Department of Psychiatry and Behavioral Sciences, College of Medicine, Medical University of South Carolina, Charleston, SC, USA.
| | - Julianne C Flanagan
- Department of Psychiatry and Behavioral Sciences, College of Medicine, Medical University of South Carolina, Charleston, SC, USA.
| | - Peter W Kalivas
- Department of Neuroscience, College of Medicine, Medical University of South Carolina, Charleston, SC, USA.
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11
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Abstinence-dependent dissociable central amygdala microcircuits control drug craving. Proc Natl Acad Sci U S A 2020; 117:8126-8134. [PMID: 32205443 DOI: 10.1073/pnas.2001615117] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
We recently reported that social choice-induced voluntary abstinence prevents incubation of methamphetamine craving in rats. This inhibitory effect was associated with activation of protein kinase-Cδ (PKCδ)-expressing neurons in central amygdala lateral division (CeL). In contrast, incubation of craving after forced abstinence was associated with activation of CeL-expressing somatostatin (SOM) neurons. Here we determined the causal role of CeL PKCδ and SOM in incubation using short-hairpin RNAs against PKCδ or SOM that we developed and validated. We injected two groups with shPKCδ or shCtrlPKCδ into CeL and trained them to lever press for social interaction (6 d) and then for methamphetamine infusions (12 d). We injected two other groups with shSOM or shCtrlSOM into CeL and trained them to lever press for methamphetamine infusions (12 d). We then assessed relapse to methamphetamine seeking after 1 and 15 abstinence days. Between tests, the rats underwent either social choice-induced abstinence (shPKCδ groups) or homecage forced abstinence (shSOM groups). After test day 15, we assessed PKCδ and SOM, Fos, and double-labeled expression in CeL and central amygdala medial division (CeM). shPKCδ CeL injections decreased Fos in CeL PKCδ-expressing neurons, increased Fos in CeM output neurons, and reversed the inhibitory effect of social choice-induced abstinence on incubated drug seeking on day 15. In contrast, shSOM CeL injections decreased Fos in CeL SOM-expressing neurons, decreased Fos in CeM output neurons, and decreased incubated drug seeking after 15 forced abstinence days. Our results identify dissociable central amygdala mechanisms of abstinence-dependent expression or inhibition of incubation of craving.
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12
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Zhang R, Volkow ND. Brain default-mode network dysfunction in addiction. Neuroimage 2019; 200:313-331. [DOI: 10.1016/j.neuroimage.2019.06.036] [Citation(s) in RCA: 131] [Impact Index Per Article: 26.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Revised: 06/14/2019] [Accepted: 06/17/2019] [Indexed: 12/21/2022] Open
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13
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Joseph JE, Vaughan BK, Camp CC, Baker NL, Sherman BJ, Moran-Santa Maria M, McRae-Clark A, Brady KT. Oxytocin-Induced Changes in Intrinsic Network Connectivity in Cocaine Use Disorder: Modulation by Gender, Childhood Trauma, and Years of Use. Front Psychiatry 2019; 10:502. [PMID: 31379621 PMCID: PMC6658612 DOI: 10.3389/fpsyt.2019.00502] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2019] [Accepted: 06/25/2019] [Indexed: 12/11/2022] Open
Abstract
Cocaine use disorder (CUD) is a major public health concern with devastating social, economic, and mental health implications. A better understanding of the underlying neurobiology and phenotypic variations in individuals with CUD is necessary for the development of effective and targeted treatments. In this study, 39 women and 54 men with CUD completed a 6-min resting-state functional magnetic resonance imaging scan after intranasal oxytocin (OXY) or placebo administration. Graph-theory network analysis was used to quantify functional connectivity changes caused by OXY in striatum, anterior cingulate cortex (ACC), insula, and amygdala nodes of interest. OXY increased connectivity in the right ACC and left amygdala in males, whereas OXY increased connectivity in the right ACC and right accumbens in females. Machine learning was then used to associate treatment response (placebo minus OXY) in nodes of interest with years of cocaine use and severity of childhood trauma separately for males and females. Childhood trauma and years of cocaine use were associated with OXY-induced changes in ACC connectivity for both men and women, but connectivity changes in the amygdala were associated with years of cocaine use in men and connectivity changes in the right insula were associated with years of cocaine use in women. These findings suggest that salience network nodes (ACC and insula) are potential OXY treatment targets in CUD, with the amygdala as a treatment target for men and the accumbens as a treatment target for women.
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Affiliation(s)
- Jane E. Joseph
- Department of Neuroscience, Medical University of South Carolina, Charleston, SC, United States
| | - Brandon K. Vaughan
- Department of Neuroscience, Medical University of South Carolina, Charleston, SC, United States
| | - Christopher C. Camp
- Department of Neuroscience, Medical University of South Carolina, Charleston, SC, United States
| | - Nathaniel L. Baker
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, United States
| | - Brian J. Sherman
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, United States
| | - Megan Moran-Santa Maria
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, United States
| | - Aimee McRae-Clark
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, United States
- Ralph H. Johnson VA Medical Center, Charleston, SC, United States
| | - Kathleen T. Brady
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, United States
- Ralph H. Johnson VA Medical Center, Charleston, SC, United States
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14
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Design of a randomized controlled trial examining the efficacy of oxytocin to enhance alcohol behavioral couple therapy. Contemp Clin Trials 2019; 82:1-8. [PMID: 31063869 DOI: 10.1016/j.cct.2019.05.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2019] [Revised: 04/20/2019] [Accepted: 05/02/2019] [Indexed: 12/15/2022]
Abstract
Combining pharmacological interventions with evidence-based behavioral interventions may help optimize treatment outcomes for alcohol use disorder (AUD). While several effective behavioral interventions for AUD have been developed, the vast majority target individual patients, despite evidence that behavioral interventions for couples have the ability to outperform individual treatments for AUD. Alcohol Behavioral Couples Therapy (ABCT) is an evidence-based behavioral intervention for couples that has been shown to significantly reduce AUD severity as well as improve relationship functioning. Accumulating evidence suggests that the neuropeptide oxytocin has the ability to reduce alcohol craving and consumption, symptoms of tolerance and withdrawal, and ameliorate neurobiological deficits associated with AUD. Furthermore, oxytocin has demonstrated the ability to increase prosocial behavior and cognition, and restore sensitivity to natural rewards such as interpersonal relationships. No study to date has examined the ability of oxytocin to enhance ABCT. Thus, the primary objective of this Phase II study is to examine the effects of oxytocin versus placebo in combination with ABCT in reducing AUD severity and improving relationship functioning. We also will utilize neuroimaging techniques before and after treatment to investigate the underlying pathophysiology of AUD among couples and identify prognostic indicators of treatment outcome. The findings from this study might provide critical new information to help inform clinical practice and accelerate research on the pharmacological treatment of AUD.
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15
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Wilcox CE, Abbott CC, Calhoun VD. Alterations in resting-state functional connectivity in substance use disorders and treatment implications. Prog Neuropsychopharmacol Biol Psychiatry 2019; 91:79-93. [PMID: 29953936 PMCID: PMC6309756 DOI: 10.1016/j.pnpbp.2018.06.011] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Revised: 06/18/2018] [Accepted: 06/23/2018] [Indexed: 02/06/2023]
Abstract
Substance use disorders (SUD) are diseases of the brain, characterized by aberrant functioning in the neural circuitry of the brain. Resting state functional connectivity (rsFC) can illuminate these functional changes by measuring the temporal coherence of low-frequency fluctuations of the blood oxygenation level-dependent magnetic resonance imaging signal in contiguous or non-contiguous regions of the brain. Because this data is easy to obtain and analyze, and therefore fairly inexpensive, it holds promise for defining biological treatment targets in SUD, which could help maximize the efficacy of existing clinical interventions and develop new ones. In an effort to identify the most likely "treatment targets" obtainable with rsFC we summarize existing research in SUD focused on 1) the relationships between rsFC and functionality within important psychological domains which are believed to underlie relapse vulnerability 2) changes in rsFC from satiety to deprived or abstinent states 3) baseline rsFC correlates of treatment outcome and 4) changes in rsFC induced by treatment interventions which improve clinical outcomes and reduce relapse risk. Converging evidence indicates that likely "treatment target" candidates, emerging consistently in all four sections, are reduced connectivity within executive control network (ECN) and between ECN and salience network (SN). Other potential treatment targets also show promise, but the literature is sparse and more research is needed. Future research directions include data-driven prediction analyses and rsFC analyses with longitudinal datasets that incorporate time since last use into analysis to account for drug withdrawal. Once the most reliable biological markers are identified, they can be used for treatment matching, during preliminary testing of new pharmacological compounds to establish clinical potential ("target engagement") prior to carrying out costly clinical trials, and for generating hypotheses for medication repurposing.
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16
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Abstract
OBJECTIVE The authors sought to identify a brain-based predictor of cocaine abstinence by using connectome-based predictive modeling (CPM), a recently developed machine learning approach. CPM is a predictive tool and a method of identifying networks that underlie specific behaviors ("neural fingerprints"). METHODS Fifty-three individuals participated in neuroimaging protocols at the start of treatment for cocaine use disorder, and again at the end of 12 weeks of treatment. CPM with leave-one-out cross-validation was conducted to identify pretreatment networks that predicted abstinence (percent cocaine-negative urine samples during treatment). Networks were applied to posttreatment functional MRI data to assess changes over time and ability to predict abstinence during follow-up. The predictive ability of identified networks was then tested in a separate, heterogeneous sample of individuals who underwent scanning before treatment for cocaine use disorder (N=45). RESULTS CPM predicted abstinence during treatment, as indicated by a significant correspondence between predicted and actual abstinence values (r=0.42, df=52). Identified networks included connections within and between canonical networks implicated in cognitive/executive control (frontoparietal, medial frontal) and in reward responsiveness (subcortical, salience, motor/sensory). Connectivity strength did not change with treatment, and strength at posttreatment assessment also significantly predicted abstinence during follow-up (r=0.34, df=39). Network strength in the independent sample predicted treatment response with 64% accuracy by itself and 71% accuracy when combined with baseline cocaine use. CONCLUSIONS These data demonstrate that individual differences in large-scale neural networks contribute to variability in treatment outcomes for cocaine use disorder, and they identify specific abstinence networks that may be targeted in novel interventions.
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Affiliation(s)
- Sarah W. Yip
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, 06510,Child Study Center, Yale School of Medicine, New Haven, CT, 06510,Location of work and address for correspondence: Sarah W. Yip, 1 Church Street, Suite 731, New Haven, CT, 06510, USA; Tel: (203) 704-7588;
| | - Dustin Scheinost
- Child Study Center, Yale School of Medicine, New Haven, CT, 06510,Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT, 06510
| | - Marc N. Potenza
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, 06510,Child Study Center, Yale School of Medicine, New Haven, CT, 06510,Department of Neuroscience, Yale School of Medicine, New Haven, CT, 06510,Connecticut Mental Health Center, New Haven, CT, 06519
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17
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Flanagan JC, Yonce S, Calhoun CD, Back SE, Brady KT, Joseph JE. Preliminary development of a neuroimaging paradigm to examine neural correlates of relationship conflict. Psychiatry Res Neuroimaging 2019; 283:125-134. [PMID: 30581042 PMCID: PMC6379119 DOI: 10.1016/j.pscychresns.2018.12.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2017] [Revised: 11/02/2018] [Accepted: 12/11/2018] [Indexed: 01/01/2023]
Abstract
Social stress in the form of conflict between romantic partners is a salient correlate of substance use disorders (SUD), and also plays an integral role in SUD treatment outcomes. Neuroimaging has advanced the study of social stress on SUD etiology, course, and treatment. However, no neuroimaging paradigms have yet been developed to examine neural responses to conflict among romantic couples. In order to fill this gap in the literature, the goal of this exploratory study was to examine the preliminary feasibility of a novel relationship conflict fMRI paradigm. We compared the effects of an auditory relationship conflict versus a neutral cue on functional connectivity in corticolimbic brain regions, and the associations between neural activities and self-report ratings of relationship adjustment, substance use problems, and intimate partner violence. We also explored sex differences in neural correlates of relationship conflict versus neutral cues. Participants demonstrated increased functional connectivity between the amygdala and the prefrontal cortex during the relationship conflict cue compared to the neutral cue. Intimate partner violence was associated with functional connectivity. Sex differences emerged in neural responses to the relationship conflict cue compared to the neutral cue. Collectively, the findings demonstrate preliminary validity of this novel neuroimaging paradigm for couples.
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Affiliation(s)
- Julianne C Flanagan
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 67 President St., MSC 861, Charleston, SC 29425, USA.
| | - Shayla Yonce
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 67 President St., MSC 861, Charleston, SC 29425, USA
| | - Casey D Calhoun
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 67 President St., MSC 861, Charleston, SC 29425, USA
| | - Sudie E Back
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 67 President St., MSC 861, Charleston, SC 29425, USA; Ralph H. Johnson Veterans Affairs Medical Center, Charleston, SC, USA
| | - Kathleen T Brady
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 67 President St., MSC 861, Charleston, SC 29425, USA; Ralph H. Johnson Veterans Affairs Medical Center, Charleston, SC, USA
| | - Jane E Joseph
- Department of Neuroscience, Medical University of South Carolina, Charleston, SC, USA
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Changes in Functional Brain Connectivity Highlight the Importance of a Baseline Measurement and Multiple Imaging Sessions for Cocaine Abstinence Studies. eNeuro 2018; 5:eN-RHL-0372-18. [PMID: 30283814 PMCID: PMC6168317 DOI: 10.1523/eneuro.0372-18.2018] [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: 09/24/2018] [Accepted: 09/24/2018] [Indexed: 11/21/2022] Open
Abstract
Highlighted Research Paper:Functional Connectivity of Chronic Cocaine Use Reveals Progressive Neuroadaptations in Neocortical, Striatal, and Limbic Networks by, Caitlin A. Orsini, Luis M. Colon-Perez, Sara C. Heshmati, Barry Setlow, and Marcelo Febo
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19
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Perez PD, Hall G, Zubcevic J, Febo M. Cocaine differentially affects synaptic activity in memory and midbrain areas of female and male rats: an in vivo MEMRI study. Brain Imaging Behav 2018; 12:201-216. [PMID: 28236167 DOI: 10.1007/s11682-017-9691-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Manganese enhanced magnetic resonance imaging (MEMRI) has been previously used to determine the effect of acute cocaine on calcium-dependent synaptic activity in male rats. However, there have been no MEMRI studies examining sex differences in the functional neural circuits affected by repeated cocaine. In the present study, we used MEMRI to investigate the effects of repeated cocaine on brain activation in female and male rats. Adult female and male rats were scanned at 4.7 Tesla three days after final treatment with saline, a single cocaine injection (15 mg kg-1, i.p. × 1 day) or repeated cocaine injections (15 mg kg-1, i.p. × 10 days). A day before imaging rats were provided with an i.p. injection of manganese chloride (70 mg kg-1). Cocaine produced effects on MEMRI activity that were dependent on sex. In females, we observed that a single cocaine injection reduced MEMRI activity in hippocampal CA3, ventral tegmental area (VTA), and median Raphé, whereas repeated cocaine increased MEMRI activity in dentate gyrus and interpeduncular nucleus. In males, repeated cocaine reduced MEMRI activity in VTA. Overall, it appeared that female rats showed a general trend towards increase MEMRI activity with single cocaine and reduced activity with repeated exposure, while male rats showed a trend towards opposite effects. Our results provide evidence for sex differences in the in vivo neural response to cocaine, which involves primarily hippocampal, amygdala and midbrain areas.
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Affiliation(s)
- Pablo D Perez
- Department of Psychiatry, McKnight Brain Institute, College of Medicine, University of Florida, Gainesville, FL, 32610, USA
| | - Gabrielle Hall
- Department of Psychiatry, McKnight Brain Institute, College of Medicine, University of Florida, Gainesville, FL, 32610, USA
| | - Jasenka Zubcevic
- Department of Physiological Sciences, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Marcelo Febo
- Department of Psychiatry, McKnight Brain Institute, College of Medicine, University of Florida, Gainesville, FL, 32610, USA.
- Center for Addiction Research and Education (CARE), University of Florida, Gainesville, FL, USA.
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20
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Functional Connectivity of Chronic Cocaine Use Reveals Progressive Neuroadaptations in Neocortical, Striatal, and Limbic Networks. eNeuro 2018; 5:eN-NWR-0081-18. [PMID: 30073194 PMCID: PMC6071197 DOI: 10.1523/eneuro.0081-18.2018] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Revised: 06/25/2018] [Accepted: 07/10/2018] [Indexed: 12/21/2022] Open
Abstract
Brain imaging studies indicate that chronic cocaine users display altered functional connectivity between prefrontal cortical, thalamic, striatal, and limbic regions; however, the use of cross-sectional designs in these studies precludes measuring baseline brain activity prior to cocaine use. Animal studies can circumvent this limitation by comparing functional connectivity between baseline and various time points after chronic cocaine use. In the present study, adult male Long–Evans rats were trained to self-administer cocaine intravenously for 6 h sessions daily over 14 consecutive days. Two additional groups serving as controls underwent sucrose self-administration or exposure to the test chambers alone. Functional magnetic resonance imaging was conducted before self-administration and after 1 and 14 d of abstinence (1d and 14d Abs). After 1d Abs from cocaine, there were increased clustering coefficients in brain areas involved in reward seeking, learning, memory, and autonomic and affective processing, including amygdala, hypothalamus, striatum, hippocampus, and thalamus. Similar changes in clustering coefficient after 1d Abs from sucrose were evident in predominantly thalamic brain regions. Notably, there were no changes in strength of functional connectivity at 1 or 14 d after either cocaine or sucrose self-administration. The results suggest that cocaine and sucrose can change the arrangement of functional connectivity of brain regions involved in cognition and emotion, but that these changes dissipate across the early stages of abstinence. The study also emphasizes the importance of including baseline measures in longitudinal functional neuroimaging designs seeking to assess functional connectivity in the context of substance use.
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21
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Zhang Y, Zhang S, Ide JS, Hu S, Zhornitsky S, Wang W, Dong G, Tang X, Li CSR. Dynamic network dysfunction in cocaine dependence: Graph theoretical metrics and stop signal reaction time. NEUROIMAGE-CLINICAL 2018; 18:793-801. [PMID: 29876265 PMCID: PMC5988015 DOI: 10.1016/j.nicl.2018.03.016] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Revised: 01/09/2018] [Accepted: 03/14/2018] [Indexed: 01/04/2023]
Abstract
Graphic theoretical metrics have become increasingly popular in characterizing functional connectivity of neural networks and how network connectivity is compromised in neuropsychiatric illnesses. Here, we add to this literature by describing dynamic network connectivities of 78 cocaine dependent (CD) and 85 non-drug using healthy control (HC) participants who underwent fMRI during performance of a stop signal task (SST). Compared to HC, CD showed prolonged stop signal reaction time (SSRT), consistent with deficits in response inhibition. In graph theoretical analysis of dynamic functional connectivity, we examined temporal flexibility and spatiotemporal diversity of 14 networks covering the whole brain. Temporal flexibility quantifies how frequently a brain region interacts with regions of other communities across time, with high temporal flexibility indicating that a region interacts predominantly with regions outside its own community. Spatiotemporal diversity quantifies how uniformly a brain region interacts with regions in other communities over time, with high spatiotemporal diversity indicating that the interactions are more evenly distributed across communities. Compared to HC, CD exhibited decreased temporal flexibility and increased spatiotemporal diversity in the great majority of neural networks. The graph metric measures of the default mode network negatively correlated with SSRT in CD but not HC. The findings are consistent with diminished temporal flexibility and a compensatory increase in spatiotemporal diversity, in association with impairment of a critical executive function, in cocaine addiction. More broadly, the findings suggest that graph theoretical metrics provide new insights for connectivity analyses to elucidate network dysfunction that may elude conventional measures. Cocaine addiction (CA) is associated with prolonged stop signal reaction time (SSRT). CA is associated with decreased temporal flexibility (TF) of neural networks. CA is associated with increased spatial temporal diversity (STD) of neural networks. The TF and STD of default mode network correlated negatively with SSRT in CA. Dynamic connectivity captures network dysfunction in link with inhibition deficits in CA.
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Affiliation(s)
- Yihe Zhang
- Department of Biomedical engineering, School of Life Sciences, Beijing Institute of technology, Beijing, China; Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Sheng Zhang
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Jaime S Ide
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Sien Hu
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA; Department of Psychology, State University of New York, Oswego, NY, USA
| | - Simon Zhornitsky
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Wuyi Wang
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Guozhao Dong
- Department of Biomedical engineering, School of Life Sciences, Beijing Institute of technology, Beijing, China
| | - Xiaoying Tang
- Department of Biomedical engineering, School of Life Sciences, Beijing Institute of technology, 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; Interdepartmental Neuroscience Program, Yale University School of Medicine, New Haven, CT, USA; Beijing Huilongguan Hospital, Beijing, China.
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Toward biomarkers of the addicted human brain: Using neuroimaging to predict relapse and sustained abstinence in substance use disorder. Prog Neuropsychopharmacol Biol Psychiatry 2018; 80:143-154. [PMID: 28322982 PMCID: PMC5603350 DOI: 10.1016/j.pnpbp.2017.03.003] [Citation(s) in RCA: 78] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Revised: 02/17/2017] [Accepted: 03/01/2017] [Indexed: 01/23/2023]
Abstract
The ability to predict relapse is a major goal of drug addiction research. Clinical and diagnostic measures are useful in this regard, but these measures do not fully and consistently identify who will relapse and who will remain abstinent. Neuroimaging approaches have the potential to complement these standard clinical measures to optimize relapse prediction. The goal of this review was to survey the existing drug addiction literature that either used a baseline functional or structural neuroimaging phenotype to longitudinally predict a clinical outcome, or that examined test-retest of a neuroimaging phenotype during a course of abstinence or treatment. Results broadly suggested that, relative to individuals who sustained abstinence, individuals who relapsed had (1) enhanced activation to drug-related cues and rewards, but reduced activation to non-drug-related cues and rewards, in multiple corticolimbic and corticostriatal brain regions; (2) weakened functional connectivity of these same corticolimbic and corticostriatal regions; and (3) reduced gray and white matter volume and connectivity in prefrontal regions. Thus, beyond these regions showing baseline group differences, reviewed evidence indicates that function and structure of these regions can prospectively predict - and normalization of these regions can longitudinally track - important clinical outcomes including relapse and adherence to treatment. Future clinical studies can leverage this information to develop novel treatment strategies, and to tailor scarce therapeutic resources toward individuals most susceptible to relapse.
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Hanlon CA, Kearney-Ramos T, Dowdle LT, Hamilton S, DeVries W, Mithoefer O, Austelle C, Lench DH, Correia B, Canterberry M, Smith JP, Brady KT, George MS. Developing Repetitive Transcranial Magnetic Stimulation (rTMS) as a Treatment Tool for Cocaine Use Disorder: a Series of Six Translational Studies. Curr Behav Neurosci Rep 2017; 4:341-352. [PMID: 30009124 PMCID: PMC6039979 DOI: 10.1007/s40473-017-0135-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
PURPOSE OF THE REVIEW Cocaine dependence is a chronic and relapsing disorder which is particularly resistant to behavioral or pharmacologic treatment, and likely involves multiple dysfunctional frontal-striatal circuits. Through advances in preclinical research in the last decade, we now have an unprecedented understanding of the neural control of drug-taking behavior. In both rodent models and human clinical neuroimaging studies, it is apparent that medial frontal-striatal limbic circuits regulate drug cue-triggered behavior. While non-human preclinical studies can use invasive stimulation techniques to inhibit drug cue-evoked behavior, in human clinical neuroscience, we are pursuing non-invasive theta burst stimulation (TBS) as a novel therapeutic tool to inhibit drug cue-associated behavior. RECENT FINDINGS Our laboratory and others have spent the last 7 years systematically and empirically developing a non-invasive, neural circuit-based intervention for cocaine use disorder. Utilizing a multimodal approach of functional brain imaging and brain stimulation, we have attempted to design and optimize a repetitive transcranial magnetic stimulation treatment protocol for cocaine use disorder. This manuscript will briefly review the data largely from our own lab that motivated our selection of candidate neural circuits, and then summarize the results of six studies, culminating in the first double-blinded, sham-controlled clinical trial of TMS as a treatment adjuvant for treatment-engaged cocaine users (10 sessions, medial prefrontal cortex, 110% resting motor threshold, continuous theta burst stimulation, 3600 pulses/session). SUMMARY The intent of this review is to highlight one example of a systematic path for TMS treatment development in patients. This path is not necessarily optimal, exclusive, or appropriate for every neurologic or psychiatric disease. Rather, it is one example of a reasoned, empirically derived pathway which we hope will serve as scaffolding for future investigators seeking to develop TMS treatment protocols.
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Affiliation(s)
- Colleen A Hanlon
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
- Department of Neurosciences, Medical University of South Carolina, Charleston, SC, USA
- Center for Biomedical Imaging, Medical University of South Carolina, Charleston, SC, USA
- Ralph H Johnson Veterans Affairs Medical Center, Charleston, SC, USA
| | - Tonisha Kearney-Ramos
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Logan T Dowdle
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Sarah Hamilton
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - William DeVries
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Oliver Mithoefer
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Christopher Austelle
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Daniel H Lench
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Brittany Correia
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Melanie Canterberry
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Joshua P Smith
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Kathleen T Brady
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
- Department of Neurosciences, Medical University of South Carolina, Charleston, SC, USA
- Center for Biomedical Imaging, Medical University of South Carolina, Charleston, SC, USA
- Ralph H Johnson Veterans Affairs Medical Center, Charleston, SC, USA
| | - Mark S George
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
- Department of Neurosciences, Medical University of South Carolina, Charleston, SC, USA
- Center for Biomedical Imaging, Medical University of South Carolina, Charleston, SC, USA
- Ralph H Johnson Veterans Affairs Medical Center, Charleston, SC, USA
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McRae-Clark AL, Cason AM, Kohtz AS, Moran Santa-Maria M, Aston-Jones G, Brady KT. Impact of gender on corticotropin-releasing factor and noradrenergic sensitivity in cocaine use disorder. J Neurosci Res 2017; 95:320-327. [PMID: 27870396 DOI: 10.1002/jnr.23860] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Revised: 06/30/2016] [Accepted: 07/11/2016] [Indexed: 12/21/2022]
Abstract
Responses to stress may be important in understanding gender differences in substance use disorders and may also be a target for development of treatment interventions. A growing body of both preclinical and clinical research supports important underlying gender differences in the corticotropin-releasing factor (CRF) and noradrenergic systems, which may contribute to drug use. Preclinical models have demonstrated increased sensitivity of females to CRF and noradrenergic-induced drug reinstatement compared with males, and, consistent with these findings, human laboratory studies have demonstrated greater sensitivity to corticotropin-releasing hormone (CRH) and noradrenergic stimulation in cocaine-dependent women compared with men. Furthermore, neuroimaging studies have demonstrated increased neural response to stressful stimuli in cocaine-dependent women compared with men as well as showing significant sex differences in the sensitivity of brain regions responsible for regulating the response to CRH. Development of interventions targeting the noradrenergic system and stress response in drug-dependent individuals could have important clinical implications for both women and men. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Aimee L McRae-Clark
- Department of Psychiatry, Medical University of South Carolina, Charleston, South Carolina
| | - Angie M Cason
- Department of Neuroscience, Medical University of South Carolina, Charleston, South Carolina
| | - Amy S Kohtz
- Brain Health Institute, Rutgers University, Piscataway, New Jersey
| | | | - Gary Aston-Jones
- Brain Health Institute, Rutgers University, Piscataway, New Jersey
| | - Kathleen T Brady
- Department of Psychiatry, Medical University of South Carolina, Charleston, South Carolina
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Regier PS, Monge ZA, Franklin TR, Wetherill RR, Teitelman A, Jagannathan K, Suh JJ, Wang Z, Young KA, Gawrysiak M, Langleben DD, Kampman KM, O'Brien CP, Childress AR. Emotional, physical and sexual abuse are associated with a heightened limbic response to cocaine cues. Addict Biol 2017; 22:1768-1777. [PMID: 27654662 DOI: 10.1111/adb.12445] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2016] [Revised: 07/08/2016] [Accepted: 08/02/2016] [Indexed: 12/24/2022]
Abstract
Drug-reward cues trigger motivational circuitry, a response linked to drug-seeking in animals and in humans. Adverse life events have been reported to increase sensitivity to drug rewards and to bolster drug reward signaling. Therefore, we hypothesized that cocaine-dependent individuals with prior emotional, physical and sexual abuse might have a heightened mesolimbic brain response to cues for drug reward in a new brief-cue probe. Cocaine-dependent human individuals (N = 68) were stabilized in an inpatient setting and then completed an event-related blood-oxygen-level dependent functional magnetic resonance imaging task featuring 500-ms evocative (cocaine, sexual, aversive) and comparator (neutral) cues. Responses to three questions about emotional, physical and sexual abuse from the Addiction Severity Index were used to divide the patients into subgroups (history of Abuse [n = 40] versus No Abuse [n = 28]). When subjects were grouped by the historical presence or absence of emotional, physical or sexual abuse, the Abuse group showed a heightened midbrain, thalamic, caudate, and caudal orbitofrontal cortex response to cocaine cues; a similar result was found in other evocative cues, as well. These findings are the first reported for a 500-ms cocaine-cue probe, and they highlight the ability of very brief evocative cues to activate the brain's motivational circuitry. Although all participants had severe cocaine use disorders, individuals reporting prior abuse had a heightened mesolimbic response to evocative cues. To our knowledge, this is the first study in humans linking a history of abuse to a brain vulnerability (heightened mesolimbic response to drug cues) previously shown to contribute to drug-seeking.
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Affiliation(s)
- Paul S. Regier
- Department of Psychiatry; University of Pennsylvania Perelman School of Medicine; Philadelphia PA USA
| | - Zachary A. Monge
- Department of Psychiatry; University of Pennsylvania Perelman School of Medicine; Philadelphia PA USA
| | - Teresa R. Franklin
- Department of Psychiatry; University of Pennsylvania Perelman School of Medicine; Philadelphia PA USA
| | - Reagan R. Wetherill
- Department of Psychiatry; University of Pennsylvania Perelman School of Medicine; Philadelphia PA USA
| | - Anne Teitelman
- School of Nursing; University of Pennsylvania; Philadelphia PA USA
| | - Kanchana Jagannathan
- Department of Psychiatry; University of Pennsylvania Perelman School of Medicine; Philadelphia PA USA
| | - Jesse J. Suh
- Department of Psychiatry; University of Pennsylvania Perelman School of Medicine; Philadelphia PA USA
| | - Ze Wang
- Department of Psychiatry; University of Pennsylvania Perelman School of Medicine; Philadelphia PA USA
| | - Kimberly A. Young
- Department of Psychiatry; University of Pennsylvania Perelman School of Medicine; Philadelphia PA USA
| | - Michael Gawrysiak
- Department of Psychiatry; University of Pennsylvania Perelman School of Medicine; Philadelphia PA USA
| | - Daniel D. Langleben
- Department of Psychiatry; University of Pennsylvania Perelman School of Medicine; Philadelphia PA USA
| | - Kyle M. Kampman
- Department of Psychiatry; University of Pennsylvania Perelman School of Medicine; Philadelphia PA USA
| | - Charles P. O'Brien
- Department of Psychiatry; University of Pennsylvania Perelman School of Medicine; Philadelphia PA USA
| | - Anna Rose Childress
- Department of Psychiatry; University of Pennsylvania Perelman School of Medicine; Philadelphia PA USA
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Sui J, Gu X. Self as Object: Emerging Trends in Self Research. Trends Neurosci 2017; 40:643-653. [DOI: 10.1016/j.tins.2017.09.002] [Citation(s) in RCA: 66] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Revised: 09/01/2017] [Accepted: 09/10/2017] [Indexed: 02/07/2023]
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McHugh MJ, Gu H, Yang Y, Adinoff B, Stein EA. Executive control network connectivity strength protects against relapse to cocaine use. Addict Biol 2017; 22:1790-1801. [PMID: 27600492 DOI: 10.1111/adb.12448] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2015] [Revised: 08/06/2016] [Accepted: 08/09/2016] [Indexed: 11/30/2022]
Abstract
Cocaine addiction is characterized by notoriously high relapse rates following treatment. Recent efforts to address poor treatment outcomes have turned to potential neural markers of relapse risk. Accordingly, the present study examined resting state functional connectivity (rsFC) within and between three large-scale cortical networks: the default mode network (DMN), salience network (SN) and executive control network (ECN). All three have been implicated in relapse-related phenomena including craving, withdrawal and executive control deficits. Forty-five cocaine-dependent individuals and 22 healthy controls completed 6-min resting fMRI scans, The Wisconsin Card Sorting Task, Continuous Performance Test and Cocaine Craving Questionnaire. Cocaine-dependent individuals completed all measures in the final week of a residential treatment episode. Ten control and 9 abstinent cocaine-dependent individuals returned for 3-6 month follow-up scan visits. A group-level independent component analysis was employed to generate ECN, DMN and SN components. For individuals abstinent up to day 30 post-treatment (n = 21), we found enhanced pre-discharge rsFC between the left ECN and both the right ECN and SN as well as between the right ECN and left ECN. Left ECN rsFC effects remained elevated 3-6 months later among abstinent cocaine-dependent individuals. Relapse was related to fewer years of education and more years smoking but no other demographic, clinical, treatment and neurocognitive characteristics. Findings suggest that interhemispheric ECN and ECN-SN connectivity strength may protect against relapse to cocaine use following treatment. These patterns of enhanced interhemispheric network connectivity may reflect a greater capacity to engage executive control processes when faced with opportunities to use cocaine post-treatment.
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Affiliation(s)
- Meredith J. McHugh
- Neuroimaging Research Branch; National Institute on Drug Abuse-Intramural Research Program; Baltimore MD USA
- Orygen, The National Centre of Excellence in Youth Mental Health; Melbourne VIC Australia
- Centre for Youth Mental Health; University of Melbourne; Melbourne VIC Australia
| | - Hong Gu
- Neuroimaging Research Branch; National Institute on Drug Abuse-Intramural Research Program; Baltimore MD USA
| | - Yihong Yang
- Neuroimaging Research Branch; National Institute on Drug Abuse-Intramural Research Program; Baltimore MD USA
| | - Bryon Adinoff
- Department of Psychiatry; UT Southwestern Medical Center; Dallas TX USA
- VA North Texas Health Care System; Dallas TX USA
| | - Elliot A. Stein
- Neuroimaging Research Branch; National Institute on Drug Abuse-Intramural Research Program; Baltimore MD USA
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Gawrysiak MJ, Jagannathan K, Regier P, Suh JJ, Kampman K, Vickery T, Childress AR. Unseen scars: Cocaine patients with prior trauma evidence heightened resting state functional connectivity (RSFC) between the amygdala and limbic-striatal regions. Drug Alcohol Depend 2017; 180:363-370. [PMID: 28957777 PMCID: PMC5648604 DOI: 10.1016/j.drugalcdep.2017.08.035] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Revised: 08/23/2017] [Accepted: 08/28/2017] [Indexed: 12/15/2022]
Abstract
BACKGROUND Substance use disorder (SUD) patients with a history of trauma exhibit poorer treatment outcome, greater functional impairment and higher risk for relapse. Endorsement of prior trauma has, in several SUD populations, been linked to abnormal functional connectivity (FC) during task-based studies. We examined amygdala FC in the resting state (RS), testing for differences between cocaine patients with and without prior trauma. METHODS Patients with cocaine use disorder (CUD; n=34) were stabilized in an inpatient setting prior to a BOLD fMRI scan. Responses to Addiction Severity Index and the Mini-International Neuropsychiatric Interview were used to characterize the No-Trauma (n=16) and Trauma (n=18) groups. Seed-based RSFC was conducted using the right and left amygdala as regions of interest. Examination of amygdala RSFC was restricted to an a priori anatomical mask that incorporated nodes of the limbic-striatal motivational network. RESULTS RSFC was compared for the Trauma versus No-Trauma groups. The Trauma group evidenced greater connectivity between the amygdala and the a priori limbic-striatal mask. Peaks within the statistically significant limbic-striatal mask included the amygdala, putamen, pallidum, caudate, thalamus, insula, hippocampus/parahippocampus, and brain stem. CONCLUSIONS Results suggest that cocaine patients with prior trauma (versus without) have heightened communication within nodes of the motivational network, even at rest. To our knowledge, this is the first fMRI study to examine amygdala RSFC among those with CUD and trauma history. Heightened RSFC intralimbic connectivity for the Trauma group may reflect a relapse-relevant brain vulnerability and a novel treatment target for this clinically-challenging population.
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Affiliation(s)
- Michael J Gawrysiak
- Department of Psychology, Delaware State University, Dover, DE, USA; Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.
| | - Kanchana Jagannathan
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Paul Regier
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Jesse J Suh
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Kyle Kampman
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Timothy Vickery
- Department of Psychological and Brain Sciences, University of Delaware, Newark, DE, USA
| | - Anna Rose Childress
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
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Geng X, Hu Y, Gu H, Salmeron BJ, Adinoff B, Stein EA, Yang Y. Salience and default mode network dysregulation in chronic cocaine users predict treatment outcome. Brain 2017; 140:1513-1524. [PMID: 28334915 DOI: 10.1093/brain/awx036] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Accepted: 01/13/2017] [Indexed: 12/14/2022] Open
Abstract
While chronic cocaine use is associated with abnormalities in both brain structure and function within and interactions between regions, previous studies have been limited to interrogating structure and function independently, and the detected neural differences have not been applied to independent samples to assess the clinical relevance of results. We investigated consequences of structural differences on resting-state functional connectivity in cocaine addiction and tested whether resting-state functional connectivity of the identified circuits predict relapse in an independent cohort. Subjects included 64 non-treatment-seeking cocaine users (NTSCUs) and 67 healthy control subjects and an independent treatment-completed cohort (n = 45) of cocaine-dependent individuals scanned at the end of a 30-day residential treatment programme. Differences in cortical thickness and related resting-state functional connectivity between NTSCUs and healthy control subjects were identified. Survival analysis, applying cortical thickness of the identified regions, resting-state functional connectivity of the identified circuits and clinical characteristics to the treatment cohort, was used to predict relapse. Lower cortical thickness in bilateral insula and higher thickness in bilateral temporal pole were found in NTSCUs versus healthy control subjects. Whole brain resting-state functional connectivity analyses with these four different anatomical regions as seeds revealed eight weaker circuits including within the salience network (insula seeds) and between temporal pole and elements of the default mode network in NTSCUs. Applying these circuits and clinical characteristics to the independent cocaine-dependent treatment cohort, functional connectivity between right temporal pole and medial prefrontal cortex, combined with years of education, predicted relapse status at 150 days with 88% accuracy. Deficits in the salience network suggest an impaired ability to process physiologically salient events, while abnormalities in a temporal pole-medial prefrontal cortex circuit might speak to the social-emotional functional alterations in cocaine addiction. The involvement of the temporal pole-medial prefrontal cortex circuit in a model highly predictive of relapse highlights the importance of social-emotional functions in cocaine dependence, and provides a potential underlying neural target for therapeutic interventions, and for identifying those at high risk of relapse.
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Affiliation(s)
- Xiujuan Geng
- Neuroimaging Research Branch, National Institute on Drug Abuse, Intramural Research Program, National Institutes of Health, Baltimore, MD, USA.,Laboratory of Neuropsychology and Laboratory of Social Cognitive Affective Neuroscience, University of Hong Kong, Hong Kong, China.,State Key Laboratory of Brain and Cognitive Sciences, University of Hong Kong, Hong Kong, China
| | - Yuzheng Hu
- Neuroimaging Research Branch, National Institute on Drug Abuse, Intramural Research Program, National Institutes of Health, Baltimore, MD, USA
| | - Hong Gu
- Neuroimaging Research Branch, National Institute on Drug Abuse, Intramural Research Program, National Institutes of Health, Baltimore, MD, USA
| | - Betty Jo Salmeron
- Neuroimaging Research Branch, National Institute on Drug Abuse, Intramural Research Program, National Institutes of Health, Baltimore, MD, USA
| | - Bryon Adinoff
- VA North Texas Health Care System, Dallas, TX, USA.,Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Elliot A Stein
- Neuroimaging Research Branch, National Institute on Drug Abuse, Intramural Research Program, National Institutes of Health, Baltimore, MD, USA
| | - Yihong Yang
- Neuroimaging Research Branch, National Institute on Drug Abuse, Intramural Research Program, National Institutes of Health, Baltimore, MD, USA
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Hanlon CA, Dowdle LT, Correia B, Mithoefer O, Kearney-Ramos T, Lench D, Griffin M, Anton RF, George MS. Left frontal pole theta burst stimulation decreases orbitofrontal and insula activity in cocaine users and alcohol users. Drug Alcohol Depend 2017; 178:310-317. [PMID: 28686990 PMCID: PMC5896018 DOI: 10.1016/j.drugalcdep.2017.03.039] [Citation(s) in RCA: 84] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Revised: 03/19/2017] [Accepted: 03/20/2017] [Indexed: 12/21/2022]
Abstract
BACKGROUND Preclinical research has demonstrated a causal relationship between medial prefrontal cortex activity and cocaine self-administration. As a step towards translating those data to a neural circuit-based intervention for patients, this study sought to determine if continuous theta burst stimulation (cTBS) to the left frontal pole (FP), would attenuate frontal-striatal activity in two substance-dependent populations. METHODS Forty-nine substance dependent individuals (25 cocaine, 24 alcohol) completed a single-blind, sham-controlled, crossover study wherein they received 6 trains of real or sham cTBS (110% resting motor threshold, FP1) each visit. Baseline evoked BOLD signal was measured immediately before and after real and sham cTBS (interleaved TMS/BOLD imaging: single pulses to left FP; scalp-to-cortex distance covariate, FWE correction p<0.05) RESULTS: Among cocaine users, real cTBS significantly decreased evoked BOLD signal in the caudate, accumbens, anterior cingulate, orbitofrontal (OFC) and parietal cortex relative to sham cTBS. Among alcohol users, real cTBS significantly decreased evoked BOLD signal in left OFC, insula, and lateral sensorimotor cortex. There was no significant difference between the groups. CONCLUSIONS These data suggest that 6 trains of left FP cTBS delivered in a single day decreases TMS-evoked BOLD signal in the OFC and several cortical nodes which regulate salience and are typically activated by drug cues. The reliability of this pattern across cocaine- and alcohol-dependent individuals suggests that cTBS may be an effective tool to dampen neural circuits typically engaged by salient drug cues. Multiday studies are required to determine it this has a sustainable effect on the brain or drug use behavior.
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Affiliation(s)
- Colleen A Hanlon
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, United States; Department of Neurosciences, Medical University of South Carolina, United States; Center for Biomedical Imaging, Medical University of South Carolina, United States.
| | - Logan T Dowdle
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, United States; Department of Neurosciences, Medical University of South Carolina, United States
| | | | - Oliver Mithoefer
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, United States
| | - Tonisha Kearney-Ramos
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, United States; Department of Neurosciences, Medical University of South Carolina, United States
| | - Daniel Lench
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, United States; Department of Neurosciences, Medical University of South Carolina, United States
| | - Millie Griffin
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, United States; Department of Neurosciences, Medical University of South Carolina, United States
| | - Raymond F Anton
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, United States; Department of Neurosciences, Medical University of South Carolina, United States; Center for Biomedical Imaging, Medical University of South Carolina, United States
| | - Mark S George
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, United States; Department of Neurosciences, Medical University of South Carolina, United States; Center for Biomedical Imaging, Medical University of South Carolina, United States; Ralph H Johnson Veterans Affairs Medical Center, United States
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Forster SE, Finn PR, Brown JW. Neural responses to negative outcomes predict success in community-based substance use treatment. Addiction 2017; 112:884-896. [PMID: 28029198 PMCID: PMC5382058 DOI: 10.1111/add.13734] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2016] [Revised: 07/25/2016] [Accepted: 12/22/2016] [Indexed: 12/29/2022]
Abstract
BACKGROUND AND AIMS Patterns of brain activation have demonstrated promise as prognostic indicators in substance dependent individuals (SDIs) but have not yet been explored in SDIs typical of community-based treatment settings. DESIGN Prospective clinical outcome design, evaluating baseline functional magnetic resonance imaging data from the Balloon Analogue Risk Task (BART) as a predictor of 3-month substance use treatment outcomes. SETTING Community-based substance use programs in Bloomington, Indiana, USA. PARTICIPANTS Twenty-three SDIs (17 male, aged 18-43 years) in an intensive outpatient or residential treatment program; abstinent 1-4 weeks at baseline. MEASUREMENTS Event-related brain response, BART performance and self-report scores at treatment onset, substance use outcome measure (based on days of use). FINDINGS Using voxel-level predictive modeling and leave-one-out cross-validation, an elevated response to unexpected negative feedback in bilateral amygdala and anterior hippocampus (Amyg/aHipp) at baseline successfully predicted greater substance use during the 3-month study interval (P ≤ 0.006, cluster-corrected). This effect was robust to inclusion of significant non-brain-based covariates. A larger response to negative feedback in bilateral Amyg/aHipp was also associated with faster reward-seeking responses after negative feedback (r(23) = -0.544, P = 0.007; r(23) = -0.588, P = 0.003). A model including Amyg/aHipp activation, faster reward-seeking after negative feedback and significant self-report scores accounted for 45% of the variance in substance use outcomes in our sample. CONCLUSIONS An elevated response to unexpected negative feedback in bilateral amygdala and anterior hippocampus (Amyg/aHipp) appears to predict relapse to substance use in people attending community-based treatment.
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Affiliation(s)
- Sarah E. Forster
- Indiana University, Department of Psychological and Brain Sciences,VA Pittsburgh Healthcare System,University of Pittsburgh, Department of Psychiatry
| | - Peter R. Finn
- Indiana University, Department of Psychological and Brain Sciences
| | - Joshua W. Brown
- Indiana University, Department of Psychological and Brain Sciences
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Adinoff B, Harris TS, Gu H, Stein EA. Posterior hippocampal regional cerebral blood flow predicts abstinence: a replication study. Addict Biol 2017; 22:857-863. [PMID: 26767350 DOI: 10.1111/adb.12361] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Revised: 11/05/2015] [Accepted: 12/05/2015] [Indexed: 12/15/2022]
Abstract
The posterior hippocampus (pHp) plays a major role in the processing and storage of drug-related cues and is linked to striatal-limbic brain circuits involved with craving and drug salience. We have recently reported that increased basal regional cerebral blood flow (rCBF) in a pHp loci, as measured by pseudo-continuous arterial spin labeling magnetic resonance imaging, predicted days to cocaine relapse following residential treatment. In this secondary analysis, we explored whether rCBF in this same pHp region would successfully predict 30-day point prevalence abstinence 60 days following residential treatment in an independent group of previously studied participants with cocaine dependence. rCBF was assessed with single photon emission computerized tomography during a saline infusion in 21 cocaine dependence and 22 healthy control participants. pHp rCBF was significantly higher in those endorsing substance use (n = 10) relative to both abstinent (n = 11) (p < 0.001) and control (p < 0.05) participants. There were no significant differences in measured demographic or clinical variables between the actively using and non-using participants. This replicative finding suggests that heightened pHp activation is a significant predictor of substance use in cocaine-dependent individuals, possibly reflecting a neural susceptibility to continued drug cues.
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Affiliation(s)
- Bryon Adinoff
- VA North Texas Health Care System; Dallas TX USA
- Department of Psychiatry; UT Southwestern Medical Center; Dallas TX USA
| | - Thomas S. Harris
- Department of Neurology; UT Southwestern Medical Center; Dallas TX USA
| | - Hong Gu
- Intramural Research Program-Neuroimaging Research Branch; National Institute on Drug Abuse; Baltimore MD USA
| | - Elliot A. Stein
- Intramural Research Program-Neuroimaging Research Branch; National Institute on Drug Abuse; Baltimore MD USA
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Shen Z, Huang P, Wang C, Qian W, Yang Y, Zhang M. Increased network centrality as markers of relapse risk in nicotine-dependent individuals treated with varenicline. Prog Neuropsychopharmacol Biol Psychiatry 2017; 75:142-147. [PMID: 28185963 DOI: 10.1016/j.pnpbp.2017.02.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Revised: 10/19/2016] [Accepted: 02/03/2017] [Indexed: 02/01/2023]
Abstract
Identifying smokers at high risk of relapse could improve the effectiveness of cessation therapies. Although altered regional brain function in smokers has been reported, whether the whole-brain functional organization differs smokers with relapse vulnerability from others remains unclear. Thus, the goal of this study is to investigate the baseline functional connectivity differences between relapsers and quitters. Using resting-state fMRI, we acquired images from 57 smokers prior to quitting attempts. After 12-week treatment with varenicline, smokers were divided into relapsers (n=36) and quitters (n=21) (quitter: continuously abstinent for weeks 9-12). The smoking cessation outcomes were cross-validated by self-reports and expired carbon monoxide. We then used eigenvector centrality (EC) mapping to identify the functional connectivity differences between relapsers and quitters. When compared to quitters, increased EC in the right dorsolateral prefrontal cortex (DLPFC), left middle temporal gyrus (MTG) and cerebellum anterior lobe was observed in relapsers. In addition, a logistic regression analysis of EC data (with DLPFC, MTG and cerebellum included) predicted relapse with 80.7% accuracy. These findings suggest that the DLPFC, MTG and cerebellum may be important substrates of smoking relapse vulnerability. The data also suggest that relapse-vulnerable smokers can be identified before quit attempts, which could enable personalized treatment and improve smoking cessation outcomes.
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Affiliation(s)
- Zhujing Shen
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Peiyu Huang
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Chao Wang
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Wei Qian
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yihong Yang
- Neuroimaging Research Branch, National Institute on Drug Abuse, National Institutes of Health, Baltimore, MD, United States
| | - Minming Zhang
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
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Back SE, McCauley JL, Korte KJ, Gros DF, Leavitt V, Gray KM, Hamner MB, DeSantis SM, Malcolm R, Brady KT, Kalivas PW. A Double-Blind, Randomized, Controlled Pilot Trial of N-Acetylcysteine in Veterans With Posttraumatic Stress Disorder and Substance Use Disorders. J Clin Psychiatry 2016; 77:e1439-e1446. [PMID: 27736051 PMCID: PMC5226873 DOI: 10.4088/jcp.15m10239] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Accepted: 04/20/2016] [Indexed: 10/20/2022]
Abstract
OBJECTIVE The antioxidant N-acetylcysteine is being increasingly investigated as a therapeutic agent in the treatment of substance use disorders (SUDs). This study explored the efficacy of N-acetylcysteine in the treatment of posttraumatic stress disorder (PTSD), which frequently co-occurs with SUD and shares impaired prefrontal cortex regulation of basal ganglia circuitry, in particular at glutamate synapses in the nucleus accumbens. METHODS Veterans with PTSD and SUD per DSM-IV criteria (N = 35) were randomly assigned to receive a double-blind, 8-week course of N-acetylcysteine (2,400 mg/d) or placebo plus cognitive-behavioral therapy for SUD (between March 2013 and April 2014). Primary outcome measures included PTSD symptoms (Clinician-Administered PTSD Scale, PTSD Checklist-Military) and craving (Visual Analog Scale). Substance use and depression were also assessed. RESULTS Participants treated with N-acetylcysteine compared to placebo evidenced significant improvements in PTSD symptoms, craving, and depression (β values < -0.33; P values < .05). Substance use was low for both groups, and no significant between-group differences were observed. N-acetylcysteine was well tolerated, and retention was high. CONCLUSIONS This is the first randomized controlled trial to investigate N-acetylcysteine as a pharmacologic treatment for PTSD and SUD. Although preliminary, the findings provide initial support for the use of N-acetylcysteine in combination with psychotherapy among individuals with co-occurring PTSD and SUD. TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT02499029.
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Affiliation(s)
- Sudie E. Back
- Medical University of South Carolina, Charleston, SC,Ralph H. Johnson Veterans Affairs Medical Center, Charleston, SC
| | | | - Kristina J. Korte
- Medical University of South Carolina, Charleston, SC,Ralph H. Johnson Veterans Affairs Medical Center, Charleston, SC
| | - Daniel F. Gros
- Medical University of South Carolina, Charleston, SC,Ralph H. Johnson Veterans Affairs Medical Center, Charleston, SC
| | | | - Kevin M. Gray
- Medical University of South Carolina, Charleston, SC
| | - Mark B. Hamner
- Medical University of South Carolina, Charleston, SC,Ralph H. Johnson Veterans Affairs Medical Center, Charleston, SC
| | | | - Robert Malcolm
- Medical University of South Carolina, Charleston, SC,Ralph H. Johnson Veterans Affairs Medical Center, Charleston, SC
| | - Kathleen T. Brady
- Medical University of South Carolina, Charleston, SC,Ralph H. Johnson Veterans Affairs Medical Center, Charleston, SC
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Regner MF, Saenz N, Maharajh K, Yamamoto DJ, Mohl B, Wylie K, Tregellas J, Tanabe J. Top-Down Network Effective Connectivity in Abstinent Substance Dependent Individuals. PLoS One 2016; 11:e0164818. [PMID: 27776135 PMCID: PMC5077096 DOI: 10.1371/journal.pone.0164818] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Accepted: 09/30/2016] [Indexed: 01/25/2023] Open
Abstract
Objective We hypothesized that compared to healthy controls, long-term abstinent substance dependent individuals (SDI) will differ in their effective connectivity between large-scale brain networks and demonstrate increased directional information from executive control to interoception-, reward-, and habit-related networks. In addition, using graph theory to compare network efficiencies we predicted decreased small-worldness in SDI compared to controls. Methods 50 SDI and 50 controls of similar sex and age completed psychological surveys and resting state fMRI. fMRI results were analyzed using group independent component analysis; 14 networks-of-interest (NOI) were selected using template matching to a canonical set of resting state networks. The number, direction, and strength of connections between NOI were analyzed with Granger Causality. Within-group thresholds were p<0.005 using a bootstrap permutation. Between group thresholds were p<0.05, FDR-corrected for multiple comparisons. NOI were correlated with behavioral measures, and group-level graph theory measures were compared. Results Compared to controls, SDI showed significantly greater Granger causal connectivity from right executive control network (RECN) to dorsal default mode network (dDMN) and from dDMN to basal ganglia network (BGN). RECN was negatively correlated with impulsivity, behavioral approach, and negative affect; dDMN was positively correlated with impulsivity. Among the 14 NOI, SDI showed greater bidirectional connectivity; controls showed more unidirectional connectivity. SDI demonstrated greater global efficiency and lower local efficiency. Conclusions Increased effective connectivity in long-term abstinent drug users may reflect improved cognitive control over habit and reward processes. Higher global and lower local efficiency across all networks in SDI compared to controls may reflect connectivity changes associated with drug dependence or remission and requires future, longitudinal studies to confirm.
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Affiliation(s)
- Michael F. Regner
- Department of Radiology, University of Colorado School of Medicine, Aurora, CO, 80045, United States of America
- Department of Bioengineering, University of Colorado College of Engineering and Applied Sciences, Aurora, CO, 80045, United States of America
- * E-mail:
| | - Naomi Saenz
- Department of Radiology, University of Colorado School of Medicine, Aurora, CO, 80045, United States of America
| | - Keeran Maharajh
- Department of Psychiatry, University of Colorado School of Medicine, Aurora, CO, 80045, United States of America
| | - Dorothy J. Yamamoto
- Department of Radiology, University of Colorado School of Medicine, Aurora, CO, 80045, United States of America
| | - Brianne Mohl
- Department of Radiology, University of Colorado School of Medicine, Aurora, CO, 80045, United States of America
| | - Korey Wylie
- Department of Psychiatry, University of Colorado School of Medicine, Aurora, CO, 80045, United States of America
| | - Jason Tregellas
- Department of Psychiatry, University of Colorado School of Medicine, Aurora, CO, 80045, United States of America
| | - Jody Tanabe
- Department of Radiology, University of Colorado School of Medicine, Aurora, CO, 80045, United States of America
- Department of Psychiatry, University of Colorado School of Medicine, Aurora, CO, 80045, United States of America
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Colon-Perez LM, Tran K, Thompson K, Pace MC, Blum K, Goldberger BA, Gold MS, Bruijnzeel AW, Setlow B, Febo M. The Psychoactive Designer Drug and Bath Salt Constituent MDPV Causes Widespread Disruption of Brain Functional Connectivity. Neuropsychopharmacology 2016; 41:2352-65. [PMID: 26997298 PMCID: PMC4946066 DOI: 10.1038/npp.2016.40] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Revised: 03/11/2016] [Accepted: 03/16/2016] [Indexed: 01/16/2023]
Abstract
The abuse of 'bath salts' has raised concerns because of their adverse effects, which include delirium, violent behavior, and suicide ideation in severe cases. The bath salt constituent 3,4-methylenedioxypyrovalerone (MDPV) has been closely linked to these and other adverse effects. The abnormal behavioral pattern produced by acute high-dose MDPV intake suggests possible disruptions of neural communication between brain regions. Therefore, we determined if MDPV exerts disruptive effects on brain functional connectivity, particularly in areas of the prefrontal cortex. Male rats were imaged following administration of a single dose of MDPV (0.3, 1.0, or 3.0 mg/kg) or saline. Resting state brain blood oxygenation level-dependent (BOLD) images were acquired at 4.7 T. To determine the role of dopamine transmission in MDPV-induced changes in functional connectivity, a group of rats received the dopamine D1/D2 receptor antagonist cis-flupenthixol (0.5 mg/kg) 30 min before MDPV. MDPV dose-dependently reduced functional connectivity. Detailed analysis of its effects revealed that connectivity between frontal cortical and striatal areas was reduced. This included connectivity between the prelimbic prefrontal cortex and other areas of the frontal cortex and the insular cortex with hypothalamic, ventral, and dorsal striatal areas. Although the reduced connectivity appeared widespread, connectivity between these regions and somatosensory cortex was not as severely affected. Dopamine receptor blockade did not prevent the MDPV-induced decrease in functional connectivity. The results provide a novel signature of MDPV's in vivo mechanism of action. Reduced brain functional connectivity has been reported in patients suffering from psychosis and has been linked to cognitive dysfunction, audiovisual hallucinations, and negative affective states akin to those reported for MDPV-induced intoxication. The present results suggest that disruption of functional connectivity networks involving frontal cortical and striatal regions could contribute to the adverse effects of MDPV.
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Affiliation(s)
- Luis M Colon-Perez
- Department of Psychiatry, McKnight Brain Institute, University of Florida, Gainesville, FL, USA,Center for Addiction Research and Education, University of Florida, Gainesville, FL, USA
| | - Kelvin Tran
- Department of Psychiatry, McKnight Brain Institute, University of Florida, Gainesville, FL, USA
| | - Khalil Thompson
- Department of Psychiatry, McKnight Brain Institute, University of Florida, Gainesville, FL, USA
| | - Michael C Pace
- Department of Neuroscience, McKnight Brain Institute, University of Florida, Gainesville, FL, USA
| | - Kenneth Blum
- Department of Psychiatry, McKnight Brain Institute, University of Florida, Gainesville, FL, USA
| | - Bruce A Goldberger
- Department of Psychiatry, McKnight Brain Institute, University of Florida, Gainesville, FL, USA,Departments of Pathology, Immunology, and Laboratory Medicine, University of Florida, Gainesville, FL, USA,William R Maples Center for Forensic Medicine, University of Florida, Gainesville, FL, USA
| | - Mark S Gold
- Department of Psychiatry, McKnight Brain Institute, University of Florida, Gainesville, FL, USA,Department of Neuroscience, McKnight Brain Institute, University of Florida, Gainesville, FL, USA
| | - Adriaan W Bruijnzeel
- Department of Psychiatry, McKnight Brain Institute, University of Florida, Gainesville, FL, USA,Center for Addiction Research and Education, University of Florida, Gainesville, FL, USA,Department of Neuroscience, McKnight Brain Institute, University of Florida, Gainesville, FL, USA
| | - Barry Setlow
- Department of Psychiatry, McKnight Brain Institute, University of Florida, Gainesville, FL, USA,Center for Addiction Research and Education, University of Florida, Gainesville, FL, USA,Department of Neuroscience, McKnight Brain Institute, University of Florida, Gainesville, FL, USA
| | - Marcelo Febo
- Department of Psychiatry, McKnight Brain Institute, University of Florida, Gainesville, FL, USA,Center for Addiction Research and Education, University of Florida, Gainesville, FL, USA,Department of Neuroscience, McKnight Brain Institute, University of Florida, Gainesville, FL, USA,Department of Psychiatry, University of Florida Brain Institute, PO Box 100256, Gainesville, FL 32610, USA, Tel: +1 352 294 4911, Fax: +1 352 392 8217, E-mail:
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Hanlon CA, Dowdle LT, Jones JL. Biomarkers for Success: Using Neuroimaging to Predict Relapse and Develop Brain Stimulation Treatments for Cocaine-Dependent Individuals. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2016; 129:125-56. [PMID: 27503451 DOI: 10.1016/bs.irn.2016.06.006] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Cocaine dependence is one of the most difficult substance use disorders to treat. While the powerful effects of cocaine use on behavior were documented in the 19th century, it was not until the late 20th century that we realized cocaine use was affecting brain tissue and function. Following a brief introduction (Section 1), this chapter will summarize our current knowledge regarding alterations in neural circuit function typically observed in chronic cocaine users (Section 2) and highlight an emerging body of literature which suggests that pretreatment limbic circuit activity may be a reliable predictor of clinical outcomes among individuals seeking treatment for cocaine (Section 3). Finally, as the field of addiction research strives to translate this neuroimaging data into something clinically meaningful, we will highlight several new brain stimulation approaches which utilize functional brain imaging data to design noninvasive brain stimulation interventions for individuals seeking treatment for substance dependence disorders (Section 4).
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Affiliation(s)
- C A Hanlon
- Medical University of South Carolina, Charleston, SC, United States.
| | - L T Dowdle
- Medical University of South Carolina, Charleston, SC, United States
| | - J L Jones
- Medical University of South Carolina, Charleston, SC, United States
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Abstract
Impaired emotion regulation contributes to the development and severity of substance use disorders (substance disorders). This review summarizes the literature on alterations in emotion regulation neural circuitry in substance disorders, particularly in relation to disorders of negative affect (without substance disorder), and it presents promising areas of future research. Emotion regulation paradigms during functional magnetic resonance imaging are conceptualized into four dimensions: affect intensity and reactivity, affective modulation, cognitive modulation, and behavioral control. The neural circuitry associated with impaired emotion regulation is compared in individuals with and without substance disorders, with a focus on amygdala, insula, and prefrontal cortex activation and their functional and structural connectivity. Hypoactivation of the rostral anterior cingulate cortex/ventromedial prefrontal cortex (rACC/vmPFC) is the most consistent finding across studies, dimensions, and clinical populations (individuals with and without substance disorders). The same pattern is evident for regions in the cognitive control network (anterior cingulate and dorsal and ventrolateral prefrontal cortices) during cognitive modulation and behavioral control. These congruent findings are possibly related to attenuated functional and/or structural connectivity between the amygdala and insula and between the rACC/vmPFC and cognitive control network. Although increased amygdala and insula activation is associated with impaired emotion regulation in individuals without substance disorders, it is not consistently observed in substance disorders. Emotion regulation disturbances in substance disorders may therefore stem from impairments in prefrontal functioning, rather than excessive reactivity to emotional stimuli. Treatments for emotion regulation in individuals without substance disorders that normalize prefrontal functioning may offer greater efficacy for substance disorders than treatments that dampen reactivity.
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Moeller SJ, London ED, Northoff G. Neuroimaging markers of glutamatergic and GABAergic systems in drug addiction: Relationships to resting-state functional connectivity. Neurosci Biobehav Rev 2016; 61:35-52. [PMID: 26657968 PMCID: PMC4731270 DOI: 10.1016/j.neubiorev.2015.11.010] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Revised: 11/05/2015] [Accepted: 11/21/2015] [Indexed: 12/29/2022]
Abstract
Drug addiction is characterized by widespread abnormalities in brain function and neurochemistry, including drug-associated effects on concentrations of the excitatory and inhibitory neurotransmitters glutamate and gamma-aminobutyric acid (GABA), respectively. In healthy individuals, these neurotransmitters drive the resting state, a default condition of brain function also disrupted in addiction. Here, our primary goal was to review in vivo magnetic resonance spectroscopy and positron emission tomography studies that examined markers of glutamate and GABA abnormalities in human drug addiction. Addicted individuals tended to show decreases in these markers compared with healthy controls, but findings also varied by individual characteristics (e.g., abstinence length). Interestingly, select corticolimbic brain regions showing glutamatergic and/or GABAergic abnormalities have been similarly implicated in resting-state functional connectivity deficits in drug addiction. Thus, our secondary goals were to provide a brief review of this resting-state literature, and an initial rationale for the hypothesis that abnormalities in glutamatergic and/or GABAergic neurotransmission may underlie resting-state functional deficits in drug addiction. In doing so, we suggest future research directions and possible treatment implications.
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Affiliation(s)
- Scott J Moeller
- Departments of Psychiatry and Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA.
| | - Edythe D London
- Departments of Psychiatry and Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Departments of Psychiatry and Biobehavioral Sciences, and Molecular and Medical Pharmacology, University of California Los Angeles, Los Angeles, CA, USA
| | - Georg Northoff
- Brain Imaging and Neuroethics Research Unit, Institute of Mental Health Research, Ottawa, Canada.
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Resting state functional connectivity analysis for addiction medicine. PROGRESS IN BRAIN RESEARCH 2016; 224:155-73. [DOI: 10.1016/bs.pbr.2015.07.015] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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Ma L, Steinberg JL, Moeller FG, Johns SE, Narayana PA. Effect of cocaine dependence on brain connections: clinical implications. Expert Rev Neurother 2015; 15:1307-19. [PMID: 26512421 DOI: 10.1586/14737175.2015.1103183] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Cocaine dependence (CD) is associated with several cognitive deficits. Accumulating evidence, based on human and animal studies, has led to models for interpreting the neural basis of cognitive functions as interactions between functionally related brain regions. In this review, we focus on magnetic resonance imaging (MRI) studies using brain connectivity techniques as related to CD. The majority of these brain connectivity studies indicated that cocaine use is associated with altered brain connectivity between different structures, including cortical-striatal regions and default mode network. In cocaine users some of the altered brain connectivity measures are associated with behavioral performance, history of drug use, and treatment outcome. The implications of these brain connectivity findings to the treatment of CD and the pros and cons of the major brain connectivity techniques are discussed. Finally potential future directions in cocaine use disorder research using brain connectivity techniques are briefly described.
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Affiliation(s)
- Liangsuo Ma
- a Institute for Drug and Alcohol Studies , Virginia Commonwealth University (VCU) , Richmond , VA , USA.,b Department of Radiology , VCU , Richmond , VA , USA
| | - Joel L Steinberg
- a Institute for Drug and Alcohol Studies , Virginia Commonwealth University (VCU) , Richmond , VA , USA.,c Department of Psychiatry , VCU , Richmond , VA , USA
| | - F Gerard Moeller
- a Institute for Drug and Alcohol Studies , Virginia Commonwealth University (VCU) , Richmond , VA , USA.,c Department of Psychiatry , VCU , Richmond , VA , USA.,d Department of Pharmacology and Toxicology , VCU , Richmond , VA , USA.,e Department of Neurology , VCU , Richmond , VA , USA
| | - Sade E Johns
- a Institute for Drug and Alcohol Studies , Virginia Commonwealth University (VCU) , Richmond , VA , USA.,c Department of Psychiatry , VCU , Richmond , VA , USA
| | - Ponnada A Narayana
- f Department of Diagnostic and Interventional Imaging , University of Texas Health Science Center at Houston (UTHealth) , Houston , TX , USA
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Adinoff B, Gu H, Merrick C, McHugh M, Jeon-Slaughter H, Lu H, Yang Y, Stein EA. Basal Hippocampal Activity and Its Functional Connectivity Predicts Cocaine Relapse. Biol Psychiatry 2015; 78:496-504. [PMID: 25749098 PMCID: PMC5671769 DOI: 10.1016/j.biopsych.2014.12.027] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2014] [Revised: 12/18/2014] [Accepted: 12/22/2014] [Indexed: 11/19/2022]
Abstract
BACKGROUND Cocaine-induced neuroplastic changes may result in a heightened propensity for relapse. Using regional cerebral blood flow (rCBF) as a marker of basal neuronal activity, this study assessed alterations in rCBF and related resting state functional connectivity (rsFC) to prospectively predict relapse in patients following treatment for cocaine use disorder (CUD). METHODS Pseudocontinuous arterial spin labeling functional magnetic resonance imaging and resting blood oxygen level-dependent functional magnetic resonance imaging data were acquired in the same scan session in abstinent participants with CUD before residential treatment discharge and in 20 healthy matched control subjects. Substance use was assessed twice weekly following discharge. Relapsed participants were defined as those who used stimulants within 30 days following treatment discharge (n = 22); early remission participants (n = 18) did not. RESULTS Voxel-wise, whole-brain analysis revealed enhanced rCBF only in the left posterior hippocampus (pHp) in the relapsed group compared with the early remission and control groups. Using this pHp as a seed, increased rsFC strength with the posterior cingulate cortex (PCC)/precuneus was seen in the relapsed versus early remission subgroups. Together, both increased pHp rCBF and strengthened pHp-PCC rsFC predicted relapse with 75% accuracy at 30, 60, and 90 days following treatment. CONCLUSIONS In CUD participants at risk of early relapse, increased pHp basal activity and pHp-PCC circuit strength may reflect the propensity for heightened reactivity to cocaine cues and persistent cocaine-related ruminations. Mechanisms to mute hyperactivated brain regions and delink dysregulated neural circuits may prove useful to prevent relapse in patients with CUD.
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Affiliation(s)
- Bryon Adinoff
- Veterans Affairs North Texas Health Care System, University of Texas Southwestern Medical Center, Dallas, Texas; Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, Texas.
| | - Hong Gu
- Intramural Research Program-Neuroimaging Research Branch, National Institute on Drug Abuse, Baltimore, Maryland
| | - Carmen Merrick
- School of Behavior and Brain Sciences, University of Texas at Dallas
| | - Meredith McHugh
- Intramural Research Program-Neuroimaging Research Branch, National Institute on Drug Abuse, Baltimore, Maryland
| | | | - Hanzhang Lu
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, Texas; Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Yihong Yang
- Intramural Research Program-Neuroimaging Research Branch, National Institute on Drug Abuse, Baltimore, Maryland
| | - Elliot A Stein
- Intramural Research Program-Neuroimaging Research Branch, National Institute on Drug Abuse, Baltimore, Maryland
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Moeller SJ, Stoops WW. Cocaine choice procedures in animals, humans, and treatment-seekers: Can we bridge the divide? Pharmacol Biochem Behav 2015; 138:133-41. [PMID: 26432174 DOI: 10.1016/j.pbb.2015.09.020] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2015] [Revised: 09/22/2015] [Accepted: 09/27/2015] [Indexed: 10/23/2022]
Abstract
Individuals with cocaine use disorder chronically self-administer cocaine to the detriment of other rewarding activities, a phenomenon best modeled in laboratory drug-choice procedures. These procedures can evaluate the reinforcing effects of drugs versus comparably valuable alternatives under multiple behavioral arrangements and schedules of reinforcement. However, assessing drug-choice in treatment-seeking or abstaining humans poses unique challenges: for ethical reasons, these populations typically cannot receive active drugs during research studies. Researchers have thus needed to rely on alternative approaches that approximate drug-choice behavior or assess more general forms of decision-making, but whether these alternatives have relevance to real-world drug-taking that can inform clinical trials is not well-understood. In this mini-review, we (A) summarize several important modulatory variables that influence cocaine choice in nonhuman animals and non-treatment seeking humans; (B) discuss some of the ethical considerations that could arise if treatment-seekers are enrolled in drug-choice studies; (C) consider the efficacy of alternative procedures, including non-drug-related decision-making and 'simulated' drug-choice (a choice is made, but no drug is administered) to approximate drug choice; and (D) suggest opportunities for new translational work to bridge the current divide between preclinical and clinical research.
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Affiliation(s)
- Scott J Moeller
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United States; Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, United States.
| | - William W Stoops
- Department of Behavioral Science and Center on Drug and Alcohol Research, University of Kentucky College of Medicine, Lexington, KY, United States; Department of Psychiatry, University of Kentucky College of Medicine, Lexington, KY, United States; Department of Psychology, University of Kentucky College of Arts and Sciences, Lexington, KY, United States.
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Interactions between the salience and default-mode networks are disrupted in cocaine addiction. J Neurosci 2015; 35:8081-90. [PMID: 26019326 DOI: 10.1523/jneurosci.3188-14.2015] [Citation(s) in RCA: 79] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Cocaine dependence is a complex neuropsychiatric disorder manifested as dysregulation of multiple behavioral, emotional, and cognitive constructs. Neuroimaging studies have begun to identify specific neurobiological circuit impairments in cocaine-dependent (CD) individuals that may underlie these symptoms. However, whether, where, and how the interactions within and between these circuits are disrupted remain largely unknown. We used resting-state fMRI and modularity network analysis to identify brain modules of a priori interest (default-mode network [DMN], salience network [SN], executive control network [ECN], medial temporal lobe [MTL], and striatum) in 47 CD and 47 matched healthy control (HC) participants and explored alterations within and between these brain modules as a function of addiction. At the module level, intermodule connectivity decreased between DMN and SN in CD. At the nodal level, several regions showed decreased connections with multiple modules in CD: the rostral anterior cingulate connection strength was reduced with SN and MTL; the posterior cingulate had reduced connections with ECN; and the bilateral insula demonstrated decreased connections with DMN. Furthermore, alexithymia, a personality trait previously associated with addiction, correlated negatively with intramodule connectivity within SN only in cocaine users. Our results indicate that cocaine addiction is associated with disrupted interactions among DMN, MTL, and SN, which have been implicated, respectively, in self-referential functions, emotion and memory, and coordinating between internal and external stimuli, providing novel and important insights into the neurobiological mechanisms of cocaine addiction.
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Ray S, Gohel S, Biswal BB. Altered Functional Connectivity Strength in Abstinent Chronic Cocaine Smokers Compared to Healthy Controls. Brain Connect 2015; 5:476-86. [PMID: 26005203 DOI: 10.1089/brain.2014.0240] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Past research involving cocaine and resting-state functional connectivity (RSFC) has shown altered functional connectivity within the frontal and between the frontal and other cortical and subcortical brain regions in chronic users of cocaine. However, there have been discrepancies in literature regarding the relationship between RSFC between brain regions and cocaine use behavior. This study explored the RSFC between brain regions in cocaine smokers abstinent from cocaine use for 72 h and healthy controls. Also, the relationship between RSFC between brain regions and various cocaine use measures (cocaine use duration; frequency, and money spent on cocaine/week) was examined. Twenty chronic cocaine users and 17 controls completed a resting-state scan and an anatomical MPRAGE scan. Group independent component analysis performed on functional magnetic resonance imaging data identified 13 ICs pertaining to distinct resting-state networks, and group-level differences were examined. To examine inter-network functional connectivity between brain regions, these 13 ICs were divided into 61 distinct regions of interest (ROIs). Correlations were calculated between 61 ROI time series. For the ROI pairs that significantly differed from controls in connectivity strength, correlations were computed between connectivity strength and cocaine use measures. Results showed an enhanced RSFC within the sensory motor cortex and the left frontal-parietal network in cocaine users than controls. An increased inter-network RSFC between frontal-temporal and frontal-parietal brain regions, and a decreased RSFC between parietal-parietal, occipital-limbic, occipital-occipital, and occipital-parietal brain regions was found in cocaine users. This study demonstrated that intra-network connectivity strength of sensory motor cortex was negatively correlated with years of cocaine use. Inter-network connectivity strength between occipital-limbic brain regions was positively correlated with years of cocaine use, while connectivity strength within occipital brain regions was negatively related to cocaine use frequency and money spent on cocaine per week in abstinent cocaine users.
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Affiliation(s)
- Suchismita Ray
- 1 Center of Alcohol Studies, Rutgers University , Piscataway, New Jersey
| | - Suril Gohel
- 2 New Jersey Institute of Technology , Newark, New Jersey
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Blum K, Thanos PK, Badgaiyan RD, Febo M, Oscar-Berman M, Fratantonio J, Demotrovics Z, Gold MS. Neurogenetics and gene therapy for reward deficiency syndrome: are we going to the Promised Land? Expert Opin Biol Ther 2015; 15:973-85. [PMID: 25974314 DOI: 10.1517/14712598.2015.1045871] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
INTRODUCTION Addiction is a substantial health issue with limited treatment options approved by the FDA and as such currently available. The advent of neuroimaging techniques that link neurochemical and neurogenetic mechanisms to the reward circuitry brain function provides a framework for potential genomic-based therapies. AREAS COVERED Through candidate and genome-wide association studies approaches, many gene polymorphisms and clusters have been implicated in drug, food and behavioral dependence linked by the common rubric reward deficiency syndrome (RDS). The results of selective studies that include the role of epigenetics, noncoding micro RNAs in RDS behaviors especially drug abuse involving alcohol, opioids, cocaine, nicotine, pain and feeding are reviewed in this article. New targets for addiction treatment and relapse prevention, treatment alternatives such as gene therapy in animal models, and pharmacogenomics and nutrigenomics methods to manipulate transcription and gene expression are explored. EXPERT OPINION The recognition of the clinical benefit of early genetic testing to determine addiction risk stratification and dopaminergic agonistic, rather than antagonistic therapies are potentially the genomic-based wave of the future. In addition, further development, especially in gene transfer work and viral vector identification, could make gene therapy for RDS a possibility in the future.
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Affiliation(s)
- Kenneth Blum
- Department of Psychiatry & McKnight Brain Institute, University of Florida College of Medicine , Gainesville, FL , USA
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Abstract
The prevention and treatment of substance use disorders (SUDs), including addiction, would benefit from having better biomarkers for the classification of patients into categories that are reproducible and have predictive validity. Direct measurement of drugs or their metabolites in various body fluids constitutes a clinically valuable biomarker but one that can only be used to corroborate acute or relatively recent drug use. Thus, there is an urgent need for biomarkers that reflect chronic drug exposure as well as biomarkers that predict or correlate with disease trajectories and treatment responses. Advances in tools and technologies to investigate genetics, epigenetics and epitranscriptomics, and human brain function and neurochemistry (brain imaging tools including EEG) offer unprecedented opportunities for the development of such biomarkers. Progress in this area will not only enhance our ability to screen and treat patients with SUDs but also accelerate research on the neurobiological processes that underlie SUDs.
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Affiliation(s)
- Nora D Volkow
- National Institute on Drug Abuse and ‡National Institute of Alcohol Abuse
and Alcoholism, National Institutes of Health, Bethesda, Maryland 20892, United States
| | - George Koob
- National Institute on Drug Abuse and ‡National Institute of Alcohol Abuse
and Alcoholism, National Institutes of Health, Bethesda, Maryland 20892, United States
| | - Ruben Baler
- National Institute on Drug Abuse and ‡National Institute of Alcohol Abuse
and Alcoholism, National Institutes of Health, Bethesda, Maryland 20892, United States
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Ma L, Steinberg JL, Cunningham KA, Lane SD, Bjork JM, Neelakantan H, Price AE, Narayana PA, Kosten TR, Bechara A, Moeller FG. Inhibitory behavioral control: A stochastic dynamic causal modeling study comparing cocaine dependent subjects and controls. NEUROIMAGE-CLINICAL 2015; 7:837-47. [PMID: 26082893 PMCID: PMC4459041 DOI: 10.1016/j.nicl.2015.03.015] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/23/2015] [Revised: 03/02/2015] [Accepted: 03/19/2015] [Indexed: 01/08/2023]
Abstract
Cocaine dependence is associated with increased impulsivity in humans. Both cocaine dependence and impulsive behavior are under the regulatory control of cortico-striatal networks. One behavioral laboratory measure of impulsivity is response inhibition (ability to withhold a prepotent response) in which altered patterns of regional brain activation during executive tasks in service of normal performance are frequently found in cocaine dependent (CD) subjects studied with functional magnetic resonance imaging (fMRI). However, little is known about aberrations in specific directional neuronal connectivity in CD subjects. The present study employed fMRI-based dynamic causal modeling (DCM) to study the effective (directional) neuronal connectivity associated with response inhibition in CD subjects, elicited under performance of a Go/NoGo task with two levels of NoGo difficulty (Easy and Hard). The performance on the Go/NoGo task was not significantly different between CD subjects and controls. The DCM analysis revealed that prefrontal–striatal connectivity was modulated (influenced) during the NoGo conditions for both groups. The effective connectivity from left (L) anterior cingulate cortex (ACC) to L caudate was similarly modulated during the Easy NoGo condition for both groups. During the Hard NoGo condition in controls, the effective connectivity from right (R) dorsolateral prefrontal cortex (DLPFC) to L caudate became more positive, and the effective connectivity from R ventrolateral prefrontal cortex (VLPFC) to L caudate became more negative. In CD subjects, the effective connectivity from L ACC to L caudate became more negative during the Hard NoGo conditions. These results indicate that during Hard NoGo trials in CD subjects, the ACC rather than DLPFC or VLPFC influenced caudate during response inhibition. Dynamic causal modeling was used to study response inhibition in cocaine dependence. A Go/NoGo task with two levels of NoGo difficulty (Easy and Hard) was used. Patients and controls used anterior cingulate cortex to control caudate during Easy NoGo. Controls used dorsolateral/ventrolateral prefrontal cortex to control caudate during Hard NoGo. Patients continued using anterior cingulate cortex to control caudate during Hard NoGo.
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Affiliation(s)
- Liangsuo Ma
- Institute for Drug and Alcohol Studies, Virginia Commonwealth University (VCU), Richmond, VA, USA ; Department of Radiology, VCU, Richmond, VA, USA
| | - Joel L Steinberg
- Institute for Drug and Alcohol Studies, Virginia Commonwealth University (VCU), Richmond, VA, USA ; Department of Psychiatry, VCU, Richmond, VA, USA
| | - Kathryn A Cunningham
- Center for Addiction Research and Department of Pharmacology and Toxicology, University of Texas Medical Branch, Galveston, TX, USA
| | - Scott D Lane
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center, Houston (UTHSC-H), USA
| | - James M Bjork
- Institute for Drug and Alcohol Studies, Virginia Commonwealth University (VCU), Richmond, VA, USA ; Department of Psychiatry, VCU, Richmond, VA, USA
| | - Harshini Neelakantan
- Center for Addiction Research and Department of Pharmacology and Toxicology, University of Texas Medical Branch, Galveston, TX, USA
| | - Amanda E Price
- Center for Addiction Research and Department of Pharmacology and Toxicology, University of Texas Medical Branch, Galveston, TX, USA
| | - Ponnada A Narayana
- Department of Diagnostic and Interventional Imaging, UTHSC-H, Houston, TX, USA
| | - Thomas R Kosten
- Department of Psychiatry and Department of Neuroscience, Baylor College of Medicine, Houston, TX, USA
| | - Antoine Bechara
- Brain and Creativity Institute and Department of Psychology, University of Southern California, Los Angeles, CA, USA
| | - F Gerard Moeller
- Institute for Drug and Alcohol Studies, Virginia Commonwealth University (VCU), Richmond, VA, USA ; Department of Psychiatry, VCU, Richmond, VA, USA ; Department of Pharmacology and Toxicology, Richmond, VCU, VA 23219, USA
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Blum K, Febo M, Thanos PK, Baron D, Fratantonio J, Gold M. Clinically Combating Reward Deficiency Syndrome (RDS) with Dopamine Agonist Therapy as a Paradigm Shift: Dopamine for Dinner? Mol Neurobiol 2015; 52:1862-1869. [PMID: 25750061 PMCID: PMC4586005 DOI: 10.1007/s12035-015-9110-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2014] [Accepted: 01/21/2015] [Indexed: 01/23/2023]
Abstract
Everyday, there are several millions of people that are increasingly unable to combat their frustrating and even fatal romance with getting high and/or experiencing “normal” feelings of well-being. In the USA, the FDA has approved pharmaceuticals for drug and alcohol abuse: tobacco and nicotine replacement therapy. The National Institute on Drug Abuse (NIDA) and the National Institute on Alcohol Abuse and Alcoholism (NIAAA) remarkably continue to provide an increasing understanding of the intricate functions of brain reward circuitry through sophisticated neuroimaging and molecular genetic applied technology. Similar work is intensely investigated on a worldwide basis with enhanced clarity and increased interaction between not only individual scientists but across many disciplines. However, while it is universally agreed that dopamine is a major neurotransmitter in terms of reward dependence, there remains controversy regarding how to modulate its role clinically to treat and prevent relapse for both substance and non-substance-related addictive behaviors. While the existing FDA-approved medications promote blocking dopamine, we argue that a more prudent paradigm shift should be biphasic—short-term blockade and long-term upregulation, enhancing functional connectivity of brain reward circuits.
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Affiliation(s)
- Kenneth Blum
- Department of Psychiatry and McKnight Brain Institute, College of Medicine, University of Florida, P. O. Box 100256, Gainesville, FL 32610-0256 USA
- Human Integrated Services Unit, Center for Clinical and Translational Science, Department of Psychiatry, College of Medicine, University of Vermont, Burlington, VT USA
- Division of Applied Clinical Research, Dominion Diagnostics, LLC, North Kingstown, RI USA
- Department of Addiction Research and Therapy, Malibu Beach Recovery Center, Malibu, CA USA
| | - Marcelo Febo
- Department of Psychiatry and McKnight Brain Institute, College of Medicine, University of Florida, P. O. Box 100256, Gainesville, FL 32610-0256 USA
| | - Panayotis K. Thanos
- Behavior Neuropharmacology and Neuroimaging Laboratory, Department of Psychology, SUNY at Stony Brook, Stony Brook, NY USA
| | - David Baron
- Department of Psychiatry, Keck School of Medicine, University of Southern California, Los Angeles, CA USA
- Keck School of Medicine, University of Southern California, Los Angeles, CA USA
| | - James Fratantonio
- Division of Applied Clinical Research, Dominion Diagnostics, LLC, North Kingstown, RI USA
| | - Mark Gold
- Department of Psychiatry and McKnight Brain Institute, College of Medicine, University of Florida, P. O. Box 100256, Gainesville, FL 32610-0256 USA
- Department of Research, Rivermernd Health, Atlanta, GA USA
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Konova AB, Moeller SJ, Tomasi D, Goldstein RZ. Effects of chronic and acute stimulants on brain functional connectivity hubs. Brain Res 2015; 1628:147-56. [PMID: 25721787 DOI: 10.1016/j.brainres.2015.02.002] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2014] [Revised: 01/29/2015] [Accepted: 02/01/2015] [Indexed: 12/16/2022]
Abstract
The spatial distribution and strength of information processing 'hubs' are essential features of the brain׳s network topology, and may thus be particularly susceptible to neuropsychiatric disease. Despite growing evidence that drug addiction alters functioning and connectivity of discrete brain regions, little is known about whether chronic drug use is associated with abnormalities in this network-level organization, and if such abnormalities could be targeted for intervention. We used functional connectivity density (FCD) mapping to evaluate how chronic and acute stimulants affect brain hubs (i.e., regions with many short-range or long-range functional connections). Nineteen individuals with cocaine use disorders (CUD) and 15 healthy controls completed resting-state fMRI scans following a randomly assigned dose of methylphenidate (MPH; 20mg) or placebo. Short-range and long-range FCD maps were computed for each participant and medication condition. CUD participants had increased short-range and long-range FCD in the ventromedial prefrontal cortex, posterior cingulate/precuneus, and putamen/amygdala, which in areas of the default mode network correlated with years of use. Across participants, MPH decreased short-range FCD in the thalamus/putamen, and decreased long-range FCD in the supplementary motor area and postcentral gyrus. Increased density of short-range and long-range functional connections to default mode hubs in CUD suggests an overrepresentation of these resource-expensive hubs. While the effects of MPH on FCD were only partly overlapping with those of CUD, MPH-induced reduction in the density of short-range connections to the putamen/thalamus, a network of core relevance to habit formation and addiction, suggests that some FCD abnormalities could be targeted for intervention.
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Affiliation(s)
- Anna B Konova
- Center for Neural Science, New York University, New York, NY 10003, United States
| | - Scott J Moeller
- Departments of Psychiatry & Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY 10029, United States
| | - Dardo Tomasi
- National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD 20892, United States
| | - Rita Z Goldstein
- Departments of Psychiatry & Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY 10029, United States.
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