Brain activation to cocaine cues and motivation/treatment status

Department of Psychiatry and Behavioral Sciences, Clinical Neuroscience Division, Medical University of South Carolina, Charleston, SC, USA.
Addiction Biology (Impact Factor: 5.36). 03/2012; 19(2). DOI: 10.1111/j.1369-1600.2012.00446.x
Source: PubMed


Motivation to change is believed to be a key factor in therapeutic success in substance use disorders; however, the neurobiological mechanisms through which motivation to change impacts decreased substance use remain unclear. Existing research is conflicting, with some investigations supporting decreased and others reporting increased frontal activation to drug cues in individuals seeking treatment for substance use disorders. The present study investigated the relationship between motivation to change cocaine use and cue-elicited brain activity in cocaine-dependent individuals using two conceptualizations of 'motivation to change': (1) current treatment status (i.e. currently receiving versus not receiving outpatient treatment for cocaine dependence) and (2) self-reported motivation to change substance use, using the Stages of Change Readiness and Treatment Eagerness Scale. Thirty-eight cocaine-dependent individuals (14 currently in treatment) completed a diagnostic assessment and an fMRI cocaine cue-reactivity task. Whole-brain analyses demonstrated that both treatment-seeking and motivated participants had lower activation to cocaine cues in a wide variety of brain regions in the frontal, occipital, temporal and cingulate cortices relative to non-treatment-seeking and less motivated participants. Future research is needed to explain the mechanism by which treatment and/or motivation impacts neural cue reactivity, as such work could potentially aid in the development of more effective therapeutic techniques for substance-dependent patients.

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    • "Article Cue Type Substance N (users) Occipital found Braus et al. (2001) Images Alcohol 4 Y Brody et al. (2007) Video Nicotine 42 Y Dagher et al. (2009) Video Nicotine 15 Y David et al. (2007) Images Nicotine 8 Y Filbey et al. (2009) Hold/view Marijuana 38 Y Janes et al. (2009) Images Nicotine 13 Y Janes et al. (2012) Images Nicotine 24 Y Kang et al. (2012) Images Nicotine 25 Y Kushnir et al. (2013) Images Nicotine 20 Y Lee et al. (2005) Virtual Nicotine 8 Y Li et al. (2012) Images Opiate 24 Y Li et al. (2013) Images Opiate 18LT Y Lou et al. (2012) Images Opiate 17ST 17 LT Y McClernon et al. (2009) Images Nicotine 18 Y McClernon et al. (2008) Images Nicotine 30 Y Mei et al. (2010) Images Opiate 15 Y Prisciandaro et al. (2014) Images Cocaine 31 Y Rubinstein et al. (2011) Images Nicotine 12 Y Vollstadt-Klein et al. (2011a) Images Nicotine 21 Y Vollstadt-Klein et al. (2011b) Images Alcohol 30 Y Vollstadt-Klein et al. (2010) Images Alcohol 31 Y Wrase et al. (2002) Images Alcohol 6 Y Wrase et al. (2007) Images Alcohol 16 Y Zijlstra et al. (2009) Images Opiate 12 Y Criteria include: visual stimulus, report whole-brain analysis that includes the occipital lobe, report within user group contrast results for cue relative to baseline, no covariates, report coordinates in the occipital lobe for the contrast meeting study criteria. N = number of users included in the contrast of interest. "
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    ABSTRACT: Background: Although the visual cortex does not typically receive much attention in addiction literature, neuroimaging studies often report significant activity in visual areas when drug users are exposed to drug cues. The purpose of this meta-analysis was to investigate the frequency with which occipital cortex activity is observed during drug cue exposure and to determine its spatial distribution. Methods: A comprehensive literature search was performed of human functional neuroimaging studies of drug cue-reactivity. Fifty-five studies were used to determine the frequency with which clusters of significant visual cortex activity during visual drug cues versus non-drug cues were reported. The spatial distribution of visual cortex activations was determined via activation likelihood estimation (ALE; FDR corrected, p<0.01) in a subset of these studies (n=24). Results: Eighty-six percent of studies that reported fMRI results for drug versus neutral visual cues within a substance-dependent group showed significant drug-elicited activity in the visual cortex. ALE revealed clusters in the left secondary visual cortex (BA 19) and clusters in the primary visual cortex (BA 17) that were consistently activated by drug cues. Conclusions: These data demonstrate that the visual cortex, often overlooked in our discussions of the neural circuitry of addiction, consistently discriminates drug cues from neutral cues in substance dependent populations. While it remains unclear whether drug cue-elicited activation in occipital cortex is related to the rewarding properties of the drug and/or attentional mechanisms, these data support further exploration.
    Drug and Alcohol Dependence 08/2014; 143(1). DOI:10.1016/j.drugalcdep.2014.07.028 · 3.42 Impact Factor
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    • "We adapted a cue-reactivity paradigm (LaRowe et al., 2007) following standard cue-reactivity paradigms well established for pictures (Prisciandaro et al., 2012) and videos (Volkow et al., 2011). "
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    ABSTRACT: Prefrontal dysfunction is a hallmark in drug addiction, yet interventions exploring modulation of prefrontal cortex function in drug addiction have not been fully investigated with regard to physiological alterations. We tested the hypothesis that non-invasive prefrontal stimulation would change neural activity in crack-cocaine addiction, investigating the effects of transcranial Direct Current Stimulation (tDCS) of Dorsolateral Prefrontal Cortex (DLPFC) induced cortical excitability modulation on the visual P3 Event Related Potentials (ERP) component under neutral and drug cue exposition in crack-cocaine addicts. Thirteen crack-cocaine users were randomly distributed to receive five applications (once a day, every other day) of bilateral (left cathodal/right anodal) tDCS (20 min, 2 mA, 35 cm2) or sham tDCS over the DLPFC. Brain activity was measured under crack-related or neutral visual-cued ERPs. There were significant differences in P3-related parameters when comparing group of stimulation (active vs. sham tDCS) and number of sessions (single vs. repetitive tDCS). After a single session of tDCS, P3 current intensity in the left DLPFC increased during neutral cues and decreased during crack-related cues. This effect was opposite to what was observed in the sham-tDCS group. In contrast, repetitive tDCS increased current density not only in the DLPFC, but also in a wider array of prefrontal areas, including presumably the frontopolar cortex (FPC) orbitofrontal cortex (OFC) and anterior cingulate cortex (ACC), when subjects were visualizing crack-related cues. Thus, single and repetitive application of tDCS can impact cognitive processing of neutral and especially crack-related visual cues in prefrontal areas, which may be of importance for treatment of crack-cocaine addiction.
    The International Journal of Neuropsychopharmacology 04/2014; 17(09):1-11. DOI:10.1017/S1461145714000522 · 4.01 Impact Factor
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    • "The cue-reactivity paradigm was adapted [13] from standard cue-reactivity paradigms established for pictures [14]. To confirm that patients were aware of the picture presentations, the subjects were asked to press a button whenever a crack-related picture was presented (50%). "
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    ABSTRACT: Patients addicted to crack-cocaine routinely have difficulty sustaining treatment, which could be related to dysfunctional cerebral activity that occurs in addiction. To investigate the indirect electrophysiological effects of single transcranial direct current stimulation (tDCS) on cocaine-addicted brains. The patients received either left cathodal/right anodal or sham stimulation over the DLPFC. The region of interest was the anterior cingulate cortex (ACC) during the N2 time window (200-350 ms). Event-related potentials in the ACC were measured during visual presentation of crack-related cues or neutral cues. Low-resolution brain electromagnetic tomography (LORETA) indicated that exposure to crack-related images led to increased activity in the ACC in the sham group, while the tDCS group showed decreased ACC activity after visualization of drug cues. Prefrontal tDCS specifically modulated the ACC response during exposure to visual drug cues in crack-cocaine users.
    Brain Stimulation 10/2013; 7(1). DOI:10.1016/j.brs.2013.09.007 · 4.40 Impact Factor
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