Article

Abnormal structure of frontostriatal brain systems is associated with aspects of impulsivity and compulsivity in cocaine dependence

University of Cambridge, Department of Psychiatry, Herchel Smith Building for Brain and Mind Sciences, Cambridge Biomedical Campus, Cambridge CB20SZ, UK.
Brain (Impact Factor: 10.23). 07/2011; 134(Pt 7):2013-24. DOI: 10.1093/brain/awr138
Source: PubMed

ABSTRACT A growing body of preclinical evidence indicates that addiction to cocaine is associated with neuroadaptive changes in frontostriatal brain systems. Human studies in cocaine-dependent individuals have shown alterations in brain structure, but it is less clear how these changes may be related to the clinical phenotype of cocaine dependence characterized by impulsive behaviours and compulsive drug-taking. Here we compared self-report, behavioural and structural magnetic resonance imaging data on a relatively large sample of cocaine-dependent individuals (n = 60) with data on healthy volunteers (n = 60); and we investigated the relationships between grey matter volume variation, duration of cocaine use, and measures of impulsivity and compulsivity in the cocaine-dependent group. Cocaine dependence was associated with an extensive system of abnormally decreased grey matter volume in orbitofrontal, cingulate, insular, temporoparietal and cerebellar cortex, and with a more localized increase in grey matter volume in the basal ganglia. Greater duration of cocaine dependence was correlated with greater grey matter volume reduction in orbitofrontal, cingulate and insular cortex. Greater impairment of attentional control was associated with reduced volume in insular cortex and increased volume of caudate nucleus. Greater compulsivity of drug use was associated with reduced volume in orbitofrontal cortex. Cocaine-dependent individuals had abnormal structure of corticostriatal systems, and variability in the extent of anatomical changes in orbitofrontal, insular and striatal structures was related to individual differences in duration of dependence, inattention and compulsivity of cocaine consumption.

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    • "All these conditions may also influence brain morphometry and should ideally be considered in future studies of both treatment-naïve and treatment-seeking individuals with welldefined dependence on alcohol and illicit substances. To address the issue of regional specificity of volume changes within the relatively large lobes and to increase the functional relevance of such measures, reliable segmentation and examination of small brain regions or of the cortical ribbon may be needed, such as provided by whole-brain voxel-based morphometry and cortical thickness measures (see e.g., Cardenas et al., 2011; Durazzo et al., 2011; Ersche et al., 2011). These limitations notwithstanding, our neuroimaging study reveals gross brain structural differences between PSU and ALC that may have implications for different treatment approaches of polysubstance dependence and alcohol dependence. "
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    • "Moreover the pattern of smaller GM volumes observed with in utero exposure is similar to that reported in adults with chronic cocaine use. Cocaine-dependent adults exhibit GM loss in frontal regions including orbital frontal, dorsal lateral prefrontal cortex, inferior, medial and superior frontal gyri and premotor cortex, with greater lifetime exposure resulting in greater reductions (Alia-Klein et al., 2011; Barros-Loscertales et al., 2011; Ersche et al., 2011; Franklin et al., 2002; Moreno-Lopez et al., 2012; Sim et al., 2007). These deficits are accompanied by impairment in cognitive skills including decision-making, memory, nonverbal problem solving, response inhibition, impulsivity, spatial processing and reaction time tasks (Fein et al., 2002; Lane et al., 2010). "
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    • "Therefore, neural activations in this region when performing an inhibitory control task can reasonably be assumed as essential to the inhibition of behavior. The " motor impulsiveness " factor on the BIS-11 has been described as measuring the amount of spontaneous actions that an individual undertakes (Ersche et al., 2011) with higher scores indicating greater impulsiveness. Examples of questions on this subscale are, " I do things without thinking " , and " I act on the spur of the moment " . "
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