The Neuropsychology of Cocaine Addiction: Recent Cocaine Use Masks Impairment

Brookhaven National Laboratory, Medical Department, Upton, NY 11973-5000, USA.
Neuropsychopharmacology: official publication of the American College of Neuropsychopharmacology (Impact Factor: 7.05). 06/2008; 34(5):1112-22. DOI: 10.1038/npp.2008.60
Source: PubMed


Individuals with current cocaine use disorders (CUD) form a heterogeneous group, making sensitive neuropsychological (NP) comparisons with healthy individuals difficult. The current study examined the effects on NP functioning of four factors that commonly vary among CUD: urine status for cocaine (positive vs negative on study day), cigarette smoking, alcohol consumption, and dysphoria. Sixty-four cocaine abusers were matched to healthy comparison subjects on gender and race; the groups also did not differ in measures of general intellectual functioning. All subjects were administered an extensive NP battery measuring attention, executive function, memory, facial and emotion recognition, and motor function. Compared with healthy control subjects, CUD exhibited performance deficits on tasks of attention, executive function, and verbal memory (within one standard deviation of controls). Although CUD with positive urine status, who had higher frequency and more recent cocaine use, reported greater symptoms of dysphoria, these cognitive deficits were most pronounced in the CUD with negative urine status. Cigarette smoking, frequency of alcohol consumption, and dysphoria did not alter these results. The current findings replicate a previously reported statistically significant, but relatively mild NP impairment in CUD as compared with matched healthy control individuals and further suggest that frequent/recent cocaine use [corrected] may mask underlying cognitive (but not mood) disturbances. These results call for development of pharmacological agents targeted to enhance cognition, without negatively impacting mood in individuals addicted to cocaine.

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Available from: Gene-Jack Wang, Apr 13, 2015
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    • "However, in one study, no difference was found in recognizing emotional faces between cocaine abusers and normal people (Woicik et al., 2009). As there are some degrees of weakness in emotion recognition in substance abusers, there may be impairment in their attention to emotion. "
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    ABSTRACT: Introduction: We hypothesized that inappropriate attention during the period of abstinence in individuals with substance use disorder can result in an inadequate perception of emotion and unsuitable reaction to emotional scenes. The main aim of this research was to evaluate the attentional bias towards emotional images in former substance abusers and compare it to healthy adults. Methods: Paired images of general scenes consisting of pleasant, unpleasant, and neutral images were presented to subjects for 3 s while their attentional bias and eye movements were measured by eye tracking. The participants were 72 male adults consisting of 23 healthy control, 24 morphine former abusers, and 25 methamphetamine former abusers. The former abusers were recruited from a private addiction quitting center and addiction rehabilitation campus. The healthy individuals were selected from general population. Number and duration of first fixation, duration of first gaze, and sustained attention towards emotional scenes were measured as the main variables and the data were analyzed using the repeated measures ANOVA. Results: A significant difference was observed between former morphine abusers and healthy control in terms of number and duration of first fixations and first gaze duration towards pleasant images. Discussion: Individuals with morphine use disorder have more problems with attending to emotional images compared to methamphetamine abusers and healthy people.
    • "Most likely more factors (e.g. polydrug use) play a role as Woicik et al. (2009) suggested. In the present study, the average percentage correctly identified emotions was well above chance level (20%) for all the emotions in both treatment conditions and comparable or even higher than that of a healthy age-comparable norm group (Kessels et al., 2014). "
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    ABSTRACT: Chronic or repeated cocaine use has been linked to impairments in social skills. It is not clear whether cocaine is responsible for this impairment or whether other factors, like polydrug use, distort the observed relation. We aimed to investigate this relation by means of a placebo-controlled experimental study. Additionally, associations between stressor-related activity (cortisol, cardiovascular parameters) induced by the biological stressor cocaine, and potential cocaine effects on emotion recognition were studied. Twenty-four healthy recreational cocaine users participated in this placebo-controlled within-subject study. Participants were tested between 1 and 2h after treatment with oral cocaine (300mg) or placebo. Emotion recognition of low and high intensity expressions of basic emotions (fear, anger, disgust, sadness, and happiness) was tested. Findings show that cocaine impaired recognition of negative emotions; this was mediated by the intensity of the presented emotions. When high intensity expressions of Anger and Disgust were shown, performance under influence of cocaine 'normalized' to placebo-like levels while it made identification of Sadness more difficult. The normalization of performance was most notable for participants with the largest cortisol responses in the cocaine condition compared to placebo. It was demonstrated that cocaine impairs recognition of negative emotions, depending on the intensity of emotion expression and cortisol response. Copyright © 2015 Elsevier B.V. and ECNP. All rights reserved.
    European neuropsychopharmacology: the journal of the European College of Neuropsychopharmacology 08/2015; 25. DOI:10.1016/j.euroneuro.2015.08.012 · 4.37 Impact Factor
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    • "Autism spectrum disorders are associated with a global impairment of the 3 attentional networks (Keehn et al., 2013). Moreover, recent studies described altered performance related to the executive attention network among cocaine (Woicik et al., 2009) and cannabis (Abdullaev et al., 2010) abusers. These studies clearly showed the high interest of the ANT to better understand the differential attentional deficits in psychopathological states, and notably in addictions. "
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    ABSTRACT: Introduction. This study aimed at exploring the integrity of the attentional system in alcohol-dependence with a unitary and theoretically-grounded task. Attentional biases and deficits play a central role in the maintenance of alcohol-dependence but have been little explored. The Attention Network Test was used to precisely explore attentional alterations among alcohol-dependent participants, and centrally the differential deficit across three attentional networks (alerting, orienting, executive control). Method. 30 recently detoxified alcohol-dependent individuals were compared to 30 matched healthy controls. The Attention Network Test was administered. This task requires identifying the orientation of a central arrow replacing a cue and which is surrounded by flankers. On this basis, performance indexes (accuracy and reaction time) were computed for the three attention networks. Results. Alcohol-dependent individuals showed a differential deficit across attention networks as compared to controls, with a preserved performance for alerting and orienting networks but impaired executive control (p < 0.001). This deficit was not related to psychopathological comorbidities but was correlated with the duration and intensity of alcohol consumption habits. Conclusion. Attentional alterations in alcohol-dependence are centrally due to a specific alteration of executive control. Intervention programs focusing on executive components of attention should be promoted, and these results support the frontal lobe hypothesis.
    Alcoholism Clinical and Experimental Research 05/2014; 38:2105-2112. DOI:10.1093/alcalc/agu053.6 · 3.21 Impact Factor
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