Article

Prefrontal-striatl pathway underlies cognitive regulation of craving

Division of Substance Abuse, Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06519, USA.
Proceedings of the National Academy of Sciences (Impact Factor: 9.67). 08/2010; 107(33):14811-6. DOI: 10.1073/pnas.1007779107
Source: PubMed

ABSTRACT

The ability to control craving for substances that offer immediate rewards but whose long-term consumption may pose serious risks lies at the root of substance use disorders and is critical for mental and physical health. Despite its importance, the neural systems supporting this ability remain unclear. Here, we investigated this issue using functional imaging to examine neural activity in cigarette smokers, the most prevalent substance-dependent population in the United States, as they used cognitive strategies to regulate craving for cigarettes and food. We found that the cognitive down-regulation of craving was associated with (i) activity in regions previously associated with regulating emotion in particular and cognitive control in general, including dorsomedial, dorsolateral, and ventrolateral prefrontal cortices, and (ii) decreased activity in regions previously associated with craving, including the ventral striatum, subgenual cingulate, amygdala, and ventral tegmental area. Decreases in craving correlated with decreases in ventral striatum activity and increases in dorsolateral prefrontal cortex activity, with ventral striatal activity fully mediating the relationship between lateral prefrontal cortex and reported craving. These results provide insight into the mechanisms that enable cognitive strategies to effectively regulate craving, suggesting that it involves neural dynamics parallel to those involved in regulating other emotions. In so doing, this study provides a methodological tool and conceptual foundation for studying this ability across substance using populations and developing more effective treatments for substance use disorders.

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    • "Specifically, we explored the efficacy of the proposed FC-added rtfMRI-NF method at facilitating real-time control of neuronal processes involved in resisting cigarette cravings. Brain regions implicated in cigarette cravings include ACC (Hartwell et al., 2011; Kober et al., 2010; Azizian et al., 2009; Brody et al., 2007; Smolka et al., 2006; Due, Huettel, Hall, & Rubin, 2002; Ernst et al., 2001), medial pFC (Sutherland, McHugh, Pariyadath, & Stein, 2012; Hartwell et al., 2011; Brody et al., 2007; Stein et al., 1998), OFC (Lee, Kim, & Kim, 2012; Hartwell et al., 2011; Smolka et al., 2006; Due et al., 2002), posterior cingulate cortex (Lee, Kim, & Kim, 2012; Hartwell et al., 2011; Azizian et al., 2009; Brody et al., 2007), and precuneus (Lee, Kim, & Kim, 2012; Hartwell et al., 2011; Brody et al., 2007). In addition, central reward-related regions such as the ventral striatum/nucleus accumbens, dorsal striatum, and amygdala are well known for their role in addiction, and the anterior insula is especially important in nicotine addiction (Sutherland et al., 2012; Naqvi, Rudrauf, Damasio, & Bechara, 2007). "

    Full-text · Dataset · Dec 2015
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    • "Specifically, we explored the efficacy of the proposed FC-added rtfMRI-NF method at facilitating real-time control of neuronal processes involved in resisting cigarette cravings. Brain regions implicated in cigarette cravings include ACC (Hartwell et al., 2011; Kober et al., 2010; Azizian et al., 2009; Brody et al., 2007; Smolka et al., 2006; Due, Huettel, Hall, & Rubin, 2002; Ernst et al., 2001), medial pFC (Sutherland, McHugh, Pariyadath, & Stein, 2012; Hartwell et al., 2011; Brody et al., 2007; Stein et al., 1998), OFC (Lee, Kim, & Kim, 2012; Hartwell et al., 2011; Smolka et al., 2006; Due et al., 2002), posterior cingulate cortex (Lee, Kim, & Kim, 2012; Hartwell et al., 2011; Azizian et al., 2009; Brody et al., 2007), and precuneus (Lee, Kim, & Kim, 2012; Hartwell et al., 2011; Brody et al., 2007). In addition, central reward-related regions such as the ventral striatum/nucleus accumbens, dorsal striatum, and amygdala are well known for their role in addiction, and the anterior insula is especially important in nicotine addiction (Sutherland et al., 2012; Naqvi, Rudrauf, Damasio, & Bechara, 2007). "

    Full-text · Dataset · Dec 2015
    • "CR in addiction is highly related to sensitized, overactive subcortical regions (David et al. 2005; Vollstadt-Klein et al. 2012; Wrase et al. 2002) like the ventral tegmental area (VTA) and the nucleus accumbens (review: (Schacht et al. 2013)). Regulating CR, however, is related to activation in cortical regions such as the dorsolateral prefrontal cortex (dlPFC) (Kober et al. 2010). "
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    ABSTRACT: Cue reactivity (CR) is an important concept for relapse in substance use disorders (SUD). Although cue exposure (CE) therapy is discussed as relapse prevention, current approaches still need improvement considering its efficacy. From a neurobiological perspective, CR is related to an over-activation in sensitized subcortical structures, their projections to motivationally relevant cortical structures (e.g. orbitofrontal cortex, OFC) and deficient prefrontal inhibitory control. Therefore, we analyzed prefrontal cortical activation and its relation to craving during smoking CE. We focused on the OFC—as a projection area of sensitized subcortical structures—due its importance in the processing of reinforcement value and the dorsolateral prefrontal cortex (dlPFC) based on its importance for behavioral inhibition. Functional near-infrared spectroscopy (fNIRS) was used to assess hemodynamics in prefrontal regions during smoking CE in 24 subjects (n = 12 occasional smokers, n = 12 controls). Subjective craving intensity (minimum craving as marker of baseline inhibition, range as marker of inhibition time course) was additionally assessed. Craving ratings indicated that CR was elicited solely in smokers, not controls. Those subjective ratings correlated with hemodynamic activity in OFC (craving range) and dlPFC (minimum craving). OFC activation was found earlier throughout the CE in smokers compared to controls. Connectivity (seed-based correlation) between OFC and dlPFC was increased in smokers. fNIRS can capture prefrontal hemodynamic activity involved in CR elicited during CE and is therefore a promising method to investigate CR and its implications for relapse prevention in SUD.
    No preview · Article · Dec 2015 · Addiction Biology
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