Attentional deficits in cocaine-dependent patients: Converging behavioral and electrophysiological evidence

University of Wisconsin-Madison, Departments of Psychology and Psychiatry, 1202 West Johnson Street, Madison, WI 53706, USA.
Psychiatry Research (Impact Factor: 2.47). 09/2008; 160(2):145-54. DOI: 10.1016/j.psychres.2007.11.019
Source: PubMed


Although there are several reports of patients with cocaine dependence displaying cognitive deficits, the nature of their information processing deficits is not well characterized. In the present study, the attentional performance of cocaine-dependent patients (n=14) was examined and compared with that of healthy control individuals (n=15). Attention was assessed using an auditory oddball event-related task as well as the Continuous Performance Test (CPT, Identical Pairs version). The cocaine-dependent group displayed P300 amplitude reduction compared to controls. The group difference in P300 response latency did not reach significance. On the CPT, the cocaine-dependent patients displayed significantly poorer discriminability and greater errors of commission than the controls. There was a positive correlation between performance on the oddball event-related task and performance on the CPT. This investigation provides converging behavioral and electrophysiological evidence of attentional deficits in cocaine-dependent patients.

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Available from: Diane C Gooding
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    • "In our study, participants were using cocaine up until shortly prior to admission for the test period and presumably at their functional cognitive " baseline. " Even after a short course of treatment atomoxetine exerted a significant effect on a test of working memory and in the auditory Continuous Performance Task (CPT), which has been specifically shown to be impaired in cocaine users (Gooding et al., 2008). No improvements in the placebo group were noted, excluding the possibility that environmental factors were ameliorative; additionally, all participants continued to receive cocaine during their participation. "
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    ABSTRACT: Objectives: Atomoxetine has been considered as an agonist replacement therapy for cocaine. We investigated the safety of the interaction of atomoxetine with cocaine and also whether cognitive function was affected by atomoxetine during short-term administration. Methods: In a double-blind placebo-controlled inpatient study of 20 cocaine-dependent volunteers, participants received atomoxetine 80 mg daily followed by 100 mg daily for 5 days each. On the fourth and fifth day at each dose, cocaine (20 and 40 mg) was infused intravenously in sequential daily sessions. Results: Preinfusion mean systolic pressures showed a small but statistically significant difference between placebo and both doses of atomoxetine. Preinfusion mean diastolic pressures were significant between placebo and atomoxetine 80 mg only. The diastolic pressure response to 40 mg cocaine was statistically significant only between the 80- and 100-mg atomoxetine doses. All electrocardiogram parameters were unchanged. Visual Analog Scale (VAS) scores for "bad effect" in the atomoxetine group were significantly higher at baseline, then declined, and for "likely to use" declined with atomoxetine treatment. On the Addiction Research Center Inventory, the atomoxetine group scored significantly lower on amphetamine, euphoria, and energy subscales (P < 0.0001). Other VAS descriptors, Brief Substance Craving Scale, Profile of Moods State, and Brief Psychiatric Rating Scale showed no differences. Atomoxetine did not affect cocaine pharmacokinetics. In tests of working memory, sustained attention, cognitive flexibility, and decision-making, atomoxetine improved performance on the visual n-back task. There were no differences in any pharmacokinetic parameters for cocaine with atomoxetine. Conclusions: Atomoxetine was tolerated safely by all participants. Certain cognitive improvements and a dampening effect on VAS scores after cocaine were observed, but should be weighed against small but significant differences in hemodynamic responses after atomoxetine.
    Full-text · Article · Sep 2012 · Journal of Addiction Medicine
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    • "Note that all CUD used crack/cocaine in the past 30 days, and that inclusion of the CUD− subgroup is entirely new to this study. Given results by others (Biggins et al., 1997; Bauer, 2001; Papageorgiou et al., 2004; Fein and Chang, 2006; Gooding et al., 2008) and our prior neuropsychological results where we reported that cognitive impairment was most severe in CUD− as compared to CUD+ (Woicik et al., 2009), we a priori hypothesized that the recently abstinent group (with less recent cocaine use) will manifest the most severe reward-related P300 impairments. In addition to the P300, we explored earlier ERP components relevant to our task: the frontocentral P200, that has recently been described in the context of task relevance, attention and motivational spillover (Carretie et al., 2001a; Holroyd and Coles, 2002; Potts, 2004; Potts et al., 2006; Holroyd et al., 2008; Franken et al., 2010), and the fronto-central N200 that has been associated with biologically significant events (Campanella et al., 2002), stimulus novelty (Daffner et al., 2000) and top–down cortical inhibition (Folstein and Van Petten, 2008). "
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    ABSTRACT: Recent studies suggest that drug-addicted individuals have a dampened cortical response to non-drug rewards. However, it remains unclear whether recency of drug use impacts this impairment. Therefore, in this event-related potential study, recency of cocaine use was objectively determined by measuring cocaine in urine on study day. Thirty-five individuals with current cocaine use disorder [CUD: 21 testing positive (CUD+) and 14 testing negative (CUD-) for cocaine in urine] and 23 healthy controls completed a sustained attention task with graded monetary incentives (0¢, 1¢ and 45¢). Unlike in controls, in both CUD subgroups P300 amplitude was not modulated by the varying amounts of money and the CUD- showed the most severe impairment as documented by the lowest P300 amplitudes and task accuracy. Moreover, while recency of drug use was associated with better accuracy and higher P300 amplitudes, chronic drug use was associated with lower sensitivity to money. These results extend our previous findings of decreased sustained sensitivity to monetary reward in CUD+ to recently abstaining individuals, where level of impairment was most severe. Taken together, these results support the self-medication hypothesis, where CUD may be self-administering cocaine to avoid or compensate for underlying cognitive and emotional difficulties albeit with a long-term detrimental effect on sensitivity to non-drug reward.
    Full-text · Article · Jul 2012
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    • "Additionally, participants were reminded to respond as quickly and as accurately as possible. The tests were selected based on studies demonstrating that these and or similar measures were shown to be valid and reliable with respect to differentiating between cocaine-dependent individuals and matched controls (Gooding et al., 2008; Verdejo-Garcia et al., 2006). 2.5.1. "
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    ABSTRACT: The purpose of the present study was to determine the effects of modafinil, escitalopram, and modafinil + escitalopram administration on neurocognition in a sample of long-term, high-dose cocaine users. Sixty-one cocaine-dependent individuals were randomly assigned to receive placebo (n = 14), modafinil, 200 mg, once daily (n = 16), escitalopram, 20 mg, once daily (n = 16), or modafinil and escitalopram, once daily (n = 15), for five days on an inpatient basis. Urinanalysis was used to confirm abstinence from cocaine on the day of admission and the next five days. Baseline neurocognitive assessment, which included measures of attention/information processing, episodic memory, and working memory, was conducted immediately after the washout phase and prior to the administration of modafinil. The follow-up assessment was conducted after participants had received modafinil or placebo for five days. Repeated-measures, mixed model analysis of variance showed that modafinil administration was associated with significantly improved performance on two measures of working memory span (mean n-back span, maximum n-back span) and a trend toward significant improvement on a measure of visual working memory (visual accuracy) and two measures of sustained attention, consistency of response time (Variability) and reduced impulsivity (Perseveration). Modafinil administration did not modulate performance on measures of information processing speed or episodic memory. Escitalopram did not modulate performance on measures of cognition, either alone or in combination with modafinil. This study provides initial data showing that, in a sample of long-term, high-dose cocaine users, administration of psychotropic medications, such as modafinil, can improve performance on measures of working memory. Moreover, it confirms the utility of studying the interactive effects of psychotropic medications to confirm the manner in which the candidate medications independently and interactively affect neurocognition. These effects are likely relevant in the treatment of cocaine dependence, in which the remediation of impaired working memory may be associated with improved treatment outcomes. This article is part of a Special Issue entitled 'Cognitive Enhancers'.
    Full-text · Article · Jul 2012 · Neuropharmacology
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