Article

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

ABSTRACT

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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    • "An important future direction is to test whether there are unique neural mechanisms underlying the ability to exert inhibitory control in a drug-related context versus a neutral context. Insofar as inhibitory control in drug-addicted individuals is anticipated to be lowest upon being confronted with drugs or drug-associated stimuli (Goldstein and Volkow, 2011), such task designs could potentially explain unique variance in drug use outcomes—particularly since neuropsychological impairments in drug addiction, while pervasive, are generally mild in magnitude and may require more sensitive neuropsychological probes for their detection (Goldstein et al., 2004Goldstein et al., , 2007 Moeller et al., 2009; Woicik et al., 2009). Although drug Stroop tasks have been deployed to predict clinical outcome in addicted individuals as reviewed above, these studies generally have not concurrently administered a standard color-word Stroop task for direct comparisons (e.g., drug task minus matched neutral task). "
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    ABSTRACT: A core deficit in drug addiction is the inability to inhibit maladaptive drug-seeking behavior. Consistent with this deficit, drug-addicted individuals show reliable cross-sectional differences from healthy nonaddicted controls during tasks of response inhibition accompanied by brain activation abnormalities as revealed by functional neuroimaging. However, it is less clear whether inhibition-related deficits predate the transition to problematic use, and, in turn, whether these deficits predict the transition out of problematic substance use. Here, we review longitudinal studies of response inhibition in children/adolescents with little substance experience and longitudinal studies of already addicted individuals attempting to sustain abstinence. Results show that response inhibition and its underlying neural correlates predict both substance use outcomes (onset and abstinence). Neurally, key roles were observed for multiple regions of the frontal cortex (e.g., inferior frontal gyrus, dorsal anterior cingulate cortex , and dorsolateral prefrontal cortex). In general, less activation of these regions during response inhibition predicted not only the onset of substance use, but interestingly also better abstinence-related outcomes among individuals already addicted. The role of subcortical areas, although potentially important, is less clear because of inconsistent results and because these regions are less classically reported in studies of healthy response inhibition. Overall, this review indicates that response inhibition is not simply a manifestation of current drug addiction , but rather a core neurocognitive dimension that predicts key substance use outcomes. Early intervention in inhibitory deficits could have high clinical and public health relevance.
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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.
    Full-text · Article · Nov 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. "
    [Show abstract] [Hide abstract]
    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.
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