Executive Dysfunction in Cocaine Addiction: Evidence for Discordant Frontal, Cingulate, and Cerebellar Activity

Medical College of Wisconsin, Milwaukee, Wisconsin, United States
The Journal of Neuroscience : The Official Journal of the Society for Neuroscience (Impact Factor: 6.34). 01/2005; 24(49):11017-22. DOI: 10.1523/JNEUROSCI.3321-04.2004
Source: PubMed


Using a GO-NOGO response inhibition task in which working memory (WM) demands can be varied, we demonstrate that the compromised abilities of cocaine users to exert control over strong prepotent urges are associated with reduced activity in anterior cingulate and right prefrontal cortices, two regions thought to be critical for implementing cognitive control. Furthermore, unlike drug-naive controls, and opposite to the anterior cingulate pattern, cocaine users showed an over-reliance on the left cerebellum, a compensatory pattern previously seen in alcohol addiction. The results indicate that cocaine users find it difficult to inhibit their own actions, particularly when WM demands, which have been shown previously to increase during cue-induced craving for the drug, are increased. The results reveal a neuroanatomical basis for this dysexecutive component to addiction, supporting the suggested importance cognitive functions may play in prolonging abuse or predisposing users toward relapse.

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    • "Concurrently, neurocognitive mechanisms of inhibitory control are undermined in SUDs, as exemplified by compulsive drug use even in the face of negative consequences. Not surprisingly, on inhibitory control tasks, nonaddicted individuals significantly outperform those who chronically use alcohol (Kamarajan et al., 2005), stimulants (Hester and Garavan, 2004;Monterosso et al., 2005), and opioids (Fu et al., 2008). Functional neuroimaging studies of addicted populations have demonstrated that the key regions associated with these control deficits are the anterior cingulate cortex , dorsolateral prefrontal cortex, and orbitofrontal cortex (Goldstein and Volkow, 2011;Motzkin et al., 2014), and structural neuroimaging studies have found that these regions are smaller in individuals with SUDs, with reductions proportionate to severity and/or length of use (Ersche et al., 2013;Goldstein and Volkow, 2011;Liu et al., 2009). "
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    • "ously highlighted in addicts by using the stop-signal task (i.e., prolonged latency of motor response inhibition), and the Go/No-Go paradigm (i.e., more errors of commission: subject had to withhold a response but pressed a button instead) (for a review of response inhibition impairment in gambling , opiate and alcohol addiction, see respectively Brevers & Noël, 2013; Goldstein & Volkow, 2011; Noël et al., 2010). Moreover, results from several brain imaging studies showed that, in drug addicts (Hester & Garavan, 2004), impaired performance on response inhibition tasks is associated with a hypoactivation in the anterior cingulate cortex, implicated in mechanisms of error detection and conflict monitoring. "
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    • "We employed an emotional Go / NoGo task ( see Donders , 1868 / 1969 ; Hester and Garavan , 2004 ) , which presented emo - tional distractor pictures simultaneously with the Go and NoGo stimuli . In each trial , the participant was shown a square or cir - cle , lasting 2 s , which served as the Go or NoGo stimulus ( see Figure 1 ) . "
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