Marc N Potenza

McLean Hospital, Cambridge, Massachusetts, United States

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Publications (381)1667.42 Total impact

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    ABSTRACT: While reward processing appears altered in addiction, few studies track neuro-functional changes following treatment or relate these to measures of reduced drug use. The current study examined neuro-functional alterations in reward processing in cocaine dependence (CD) pre- and post-treatment to determine whether these changes relate to clinically meaningful outcome indicators. Treatment-seeking CD outpatients (N=29) underwent functional magnetic resonance imaging while performing a monetary incentive delay task (MIDT) pre- and post-treatment. The MIDT parses anticipatory from outcome phases of reward/loss processing. Abstinence indicators (negative urines, days abstinent from cocaine during follow-up) were collected throughout treatment and up to one year later. Healthy control (HC) participants (N=28) were also scanned twice with the MIDT. Relative to pre-treatment, at post-treatment CD participants demonstrated increased anticipatory reward activity in the midbrain, thalamus and precuneus (pFWE<0.05). Increased midbrain activity correlated with cocaine abstinence during the 1-year follow-up. Ventral striatal (VS) activity during loss anticipation correlated negatively with negative urine screens. HC group test-retest results showed decreased ventromedial prefrontal cortex activity during winning outcomes. CD-HC group-by-time differences revealed increased left inferior frontal gyrus activity in the CD group during anticipatory phases at post-treatment. In CD participants, increased post-treatment activity in dopamine-innervated regions suggests lowered thresholds in anticipatory signaling for non-drug rewards. Midbrain and VS responses may represent biomarkers associated with CD abstinence. Abstinence-related neurobiological changes occur in similar regions implicated during active use and may possibly be used to track progress during short and long-term recovery.Neuropsychopharmacology accepted article preview online, 21 January 2016. doi:10.1038/npp.2016.11.
    No preview · Article · Jan 2016 · Neuropsychopharmacology
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    Shane W Kraus · Valerie Voon · Marc N Potenza
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    ABSTRACT: Aims: To review the evidence base for classifying compulsive sexual behavior (CSB) as a non-substance or “behavioral” addiction. Methods: Data from multiple domains (e.g., epidemiological, phenomenological, clinical, biological) are reviewed and considered with respect to data from substance and gambling addictions. Results: Overlapping features exist between CSB and substance-use disorders. Common neurotransmitter systems may contribute to CSB and substance-use disorders, and recent neuroimaging studies highlight similarities relating to craving and attentional biases. Similar pharmacological and psychotherapeutic treatments may be applicable to CSB and substance addictions, although considerable gaps in knowledge currently exist. Conclusions: Despite the growing body of research linking compulsive sexual behavior to substance addictions, significant gaps in understanding continue to complicate classification of compulsive sexual behavior as an addiction.
    Full-text · Article · Jan 2016 · Addiction
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    Katherine E. Gendreau · Marc N. Potenza
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    ABSTRACT: Background The development of behavioral addictions (BAs) in association with dopamine agonists (DAs, commonly used to treat Parkinson's disease) has been reported. A recent report presented data that these associations are evident in the US Food and Drug Administration's (FDA) Adverse Event Reporting System (FAERS), a database containing information on adverse drug event and medication error reports submitted to the FDA. However, given that vulnerability to publicity-stimulated reporting is a potential limitation of spontaneous reporting systems like the FAERS, the potential impact of publicity on reporting in this case remains unclear. Method and aims To investigate the potential impact of publicity on FAERS reporting of BAs in association with DAs (BAs w/DAs) as presented by Moore, Glenmullen, and Mattison (2014) , news stories covering a BA/DA association were identified and compared with BA w/DA and other reporting data in the FAERS. Results Fluctuations in the growth of BA w/DA reporting to the FAERS between 2003 and 2012 appear to coincide with multiple periods of intensive media coverage of a BA/DA association, a pattern that is not evident in other reporting data in the FAERS. Discussion/Conclusions Publicity may stimulate reporting of adverse events and premature dismissal of the potential influence of publicity on reporting may lead to mistaking an increased risk of an adverse event being reported for an increased risk of an adverse event occurring.
    Preview · Article · Dec 2015 · Journal of Behavioural Addictions
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    Full-text · Article · Dec 2015 · American Journal of Psychiatry
  • Grace Kong · Philip H. Smith · Corey Pilver · Rani Hoff · Marc N. Potenza
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    ABSTRACT: Introduction: Little is known about the association between problem-gambling severity and psychiatric disorders among American-Indian/Alaska-Native (AI/AN) individuals. Thus, we examined these factors among a nationally representative sample of AI/AN and other American adults in the USA. Method: Using the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) data, we conducted separate Wald tests and multinomial logistic regression analyses comparing AI/AN to black/African American, white/Caucasian, and all other racial/ethnic groups, respectively. Results: Relative to other American adults, AI/AN adults were least likely to report non-/low-frequency gambling (NG: AI/AN 66.5%, white/Caucasian 70.5%, black/African American 72.8%, other racial/ethnic group 72.3%) and most likely to report low-risk gambling (LRG: AI/AN 30.1%, white/Caucasian 26.5%, black/African American 23.4%, other racial/ethnic group 24.7%). The association between at-risk/problem-gambling (ARPG) and any past-year Axis-I disorder was stronger among AI/AN versus other American adults. Although ARPG and LRG were associated with multiple past-year Axis-I and lifetime Axis-II psychiatric disorders in both AI/AN and other American adults, LRG was more strongly associated with both Axis-I disorders (particularly major depression, generalized anxiety disorder and nicotine dependence) and Cluster-B Axis-II (particularly antisocial personality disorder) disorders in AI/AN versus other American adults. Discussion: A stronger association between problem-gambling severity and past-year psychiatric disorders among AI/AN relative to other American adults suggests the importance of enhancing mental health and problem-gambling prevention and treatment strategies that may help AI/AN individuals.
    No preview · Article · Dec 2015 · Journal of Psychiatric Research
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    ABSTRACT: Purpose: At-Risk/Problematic Internet Use (ARPIU) has been associated with impairment in multiple domains including psychopathology. The present study examined the relationship between ARPIU and disordered eating in a large community sample. Methods: Participants (n=1000) completed an online survey about health behaviors. Two thresholds of ARPIU and disordered eating each were examined. Results: The ARPIU and Sub-ED (subthreshold eating disorders) groups reported greater depressive symptoms and poorer self-control than the Control group; the Sub-ED group reported greater impulsivity than the Control group. The ARPIU and Sub-ED groups significantly differed in key features related to each condition. Finally, the co-occurrence of ARPIU and Sub-ED was associated with greater depression. In the second set of analyses based on more stringent thresholds, the Problematic Internet Use (PIU) and ED groups differed on all measures compared to the Control group. The PIU and ED groups also differed on key features related to each condition, but did not differ on measures of impulsivity or self-control. The co-occurrence of PIU and ED was associated with greater depressive symptoms than either PIU or ED independently. Conclusions: ARPIU and Sub-ED share links to depression and poor self-control and these may represent possible therapeutic targets across Internet-use and disordered-eating behaviors. Co-occurring PIU and ED at either lenient or stringent thresholds is associated with greater depression. Future studies should examine the temporal nature of these associations and the extent to which targeting depression, Internet use, or disordered eating may lead to improvements across domains.
    No preview · Article · Dec 2015 · Addictive behaviors
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    ABSTRACT: Compulsive behaviors are driven by repetitive urges and typically involve the experience of limited voluntary control over these urges, a diminished ability to delay or inhibit these behaviors, and a tendency to perform repetitive acts in a habitual or stereotyped manner. Compulsivity is not only a central characteristic of obsessive-compulsive disorder (OCD) but is also crucial to addiction. Based on this analogy, OCD has been proposed to be part of the concept of behavioral addiction along with other non-drug-related disorders that share compulsivity, such as pathological gambling, skin-picking, trichotillomania and compulsive eating. In this review, we investigate the neurobiological overlap between compulsivity in substance-use disorders, OCD and behavioral addictions as a validation for the construct of compulsivity that could be adopted in the Research Domain Criteria (RDoC). The reviewed data suggest that compulsivity in OCD and addictions is related to impaired reward and punishment processing with attenuated dopamine release in the ventral striatum, negative reinforcement in limbic systems, cognitive and behavioral inflexibility with diminished serotonergic prefrontal control, and habitual responding with imbalances between ventral and dorsal frontostriatal recruitment. Frontostriatal abnormalities of compulsivity are promising targets for neuromodulation and other interventions for OCD and addictions. We conclude that compulsivity encompasses many of the RDoC constructs in a trans-diagnostic fashion with a common brain circuit dysfunction that can help identifying appropriate prevention and treatment targets.
    Full-text · Article · Dec 2015 · European neuropsychopharmacology: the journal of the European College of Neuropsychopharmacology
  • Barbara C. Banz · Sarah W. Yip · Yvonne H.C. Yau · Marc N. Potenza
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    ABSTRACT: Recent progress has been made in our understanding of nonsubstance or "behavioral" addictions, although these conditions and their most appropriate classification remain debated and the knowledge basis for understanding the pathophysiology of and treatments for these conditions includes important gaps. Recent developments include the classification of gambling disorder as a "Substance-Related and Addictive Disorder" in the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and proposed diagnostic criteria for Internet Gaming Disorder in Section 3 of DSM-5. This chapter reviews current neuroscientific understandings of behavioral addictions and the potential of neurobiological data to assist in the development of improved policy, prevention, and treatment efforts.
    No preview · Article · Nov 2015 · Progress in brain research
  • Iris M Balodis · Carlos M Grilo · Marc N Potenza
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    ABSTRACT: Biobehavioral features associated with binge-eating disorder (BED) have been investigated; however, few systematic reviews to date have described neuroimaging findings from studies of BED. Emerging functional and structural studies support BED as having unique and overlapping neural features as compared with other disorders. Neuroimaging studies provide evidence linking heightened responses to palatable food cues with prefrontal areas, particularly the orbitofrontal cortex (OFC), with specific relationships to hunger and reward-sensitivity measures. While few studies to date have investigated non-food-cue responses; these suggest a generalized hypofunctioning in frontostriatal areas during reward and inhibitory control processes. Early studies applying neuroimaging to treatment efforts suggest that targeting neural function underlying motivational processes may prove important in the treatment of BED.
    No preview · Article · Nov 2015 · CNS spectrums
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    Guangheng Dong · Marc N. Potenza
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    ABSTRACT: Individuals with Internet gaming disorder (IGD) continue gaming despite adverse consequences. However, the precise mechanism underlying this behavior remains unknown. In this study, data from 20 IGD subjects and 16 otherwise comparable healthy control subjects (HCs) were recorded and compared when they were undergoing risk-taking and risky decision-making during functional magnetic resonance imaging (fMRI). During risk-taking and as compared to HCs, IGD subjects selected more risk-disadvantageous trials and demonstrated less activation of the anterior cingulate, posterior cingulate and middle temporal gyrus. During risky decision-making and as compared to HCs, IGD subjects showed shorter response times and less activations of the inferior frontal and superior temporal gyri. Taken together, data suggest that IGD subjects show impaired executive control in selecting risk-disadvantageous choices, and they make risky decisions more hastily and with less recruitment of regions implicated in impulse control. These results suggest a possible neurobiological underpinning for why IGD subjects may exhibit poor control over their game-seeking behaviors even when encountering negative consequences and provide possible therapeutic targets for interventions in this population.
    Full-text · Article · Nov 2015 · Journal of Psychiatric Research
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    ABSTRACT: Background: Prenatal cocaine exposure (PCE) is associated with increased rates of illicit-substance use during adolescence. In addition, both PCE and illicit-substance use are associated with alterations in cortico-striato-limbic neurocircuitry, development of which is ongoing throughout adolescence. However, the relationship between illicit-substance use, PCE and functional neural responses has not previously been assessed concurrently. Methods: Sixty-eight adolescents were recruited from an ongoing longitudinal study of childhood and adolescent development. All participants had been followed since birth. Functional magnetic resonance imaging (fMRI) data were acquired during presentation of personalized stressful, favorite-food and neutral/relaxing imagery scripts and compared between 46 PCE and 22 non-prenatally-drug-exposed (NDE) adolescents with and without lifetime illicit-substance use initiation. Data were analyzed using multi-level ANOVAs (pFWE<.05). Results: There was a significant three-way interaction between illicit-substance use, PCE status and cue condition on neural responses within primarily cortical brain regions, including regions of the left and right insula. Among PCE versus NDE adolescents, illicit-substance use was associated with decreased subcortical and increased cortical activity during the favorite-food condition, whereas the opposite pattern of activation was observed during the neutral/relaxing condition. Among PCE versus NDE adolescents, illicit-substance use during stress processing was associated with decreased activity in cortical and subcortical regions including amygdala, hippocampus and prefrontal cortex. Neural activity within cortico-striato-limbic regions was significantly negatively associated with subjective ratings of anxiety and craving among illicit-substance users, but not among non-users. Conclusions: These findings suggest different neural substrates of experimentation with illicit drugs between adolescents with and without in utero cocaine exposure.
    No preview · Article · Nov 2015 · Drug and alcohol dependence
  • Sarah W. Yip · Kathleen M. Carroll · Marc N. Potenza

    No preview · Article · Nov 2015

  • No preview · Article · Nov 2015
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    ABSTRACT: Excessive alcohol use in young adults is associated with greater impulsivity and neurobiological alterations in executive control systems. The maximum number of drinks consumed during drinking occasions ('MaxDrinks') represents a phenotype linked to vulnerability of alcohol use disorders, and an increase, or 'escalation', in MaxDrinks may be indicative of greater risk for problematic drinking. Thirty-six young adult drinkers performed a Go/No-Go task during fMRI, completed impulsivity-related assessments, and provided monthly reports of alcohol use during a 12-month follow-up period. Participants were characterized by MaxDrinks at baseline and after follow-up, identifying 18 escalating-drinkers and 18 constant-drinkers. Independent component analysis was used to investigate functional brain networks associated with response inhibition, and relationships with principal component analysis derived impulsivity-related domains were examined. Greater baseline MaxDrinks was associated with an average reduction in the engagement of a right-lateralized fronto-parietal functional network, while an escalation in MaxDrinks was associated with a greater difference in fronto-parietal engagement between successful inhibitions and error trials. Escalating-drinkers displayed greater impulsivity/compulsivity-related domain scores that were positively associated with fronto-parietal network engagement and change in MaxDrinks during follow-up. In young adults, an escalating MaxDrinks trajectory was prospectively associated with altered fronto-parietal control mechanisms and greater impulsivity/compulsivity scores. Continued longitudinal studies of MaxDrinks trajectories, functional network activity and impulsivity/compulsivity-related features may lend further insight into an intermediate phenotype vulnerable for alcohol use and addictive disorders.Neuropsychopharmacology accepted article preview online, 30 October 2015. doi:10.1038/npp.2015.332.
    No preview · Article · Oct 2015 · Neuropsychopharmacology: official publication of the American College of Neuropsychopharmacology
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    ABSTRACT: The Internet provides a large source of novel and rewarding stimuli, particularly with respect to sexually explicit materials. Novelty-seeking and cue-conditioning are fundamental processes underlying preference and approach behaviors implicated in disorders of addiction. Here we examine these processes in individuals with compulsive sexual behaviors (CSB), hypothesizing a greater preference for sexual novelty and stimuli conditioned to sexual rewards relative to healthy volunteers. Twenty-two CSB males and forty age-matched male volunteers were tested in two separate behavioral tasks focusing on preferences for novelty and conditioned stimuli. Twenty subjects from each group were also assessed in a third conditioning and extinction task using functional magnetic resonance imaging. CSB was associated with enhanced novelty preference for sexual, as compared to control images, and a generalized preference for cues conditioned to sexual and monetary versus neutral outcomes compared to healthy volunteers. CSB individuals also had greater dorsal cingulate habituation to repeated sexual versus monetary images with the degree of habituation correlating with enhanced preference for sexual novelty. Approach behaviors to sexually conditioned cues dissociable from novelty preference were associated with an early attentional bias to sexual images. This study shows that CSB individuals have a dysfunctional enhanced preference for sexual novelty possibly mediated by greater cingulate habituation along with a generalized enhancement of conditioning to rewards. We further emphasize a dissociable role for cue-conditioning and novelty preference on the early attentional bias for sexual cues. These findings have wider relevance as the Internet provides a wide range of novel and potentially rewarding stimuli.
    Full-text · Article · Oct 2015 · Journal of Psychiatric Research
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    Shane W Kraus · Valerie Voon · Marc N Potenza

    Full-text · Article · Sep 2015 · Neuropsychopharmacology

  • No preview · Article · Sep 2015
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    ABSTRACT: Transcranial direct current stimulation (tDCS) studies often use one anode to increase cortical excitability in one hemisphere. However, mental processes may involve cortical regions in both hemispheres. This study's aim was to assess the safety and possible effects on affect and working memory of tDCS using two anodes for bifrontal stimulation. A group of healthy subjects participated in two bifrontal tDCS sessions on two different days, one for real and the other for sham stimulation. They performed a working memory task and reported their affect immediately before and after each tDCS session. Relative to sham, real bifrontal stimulation did not induce significant adverse effects, reduced decrement in vigor-activity during the study session, and did not improve working memory. These preliminary findings suggest that bifrontal anodal stimulation is feasible and safe and may reduce task-related fatigue in healthy participants. Its effects on neuropsychiatric patients deserve further study.
    Full-text · Article · Sep 2015 · The Yale journal of biology and medicine
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    Marc N. Potenza
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    ABSTRACT: Multiple controversies exist currently in the field of behavioral addictions. The opinion article by Billieux, Schimmenti, Khazaal, Maurage and Heeren (2015) proposes an approach to considering which behaviors might be considered as foci for addictions. The article raises multiple important points that foster further dialog and highlight the need for additional research. Given that how specific behaviors are considered from diagnostic and classification perspectives holds significant public health implications, targeting and eliminating current knowledge gaps relating to behavioral addictions is an important undertaking.
    Preview · Article · Sep 2015 · Journal of Behavioural Addictions
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    ABSTRACT: Substance use during pregnancy and the postpartum period may have significant implications for both mother and the developing child. However, the neurobiological basis of the impact of substance use on parenting is less well understood. Here, we examined the impact of maternal substance use on cortical gray matter (GM) and white matter (WM) volumes and whether this was associated with individual differences in motivational systems of behavioral activation and inhibition. Mothers were included in the substance-using group if any addictive substance was used during pregnancy and/or in the immediate postpartum period (within 3 months of delivery). GM volume was reduced in substance-using mothers compared to non-substance-using mothers, particularly in frontal brain regions. In substance-using mothers, we also found that frontal GM was negatively correlated with levels of behavioral activation (i.e., the motivation to approach rewarding stimuli). This effect was absent in non-substance-using mothers. Taken together, these findings indicate a reduction in GM volume is associated with substance use and that frontal GM volumetric differences may be related to approach motivation in substance-using mothers.
    Preview · Article · Sep 2015 · The Yale journal of biology and medicine

Publication Stats

13k Citations
1,667.42 Total Impact Points


  • 2015
    • McLean Hospital
      Cambridge, Massachusetts, United States
  • 1992-2015
    • Yale-New Haven Hospital
      • Department of Laboratory Medicine
      New Haven, Connecticut, United States
  • 1991-2015
    • Yale University
      • • Department of Psychiatry
      • • Department of Cell Biology
      New Haven, Connecticut, United States
  • 2013
    • Texas State University
      San Marcos, Texas, United States
  • 2012
    • University of New Haven
      New Haven, Connecticut, United States
  • 2010
    • University of Chicago
      • Department of Psychiatry and Behavioral Neuroscience
      Chicago, Illinois, United States
  • 2007-2010
    • University of Minnesota Twin Cities
      • Department of Psychiatry
      Minneapolis, MN, United States
  • 2006
    • University of Pennsylvania
      • Department of Psychiatry
      Philadelphia, PA, United States
    • New York College of Osteopathic Medicine
      New York City, New York, United States
  • 2004
    • Indiana University-Purdue University Indianapolis
      • Department of Psychiatry
      Indianapolis, Indiana, United States
    • Butler Hospital
      Providence, Rhode Island, United States
  • 2003
    • Vanderbilt University
      Нашвилл, Michigan, United States