Working memory fMRI activation in cocaine-dependent subjects: association with treatment response.
Functional magnetic resonance imaging (fMRI) studies of early abstinence cocaine users offer information about the state of the brain when most cocaine users seek treatment. This study examined the relationship between pretreatment brain function and subsequent treatment response in 19 treatment-seeking early abstinence cocaine-dependent (CD) subjects. These subjects and 14 non-drug-using control subjects underwent fMRI while performing a working memory task with three levels of difficulty. CD subjects were then randomized to treatment studies. Results showed CD subjects had significantly lower (random effects, corrected for multiple comparisons) brain activation in caudate, putamen, cingulate gyrus, middle and superior frontal gyri, inferior frontal gyrus pars triangularis and pars opercularis, precentral gyrus, and thalamus compared with non-drug-using controls. Within CD subjects, thalamic activation significantly correlated with treatment response. This study shows CD subjects in early abstinence have alterations of brain function in frontal, striatal, and thalamic brain regions known to be part of a circuit associated with motor control, reward, and cognition. Subjects with pretreatment thalamic deactivation showed the poorest treatment response, possibly related to thalamic involvement in mesocortical and mesolimbic dopamine projections.
Moeller
F Gerard
FG
Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston, 1300 Moursund, Houston, TX 77030, United States. Frederick.G.Moeller@uth.tmc.edu
Steinberg
Joel L
JL
Schmitz
Joy M
JM
Ma
Liangsuo
L
Liu
Shijing
S
Kjome
Kimberly L
KL
Rathnayaka
Nuvan
N
Kramer
Larry A
LA
Narayana
Ponnada A
PA
D000328:Adult; D000661:Amphetamine / Q000627:therapeutic use; D000704:Analysis of Variance; D001559:Benzhydryl Compounds / Q000627:therapeutic use; D001921:Brain / Q000098:blood supply* / Q000473:pathology; D001931:Brain Mapping; D002230:Carbidopa / Q000494:pharmacology; D000697:Central Nervous System Stimulants / Q000627:therapeutic use; D019970:Cocaine-Related Disorders / Q000150:complications / Q000473:pathology / Q000628:therapy; D015928:Cognitive Behavioral Therapy / Q000379:methods; D015259:Dopamine Agents / Q000627:therapeutic use; D004305:Dose-Response Relationship, Drug; D004359:Drug Therapy, Combination / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008433:Mathematics; D008569:Memory Disorders / Q000209:etiology / Q000473:pathology / Q000628:therapy; D008570:Memory, Short-Term / Q000187:drug effects / Q000502:physiology*; D008875:Middle Aged; D000077408:Modafinil; D009271:Naltrexone / Q000627:therapeutic use; D009292:Narcotic Antagonists / Q000627:therapeutic use; D009483:Neuropsychological Tests; D010100:Oxygen / Q000097:blood
D001559:Benzhydryl Compounds; D000697:Central Nervous System Stimulants; D015259:Dopamine Agents; D009292:Narcotic Antagonists; D009271:Naltrexone; D000661:Amphetamine; D002230:Carbidopa; D000077408:Modafinil; D010100:Oxygen