title: Prefrontal-striatal pathway underlies cognitive regulation of craving.
abstract: The ability to control craving for substances that offer immediate rewards but whose long-term consumption may pose serious risks lies at the root of substance use disorders and is critical for mental and physical health. Despite its importance, the neural systems supporting this ability remain unclear. Here, we investigated this issue using functional imaging to examine neural activity in cigarette smokers, the most prevalent substance-dependent population in the United States, as they used cognitive strategies to regulate craving for cigarettes and food. We found that the cognitive down-regulation of craving was associated with (i) activity in regions previously associated with regulating emotion in particular and cognitive control in general, including dorsomedial, dorsolateral, and ventrolateral prefrontal cortices, and (ii) decreased activity in regions previously associated with craving, including the ventral striatum, subgenual cingulate, amygdala, and ventral tegmental area. Decreases in craving correlated with decreases in ventral striatum activity and increases in dorsolateral prefrontal cortex activity, with ventral striatal activity fully mediating the relationship between lateral prefrontal cortex and reported craving. These results provide insight into the mechanisms that enable cognitive strategies to effectively regulate craving, suggesting that it involves neural dynamics parallel to those involved in regulating other emotions. In so doing, this study provides a methodological tool and conceptual foundation for studying this ability across substance using populations and developing more effective treatments for substance use disorders.
authors.affiliation: Division of Substance Abuse, Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06519, USA. hedy.kober@yale.edu
authors.forename: Hedy
authors.initials: H
authors.lastname: Kober
authors.forename: Peter
authors.initials: P
authors.lastname: Mende-Siedlecki
authors.forename: Ethan F
authors.initials: EF
authors.lastname: Kross
authors.forename: Jochen
authors.initials: J
authors.lastname: Weber
authors.forename: Walter
authors.initials: W
authors.lastname: Mischel
authors.forename: Carl L
authors.initials: CL
authors.lastname: Hart
authors.forename: Kevin N
authors.initials: KN
authors.lastname: Ochsner
mesh_terms: D000293:Adolescent; D000328:Adult; D001931:Brain Mapping; D003071:Cognition / Q000502:physiology*; D003342:Corpus Striatum / Q000033:anatomy & histology / Q000502:physiology*; D003463:Cues; D004435:Eating / Q000502:physiology / Q000523:psychology; D004644:Emotions / Q000502:physiology; D005260:Female; D005502:Food; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D008959:Models, Neurological; D017397:Prefrontal Cortex / Q000033:anatomy & histology / Q000502:physiology*; D011597:Psychomotor Performance / Q000502:physiology; D015398:Signal Transduction / Q000502:physiology*; D012907:Smoking / Q000523:psychology; D019966:Substance-Related Disorders / Q000503:physiopathology / Q000523:psychology; D055815:Young Adult