title: Enhanced midbrain response at 6-month follow-up in cocaine addiction, association with reduced drug-related choice.
abstract: Drug addiction is characterized by dysregulated dopamine neurotransmission. Although dopamine functioning appears to partially recover with abstinence, the specific regions that recover and potential impact on drug seeking remain to be determined. Here we used functional magnetic resonance imaging (fMRI) to study an ecologically valid sample of 15 treatment-seeking cocaine addicted individuals at baseline and 6-month follow-up. At both study sessions, we collected fMRI scans during performance of a drug Stroop task, clinical self-report measures of addiction severity and behavioral measures of cocaine seeking (simulated cocaine choice); actual drug use in between the two study sessions was also monitored. At 6-month follow-up (compared with baseline), we predicted functional enhancement of dopaminergically innervated brain regions, relevant to the behavioral responsiveness toward salient stimuli. Consistent with predictions, whole-brain analyses revealed responses in the midbrain (encompassing the ventral tegmental area/substantia nigra complex) and thalamus (encompassing the mediodorsal nucleus) that were higher (and more positively correlated) at follow-up than baseline. Increased midbrain activity from baseline to follow-up correlated with reduced simulated cocaine choice, indicating that heightened midbrain activations in this context may be marking lower approach motivation for cocaine. Normalization of midbrain function at follow-up was also suggested by exploratory comparisons with active cocaine users and healthy controls (who were assessed only at baseline). Enhanced self-control at follow-up was suggested by a trend for the commonly hypoactive dorsal anterior cingulate cortex to increase response during a drug-related context. Together, these results suggest that fMRI could be useful in sensitively tracking follow-up outcomes in drug addiction.
authors.affiliation: Brookhaven National Laboratory, Upton, NY 11973-5000, USA.
authors.forename: Scott J
authors.initials: SJ
authors.lastname: Moeller
authors.forename: Dardo
authors.initials: D
authors.lastname: Tomasi
authors.forename: Patricia A
authors.initials: PA
authors.lastname: Woicik
authors.forename: Thomas
authors.initials: T
authors.lastname: Maloney
authors.forename: Nelly
authors.initials: N
authors.lastname: Alia-Klein
authors.forename: Jean
authors.initials: J
authors.lastname: Honorio
authors.forename: Frank
authors.initials: F
authors.lastname: Telang
authors.forename: Gene-Jack
authors.initials: GJ
authors.lastname: Wang
authors.forename: Ruiliang
authors.initials: R
authors.lastname: Wang
authors.forename: Rajita
authors.initials: R
authors.lastname: Sinha
authors.forename: Deni
authors.initials: D
authors.lastname: Carise
authors.forename: Janetta
authors.initials: J
authors.lastname: Astone-Twerell
authors.forename: Joy
authors.initials: J
authors.lastname: Bolger
authors.forename: Nora D
authors.initials: ND
authors.lastname: Volkow
authors.forename: Rita Z
authors.initials: RZ
authors.lastname: Goldstein
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D002540:Cerebral Cortex / Q000503:physiopathology*; D002755:Choice Behavior / Q000502:physiology; D019970:Cocaine-Related Disorders / Q000503:physiopathology*; D004298:Dopamine / Q000502:physiology; D058999:Drug-Seeking Behavior / Q000502:physiology; D005260:Female; D005500:Follow-Up Studies; D059907:Functional Neuroimaging; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008636:Mesencephalon / Q000503:physiopathology*; D008875:Middle Aged; D020127:Recovery of Function; D013788:Thalamus / Q000503:physiopathology*
chemical_list: D004298:Dopamine