title: Reward-related brain response and craving correlates of marijuana cue exposure: a preliminary study in treatment-seeking marijuana-dependent subjects.
abstract: OBJECTIVE
  : Determining the brain substrates underlying the motivation to abuse addictive drugs is critical for understanding and treating addictive disorders. Laboratory neuroimaging studies have demonstrated differential activation of limbic and motivational circuitry (eg, amygdala, hippocampus, ventral striatum, insula, and orbitofrontal cortex) triggered by cocaine, heroin, nicotine, and alcohol cues. The literature on neural responses to marijuana cues is sparse. Thus, the goals of this study were to characterize the brain's response to marijuana cues, a major motivator underlying drug use and relapse, and determine whether these responses are linked to self-reported craving in a clinically relevant population of treatment-seeking marijuana-dependent subjects.
  
  
  METHODS
  : Marijuana craving was assessed in 12 marijuana-dependent subjects using the Marijuana Craving Questionnaire-Short Form. Subsequently, blood oxygen level dependent functional magnetic resonance imaging data were acquired during exposure to alternating 20-second blocks of marijuana-related versus matched nondrug visual cues.
  
  
  RESULTS
  : Brain activation during marijuana cue exposure was significantly greater in the bilateral amygdala and the hippocampus. Significant positive correlations between craving scores and brain activation were found in the ventral striatum and the medial and lateral orbitofrontal cortex (P < 0.0001).
  
  
  CONCLUSIONS
  : This study presents direct evidence for a link between reward-relevant brain responses to marijuana cues and craving and extends the current literature on marijuana cue reactivity. Furthermore, the correlative relationship between craving and brain activity in reward-related regions was observed in a clinically relevant sample (treatment-seeking marijuana-dependent subjects). Results are consistent with prior findings in cocaine, heroin, nicotine, and alcohol cue studies, indicating that the brain substrates of cue-triggered drug motivation are shared across abused substances.
authors.affiliation: Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA 19104, USA. marinag@mail.med.upenn.edu
authors.forename: Marina
authors.initials: M
authors.lastname: Goldman
authors.forename: Regina P
authors.initials: RP
authors.lastname: Szucs-Reed
authors.forename: Kanchana
authors.initials: K
authors.lastname: Jagannathan
authors.forename: Ronald N
authors.initials: RN
authors.lastname: Ehrman
authors.forename: Ze
authors.initials: Z
authors.lastname: Wang
authors.forename: Yin
authors.initials: Y
authors.lastname: Li
authors.forename: Jesse J
authors.initials: JJ
authors.lastname: Suh
authors.forename: Kyle
authors.initials: K
authors.lastname: Kampman
authors.forename: Charles P
authors.initials: CP
authors.lastname: O'Brien
authors.forename: Anna Rose
authors.initials: AR
authors.lastname: Childress
authors.forename: Teresa R
authors.initials: TR
authors.lastname: Franklin
mesh_terms: D000328:Adult; D000679:Amygdala / Q000473:pathology / Q000503:physiopathology; D016739:Behavior, Addictive / Q000175:diagnosis / Q000503:physiopathology; D001931:Brain Mapping / Q000379:methods*; D003463:Cues; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006624:Hippocampus / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D002189:Marijuana Abuse / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D010775:Photic Stimulation / Q000379:methods*; D011237:Predictive Value of Tests; D011569:Psychiatric Status Rating Scales; D011580:Psychological Techniques; D012008:Recurrence; D012201:Reward; D015813:Substance Abuse Detection / Q000379:methods