title: Cocaine users with comorbid Cluster B personality disorders show dysfunctional brain activation and connectivity in the emotional regulation networks during negative emotion maintenance and reappraisal.
abstract: Cocaine dependence often co-occurs with Cluster B personality disorders. Since both disorders are characterized by emotion regulation deficits, we predicted that cocaine comorbid patients would exhibit dysfunctional patterns of brain activation and connectivity during reappraisal of negative emotions. We recruited 18 cocaine users with comorbid Cluster B personality disorders, 17 cocaine users without comorbidities and 21 controls to be scanned using functional magnetic resonance imaging (fMRI) during performance on a reappraisal task in which they had to maintain or suppress the emotions induced by negative affective stimuli. We followed region of interest (ROI) and whole-brain approaches to investigate brain activations and connectivity associated with negative emotion experience and reappraisal. Results showed that cocaine users with comorbid personality disorders had reduced activation of the subgenual anterior cingulate cortex during negative emotion maintenance and increased activation of the lateral orbitofrontal cortex and the amygdala during reappraisal. Amygdala activation correlated with impulsivity and antisocial beliefs in the comorbid group. Connectivity analyses showed that in the cocaine comorbid group the subgenual cingulate was less efficiently connected with the amygdala and the fusiform gyri and more efficiently connected with the anterior insula during maintenance, whereas during reappraisal the left orbitofrontal cortex was more efficiently connected with the amygdala and the right orbitofrontal cortex was less efficiently connected with the dorsal striatum. We conclude that cocaine users with comorbid Cluster B personality disorders have distinctive patterns of brain activation and connectivity during maintenance and reappraisal of negative emotions, which correlate with impulsivity and dysfunctional beliefs.
authors.affiliation: Department of Clinical Psychology, Universidad de Granada, Spain.
authors.forename: Natalia
authors.initials: N
authors.lastname: Albein-Urios
authors.forename: Juan
authors.initials: J
authors.lastname: Verdejo-Román
authors.forename: Carles
authors.initials: C
authors.lastname: Soriano-Mas
authors.forename: Samuel
authors.initials: S
authors.lastname: Asensio
authors.forename: José Miguel
authors.initials: JM
authors.lastname: Martínez-González
authors.forename: Antonio
authors.initials: A
authors.lastname: Verdejo-García
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D001921:Brain / Q000098:blood supply / Q000473:pathology*; D001931:Brain Mapping; D019970:Cocaine-Related Disorders / Q000150:complications / Q000175:diagnosis*; D004644:Emotions / Q000502:physiology*; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007600:Judgment / Q000502:physiology*; D008279:Magnetic Resonance Imaging; D008297:Male; D010100:Oxygen / Q000097:blood; D010554:Personality Disorders / Q000150:complications / Q000175:diagnosis*; D010555:Personality Inventory; D013223:Statistics as Topic
chemical_list: D010100:Oxygen
keywords: Amygdala; Anterior cingulate cortex; Antisocial personality disorder; Borderline personality disorder; Cocaine; Histrionic personality disorder; Lateral orbitofrontal cortex; Negative emotion; Reappraisal