title: Altered cingulate and insular cortex activation during risk-taking in methamphetamine dependence: losses lose impact.
abstract: OBJECTIVE
  To determine if methamphetamine-dependent (MD) individuals exhibit behavioral or neural processing differences in risk-taking relative to healthy comparison participants (CTL).
  
  
  METHODS
  This was a cross-sectional study comparing two groups' behavior on a risk-taking task and neural processing as assessed using functional magnetic resonance imaging (fMRI).
  
  
  METHODS
  The study was conducted in an in-patient treatment center and a research fMRI facility in the United States.
  
  
  METHODS
  Sixty-eight recently abstinent MD individuals recruited from a treatment program and 40 CTL recruited from the community completed the study.
  
  
  METHODS
  The study assessed risk-taking behavior (overall and post-loss) using the Risky Gains Task (RGT), sensation-seeking, impulsivity and blood-oxygenation-level-dependent activation in the brain during the decision phase of the RGT.
  
  
  RESULTS
  Relative to CTL, MD displayed decreased activation in the bilateral rostral anterior cingulate cortex (ACC) and greater activation in the left insula across risky and safe decisions (P < 0.05). Right mid-insula activation among CTL did not vary between risky and safe decisions, but among MD it was higher during risky relative to safe decisions (P < 0.05). Among MD, lower activation in the right rostral ACC (r = -0.39, P < 0.01) and higher activation in the right mid-insula (r = 0.35, P < 0.01) during risky decisions were linked to a higher likelihood of choosing a risky option following a loss.
  
  
  CONCLUSIONS
  Methamphetamine-dependent individuals show disrupted risk-related processing in both anterior cingulate and insula, brain areas that have been implicated in cognitive control and interoceptive processing. Attenuated neural processing of risky options may lead to risk-taking despite experiencing negative consequences.
authors.affiliation: Psychiatry, UCSD, La Jolla, CA, USA.
authors.forename: Joshua L
authors.initials: JL
authors.lastname: Gowin
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Stewart
authors.forename: April C
authors.initials: AC
authors.lastname: May
authors.forename: Tali M
authors.initials: TM
authors.lastname: Ball
authors.forename: Marc
authors.initials: M
authors.lastname: Wittmann
authors.forename: Susan F
authors.initials: SF
authors.lastname: Tapert
authors.forename: Martin P
authors.initials: MP
authors.lastname: Paulus
mesh_terms: D000328:Adult; D019969:Amphetamine-Related Disorders / Q000503:physiopathology / Q000523:psychology*; D000704:Analysis of Variance; D000697:Central Nervous System Stimulants / Q000494:pharmacology*; D002540:Cerebral Cortex / Q000187:drug effects* / Q000502:physiology; D003192:Compulsive Behavior / Q000503:physiopathology; D003657:Decision Making; D005106:Exploratory Behavior / Q000187:drug effects / Q000502:physiology; D005260:Female; D006179:Gyrus Cinguli / Q000187:drug effects* / Q000502:physiology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008694:Methamphetamine / Q000494:pharmacology*; D010551:Personality; D011581:Psychological Tests; D012309:Risk-Taking
chemical_list: D000697:Central Nervous System Stimulants; D008694:Methamphetamine
keywords: Decision-making; neuroimaging; relapse; treatment
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