title: Neural correlates of craving and impulsivity in abstinent former cocaine users: Towards biomarkers of relapse risk.
abstract: A significant hindrance to effective treatment of addiction is identifying those most likely to relapse. Cocaine addiction is characterized by deficits in inhibitory control and elevated reactivity to cocaine cues, both hypothesized to be integral to development of addiction and propensity to relapse. It follows that reduction of both impulsivity and cue-reactivity following abstinence is protective against relapse, and that persistence of these factors increases vulnerability. Using functional magnetic resonance imaging, we examined neural activation patterns in dorsal and ventral striatum in abstinent cocaine dependent (CD) individuals (N=20) and non-using controls (N=19) as they performed a cocaine craving task. We also examined activations in nodes of the response inhibition circuit (RIC) as they performed an inhibition task. At the between-groups level, no differences in RIC or striatal activation were seen in former users, in contrast to previous investigations in current users, suggesting large-scale functional recovery with abstinence. However, at the individual participant-level, abstinent CD individuals displayed an association between cocaine cue-related neural activations in the right ventral striatum and compulsive cocaine craving scores. Compulsive craving scores were also negatively correlated with duration of abstinence. Further, there was an association between motor impulsivity scores and inhibition-related activations in the right inferior frontal gyrus and pre-supplementary motor area in abstinent CD individuals. Thus, while former users as a group did not show deficits in inhibitory function or cocaine-cue reactivity, participant-level results pointed to activation patterns in a minority of these individuals that likely contributes to enduring relapse vulnerability.
authors.affiliation: The Sheryl and Daniel R. Tishman Cognitive Neurophysiology Laboratory, Children's Evaluation and Rehabilitation Center (CERC), Department of Pediatrics, Albert Einstein College of Medicine & Montefiore Medical Center, Van Etten Building - Wing 1C, 1300 Morris Park Avenue, Bronx, NY 10461, USA; Program in Cognitive Neuroscience, The Graduate Center of the City University of New York, 365 Fifth Avenue, New York, NY 10016, USA.
authors.forename: Ryan P
authors.initials: RP
authors.lastname: Bell
authors.affiliation: University of Vermont, Department of Psychiatry, 1 South Prospect St, Burlington, VT 05401, USA; The Nathan S. Kline Institute for Psychiatric Research, 140 Old Orangeburg Road, Orangeburg, NY 10962, USA.
authors.forename: Hugh
authors.initials: H
authors.lastname: Garavan
authors.affiliation: The Sheryl and Daniel R. Tishman Cognitive Neurophysiology Laboratory, Children's Evaluation and Rehabilitation Center (CERC), Department of Pediatrics, Albert Einstein College of Medicine & Montefiore Medical Center, Van Etten Building - Wing 1C, 1300 Morris Park Avenue, Bronx, NY 10461, USA; Program in Cognitive Neuroscience, The Graduate Center of the City University of New York, 365 Fifth Avenue, New York, NY 10016, USA; The Dominick P. Purpura Department of Neuroscience, Rose F. Kennedy Center, Albert Einstein College of Medicine, 1410 Pelham Parkway South, Bronx, NY 10461, USA; The Nathan S. Kline Institute for Psychiatric Research, 140 Old Orangeburg Road, Orangeburg, NY 10962, USA. Electronic address: john.foxe@einstein.yu.edu.
authors.forename: John J
authors.initials: JJ
authors.lastname: Foxe
mesh_terms: D000328:Adult; D001921:Brain / Q000503:physiopathology*; D001931:Brain Mapping; D003042:Cocaine; D019970:Cocaine-Related Disorders / Q000503:physiopathology* / Q000523:psychology*; D066249:Craving / Q000502:physiology*; D003430:Cross-Sectional Studies; D003463:Cues; D006801:Humans; D007175:Impulsive Behavior / Q000502:physiology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D011597:Psychomotor Performance / Q000502:physiology; D012306:Risk; D011795:Surveys and Questionnaires
chemical_list: D003042:Cocaine
keywords: Abstinence; Addiction; Basal ganglia; Drugs of abuse; Impulsivity; Recovery; Response inhibition; fMRI