title: Hyperresponsiveness of the Neural Fear Network During Fear Conditioning and Extinction Learning in Male Cocaine Users.
abstract: OBJECTIVE
  The authors investigated whether cocaine use disorder is associated with abnormalities in the neural underpinnings of aversive conditioning and extinction learning, as these processes may play an important role in the development and persistence of drug abuse.
  
  
  METHODS
  Forty male regular cocaine users and 51 male control subjects underwent a fear conditioning and extinction protocol during functional MRI. Skin conductance response was measured throughout the experiment as an index of conditioned responses.
  
  
  RESULTS
  Cocaine users showed hyperresponsiveness of the amygdala and insula during fear conditioning, as well as hyporesponsiveness of the dorsomedial prefrontal cortex during extinction learning. In cocaine users, but not in control subjects, skin conductance responses were positively correlated with responsiveness of the insula, amygdala, and dorsomedial prefrontal cortex during fear conditioning but negatively correlated with responsiveness of the ventromedial prefrontal cortex during extinction learning.
  
  
  CONCLUSIONS
  Increased sensitivity to aversive conditioned cues in cocaine users might be a risk factor for stress-relief craving in cocaine use disorder. These results support the postulated role of altered aversive conditioning in cocaine use disorder and may be an important step in understanding the role of aversive learning in the pathology of cocaine use disorder.
authors.affiliation: From the Departments of Psychiatry and Radiology, Academic Medical Center, Amsterdam; the Spinoza Center for Neuroimaging, Institute of the Royal Netherlands Academy of Arts and Sciences, Amsterdam; Amsterdam Brain and Cognition, University of Amsterdam, Amsterdam; and the Donders Institute for Brain, Cognition, and Behavior, Radboud University Medical Center, Nijmegen, the Netherlands.
authors.forename: Anne Marije
authors.initials: AM
authors.lastname: Kaag
authors.affiliation: From the Departments of Psychiatry and Radiology, Academic Medical Center, Amsterdam; the Spinoza Center for Neuroimaging, Institute of the Royal Netherlands Academy of Arts and Sciences, Amsterdam; Amsterdam Brain and Cognition, University of Amsterdam, Amsterdam; and the Donders Institute for Brain, Cognition, and Behavior, Radboud University Medical Center, Nijmegen, the Netherlands.
authors.forename: Nina
authors.initials: N
authors.lastname: Levar
authors.affiliation: From the Departments of Psychiatry and Radiology, Academic Medical Center, Amsterdam; the Spinoza Center for Neuroimaging, Institute of the Royal Netherlands Academy of Arts and Sciences, Amsterdam; Amsterdam Brain and Cognition, University of Amsterdam, Amsterdam; and the Donders Institute for Brain, Cognition, and Behavior, Radboud University Medical Center, Nijmegen, the Netherlands.
authors.forename: Karlijn
authors.initials: K
authors.lastname: Woutersen
authors.affiliation: From the Departments of Psychiatry and Radiology, Academic Medical Center, Amsterdam; the Spinoza Center for Neuroimaging, Institute of the Royal Netherlands Academy of Arts and Sciences, Amsterdam; Amsterdam Brain and Cognition, University of Amsterdam, Amsterdam; and the Donders Institute for Brain, Cognition, and Behavior, Radboud University Medical Center, Nijmegen, the Netherlands.
authors.forename: Judith
authors.initials: J
authors.lastname: Homberg
authors.affiliation: From the Departments of Psychiatry and Radiology, Academic Medical Center, Amsterdam; the Spinoza Center for Neuroimaging, Institute of the Royal Netherlands Academy of Arts and Sciences, Amsterdam; Amsterdam Brain and Cognition, University of Amsterdam, Amsterdam; and the Donders Institute for Brain, Cognition, and Behavior, Radboud University Medical Center, Nijmegen, the Netherlands.
authors.forename: Wim
authors.initials: W
authors.lastname: van den Brink
authors.affiliation: From the Departments of Psychiatry and Radiology, Academic Medical Center, Amsterdam; the Spinoza Center for Neuroimaging, Institute of the Royal Netherlands Academy of Arts and Sciences, Amsterdam; Amsterdam Brain and Cognition, University of Amsterdam, Amsterdam; and the Donders Institute for Brain, Cognition, and Behavior, Radboud University Medical Center, Nijmegen, the Netherlands.
authors.forename: Liesbeth
authors.initials: L
authors.lastname: Reneman
authors.affiliation: From the Departments of Psychiatry and Radiology, Academic Medical Center, Amsterdam; the Spinoza Center for Neuroimaging, Institute of the Royal Netherlands Academy of Arts and Sciences, Amsterdam; Amsterdam Brain and Cognition, University of Amsterdam, Amsterdam; and the Donders Institute for Brain, Cognition, and Behavior, Radboud University Medical Center, Nijmegen, the Netherlands.
authors.forename: Guido
authors.initials: G
authors.lastname: van Wingen
mesh_terms: D000293:Adolescent; D000328:Adult; D000679:Amygdala / Q000503:physiopathology*; D016022:Case-Control Studies; D002540:Cerebral Cortex / Q000503:physiopathology*; D019970:Cocaine-Related Disorders / Q000503:physiopathology*; D003213:Conditioning, Psychological / Q000502:physiology*; D005108:Extinction, Psychological / Q000502:physiology*; D005239:Fear / Q000502:physiology*; D059907:Functional Neuroimaging; D005712:Galvanic Skin Response / Q000502:physiology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D017397:Prefrontal Cortex / Q000503:physiopathology*; D055815:Young Adult