title: Neural correlates of impaired self-awareness of apathy, disinhibition and dysexecutive deficits in cocaine-dependent individuals.
abstract: Cocaine addiction is characterized by impaired self-awareness about cognitive and motivational deficits, leading to poor treatment outcomes. However, there is still limited understanding of the neurophysiological underpinnings of this impairment. We aimed to establish if impaired self-awareness is underpinned by brain structural phenotypes among cocaine-dependent individuals (CDI). Sixty-five CDI and 65 designated informants completed the Frontal Systems Behavior Scale, and a subsample of 40 CDI were scanned via magnetic resonance imaging. We applied multiple regression models to establish the association between levels of self-awareness indexed by Frontal Systems Behavior Scale's discrepancy scores (i.e. informant ratings minus self-reports of apathy, disinhibition and dysexecutive deficits) and gray matter volumes indexed by magnetic resonance imaging voxel-based measures within five brain regions of interest: anterior cingulate cortex, orbitofrontal cortex (OFC), striatum, insula and dorsolateral prefrontal cortex (DLPFC). We also examined the neural underpinnings of underestimation versus overestimation of deficits, by splitting the CDI group according to the positive or negative value of their discrepancy scores. We found that poorer self-awareness of apathy deficits was associated with greater gray matter volume in the dorsal striatum, and poorer self-awareness of disinhibition deficits was associated with greater gray matter volume in the OFC in the whole sample. More underestimation and more overestimation of executive deficits were linked to lower DLPFC volume. We show that impaired self-awareness of cognitive and motivational deficits in cocaine addiction has a neural underpinning, implicating striatum, OFC and DLPFC structural phenotypes.
authors.affiliation: Institute of Neuroscience F. Oloriz and Department of Clinical Psychology, University of Granada, Spain.|Division of Anaesthesia, University of Cambridge, UK.
authors.forename: Laura
authors.initials: L
authors.lastname: Moreno-López
authors.affiliation: Cognitive Neuroscience Unit, Deakin University, Australia.
authors.forename: Natalia
authors.initials: N
authors.lastname: Albein-Urios
authors.affiliation: Red de Trastornos Adictivos, Universidad de Granada, Spain.
authors.forename: José M
authors.initials: JM
authors.lastname: Martínez-González
authors.affiliation: Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Spain.|Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain.|Department of Psychobiology and Methodology of Health Sciences, Universitat Autònoma de Barcelona, Spain.
authors.forename: Carles
authors.initials: C
authors.lastname: Soriano-Mas
authors.affiliation: Institute of Neuroscience F. Oloriz and Department of Clinical Psychology, University of Granada, Spain.|Red de Trastornos Adictivos, Universidad de Granada, Spain.|School of Psychological Sciences and Monash Institute of Cognitive and Clinical Neuroscience, Monash University, Australia.
authors.forename: Antonio
authors.initials: A
authors.lastname: Verdejo-García
mesh_terms: D000328:Adult; D057565:Apathy; D001921:Brain / Q000000981:diagnostic imaging* / Q000473:pathology; D002540:Cerebral Cortex / Q000000981:diagnostic imaging / Q000473:pathology; D019970:Cocaine-Related Disorders / Q000000981:diagnostic imaging / Q000523:psychology*; D003342:Corpus Striatum / Q000000981:diagnostic imaging / Q000473:pathology; D056344:Executive Function; D005260:Female; D066128:Gray Matter / Q000000981:diagnostic imaging* / Q000473:pathology; D006179:Gyrus Cinguli / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D007266:Inhibition, Psychological; D008279:Magnetic Resonance Imaging; D008297:Male; D017072:Neostriatum / Q000000981:diagnostic imaging / Q000473:pathology; D009929:Organ Size; D017397:Prefrontal Cortex / Q000000981:diagnostic imaging / Q000473:pathology; D012044:Regression Analysis
keywords: Awareness; cocaine; dorsolateral prefrontal cortex; gray matter; orbitofrontal cortex; striatum