title: Anticipatory reward processing among cocaine-dependent individuals with and without concurrent methadone-maintenance treatment: Relationship to treatment response.
abstract: Cocaine dependence among opioid-dependent methadone-maintained individuals is a significant public health problem and is particularly challenging to treat. The neurobiology of this clinically complex population has not been previously assessed using fMRI.
  
  
  
  fMRI data from cocaine-dependent, methadone-maintained (CD-MM) patients (n=24), cocaine-dependent (CD) patients (n=20) and healthy comparison (HC) participants (n=21) were acquired during monetary incentive delay task performance. All patients were scanned prior to treatment for cocaine dependence. Between-group differences in anticipatory reward and loss processing were assessed using whole-brain ANOVAs in SPM12 (pFWE<0.05). Correlations between durations of abstinence during treatment and BOLD responses within the insula and caudate were also explored.
  
  
  
  Main effects of diagnostic group, primarily involving decreased BOLD responses among CD-MM patients in comparison to HCs, were observed during anticipatory reward and loss processing within regions of posterior cingulate cortex, precuneus, inferior frontal gyrus and dorsolateral prefrontal cortex. BOLD responses within the right caudate were negatively associated with percentage of cocaine-negative urines during treatment among CD-MM patients, but not among non-methadone-maintained CD patients.
  
  
  
  These data suggest neurofunctional differences that may be related to treatment outcomes for behavioral therapies between cocaine-dependent individuals with and without methadone-maintenance treatment. These findings may relate to differences in treatment efficacies and to the elevated relapse rates observed in methadone-maintained populations.
authors.affiliation: National Center on Addiction and Substance Abuse, Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA; Division of Substance Abuse, Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA. Electronic address: sarah.yip@yale.edu.
authors.forename: Sarah W
authors.initials: SW
authors.lastname: Yip
authors.affiliation: Division of Substance Abuse, Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA.
authors.forename: Elise E
authors.initials: EE
authors.lastname: DeVito
authors.affiliation: Division of Substance Abuse, Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA.
authors.forename: Hedy
authors.initials: H
authors.lastname: Kober
authors.affiliation: Division of Substance Abuse, Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA; Diagnostic Radiology, Yale University School of Medicine, New Haven, CT, USA.
authors.forename: Patrick D
authors.initials: PD
authors.lastname: Worhunsky
authors.affiliation: Division of Substance Abuse, Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA.
authors.forename: Kathleen M
authors.initials: KM
authors.lastname: Carroll
authors.affiliation: National Center on Addiction and Substance Abuse, Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA; Division of Substance Abuse, Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA; Department of Neuroscience, Yale University School of Medicine, New Haven, CT, USA; Yale Child Study Center, Yale University School of Medicine, New Haven, CT, USA.
authors.forename: Marc N
authors.initials: MN
authors.lastname: Potenza
mesh_terms: D000328:Adult; D000701:Analgesics, Opioid / Q000627:therapeutic use; D059031:Anticipation, Psychological; D001521:Behavior Therapy / Q000379:methods; D019970:Cocaine-Related Disorders / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000523:psychology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008691:Methadone / Q000008:administration & dosage*; D008875:Middle Aged; D009042:Motivation; D058850:Opiate Substitution Treatment / Q000379:methods / Q000523:psychology*; D012201:Reward; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000701:Analgesics, Opioid; D008691:Methadone
keywords: Cocaine; Heroin; Medication; Methadone; Opioids; Polysubstance use