A neurocognitive approach to understanding the neurobiology of addiction

Differential contributions of striatal dopamine D1 and D2 receptors to component processes of value-based decision making

Dopamine has been implicated in value-based learning and decision making by signaling reward prediction errors and facilitating cognitive flexibility, incentive motivation, and voluntary movement. Dopamine receptors can roughly be divided into the D1 and D2 subtypes, and it has been hypothesized that these two types of receptors have an opposite function in facilitating reward-related and aversion-related behaviors, respectively. Here, we tested the contribution of striatal dopamine D1 and D2 receptors to processes underlying value-based learning and decision making in rats, employing a probabilistic reversal learning paradigm. Using computational trial-by-trial analysis of task behavior after systemic or intracranial treatment with dopamine D1 and D2 receptor agonists and antagonists, we show that negative feedback learning can be modulated through D2 receptor signaling and positive feedback learning through D1 receptor signaling in the ventral striatum. Furthermore, stimulation of D2 receptors in the ventral or dorsolateral (but not dorsomedial) striatum promoted explorative choice behavior, suggesting an additional function of dopamine in these areas in value-based decision making. Finally, treatment with most dopaminergic drugs affected response latencies and number of trials completed, which was also seen after infusion of D2, but not D1 receptor-acting drugs into the striatum. Together, our data support the idea that dopamine D1 and D2 receptors have complementary functions in learning on the basis of emotionally valenced feedback, and provide evidence that dopamine facilitates value-based and motivated behaviors through distinct striatal regions.

White matter integrity alternations associated with cocaine dependence and long-term abstinence: Preliminary findings

Cocaine dependence has been associated with deficits in white matter (WM) integrity. Nevertheless, what happens to WM integrity after long-term abstinence is not fully understood. To bridge this gap, changes in WM integrity were examined with diffusion tensor imaging (DTI) applied to 39 participants: 12 participants who used cocaine in the last year (CURRENT USERS), 20 who were at different stages of cocaine abstinence (ABSTINENCE) [five with 1-5 years of abstinence (ABS1), five with 6-10 years of abstinence (ABS2), and 10 with over 10 years of abstinence (ABS3)], and 7 healthy controls (CONTROLS). The CONTROL group had higher fractional anisotropy (FA) compared to CURRENT USERS in frontal cortex tracts, including the bilateral corpus callosum, bilateral superior longitudinal fasciculus, bilateral inferior fronto-occipital fasciculus, left internal capsule, left middle cingulum, and left ventral and dorsal medial frontal regions. The ABSTINENCE group also had higher FA compared to CURRENT USERS in frontal cortex tracts, such as the bilateral corpus callosum, bilateral superior longitudinal fasciculus, left inferior longitudinal fasciculus, left uncinate fasciculus, left inferior fronto-occipital fasciculus, and the left ventral and dorsal medial frontal regions. Tractography analysis showed (1) deficits in terms of number of fibers and fiber length in these regions, and that (2) while there was some recovery of white matter in dorsolateral regions during abstinence, duration of abstinence was not associated with such recovery. The results identified WM differences among cocaine users, cocaine abstinent participants, and controls. These preliminary findings point to WM tracts that recover, and some that do not, after long-term abstinence from cocaine.

Moderate-Intensity Aerobic Exercise Restores Appetite and Prefrontal Brain Activity to Images of Food Among Persons Dependent on Methamphetamine: A Functional Near-Infrared Spectroscopy Study

The brain prefrontal control system is critical to successful recovery from substance use disorders, and the prefrontal cortex (PFC) regulates striatal reward-related processes. Substance-dependent individuals exhibit an increased response to drug rewards and decreased response to natural, nondrug rewards. Short-term aerobic exercise can ameliorate craving and inhibitory deficits in methamphetamine users, but the effect of exercise on food reward is unknown. This study used functional near-infrared spectroscopy (fNIRS) to measure the effects of moderate- and high-intensity short-term aerobic exercise on prefrontal activity related to food images and recorded the subjective feelings of appetite in methamphetamine-dependent users. In total, 56 men who met the Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) criteria for methamphetamine dependence, with a mean (SD) body mass index of 24.7 (3.5) kg/m2 and age of 30.2 (5.1) years, were randomly assigned to one of two exercise groups: moderate intensity (n = 28; 65%-75% of maximum heart rate) and high intensity (n = 28; 76%-85% of heart rate maximum). Each group also performed a resting control session for 35 min 1 week before or after the exercise, in a counterbalanced order. Mean oxygenated hemoglobin concentration changes in the PFC when viewing visual food cues were assessed by fNIRS, and subjective feelings of appetite were self-rated using visual analog scales after moderate- or high-intensity aerobic exercise and after the resting control session. A continuous-wave NIRS device was used to obtain functional data: eight sources and seven detectors were placed on the scalp covering the PFC, resulting in 20 channels per participant. We found that moderate-intensity aerobic exercise significantly increased both, the activation of the left orbitofrontal cortex (OFC) to images of high-calorie food (P = 0.02) and subjective sensations of hunger (F (1,54) = 7.16, P = 0.01). To our knowledge, this study provides the first evidence that moderate-intensity aerobic exercise increases OFC activity associated with high-calorie food images and stimulates appetite in methamphetamine-dependent individuals. These changes suggest that exercise may reestablish the food reward pathway hijacked by drugs and restore sensitivity to natural rewards. This evidence may contribute to the development of specific exercise programs for populations with methamphetamine dependence.

Prefrontal Cortical Activity During the Stroop Task: New Insights into the Why and the Who of Real-World Risky Sexual Behavior

Background

Research suggests that deficits in both executive functioning and trait impulsivity may play a role in risky sexual behavior. At the neural level, differences in regulation of the prefrontal cortex have been linked to impulsivity, measured neurocognitively and through self-report. The relationship between neurocognitive measures of executive control and trait impulsivity in predicting risky sexual behavior has not been investigated.

Purpose

To investigate the relationship between neural functioning during the Stroop task and risky sexual behavior, as well as the effect of individual differences in urgent (positive and negative) impulsivity on this relationship.

Methods

A total of 105 sexually active men who have sex with men completed the Stroop task during functional magnetic resonance imaging scanning. They also completed impulsivity inventories and self-reported their risky sexual behavior (events of condomless anal sex in the last 90 days).

Results

Risky participants had greater activation than safe participants during the color congruent condition of the Stroop task in anterior cingulate cortex/dorsomedial prefrontal cortex, dorsolateral prefrontal cortex, left frontal pole, and right insula. Across these regions, this neural activation mediated the link between (positive and/or negative) urgent impulsivity and risky sexual behavior.

Conclusions

Findings suggest that the brains of men who engage in risky sexual behavior may employ a different distribution of cognitive resources during tasks of executive functioning than men who practice safe sex, and that this may relate to differences in the prefrontal cortical/fronto-insular system responsible for impulse control.

The effectiveness of a brief motivational nursing intervention to reduce psychoactive substance consumption in entertainment-sector workers: A transversal, observation, and semi-experimental study

Checking whether changes in the perception of the quality of life related to health, after the nursing intervention, influence these patients' motivation to change. This was a two-staged study undertaken in entertainment-sector workers in Spain: the first part was transversal and observational, and the second was semi-experimental. First part undertook in 284 entertainment-sector workers, selected by non-probabilistic sampling, while second part undertook in 50 entertainment-business workers, selected by consecutive sampling from those who consumed substances. A short group-based motivational intervention session was implemented by nursing staff, and a before and after evaluation was completed. The EuroQol-5D and Test for the Evaluation of the Quality of Life in Addicts to Psychoactive Substances (TECVASP) were used. The patients' motivation to change was evaluated through the Stages of Change Readiness and Treatment Eagerness Scale. The results analysis showed that the nursing intervention reduced the participants' perceptions of their health-related quality of life (t = 4.23; P = 0.00009) and of their quality of life in addicts to psychoactive substances (t = 3.38; P = 0.00140). There was an increase in the motivation of 6 workers (12%) to seek treatment of their addiction (χ²  = 13.02; P = 0.0091). The post-test contemplation stage score was predicted (F = 6.56; P = 0.003; R = 0.46) with post-test TECVASP score and pre-post difference in TECVASP score. By reducing the patients' perception of their quality of life, this brief nursing intervention facilitated a favourable increase in the motivation for change among these workers and was effective in 12% of cases.

Gambling and Social Cognition: a Systematic Review

Purpose of Review

The aim of this article was to review current research regarding social cognition (SC) in gambling disorder (GD), to (i) compile and synthetize the current state of existing literature on this topic, and (ii) propose cognitive remediation therapy approaches focused on SC for clinicians.

Recent Findings

It is well known that disordered gamblers show impairment regarding non-social cognitive functions such as inhibition, attention, and decision-making. Furthermore, patients with substance use disorders also present certain deficits regarding social information processing which are difficult to differentiate from the intrinsic toxic effects linked to drugs or alcohol consumption.

Summary

To date, relatively little research has been undertaken to explore SC in gambling disorder (GD) with neuropsychological tasks. Preliminary results suggest impaired non-verbal emotion processing, but only one study has directly measured SC in GD. As a consequence, future research on this framework should propose diverse measures of SC, while controlling for other factors such as personality traits and subtypes of disordered gamblers.

Addictive behaviors in alcohol use disorder: dysregulation of reward processing systems and maladaptive coping strategies

DSM-5 has included within the substance-related and addictive disorders diagnostic category behavioral addictions, such as gambling disorder. Some scholars also considered ICD-11 compulsive sex as a behavioral addiction. Furthermore, an addiction model of dysfunctional eating behaviors has been proposed. Consistently, the existence of common addiction mechanisms related to substance and non-substance related disorders has been hypothesized. Nevertheless, this approach was called into question, especially considering alternative processes which might be implicated in such conditions. This study aims to compare these opposite theoretical positions concerning substance- and nonsubstance related disorders, investigating the latent structure of addictive behaviors among alcohol use disorder (AUD) individuals. Addictive behaviors were self-reported assessed using the Shorter PROMIS Questionnaire (SPQ). We recruited 456 (59.2% male; 40.8% female) AUD treatment-seeking patients. Two latent structures were tested using a confirmatory factor analytic approach. We compared a one-factor (i.e., common addiction mechanisms) with a two-factor solution (i.e., dysregulation of reward processing systems and maladaptive coping strategies). The two-factor solution showed adequate goodness-of-fit indexes. Specifically, dysregulation of the reward processing systems dimension predicted the SPQ illicit and prescription drugs, gambling, and sex subscales. Conversely, the maladaptive coping strategies dimension predicted the SPQ compulsive buying, binge eating and food restriction subscales. The latent dimensions significantly correlated with each other. Compulsive sex might be preliminarily considered as a behavioral addiction. AUD individuals might show complex patterns of maladaptive behaviors functionally related to different latent processes. Differential treatment approaches are suggested to treat these conditions.

Neural correlates of intertemporal choice in aggressive behavior

People often have to make decisions between immediate rewards and more long-term goals. Such intertemporal judgments are often investigated in the context of monetary choice or drug use, yet not in regard to aggressive behavior. We combined a novel intertemporal aggression paradigm with functional neuroimaging to examine the role of temporal delay in aggressive behavior and the neural correlates thereof. Sixty-one participants (aged 18-22 years; 37 females) exhibited substantial variability in the extent to which they selected immediate acts of lesser aggression versus delayed acts of greater aggression against a same-sex opponent. Choosing delayed-yet-more-severe aggression was increased by provocation and associated with greater self-control. Preferences for delayed aggression were associated with greater activity in the ventromedial prefrontal cortex (VMPFC) during such choices, and reduced functional connectivity between the VMPFC and brain regions implicated in motor impulsivity. Preferences for immediate aggression were associated with reduced functional connectivity between the VMPFC and the frontoparietal control network. Dispositionally aggressive participants exhibited reduced VMPFC activity, which partially explained and suppressed their preferences for delayed aggression. Blunted VMPFC activity may thus be a neural mechanism that promotes reactive aggression towards provocateurs among dispositionally aggressive individuals. These findings demonstrate the utility of an intertemporal framework for investigating aggression and provide further evidence for the similar underlying neurobiology between aggression and other rewarding behaviors.

Examining neural reactivity to gambling cues in the age of online betting

Purpose of Review

The goal of this review is to provide new insights as to how and why functional magnetic resonance imaging (fMRI) research on gambling cue reactivity can contribute to significant progress towards the understanding of gambling disorder. After having offered a detailed description of experimental paradigms and a comprehensive summary of findings related to gambling cue reactivity, the present review suggests methodological avenues for future research.

Recent Findings

The fMRI literature on problem gambling has identified the main neural pathways associated with reactivity to gambling cues. Yet, the current knowledge on the key factors underlying cue reactivity in gambling is still very incomplete. Here, we suggest that the recent expansion of online sports betting calls for a new line of research offering a fine-grained and up-to-date approach of neural cue reactivity in gambling disorder.

Summary

Experimental designs that investigate individual-specific and study-specific factors related to sports betting have the potential to foster progress towards efficient treatment and prevention of gambling disorder.

Preliminary examination of the orexin system on relapse-related factors in cocaine use disorder

RATIONALE

Current evidence and literature reviews provide a strong justification for examining the orexin receptor (OXR) system as a therapeutic target in substance use disorders, including cocaine and other psychostimulants.

OBJECTIVES

In this preliminary, proof-of-concept examination of orexin modulation in humans with cocaine use disorder, we measured changes in domains tied to relapse: stress, sleep, cue reactivity, and inhibitory control. Additionally, mood symptoms (anxiety, depression), medication compliance, and side effects were assessed.

METHODS

Twenty non-treatment seeking subjects with cocaine use disorder (CUD) received either the OX₁R / OX₂R antagonist suvorexant PO or placebo at 10 PM daily for two weeks (10 mg week 1, 20 mg week 2). Using psychometrics, smart-watch actigraphy, a cold-pressor stress challenge, and eye-tracking technology, the following domains were examined: sleep, stress/anxiety, cue-reactivity (attentional bias, craving), and inhibitory control. Psychometric data were collected every M/W/F (7 time points). Laboratory data were collected weekly (3 time points).

RESULTS

Bayesian and frequentist generalized linear models were employed in parallel to examine the effects of suvorexant compared to placebo, with a Bayesian posterior probability threshold >80% as evidence of a signal for suvorexant. Notable results favoring suvorexant over placebo included fewer total anti-saccade errors, improved sleep actigraphy (sleep/awake periods), pre/post cold-pressor change in heart rate and salivary cortisol (all posterior probabilities >94%), and craving (posterior probability >87%).

CONCLUSIONS

Initial but restricted evidence is provided supporting the orexin system as a modulator of relapse-related processes in cocaine use disorder. Baseline differences in the main outcome variables were not experimentally controlled and differences in craving were observed at baseline. This, in combination with a limited sample size, constrain the nature of the project. The results may serve to inform more comprehensive future research.

Choice Quality as a Function of Decision Accuracy and Search Cost

Objective: A prominent challenge in modeling choice is specification of the underlying cognitive processes. Many cognitive-based models of decision-making draw substantially on algorithmic models of artificial intelligence and thus rely on associated metaphors of this field. In contrast, the current study avoids metaphors and aims at a first-hand identification of the behavioral elements of a process of choice. Method : We designed a game in Mouselab resembling the real-world procedure of choosing a wife. 17 male subjects were exposed to cost-benefit decision criteria that closely mimic their societal respective conditions. Results: The quality of choice index was measured with respect to its sensitivity to the final outcomes as well as process tracing of decisions. The correlation between this index and individual components of process tracing are discussed in detail. The choice quality index can be configured as a function of expected value and utility. In our sample the quality of choice with an average of 75.98% (SD: ±12.67) suggests that subjects obtained close to 76% of their expected gains. Conclusion: The quality of choice index, therefore, may be used for comparison of different conditions where the variables of decision-making are altered. The analysis of results also reveals that the cost of incorrect choice is significantly correlated with expected value (0.596, sig = 0.012) but not with utility. This means that when sub-jects face higher costs prior to making a decision, there exists a corresponding higher expectation of gains, i.e., higher expected value.

Food Addiction in Adolescents: Exploration of psychological symptoms and executive functioning difficulties in a non-clinical sample

Recent studies on food addiction (FA) provided a better understanding of this condition in various populations. Indeed, authors have shown that FA was nearly as prevalent in adolescents as in adults, and similar correlates were observed in both populations (disordered eating behaviors, depressive and anxiety symptoms, impulsivity). The aim of the present study was to characterize FA in adolescents, according to psychological symptoms and executive functioning difficulties. A sample of 969 adolescents, aged between 12 and 18 years old, was recruited in the Quebec City area. They completed a series of questionnaires, including the Yale Food Addiction Scale 2.0 to measure FA symptoms, the Behaviour Rating Inventory of Executive Function to measure executive functioning difficulties, as well as other self-reported questionnaires assessing psychological symptoms (depressive and anxiety symptoms, impulsivity). Group comparisons showed that adolescents with a high level of FA symptoms reported significantly more psychological symptoms (binge eating, depression, anxiety, impulsivity), and more executive functioning difficulties. Finally, the relationship between FA symptoms and executive functioning difficulties was moderated by age and sex. More precisely, the previously mentioned relationship was stronger in young teen girls. The present work provides a preliminary framework in the developmental study of FA.

Modulating Activity in the Prefrontal Cortex Changes Intertemporal Choice for Loss: A Transcranial Direct Current Stimulation Study

Intertemporal choice refers to decisions involving tradeoffs between costs and benefits occurring at different times. Studies have found that weighting the time and benefits during decision-making involves a complex neural network that includes the dorsolateral prefrontal cortex (DLPFC). However, in contrast to literature regarding intertemporal choice for gains, studies have not provided causal evidence that the DLPFC is involved in intertemporal choice for losses. We examined whether bifrontal transcranial direct current stimulation (tDCS) applied over the right and left prefrontal cortex can alter the balance of intertemporal preference in the loss condition. A total of 60 participants performed delay discounting tasks for losses while receiving either right anodal/left cathodal, left anodal/right cathodal, or sham stimulation. The results showed that participants tended to choose larger delayed losses after receiving left anodal/right cathodal tDCS. Left anodal/right cathodal tDCS significantly decreased the discounting rate compared with the sham stimulation. These findings confirm that DLPFC activity is critical during intertemporal decision-making for losses.

Longitudinal effects of interoceptive awareness training through mindful awareness in body-oriented therapy (MABT) as an adjunct to women's substance use disorder treatment: A randomized controlled trial

BACKGROUND

Training in interoceptive awareness is a promising behavioral approach for improving substance use disorder (SUD) treatment. This study examined the longitudinal effects of Mindful Awareness in Body-oriented Therapy (MABT) as an adjunct to women's SUD treatment. MABT teaches interoceptive awareness skills to promote self-care and emotion regulation.

METHODS

Women in intensive outpatient treatment for SUD at three community clinics were recruited and randomly assigned to one of three study conditions Treatment as Usual (TAU) + MABT, TAU + Women's Health Education (WHE), and TAU only. Four assessments were delivered over one year (N = 187) baseline, 3, 6 and 12 months to examine primary outcome of percent days abstinent from substance use, and secondary outcomes of emotion dysregulation, craving, psychological distress, mindfulness and interoceptive awareness. Changes in outcomes across time were assessed using multilevel mixed effects linear regression.

RESULTS

Substance use improved significantly for MABT vs. TAU at 6 months and 12 months. Positive longitudinal effects on secondary outcomes for MABT were evident on respiratory sinus arrhythmia (RSA), a physiological index of emotion regulation; on craving; and on interoceptive awareness skills. Analyses based on participants who completed >75% of the intervention sessions revealed additional immediate significant improvements for MABT vs. TAU and WHE on depressive symptoms and emotion regulation difficulties and longitudinal improvement on mindfulness skills.

CONCLUSIONS

Results show MABT to be efficacious for longitudinal health outcomes to support women's recovery as an adjunct to community-based SUD treatment.

Substance abuse and white matter: Findings, limitations, and future of diffusion tensor imaging research

Individuals who abuse substances often differ from nonusers in their brain structure. Substance abuse and addiction is often associated with atrophy and pathology of grey matter, but much less is known about the role of white matter, which constitutes over half of human brain volume. Diffusion tensor imaging (DTI), a method for non-invasively estimating white matter, is increasingly being used to study addiction and substance abuse. Here we review recent DTI studies of major substances of abuse (alcohol, opiates, cocaine, cannabis, and nicotine substance abuse) to examine the relationship, specificity, causality, and permanence of substance-related differences in white matter microstructure. Across substance, users tended to exhibit differences in the microstructure of major fiber pathways, such as the corpus callosum. The direction of these differences, however, appeared substance-dependent. The subsample of longitudinal studies reviewed suggests that substance abuse may cause changes in white matter, though it is unclear to what extent such alterations are permanent. While collectively informative, some studies reviewed were limited by methodological and technical approach. We therefore also provide methodological guidance for future research using DTI to study substance abuse.

The Impact of Facebook Use and Facebook Intrusion on Cognitive Control: Effect in Proactive and Reactive Control

More and more people are using social networking sites, with Facebook being one of the most popular. So far, most of the research on using Facebook has focused on emotional, social, and personality-related factors and few studies have investigated the phenomenon from a cognitive perspective. The aim of our study was, therefore, to identify relationships between cognitive control and Facebook intrusion, with regard to proactive and reactive modes of cognitive control. The study was also designed to investigate the effects of neutral and Facebook-related context. The subjects (N = 80 young adults, M_age = 21.13 years; SD = 1.60) were divided into two groups based on their level of Facebook intrusion. The Facebook Intrusion Scale was used for selection. Using the AX-continuous performance task, we found that subjects with high Facebook intrusion showed more reactive control than their low Facebook intrusion peers. We also demonstrated that all subjects showed less proactive control in a Facebook-related context than in a neutral context. The results were interpreted in the light of the dual mechanism of cognitive control model.

Attentional Bias, "Cool" and "Hot" Executive Functions in Obese Patients: Roles of Body Mass Index, Binge Eating, and Eating Style

PURPOSE/BACKGROUND

Obesity is recognized as an important risk factor for many chronic diseases and is a major health issue. The current study examined attentional bias to food and the "cool" (inhibitory control and mental flexibility) and "hot" (affective decision making) executive functions (EFs) in obese patients preparing for bariatric surgery. In addition to body mass index (BMI), this study examined the impact of the binge-eating tendency and eating styles.

METHODS

The study population comprised 21 morbidly obese patients preparing to undergo bariatric surgery (BMI ≥30 kg/m) and 21 normal-weight controls (24 kg/m > BMI ≥ 18.5 kg/m). The Visual Probe Task was adopted to examine attentional bias toward food-related cues. The Stop-Signal Task and the Color Trails Test were used to assess inhibitory control and mental flexibility, respectively. The Iowa Gambling Task was administered to assess the affective decision making.

RESULTS

(1) The obese patients showed poorer performances on cool EFs (for Color Trails Test, P = 0.016, ηp = 0.136; for Stop-Signal Task, P = 0.049, ηp = 0.093) and hot EF (for Iowa Gambling Task, normal controls showed progressed performance, P = 0.012, ηp = 0.077, but obese patients did not show this progress, P = 0.111, ηp = 0.089) compared with the normal controls; (2) participants with low binge-eating tendency had larger attentional biases at 2000 milliseconds than at 200 milliseconds on food-related cues (P = 0.003, ηp = 0.363); and (3) low-restrained participants exhibited attentional bias toward the low-calorie food cues, compared with the high-restrained group (P = 0.009, ηp = 0.158).

CONCLUSIONS

The current study contributes to the development of a different therapeutic focus on obese patients and binge eaters.

How Reward and Aversion Shape Motivation and Decision Making: A Computational Account

Processing rewarding and aversive signals lies at the core of many adaptive behaviors, including value-based decision making. The brain circuits processing these signals are widespread and include the prefrontal cortex, amygdala and striatum, and their dopaminergic innervation. In this review, we integrate historic findings on the behavioral and neural mechanisms of value-based decision making with recent, groundbreaking work in this area. On the basis of this integrated view, we discuss a neuroeconomic framework of value-based decision making, use this to explain the motivation to pursue rewards and how motivation relates to the costs and benefits associated with different courses of action. As such, we consider substance addiction and overeating as states of altered value-based decision making, in which the expectation of reward chronically outweighs the costs associated with substance use and food consumption, respectively. Together, this review aims to provide a concise and accessible overview of important literature on the neural mechanisms of behavioral adaptation to reward and aversion and how these mediate motivated behaviors.

A test of dopamine hyper- and hyposensitivity in alcohol use

Biases in outcome processing, mediated by the mesocortical dopaminergic (DA) system, may predict individual differences in the frequency and quantity of alcohol use. We tested the hypothesis that genetic markers associated with increased DA neurotransmission contribute to reduced neural sensitivity to costs and increased alcohol use in an undergraduate sample. We created a DA transmission score using five genetic markers related to DA transmission and assessed neural sensitivity to cost using the feedback-related negativity (FRN), an event-related potential implicated in neural outcome evaluation, on both passive evaluative and active decision-making tasks. Self-reported alcohol use was assessed using the Daily Drinking Questionnaire-Revised. Participants with a higher DA transmission score reported increased alcohol consumption and exhibited a more blunted FRN on both the passive and active tasks. While dopamine hyposensitivity is common among chronic alcohol users, these data provide preliminary evidence that hypersensitivity of the dopamine system may underlie increased alcohol use in those who have not yet developed a chronic alcohol use disorder.

Structural and Functional Alterations in Betel-Quid Chewers: A Systematic Review of Neuroimaging Findings

Background: A number of neuroimaging studies have investigated structural, metabolic, and functional connectivity changes in betel quid (BQ) chewers. We present a systematic review of neuroimaging studies with emphasis on key brain systems affected by BQ chewing to bring a better understanding on the neuro mechanisms involved in BQD. Methods: All BQ neuroimaging studies were identified by searching PubMed, EMBASE, and Google scholar for English articles published until March 2018 using the key words: Betel-quid, resting state, functional MRI, structural MRI, diffusion tensor imaging (DTI), and betel quid dependence basing on the PRISMA criteria. We also sought unpublished studies, and the rest were obtained from reference lists of the retrieved articles. All neuroimaging studies investigating brain structural, and functional alterations related to BQ chewing and BQ dependence were included. Our systematic review registration number is CRD42018092669. Results: A review of 12 studies showed that several systems in the brain of BQ chewers exhibited structural, metabolic, and functional alterations. BQ chewing was associated with alterations in the reward [areas in the midbrain, and prefrontal cortex (PFC)], impulsivity (anterior cingulate cortex, PFC) and cognitive (PFC, the default mode, frontotemporal, frontoparietal, occipital/temporal, occipital/parietal, temporal/limbic networks, hippocampal/hypothalamus, and the cerebellum) systems in the brain. BQ duration and severity of betel quid dependence were associated with majority of alterations in BQ chewers. Conclusion: Betel quid chewing is associated with brain alterations in structure, metabolism and function in the cognitive, reward, and impulsivity circuits which are greatly influenced by duration and severity of betel quid dependence.

Dynamic Causal Modeling of Insular, Striatal, and Prefrontal Cortex Activities During a Food-Specific Go/NoGo Task

BACKGROUND

This study aimed to investigate the dynamic interactions among three neural systems that are implicated in substance and behavioral addictions in response to food cues in young adults. These include an impulsive system involving the striatum, a reflective system involving the prefrontal cortex, and a homeostasis sensing system involving the insular cortex.

METHODS

College students (N = 45) with various levels of body mass index were recruited. Functional magnetic resonance imaging data were acquired while participants performed food-related Go/NoGo tasks, with low-calorie and high-calorie food cues. Participants were scanned under both food satiety and deprivation conditions. Dynamic causal modeling was applied to the data to examine the causal architecture of coupled or distributed dynamics among the aforementioned systems.

RESULTS

Participants showed difficulty inhibiting responses to high-calorie foods as suggested by higher false alarm rate and decision bias for low-calorie food Go task. This difficulty was enhanced during the food deprivation condition. Deprivation increased neural activity of both the insula and the striatum bilaterally in response to high-calorie foods during Go trials and anterior cingulate cortex and dorsolateral prefrontal cortex activity during NoGo trials. Dynamic causal modeling analysis revealed that food deprivation modulated the communications between the insula, striatum, and dorsolateral prefrontal cortex, and the modulations were positively associated with body mass index.

CONCLUSIONS

The results support tripartite views of decision making. Deprivation states, such as hunger, trigger insular activity, which modulates the balance between impulsive and reflective systems when facing tempting food cues.

Psychological and Autonomic Correlates of Emotion Dysregulation among Women in Substance Use Disorder Treatment

BACKGROUND

Emotion regulation is increasingly recognized as important for the prevention and treatment of substance use disorder (SUD). However, there is an identified lack of physiological indexes of emotion dysregulation in SUD treatment studies, critically needed to better understand the link between emotion regulation capacity (measured physiologically) and self-report health outcomes among individuals in SUD treatment.

OBJECTIVE

To examine the association between respiratory sinus arrhythmia (RSA) and self-report health outcomes among women in SUD treatment.

METHODS

This is a cross-sectional study based on baseline data from 217 women enrolled in a randomized control trial to study a mind-body intervention as an adjunct to SUD treatment. All participants were enrolled in community-based outpatient treatment. Participants were administered questionnaires to examine sample characteristics, mental health symptoms, and interoceptive awareness and mindfulness skills. RSA data was gathered as an index of emotion dysregulation. Descriptive statistics, bivariate correlations, and regression were used in the analyses.

RESULTS

Findings highlight the extensive trauma histories, low SES, and the high symptoms of distress in this sample. RSA was only significantly correlated with interoceptive awareness after controlling for age and BMI. Measures of symptomatic distress and mindfulness were not correlated with RSA. Conclusions/Importance: Results provide the first evidence of RSA as an index of interoceptive awareness in this population. The inclusion of biomarkers such as RSA in SUD clinical studies may help identify individuals that are in need of targeted treatments that include interoceptive awareness training focused on improving emotion regulation.

On the Processes Underlying the Relationship Between Alexithymia and Gambling Severity

A great number of individuals with persistent problematic gambling behavior exhibit alexithymic tendencies, greater impulsivity, impaired working memory and poor mood. However, the relationship between these cognitive, affective and personality factors in problem gambling remains poorly understood. Our aim was to investigate multiple pathways of the alexithymia and problem gambling relationship. One hundred and six male subjects with different levels of gambling problem severity were recruited. Alexithymia, impulsivity and verbal working memory were evaluated, and their relationships to disordered gambling was examined by means of a path analysis. Results indicate that alexithymia is related to an increase in the severity of gambling indirectly, i.e., through distress severity. In addition, a rise of alexithymic tendencies was also associated with problem gambling severity through enhanced impulsivity that directly increased distress. Working memory capacity failed to significantly impact our path model. Overall, our findings contribute a new finding to the literature by highlighting the importance of alexithymia, in addition to impulsivity, in the understanding of gambling problem severity and its clinical course.

Hazardous drinking has unique relationships with implicit and explicit drinking identity

Measures of drinking identity are predictive of hazardous drinking. The extent to which hazardous drinking is differentially related to implicit compared to explicit drinking identity is not well understood. Neurocognitive models of addiction indicate that chronic alcohol use is associated with deficits in self-awareness which could limit the growth or recognition of drinking identity for individuals engaging in hazardous drinking. This might be particularly true for more reflective explicit measures of identity because their assessment and underlying cognitive processes rely more on self-awareness and conscious introspection. We predicted there would be different patterns of relationships between hazardous drinking and implicit/explicit drinking identity measures. A linear model was predicted to better fit the hazardous drinking and implicit identity relationship whereas a non-linear model was predicted to better fit the hazardous drinking and explicit identity relationship due to decreased ability to reflect on changes in identity at high levels of hazardous drinking. The present study is a re-analysis of a large secondary dataset (Project Implicit Mental Health; N = 11,320) which included measures of hazardous drinking (e.g., Alcohol Use Disorder Identification Test) and implicit/explicit identity. Results were consistent with predictions. The relationship between hazardous drinking and implicit drinking identity was best modeled by a linear function whereas the relationship between hazardous drinking and explicit drinking identity was best modeled by a non-linear cubit spline function. These findings are consistent not only with neurocognitive models but also with dual process formulations that implicit and explicit drinking identity are somewhat related but also quite distinct.

Executive function deficit in betel-quid-dependent chewers: Mediating role of prefrontal cortical thickness

BACKGROUND

Betel quid is the fourth most popular psychoactive agent worldwide. Neuroimaging studies have suggested betel-quid dependence is accompanied by abnormality in brain structure and function. However, the neural correlates of executive function deficit and prefrontal cortical thickness associated with betel-quid chewing still remain unclear.

OBJECTIVE

The present study aimed to examine the relationship between executive function deficit and prefrontal cortical thickness in chronic betel-quid chewers.

METHODS

Twenty-three betel-quid-dependent chewers and 26 healthy controls were recruited to participate in this study. Executive function was tested using three tasks. Cortical thickness analysis was analyzed with the FreeSurfer software package.

RESULTS

Behavioral results suggested a profound deficit of executive function in betel-quid-dependent chewers. Cortical thickness analysis revealed thinner cortex in the bilateral dorsolateral prefrontal cortex in betel-quid-dependent chewers. Further analysis suggested that cortical thickness of the bilateral dorsolateral prefrontal cortex mediated the correlation of betel-quid chewing and executive function.

CONCLUSIONS

These results suggest the important role of executive function and cortical thickness of the dorsolateral prefrontal cortex with betel-quid chewing. Our findings provide evidence that executive function deficit may be mediated by the cortical thickness of the dorsolateral prefrontal cortex. These results could potentially help us develop novel ways to diagnose and prevent betel-quid dependence.

Virtually 'in the heat of the moment': insula activation in safe sex negotiation among risky men

HIV is most prevalent among men who have sex with men (MSM), and although most MSM use condoms consistently during casual sex, some take risks. To better understand the psychology of those risky decisions, we examined neural correlates of playing a virtual sexual 'hook up' game in an functional magnetic resonance imaging scanner in MSM who had, in the past 90 days, been sexually risky (N = 76) or safe (N = 31). We found that during potentially risky sexual choices, previously risky MSM had more right insula activity than previously safe MSM. Real-life sexual risk was related to trait positive and negative urgency. Insula activity that differentiated risky and safe MSM was related to trait positive and negative urgency. Future work should further examine if, and to what extent, insula activation during safe sex negotiation drives MSM's rash risky sexual decision-making.

Cognitive training: A new avenue in gambling disorder management?

INTRODUCTION

Cognitive deficits are being robustly documented in gambling disorder. Cognitive training has been increasingly investigated as a treatment of substance use disorders. Four training components have been listed to date: cognitive bias, response inhibition, working memory, and goal-directed. This review aimed at the identification of use and efficacy findings in cognitive training in gambling disorder.

METHODS

We conducted a systematic search to identify use and efficacy data of cognitive training in gambling disorder. No use or efficacy data was available.

DISCUSSION AND PERSPECTIVES

Studies assessing cognitive training in gambling disorder are being conducted and first results should be upcoming. Methodological challenges have been identified. Several candidate target cognitive functions of training programs are being investigated, relying on the most documented impairments in gambling disorder, inhibition, reward sensitivity and decision making. Gambling-specific or neutral environments are to be distinguished clearly and do not rely on similar assumptions, i.e. general vulnerability or vulnerability expressed only in the specific context of gambling. Proper control groups with placebo conditions should be implemented. Assessment of efficacy should include clinical and neuropsychological assessments to give information of underlying mechanisms of action.

Competing Motivations: Proactive Response Inhibition Toward Addiction-Related Stimuli in Quitting-Motivated Individuals

We examined whether addiction-related cues impact proactive inhibition (the restraint of actions in preparation for stopping) in individuals who are motivated to quit gambling or cannabis use. In Study 1, treatment-seeking individuals with cannabis use disorder and matched controls performed a stop-signal task that required them to inhibit categorizing cannabis or neutral pictures, and within varying levels of stop-signal probability. In Study 2, two groups of individuals, who applied to a voluntary self-exclusion program toward gambling, performed the stop-task following relaxation or gambling craving induction, with results compared to non-gamblers. Study 1 showed that despite being less efficient in proactive inhibition, individuals with cannabis use disorder exhibited heightened proactive inhibition toward cannabis cues. In Study 2, proactive inhibition toward gambling cues was heightened in gamblers after craving, but the degree of proactive adjustment decreased as a function of induced changes in gambling-related motivation. Present findings demonstrate that exposure to addiction-related cues can modulate proactive inhibition in individuals who are motivated to restrict their addictive behaviors.

Let's Open the Decision-Making Umbrella: A Framework for Conceptualizing and Assessing Features of Impaired Decision Making in Addiction

Decision-making impairments play a pivotal role in the emergence and maintenance of addictive disorders. However, a sound conceptualization of decision making as an umbrella construct, encompassing its cognitive, affective, motivational, and physiological subcomponents, is still lacking. This prevents an efficient evaluation of the heterogeneity of decision-making impairments and the development of tailored treatment. This paper thus unfolds the various processes involved in decision making by adopting a critical approach of prominent dual- or triadic-process models, which postulate that decision making is influenced by the interplay of impulsive-automatic, reflective-controlled, and interoceptive processes. Our approach also focuses on social cognition processes, which play a crucial role in decision making and addictive disorders but were largely ignored in previous dual- or triadic-process models. We propose here a theoretical framework in which a range of coordinated processes are first identified on the basis of their theoretical and clinical relevance. Each selected process is then defined before reviewing available results underlining its role in addictive disorders (i.e., substance use, gambling, and gaming disorders). Laboratory tasks for measuring each process are also proposed, initiating a preliminary process-based decision-making assessment battery. This original approach may offer an especially informative view of the constitutive features of decision-making impairments in addiction. As prior research has implicated these features as risk factors for the development and maintenance of addictive disorders, our processual approach sets the scene for novel and transdiagnostic experimental and applied research avenues.

Evaluation of Psychometric Properties of the Second Version of the Taqwa (Piety) Questionnaire in Bahasa Melayu

The aim of the study is to evaluate the psychometric properties of the Bahasa Melayu version of the Taqwa (piety) questionnaire, used for the measurement of behaviour of Drug Dependency Syndrome (DDS), in Malay patients. A sample of 98 males with a psychiatric diagnosis (DSM-IV-R) as the DDS was randomly selected from Kajang Khafidz Polyclinic Kuala Lumpur, Malaysia. After receiving their agreement to attend the study, they completed the Taqwa (piety) questionnaire. The reliability was assessed by determining the Cronbach's [Formula: see text] to measure the consistency of related questions for all four dimensions (subscales), including individual, social, cognitional, and emotional Taqwa behaviour. In the next step to evaluate the composite reliability, convergent, and discrimination validity, a measurement model was determined via Conformity Factor Analysis (CFA) based on Partial List Square method (Smart- PLS Ver: 2M3). The reliability of four dimensions of the questionnaire was acceptable ([Formula: see text] correlated to each other. However, according to the CFA method, the items with low loading factor (<0.5) were excluded from each dimension. Item 24 and 35 that were related to individual Taqwa, and item 35 that belonged to emotional Taqwa were excluded from the analysis. The composite reliability and convergent, and discrimination validity were satisfied in all conformity factor loading that exceeded 0/05. The psychometric properties of the Taqwa questionnaire are acceptable, and the scale is a good instrument for assessing the Islamic attitude, beliefs, and behaviour of the Bahasa Melayu DDS patients.

Immediate effects of interoceptive awareness training through Mindful Awareness in Body-oriented Therapy (MABT) for women in substance use disorder treatment

Background: Sensory information gained through interoceptive awareness may play an important role in affective behavior and successful inhibition of drug use. This study examined the immediate pre-post effects of the mind-body intervention Mindful Awareness in Body-oriented Therapy (MABT) as an adjunct to women's substance use disorder (SUD) treatment. MABT teaches interoceptive awareness skills to promote self-care and emotion regulation. Methods: Women in intensive outpatient treatment (IOP) for chemical dependency (N = 217) at 3 community clinics in the Pacific Northwest of the United States were recruited and randomly assigned to one of 3 study conditions: MABT + treatment as usual (TAU), women's health education (WHE) +TAU (active control condition), and TAU only. At baseline and 3 months post-intervention, assessments were made of interoceptive awareness skills and mindfulness, emotion regulation (self-report and psychophysiological measures), symptomatic distress (depression and trauma-related symptoms), and substance use (days abstinent) and craving. Changes in outcomes across time were assessed using multilevel mixed-effects linear regression. Results: Findings based on an intent-to-treat approach demonstrated significant improvements in interoceptive awareness and mindfulness skills, emotion dysregulation (self-report and psychophysiology), and days abstinent for women who received MABT compared with the other study groups. Additional analyses based on participants who completed the major components of MABT (at least 75% of the intervention sessions) revealed these same improvements as well as reductions in depressive symptoms and substance craving. Conclusions: Findings that interoceptive training is associated with health outcomes for women in SUD treatment are consistent with emerging neurocognitive models that link interoception to emotion regulation and to related health outcomes, providing knowledge critical to supporting and improving SUD treatment.

Shifted balance of dorsal versus ventral striatal communication with frontal reward and regulatory regions in cannabis-dependent males

The transition from voluntary to addictive behavior is characterized by a loss of regulatory control in favor of reward driven behavior. Animal models indicate that this process is neurally underpinned by a shift in ventral-dorsal striatal control of behavior; however, this shift has not been directly examined in humans. The present resting state functional magnetic resonance imaging (fMRI) study employed a two-step approach to: (a) precisely map striatal alterations using a novel, data-driven network classification strategy combining intrinsic connectivity contrast with multivoxel pattern analysis and, (b) to determine whether a ventral to dorsal striatal shift in connectivity with reward and regulatory control regions can be observed in abstinent (28 days) male cannabis-dependent individuals (n = 24) relative to matched controls (n = 28). Network classification revealed that the groups can be reliably discriminated by global connectivity profiles of two striatal regions that mapped onto the ventral (nucleus accumbens) and dorsal striatum (caudate). Subsequent functional connectivity analysis demonstrated a relative shift between ventral and dorsal striatal communication with fronto-limbic regions that have been consistently involved in reward processing (rostral anterior cingulate cortex [ACC]) and executive/regulatory functions (dorsomedial prefrontal cortex [PFC]). Specifically, in the cannabis-dependent subjects, connectivity between the ventral striatum with the rostral ACC increased, whereas both striatal regions were uncoupled from the regulatory dorsomedial PFC. Together, these findings suggest a shift in the balance between dorsal and ventral striatal control in cannabis dependence. Similar changes have been observed in animal models and may promote the loss of control central to addictive behavior.

For whom is social-network usage associated with anxiety? The moderating role of neural working-memory filtering of Facebook information

Is Facebook usage bad for mental health? Existing studies provide mixed results, and direct evidence for neural underlying moderators is lacking. We suggest that being able to filter social-network information from accessing working memory is essential to preserve limited cognitive resources to pursue relevant goals. Accordingly, among individuals with impaired neural social-network filtering ability, enhanced social-network usage would be associated with negative mental health. Specifically, participants performed a novel electrophysiological paradigm that isolates neural Facebook filtering ability. Participants' actual Facebook behavior and anxious symptomatology were assessed. Confirming evidence showed that enhanced Facebook usage was associated with anxious symptoms among individuals with impaired neural Facebook filtering ability. Although less robust and tentative, additional suggestive evidence indicated that this specific Facebook filtering impairment was not better explained by a general filtering deficit. These results involving a neural social-network filtering moderator, may help understand for whom increased online social-network usage is associated with negative mental health.

Executive functioning and psychological symptoms in food addiction: a study among individuals with severe obesity

Food addiction (FA) has recently emerged as a new field in the study of obesity. Previous studies have contributed to identifying psychological correlates of FA. However, few researchers have examined the cognitive profile related to this condition; up until now, attentional biases related to food cues and a poorer performance monitoring have been observed. The present study aimed to examine the psychological profile and executive functioning related to FA in individuals with severe obesity and awaiting bariatric surgery. Participants (N = 86) were split into two groups, according to their level of FA symptoms (low FA vs high FA). Groups were compared on questionnaires measuring binge eating, depression and anxiety symptoms, and impulsivity as well as on measures reflecting executive functioning (D-KEFS and BRIEF-A). The relationship between FA groups and patterns of errors during the D-KEFS' Color-Word Interference Test was further analyzed. Individuals within the high FA group reported significantly more binge eating, depressive and anxiety symptoms, and more metacognitive difficulties. They also tended to show a poorer inhibition/cognitive flexibility score and a typical pattern of errors, characterized by an increased number of errors as the tasks' difficulty rose as opposed to a decreased number of errors, which characterizes an atypical pattern of errors. The present results show that the inability to learn from errors or past experiences is related to the severity of FA and overall impairments.Level of evidence Level V, descriptive study.

'Cool' and 'Hot' executive functions in suicide attempters with major depressive disorder

RATIONALE

The World Health Organization reports that, by 2030, depression is expected to be the largest contributor to disease burden. Only small proportion of patients with major depressive disorder (MDD) achieves remission and the majority of them do not achieve long-term functional recovery. One of the neuropsychological domains that have been shown to be particularly impaired in depression, is that of executive function (EF).

OBJECTIVES

We examined whether the patients with MDD with and without suicide attempts had deteriorated 'cool' EF and 'hot' EF.

METHODS

The study population comprised 34 MDD attempters, 36 MDD non-attempters, and 55 healthy controls. We adopted the symmetry span task (SSPAN) to measure the updating and the affective shifting task (AST) to measure the inhibition and set-shifting in general and in response to emotional material. The Iowa gambling task (IGT) was used to examine the affective decision-making ability.

RESULTS

After controlling for PHQ-9, Anxiety (HADS), suicidal ideation, education year and gender, we reported that (1) the MDD non-attempters had worse updating than the healthy controls and the MDD attempters; (2) the MDD attempters had worse general inhibition (GI) than the healthy controls and the MDD non-attempters; (3) the MDD non-attempters had worse general set-shifting (GS) than the healthy controls and the MDD attempters; (4) there was no between-group difference in the 'hot' EFs; and (5) MDD attempters with longer durations (over 5 years) since last attempt had worse general inhibition.

CONCLUSIONS

The disrupted 'cool' EFs patients with MDD are consistent with previous review and meta-analytic studies. On the other hand, the two groups with MDD performed similarly to the healthy controls in the 'hot' EF.

Effects of Mild Blast Traumatic Brain Injury on Cognitive- and Addiction-Related Behaviors

Traumatic brain injury (TBI) commonly results in cognitive and psychiatric problems. Cognitive impairments occur in approximately 30% of patients suffering from mild TBI (mTBI), and correlational evidence from clinical studies indicates that substance abuse may be increased following mTBI. However, understanding the lasting cognitive and psychiatric problems stemming from mTBI is difficult in clinical settings where pre-injury assessment may not be possible or accurate. Therefore, we used a previously characterized blast model of mTBI (bTBI) to examine cognitive- and addiction-related outcomes. We previously demonstrated that this model leads to bilateral damage of the medial prefrontal cortex (mPFC), a region critical for cognitive function and addiction. Rats were exposed to bTBI and tested in operant learning tasks several weeks after injury. bTBI rats made more errors during acquisition of a cue discrimination task compared to sham treated rats. Surprisingly, we observed no differences between groups in set shifting and delayed matching to sample, tasks known to require the mPFC. Separate rats performed cocaine self-administration. No group differences were found in intake or extinction, and only subtle differences were observed in drug-primed reinstatement 3-4 months after injury. These findings indicate that bTBI impairs acquisition of a visual discrimination task and that bTBI does not significantly increase the ability of cocaine exposure to trigger drug seeking.

Mindfulness-based interventions modulate structural network strength in patients with opioid dependence

Mindfulness-based interventions (MBI) are increasingly used in the treatment of patients with mental disorders, in particular in individuals presenting with affective disorders or in patients exhibiting abnormal levels of impulsive behavior. MBI have been also offered to patients with substance use disorders, where such treatment options may yield considerable clinical effects. Neural effects associated with MBI have been increasingly acknowledged, but is unknown whether MBI exert specific effects on brain structure in patients with substance use disorders. In this study, we investigated 19 inpatients with opioid dependence receiving treatment-as-usual (TAU, n = 9) or additional MBI (n = 10). Structural magnetic resonance imaging data were acquired before and after four weeks of treatment. Source-based morphometry was used to investigate modulation of structural networks after treatment. Both treatment modalities led to significant clinical improvement. Patients receiving MBI showed a significant change in distress tolerance levels. An increase in bilateral striatal/insular and prefrontal/cingulate network strength was found in patients receiving MBI compared to individuals receiving TAU. Prefrontal/cingulate cortical network strength was associated with impulsivity levels. These findings suggest that MBI can have a recognizable role in treatment of substance use disorders and that neural effects of MBI may be captured in terms of frontostriatal structural network change.

Neural correlates of executive functions in patients with obesity

Obesity is one of the most challenging problems in human health and is recognized as an important risk factor for many chronic diseases. It remains unclear how the neural systems (e.g., the mesolimbic "reward" and the prefrontal "control" neural systems) are correlated with patients' executive function (EF), conceptualized as the integration of "cool" EF and "hot" EF. "Cool" EF refers to relatively abstract, non-affective operations such as inhibitory control and mental flexibility. "Hot" EF refers to motivationally significant affective operations such as affective decision-making. We tried to find the correlation between structural and functional neuroimaging indices and EF in obese patients. The study population comprised seventeen patients with obesity (seven males and 10 females, BMI = 37.99 ± 5.40, age = 31.82 ± 8.75 year-old) preparing to undergo bariatric surgery. We used noninvasive diffusion tensor imaging, generalized q-sampling imaging, and resting-state functional magnetic resonance imaging to examine the neural correlations between structural and functional neuroimaging indices and EF performances in patients with obesity. We reported that many brain areas are correlated to the patients' EF performances. More interestingly, some correlations may implicate the possible associations of EF and the incentive motivational effects of food. The neural correlation between the left precuneus and middle occipital gyrus and inhibitory control may suggest that patients with a better ability to detect appetitive food may have worse inhibitory control. Also, the neural correlation between the superior frontal blade and affective decision-making may suggest that patients' affective decision-making may be associated with the incentive motivational effects of food. Our results provide evidence suggesting neural correlates of EF in patients with obesity.

Presumed structural and functional neural recovery after long-term abstinence from cocaine in male military veterans

Cumulative evidence suggests that cocaine use could alter the structure and function of different brain systems. However, the extent to which the altered brain structure and function possibly recover over time after cocaine abstinence remains less clear. The present study examines 39 male military veterans with different stages of cocaine addiction and long-term abstinence (from 1 year up to 30 years) and evaluates plausible changes in brain structure and function of specific brain regions that sub-serve addictions. These include the striatum that is involved in cocaine reward; the lateral prefrontal cortex (especially the dorsolateral PFC) that plays a major role in inhibitory control; the insula, which has been implicated in craving; and the medial orbitofrontal (OFC) and ventromedial prefrontal cortex (VMPFC) shown to play key roles in foresight and decision-making. The results suggest that there are differences in both brain structure (gray matter volume, GMV) and function between cocaine USERS and CONTROLS, with USERS showing plausible relative strengthening in neural systems for processing reward and craving, and relative weakening in neural systems involved in inhibitory control and decision-making. Examination of possible neural changes after abstinence suggests that presumed recovery occurs mostly in neural systems related to reward, craving, and inhibitory control, but to a lesser extent in neural systems related to decision-making. Given the limitations of the data in terms of a small sample size, as well as the lack of certainty about occasional use in the abstinent group, these results may be considered as preliminary. However, they are compelling in that they suggest that male military veterans cocaine USERS are indefinitely at a higher risk compared to CONTROLS for making lapses in judgment and decision-making leading to possible relapse, if reward salience and craving become more intense. Understanding the neurobiology of long-term cocaine abstinence in vulnerable populations and beyond could help devising better therapeutic strategies that prevent relapse.

Facing temptation: The neural correlates of gambling availability during sports picture exposure

Nowadays, sports betting has become increasingly available and easy to engage in. Here we examined the neural responses to stimuli that represent sporting events available for betting as compared to sporting events without a gambling opportunity. We used a cue exposure task in which football (soccer) fans (N = 42) viewed cues depicting scheduled football games that would occur shortly after the scanning session. In the "betting" condition, participants were instructed to choose, at the end of each block, the game (and the team) they wanted to bet on. In the "watching" condition, participants chose the game they would prefer to watch. After the scanning session, participants completed posttask rating questionnaires assessing, for each cue, their level of confidence about the team they believed would win and how much they would enjoy watching the game. We found that stimuli representing sport events available for betting elicited higher fronto-striatal activation, as well as higher insular cortex activity and functional connectivity, than sport events without a gambling opportunity. Moreover, games rated with more confidence towards the winning team resulted in greater brain activations within regions involved in affective decision-making (ventromedial prefrontal cortex), cognitive inhibitory control (medial and superior frontal gyri) and reward processing (ventral and dorsal striatum). Altogether, these novel findings offer a sensible simulation of how the high availability of sports betting in today's environment impacts on the reward and cognitive control systems. Future studies are needed to extend the present findings to a sample of football fans that includes a samilar proportion of female and male participants.

Corticotropin-releasing factor receptor 2-deficiency eliminates social behaviour deficits and vulnerability induced by cocaine

BACKGROUND AND PURPOSE

Poor social behaviour and vulnerability to stress are major clinical features of stimulant use disorders. The corticotropin-releasing factor (CRF) system mediates stress responses and might underlie substance use disorders; however, its involvement in social impairment induced by stimulant substances remains unknown. CRF signalling is mediated by two receptor types, CRF₁ and CRF₂ . In the present study we investigated the role of the CRF₂ receptor in social behaviour deficits, vulnerability to stress and related brain alterations induced by cocaine administration and withdrawal.

EXPERIMENTAL APPROACH

CRF₂ receptor-deficient (CRF₂ -/-) and littermate wild-type mice were repeatedly tested in the three-chamber task for sociability (i.e. preference for an unfamiliar conspecific vs. an object) and social novelty preference (SNP; i.e. preference for a novel vs. a familiar conspecific) before and after chronic cocaine administration. An in situ hybridization assay was used to assess gene expression of the stress-responsive arginine vasopressin (AVP) and oxytocin (OT) neuropeptides in the hypothalamus.

KEY RESULTS

CRF₂ receptor deficiency eliminated the sociability deficit induced by cocaine withdrawal. Moreover, CRF₂ -/- mice did not show either the stress-induced sociability deficit or the increased AVP and OT expression associated with long-term cocaine withdrawal, indicating resilience to stress. Throughout, wild-type and CRF₂ -/- mice displayed SNP, suggesting that cocaine withdrawal-induced sociability deficits were not due to impaired detection of social stimuli.

CONCLUSIONS AND IMPLICATIONS

These findings demonstrate a central role for the CRF₂ receptor in social behaviour deficits and biomarkers of vulnerability induced by cocaine withdrawal, suggesting new therapeutic strategies for stimulant use disorders.

The Translational Value of Psychophysiology Methods and Mechanisms: Multilevel, Dynamic, Personalized

OBJECTIVE

It has been nearly 15 years since Kazdin and Nock published methodological and research recommendations for understanding mechanisms of change in child and adolescent therapy. Their arguments and enthusiasm for research on mechanisms of behavior change (MOBCs) resonated across disciplines and disorders, as it shined a light on the crucial importance of understanding how and for whom treatments instigate behavior change and how therapeutic mechanisms might be extended to "situations and settings of everyday life." Initial efforts focused on how psychotherapy works and linear models, yet the use of theory to guide the study of mechanisms, and laboratory experiments to manipulate them, is broadly applicable.

METHOD

This article considers dynamic physiological processes that support behavior change. Specifically, it examines the utility of psychophysiological methods to measure and promote behavior change. Moreover, it embeds the baroreflex mechanism, a well-defined heart-brain feedback loop, within the theories and strategies of MOBC research.

RESULTS AND CONCLUSION

Individuals' subjective and expressive experience of change does not always align with their physiological reactivity. Thus, behavior change may be best understood when concurrently assessed across multiple biobehavioral levels. Further, behavior is initiated in the moment, often before conscious deliberation, suggesting that multilevel behavior change research may benefit from real-time methodological designs. Last, substance use trajectories vary widely, suggesting that different MOBCs are more or less active in individuals depending on their personal constituency and the functional need that their substance use serves; thus, methods that are amenable to personalized modeling approaches are important.

A neuronal mechanism underlying decision-making deficits during hyperdopaminergic states

Hyperdopaminergic states in mental disorders are associated with disruptive deficits in decision making. However, the precise contribution of topographically distinct mesencephalic dopamine pathways to decision-making processes remains elusive. Here we show, using a multidisciplinary approach, how hyperactivity of ascending projections from the ventral tegmental area (VTA) contributes to impaired flexible decision making in rats. Activation of the VTA-nucleus accumbens pathway leads to insensitivity to loss and punishment due to impaired processing of negative reward prediction errors. In contrast, activation of the VTA-prefrontal cortex pathway promotes risky decision making without affecting the ability to choose the economically most beneficial option. Together, these findings show how malfunction of ascending VTA projections affects value-based decision making, suggesting a potential mechanism through which increased forebrain dopamine signaling leads to aberrant behavior, as is seen in substance abuse, mania, and after dopamine replacement therapy in Parkinson's disease.

Altered anterior cingulate cortex to hippocampus effective connectivity in response to drug cues in men with cocaine use disorder

Drug-related attentional bias may have significant implications for the treatment of cocaine use disorder (CocUD). However, the neurobiology of attentional bias is not completely understood. This study employed dynamic causal modeling (DCM) to conduct an analysis of effective (directional) connectivity involved in drug-related attentional bias in treatment-seeking CocUD subjects. The DCM analysis was conducted based on functional magnetic resonance imaging (fMRI) data acquired from fifteen CocUD subjects while performing a cocaine-word Stroop task, during which blocks of Cocaine Words (CW) and Neutral Words (NW) alternated. There was no significant attentional bias at group level. Although no significant brain activation was found, the DCM analysis found that, relative to the NW, the CW caused a significant increase in the strength of the right (R) anterior cingulate cortex (ACC) to R hippocampus effective connectivity. Greater increase of this connectivity was associated with greater CW reaction time (relative to NW reaction time). The increased strength of R ACC to R hippocampus connectivity may reflect ACC activation of hippocampal memories related to drug use, which was triggered by the drug cues. This circuit could be a potential target for therapeutics in CocUD patients. No significant change was found in the other modeled connectivities.