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Upton S, Brown AA, Ithman M, Newman-Norlund R, Sahlem G, Prisciandaro JJ, McClure EA, Froeliger B. Effects of Hyperdirect Pathway Theta Burst Transcranial Magnetic Stimulation on Inhibitory Control, Craving, and Smoking in Adults With Nicotine Dependence: A Double-Blind, Randomized Crossover Trial. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2023; 8:1156-1165. [PMID: 37567363 PMCID: PMC10840958 DOI: 10.1016/j.bpsc.2023.07.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 07/27/2023] [Accepted: 07/28/2023] [Indexed: 08/13/2023]
Abstract
BACKGROUND Nicotine dependence is associated with dysregulated hyperdirect pathway (HDP)-mediated inhibitory control (IC). However, there are currently no evidence-based treatments that have been shown to target the HDP to improve IC and reduce cigarette cravings and smoking. METHODS Following a baseline nonstimulation control session, this study (N = 37; female: n = 17) used a double-blind, randomized crossover design to examine the behavioral and neural effects of intermittent theta burst stimulation (iTBS) and continuous TBS (cTBS) to the right inferior frontal gyrus (rIFG)-a key cortical node of the HDP. Associations between treatment effects were also explored. RESULTS At baseline, HDP IC task-state functional connectivity was positively associated with IC task performance, which confirmed the association between HDP circuit function and IC. Compared with iTBS, rIFG cTBS improved IC task performance. Compared with the baseline nonstimulation control session, both TBS conditions reduced cigarette craving and smoking; however, although craving and smoking were lower for cTBS, no differences were found between the two active conditions. In addition, although HDP IC task-state functional connectivity was greater following cTBS than iTBS, there was no significant difference between conditions. Finally, cTBS-induced improvement in IC task performance was associated with reduced craving, and cTBS-induced reduction in craving was associated with reduced smoking. CONCLUSIONS These findings warrant further investigation into the effects of rIFG cTBS for increasing IC and reducing craving and smoking among individuals with nicotine dependence. Future sham-controlled cTBS studies may help further elucidate the mechanisms by which rIFG cTBS mediates IC and smoking behavior.
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Affiliation(s)
- Spencer Upton
- Department of Psychological Sciences, University of Missouri, Columbia, Missouri
| | - Alexander A Brown
- Department of Psychological Sciences, University of Missouri, Columbia, Missouri
| | - Muaid Ithman
- Department of Psychiatry, University of Missouri, Columbia, Missouri
| | - Roger Newman-Norlund
- Department of Psychology, University of South Carolina, Columbia, South Carolina
| | - Greg Sahlem
- Department of Psychiatry, Stanford University Medical Center, Palo Alto, California
| | - Jim J Prisciandaro
- Department of Psychiatry, Medical University of South Carolina, Charleston, South Carolina
| | - Erin A McClure
- Department of Psychiatry, Medical University of South Carolina, Charleston, South Carolina
| | - Brett Froeliger
- Department of Psychological Sciences, University of Missouri, Columbia, Missouri; Department of Psychiatry, University of Missouri, Columbia, Missouri; Cognitive Neuroscience Systems Core Facility, University of Missouri, Columbia, Missouri.
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2
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Upton S, Brown AA, Golzy M, Garland EL, Froeliger B. Right inferior frontal gyrus theta-burst stimulation reduces smoking behaviors and strengthens fronto-striatal-limbic resting-state functional connectivity: a randomized crossover trial. Front Psychiatry 2023; 14:1166912. [PMID: 37457779 PMCID: PMC10338839 DOI: 10.3389/fpsyt.2023.1166912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 05/22/2023] [Indexed: 07/18/2023] Open
Abstract
Introduction Functional and anatomical irregularities in the right inferior frontal gyrus (rIFG), a ventrolateral prefrontal region that mediates top-down inhibitory control over prepotent behavioral responding, are implicated in the ongoing maintenance of nicotine dependence (ND). However, there is little research on the effects of neuromodulation of the rIFG on smoking behavior, inhibitory control, and resting-state functional connectivity (rsFC) among individuals with ND. Methods In this double-blind, crossover, theta-burst stimulation (TBS) study, adults with ND (N = 31; female: n = 15) completed a baseline session and were then randomized to two counterbalanced sessions of functionally neuronavigated TBS to the rIFG: continuous TBS (cTBS) on 1 day and intermittent TBS (iTBS) on another. Differences in cigarette cravings, smoking, and fronto-striatal-limbic rsFC were assessed. Results Relative to baseline, cTBS significantly reduced appetitive and withdrawal cravings immediately after treatment. The effects of cTBS on withdrawal craving persisted for 24 h, as well as produced a reduction in smoking. Furthermore, cTBS significantly strengthened rsFC between the rIFG pars opercularis and subcallosal cingulate (fronto-striatal circuit), and between the rIFG pars opercularis and the right posterior parahippocampal gyrus (fronto-limbic circuit). At post-24 h, cTBS-induced increase in fronto-striatal rsFC was significantly associated with less appetitive craving, while the increase in fronto-limbic rsFC was significantly associated with less withdrawal craving and smoking. Discussion These findings warrant further investigation into the potential value of rIFG cTBS to attenuate smoking behavior among individuals with ND.
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Affiliation(s)
- Spencer Upton
- Department of Psychological Sciences, University of Missouri, Columbia, MO, United States
| | - Alexander A. Brown
- Department of Psychological Sciences, University of Missouri, Columbia, MO, United States
- Department of Psychiatry, School of Medicine, University of Missouri, Columbia, MO, United States
- Cognitive Neuroscience Systems Core Facility, University of Missouri, Columbia, MO, United States
| | - Mojgan Golzy
- Biostatistics Unit, Department of Family and Community Medicine, School of Medicine, University of Missouri, Columbia, MO, United States
| | - Eric L. Garland
- Center on Mindfulness and Integrative Health Intervention Development, College of Social Work, University of Utah, Salt Lake City, UT, United States
| | - Brett Froeliger
- Department of Psychological Sciences, University of Missouri, Columbia, MO, United States
- Department of Psychiatry, School of Medicine, University of Missouri, Columbia, MO, United States
- Cognitive Neuroscience Systems Core Facility, University of Missouri, Columbia, MO, United States
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3
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Abi-Dargham A, Moeller SJ, Ali F, DeLorenzo C, Domschke K, Horga G, Jutla A, Kotov R, Paulus MP, Rubio JM, Sanacora G, Veenstra-VanderWeele J, Krystal JH. Candidate biomarkers in psychiatric disorders: state of the field. World Psychiatry 2023; 22:236-262. [PMID: 37159365 PMCID: PMC10168176 DOI: 10.1002/wps.21078] [Citation(s) in RCA: 35] [Impact Index Per Article: 35.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/08/2023] [Indexed: 05/11/2023] Open
Abstract
The field of psychiatry is hampered by a lack of robust, reliable and valid biomarkers that can aid in objectively diagnosing patients and providing individualized treatment recommendations. Here we review and critically evaluate the evidence for the most promising biomarkers in the psychiatric neuroscience literature for autism spectrum disorder, schizophrenia, anxiety disorders and post-traumatic stress disorder, major depression and bipolar disorder, and substance use disorders. Candidate biomarkers reviewed include various neuroimaging, genetic, molecular and peripheral assays, for the purposes of determining susceptibility or presence of illness, and predicting treatment response or safety. This review highlights a critical gap in the biomarker validation process. An enormous societal investment over the past 50 years has identified numerous candidate biomarkers. However, to date, the overwhelming majority of these measures have not been proven sufficiently reliable, valid and useful to be adopted clinically. It is time to consider whether strategic investments might break this impasse, focusing on a limited number of promising candidates to advance through a process of definitive testing for a specific indication. Some promising candidates for definitive testing include the N170 signal, an event-related brain potential measured using electroencephalography, for subgroup identification within autism spectrum disorder; striatal resting-state functional magnetic resonance imaging (fMRI) measures, such as the striatal connectivity index (SCI) and the functional striatal abnormalities (FSA) index, for prediction of treatment response in schizophrenia; error-related negativity (ERN), an electrophysiological index, for prediction of first onset of generalized anxiety disorder, and resting-state and structural brain connectomic measures for prediction of treatment response in social anxiety disorder. Alternate forms of classification may be useful for conceptualizing and testing potential biomarkers. Collaborative efforts allowing the inclusion of biosystems beyond genetics and neuroimaging are needed, and online remote acquisition of selected measures in a naturalistic setting using mobile health tools may significantly advance the field. Setting specific benchmarks for well-defined target application, along with development of appropriate funding and partnership mechanisms, would also be crucial. Finally, it should never be forgotten that, for a biomarker to be actionable, it will need to be clinically predictive at the individual level and viable in clinical settings.
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Affiliation(s)
- Anissa Abi-Dargham
- Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA
| | - Scott J Moeller
- Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA
| | - Farzana Ali
- Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA
| | - Christine DeLorenzo
- Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA
| | - Katharina Domschke
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, University of Freiburg, Freiburg, Germany
- Centre for Basics in Neuromodulation, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Guillermo Horga
- Department of Psychiatry, Columbia University, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - Amandeep Jutla
- Department of Psychiatry, Columbia University, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - Roman Kotov
- Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA
| | | | - Jose M Rubio
- Zucker School of Medicine at Hofstra-Northwell, Hempstead, NY, USA
- Feinstein Institute for Medical Research - Northwell, Manhasset, NY, USA
- Zucker Hillside Hospital - Northwell Health, Glen Oaks, NY, USA
| | - Gerard Sanacora
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Jeremy Veenstra-VanderWeele
- Department of Psychiatry, Columbia University, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - John H Krystal
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
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4
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Jones SK, Alberg AJ, Wallace K, Froeliger B, Carpenter MJ, Wolf B. Genetic Associations with Smoking Relapse and Proportion of Follow-up in Smoking Relapse throughout Adulthood in Pre- and Postmenopausal Women. Cancer Prev Res (Phila) 2023; 16:269-279. [PMID: 37070666 PMCID: PMC10159950 DOI: 10.1158/1940-6207.capr-22-0421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 01/10/2023] [Accepted: 03/08/2023] [Indexed: 04/19/2023]
Abstract
PREVENTION RELEVANCE This study is the first to quantify genetic associations with smoking relapse among female smokers throughout adulthood. These findings could inform precision medicine approaches to improve long-term smoking relapse prevention to reduce smoking attributable cancer morbidity and mortality.
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Affiliation(s)
| | - Anthony J. Alberg
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia SC 29208
| | - Kristin Wallace
- Department of Public Health Sciences, Medical University of South Carolina, Charleston SC 29425
- Hollings Cancer Center, 86 Jonathan Lucas Street, Medical University of South Carolina, Charleston SC 29425
| | - Brett Froeliger
- Department of Psychological Sciences, University of Missouri, Columbia MO 65211
| | - Matthew J. Carpenter
- Hollings Cancer Center, 86 Jonathan Lucas Street, Medical University of South Carolina, Charleston SC 29425
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston SC 29425
| | - Bethany Wolf
- Department of Public Health Sciences, Medical University of South Carolina, Charleston SC 29425
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5
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Drossel G, Brucar LR, Rawls E, Hendrickson TJ, Zilverstand A. Subtypes in addiction and their neurobehavioral profiles across three functional domains. Transl Psychiatry 2023; 13:127. [PMID: 37072391 PMCID: PMC10113211 DOI: 10.1038/s41398-023-02426-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 03/28/2023] [Accepted: 03/31/2023] [Indexed: 04/20/2023] Open
Abstract
Rates of return to use in addiction treatment remain high. We argue that the development of improved treatment options will require advanced understanding of individual heterogeneity in Substance Use Disorders (SUDs). We hypothesized that considerable individual differences exist in the three functional domains underlying addiction-approach-related behavior, executive function, and negative emotionality. We included N = 593 participants from the enhanced Nathan Kline Institute-Rockland Sample community sample (ages 18-59, 67% female) that included N = 420 Controls and N = 173 with past SUDs [54% female; N = 75 Alcohol Use Disorder (AUD) only, N = 30 Cannabis Use Disorder (CUD) only, and N = 68 Multiple SUDs]. To test our a priori hypothesis that distinct neuro-behavioral subtypes exist within individuals with past SUDs, we conducted a latent profile analysis with all available phenotypic data as input (74 subscales from 18 measures), and then characterized resting-state brain function for each discovered subtype. Three subtypes with distinct neurobehavioral profiles were recovered (p < 0.05, Cohen's D: 0.4-2.8): a "Reward type" with higher approach-related behavior (N = 69); a "Cognitive type" with lower executive function (N = 70); and a "Relief type" with high negative emotionality (N = 34). For those in the Reward type, substance use mapped onto resting-state connectivity in the Value/Reward, Ventral-Frontoparietal and Salience networks; for the Cognitive type in the Auditory, Parietal Association, Frontoparietal and Salience networks; and for the Relief type in the Parietal Association, Higher Visual and Salience networks (pFDR < 0.05). Subtypes were equally distributed amongst individuals with different primary SUDs (χ2 = 4.71, p = 0.32) and gender (χ2 = 3.44, p = 0.18). Results support functionally derived subtypes, demonstrating considerable individual heterogeneity in the multi-dimensional impairments in addiction. This confirms the need for mechanism-based subtyping to inform the development of personalized addiction medicine approaches.
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Affiliation(s)
- Gunner Drossel
- Graduate Program in Neuroscience, University of Minnesota, Minneapolis, MN, USA
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, USA
| | - Leyla R Brucar
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, USA
| | - Eric Rawls
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, USA
| | - Timothy J Hendrickson
- University of Minnesota Informatics Institute, University of Minnesota, Minneapolis, MN, USA
- Masonic Institute for the Developing Brain, University of Minnesota, Minneapolis, MN, USA
| | - Anna Zilverstand
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, USA.
- Medical Discovery Team on Addiction, University of Minnesota, Minneapolis, MN, USA.
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6
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Mata-Marín D, Pineda-Pardo JÁ, Michiels M, Pagge C, Ammann C, Martínez-Fernández R, Molina JA, Vela-Desojo L, Alonso-Frech F, Obeso I. A circuit-based approach to modulate hypersexuality in Parkinson's disease. Psychiatry Clin Neurosci 2022; 77:223-232. [PMID: 36579893 DOI: 10.1111/pcn.13523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 12/17/2022] [Accepted: 12/20/2022] [Indexed: 12/30/2022]
Abstract
AIM Impulse-control disorder is a common neuropsychiatric complication in Parkinson's disease (PD) under dopamine replacement therapy. Prior studies tested the balance between enhanced desire towards reward and cognitive control deficits, hypothesized to be biased towards the former in impulse control disorders. We provide evidence for this hypothesis by measuring behavioral and neural patterns behind the influence of sexual desire over response inhibition and tools towards functional restoration using repetitive transcranial stimulation in patients with hypersexuality as predominant impulsive disorder. METHODS The effect of sexual cues on inhibition was measured with a novel erotic stop-signal task under on and off dopaminergic medication. Task-related functional and anatomical connectivity models were estimated in 16 hypersexual and 17 nonhypersexual patients with PD as well as in 17 healthy controls. Additionally, excitatory neuromodulation using intermittent theta-burst stimulation (sham-controlled) was applied over the pre-supplementary motor area in 20 additional hypersexual patients with PD aiming to improve response inhibition. RESULTS Compared with their nonhypersexual peers, patients with hypersexuality recruited caudate, pre-supplementary motor area, ventral tegmental area, and anterior cingulate cortex while on medication. Reduced connectivity was found between pre-supplementary motor area and caudate nucleus in hypersexual compared with nonhypersexual patients (while medicated), a result paralleled by compensatory enhanced anatomical connectivity. Furthermore, stimulation over the pre-supplementary motor area improved response inhibition in hypersexual patients with PD when exposed to sexual cues. CONCLUSION This study, therefore, has identified a specific fronto-striatal and mesolimbic circuitry underlying uncontrolled sexual responses in medicated patients with PD where cortical neuromodulation halts its expression.
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Affiliation(s)
- David Mata-Marín
- Centro Integral de Neurociencias Abarca Campal (HM CINAC), Hospital Universitario HM Puerta del Sur. HM Hospitales, Madrid, Spain.,Network Center for Biomedical Research on Neurodegenerative Diseases (CIBERNED), Instituto Carlos III, Madrid, Spain.,PhD program in Neuroscience, Autonoma University of Madrid, Madrid, Spain
| | - José Ángel Pineda-Pardo
- Centro Integral de Neurociencias Abarca Campal (HM CINAC), Hospital Universitario HM Puerta del Sur. HM Hospitales, Madrid, Spain.,Network Center for Biomedical Research on Neurodegenerative Diseases (CIBERNED), Instituto Carlos III, Madrid, Spain
| | - Mario Michiels
- Centro Integral de Neurociencias Abarca Campal (HM CINAC), Hospital Universitario HM Puerta del Sur. HM Hospitales, Madrid, Spain.,Network Center for Biomedical Research on Neurodegenerative Diseases (CIBERNED), Instituto Carlos III, Madrid, Spain.,PhD program in Neuroscience, Autonoma University of Madrid, Madrid, Spain
| | - Cristina Pagge
- Centro Integral de Neurociencias Abarca Campal (HM CINAC), Hospital Universitario HM Puerta del Sur. HM Hospitales, Madrid, Spain.,PhD program in Neuroscience, Autonoma University of Madrid, Madrid, Spain
| | - Claudia Ammann
- Centro Integral de Neurociencias Abarca Campal (HM CINAC), Hospital Universitario HM Puerta del Sur. HM Hospitales, Madrid, Spain
| | - Raúl Martínez-Fernández
- Centro Integral de Neurociencias Abarca Campal (HM CINAC), Hospital Universitario HM Puerta del Sur. HM Hospitales, Madrid, Spain.,Network Center for Biomedical Research on Neurodegenerative Diseases (CIBERNED), Instituto Carlos III, Madrid, Spain
| | | | | | | | - Ignacio Obeso
- Centro Integral de Neurociencias Abarca Campal (HM CINAC), Hospital Universitario HM Puerta del Sur. HM Hospitales, Madrid, Spain.,Network Center for Biomedical Research on Neurodegenerative Diseases (CIBERNED), Instituto Carlos III, Madrid, Spain.,Department of Psychobiology & Methods for the Behavioral Sciences Department, Complutense University of Madrid, Madrid, Spain
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7
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Ghasemian S, Vardanjani MM, Sheibani V, Mansouri FA. Dynamic modulation of inhibition ability following repeated exposures to morphine in macaque monkey. J Psychopharmacol 2022; 36:1151-1160. [PMID: 35971887 DOI: 10.1177/02698811221112952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Deficits in cognitive control, particularly inhibition ability, play crucial roles in susceptibility, progress, and relapse to opioid addiction. However, it is unclear when and how such deficits develop and interact with repeated exposures to prescribed opioids. AIM Using macaque monkey (Macaca mulatta), as an animal model with high translational merits in cognitive neuroscience, we tried to delineate alterations of inhibition ability in the course of repeated exposures to morphine. METHODS Monkeys were trained to perform stop-signal task and then we closely monitored their inhibition ability before exposure, after initial exposure, and following repeated exposures to morphine when they experienced abstinent periods. We also assessed morphine-induced conditioned place preference (CPP) in these monkeys to monitor the long-lasting effects of morphine on other behaviors. RESULTS Compared to the baseline level, monkeys' inhibition ability was significantly enhanced after initial exposure to morphine (early phase); however, it became significantly attenuated after repeated exposures (late phase). These alterations occurred while monkeys consistently expressed the morphine-induced CPP over the course of morphine exposure. CONCLUSIONS Our findings indicate that repeated and scheduled exposures to morphine, which is akin to its clinical and recreational use, lead to dynamic alterations in primates' cognitive control depending on the extent of exposure. Enhancement of inhibition after limited exposure might provide opportunities to intervene and prevent the progress and culmination of opioid addiction, which is characterized by disinhibited drug-seeking and consumption.
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Affiliation(s)
- Sadegh Ghasemian
- Neuroscience Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran.,Cognitive Neuroscience Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran
| | - Marzieh M Vardanjani
- Neuroscience Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran.,Cognitive Neuroscience Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran
| | - Vahid Sheibani
- Neuroscience Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran.,Cognitive Neuroscience Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran
| | - Farshad A Mansouri
- ARC Centre of Excellence for Integrative Brain function, Monash University, Clayton, VIC, Australia
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8
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Hua JPY, Cano M, Batki SL, Pennington DL. Impact of Alcohol Use, Traumatic Stress, and Cigarette Smoking on Cognitive Functioning in Veterans With Co-occurring Alcohol Use Disorder and Posttraumatic Stress Disorder. Mil Med 2022; 188:usac282. [PMID: 36179109 PMCID: PMC10362996 DOI: 10.1093/milmed/usac282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 08/28/2022] [Accepted: 09/12/2022] [Indexed: 06/16/2023] Open
Abstract
INTRODUCTION Alcohol use disorder (AUD) and PTSD have high rates of co-occurrence in U.S. Military Veterans resulting in incrementally worse functional outcomes relative to having either one of these disorders alone. Cognitive dysfunction can impede one's ability to benefit from standard behavioral AUD and PTSD treatments. Cigarette smoking is also highly prevalent among U.S. Military Veterans, and cognitive dysfunction is associated with chronic cigarette use among individuals with AUD and PTSD independently. However, much less is known about to what extent cigarette smoking further impairs cognitive functioning in individuals with both co-occurring AUD and PTSD. MATERIALS AND METHODS U.S. Veterans with co-occurring AUD and PTSD (n = 162) completed a comprehensive cognitive assessment covering various domains: working memory, processing speed, mental switching, cognitive inhibition, auditory-verbal learning, auditory-verbal memory, and verbal fluency. To examine the impact of alcohol use, traumatic stress, and cigarette smoking on cognitive function, we conducted a three-way interaction examining the moderated effects of smoking status on the association between alcohol use and PTSD symptoms on a composite domain of global cognition. RESULTS Smoking status in Veterans with co-occurring AUD and PTSD moderated the relationship between alcohol use and global cognition (P = .042), such that higher levels of alcohol use in the past week were related to worse global cognitive function among Veterans cigarette smokers (P = .015) but not among nonsmokers (P = .833). On follow-up analyses of individual cognitive domains, greater alcohol use in the past week was associated with lower cognitive inhibition in smokers but not nonsmokers, with traumatic stress symptoms moderating this effect (P = .039). Additionally, smoking status moderated the relationship between alcohol use and auditory-verbal learning, such that there was a differential relationship between alcohol use and auditory-verbal learning between smokers and nonsmokers. CONCLUSIONS Overall, results provide evidence for the compounding impact of alcohol use, traumatic stress, and cigarette smoking on cognitive functioning. Impaired cognitive performance on a global level as well as on individual domains of cognitive inhibition and auditory-verbal learning were evident. Cognitive dysfunction may impede a Veteran's ability to benefit from therapeutic treatment, and these cognitive domains may represent potential targets for cognitive training efforts. Further, study results support smoking cessation initiatives and smoke-free policies enacted at Veterans Affairs healthcare facilities and medical centers.
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Affiliation(s)
- Jessica P Y Hua
- Sierra Pacific Mental Illness Research Education and Clinical Centers, San Francisco VA Medical Center and the University of California, San Francisco, CA, 94121, USA
- San Francisco Veterans Affairs Health Care System, San Francisco, CA 94121, USA
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, CA 94143, USA
- Department of Psychological Sciences, University of Missouri, Columbia, MO 65211, USA
| | - Monique Cano
- San Francisco Veterans Affairs Health Care System, San Francisco, CA 94121, USA
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, CA 94143, USA
| | - Steven L Batki
- San Francisco Veterans Affairs Health Care System, San Francisco, CA 94121, USA
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, CA 94143, USA
- Northern California Institute for Research and Education, San Francisco, CA 94121, USA
| | - David L Pennington
- San Francisco Veterans Affairs Health Care System, San Francisco, CA 94121, USA
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, CA 94143, USA
- Northern California Institute for Research and Education, San Francisco, CA 94121, USA
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9
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Taebi A, Becker B, Klugah-Brown B, Roecher E, Biswal B, Zweerings J, Mathiak K. Shared network-level functional alterations across substance use disorders: A multi-level kernel density meta-analysis of resting-state functional connectivity studies. Addict Biol 2022; 27:e13200. [PMID: 35754101 DOI: 10.1111/adb.13200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 04/21/2022] [Accepted: 06/02/2022] [Indexed: 11/30/2022]
Abstract
An increasing number of neuroimaging studies indicate functional alterations in cortico-striatal loops in individuals with substance use disorders (SUD). Dysregulations in these circuits may contribute to drug-seeking and drug-consuming behaviour by impeding inhibitory control, habit formation, and reward processing. Despite evidence of network-level changes in SUD, a shared pattern of functional alterations within and between spatially distributed brain networks has not been systematically investigated. The present meta-analytic investigation aims at identifying common alterations in resting-state functional connectivity patterns across different SUD, including stimulant, heroin, alcohol, cannabis, and nicotine use. To this aim, seed-based whole-brain connectivity maps for different functional networks were extracted and subjected to multi-level kernel density analysis to identify dysfunctional networks in individuals with SUD compared with healthy controls. In addition, an exploratory analysis examined substance-specific effects as well as the influence of drug use status on the main findings. Our findings indicate a hypoconnectivity pattern for the limbic, salience, and frontoparietal networks in individuals with SUD as compared with healthy controls. The default mode network additionally exhibited a complex pattern of hypo- and hyperconnectivity across the studies. The observed disrupted connectivity between networks in SUD may associate with deficient inhibitory control mechanisms that are thought to contribute to excessive craving and automatic drug-related behaviour as well as failure in substance use cessation. The identified network-based alterations in SUD represent potential treatment targets for neuromodulation, for example, network-based real-time functional magnetic resonance imaging (fMRI) neurofeedback. Such interventions can evaluate the behavioural relevance of the identified neural circuits.
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Affiliation(s)
- Arezoo Taebi
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine, RWTH Aachen, Aachen, Germany
| | - Benjamin Becker
- The Clinical Hospital of the Chengdu Brain Science Institute, School of Life Science and Technology, Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China
| | - Benjamin Klugah-Brown
- The Clinical Hospital of the Chengdu Brain Science Institute, School of Life Science and Technology, Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China
| | - Erik Roecher
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine, RWTH Aachen, Aachen, Germany
| | - Bharat Biswal
- Department of Biomedical Engineering, New Jersey Institute of Technology, Newark, New Jersey, USA
| | - Jana Zweerings
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine, RWTH Aachen, Aachen, Germany
| | - Klaus Mathiak
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine, RWTH Aachen, Aachen, Germany.,Institute of Neuroscience and Medicine: JARA-Institute Brain Structure Function Relationship (INM 10), Research Center Jülich, Jülich, Germany
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10
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Cecilia A, Patricio P, Donna C, Rakibul H, Sussanne R, Betsy L, Bharat B. Cognitive control inhibition networks in adulthood are impaired by early iron deficiency in infancy. Neuroimage Clin 2022; 35:103089. [PMID: 35753235 PMCID: PMC9249946 DOI: 10.1016/j.nicl.2022.103089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 06/14/2022] [Accepted: 06/16/2022] [Indexed: 12/26/2022]
Abstract
Iron deficiency, a common form of micronutrient deficiency, primarily affects children and women. The principal cause of iron deficiency is undernutrition in low-income countries and malnutrition in middle to upper income regions. Iron is a key element for myelin production, neuronal metabolism, and dopamine functions. Iron deficiency in early life can alter brain development and exert long-lasting effects. Control inhibition is an executive function that involves several brain regions, including the prefrontal cortex and caudate and sub-thalamic nuclei. Dopamine is the prevalent neurotransmitter underlying cognitive inhibition. We followed cohort study participants who had iron deficiency anemia in infancy as well non-anemic controls. At 22 years of age, the participants were subjected to functional magnetic resonance imaging (fMRI) to evaluate the correlation between functional connectivity and performance on an inhibitory cognitive task (Go/No-Go). We hypothesized that former iron deficient anemic (FIDA) participants demonstrate less strength in functional connectivity compared with controls (C). There were not significant group differences in the behavioral results in terms of accuracy and response time. A continuous covariate interaction analysis of functional connectivity and the Go/No-Go scores demonstrated significant differences between the FIDA and C groups. The FIDA participants demonstrated less strength in connectivity in brain regions related to control inhibition, including the medial temporal lobe, impairment in the integration of the default mode network (indicating decreased attention and alertness), and an increase in connectivity in posterior brain areas, all of which suggest slower circuitry maturation. The results support the hypothesis that FIDA young adults show differences in the connectivity of networks related to executive functions. These differences could increase their vulnerability to develop cognitive dysfunctions or mental disorders in adulthood.
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Affiliation(s)
- Algarín Cecilia
- Sleep and Functional Neurobiology Laboratory, Institute of Nutrition and Food Technology, University of Chile, Chile,Corresponding author at: El Líbano 5524, Macul 7830490, Región Metropolitana, Santiago, Chile.
| | - Peirano Patricio
- Sleep and Functional Neurobiology Laboratory, Institute of Nutrition and Food Technology, University of Chile, Chile
| | - Chen Donna
- Department of Biomedical Engineering, New Jersey Institute of Technology, University Heights, Newark, NJ, United States
| | - Hafiz Rakibul
- Department of Biomedical Engineering, New Jersey Institute of Technology, University Heights, Newark, NJ, United States
| | - Reyes Sussanne
- Sleep and Functional Neurobiology Laboratory, Institute of Nutrition and Food Technology, University of Chile, Chile
| | - Lozoff Betsy
- Department of Pediatrics and Environmental Health Sciences, University of Michigan, Ann Arbor, MI, United States
| | - Biswal Bharat
- Department of Biomedical Engineering, New Jersey Institute of Technology, University Heights, Newark, NJ, United States
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11
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Parvaz MA, Gross JJ. Emotion Dysregulation and Opioid Misuse. Biol Psychiatry 2022; 91:1005-1007. [PMID: 35654558 DOI: 10.1016/j.biopsych.2022.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 04/18/2022] [Indexed: 11/02/2022]
Affiliation(s)
- Muhammad A Parvaz
- Departments of Psychiatry and Neuroscience, Icahn School of Medicine at Mount Sinai, New York, New York.
| | - James J Gross
- Department of Psychology, Stanford University, Palo Alto, California
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12
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Hudak J, Bernat EM, Fix ST, Prince KC, Froeliger B, Garland EL. Neurophysiological Deficits During Reappraisal of Negative Emotional Stimuli in Opioid Misuse. Biol Psychiatry 2022; 91:1070-1078. [PMID: 35393080 PMCID: PMC9167218 DOI: 10.1016/j.biopsych.2022.01.019] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 01/19/2022] [Accepted: 01/21/2022] [Indexed: 11/21/2022]
Abstract
BACKGROUND Opioid misuse is hypothesized to compromise the ability to regulate negative emotions, as manifested through visceral and peripheral physiological signals. However, neurophysiological impairment of top-down cognitive emotion regulation in opioid misuse has not previously been shown. METHODS Patients with chronic pain who had been taking opioids for 90 days or longer (N = 149; female, n = 98) underwent a negative emotion regulation task with electroencephalography. Participants were instructed to view or reappraise negative images presented for 3 seconds. Using a validated cutoff score on the Current Opioid Misuse Measure, participants were classified as exhibiting aberrant drug-related behavior consistent with opioid misuse (MISUSE+) or as being low risk for opioid misuse (MISUSE-). Participants reported their craving in response to negative emotions over the past week. RESULTS We observed a group × condition interaction (p = .003) such that the MISUSE- group decreased the late positive potential of the electroencephalography during reappraisal, whereas the MISUSE+ group showed increased late positive potential during reappraisal. This deficit in negative emotion regulation remained significant after controlling for an array of potential confounding variables, including opioid dose, pain, and depression. Heightened late positive potential during reappraisal was associated with more severe opioid craving. CONCLUSIONS Opioid misuse may occasion top-down deficits in emotional regulation that begin as early as 400 ms after presentation of negative stimuli. It remains unknown whether emotion dysregulation is the cause, correlate, or consequence of opioid misuse. Nonetheless, targeting emotion dysregulation in opioid misuse with reappraisal-focused interventions may represent an important treatment approach.
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Affiliation(s)
- Justin Hudak
- Center on Mindfulness and Integrative Health Intervention Development, University of Utah, Salt Lake City, Utah
| | - Edward M Bernat
- Department of Psychology, University of Maryland, College Park, Maryland
| | - Spencer T Fix
- Department of Psychology, University of Maryland, College Park, Maryland
| | - Kort C Prince
- College of Social Work, University of Utah, Salt Lake City, Utah
| | - Brett Froeliger
- Departments of Psychiatry and Psychology, University of Missouri, Columbia, Missouri
| | - Eric L Garland
- Center on Mindfulness and Integrative Health Intervention Development, University of Utah, Salt Lake City, Utah; College of Social Work, University of Utah, Salt Lake City, Utah; Veterans Health Care Administration VISN 19 Whole Health Flagship, VA Salt Lake City Health Care System, Salt Lake City, Utah.
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13
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Pandey AK, Ardekani BA, Byrne KNH, Kamarajan C, Zhang J, Pandey G, Meyers JL, Kinreich S, Chorlian DB, Kuang W, Stimus AT, Porjesz B. Statistical Nonparametric fMRI Maps in the Analysis of Response Inhibition in Abstinent Individuals with History of Alcohol Use Disorder. Behav Sci (Basel) 2022; 12:bs12050121. [PMID: 35621418 PMCID: PMC9137506 DOI: 10.3390/bs12050121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 04/13/2022] [Accepted: 04/14/2022] [Indexed: 11/26/2022] Open
Abstract
Inhibitory impairments may persist after abstinence in individuals with alcohol use disorder (AUD). Using traditional statistical parametric mapping (SPM) fMRI analysis, which requires data to satisfy parametric assumptions often difficult to satisfy in biophysical system as brain, studies have reported equivocal findings on brain areas responsible for response inhibition, and activation abnormalities during inhibition found in AUD persist after abstinence. Research is warranted using newer analysis approaches. fMRI scans were acquired during a Go/NoGo task from 30 abstinent male AUD and 30 healthy control participants with the objectives being (1) to characterize neuronal substrates associated with response inhibition using a rigorous nonparametric permutation-based fMRI analysis and (2) to determine whether these regions were differentially activated between abstinent AUD and control participants. A blood oxygen level dependent contrast analysis showed significant activation in several right cortical regions and deactivation in some left cortical regions during successful inhibition. The largest source of variance in activation level was due to group differences. The findings provide evidence of cortical substrates employed during response inhibition. The largest variance was explained by lower activation in inhibition as well as ventral attentional cortical networks in abstinent individuals with AUD, which were not found to be associated with length of abstinence, age, or impulsiveness.
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Affiliation(s)
- Ashwini Kumar Pandey
- Henri Begleiter Neurodynamics Laboratory, Department of Psychiatry and Behavioral Sciences, SUNY Downstate Health Sciences University, 450 Clarkson Avenue, MSC #1203, Brooklyn, NY 11203, USA; (C.K.); (J.Z.); (G.P.); (J.L.M.); (S.K.); (D.B.C.); (W.K.); (A.T.S.); (B.P.)
- Correspondence:
| | - Babak Assai Ardekani
- Center for Biomedical Imaging and Neuromodulation, The Nathan S. Kline Institute for Psychiatric Research, 140 Old Orangeburg Road, Orangeburg, NY 10962, USA; (B.A.A.); (K.N.-H.B.)
| | - Kelly Nicole-Helen Byrne
- Center for Biomedical Imaging and Neuromodulation, The Nathan S. Kline Institute for Psychiatric Research, 140 Old Orangeburg Road, Orangeburg, NY 10962, USA; (B.A.A.); (K.N.-H.B.)
| | - Chella Kamarajan
- Henri Begleiter Neurodynamics Laboratory, Department of Psychiatry and Behavioral Sciences, SUNY Downstate Health Sciences University, 450 Clarkson Avenue, MSC #1203, Brooklyn, NY 11203, USA; (C.K.); (J.Z.); (G.P.); (J.L.M.); (S.K.); (D.B.C.); (W.K.); (A.T.S.); (B.P.)
| | - Jian Zhang
- Henri Begleiter Neurodynamics Laboratory, Department of Psychiatry and Behavioral Sciences, SUNY Downstate Health Sciences University, 450 Clarkson Avenue, MSC #1203, Brooklyn, NY 11203, USA; (C.K.); (J.Z.); (G.P.); (J.L.M.); (S.K.); (D.B.C.); (W.K.); (A.T.S.); (B.P.)
| | - Gayathri Pandey
- Henri Begleiter Neurodynamics Laboratory, Department of Psychiatry and Behavioral Sciences, SUNY Downstate Health Sciences University, 450 Clarkson Avenue, MSC #1203, Brooklyn, NY 11203, USA; (C.K.); (J.Z.); (G.P.); (J.L.M.); (S.K.); (D.B.C.); (W.K.); (A.T.S.); (B.P.)
| | - Jacquelyn Leigh Meyers
- Henri Begleiter Neurodynamics Laboratory, Department of Psychiatry and Behavioral Sciences, SUNY Downstate Health Sciences University, 450 Clarkson Avenue, MSC #1203, Brooklyn, NY 11203, USA; (C.K.); (J.Z.); (G.P.); (J.L.M.); (S.K.); (D.B.C.); (W.K.); (A.T.S.); (B.P.)
| | - Sivan Kinreich
- Henri Begleiter Neurodynamics Laboratory, Department of Psychiatry and Behavioral Sciences, SUNY Downstate Health Sciences University, 450 Clarkson Avenue, MSC #1203, Brooklyn, NY 11203, USA; (C.K.); (J.Z.); (G.P.); (J.L.M.); (S.K.); (D.B.C.); (W.K.); (A.T.S.); (B.P.)
| | - David Balin Chorlian
- Henri Begleiter Neurodynamics Laboratory, Department of Psychiatry and Behavioral Sciences, SUNY Downstate Health Sciences University, 450 Clarkson Avenue, MSC #1203, Brooklyn, NY 11203, USA; (C.K.); (J.Z.); (G.P.); (J.L.M.); (S.K.); (D.B.C.); (W.K.); (A.T.S.); (B.P.)
| | - Weipeng Kuang
- Henri Begleiter Neurodynamics Laboratory, Department of Psychiatry and Behavioral Sciences, SUNY Downstate Health Sciences University, 450 Clarkson Avenue, MSC #1203, Brooklyn, NY 11203, USA; (C.K.); (J.Z.); (G.P.); (J.L.M.); (S.K.); (D.B.C.); (W.K.); (A.T.S.); (B.P.)
| | - Arthur T. Stimus
- Henri Begleiter Neurodynamics Laboratory, Department of Psychiatry and Behavioral Sciences, SUNY Downstate Health Sciences University, 450 Clarkson Avenue, MSC #1203, Brooklyn, NY 11203, USA; (C.K.); (J.Z.); (G.P.); (J.L.M.); (S.K.); (D.B.C.); (W.K.); (A.T.S.); (B.P.)
| | - Bernice Porjesz
- Henri Begleiter Neurodynamics Laboratory, Department of Psychiatry and Behavioral Sciences, SUNY Downstate Health Sciences University, 450 Clarkson Avenue, MSC #1203, Brooklyn, NY 11203, USA; (C.K.); (J.Z.); (G.P.); (J.L.M.); (S.K.); (D.B.C.); (W.K.); (A.T.S.); (B.P.)
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14
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Pacheco-Colón I, Lopez-Quintero C, Coxe S, Limia JM, Pulido W, Granja K, Paula DC, Gonzalez I, Ross JM, Duperrouzel JC, Hawes SW, Gonzalez R. Risky decision-making as an antecedent or consequence of adolescent cannabis use: findings from a 2-year longitudinal study. Addiction 2022; 117:392-410. [PMID: 34184776 PMCID: PMC8714869 DOI: 10.1111/add.15626] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 02/26/2021] [Accepted: 06/16/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND AND AIMS Although poor decision-making (DM) has been correlated with problematic cannabis use (CU), cross-sectional designs make it difficult to determine whether poor DM represents an antecedent and/or consequence of CU. The current study measured bidirectional associations between CU and DM among adolescents over 2 years and compared these findings to those observed with episodic memory, which is consistently reported as a consequence of CU. We also measured the role of DM as a risk factor for cannabis use disorder (CUD) onset. DESIGN Two-year longitudinal study with five bi-annual assessments. PARTICIPANTS Participants were 401 adolescents aged 14-17 years at baseline. SETTING Miami, Florida, USA. MEASUREMENTS CU frequency and CUDs were assessed at each time-point through the Drug Use History Questionnaire and Structured Clinical Interview for DSM-IV, respectively. Neurocognition was assessed at odd time-points throughout the Iowa Gambling Task, Game of Dice Task and Cups Task [decision-making (DM)] and the Wechsler Memory Scale IV and California Verbal Learning Test II (episodic memory). We used latent growth curve modeling to examine bidirectional influences between CU and neurocognition over time. We applied discrete time survival analyses to determine whether baseline DM predicted CUD onset. FINDINGS Greater lifetime CU frequency was associated with poorer episodic memory at baseline (bs = -14.84, -16.44, Ps = 0.038, 0.021). Greater CU escalation predicted lesser gains in immediate episodic memory (b = -0.05, P = 0.020). Baseline DM did not predict CU escalation (b = 0.07, P = 0.421), nor did escalation in CU predict changes in DM (b = 0.02, P = 0.352). Baseline DM also did not predict CUD onset (adjusted OR = 1.01, 95% confidence interval = 0.98-1.06). CONCLUSIONS This study replicates findings that poorer episodic memory in adolescents appears to be a consequence of cannabis use, even among adolescents at earlier stages of use. Poor decision-making does not appear to be either a consequence of or a risk factor for escalating cannabis use or onset of cannabis use disorder among adolescents.
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Affiliation(s)
- Ileana Pacheco-Colón
- Center for Children and Families, Department of Psychology, Florida International University, Miami, FL, USA
| | - Catalina Lopez-Quintero
- Department of Epidemiology, College of Public Health and Health Professions and College of Medicine, University of Florida, Gainesville, FL, USA
| | - Stefany Coxe
- Center for Children and Families, Department of Psychology, Florida International University, Miami, FL, USA
| | - Jorge M. Limia
- Center for Children and Families, Department of Psychology, Florida International University, Miami, FL, USA
| | - William Pulido
- Center for Children and Families, Department of Psychology, Florida International University, Miami, FL, USA
| | - Karen Granja
- Center for Children and Families, Department of Psychology, Florida International University, Miami, FL, USA
| | - Dayana C. Paula
- Center for Children and Families, Department of Psychology, Florida International University, Miami, FL, USA
| | - Ingrid Gonzalez
- Department of Biostatistics, Florida International University, Miami, FL, USA
| | - J. Megan Ross
- Division of Addiction Sciences, Prevention and Treatment, Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | | | - Samuel W. Hawes
- Center for Children and Families, Department of Psychology, Florida International University, Miami, FL, USA
| | - Raul Gonzalez
- Center for Children and Families, Department of Psychology, Florida International University, Miami, FL, USA
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15
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Cavicchioli M, Ogliari A, Movalli M, Maffei C. Persistent Deficits in Self-Regulation as a Mediator between Childhood Attention-Deficit/Hyperactivity Disorder Symptoms and Substance Use Disorders. Subst Use Misuse 2022; 57:1837-1853. [PMID: 36096483 DOI: 10.1080/10826084.2022.2120358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
The link between attention-deficit/hyperactivity disorder (ADHD) and substance use disorders (SUDs) has been largely demonstrated. Some scholars have hypothesized that self-regulation mechanisms might play a key role in explaining this association. Objective(s): The current study tested the hypothesis that retrospective childhood ADHD symptoms might lead to more severe SUDs and this association should be mediated by current self-ratings of behavioral disinhibition, inattention, and emotional dysregulation among 204 treatment-seeking adults (male: 67.3%; female: 32.7%) with a primary diagnosis of alcohol use disorder and other SUDs. Methods: The mediational model was estimated through self-report measures of childhood ADHD symptoms (independent variable; WURS), current self-regulation mechanisms (mediators)-behavioral disinhibition (BIS-11 motor subscale), difficulties with attention regulation (MAAS) and emotion regulation (DERS)-and severity of SUDs (dependent variable; SPQ alcohol, illicit and prescribed drugs). Results: The analysis showed that alterations in the self-regulation system fully mediated the association between the severity of childhood ADHD symptoms and SUDs in adulthood. Behavioral disinhibition and difficulties in attention regulation were the most representative alterations in self-regulation processes that explained this association. Conclusions: These findings suggest it is useful to implement several therapeutic approaches (e.g. behavioral, mindfulness-based, and pharmacological) to increase the self-regulation abilities of children and adolescents with ADHD in order to reduce the probability of SUD onset in adulthood. However, future longitudinal neuroimaging and neuropsychological studies are needed to further support the role of self-regulation mechanisms in explaining the prospective association between childhood ADHD symptoms and SUDs in adulthood.
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Affiliation(s)
- Marco Cavicchioli
- Department of Psychology, University "Vita-Salute San Raffaele", Milan, Italy.,Unit of Clinical Psychology and Psychotherapy, San Raffaele-Turro Hospital, Milan, Italy
| | - Anna Ogliari
- Unit of Clinical Psychology and Psychotherapy, San Raffaele-Turro Hospital, Milan, Italy.,Child in Mind Lab, University "Vita-Salute San Raffaele", Milan, Italy
| | - Mariagrazia Movalli
- Department of Psychology, University "Vita-Salute San Raffaele", Milan, Italy.,Unit of Clinical Psychology and Psychotherapy, San Raffaele-Turro Hospital, Milan, Italy
| | - Cesare Maffei
- Department of Psychology, University "Vita-Salute San Raffaele", Milan, Italy.,Unit of Clinical Psychology and Psychotherapy, San Raffaele-Turro Hospital, Milan, Italy
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16
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Alderson Myers AB, Arienzo D, Molnar SM, Marinkovic K. Local and network-level dysregulation of error processing is associated with binge drinking. NEUROIMAGE-CLINICAL 2021; 32:102879. [PMID: 34768146 PMCID: PMC8591397 DOI: 10.1016/j.nicl.2021.102879] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 11/04/2021] [Accepted: 11/05/2021] [Indexed: 01/22/2023]
Abstract
Go/NoGo performance does not differ between binge (BDs) and light drinkers. BDs show greater BOLD activity to inhibition errors primarily in prefrontal areas. Greater functional connectivity in the frontal cortex correlates with drinking. Observed increase in error-related activity may serve a compensatory role. This is consistent with allostatic hyperexcitability reflecting neuroadaptation.
Binge drinking refers to the pattern of alcohol consumption that brings blood alcohol levels to or above legal intoxication levels. Commonly practiced by young adults, it is associated with neurofunctional alterations, raising health-related concerns. Executive deficits may contribute to the inability to refrain from excessive alcohol intake. As a facet of cognitive control, error processing allows for flexible modification of behavior to optimize future outcomes. It is highly relevant to addiction research, as a failure to inhibit excessive drinking results in relapses, which is a hallmark of alcohol use disorder. However, research on local and system-level neural underpinnings of inhibition failures as a function of binge drinking is limited. To address these gaps, functional magnetic resonance imaging (fMRI) was used to examine local changes and interregional functional connectivity during response inhibition errors on a Go/NoGo task. Young adult binge drinkers (BDs) performed equally well as light drinkers (LDs), a group of demographically matched individuals who drink regularly but in low-risk patterns. In contrast, BDs exhibited greater fMRI activity to inhibition errors contrasted with correct NoGo trials in the rostral anterior (rACC) and posterior cingulate cortices (PCC), as well as right middle frontal gyrus (R-MFG). Furthermore, BDs showed increased connectivity between the rACC and right lateral prefrontal cortex, in addition to greater connectivity between the R-MFG and the left ventrolateral and superior frontal cortices. Imaging indices were positively correlated only with alcohol-related measures, but not with those related to moods, disposition, or cognitive capacity. Taken together, greater error-related activity and expanded functional connectivity among prefrontal regions may serve a compensatory role to maintain efficiency of inhibitory control. Aligned with prominent models of addiction, these findings accentuate the importance of top-down control in maintaining low-risk drinking levels. They provide insight into potentially early signs of deteriorating cognitive control functions in BDs and may help guide intervention strategies aimed at preventing excessive drinking habits.
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Affiliation(s)
- Austin B Alderson Myers
- Department of Psychology, San Diego State University, 5500 Campanile Dr., San Diego, CA 92182, USA.
| | - Donatello Arienzo
- Department of Psychology, San Diego State University, 5500 Campanile Dr., San Diego, CA 92182, USA.
| | - Sean M Molnar
- Department of Psychology, San Diego State University, 5500 Campanile Dr., San Diego, CA 92182, USA.
| | - Ksenija Marinkovic
- Department of Psychology, San Diego State University, 5500 Campanile Dr., San Diego, CA 92182, USA; Department of Radiology, University of California, San Diego, 9500 Gilman Dr., La Jolla, CA 92093, USA.
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17
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Shi Z, Langleben DD, O'Brien CP, Childress AR, Wiers CE. Multivariate pattern analysis links drug use severity to distributed cortical hypoactivity during emotional inhibitory control in opioid use disorder. Neuroimage Clin 2021; 32:102806. [PMID: 34525436 PMCID: PMC8436158 DOI: 10.1016/j.nicl.2021.102806] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 08/17/2021] [Accepted: 08/20/2021] [Indexed: 11/22/2022]
Abstract
Opioid use disorder (OUD) is characterized by emotional and cognitive impairements that are associated with poor treatment outcomes. The present study investigated the neural mechanism underlying emotion evaluation and inhibitory control using an affective go/no-go (AGN) task and its association with drug use severity and craving in patients with OUD. Twenty-six recently detoxified patients with OUD underwent functional magnetic resonance imaging (fMRI) while performing the AGN task that required response to frequently presented appetitive stimuli ("go") and inhibition of response to infrequently presented aversive stimuli ("no-go"). The fMRI session was immediately followed by an injection of extended-release opioid antagonist naltrexone (XR-NTX). Participants' opioid craving was assessed immediately before fMRI and 10 ± 2 days after XR-NTX injection. Multivariate pattern analysis (MVPA) showed that drug use severity was associated with distributed brain hypoactivity in response to aversive no-go stimuli, with particularly large negative contributions from the cognitive control and dorsal attention brain networks. While drug use severity and its associated MVPA brain response pattern were both correlated with opioid craving at baseline, only the brain response pattern predicted craving during XR-NTX treatment. Our findings point to widespread functional hypoactivity in the brain networks underlying emotional inhibitory control in OUD. Such a distributed pattern is consistent with the multifaceted nature of OUD, which affects multiple brain networks. It also highlights the utility of the multivariate approach in uncovering large-scale cortical substrates associated with clinical severity in complex psychiatric disorders and in predicting treatment response.
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Affiliation(s)
- Zhenhao Shi
- Center for Studies of Addiction, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, 3535 Market St Ste 500, Philadelphia, PA 19104, USA.
| | - Daniel D Langleben
- Center for Studies of Addiction, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, 3535 Market St Ste 500, Philadelphia, PA 19104, USA
| | - Charles P O'Brien
- Center for Studies of Addiction, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, 3535 Market St Ste 500, Philadelphia, PA 19104, USA
| | - Anna Rose Childress
- Center for Studies of Addiction, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, 3535 Market St Ste 500, Philadelphia, PA 19104, USA
| | - Corinde E Wiers
- Center for Studies of Addiction, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, 3535 Market St Ste 500, Philadelphia, PA 19104, USA
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18
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Fisher ML, Pauly JR, Froeliger B, Turner JR. Translational Research in Nicotine Addiction. Cold Spring Harb Perspect Med 2021; 11:cshperspect.a039776. [PMID: 32513669 DOI: 10.1101/cshperspect.a039776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
While commendable strides have been made in reducing smoking initiation and improving smoking cessation rates, current available smoking cessation treatment options are still only mildly efficacious and show substantial interindividual variability in their therapeutic responses. Therefore, the primary goal of preclinical research has been to further the understanding of the neural substrates and genetic influences involved in nicotine's effects and reassess potential drug targets. Pronounced advances have been made by investing in new translational approaches and placing more emphasis on bridging the gap between human and rodent models of dependence. Functional neuroimaging studies have identified key brain structures involved with nicotine-dependence phenotypes such as craving, impulsivity, withdrawal symptoms, and smoking cessation outcomes. Following up with these findings, rodent-modeling techniques have made it possible to dissect the neural circuits involved in these motivated behaviors and ascertain mechanisms underlying nicotine's interactive effects on brain structure and function. Likewise, translational studies investigating single-nucleotide polymorphisms (SNPs) within the cholinergic, dopaminergic, and opioid systems have found high levels of involvement of these neurotransmitter systems in regulating the reinforcing aspects of nicotine in both humans and mouse models. These findings and coordinated efforts between human and rodent studies pave the way for future work determining gene by drug interactions and tailoring treatment options to each individual smoker.
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Affiliation(s)
- Miranda L Fisher
- Department of Pharmaceutical Sciences, University of Kentucky College of Pharmacy, Lexington, Kentucky 40536-0596, USA
| | - James R Pauly
- Department of Pharmaceutical Sciences, University of Kentucky College of Pharmacy, Lexington, Kentucky 40536-0596, USA
| | - Brett Froeliger
- Department of Neuroscience, Medical University of South Carolina, Charleston, South Carolina 29425, USA
| | - Jill R Turner
- Department of Pharmaceutical Sciences, University of Kentucky College of Pharmacy, Lexington, Kentucky 40536-0596, USA
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Garland EL, Howard MO. Prescription opioid misusers exhibit blunted parasympathetic regulation during inhibitory control challenge. Psychopharmacology (Berl) 2021; 238:765-774. [PMID: 33410988 PMCID: PMC7914222 DOI: 10.1007/s00213-020-05729-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 11/18/2020] [Indexed: 01/12/2023]
Abstract
RATIONALE Among opioid-treated chronic pain patients, response inhibition deficits in emotional contexts may contribute to opioid misuse. OBJECTIVES Using high-frequency heart rate variability (HF-HRV) to index-impaired response inhibition, we examined associations between opioid misuse and response inhibition in emotional and neutral contexts in a sample of opioid-treated chronic pain patients. METHOD Chronic pain patients taking opioid analgesics (N = 97) for ≥ 90 days completed an Emotional Go/NoGo task that presented an inhibitory control challenge in the context of neutral, opioid, negative affective, and positive affective background images while HF-HRV was computed. Opioid misuse and craving were assessed. Using a validated cut-point on the Current Opioid Misuse Measure, participants were classified as opioid misusers or non-misusers. Opioid misuse was examined as a predictor of behavioral and HF-HRV metrics of response inhibition. RESULTS Negative affective and opioid images elicited more errors of commission (p = .002, η2partial = .16) and slowed reaction times (p = .045, η2partial = .09) compared to neutral and positive affective images, respectively. Though no between-group behavioral differences were observed on the task, opioid misusers exhibited significantly blunted phasic HF-HRV during the task relative to non-misusers (p = .027, η2partial = .11). HF-HRV during the task was significantly inversely associated with opioid craving. It was not clear whether these autonomic findings reflected a durable phenotypic difference between groups or between-group differences in opioid dosing and withdrawal. CONCLUSION Reduced parasympathetic regulation during inhibitory control challenge may indicate heightened opioid misuse risk among opioid-treated chronic pain patients.
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Qiu Z, Wang J. Altered neural activities during response inhibition in adults with addiction: a voxel-wise meta-analysis. Psychol Med 2021; 51:387-399. [PMID: 33612127 DOI: 10.1017/s0033291721000362] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Previous literature has extensively investigated the brain activity during response inhibition in adults with addiction. Inconsistent results including both hyper- and hypo-activities in the fronto-parietal network (FPN) and the ventral attention network (VAN) have been found in adults with addictions, compared with healthy controls (HCs). METHODS Voxel-wise meta-analyses of abnormal task-evoked regional activity were conducted for adults with substance dependence (SD) and behavioral addiction during response inhibition tasks to solve previous inconsistencies. Twenty-three functional magnetic resonance imaging studies including 479 substance users, 38 individuals with behavioral addiction and 494 HCs were identified. RESULTS Compared with HCs, all addictions showed hypo-activities in regions within FPN (inferior frontal gyrus and supramarginal gyrus) and VAN (inferior frontal gyrus, middle temporal gyrus, temporal pole and insula), and hyper-activities in the cerebellum during response inhibition. SD subgroup showed almost the same activity patterns, with an additional hypoactivation of the precentral gyrus, compared with HCs. Stronger activation of the cerebellum was associated with longer addiction duration for adults with SD. We could not conduct meta-analytic investigations into the behavioral addiction subgroup due to the small number of datasets. CONCLUSION This meta-analysis revealed altered activation of FPN, VAN and the cerebellum in adults with addiction during response inhibition tasks using non-addiction-related stimuli. Although FPN and VAN showed lower activity, the cerebellum exhibited stronger activity. These results may help to understand the neural pathology of response inhibition in addiction.
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Affiliation(s)
- Zeguo Qiu
- Department of Applied Psychology, Guangdong University of Foreign Studies, Guangzhou510006, China
- School of Psychology, The University of Queensland, Brisbane4072, Australia
| | - Junjing Wang
- Department of Applied Psychology, Guangdong University of Foreign Studies, Guangzhou510006, China
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21
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Garland EL, Bryan MA, Priddy SE, Riquino MR, Froeliger B, Howard MO. Effects of Mindfulness-Oriented Recovery Enhancement Versus Social Support on Negative Affective Interference During Inhibitory Control Among Opioid-Treated Chronic Pain Patients: A Pilot Mechanistic Study. Ann Behav Med 2020; 53:865-876. [PMID: 30668631 DOI: 10.1093/abm/kay096] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Among opioid-treated chronic pain patients, deficient response inhibition in the context of emotional distress may contribute to maladaptive pain coping and prescription opioid misuse. Interventions that aim to bolster cognitive control and reduce emotional reactivity (e.g., mindfulness) may remediate response inhibition deficits, with consequent clinical benefits. PURPOSE To test the hypothesis that a mindfulness-based intervention, Mindfulness-Oriented Recovery Enhancement (MORE), can reduce the impact of clinically relevant, negative affective interference on response inhibition function in an opioid-treated chronic pain sample. METHODS We examined data from a controlled trial comparing adults with chronic pain and long-term prescription opioid use randomized to either MORE (n = 27) treatment or to an active support group comparison condition (n = 30). Participants completed an Emotional Go/NoGo Task at pre- and post-treatment, which measured response inhibition in neutral and clinically relevant, negative affective contexts (i.e., exposure to pain-related visual stimuli). RESULTS Repeated-measures analysis of variance indicated that compared with the support group, participants in MORE evidenced significantly greater reductions from pre- to post-treatment in errors of commission on trials with pain-related distractors relative to trials with neutral distractors, group × time × condition F(1,55) = 4.14, p = .047, η2partial = .07. Mindfulness practice minutes and increased nonreactivity significantly predicted greater emotional response inhibition. A significant inverse association was observed between improvements in emotional response inhibition and treatment-related reductions in pain severity by 3-month follow-up. CONCLUSIONS Study results provide preliminary evidence that MORE enhances inhibitory control function in the context of negative emotional interference.
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Affiliation(s)
- Eric L Garland
- College of Social Work, University of Utah, Salt Lake City, UT, USA.,Center on Mindfulness and Integrative Health Intervention Development, University of Utah, Salt Lake City, UT, USA
| | - Myranda A Bryan
- College of Social Work, University of Utah, Salt Lake City, UT, USA.,Center on Mindfulness and Integrative Health Intervention Development, University of Utah, Salt Lake City, UT, USA
| | - Sarah E Priddy
- College of Social Work, University of Utah, Salt Lake City, UT, USA.,Center on Mindfulness and Integrative Health Intervention Development, University of Utah, Salt Lake City, UT, USA
| | - Michael R Riquino
- College of Social Work, University of Utah, Salt Lake City, UT, USA.,Center on Mindfulness and Integrative Health Intervention Development, University of Utah, Salt Lake City, UT, USA
| | - Brett Froeliger
- Department of Neuroscience, Medical University of South Carolina, USA
| | - Matthew O Howard
- School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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22
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Acheson A. Behavioral processes and risk for problem substance use in adolescents. Pharmacol Biochem Behav 2020; 198:173021. [PMID: 32871140 DOI: 10.1016/j.pbb.2020.173021] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 08/17/2020] [Accepted: 08/26/2020] [Indexed: 10/23/2022]
Abstract
This narrative review examines associations of delay discounting, response inhibition, sensation-seeking, and urgency with adolescent problem substance use. Each of these processes is linked to adult substance use disorders, is associated with conditions linked to increased risk for adolescent problem substance use, and predicts problem substance use. Notably, all processes are linked to early life adversity (ELA) exposure and most appear to help explain links between ELA exposure and problem substance use. These findings are consistent with a growing body of literature indicating ELA interferes with the development of neural circuits crucial to cognitive functioning and emotion regulation. Further, developmental trajectories of these processes generally align with maturational imbalance hypotheses of adolescent risk. Ongoing and pending large longitudinal studies may be essential for better understanding how ELA and other influences shapes these processes and the role of these processes in risk for problem substance use in adolescence and beyond. Finally it is possible that risk-related processes may be useful metrics in the context of implementing and evaluating strategies to prevent problem substance use in adolescence.
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Affiliation(s)
- Ashley Acheson
- Psychiatry and Behavioral Science, University of Arkansas for Medical Sciences, Little Rock, AR, United States of America.
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23
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Darcey VL, Serafine KM. Omega-3 Fatty Acids and Vulnerability to Addiction: Reviewing Preclinical and Clinical Evidence. Curr Pharm Des 2020; 26:2385-2401. [DOI: 10.2174/1381612826666200429094158] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2019] [Accepted: 04/06/2020] [Indexed: 01/05/2023]
Abstract
Omega-3 (N3) fatty acids are dietary nutrients that are essential for human health. Arguably, one of their most critical contributions to health is their involvement in the structure and function of the nervous system. N3 fatty acids accumulate in neuronal membranes through young adulthood, becoming particularly enriched in a brain region known to be the locus of cognitive control of behavior-the prefrontal cortex (PFC). The PFC undergoes a surge in development during adolescence, coinciding with a life stage when dietary quality and intake of N3 fatty acids tend to be suboptimal. Such low intake may impact neurodevelopment and normative development of cognitive functions suggested to be protective for the risk of subsequent substance and alcohol use disorders (UD). While multiple genetic and environmental factors contribute to risk for and resilience to substance and alcohol use disorders, mounting evidence suggests that dietary patterns early in life may also modulate cognitive and behavioral factors thought to elevate UD risk (e.g., impulsivity and reward sensitivity). This review aims to summarize the literature on dietary N3 fatty acids during childhood and adolescence and risk of executive/ cognitive or behavioral dysfunction, which may contribute to the risk of subsequent UD. We begin with a review of the effects of N3 fatty acids in the brain at the molecular to cellular levels–providing the biochemical mechanisms ostensibly supporting observed beneficial effects. We continue with a review of cognitive, behavioral and neurodevelopmental features thought to predict early substance and alcohol use in humans. This is followed by a review of the preclinical literature, largely demonstrating that dietary manipulation of N3 fatty acids contributes to behavioral changes that impact drug sensitivity. Finally, a review of the available evidence in human literature, suggesting an association between dietary N3 fatty and neurodevelopmental profiles associated with risk of adverse outcomes including UD. We conclude with a brief summary and call to action for additional research to extend the current understanding of the impact of dietary N3 fatty acids and the risk of drug and alcohol UD.
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Affiliation(s)
- Valerie L. Darcey
- Georgetown University, Interdisciplinary Program in Neuroscience, Washington DC, United States
| | - Katherine M. Serafine
- Department of Psychology, The University of Texas at El Paso, El Paso, TX 79968, United States
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24
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Williams JR, Cole V, Girdler S, Cromeens MG. Exploring stress, cognitive, and affective mechanisms of the relationship between interpersonal trauma and opioid misuse. PLoS One 2020; 15:e0233185. [PMID: 32413081 PMCID: PMC7228080 DOI: 10.1371/journal.pone.0233185] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Accepted: 04/29/2020] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND People with a history of interpersonal trauma, including intimate partner violence, sexual assault, and adverse childhood experiences, are disproportionately affected by the current opioid epidemic. Interpersonal trauma has been shown to increase risk for chronic pain conditions, prescription opioid use, and opioid misuse. Stress, cognition, and affective function have been examined as potential mechanisms that may influence opioid misuse among individuals with a history of interpersonal trauma. However, no studies have examined these factors simultaneously, despite their interrelatedness. OBJECTIVE The purpose of this study was to 1) examine perceived stress, perceived cognitive function, depressive symptoms, and PTSD symptoms as potential mechanisms of opioid misuse among individuals with a history of interpersonal trauma, 2) examine the types of interpersonal trauma that are associated with opioid misuse, and 3) assess the mediating role of pain and opioid prescription. METHODS A cross-sectional, observational study design was conducted. Data were collected through a confidential self-report online survey using validated instruments (n = 230). A series of regression analyses were conducted to identify mechanistic factors and interpersonal trauma types associated with opioid misuse, opioid prescription, and pain intensity. Structural equation modeling was used to examine mediating effects of pain intensity and opioid prescription. RESULTS Opioid prescription, depressive symptoms, and intimate partner violence increased the odds of reporting opioid misuse. Pain intensity and adverse childhood experiences increased the odds of opioid prescription. Higher levels of perceived stress and depressive symptoms were associated with increased pain intensity. Pain intensity emerged as a mediator of the relationship between depressive symptoms and opioid misuse. CONCLUSIONS Our work shows that there are likely several pathways through which interpersonal trauma can lead to opioid misuse. Interventions aimed at improving depressive symptoms and coping with traumatizing events should be included as part of comprehensive trauma-informed pain management practices.
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Affiliation(s)
- Jessica Roberts Williams
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
- * E-mail:
| | - Veronica Cole
- Department of Psychology, Wake Forest University, Wake Forest, North Carolina, United States of America
| | - Susan Girdler
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Martha Grace Cromeens
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
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25
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Duan S, Ma Y, Xie L, Zheng L, Huang J, Guo R, Sun Z, Xie Y, Lv J, Lin Z, Ma S. Effects of Chronic Ephedrine Toxicity on Functional Connections, Cell Apoptosis, and CREB-Related Proteins in the Prefrontal Cortex of Rhesus Monkeys. Neurotox Res 2020; 37:602-615. [PMID: 31858422 DOI: 10.1007/s12640-019-00146-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Revised: 11/20/2019] [Accepted: 11/29/2019] [Indexed: 02/05/2023]
Abstract
Ephedrine abuse has spread in many parts of the world, severely threatening human health. The mechanism of ephedrine toxicity is still unclear. To explore the possible neural mechanisms of ephedrine toxicity, this study established a non-human primate model of ephedrine exposure, analyzed the functional connectivity changes in its prefrontal cortex through resting state BOLD-fMRI, and then inspected the pathophysiological changes as well as the expression of the cyclic adenosine monophosphate response element-binding protein (CREB), phosphorylated CREB (P-CREB), and CREB target proteins (c-fos and fosB) in the prefrontal cortex. After ephedrine toxicity, we found that the prefrontal cortex of monkeys strengthened its functional connectivity with the brain regions that perform motivation, drive, reward, and learning and memory functions and weakened its functional connectivity with the brain regions that perform cognitive control. These results suggest that ephedrine toxicity causes abnormal neural circuits that lead to the amplification and enhancement of drug-related cues and the weakening and damage of cognitive control function. Histology showed that the neurocytotoxicity of ephedrine can cause neuronal degeneration and apoptosis. Real-time PCR and Western blot showed increased expression of CREB mRNA and CREB/P-CREB/c-fos/fosB protein in the prefrontal cortex after ephedrine toxicity. Collectively, the present study indicates that the enhancement of drug-related cues and the weakening of cognitive control caused by abnormal neural circuits after drug exposure may be a major mechanism of brain function changes caused by ephedrine. These histological and molecular changes may be the pathophysiological basis of brain function changes caused by ephedrine.
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Affiliation(s)
- Shouxing Duan
- Department of Pediatric Surgery, The First Affiliated Hospital of Shantou University Medical College, No. 57 Changping Road, Shantou, Guangdong, 515041, People's Republic of China
- Shantou University Medical College, No. 22 Xinling Road, Shantou, Guangdong, 515041, People's Republic of China
- Guangdong Key Laboratory of Medical Molecular Imaging, No. 57 Changping Road, Shantou, Guangdong, 515041, People's Republic of China
| | - Ye Ma
- Department of Linguistics & Languages, Michigan State University, East Lansing, MI, 48824, USA
| | - Lei Xie
- Shantou University Medical College, No. 22 Xinling Road, Shantou, Guangdong, 515041, People's Republic of China
- Guangdong Key Laboratory of Medical Molecular Imaging, No. 57 Changping Road, Shantou, Guangdong, 515041, People's Republic of China
- Department of Radiology, The First Affiliated Hospital of Shantou University Medical College, No. 57 Changping Road, Shantou, Guangdong, 515041, People's Republic of China
| | - Lian Zheng
- Department of Pediatric Surgery, The First Affiliated Hospital of Shantou University Medical College, No. 57 Changping Road, Shantou, Guangdong, 515041, People's Republic of China
| | - Jinzhuang Huang
- Shantou University Medical College, No. 22 Xinling Road, Shantou, Guangdong, 515041, People's Republic of China
- Guangdong Key Laboratory of Medical Molecular Imaging, No. 57 Changping Road, Shantou, Guangdong, 515041, People's Republic of China
- Department of Radiology, The First Affiliated Hospital of Shantou University Medical College, No. 57 Changping Road, Shantou, Guangdong, 515041, People's Republic of China
| | - Ruiwei Guo
- Shantou University Medical College, No. 22 Xinling Road, Shantou, Guangdong, 515041, People's Republic of China
- Guangdong Key Laboratory of Medical Molecular Imaging, No. 57 Changping Road, Shantou, Guangdong, 515041, People's Republic of China
- Department of Radiology, The First Affiliated Hospital of Shantou University Medical College, No. 57 Changping Road, Shantou, Guangdong, 515041, People's Republic of China
| | - Zongbo Sun
- Shantou University Medical College, No. 22 Xinling Road, Shantou, Guangdong, 515041, People's Republic of China
- Guangdong Key Laboratory of Medical Molecular Imaging, No. 57 Changping Road, Shantou, Guangdong, 515041, People's Republic of China
- Department of Radiology, The First Affiliated Hospital of Shantou University Medical College, No. 57 Changping Road, Shantou, Guangdong, 515041, People's Republic of China
| | - Yao Xie
- Shantou University Medical College, No. 22 Xinling Road, Shantou, Guangdong, 515041, People's Republic of China
- Guangdong Key Laboratory of Medical Molecular Imaging, No. 57 Changping Road, Shantou, Guangdong, 515041, People's Republic of China
- Department of Radiology, The First Affiliated Hospital of Shantou University Medical College, No. 57 Changping Road, Shantou, Guangdong, 515041, People's Republic of China
| | - Junyao Lv
- Department of Forensic Medicine, Shantou University Medical College, No. 22 Xinling Road, Shantou, Guangdong, 515041, People's Republic of China
| | - Zhirong Lin
- Shantou University Medical College, No. 22 Xinling Road, Shantou, Guangdong, 515041, People's Republic of China
- Guangdong Key Laboratory of Medical Molecular Imaging, No. 57 Changping Road, Shantou, Guangdong, 515041, People's Republic of China
- Department of Radiology, The First Affiliated Hospital of Shantou University Medical College, No. 57 Changping Road, Shantou, Guangdong, 515041, People's Republic of China
| | - Shuhua Ma
- Shantou University Medical College, No. 22 Xinling Road, Shantou, Guangdong, 515041, People's Republic of China.
- Guangdong Key Laboratory of Medical Molecular Imaging, No. 57 Changping Road, Shantou, Guangdong, 515041, People's Republic of China.
- Department of Radiology, The First Affiliated Hospital of Shantou University Medical College, No. 57 Changping Road, Shantou, Guangdong, 515041, People's Republic of China.
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26
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Newman-Norlund RD, Gibson M, McConnell PA, Froeliger B. Dissociable Effects of Theta-Burst Repeated Transcranial Magnetic Stimulation to the Inferior Frontal Gyrus on Inhibitory Control in Nicotine Addiction. Front Psychiatry 2020; 11:260. [PMID: 32351412 PMCID: PMC7174714 DOI: 10.3389/fpsyt.2020.00260] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Accepted: 03/17/2020] [Indexed: 11/17/2022] Open
Abstract
Nicotine addiction, like other substance use disorders (SUD's), is associated with deficits in prefrontal mediated inhibitory control. The strength of inhibitory control task-based functional connectivity (tbFC) between the right inferior frontal gyrus (r.IFG) and thalamus (corticothalamic circuit) mediates the association between successful inhibition and smoking relapse vulnerability. However, the potential efficacy of theta burst stimulation (TBS) to the r.IFG, a treatment known to alter clinical symptoms among neuropsychiatric patients, has not been reported in a SUD population. This study utilized fMRI guided neuronavigation to examine the effects of TBS on inhibitory control among nicotine dependent individuals. Participants (N=12) were scanned while performing an inhibitory control task known to elicit inhibition-related activity in the r.IFG. Using a randomized, counterbalanced cross-over design, participants then received TBS over two visits: excitatory (iTBS) on one visit and inhibitory (cTBS) TBS on the other visit. The effects of each TBS condition on subsequent inhibitory control task performance were examined. A significant condition x time interaction was identified on trials requiring inhibitory control (F (1,10) = 7.27, p = .022, D = 1.63). iTBS improved inhibitory control, whereas cTBS impaired inhibitory control. Brain stimulation did not influence performance in control conditions including novelty detection and response execution. This is the first study to demonstrate that non-invasive neural stimulation using iTBS to the r.IFG enhances baseline inhibitory control among individuals with a SUD. Further research is needed to directly examine the potential parametric effects of TBS on corticothalamic tbFC in individuals with a SUD.
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Affiliation(s)
| | - Makayla Gibson
- Department of Psychology, University of South Carolina, Columbia, SC, United States
| | - Patrick A McConnell
- Department of Neuroscience, Medical University of South Carolina, Charleston, SC, United States
| | - Brett Froeliger
- Department of Neuroscience, Medical University of South Carolina, Charleston, SC, United States.,Hollings Cancer Center, Medical University of South Carolina, Charleston, SC, United States
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27
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Schluter RS, van Holst RJ, Goudriaan AE. Effects of Ten Sessions of High Frequency Repetitive Transcranial Magnetic Stimulation (HF-rTMS) Add-on Treatment on Impulsivity in Alcohol Use Disorder. Front Neurosci 2019; 13:1257. [PMID: 31866805 PMCID: PMC6904338 DOI: 10.3389/fnins.2019.01257] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Accepted: 11/06/2019] [Indexed: 01/11/2023] Open
Abstract
Introduction Alcohol use disorder (AUD) is characterized by increased impulsivity, which is multifactorial and can be assessed by tests like the delay discounting, Go-Nogo, and stop signal task (SST). Impulsivity has been related to poor treatment outcomes in substance use disorders, including AUD. In order to decrease impulsivity or improve inhibitory control, high frequency transcranial magnetic stimulation (HF-rTMS) has gained interest. Studies applying HF-rTMS over the DLPFC of individuals suffering from AUD assessing its effects on impulsivity measures are scarce, and results are inconclusive. Methods The current study (registered in Netherlands Trial Register with trial number 5291: https://www.trialregister.nl/trial/5151) applied 10 sessions of HF-rTMS [sixty 10 Hz trains of 5 s at 110% motor threshold (MT)] over the right DLPFC of 80 alcohol dependent patients in clinical treatment on 10 consecutive workdays. At baseline, halfway and after the HF-rTMS treatment, the delay discounting, Go-NoGo, and SST were assessed. Results Ten sessions of HF-rTMS over the right DLPFC versus sham HF-rTMS did not affect performance on the delay discounting, Go-NoGo, and SSTs. A significant effect of age was found for the Go-NoGo task, with higher age associated with better performance. Furthermore, no significant correlations were found between difference scores of task performance and baseline impulsivity or severity of AUD. Discussion Results of this study, in combination with other studies using HF-rTMS studies in alcohol and substance use disorder, indicate mixed and inconclusive findings of HF-rTMS on impulsivity. Future studies within patient groups hospitalized at the same department are recommended to consider using a sham coil that mimics the sensations on the scalp of active HF-rTMS and to measure motivation across test sessions.
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Affiliation(s)
- Renée S Schluter
- Department of Psychiatry, Amsterdam Institute for Addiction Research, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Ruth J van Holst
- Department of Psychiatry, Amsterdam Institute for Addiction Research, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Anna E Goudriaan
- Department of Psychiatry, Amsterdam Institute for Addiction Research, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands.,Department of Research and Quality of Care, Arkin, Amsterdam, Netherlands.,Jellinek, Amsterdam, Netherlands
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Szumlinski KK, Ary AW, Shin CB, Wroten MG, Courson J, Miller BW, Ruppert‐Majer M, Hiller JW, Shahin JR, Ben‐Shahar O, Kippin TE. PI3K activation within ventromedial prefrontal cortex regulates the expression of drug-seeking in two rodent species. Addict Biol 2019; 24:1216-1226. [PMID: 30450839 DOI: 10.1111/adb.12696] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Revised: 09/11/2018] [Accepted: 10/10/2018] [Indexed: 12/25/2022]
Abstract
Phosphatidylinositide 3-kinases (PI3Ks) are intracellular signal transducer enzymes that recruit protein kinase B (aka Akt) to the cell membrane, the subsequent activation of which regulates many cellular functions. PI3K/Akt activity is up-regulated within mesocorticolimbic structures in animal models of alcoholism, but less is known regarding PI3K/Akt activity in animal models of cocaine addiction. Given that prefrontal cortex (PFC) is grossly dysregulated in addiction, we studied how cocaine affects protein indices of PFC PI3K/Akt activity in rat and mouse models and examined the relevance of PI3K activity for cocaine-related learning. Immunoblotting of mouse medial PFC at 3 weeks withdrawal from a cocaine-sensitization regimen (seven injections of 30 mg/kg, intraperitoneal [IP]) revealed increased kinase activity, as did immunoblotting of tissue from the ventral PFC of rats with a history of long-access intravenous cocaine self-administration (0.25 mg/0.1 mL infusion; 10 days of 6 h/d cocaine access). Interestingly, increased Akt phosphorylation was observed in rat ventromedial PFC at both 3- and 30-day withdrawal only in animals re-exposed to cocaine-associated cues. A conditioned place-preference paradigm in mice and a cue-elicited drug-seeking test in rats were conducted to determine the functional relevance for elevated PI3K activity for addiction-related behavior. In both cases, an intra-PFC infusion of the PI3K inhibitor wortmannin (50μM) reduced drug-seeking behavior. Taken together, this cross-species, interdisciplinary, study provides convincing evidence that cocaine history produces an enduring increase in PI3K/Akt-dependent signaling within the more ventral aspect of the PFC that is relevant to behavioral reactivity to drug-associated cues/contexts. As such, PI3K inhibitors may well serve as an effective strategy for reducing drug cue reactivity and craving in cocaine addiction.
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Affiliation(s)
- Karen K. Szumlinski
- Department of Psychological and Brain SciencesUniversity of California Santa Barbara Santa Barbara California
- Department of MolecularCellular and Developmental Biology and the Neuroscience Research Institute Santa Barbara California
| | - Alexis W. Ary
- Department of Psychological and Brain SciencesUniversity of California Santa Barbara Santa Barbara California
| | - Christina B. Shin
- Department of Psychological and Brain SciencesUniversity of California Santa Barbara Santa Barbara California
| | - Melissa G. Wroten
- Department of Psychological and Brain SciencesUniversity of California Santa Barbara Santa Barbara California
| | - Justin Courson
- Department of Psychological and Brain SciencesUniversity of California Santa Barbara Santa Barbara California
| | - Bailey W. Miller
- Department of Psychological and Brain SciencesUniversity of California Santa Barbara Santa Barbara California
| | - Micaela Ruppert‐Majer
- Department of Psychological and Brain SciencesUniversity of California Santa Barbara Santa Barbara California
| | - John W. Hiller
- Department of Psychological and Brain SciencesUniversity of California Santa Barbara Santa Barbara California
| | - John R. Shahin
- Department of Psychological and Brain SciencesUniversity of California Santa Barbara Santa Barbara California
| | - Osnat Ben‐Shahar
- Department of Psychological and Brain SciencesUniversity of California Santa Barbara Santa Barbara California
| | - Tod E. Kippin
- Department of Psychological and Brain SciencesUniversity of California Santa Barbara Santa Barbara California
- Department of MolecularCellular and Developmental Biology and the Neuroscience Research Institute Santa Barbara California
- Center for Collaborative BiotechnologyUniversity of California Santa Barbara Santa Barbara California
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Drug-related Virtual Reality Cue Reactivity is Associated with Gamma Activity in Reward and Executive Control Circuit in Methamphetamine Use Disorders. Arch Med Res 2019; 50:509-517. [DOI: 10.1016/j.arcmed.2019.09.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2019] [Revised: 08/14/2019] [Accepted: 09/09/2019] [Indexed: 01/10/2023]
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30
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Zilverstand A, Huang AS, Alia-Klein N, Goldstein RZ. Neuroimaging Impaired Response Inhibition and Salience Attribution in Human Drug Addiction: A Systematic Review. Neuron 2019; 98:886-903. [PMID: 29879391 DOI: 10.1016/j.neuron.2018.03.048] [Citation(s) in RCA: 276] [Impact Index Per Article: 55.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2017] [Revised: 03/09/2018] [Accepted: 03/27/2018] [Indexed: 12/27/2022]
Abstract
The impaired response inhibition and salience attribution (iRISA) model proposes that impaired response inhibition and salience attribution underlie drug seeking and taking. To update this model, we systematically reviewed 105 task-related neuroimaging studies (n > 15/group) published since 2010. Results demonstrate specific impairments within six large-scale brain networks (reward, habit, salience, executive, memory, and self-directed networks) during drug cue exposure, decision making, inhibitory control, and social-emotional processing. Addicted individuals demonstrated increased recruitment of these networks during drug-related processing but a blunted response during non-drug-related processing, with the same networks also being implicated during resting state. Associations with real-life drug use, relapse, therapeutic interventions, and the relevance to initiation of drug use during adolescence support the clinical relevance of the results. Whereas the salience and executive networks showed impairments throughout the addiction cycle, the reward network was dysregulated at later stages of abuse. Effects were similar in alcohol, cannabis, and stimulant addiction.
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Affiliation(s)
- Anna Zilverstand
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Anna S Huang
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Nelly Alia-Klein
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Rita Z Goldstein
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA.
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Sullivan RM, Perlman G, Moeller SJ. Meta-analysis of aberrant post-error slowing in substance use disorder: implications for behavioral adaptation and self-control. Eur J Neurosci 2019; 50:2467-2476. [PMID: 30383336 PMCID: PMC6494729 DOI: 10.1111/ejn.14229] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Revised: 09/28/2018] [Accepted: 10/08/2018] [Indexed: 11/30/2022]
Abstract
Individual with substance use disorders have well-recognized impairments in cognitive control, including in behavioral adaptation after mistakes. One way in which this impairment manifests is via diminished post-error slowing, the increase in reaction time following a task-related error that is posited to reflect cautionary or corrective behavior. Yet, in the substance use disorder literature, findings with regard to post-error slowing have been inconsistent, and thus could benefit from quantitative integration. Here, we conducted a meta-analysis of case-control studies examining post-error slowing in addiction. Twelve studies with 15 unique comparisons were identified, comprising 567 substance users and 384 healthy controls across three broad types of inhibitory control paradigms (go-no/go, conflict resolution, and stop signal tasks, respectively). Results of the random-effects meta-analysis revealed a moderate group difference across all studies (Cohen's d = 0.31), such that the individuals with substance use disorder had diminished post-error slowing compared with controls. Despite this omnibus effect, there was also large variability in the magnitude of the effects, explained in part by differences between studies in task complexity. These findings suggest that post-error slowing may serve as a promising and easy-to-implement measure of cognitive control impairment in substance use disorder, with potential links to aberrant brain function in cognitive control areas such as the anterior cingulate cortex.
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Affiliation(s)
- Ryan M. Sullivan
- Department of Psychiatry, Stony Brook University School of
Medicine
- Department of Psychology, University of
Wisconsin-Milwaukee
| | - Greg Perlman
- Department of Psychiatry, Stony Brook University School of
Medicine
| | - Scott J. Moeller
- Department of Psychiatry, Stony Brook University School of
Medicine
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Abstract
Cognitive impairments in substance use disorders have been extensively researched, especially since the advent of cognitive and computational neuroscience and neuroimaging methods in the last 20 years. Conceptually, altered cognitive function can be viewed as a hallmark feature of substance use disorders, with documented alterations in the well-known "executive" domains of attention, inhibition/regulation, working memory, and decision-making. Poor cognitive (sometimes referred to as "top-down") regulation of downstream motivational processes-whether appetitive (reward, incentive salience) or aversive (stress, negative affect)-is recognized as a fundamental impairment in addiction and a potentially important target for intervention. As addressed in this special issue, cognitive impairment is a transdiagnostic domain; thus, advances in the characterization and treatment of cognitive dysfunction in substance use disorders could have benefit across multiple psychiatric disorders. Toward this general goal, we summarize current findings in the abovementioned cognitive domains of substance use disorders, while suggesting a potentially useful expansion to include processes that both precede (precognition) and supersede (social cognition) what is usually thought of as strictly cognition. These additional two areas have received relatively less attention but phenomenologically and otherwise are important features of substance use disorders. The review concludes with suggestions for research and potential therapeutic targeting of both the familiar and this more comprehensive version of cognitive domains related to substance use disorders.
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Moeller SJ, Fox HC, Hsu DT, Rosenthal RN. Dispositional Neural Signatures: When Group Main Effects on Functional Magnetic Resonance Imaging Tasks Can Still Be Interesting. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2018; 3:905-906. [PMID: 30409388 DOI: 10.1016/j.bpsc.2018.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Accepted: 09/10/2018] [Indexed: 10/27/2022]
Affiliation(s)
- Scott J Moeller
- Department of Psychiatry, Stony Brook University School of Medicine, Stony Brook, New York.
| | - Helen C Fox
- Department of Psychiatry, Stony Brook University School of Medicine, Stony Brook, New York
| | - David T Hsu
- Department of Psychiatry, Stony Brook University School of Medicine, Stony Brook, New York
| | - Richard N Rosenthal
- Department of Psychiatry, Stony Brook University School of Medicine, Stony Brook, New York
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Logrip ML, Milivojevic V, Bertholomey ML, Torregrossa MM. Sexual dimorphism in the neural impact of stress and alcohol. Alcohol 2018; 72:49-59. [PMID: 30227988 DOI: 10.1016/j.alcohol.2018.02.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Revised: 02/07/2018] [Accepted: 02/19/2018] [Indexed: 12/18/2022]
Abstract
Alcohol use disorder is a widespread mental illness characterized by periods of abstinence followed by recidivism, and stress is the primary trigger of relapse. Despite the higher prevalence of alcohol use disorder in males, the relationship between stress and behavioral features of relapse, such as craving, is stronger in females. Given the greater susceptibility of females to stress-related psychiatric disorders, understanding sexual dimorphism in the relationship between stress and alcohol use is essential to identifying better treatments for both male and female alcoholics. This review addresses sex differences in the impact of stressors on alcohol drinking and seeking in rodents and humans. As these behavioral differences in alcohol use and relapse originate from sexual dimorphism in neuronal function, the impact of stressors and alcohol, and their interaction, on molecular adaptations and neural activity in males and females will also be discussed. Together, the data reviewed herein, arising from a symposium titled "Sex matters in stress-alcohol interactions" presented at the Fourth Volterra Conference on Stress and Alcohol, will highlight the importance of identifying sex differences to improve treatments for comorbid stress and alcohol use disorder in both sexes.
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Affiliation(s)
- Marian L Logrip
- Department of Psychology, Indiana University-Purdue University Indianapolis, Indianapolis, IN 46202, United States.
| | - Verica Milivojevic
- The Yale Stress Center, Yale University School of Medicine, New Haven, CT 06519, United States
| | - Megan L Bertholomey
- Department of Psychiatry, Translational Neuroscience Program, University of Pittsburgh, Pittsburgh, PA 15219, United States
| | - Mary M Torregrossa
- Department of Psychiatry, Translational Neuroscience Program, University of Pittsburgh, Pittsburgh, PA 15219, United States
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Aharonovich E, Hasin DS, Nunes EV, Stohl M, Cannizzaro D, Sarvet A, Bolla K, Carroll KM, Genece KG. Modified cognitive behavioral therapy (M-CBT) for cocaine dependence: Development of treatment for cognitively impaired users and results from a Stage 1 trial. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2018; 32:800-811. [PMID: 30346186 DOI: 10.1037/adb0000398] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Cognitive impairments are associated with poor outcomes when treating cocaine dependent patients, but behavioral interventions to mitigate this impact have not been developed. In this Stage 1A/1B treatment development study, several compensatory strategies (e.g., content repetition, daily logs, diaries, visual presentation) were combined to create a modified cognitive behavioral therapy (M-CBT) for treating cocaine dependence. Initially, a select group of therapists, neuropsychology experts, and patients were asked to provide input on early drafts of the treatment manual and companion patient workbook. After an uncontrolled small trial (N = 15) and two rounds of manual development (Stage 1A), a pilot randomized clinical trial (N = 102) of cocaine dependent outpatients with and without cognitive impairments was conducted (Stage 1B). Participants were randomized to M-CBT (N = 52) or CBT (N = 50). Both treatments were individually delivered over 12 weeks with assessments conducted at baseline, end-of-treatment, and 3-month follow-up. The primary outcome was frequency of cocaine use, measured by number of days used in the prior 7 days. Participants in the two treatment groups did not differ significantly on drug use reduction or retention in treatment. However, among participants who completed at least 9 weeks of treatment, those in M-CBT showed a trend toward greater reduction in cocaine use compared to those in the CBT group. M-CBT is feasible for impaired and nonimpaired cocaine dependent participants. However, M-CBT treatment did not show significant superiority over standard CBT in the present sample. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
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Affiliation(s)
| | | | | | | | | | | | - Karen Bolla
- Department of Neurology, Bayview Medical Center, Johns Hopkins University
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Transition to drug co-use among adolescent cannabis users: The role of decision-making and mental health. Addict Behav 2018; 85:43-50. [PMID: 29843040 DOI: 10.1016/j.addbeh.2018.05.010] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Revised: 04/17/2018] [Accepted: 05/15/2018] [Indexed: 12/25/2022]
Abstract
BACKGROUND Co-use of cannabis and drugs other than cannabis (DOTC) influences the risk of experiencing cannabis disorders. Accordingly, we explored whether speed of transition to drug co-use, the number of DOTC used, and/or being an experimental cannabis-only user, a regular cannabis-only user, or a regular cannabis user who co-uses DOTC (i.e., cannabis-plus user) were associated with decision-making (DM), mental health disorder symptoms, or cannabis use-related characteristics. METHODS We analyzed baseline data from a sub-sample of 266 adolescent (ages 14 to 16) cannabis users (CU) participating in an ongoing longitudinal study. Assessments included semi-structured interviews, self-report questionnaires, and measures of drug use, DM (measured via the Iowa Gambling Task), mental health disorders, and cannabis use-related problems. RESULTS Endorsing a larger number of mood disorders symptoms was associated with being a regular cannabis-plus user rather than a regular cannabis-only user (AOR = 1.08, C.I.95% 1.01, 1.15). Poorer DM was associated with a faster transition to co-use, such that for each one unit increase in DM performance, the years to onset of drug co-use increased by 1% (p = 0.032). Endorsing a larger number of cannabis use-related problems was positively associated with endorsing a larger number of DOTC used (p = 0.001). CONCLUSIONS This study provides new evidence on the process of drug co-use among CU. Specifically, mood disorder symptoms were associated with use of DOTC among regular CU. Furthermore, poorer DM was associated with a faster transition to drug co-use. Poorer DM and mood disorder symptoms may aggravate or accelerate the onset of adverse consequences among adolescent CU.
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Age sensitive associations of adolescent substance use with amygdalar, ventral striatum, and frontal volumes in young adulthood. Drug Alcohol Depend 2018; 186:94-101. [PMID: 29558674 PMCID: PMC5911233 DOI: 10.1016/j.drugalcdep.2018.02.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Revised: 01/30/2018] [Accepted: 02/03/2018] [Indexed: 01/19/2023]
Abstract
INTRODUCTION This study evaluated an age sensitive model of substance use across adolescence to determine if substance use was associated with smaller volumes for an earlier developing brain region, the amygdala, a later developing region, the inferior frontal gyrus, and the ventral striatum. METHOD Participants (N = 110) were African American young adults who were members of a longitudinal cohort across childhood and adolescence. Measures of substance use were collected across early (ages 12-15 yrs.), middle (ages 16-18 yrs.), and later (ages 19-21 yrs.) adolescence; then, at age 25, a representative subset of the sample completed magnetic resonance imaging (MRI) that assessed regional brain volumes. RESULTS Higher levels of substance use during early adolescence, but not middle or later adolescence, were significantly associated with smaller amygdalar volume in young adulthood. Higher levels of substance use during middle adolescence, but not early or later adolescence, were significantly associated with smaller pars opercularis volume. Substance use was not associated with the pars triangularis or ventral striatum. CONCLUSION These findings support age sensitive associations between substance use and smaller gray matter volumes at age 25 and are consistent with literature supporting the differential nature of substance use and brain maturation across adolescence and into young adulthood.
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Schulte T, Jung YC, Sullivan EV, Pfefferbaum A, Serventi M, Müller-Oehring EM. The neural correlates of priming emotion and reward systems for conflict processing in alcoholics. Brain Imaging Behav 2017; 11:1751-1768. [PMID: 27815773 PMCID: PMC5418124 DOI: 10.1007/s11682-016-9651-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Emotional dysregulation in alcoholism (ALC) may result from disturbed inhibitory mechanisms. We therefore tested emotion and alcohol cue reactivity and inhibitory processes using negative priming. To test the neural correlates of cue reactivity and negative priming, 26 ALC and 26 age-matched controls underwent functional MRI performing a Stroop color match-to-sample task. In cue reactivity trials, task-irrelevant emotion and alcohol-related pictures were interspersed between color samples and color words. In negative priming trials, pictures primed the semantic content of an alcohol or emotion Stroop word. Behaviorally, both groups showed response facilitation to picture cue trials and response inhibition to primed trials. For cue reactivity to emotion and alcohol pictures, ALC showed midbrain-limbic activation. By contrast, controls activated frontoparietal executive control regions. Greater midbrain-hippocampal activation in ALC correlated with higher amounts of lifetime alcohol consumption and higher anxiety. With negative priming, ALC exhibited frontal cortical but not midbrain-hippocampal activation, similar to the pattern observed in controls. Higher frontal activation to alcohol-priming correlated with less craving and to emotion-priming with fewer depressive symptoms. The findings suggest that neurofunctional systems in ALC can be primed to deal with upcoming emotion- and alcohol-related conflict and can overcome the prepotent midbrain-limbic cue reactivity response.
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Affiliation(s)
- T Schulte
- Neuroscience Program, Biosciences Division, SRI International, Menlo Park, CA, 94025-3493, USA.
- Pacific Graduate School of Psychology, Palo Alto University, Palo Alto, CA, USA.
| | - Y-C Jung
- Deptartment of Psychiatry & Beh. Sci, Stanford University, Stanford, CA, USA
- Department of Psychiatry, Yonsei University College of Medicine, Seoul, South Korea
| | - E V Sullivan
- Deptartment of Psychiatry & Beh. Sci, Stanford University, Stanford, CA, USA
| | - A Pfefferbaum
- Neuroscience Program, Biosciences Division, SRI International, Menlo Park, CA, 94025-3493, USA
- Deptartment of Psychiatry & Beh. Sci, Stanford University, Stanford, CA, USA
| | - M Serventi
- Neuroscience Program, Biosciences Division, SRI International, Menlo Park, CA, 94025-3493, USA
- Deptartment of Psychiatry & Beh. Sci, Stanford University, Stanford, CA, USA
| | - E M Müller-Oehring
- Neuroscience Program, Biosciences Division, SRI International, Menlo Park, CA, 94025-3493, USA
- Deptartment of Psychiatry & Beh. Sci, Stanford University, Stanford, CA, USA
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Lynch WJ, Abel J, Robinson AM, Smith MA. Exercise as a Sex-Specific Treatment for Substance Use Disorder. CURRENT ADDICTION REPORTS 2017; 4:467-481. [PMID: 29404264 PMCID: PMC5796660 DOI: 10.1007/s40429-017-0177-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
PURPOSE OF REVIEW Exercise is a promising treatment for substance use disorder that may reduce withdrawal symptoms and prevent relapse. In this review, we discuss recent evidence from clinical and preclinical studies for its efficacy, from a behavioral to a molecular level, in order to understand the exercise conditions that lead to beneficial effects. We also highlight the few recent findings of sex-specific differences. RECENT FINDINGS Clinical and preclinical findings show that exercise decreases withdrawal symptoms, including craving, in both males and females. Evidence from clinical studies support the efficacy of exercise to prevent relapse to smoking, although further research is needed to examine sex differences, establish long-term efficacy, and to determine if effects extend to other substance use disorders. Preclinical findings also support the potential utility of exercise to prevent relapse with evidence suggesting that its efficacy is enhanced in males, and mediated by blocking drug-induced adaptations that occur during early abstinence. SUMMARY Sex differences and timing of exercise availability during abstinence should be considered in future studies examining exercise as an intervention for relapse. A better understanding of the neurobiological mechanisms underlying the efficacy of exercise to reduce withdrawal symptoms and prevent relapse is needed to guide its development as a sex-specific treatment.
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Affiliation(s)
- Wendy J Lynch
- Associate Professor of Psychiatry and Neurobehavioral Sciences University of Virginia: P.O. Box 801402, Charlottesville, VA 22904 434-243-0580 (phone); 434-973-7031 (fax)
| | - Jean Abel
- Assistant Professor of Psychiatry and Neurobehavioral Sciences University of Virginia; P.O. Box 801402, Charlottesville, VA 22904-1402 434) 243-5767 (phone); 434-973-7031 (fax)
| | - Andrea M Robinson
- Postdoctoral Fellow of Psychology Davidson College: Box 7136 Davidson, NC 28035 704-894-3012 (phone); 704-894-2512 (fax)
| | - Mark A Smith
- Professor of Psychology Davidson College, Davidson, NC 28035 704-894-2470 (phone); 704-894-2512 (fax)
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Milivojevic V, Fox HC, Jayaram-Lindstrom N, Hermes G, Sinha R. Sex differences in guanfacine effects on stress-induced stroop performance in cocaine dependence. Drug Alcohol Depend 2017; 179:275-279. [PMID: 28823835 PMCID: PMC5599361 DOI: 10.1016/j.drugalcdep.2017.07.017] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Revised: 07/18/2017] [Accepted: 07/20/2017] [Indexed: 12/21/2022]
Abstract
AIMS Chronic drug abuse leads to sex-specific changes in drug cue and stress physiologic and neuroendocrine reactivity as well as in neural responses to stress and cue-related challenges and in executive function such as inhibitory control, cognitive flexibility and self control. Importantly, these functions have been associated with high risk of relapse and treatment. Alpha-2 agonism may enhance inhibitory cognitive processes in the face of stress with sex-specific effects, however this has not been previously assessed in cocaine dependence. METHOD Forty inpatient treatment-seeking cocaine dependent individuals (13F/27M) were randomly assigned to receive either placebo or up to 3mgs of Guanfacine. Three laboratory sessions were conducted following 3-4 weeks of abstinence, where patients were exposed to three 10-min personalized guided imagery conditions (stress, drug cue, combined stress/cue), one per day, on consecutive days in a random, counterbalanced order. The Stroop task was administered at baseline and immediately following imagery exposure. RESULTS Guanfacine treated women improved their performance on the Stroop task following exposure to all 3 imagery conditions compared with placebo women (p=0.02). This improvement in cognitive inhibitory performance was not observed in the men. CONCLUSIONS Enhancing the ability to cognitively regulate in the face of stress, drug cues and combined stress and drug cue reactivity may be key targets for medications development in cocaine dependent women.
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Affiliation(s)
- Verica Milivojevic
- The Yale Stress Center, Yale University School of Medicine, Department of Psychiatry 2 Church Street South, Suite 209, New Haven, CT, 06519, USA.
| | - Helen C Fox
- Stony Brook University, Health Sciences Center, T10-040B, Stony Brook, NY, 11794, USA
| | - Nitya Jayaram-Lindstrom
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, and Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden
| | - Gretchen Hermes
- The Yale Stress Center, Yale University School of Medicine, Department of Psychiatry 2 Church Street South, Suite 209, New Haven, CT, 06519, USA; APT Foundation, One Long Wharf Drive, New Haven, CT, 065111, USA
| | - Rajita Sinha
- The Yale Stress Center, Yale University School of Medicine, Department of Psychiatry 2 Church Street South, Suite 209, New Haven, CT, 06519, USA
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Stewart JL, Butt M, May AC, Tapert SF, Paulus MP. Insular and cingulate attenuation during decision making is associated with future transition to stimulant use disorder. Addiction 2017; 112:1567-1577. [PMID: 28387975 PMCID: PMC5544547 DOI: 10.1111/add.13839] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Revised: 01/17/2017] [Accepted: 04/03/2017] [Indexed: 01/18/2023]
Abstract
AIMS To understand processes placing individuals at risk for stimulant (amphetamine and cocaine) use disorder. DESIGN Longitudinal study. SETTING University of California, San Diego Department of Psychiatry, CA, USA. PARTICIPANTS Occasional stimulant users (OSU; n = 184) underwent a baseline clinical interview and a functional magnetic resonance imaging (fMRI) session. On the basis of a follow-up clinical interview completed 3 years later, OSU (n = 147) were then categorized as problem stimulant users (PSU: n = 36; those who developed stimulant use disorders in the interim) or desisted stimulant users (DSU: n = 74; those who stopped using). OSU who did not meet criteria for PSU or DSU (n = 37) were included in dimensional analyses. MEASUREMENTS fMRI blood oxygen level-dependent (BOLD) contrast percentage signal change from baseline collected during a Paper-Scissors-Rock task was examined during three decision-making conditions, those resulting in: (1) wins, (2) ties and (3) losses. These data were used as dependent variables in categorical analyses comparing PSU and DSU, as well as dimensional analyses including interim drug use as predictors, controlling for baseline drug use. FINDINGS PSU exhibited lower anterior cingulate, middle insula, superior temporal, inferior parietal, precuneus and cerebellum activation than DSU across all three conditions (significant brain clusters required > 19 neighboring voxels to exceed F(1,108) = 5.58, P < 0.01 two-tailed; all Cohen's d > 0.83). Higher interim marijuana use was linked to lower pre-central and superior temporal activation during choices resulting in wins (> 19 neighboring voxels to exceed t = 2.61, P < 0.01 two-tailed; R2 change > 0.11). CONCLUSIONS Individuals who transition from stimulant use to stimulant use disorder appear to show alterations in neural processing of stimulus valuation and outcome monitoring, patterns also evident in chronic stimulant use disorder. Attenuated anterior cingulate and insular processing may constitute a high-risk neural processing profile, which could be used to calculate risk scores for individuals experimenting with stimulants.
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Affiliation(s)
- Jennifer L. Stewart
- Department of Psychology, Queens College, City University of New York, Flushing, NY 11367,Department of Psychology, The Graduate Center, City University of New York, New York, NY 10016
| | - Mamona Butt
- Department of Psychology, Queens College, City University of New York, Flushing, NY 11367
| | - April C. May
- Department of Psychiatry, University of California San Diego, La Jolla, CA 92093
| | - Susan F. Tapert
- Department of Psychiatry, University of California San Diego, La Jolla, CA 92093
| | - Martin P. Paulus
- Department of Psychiatry, University of California San Diego, La Jolla, CA 92093,Laureate Institute of Brain Research, Tulsa, OK 74136
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DeVito EE, Dong G, Kober H, Xu J, Carroll KM, Potenza MN. Functional neural changes following behavioral therapies and disulfiram for cocaine dependence. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2017; 31:534-547. [PMID: 28714728 DOI: 10.1037/adb0000298] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
A growing literature exists on neural correlates of treatment outcome. However, different types-or components of-treatment have distinct theorized mechanisms of action. And it is not yet known how changes in neural activity across treatment relate to engagement in different treatment components. Participants with cocaine use disorders in a randomized clinical trial received cognitive-behavioral therapy (CBT) plus, in a 2 × 2 design, contingency management (CM) or no CM, and disulfiram or placebo. Participants performed a functional MRI Stroop task, a measure of cognitive control, at the beginning of and after the 12-week treatment. Analyses assessed changes in Stroop-related neural activity within the sample overall and assessed how changes in Stroop-related activity correlated with measures of treatment process specific to each form of treatment (i.e., participation in CBT sessions, receipt of CM prizes, administration of disulfiram pills). Within the sample overall, compared with beginning of treatment, posttreatment Stroop-related neural activity was diminished in the hippocampus, thalamus, cingulate, precentral, post- and precentral gyrus, and precuneus and culmen regions (pFWE < .05). In separate whole-brain correlation analyses, greater reductions in Stroop-related activity were associated with more treatment engagement-"CBT sessions" with the precentral gyrus, inferior parietal lobule, and middle and medial frontal gyrus; "CM prizes" with the postcentral frontal gyrus. Disulfiram "medication days" were not associated with changes in Stroop-related activity. Findings suggest that key process indicators of CBT and CM may be associated with functional changes in cognitive-control-related neurocircuitry. (PsycINFO Database Record
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Affiliation(s)
- Elise E DeVito
- Department of Psychiatry, Yale University School of Medicine
| | - Guangheng Dong
- Department of Psychiatry, Yale University School of Medicine
| | - Hedy Kober
- Department of Psychiatry, Yale University School of Medicine
| | - Jiansong Xu
- Department of Psychiatry, Yale University School of Medicine
| | | | - Marc N Potenza
- Department of Psychiatry, Neurobiology, and Child Study Center, Yale University School of Medicine
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Froeliger B, McConnell PA, Bell S, Sweitzer M, Kozink RV, Eichberg C, Hallyburton M, Kaiser N, Gray KM, McClernon FJ. Association Between Baseline Corticothalamic-Mediated Inhibitory Control and Smoking Relapse Vulnerability. JAMA Psychiatry 2017; 74:379-386. [PMID: 28249070 PMCID: PMC5562280 DOI: 10.1001/jamapsychiatry.2017.0017] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
IMPORTANCE Tobacco use disorder is associated with dysregulated neurocognitive function in the right inferior frontal gyrus (IFG)-one node in a corticothalamic inhibitory control (IC) network. OBJECTIVE To examine associations between IC neural circuitry structure and function and lapse/relapse vulnerability in 2 independent studies of adult smokers. DESIGN, SETTING, AND PARTICIPANTS In study 1, treatment-seeking smokers (n = 81) completed an IC task during functional magnetic resonance imaging (fMRI) before making a quit attempt and then were followed up for 10 weeks after their quit date. In study 2, a separate group of smokers (n = 26) performed the same IC task during fMRI, followed by completing a laboratory-based smoking relapse analog task. Study 1 was performed at Duke University Medical Center between 2008 and 2012; study 2 was conducted at the Medical University of South Carolina between 2013 and 2016. MAIN OUTCOMES AND MEASURES Associations between corticothalamic-mediated IC, gray-matter volume, and smoking lapse/relapse. RESULTS Of the 81 study participants in study 1 (cessation study), 45 were women (56%), with mean (SD) age, 38.4 (10.2) years. In study 1, smoking relapse was associated with less gray-matter volume (F1,74 = 28.32; familywise error P threshold = 0.03), greater IC task-related blood oxygenation level-dependent (BOLD) response in the right IFG (F1,78 = 14.87) and thalamus (F1,78 = 14.97) (P < .05), and weaker corticothalamic task-based functional connectivity (tbFC) (F1,77 = 5.87; P = .02). Of the 26 participants in study 2 (laboratory study), 15 were women (58%), with mean (SD) age, 34.9 (10.3). Similar to study 1, in study 2, greater IC-BOLD response in the right IFG (t23 = -2.49; β = -0.47; P = .02), and weaker corticothalamic tbFC (t22 = 5.62; β = 0.79; P < .001) were associated with smoking sooner during the smoking relapse-analog task. In both studies, corticothalamic tbFC mediated the association between IC performance and smoking outcomes. CONCLUSIONS AND RELEVANCE In these 2 studies, baseline differences in corticothalamic circuitry function were associated with mediated IC and smoking relapse vulnerability. These findings warrant further examination of interventions for augmenting corticothalamic neurotransmission and enhancing IC during the course of tobacco use disorder treatment.
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Affiliation(s)
- Brett Froeliger
- Department of Neuroscience, Medical University of South Carolina, Charleston2Department of Psychiatry, Medical University of South Carolina, Charleston3Hollings Cancer Center, Medical University of South Carolina, Charleston4Center for Biomedical Imaging, Medical University of South Carolina, Charleston
| | | | - Spencer Bell
- Department of Neuroscience, Medical University of South Carolina, Charleston
| | - Maggie Sweitzer
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina
| | - Rachel V. Kozink
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina
| | - Christie Eichberg
- Department of Neuroscience, Medical University of South Carolina, Charleston
| | - Matt Hallyburton
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina
| | - Nicole Kaiser
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina
| | - Kevin M. Gray
- Department of Psychiatry, Medical University of South Carolina, Charleston
| | - F. Joseph McClernon
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina6Brain Imaging and Analysis Center, Duke University Medical Center, Durham, North Carolina
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Moeller SJ, Konova AB, Tomasi D, Parvaz MA, Goldstein RZ. Abnormal response to methylphenidate across multiple fMRI procedures in cocaine use disorder: feasibility study. Psychopharmacology (Berl) 2016; 233:2559-69. [PMID: 27150080 PMCID: PMC4916842 DOI: 10.1007/s00213-016-4307-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Accepted: 04/18/2016] [Indexed: 12/14/2022]
Abstract
RATIONALE The indirect dopamine agonist methylphenidate remediates cognitive deficits in psychopathology, but the individual characteristics that determine its effects on the brain are not known. OBJECTIVES We aimed to determine whether targeted dopaminergically modulated traits and individual differences could predict neural response to methylphenidate across multiple functional magnetic resonance imaging (fMRI) procedures. METHODS We combined neural measures from three separate procedures (two inhibitory control tasks differing in their degree of emotional salience and resting-state functional connectivity) during methylphenidate (20 mg oral, versus randomized and counterbalanced placebo) and correlated these aggregated responses with cocaine use disorder diagnosis (22 cocaine abusers, 21 controls), symptoms of attention deficit hyperactivity disorder, and working memory capacity. RESULTS Cocaine abusers, relative to controls, had a lower response in the dorsolateral prefrontal cortex to methylphenidate across all three procedures, driven by responses to the two inhibitory control tasks; reduced methylphenidate fMRI response in this region further correlated with more frequent cocaine use. CONCLUSIONS Cocaine abuse (and its frequency), associated with lower tonic dopamine levels, correlated with a reduction in activation to methylphenidate (versus placebo). These initial results provide feasibility to the idea that multimodal fMRI tasks can be meaningfully aggregated, and that these aggregated procedures show a common disruption in addiction in a highly anticipated region relevant to cognitive control. Results also suggest that drug use frequency may represent an important modulatory variable in interpreting the efficacy of pharmacologically enhanced cognitive interventions in addiction.
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Affiliation(s)
- Scott J. Moeller
- Departments of Psychiatry and Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY 10029,Correspondence may be addressed to: Scott J. Moeller, 1470 Madison Ave (Room 9-115), New York, NY 10029; Tel: 212-824-8973; Fax: 212-803-6743; . Or to: Rita Z. Goldstein, One Gustave L. Levy Place, Box 1230, New York, NY 10029; tel. (212) 824-9312; fax (212) 996-8931;
| | - Anna B. Konova
- Center for Neural Science, New York University, NY 10003
| | - Dardo Tomasi
- National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD 20892
| | - Muhammad A. Parvaz
- Departments of Psychiatry and Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY 10029
| | - Rita Z. Goldstein
- Departments of Psychiatry and Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY 10029,Correspondence may be addressed to: Scott J. Moeller, 1470 Madison Ave (Room 9-115), New York, NY 10029; Tel: 212-824-8973; Fax: 212-803-6743; . Or to: Rita Z. Goldstein, One Gustave L. Levy Place, Box 1230, New York, NY 10029; tel. (212) 824-9312; fax (212) 996-8931;
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Cognitive interventions for addiction medicine: Understanding the underlying neurobiological mechanisms. PROGRESS IN BRAIN RESEARCH 2015; 224:285-304. [PMID: 26822363 DOI: 10.1016/bs.pbr.2015.07.019] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Neuroimaging provides a tool for investigating the neurobiological mechanisms of cognitive interventions in addiction. The aim of this review was to describe the brain circuits that are recruited during cognitive interventions, examining differences between various treatment modalities while highlighting core mechanisms, in drug addicted individuals. Based on a systematic Medline search we reviewed neuroimaging studies on cognitive behavioral therapy, cognitive inhibition of craving, motivational interventions, emotion regulation, mindfulness, and neurofeedback training in addiction. Across intervention modalities, common results included the normalization of aberrant activity in the brain's reward circuitry, and the recruitment and strengthening of the brain's inhibitory control network. Results suggest that different cognitive interventions act, at least partly, through recruitment of a common inhibitory control network as a core mechanism. This implies potential transfer effects between training modalities. Overall, results confirm that chronically hypoactive prefrontal regions implicated in cognitive control in addiction can be normalized through cognitive means.
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