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Bergeria CL, Gipson CD, Smith KE, Stoops WW, Strickland JC. Opioid craving does not incubate over time in inpatient or outpatient treatment studies: Is the preclinical incubation of craving model lost in translation? Neurosci Biobehav Rev 2024; 160:105618. [PMID: 38492446 PMCID: PMC11046527 DOI: 10.1016/j.neubiorev.2024.105618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 02/29/2024] [Accepted: 03/05/2024] [Indexed: 03/18/2024]
Abstract
Within addiction science, incubation of craving is an operational label used to describe time-dependent increases in drug seeking during periods of drug deprivation. The purpose of this systematic review was to describe the preclinical literature on incubation of craving and the clinical literature on craving measured over extended periods of abstinence to document this translational homology and factors impacting correspondence. Across the 44 preclinical studies that met inclusion criteria, 31 reported evidence of greater lever pressing, nose pokes, spout licks, or time spent in drug-paired compartments (i.e., drug seeking) relative to neutral compartments after longer periods of abstinence relative to shorter periods of abstinence, labelled as "incubation of craving." In contrast, no clinical studies (n = 20) identified an increase in opioid craving during longer abstinence periods. The lack of clinical evidence for increases in craving in clinical populations weakens the translational utility of operationalizing the time-dependent increase in drug-seeking behavior observed in preclinical models as models of incubation of "craving".
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Affiliation(s)
- Cecilia L Bergeria
- Johns Hopkins University School of Medicine, Department of Psychiatry and Behavioral Sciences, Baltimore, MD, United States.
| | - Cassandra D Gipson
- University of Kentucky College of Medicine, Department of Pharmacology and Nutritional Sciences, Lexington, KY, United States
| | - Kirsten E Smith
- Johns Hopkins University School of Medicine, Department of Psychiatry and Behavioral Sciences, Baltimore, MD, United States
| | - William W Stoops
- University of Kentucky College of Medicine, Department of Behavioral Science, Lexington, KY, United States
| | - Justin C Strickland
- Johns Hopkins University School of Medicine, Department of Psychiatry and Behavioral Sciences, Baltimore, MD, United States
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2
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Pape VR, Braun S, Peters S, Stingl M, Tucha O, Sammer G. The riddle of deliberate self-harm: Physiological and subjective effects of self-cutting cues in patients with borderline personality disorder and healthy controls. Personal Ment Health 2023; 17:328-351. [PMID: 37042027 DOI: 10.1002/pmh.1583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 02/15/2023] [Accepted: 02/19/2023] [Indexed: 04/13/2023]
Abstract
Self-harming behavior is a core symptom of borderline personality disorder. Self-report studies show a correlation between a lack of self-reported negative feelings toward self-cutting cues and the likelihood of future self-destructive behavior. Despite these findings, there has so far been insufficient investigation into the implicit emotional processes evoked by this stimulus type. Forty patients with borderline personality disorder and 35 healthy controls between 20 and 50 years of age were confronted with pictures of self-cutting cues and affective reference pictures. A startle reflex paradigm was used for measuring implicit emotional responses, and the Self-Assessment Manikin was used for subjective responses. In line with previous studies, the patients rated the self-cutting pictures significantly less negatively than healthy individuals. On the physiological level, a significant startle inhibition was observed, indicating an activation of the behavioral approach system. A more detailed analysis showed that this startle inhibition effect was specific to scary pictures, whereas no such effect was observed for bloody wounds and self-cutting instruments. For pleasant standard pictures, in contrast, no startle reflex inhibition and no increase in emotional arousal parameters were found. The data replicate the findings of previous studies, demonstrating a generally diminished emotional reactivity to pleasant stimuli in patients with borderline personality disorder. In addition, a physiological approach reaction to self-cutting pictures was found, especially for the scary pictures. These results might indicate a positive identification with the long-lasting consequences of self-cutting behavior in the patients. Implications for therapy are discussed.
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Affiliation(s)
- Valeska Reichel Pape
- Institute of Psychiatry and Psychotherapy, University Medicine Rostock, Gehlsheimer Straße 20, 18147, Rostock, Germany
| | - Silke Braun
- Institute of Psychiatry and Psychotherapy, University Medicine Giessen, Klinikstraße 36, 35392, Giessen, Germany
| | - Svenja Peters
- Institute of Psychiatry and Psychotherapy, University Medicine Giessen, Klinikstraße 36, 35392, Giessen, Germany
| | - Markus Stingl
- Institute of Psychiatry and Psychotherapy, University Medicine Giessen, Klinikstraße 36, 35392, Giessen, Germany
| | - Oliver Tucha
- Institute of Psychiatry and Psychotherapy, University Medicine Rostock, Gehlsheimer Straße 20, 18147, Rostock, Germany
| | - Gebhard Sammer
- Institute of Psychiatry and Psychotherapy, University Medicine Giessen, Klinikstraße 36, 35392, Giessen, Germany
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3
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Qian S, Shi C, Huang S, Yang C, Luo Y. DNA methyltransferase activity in the basolateral amygdala is critical for reconsolidation of a heroin reward memory. Front Mol Neurosci 2022; 15:1002139. [PMID: 36176958 PMCID: PMC9513049 DOI: 10.3389/fnmol.2022.1002139] [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: 07/24/2022] [Accepted: 08/18/2022] [Indexed: 11/17/2022] Open
Abstract
The persistence of drug memory contributes to relapse to drug seeking. The association between repeated drug exposure and drug-related cues leads to cravings triggered by drug-paired cues. The erasure of drug memories has been considered a promising way to inhibit cravings and prevent relapse. The re-exposure to drug-related cues destabilizes well-consolidated drug memories, during which a de novo protein synthesis-dependent process termed “reconsolidation” occurs to restabilize the reactivated drug memory. Disrupting reconsolidation of drug memories leads to the attenuation of drug-seeking behavior in both animal models and people with addictions. Additionally, epigenetic mechanisms regulated by DNA methyltransferase (DNMT) are involved in the reconsolidation of fear and cocaine reward memory. In the present study, we investigated the role of DNMT in the reconsolidation of heroin reward memory. In the heroin self-administration model in rats, we tested the effects of DNMT inhibition during the reconsolidation process on cue-induced reinstatement, heroin-priming-induced reinstatement, and spontaneous recovery of heroin-seeking behavior. We found that the bilateral infusion of 5-azacytidine (5-AZA) inhibiting DNMT into the basolateral amygdala (BLA) immediately after heroin reward memory retrieval, but not delayed 6 h after retrieval or without retrieval, decreased subsequent cue-induced and heroin-priming-induced reinstatement of heroin-seeking behavior. These findings demonstrate that inhibiting the activity of DNMT in BLA during the reconsolidation of heroin reward memory attenuates heroin-seeking behavior, which may provide a potential strategy for the therapeutic of heroin addiction.
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Affiliation(s)
- Shuyi Qian
- Department of Nephrology and Laboratory of Kidney Disease, Hunan Provincial People’s Hospital, Hunan Normal University, Changsha, China
| | - Cuijie Shi
- Hunan Province People’s Hospital, The First-Affiliated Hospital of Hunan Normal University, Changsha, China
| | - Shihao Huang
- National Institute on Drug Dependence, Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China
| | - Chang Yang
- Hunan Province People’s Hospital, The First-Affiliated Hospital of Hunan Normal University, Changsha, China
| | - Yixiao Luo
- Hunan Province People’s Hospital, The First-Affiliated Hospital of Hunan Normal University, Changsha, China
- *Correspondence: Yixiao Luo,
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4
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Li Q, Fu Y, Liu C, Meng Z. Transcranial Direct Current Stimulation of the Dorsolateral Prefrontal Cortex for Treatment of Neuropsychiatric Disorders. Front Behav Neurosci 2022; 16:893955. [PMID: 35711693 PMCID: PMC9195619 DOI: 10.3389/fnbeh.2022.893955] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 04/04/2022] [Indexed: 12/16/2022] Open
Abstract
Background The dorsolateral prefrontal cortex (DLPFC) is a key node of the frontal cognitive circuit. It is involved in executive control and many cognitive processes. Abnormal activities of DLPFC are likely associated with many psychiatric diseases. Modulation of DLPFC may have potential beneficial effects in many neural and psychiatric diseases. One of the widely used non-invasive neuromodulation technique is called transcranial direct current stimulation (or tDCS), which is a portable and affordable brain stimulation approach that uses direct electrical currents to modulate brain functions. Objective This review aims to discuss the results from the past two decades which have shown that tDCS can relieve clinical symptoms in various neurological and psychiatric diseases. Methods Here, we performed searches on PubMed to collect clinical and preclinical studies that using tDCS as neuromodulation technique, DLPFC as the stimulation target in treating neuropsychiatric disorders. We summarized the stimulation sites, stimulation parameters, and the overall effects in these studies. Results Overall, tDCS stimulation of DLPFC could alleviate the clinical symptoms of schizophrenia, depression, drug addiction, attention deficit hyperactivity disorder and other mental disorders. Conclusion The stimulation parameters used in these studies were different from each other. The lasting effect of stimulation was also not consistent. Nevertheless, DLPFC is a promising target for non-invasive stimulation in many psychiatric disorders. TDCS is a safe and affordable neuromodulation approach that has potential clinical uses. Larger clinical studies will be needed to determine the optimal stimulation parameters in each condition.
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Affiliation(s)
- Qing Li
- Medical School, Kunming University of Science and Technology, Kunming, China
- Shenzhen Key Laboratory of Drug Addiction, Brain Cognition and Brain Disease Institute, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Yu Fu
- Medical School, Kunming University of Science and Technology, Kunming, China
| | - Chang Liu
- Shenzhen Key Laboratory of Viral Vectors for Biomedicine, Brain Cognition and Brain Disease Institute, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
- Shenzhen-Hong Kong Institute of Brain Science, Shenzhen Fundamental Research Institutions, Shenzhen, China
- CAS Key Laboratory of Brain Connectome and Manipulation, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
- *Correspondence: Chang Liu,
| | - Zhiqiang Meng
- Shenzhen Key Laboratory of Drug Addiction, Brain Cognition and Brain Disease Institute, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
- Shenzhen-Hong Kong Institute of Brain Science, Shenzhen Fundamental Research Institutions, Shenzhen, China
- CAS Key Laboratory of Brain Connectome and Manipulation, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
- Zhiqiang Meng,
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5
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Wang PW, Lin HC, Lee KH, Pai-Cheng L, Wu HC, Hsu CY, Chung KS, Ko CH, Connie Yang YH, Yen CF. Craving and implicit attitude toward heroin use and their relationships with the levels of heroin dependence and methadone adherence in heroin users. J Addict Dis 2021; 39:459-467. [PMID: 33624578 DOI: 10.1080/10550887.2021.1889782] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Craving is a core feature of heroin use disorder. Craving for heroin is a conscious cognitive process. Recently, implicit (i.e., an implicit attitude toward heroin use) cognitive processes have been thought to be precursors of cravings. This study aimed to explore the associations of craving and implicit attitude toward heroin use with the level of heroin use disorder and adherence to methadone maintenance treatment (MMT). This study recruited 213 intravenous heroin users (196 males and 17 females) from MMT clinics of two hospitals. The mean age of participants was 42.3 years. They provided details of their severity of heroin use disorder and craving for heroin via questionnaires and also completed a computerized test to assess implicit attitude toward heroin use. The relationships between implicit attitude, craving, age, heroin use disorder, and MMT adherence were examined using path analysis. Craving was positively related to heroin use disorder (beta = 0.4). Implicit attitude directly and indirectly positively contributed to heroin use disorder (betas: 0.1 and 0.3). Craving was positively related to MMT adherence (beta: 0.2), whereas implicit attitude had an indirect effect on MMT adherence (beta: 0.03). Age was negatively associated with craving but was not associated with implicit attitude toward heroin. Methadone dosage was negatively associated with craving. Craving is significantly associated with the levels of heroin use disorder and MMT adherence. Meanwhile, craving mediates the relationship between implicit attitude and heroin use disorder, as well as MMT adherence. Implicit attitude also contributes to the level of heroin use disorder directly. For reducing craving, adequate dosage may be necessary.
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Affiliation(s)
- Peng-Wei Wang
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,Department of Psychiatry, Faculty of Medicine and Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Huang-Chi Lin
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,Department of Psychiatry, Faculty of Medicine and Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Kun-Hua Lee
- Yuli Hospital, Ministry of Health and Welfare
| | - Lin Pai-Cheng
- Department of psychiatry, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University, Kaohsiung City, Taiwan
| | - Hung-Chi Wu
- Departments of Community Psychiatry, Kai-Suan Psychiatric Hospital, Kaohsiung, Taiwan
| | - Chih-Yao Hsu
- Departments of Addiction Science, Kai-Suan Psychiatric Hospital, Kaohsiung, Taiwan
| | - Kuan-Sheng Chung
- Departments of Addiction Science, Kai-Suan Psychiatric Hospital, Kaohsiung, Taiwan
| | - Chih-Hung Ko
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,Department of Psychiatry, Faculty of Medicine and Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Psychiatry, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | | | - Cheng-Fang Yen
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,Department of Psychiatry, Faculty of Medicine and Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
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6
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Manoliu A, Haugg A, Sladky R, Hulka L, Kirschner M, Brühl AB, Seifritz E, Quednow B, Herdener M, Scharnowski F. SmoCuDa: A Validated Smoking Cue Database to Reliably Induce Craving in Tobacco Use Disorder. Eur Addict Res 2021; 27:107-114. [PMID: 32854096 DOI: 10.1159/000509758] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2019] [Accepted: 05/04/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND Cue-reactivity paradigms provide valuable insights into the underlying mechanisms of nicotine craving in nicotine-dependent subjects. In order to study cue-driven nicotine craving, robust and validated stimulus datasets are essential. OBJECTIVES The aim of this study was to generate and validate a large set of individually rated smoking-related cues that allow for assessment of different stimulus intensities along the dimensions craving, valence, and arousal. METHODS The image database consisted of 330 visual cues. Two hundred fifty smoking-associated pictures (Creative Commons license) were chosen from online databases and showed a widespread variety of smoking-associated content. Eighty pictures from previously published databases were included for cross-validation. Forty volunteers with tobacco use disorder rated "urge-to-smoke," "valence," and "arousal" for all images on a 100-point visual analogue scale. Pictures were also labelled according to 18 categories such as lit/unlit cigarettes in mouth, cigarette end, and cigarette in ashtray. RESULTS Ratings (mean ± SD) were as follows: urge to smoke, 44.9 ± 13.2; valence, 51.2 ± 7.6; and arousal, 54.6 ± 7.1. All ratings, particularly "urge to smoke," were widely distributed along the whole scale spectrum. CONCLUSIONS We present a novel image library of well-described smoking-related cues, which were rated on a continuous scale along the dimensions craving, valence, and arousal that accounts for inter-individual differences. The rating software, image database, and their ratings are publicly available at https://smocuda.github.io.
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Affiliation(s)
- Andrei Manoliu
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland, .,Wellcome Centre for Human Neuroimaging, University College London, London, United Kingdom, .,Max Planck University College London Centre for Computational Psychiatry and Ageing Research, London, United Kingdom,
| | - Amelie Haugg
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland.,Neuroscience Center Zurich, University of Zurich and Swiss Federal Institute of Technology, Zurich, Switzerland
| | - Ronald Sladky
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland.,Department of Basic Psychological Research and Research Methods, Faculty of Psychology, University of Vienna, Vienna, Austria.,Department of Cognition, Emotion, and Methods in Psychology, Faculty of Psychology, University of Vienna, Vienna, Austria
| | - Lea Hulka
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Matthias Kirschner
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland.,Montreal Neurological Institute, McGill University, Montreal, Québec, Canada
| | - Annette B Brühl
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland.,Behavioural and Clinical Neuroscience Institute and Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
| | - Erich Seifritz
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Boris Quednow
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Marcus Herdener
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Frank Scharnowski
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland.,Neuroscience Center Zurich, University of Zurich and Swiss Federal Institute of Technology, Zurich, Switzerland.,Department of Basic Psychological Research and Research Methods, Faculty of Psychology, University of Vienna, Vienna, Austria.,Zurich Center for Integrative Human Physiology (ZIHP), University of Zurich, Zurich, Switzerland
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7
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Effects of lorcaserin on oxycodone self-administration and subjective responses in participants with opioid use disorder. Drug Alcohol Depend 2020; 208:107859. [PMID: 31980285 PMCID: PMC7063580 DOI: 10.1016/j.drugalcdep.2020.107859] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 12/18/2019] [Accepted: 01/01/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Lorcaserin, a high-affinity 5-HT2C receptor agonist approved for treating obesity, decreased self-administration of oxycodone and cue-induced reinstatement of drug-seeking behavior in preclinical studies. The current investigation is the first clinical trial to evaluate the ability of lorcaserin to alter the reinforcing and subjective effects of oxycodone. METHODS In this 7-week inpatient trial, 12 non-treatment-seeking volunteers (11 males) with moderate-to-severe opioid use disorder were detoxified from opioids. In a randomized cross-over fashion, participants were first stabilized on lorcaserin (10 mg BID) or placebo (0 mg BID). Participants underwent a two-week testing period during which the reinforcing and subjective effects of intranasal oxycodone were examined in verbal choice, cue-exposure, and progressive-ratio choice sessions. The two testing weeks were identical with the exception that during the first week, active oxycodone (10 mg) was available during verbal choice (self-administration) sessions, and during the second week placebo oxycodone was available. Subsequently, participants were stabilized on the other medication condition (placebo or lorcaserin) and underwent the same testing procedures again. RESULTS Lorcaserin did not alter oxycodone self-administration. However, lorcaserin had a trend to increase "wanting heroin" when oxycodone was available, and to accentuate oxycodone-induced miosis. CONCLUSION Under the current experimental conditions, lorcaserin at a dose of 10 mg BID did not reliably decrease the abuse liability of oxycodone, even though the study was sufficiently powered (≥80 %) to detect clinically meaningful differences in the main outcome variables between the placebo and active lorcaserin condition. Future research could explore a wider dose range of lorcaserin and oxycodone.
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8
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Boecker L, Pauli P. Affective startle modulation and psychopathology: Implications for appetitive and defensive brain systems. Neurosci Biobehav Rev 2019; 103:230-266. [PMID: 31129237 DOI: 10.1016/j.neubiorev.2019.05.019] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Revised: 05/12/2019] [Accepted: 05/18/2019] [Indexed: 02/06/2023]
Abstract
Startle reflex potentiation versus startle attenuation to unpleasant versus pleasant stimuli likely reflect priming of the defensive versus appetitive motivational systems, respectively. This review summarizes and systemizes the literature on affective startle modulation related to psychopathologies with the aim to reveal underlying mechanisms across psychopathologies. We found evidence for psychopathologies characterized by increased startle potentiation to unpleasant stimuli (anxiety disorders), decreased startle potentiation to unpleasant stimuli (psychopathy), decreased startle attenuation to pleasant stimuli (ADHD), as well as a general hyporeactivity to affective stimuli (depression). Increased versus decreased startle responses to disorder-specific stimuli characterize specific phobia and drug dependence. No psychopathology is characterized by increased startle attenuation to standard pleasant stimuli or a general hyperreactivity to affective stimuli. This review indicates that the defensive and the appetitive systems operate independently mostly in accordance with the motivational priming hypothesis and that affective startle modulation is a highly valuable paradigm to unraveling dysfunctions of the defensive and appetitive systems in psychopathologies as requested by the Research Domain Criteria initiative.
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Affiliation(s)
- Lea Boecker
- Department of Economic Psychology, Social Psychology & Experimental Methods, Leuphana University of Lüneburg, Universitätsallee 1, 21335 Lüneburg, Germany.
| | - Paul Pauli
- Department of Psychology (Biological Psychology, Clinical Psychology, and Psychotherapy), University of Würzburg, Marcusstraße 9-11, 97070 Germany; Center of Mental Health, Medical Faculty, University of Würzburg, Germany
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9
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Yang L, Zhang J, Zong M, Xu Q, Yang X, Zhang Y, Ren J. Attenuation of response to drug-related cues in male heroin abstainers is modulated by cognitive control mechanisms. Subst Use Misuse 2019; 54:2127-2133. [PMID: 31290365 DOI: 10.1080/10826084.2019.1637893] [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: 10/26/2022]
Abstract
Background: Many research studies reveal that both attentional bias and impaired cognitive control significantly influence heroin addiction. However, limited research has been conducted into how the interplay between attentional bias and cognitive control modulates heroin-seeking behavior. Objectives: A modified version of the flanker task was used to investigate whether attentional bias to drug-related stimuli is modulated by cognitive control mechanisms among heroin users. Methods: Sixty participants (30 male heroin users during their abstinence period and 30 normal controls) responded to the direction of the middle arrow, while ignoring the adjacent arrow and the pictures (drug-related cues and neutral cues) presented as part of the task. Results: The abstinent heroin users had a significantly larger flanker effect under drug-related cues compared to neutral cues, whereas the control group showed no such trend. This effect was primarily influenced by increased reaction times in the presence of drug-related cues relative to neutral cues in the incongruent condition among abstinent heroin users, but not in the control group. Conclusions/Importance: Among abstinent heroin users, attentional bias to drug-related cues was moderated by attentional control. Further, high cognitive control demand was found to reduce heroin users' ability to resist attentional capture from salient, but irrelevant, drug-related information, which may contribute to compulsive drug-seeking behavior and relapse in heroin users.
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Affiliation(s)
- Ling Yang
- Key Laboratory of Behavioral and Mental Health of Gansu Province, School of Psychology, Northwest Normal University , Lanzhou , P. R. China
| | - Jianxun Zhang
- Key Laboratory of Behavioral and Mental Health of Gansu Province, School of Psychology, Northwest Normal University , Lanzhou , P. R. China
| | - Mingjiang Zong
- Key Laboratory of Behavioral and Mental Health of Gansu Province, School of Psychology, Northwest Normal University , Lanzhou , P. R. China
| | - Qiongying Xu
- Key Laboratory of Behavioral and Mental Health of Gansu Province, School of Psychology, Northwest Normal University , Lanzhou , P. R. China
| | - Xiaohui Yang
- Key Laboratory of Behavioral and Mental Health of Gansu Province, School of Psychology, Northwest Normal University , Lanzhou , P. R. China
| | - Yang Zhang
- Key Laboratory of Behavioral and Mental Health of Gansu Province, School of Psychology, Northwest Normal University , Lanzhou , P. R. China
| | - Jing Ren
- Key Laboratory of Behavioral and Mental Health of Gansu Province, School of Psychology, Northwest Normal University , Lanzhou , P. R. China
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10
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Glucocorticoid-induced enhancement of extinction-from animal models to clinical trials. Psychopharmacology (Berl) 2019; 236:183-199. [PMID: 30610352 PMCID: PMC6373196 DOI: 10.1007/s00213-018-5116-0] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Accepted: 11/06/2018] [Indexed: 12/13/2022]
Abstract
Extensive evidence from both animal model and human research indicates that glucocorticoid hormones are crucially involved in modulating memory performance. Glucocorticoids, which are released during stressful or emotionally arousing experiences, enhance the consolidation of new memories, including extinction memory, but reduce the retrieval of previously stored memories. These memory-modulating properties of glucocorticoids have recently received considerable interest for translational purposes because strong aversive memories lie at the core of several fear-related disorders, including post-traumatic stress disorder and phobias. Moreover, exposure-based psychological treatment of these disorders relies on successful fear extinction. In this review, we argue that glucocorticoid-based interventions facilitate fear extinction by reducing the retrieval of aversive memories and enhancing the consolidation of extinction memories. Several clinical trials have already indicated that glucocorticoids might be indeed helpful in the treatment of fear-related disorders.
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11
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Jones JD, Bisaga A, Metz VE, Manubay JM, Mogali S, Ciccocioppo R, Madera G, Doernberg M, Comer SD. The PPARγ Agonist Pioglitazone Fails to Alter the Abuse Potential of Heroin, But Does Reduce Heroin Craving and Anxiety. J Psychoactive Drugs 2018; 50:390-401. [PMID: 30204554 DOI: 10.1080/02791072.2018.1508789] [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] [Indexed: 12/25/2022]
Abstract
Possibly through its effects on glia, the peroxisome proliferator-activated gamma receptor (PPARγ) agonist pioglitazone (PIO) has been shown to alter the effects of heroin in preclinical models. Until now, these results have not been assessed in humans. Heroin-dependent participants were randomized to either active (45 mg, n = 14) or placebo (0 mg, n = 16) PIO maintenance for the duration of the three-week study. After stabilization on buprenorphine (8 mg), participants began a two-week testing period. On the first to fourth test days, participants could self-administer drug or money by making verbal choices for either option. On the fifth day, active heroin and money were administered and participants could work to receive heroin or money using a progressive ratio choice procedure. Test days 6-10 were identical to test days 1-5 with the exception that, during one of the test weeks, placebo was available on the first four days, and during the other week heroin was available. PIO failed to alter the reinforcing or positive subjective effects of heroin, but it did reduce heroin craving and overall anxiety. Although we were unable to replicate the robust effects found in preclinical models, these data provide an indication of drug effects that deserves further exploration.
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Affiliation(s)
- Jermaine D Jones
- a Division on Substance Use Disorders , New York State Psychiatric Institute and College of Physicians and Surgeons of Columbia University , New York , NY , USA
| | - Adam Bisaga
- a Division on Substance Use Disorders , New York State Psychiatric Institute and College of Physicians and Surgeons of Columbia University , New York , NY , USA
| | - Verena E Metz
- a Division on Substance Use Disorders , New York State Psychiatric Institute and College of Physicians and Surgeons of Columbia University , New York , NY , USA
| | - Jeanne M Manubay
- a Division on Substance Use Disorders , New York State Psychiatric Institute and College of Physicians and Surgeons of Columbia University , New York , NY , USA
| | - Shanthi Mogali
- a Division on Substance Use Disorders , New York State Psychiatric Institute and College of Physicians and Surgeons of Columbia University , New York , NY , USA
| | - Roberto Ciccocioppo
- b Department of Experimental Medicine and Public Health, School of Pharmacy, Pharmacology Unit , University of Camerino , Macerata , Italy
| | - Gabriela Madera
- a Division on Substance Use Disorders , New York State Psychiatric Institute and College of Physicians and Surgeons of Columbia University , New York , NY , USA
| | - Molly Doernberg
- a Division on Substance Use Disorders , New York State Psychiatric Institute and College of Physicians and Surgeons of Columbia University , New York , NY , USA
| | - Sandra D Comer
- a Division on Substance Use Disorders , New York State Psychiatric Institute and College of Physicians and Surgeons of Columbia University , New York , NY , USA
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12
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Schippers MC, Gaastra M, Mesman T, Schetters D, van Mourik Y, Denys D, Pattij T, De Vries TJ. Deep brain stimulation of the nucleus accumbens core but not shell reduces motivational components of heroin taking and seeking in rats. Brain Neurosci Adv 2017; 1:2398212817711083. [PMID: 32166132 PMCID: PMC7058223 DOI: 10.1177/2398212817711083] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Accepted: 04/21/2017] [Indexed: 12/04/2022] Open
Abstract
Background: Deep brain stimulation is explored as a new intervention for treatment-resistant substance use dependence. A candidate brain region is the nucleus accumbens, due to its involvement in reward and motivation. This study aimed to explore effects of NAcore and NAshell deep brain stimulation on aspects of heroin taking and seeking in a self-administration model for rats. Methods: NAcore and NAshell deep brain stimulation was applied during 25 or 100 µg/kg/infusion heroin self-administration on an FR4 schedule of reinforcement and during cue- and heroin-induced reinstatement. In a separate group, effects of NAcore deep brain stimulation on heroin self-administration on a progressive ratio schedule and the first extinction session were examined. Results: NAcore and NAshell deep brain stimulation did not alter heroin self-administration on an FR4 schedule. NAcore deep brain stimulation decreased cue – but not drug-induced reinstatement of heroin seeking, whereas NAshell deep brain stimulation did not affect reinstatement responding. In the second experiment, NAcore deep brain stimulation reduced responding during a progressive ratio schedule of heroin reinforcement. Finally, deep brain stimulation facilitated extinction from day 1 throughout the course of extinction learning. Conclusion: Taken together, the differential effects of NAcore and NAshell deep brain stimulation on heroin taking and seeking are in line with the distinct functional roles of these sub-regions therein. Conditioned cues have been shown to be very powerful stimuli for the persistence of addiction and relapse to drug use. Therefore, the present findings that NAcore deep brain stimulation decreases motivation for heroin taking and cue-conditioned behaviour and facilitates extinction learning are very promising, supporting the positive findings from clinical case studies.
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Affiliation(s)
- Maria C Schippers
- Department of Anatomy & Neurosciences, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, The Netherlands
| | - Mathijs Gaastra
- Department of Anatomy & Neurosciences, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, The Netherlands
| | - Tanja Mesman
- Department of Anatomy & Neurosciences, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, The Netherlands
| | - Dustin Schetters
- Department of Anatomy & Neurosciences, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, The Netherlands
| | - Yvar van Mourik
- Department of Anatomy & Neurosciences, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, The Netherlands
| | - Damiaan Denys
- Department of Psychiatry, Amsterdam Neuroscience, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Tommy Pattij
- Department of Anatomy & Neurosciences, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, The Netherlands
| | - Taco J De Vries
- Department of Anatomy & Neurosciences, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, The Netherlands
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13
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Fitzpatrick CJ, Morrow JD. Subanesthetic ketamine decreases the incentive-motivational value of reward-related cues. J Psychopharmacol 2017; 31:67-74. [PMID: 27649773 PMCID: PMC5453722 DOI: 10.1177/0269881116667709] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The attribution of incentive-motivational value to reward-related cues contributes to cue-induced craving and relapse in addicted patients. Recently, it was demonstrated that subanesthetic ketamine increases motivation to quit and decreases cue-induced craving in cocaine-dependent individuals. Although the underlying mechanism of this effect is currently unknown, one possibility is that subanesthetic ketamine decreases the incentive-motivational value of reward-related cues. In the present study, we used a Pavlovian conditioned approach procedure to identify sign-trackers, rats that attribute incentive-motivational value to reward-related cues, and goal-trackers, rats that assign only predictive value to reward-related cues. This model is of interest because sign-trackers are more vulnerable to cue-induced reinstatement of drug-seeking behavior and will persist in this drug-seeking behavior despite adverse consequences. We tested the effect of subanesthetic ketamine on the expression of Pavlovian conditioned approach behavior and the conditioned reinforcing properties of a reward-related cue in sign- and goal-trackers. We found that subanesthetic ketamine decreased sign-tracking and increased goal-tracking behavior in sign-trackers, though it had no effect on conditioned reinforcement. These results suggest that subanesthetic ketamine may be a promising pharmacotherapy for addiction that acts by decreasing the incentive-motivational value of reward-related cues.
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Affiliation(s)
| | - Jonathan D Morrow
- 1 Neuroscience Graduate Program, University of Michigan, Ann Arbor, USA.,2 Department of Psychiatry, University of Michigan, Ann Arbor, USA
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14
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de Quervain D, Schwabe L, Roozendaal B. Stress, glucocorticoids and memory: implications for treating fear-related disorders. Nat Rev Neurosci 2016; 18:7-19. [PMID: 27881856 DOI: 10.1038/nrn.2016.155] [Citation(s) in RCA: 310] [Impact Index Per Article: 38.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Glucocorticoid stress hormones are crucially involved in modulating mnemonic processing of emotionally arousing experiences. They enhance the consolidation of new memories, including those that extinguish older memories, but impair the retrieval of information stored in long-term memory. As strong aversive memories lie at the core of several fear-related disorders, including post-traumatic stress disorder and phobias, the memory-modulating properties of glucocorticoids have recently become of considerable translational interest. Clinical trials have provided the first evidence that glucocorticoid-based pharmacotherapies aimed at attenuating aversive memories might be helpful in the treatment of fear-related disorders. Here, we review important advances in the understanding of how glucocorticoids mediate stress effects on memory processes, and discuss the translational potential of these new conceptual insights.
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Affiliation(s)
- Dominique de Quervain
- Transfaculty Research Platform, University of Basel, CH-4055, Basel, Switzerland.,Division of Cognitive Neuroscience, Department of Psychology, University of Basel, CH-4055, Basel, Switzerland.,University Psychiatric Clinics, University of Basel, CH-4012, Basel, Switzerland
| | - Lars Schwabe
- Department of Cognitive Psychology, Institute of Psychology, University of Hamburg, 20146 Hamburg, Germany
| | - Benno Roozendaal
- Department of Cognitive Neuroscience, Radboud University Medical Center, 6500 HB Nijmegen, The Netherlands.,Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, 6525 EN Nijmegen, The Netherlands
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15
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Wolf OT, Atsak P, de Quervain DJ, Roozendaal B, Wingenfeld K. Stress and Memory: A Selective Review on Recent Developments in the Understanding of Stress Hormone Effects on Memory and Their Clinical Relevance. J Neuroendocrinol 2016; 28. [PMID: 26708929 DOI: 10.1111/jne.12353] [Citation(s) in RCA: 65] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2015] [Revised: 12/14/2015] [Accepted: 12/16/2015] [Indexed: 01/23/2023]
Abstract
Stress causes a neuroendocrine response cascade, leading to the release of catecholamines and glucocorticoids (GCs). GCs influence learning and memory by acting on mineralocorticoid (MR) and glucocorticoid (GR) receptors. Typically, GCs enhance the consolidation of memory processing at the same time as impairing the retrieval of memory of emotionally arousing experiences. The present selective review addresses four recent developments in this area. First, the role of the endocannabinoid system in mediating the rapid, nongenomic effects of GCs on memory is illustrated in rodents. Subsequently, studies on the impact of the selective stimulation of MRs on different memory processes in humans are summarised. Next, a series of human experiments on the impact of stress or GC treatment on fear extinction and fear reconsolidation is presented. Finally, the clinical relevance of the effects of exogenous GC administration is highlighted by the description of patients with anxiety disorders who demonstrate an enhancement of extinction-based therapies by GC treatment. The review highlights the substantial progress made in our mechanistic understanding of the memory-modulating properties of GCs, as well as their clinical potential.
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Affiliation(s)
- O T Wolf
- Department of Cognitive Psychology, Institute for Cognitive Neuroscience, Faculty of Psychology, Ruhr University Bochum, Bochum, Germany
| | - P Atsak
- Department of Cognitive Neuroscience, Radboud University Medical Center, Nijmegen, The Netherlands
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, Nijmegen, The Netherlands
| | - D J de Quervain
- Division of Cognitive Neuroscience, Faculty of Medicine, Department of Psychology, University Psychiatric Clinics Basel, Basel, Switzerland
| | - B Roozendaal
- Department of Cognitive Neuroscience, Radboud University Medical Center, Nijmegen, The Netherlands
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, Nijmegen, The Netherlands
| | - K Wingenfeld
- Department of Psychiatry and Psychotherapy, Campus Benjamin Franklin, Charité University Medicine Berlin, Berlin, Germany
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16
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Parvaz MA, Moeller SJ, Malaker P, Sinha R, Alia-Klein N, Goldstein RZ. Abstinence reverses EEG-indexed attention bias between drug-related and pleasant stimuli in cocaine-addicted individuals. J Psychiatry Neurosci 2016; 41:150358. [PMID: 27434467 PMCID: PMC5373704 DOI: 10.1503/jpn.150358] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Revised: 03/15/2016] [Accepted: 04/19/2016] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND Increased attention bias toward drug-related cues over non-drug-related intrinsically pleasant reinforcers is a hallmark of drug addiction. In this study we used the late positive potential (LPP) to investigate whether such increased attention bias toward drug-related relative to non-drug-related cues changes over a protracted period of reduced drug use in treatment-seeking individuals with a cocaine use disorder (CUD). METHODS Treatment-seeking individuals with CUD and matched healthy controls passively viewed a series of pleasant, neutral and drug-related pictures while their event-related potentials were recorded at baseline (≤ 3 weeks after treatment initiation) and at 6-month follow-up (only CUD). RESULTS We included 19 treatment-seeking individuals with CUD and 18 matched controls in our analyses. The results showed a reversal in attention bias (i.e., LPP amplitude) from baseline (i.e., drug > pleasant) to follow-up (i.e., pleasant > drug) driven by an increased attentional engagement with pleasant pictures; this LPP reversal was paralleled by a concomitant reduction in self-reported wanting and craving for cocaine in the CUD group. Furthermore, reduced attention bias toward drug-related cues (relative to pleasant cues) was correlated with longer duration of abstinence at baseline, and the extent of its longitudinal reversal was correlated with decreased craving at follow-up, providing support for abstinence as a putative mechanism of this bottom-up attentional change. LIMITATIONS A limited sample size and the use of the same set of pictures at baseline and follow-up were the major limitations of this study. CONCLUSION Results collectively indicate that, by tracking with drug abstinence, LPP in response to drug-related relative to pleasant cues may serve as an indicator of clinical progress in treatment-seeking individuals with CUD.
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Affiliation(s)
- Muhammad A. Parvaz
- From the Icahn School of Medicine, Mount Sinai, New York, NY, USA (Parvaz, Moeller, Malaker, Alia-Klein, Goldstein); and Yale University School of Medicine, New Haven, Conn., USA (Sinha)
| | - Scott J. Moeller
- From the Icahn School of Medicine, Mount Sinai, New York, NY, USA (Parvaz, Moeller, Malaker, Alia-Klein, Goldstein); and Yale University School of Medicine, New Haven, Conn., USA (Sinha)
| | - Pias Malaker
- From the Icahn School of Medicine, Mount Sinai, New York, NY, USA (Parvaz, Moeller, Malaker, Alia-Klein, Goldstein); and Yale University School of Medicine, New Haven, Conn., USA (Sinha)
| | - Rajita Sinha
- From the Icahn School of Medicine, Mount Sinai, New York, NY, USA (Parvaz, Moeller, Malaker, Alia-Klein, Goldstein); and Yale University School of Medicine, New Haven, Conn., USA (Sinha)
| | - Nelly Alia-Klein
- From the Icahn School of Medicine, Mount Sinai, New York, NY, USA (Parvaz, Moeller, Malaker, Alia-Klein, Goldstein); and Yale University School of Medicine, New Haven, Conn., USA (Sinha)
| | - Rita Z. Goldstein
- From the Icahn School of Medicine, Mount Sinai, New York, NY, USA (Parvaz, Moeller, Malaker, Alia-Klein, Goldstein); and Yale University School of Medicine, New Haven, Conn., USA (Sinha)
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17
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Altered economic decision-making in abstinent heroin addicts: Evidence from the ultimatum game. Neurosci Lett 2016; 627:148-54. [PMID: 27264486 DOI: 10.1016/j.neulet.2016.06.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Revised: 05/18/2016] [Accepted: 06/01/2016] [Indexed: 12/20/2022]
Abstract
BACKGROUND The development and persistence of drug addiction has been suggested to involve decision-making deficits. The Ultimatum Game is a widely used economic decision-making paradigm that illustrates the tension between financial self-interest and fairness motives. The behavior of responders in the Ultimatum Game has been associated with emotional reactions and cognitive control abilities, both of which are dysregulated in drug addicts. In this study, we investigated whether this economic decision-making process that involves considerations of social norms is affected by heroin addiction. METHODS Heroin addicts (n=17) and demographically matched healthy control subjects (n=18) were recruited to play the part of responders in the Ultimatum Game, during which they decided to accept or reject the monetary offers proposed by strangers. The offers were manipulated by varying the stake sizes and fairness scales. The rejection rates of all of the offer categories, response times, fairness judgments, and impulsivity were compared between heroin addicts and healthy controls. RESULTS Compared with healthy subjects, the rejection rates of most unfair offers in the Ultimatum Game were significantly higher under low-offer-size conditions among heroin addicts. In contrast, the most unfair offers were more likely to be accepted by heroin addicts in the high-offer-size condition than by healthy subjects. The ratings of unfairness were equal in both conditions although the rejection rates were different. Heroin addicts had higher scores on BIS attentional/cognitive impulsivity and non-planning impulsivity, but not in motor impulsivity. Rejection rates to most unfair offers under low-offer-size conditions significantly correlated with score on BIS non-planning impulsivity and total score of impulsivity. CONCLUSIONS Heroin addicts differentially responded under different stake-level conditions in the Ultimatum Game, with emotional impulses in low-offer-size conditions and selfish motives in the face of high monetary reward. These findings indicate that Ultimatum Game may be associated with heroin addiction and provide a productive new target for enhancing treatment for heroin addiction.
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18
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Walter M, Bentz D, Schicktanz N, Milnik A, Aerni A, Gerhards C, Schwegler K, Vogel M, Blum J, Schmid O, Roozendaal B, Lang UE, Borgwardt S, de Quervain D. Effects of cortisol administration on craving in heroin addicts. Transl Psychiatry 2015; 5. [PMID: 26218852 PMCID: PMC5068724 DOI: 10.1038/tp.2015.101] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Heroin dependence is a severe and chronically relapsing substance use disorder with limited treatment options. Stress is known to increase craving and drug-taking behavior, but it is not known whether the stress hormone cortisol mediates these stress effects or whether cortisol may rather reduce craving, for example, by interfering with addiction memory. The aim of the present study was to determine the effects of cortisol administration on craving in heroin-dependent patients and to determine whether the effects depend on the daily dose of heroin consumption. We used a double-blind, placebo-controlled, cross-over study in 29 heroin-dependent patients in a stable heroin-assisted treatment setting. A single oral dose of 20 mg of cortisol or placebo was administered 105 min before the daily heroin administration. The primary outcome measure was cortisol-induced change in craving. Secondary measures included anxiety, anger and withdrawal symptoms. For the visual analog scale for craving, we found a significant interaction (P = 0.0027) between study medication and heroin-dose group (that is, daily low, medium or high dose of heroin). Cortisol administration reduced craving in patients receiving a low dose of heroin (before heroin administration: P = 0.0019; after heroin administration: P = 0.0074), but not in patients receiving a medium or high dose of heroin. In a picture-rating task with drug-related pictures, cortisol administration did not affect the ratings for the picture-characteristic craving in all the three heroin-dose groups. Cortisol also did not significantly affect secondary outcome measures. In conclusion, a single administration of cortisol leads to reduced craving in low-dose heroin addicts. The present findings might have important clinical implications with regard to understanding stress effects and regarding treatment of addiction.
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Affiliation(s)
- M Walter
- Psychiatric University Clinics Basel, University of Basel, Basel, Switzerland,Psychiatric University Clinics Basel, University of Basel, Wilhelm Klein-Strasse 27, CH-4012 Basel, Switzerland E-mail:
| | - D Bentz
- Psychiatric University Clinics Basel, University of Basel, Basel, Switzerland,Division of Cognitive Neuroscience, Department of Psychology, University of Basel, Basel, Switzerland
| | - N Schicktanz
- Division of Cognitive Neuroscience, Department of Psychology, University of Basel, Basel, Switzerland
| | - A Milnik
- Psychiatric University Clinics Basel, University of Basel, Basel, Switzerland,Division of Molecular Neuroscience, Department of Psychology, University of Basel, Basel, Switzerland
| | - A Aerni
- Division of Cognitive Neuroscience, Department of Psychology, University of Basel, Basel, Switzerland
| | - C Gerhards
- Division of Cognitive Neuroscience, Department of Psychology, University of Basel, Basel, Switzerland
| | - K Schwegler
- Psychiatric University Clinics Basel, University of Basel, Basel, Switzerland,Division of Cognitive Neuroscience, Department of Psychology, University of Basel, Basel, Switzerland
| | - M Vogel
- Psychiatric University Clinics Basel, University of Basel, Basel, Switzerland
| | - J Blum
- Psychiatric University Clinics Basel, University of Basel, Basel, Switzerland
| | - O Schmid
- Psychiatric University Clinics Basel, University of Basel, Basel, Switzerland
| | - B Roozendaal
- Department of Cognitive Neuroscience, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, Nijmegen, Netherlands
| | - U E Lang
- Psychiatric University Clinics Basel, University of Basel, Basel, Switzerland
| | - S Borgwardt
- Psychiatric University Clinics Basel, University of Basel, Basel, Switzerland
| | - D de Quervain
- Psychiatric University Clinics Basel, University of Basel, Basel, Switzerland,Division of Cognitive Neuroscience, Department of Psychology, University of Basel, Basel, Switzerland,Transfaculty Research Platform, University of Basel, Basel, Switzerland,Division of Cognitive Neuroscience, University of Basel, Birmannsgasse 8, 4055 Basel, Switzerland. E-mail:
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19
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Liang CW, Zhong RYX, Chung YC, Pan CH, Yen MY, Cheng CP, Hsu WY. Using cognitive modelling to investigate the psychological processes of the Go/NoGo discrimination task in male abstinent heroin misusers. Addiction 2014; 109:1355-62. [PMID: 24750243 DOI: 10.1111/add.12591] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2013] [Revised: 11/27/2013] [Accepted: 04/11/2014] [Indexed: 11/29/2022]
Abstract
AIMS To use cognitive modelling to investigate psychological processes underlying decision-making in male abstinent heroin misusers (AHMs). DESIGN A case-control study design. SETTING A drug misuse treatment centre in Taiwan. PARTICIPANTS Eighty-eight male AHMs and 48 male controls. MEASUREMENTS Four parameters representing the attention to wins, learning rate, response sensitivity and incentive of heroin-related stimuli from the modified Go/NoGo discrimination task. FINDINGS A modified cue-dependent learning (CD) model with four parameters representing attention to wins, learning rate, response sensitivity and incentive of heroin-related stimuli had a lower value of the sum of Bayesian information criterion (showing a better fit) than the original CD model (9555.50 versus 11,192.22, P < 0.001). The AHM group had a higher value of the heroin-incentive parameter than the control group (0.26 versus -1.66, P < 0.05). The attention to wins and heroin-incentive parameters were associated positively with total commission rate and negatively with total omission rate in the AHM group (P < 0.001). CONCLUSIONS Male abstinent heroin misusers appear to be more influenced by heroin-related stimuli during decision-making than males with no history of heroin misuse.
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Affiliation(s)
- Chi-Wen Liang
- Department of Psychology, Chung Yuan Christian University, Chung Li City, Taiwan; Department of Psychology, National Chengchi University, Taipei, Taiwan
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20
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Abstract
The present study examined 25 male prisoners with a history of heroin dependency (M = 35.3 yr., SD = 8.5, range = 21-48) and 25 male prisoners with no history of substance abuse (M = 31.5 yr., SD = 9.8, range = 19-47) who were selected to complete the Emotion Regulation Questionnaire. Results showed that the group with a history of heroin dependency used a cognitive reappraisal strategy less frequently than controls and that there was no difference in the use of expression suppression strategies between the two groups. It was concluded that the negative impact of heroin abuse on an individual's emotion regulation is primarily reflected in the cognitive reappraisal dimension.
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21
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McHugh RK, Park S, Weiss RD. Cue-induced craving in dependence upon prescription opioids and heroin. Am J Addict 2014; 23:453-8. [PMID: 24628912 DOI: 10.1111/j.1521-0391.2014.12129.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2013] [Revised: 10/12/2013] [Accepted: 11/02/2013] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Cues associated with heroin use (eg, needles, powder) elicit robust craving responses in individuals dependent upon heroin. Elevated cue-induced craving may be a risk factor for relapse and can persist after periods of drug abstinence. Despite the growing prevalence of opioid dependence involving prescription opioids, published studies have yet to examine whether cue-induced craving is also present in prescription opioid dependence. METHODS A sample of 50 adults diagnosed with opioid dependence (20 prescription opioid users, 25 heroin users, and 5 mixed opioid users) completed a cue reactivity assessment. Participants were administered a series of 90 pictures, including heroin-specific, prescription opioid-specific, and neutral images, and were asked to rate craving and cue salience after each image. RESULTS Both the prescription opioid and heroin groups experienced significantly more craving to drug than to neutral stimuli. The prescription opioid group reported significantly less craving to prescription opioid stimuli than the heroin group to heroin stimuli; however, this effect was smaller and non-significant when controlling for group differences in cue salience. DISCUSSION AND CONCLUSIONS This study found evidence for cue-induced craving in individuals dependent upon prescription opioids. Further research is needed to better understand the role of cue reactivity in the course and treatment of opioid dependence involving prescription opioid use. SCIENTIFIC SIGNIFICANCE As elevated craving reactivity to drug cues may reflect a risk factor for relapse, understanding the nature of cue-induced craving in individuals with opioid dependence is important to improving treatments for this population.
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Affiliation(s)
- R Kathryn McHugh
- Division of Alcohol and Drug Abuse, McLean Hospital, Belmont, Massachusetts; Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
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