Functional changes of the reward system underlie blunted response to social gaze in cocaine users

The enhancing effect of social reward on inhibitory control in smokers: Evidence from behaviour and ERP studies

OBJECTIVE

Prior research has revealed impaired inhibitory control as a pivotal factor contributing to smokers' struggle to control smoking impulses. However, few studies focus on enhancing smokers' inhibitory control. This study investigates the potential of social rewards to bolster inhibitory control among smokers and elucidates the underlying mechanisms.

METHODS

In Experiment 1, a reward-based Go/Nogo paradigm assessed error rates and reaction times for 30 smokers exposed to social reward and neutral feedback in distinct contexts (smoking-related and neutral). Experiment 2 used a modified paradigm, incorporating cognitive load manipulation, to investigate error rates, reaction times, N2, and P3 ERPs among 32 smokers facing social reward and neutral feedback under different cognitive loads (high and low).

RESULTS

Smokers exhibit lower Nogo error rates with social reward feedback; higher error rates occur with smoking cues and high cognitive load; increased N2, P3 amplitudes under social reward versus neutral feedback; low cognitive load enhances P3 amplitude under social reward.

CONCLUSION

Social reward improves smokers' inhibitory control, but this effect weakens with exposure to smoking cues; higher cognitive load further diminishes the enhancement of smokers' inhibitory control by social reward under smoking cues.

N-acetylcysteine reduces prefrontal reactivity to cocaine cues in individuals with cocaine use disorder

Background

Individuals with cocaine use disorder experience heightened motivation to pursue rewards tied to cocaine, often triggered by associated cues. Cue reactivity and subsequent craving significantly elevate the risk of substance use, creating a pressing need for treatments that can help alleviate cravings. However, no pharmaceutical therapies for treating cocaine use disorder have been approved. Preclinical findings reveal dysfunctions in the glutamatergic pathway connecting prefrontal regions with the nucleus accumbens, which are correlated with cue-induced substance-seeking behaviour. These alterations, at both molecular and behavioural levels, can be reversed in rodents with N-acetylcysteine, a modulator of glutamatergic signalling. In contrast, the therapeutic potential for humans remains uncertain.

Methods

Here, we assessed the impact of a short-term challenge with N-acetylcysteine on neural responses to cocaine cues and cue-induced craving in a randomised, placebo-controlled cross-over trial using a fMRI cue reactivity paradigm. In total, 44 fMRI cue reactivity scans of 22 individuals with cocaine use disorder were recorded-once after the administration of 2,400 mg of N-acetylcysteine/day for 2 days and once after placebo intake.

Results

In the placebo condition, participants showed increased cue reactivity towards cocaine pictures, accompanied by significantly higher cravings as compared to neutral images. In accordance with recent meta-analyses, cue reactivity was evident in parietal regions such as the posterior cingulate and precuneus, temporal regions like the hippocampus, the bilateral insula, and medial prefrontal regions, namely the inferior, middle, and superior frontal gyrus. Cue-induced activity in the superior frontal gyrus was strongly predicted by the individual duration of cocaine use. While N-acetylcysteine showed no impact on subjectively rated cocaine craving, neural cue reactivity in the superior frontal gyrus was significantly decreased under N-acetylcysteine compared to placebo.

Conclusions

Our findings show that prefrontal reactivity to cocaine cues can be reduced even by a brief pharmacological challenge with N-acetylcysteine. Since neural drug cue reactivity has been shown to be a precursor of relapse behaviour, N-acetylcysteine's therapeutic potential should be further investigated in future studies by extending treatment periods.

Clinical Trial Registration

https://clinicaltrials.gov, identifier NCT02626494.

Dissociating social reward learning and behavior in alcohol use disorder

BACKGROUND

Alcohol use disorder (AUD) is associated with deficits in social cognition and behavior, but why these deficits are acquired is unknown. We hypothesized that a reduced association between actions and outcomes for others, i.e., social reward learning, would explain prevalent social deficiencies in AUD.

METHODS

We conducted one laboratory study (n = 234) and one confirmatory online study (n = 258), comparing young adults with AUD to age-, gender-, and education-matched healthy controls on a standardized reward learning task. In the task, participants learned to maximize reward for another person and for oneself. To elucidate the potential relation between reward learning and social behavior in AUD, we administered two measures: a dictator game task and a self-report measure. Finally, we applied reinforcement learning models to examine the computational properties of learning.

RESULTS

Social and individual learning, expressed in choice behavior, were comparable in individuals with AUD and healthy controls. Individual differences in learning were not associated with reduced social behavior in AUD. Computational modeling suggested that the learning mechanisms are comparable in AUD and healthy controls and indifferent to whether learning maximizes reward for another person or oneself.

CONCLUSIONS

Individuals with AUD demonstrated preserved reward learning abilities that do not vary with social behavior. Together, these results indicate that reward processes may not be relevant for understanding compromised social behavior in AUD.

Social context and drug cues modulate inhibitory control in cocaine addiction: involvement of the STN evidenced through functional MRI

Addictions often develop in a social context, although the influence of social factors did not receive much attention in the neuroscience of addiction. Recent animal studies suggest that peer presence can reduce cocaine intake, an influence potentially mediated, among others, by the subthalamic nucleus (STN). However, there is to date no neurobiological study investigating this mediation in humans. This study investigated the impact of social context and drug cues on brain correlates of inhibitory control in individuals with and without cocaine use disorder (CUD) using functional Magnetic Resonance Imaging (fMRI). Seventeen CUD participants and 17 healthy controls (HC) performed a novel fMRI "Social" Stop-Signal Task (SSST) in the presence or absence of an observer while being exposed to cocaine-related (vs. neutral) cues eliciting craving in drug users. The results showed that CUD participants, while slower at stopping with neutral cues, recovered control level stopping abilities with cocaine cues, while HC did not show any difference. During inhibition (Stop Correct vs Stop Incorrect), activity in the right STN, right inferior frontal gyrus (IFG), and bilateral orbitofrontal cortex (OFC) varied according to the type of cue. Notably, the presence of an observer reversed this effect in most areas for CUD participants. These findings highlight the impact of social context and drug cues on inhibitory control in CUD and the mediation of these effects by the right STN and bilateral OFC, emphasizing the importance of considering the social context in addiction research. They also comfort the STN as a potential addiction treatment target.

Effective connectivity of default mode network subsystems and automatic smoking behaviour among males

BACKGROUND

The default mode network (DMN) is not a single system, but rather is composed of smaller and distinct functional subsystems that interact with each other. The functional relevance of these subsystems in tobacco use disorder (TUD) and the neurobiological features associated with smoking motivation are still unclear; thus, we sought to assess causal or direct connectivity alterations within 3 subsystems of the DMN among people with TUD.

METHODS

We recruited male smokers and nonsmokers. We conducted resting-state functional magnetic resonance imaging (rs-fMRI) and collected ratings on smoking-related clinical scales. We applied dynamic causal modelling (DCM) to rs-fMRI to characterize changes of effective connectivity in TUD from 3 DMN subsystems, including the midline core network (i.e., the posterior cingulate cortex and the anterior medial prefrontal cortex [PCC-aMPFC] core DMN), the medial temporal subsystem (MTL-DMN), and the dorsal medial prefrontal cortex subsystem (dMPFC-DMN). We used leave-one-out cross-validation to investigate whether the neural response could predict smoking reasons, evaluated using the Russell Reason for Smoking Questionnaire).

RESULTS

We recruited 88 smokers and 54 nonsmokers. Among people with TUD, the parahippocampal cortex (PHC) region showed enhanced self-connection, which was associated with the severity of TUD after nighttime withdrawal. Compared with nonsmokers, people with TUD displayed significant increased effective connectivity within the dMPFC-DMN, and decreased effective connectivity from the dMPFC-DMN to the PCC-aMPFC core DMN. Moreover, decreased effective connectivity from the lateral temporal cortex to the dMPFC could predict the smoking reason related to automatic behaviour.

LIMITATIONS

Although we found aberrance in causal connections in DMN subsystems among people with TUD, our cross-sectional study could not be used to investigate changes in effective connectivity over time and their relationship with clinical features.

CONCLUSION

This study emphasized the aberrant causal connections of different functional subsystems of the DMN in TUD and revealed the neural correlates of automatic smoking behaviours. These findings suggested DMN subsystem-derived indicators could be a potential biomarker for TUD and could be used to identify the heterogeneity in motivation for smoking behaviour.

Investigating the impact of psychedelic drugs on social cognition defects: A scoping review protocol

BACKGROUND

Impairments in social cognition are known to be a key factor in several psychiatric and neurodevelopmental disorders. Interest in psychedelic drugs has increased in recent years, with significant research identifying psychedelic and hallucinogenic drugs as modulators of social cognition. However, more research is necessary before psychedelics are implemented in clinical settings as treatments for social cognition defects. Therefore, this study describes a scoping review protocol which will be used to analyze the body of literature on psychedelic drugs as modulators of social cognition in patients with psychiatric and neurodevelopmental disorders.

METHODS

This scoping review protocol was developed using the JBI Scoping Review Methodology Group's description of how to conduct a scoping review. The guidelines identified by this group as well as a search strategy developed with the assistance of a research librarian will be applied to a search of several peer-reviewed journals, including MEDLINE (Ovid), PsycINFO, EMBASE (Elsevier), and Scopus (Elsevier). Each study extracted will be screened in a two-step screening process, including a title and abstract screen, and a full-text screen. One independent individual will complete both steps of the screening, and a second independent individual will review the completed screening.

DISCUSSION

An understanding of the current literature on psychedelic drugs as modulators of social cognition will provide insight into what is presently known on the subject, and any gaps in the literature that can be addressed in future studies. The knowledge gained from this scoping review could lead to a new treatment for social cognition defects in clinical populations.

Impaired social reward processing in individuals with Internet gaming disorder and its relationship with early face perception

Previous research has found that individuals with Internet gaming disorder (IGD) show different patterns of social function impairments in game-related and real-life social contexts. Impaired social reward processing may be the underlying mechanism according to the Social Motivation Theory. Thus, in this study, event-related potentials were recorded from 24 individuals with IGD and 24 healthy gamers during a social judgement task. We focused on reward positivity (RewP) elicited by game-related and real-life social rewards, and N170 elicited by game avatar faces and real faces. These indicators were used to explore the neurocognitive mechanism of impaired social reward processing in individuals with IGD and its relationship with early face perception. Results showed that (1) the RewP elicited by real-life social reward was considerably reduced in individuals with IGD relative to healthy gamers. (2) The N170 elicited by game avatar faces in individuals with IGD was larger than that elicited by real faces. However, the N170 was not associated with RewP in either group. (3) The score for IGD severity was correlated with the RewP elicited by real-life social reward and the N170 elicited by game avatar face. In conclusion, the present study suggests that the impaired social reward processing in individuals with IGD is mainly manifested in a decreased neural sensitivity to real-life social reward. Meanwhile, the reduced RewP elicited by real-life social reward and the enhanced N170 elicited by game avatar face might serve as potential biomarkers for IGD.

Substance use disorders in hospice palliative care: A narrative review of challenges and a case for physician intervention

OBJECTIVES

Substance use disorders (SUDs) are frequently encountered in hospice palliative care (HPC) and pose substantial quality-of-life issues for patients. However, most HPC physicians do not directly treat their patients' SUDs due to several institutional and personal barriers. This review will expand upon arguments for the integration of SUD treatment into HPC, will elucidate challenges for HPC providers, and will provide recommendations that address these challenges.

METHODS

A thorough review of the literature was conducted. Arguments for the treatment of SUDs and recommendations for physicians have been synthesized and expanded upon.

RESULTS

Treating SUD in HPC has the potential to improve adherence to care, access to social support, and outcomes for pain, mental health, and physical health. Barriers to SUD treatment in HPC include difficulties with accurate assessment, insufficient training, attitudes and stigma, and compromised pain management regimens. Recommendations for physicians and training environments to address these challenges include developing familiarity with standardized SUD assessment tools and pain management practice guidelines, creating and disseminating visual campaigns to combat stigma, including SUD assessment and intervention as fellowship competencies, and obtaining additional training in psychosocial interventions.

SIGNIFICANCE OF RESULTS

By following these recommendations, HPC physicians can improve their competence and confidence in working with individuals with SUDs, which will help meet the pressing needs of this population.

To bridge or not to bridge: Moral Judgement in Cocaine Use Disorders, a case-control study on human morality

BACKGROUND

In the "Dual-Process theory", morality is characterized by the interaction between an automatic-emotional process, mediated by the Anterior Cingulate Cortex (ACC) and linked to personal-deontological decisions, and a rational-conscious one, mediated by the Dorso-Lateral Prefrontal Cortex (DLPFC) and linked to impersonal-utilitarian decisions. These areas are altered by chronic use of cocaine, with a possible impact on moral decision-making.

OBJECTIVE

To evaluate the difference between a group of Cocaine Use Disorder (CUD) patients and a control group in moral decision-making.

METHODS

Subjects with CUD were compared to an equal-sized healthy group regarding their moral decision-making. Trolley and Footbridge Moral Dilemmas were administered to each group. The quality of the answer (yes or no) and the time needed to answer were recorded.

RESULTS

The recruited group includes 72 subjects, 36 with CUD and 36 healthy subjects (average age of 39.51 ± 9.89). In the Trolley dilemma, almost all the subjects (97.3%) answered "yes", while in the Footbridge dilemma CUD subjects answered "yes" more often (52.7%) than the healthy group (19.4%).

CONCLUSION

For strong emotional dilemmas (Footbridge), cocaine users answered "yes" with a higher frequency compared to healthy subjects, highlighting a wider utilitarian tendency in decision-making and a poor emotional participation.

Is Empathy Associated with Gambling and Its Addiction? A Scoping Review of Empirical Studies

Considering the low levels of empathy associated with substance-related addictions and the similarities between gambling disorder (GD) and substance-related addiction, understanding the relationship between empathy and GD may clarify the mechanism of addiction development. This scoping review aimed to evaluate the empirical evidence for the potential protective role of emotional and cognitive empathy against GD development via internalizing and/or externalizing pathways. We followed the preferred reporting items for systematic review and meta-analyses extension for scoping reviews and 11 articles met the inclusion criteria. Although most of the reviewed studies used correlational designs and non-gambling-specific samples, this review highlights (1) significant relationships between both types of empathy and the neural activity of gambling behaviors, and (2) reduced cognitive empathy (i.e., fantasy and perspective taking) and increased emotional empathy (i.e., personal distress) among problem gamblers than their gambling counterparts. Despite the lack of studies directly testing the protective role of empathy against GD, the existing studies (n = 8) nevertheless shed light on the potential protective effects of both types of empathy on GD development. This review identified research gaps, which can be addressed in future studies by discovering the underlying mechanisms (e.g., internalizing and externalizing pathways) of these relationships. Experimental or longitudinal studies in gamblers investigating how different types of empathy are associated with GD via these pathways are called for as their findings have implications for prevention and intervention designs for GD and other addictive disorders.

An eye-tracking study of biased attentional processing of emotional faces in severe alcohol use disorder

BACKGROUND

Social cognition impairments in severe alcohol use disorder (SAUD) are increasingly established. However, fundamental aspects of social cognition, and notably the attentional processing of socio-affective information, remain unexplored, limiting our understanding of underlying mechanisms. Here, we determined whether patients with SAUD show attentional biases to specific socio-affective cues, namely emotional faces.

METHOD

In a modified dot-probe paradigm, 30 patients with SAUD and 30 demographically matched healthy controls (HC) were presented with pairs of neutral-emotional (angry, disgusted, happy, sad) faces while having their eye movements recorded. Indices of early/automatic (first fixations, latency to first fixations) and later/controlled (number of fixations, dwell-time) processes were computed.

RESULTS

Patients with SAUD did not differ from HC in their attention to angry/disgusted/sad vs. neutral faces. However, patients with SAUD fixated/dwelled less on happy vs. neutral faces in the first block of stimuli than HC, who presented an attentional bias to happy faces.

LIMITATIONS

Sample-size was determined to detect medium-to-large effects and subtler ones may have been missed. Further, our cross-sectional design provides no explanation as to whether the evidenced biases precede or are a consequence of SAUD.

CONCLUSIONS

These results extend the social cognition literature in SAUD to the attentional domain, by evidencing the absence of a controlled attentional bias toward positive social cues in SAUD. This may reflect reduced sensitivity to social reward and could contribute to higher order social cognition difficulties and social dysfunction.

Hub-connected functional connectivity within social brain network weakens the association with real-life social network in schizophrenia patients

Hubs in the brain network are the regions with high centrality and are crucial in the network communication and information integration. Patients with schizophrenia (SCZ) exhibit wide range of abnormality in the hub regions and their connected functional connectivity (FC) at the whole-brain network level. Study of the hubs in the brain networks supporting complex social behavior (social brain network, SBN) would contribute to understand the social dysfunction in patients with SCZ. Forty-nine patients with SCZ and 27 healthy controls (HC) were recruited to undertake the resting-state magnetic resonance imaging scanning and completed a social network (SN) questionnaire. The resting-state SBN was constructed based on the automatic analysis results from the NeuroSynth. Our results showed that the left temporal lobe was the only hub of SBN, and its connected FCs strength was higher than the remaining FCs in both two groups. SCZ patients showed the lower association between the hub-connected FCs (compared to the FCs not connected to the hub regions) with the real-life SN characteristics. These results were replicated in another independent sample (30 SCZ and 28 HC). These preliminary findings suggested that the hub-connected FCs of SBN in SCZ patients exhibit the abnormality in predicting real-life SN characteristics.

Alcohol Use Disorder Displays Trait-Related Reductions in Prosocial Decision Making

BACKGROUND

Alcohol use disorder (AUD) is associated with deficits in social cognition, but the relationship between harmful alcohol use and the processes underlying interactive social behavior is still unknown. We hypothesized that prosocial decision making is reduced in AUD and that individual differences in the underlying processes are key to better understanding these reductions.

METHODS

In one laboratory study (Swedish participants, n = 240) and one confirmatory online study (American participants, n = 260), we compared young adults with AUD with age-, gender-, and education-matched healthy control subjects on 6 facets of prosocial decision making. We used standardized behavioral economic tasks, namely the dictator game, ultimatum game, trust game, and third-party game. To better understand the expected differences in prosociality, we evaluated attention by tracking eye gaze, decision response time, clinical symptoms, and social cognition.

RESULTS

Altruism (lab study: p = .007; online study: p < .001), fairness (lab study: p = .003; online study: p = .007), and reciprocal trust (lab study: p = .007; online study: p = .039) were reduced in individuals with AUD compared with healthy control subjects, whereas trust and third-party punishment and compensation were comparable in both studies. Reduced prosociality was associated with attending to the selfish response option, faster response time, and moral attitudes, while being dissociated from both psychiatric symptoms and drinking history in AUD.

CONCLUSIONS

Individuals with AUD have trait-related reductions in prosocial decision making that do not vary with drinking history or psychiatric symptom load. These reductions were confined to one-to-one interactions accompanied by differences in attention, decision time, and moral attitudes.

In- and Out-Group Effects on Social Perception and Empathy in Cocaine Use Disorder

Earlier research revealed that cocaine users display impairments in emotional but not necessarily in cognitive empathy. However, no study to date has tested whether empathy is generally altered or whether impairments are restricted to specific social targets. The current investigation addresses this open question. In addition, we examined whether attributions of warmth and competence as well as personal future expectancies differed between cocaine users and substance-naïve controls. Twenty-two chronic cocaine users and 40 stimulant-naïve controls specified their perceived warmth and competence for four social targets [in-group member, opposite consumption out-group member (cocaine user for controls and non-user for cocaine user), opposite consumption out-group member of opposite gender, and elderly person]. They also specified their cognitive and emotional empathy for these four targets facing eight desirable and eight undesirable events. Finally, they rated the likelihood of these scenarios happening to themselves. Both cocaine users and controls attributed lower warmth to cocaine-using than non-using targets. Comparably, no in-group preference was observed in cocaine user's emotional empathy ratings, and greater denigration of the in-group was associated with higher frequency and doses of cocaine consumption. In addition, cocaine users rated both desirable and undesirable events as more likely to happen to themselves than did controls. Results show that substance-naïve individuals stigmatize cocaine users. They further point to compromised self-esteem in cocaine users resulting from such stigmatization. Interventions should address stigmatization processes to break the vicious circle of mutual social distancing and stronger dedication to the drug.

Neural mechanisms underlying empathy during alcohol abstinence: evidence from connectome-based predictive modeling

Empathy impairments have been linked to alcohol dependence even during abstinent periods. Nonetheless, the neural underpinnings of abstinence-induced empathy deficits remain unclear. In this study, we employed connectome-based predictive modeling (CPM) by using whole brain resting-state functional connectivity (rs-FC) to predict empathy capability of abstinent alcoholics (n = 47) versus healthy controls (n = 59). In addition, the generalizability of the predictive model (i.e., one group treated as a training dataset and another one treated as a test dataset) was performed to determine whether healthy controls and abstinent alcoholics share common neural fingerprints of empathy. Our results showed that abstinent alcoholics relative to healthy controls had decreased empathy capacity. Although no predictive models were observed in the abstinence group, we found that individual empathy scores in the healthy group can be reliably predicted by functional connectivity from the default mode network (DMN) to the sensorimotor network (SMN), occipital network, and cingulo-opercular network (CON). Moreover, the identified connectivity fingerprints of healthy controls could be generalized to predict empathy in the abstinence group. These findings indicate that neural circuits accounting for empathy may be disrupted by alcohol use and the impaired degree varies greatly among abstinent individuals. The large inter-individual variation may impede identification of the predictive model of empathy in alcohol abstainers.

Psychedelic-Assisted Therapy for Substance Use Disorders and Potential Mechanisms of Action

Substance use disorders (SUD) represent a significant public health issue with a high need for novel and efficacious treatment options. In light of this high unmet need, recent results reporting beneficial outcomes of psychedelic-assisted therapy in SUD are particularly relevant. However, several questions remain with regard to this treatment approach. The clinical mechanisms of action of psychedelic substances in the treatment of SUD are not well understood. Closing this knowledge gap is critical to inform and optimize the psychotherapeutic embedding of the acute substance administration. In this chapter, we discuss potential mechanisms that have implications on psychotherapeutic approaches including induced neuroplasticity, alterations in brain network connectivity, reward and emotion processing, social connectedness, insight, and mystical experiences. Furthermore, we outline considerations and approaches that leverage these mechanisms in order to optimize the therapeutic embedding by maximizing synergy between substance effects and psychotherapy. Understanding the mechanisms of action, developing psychotherapeutic approaches accordingly, and evaluating their synergistic efficacy in scientific studies will be critical to advance the framework of psychedelic-assisted therapy for addiction, create evidence-based approaches, and achieve the best treatment outcome for patients with SUD.

Negative symptoms in alcohol use disorder: A pilot study applying the two-factor model of negative symptoms to patients with alcohol use disorder

BACKGROUND AND AIMS

Alcohol Use Disorder (AUD) is characterized by a reduction in goal-directed behavior, with alcohol use taking precedence over other areas of life. These features in AUD resemble negative symptoms in schizophrenia, especially the reduction in motivation and pleasure (MAP). Given the clinical similarities of negative symptoms across diagnostic categories, it comes as a surprise that there are few investigations on negative symptoms in alcohol and other substance use disorders. To our knowledge, our study is the first to assess negative symptoms in AUD based on a two-factorial approach, and to investigate the interrelation of these dimensions with the severity of AUD, and alcohol craving.

MATERIALS AND METHODS

We examined a sample of 42 patients with AUD at the Psychiatric University Hospital in Zurich. Participants provided self-report and interview-based measures of the severity of AUD, negative symptoms, and alcohol craving. Finally, we used data from the electronic health records of the patients.

RESULTS

Patients with AUD show negative symptoms to a similar extent as patients with schizophrenia or bipolar disorder. We found a positive correlation between the extent of impairment within the MAP factor and overall severity of AUD. Furthermore, MAP negative symptoms were correlated with alcohol craving. In a linear regression, negative symptoms predicted alcohol craving whereas depression did not.

SUMMARY

Negative symptoms as conceptualized for schizophrenia are prevalent in patients with AUD and associated with the severity of AUD. More specifically, severity of AUD correlates with diminished motivation and pleasure, highlighting the importance of disturbances in motivational functions in AUD. This is further supported by the correlation between negative symptoms and craving, a hallmark of AUD. Taken together, our findings suggest that negative symptoms might be a highly relevant but hitherto often neglected therapeutic target in AUD.

More than just statics: Temporal dynamic changes of intrinsic brain activity in cigarette smoking

Smoking is companied with altered intrinsic activity of the brain measured by amplitude of low-frequency fluctuation. Evidence has revealed that human brain activity is a highly dynamic and rapidly changing system. How exactly cigarette smoking affect temporal dynamic intrinsic brain activity is not fully understood nor is it clear how smoking severity influences spontaneous brain activity. Dynamic amplitude of low-frequency fluctuation (dALFF) was used to examine the dynamic temporal variability in 93 participants (63 smokers, 30 nonsmokers). We further divided smokers into light and heavy smokers. The temporal variability in intrinsic brain activity among these groups was compared. Correlation analyses were performed between dALFF in areas showing group differences and smoking behaviour (e.g., the Fagerström Test for Nicotine Dependence [FTND] scores and pack-years). Smokers showed significantly increased dALFF in the left inferior/middle frontal gyrus, right orbitofrontal gyrus, right insula, left superior/medial frontal gyrus and right middle frontal gyrus than nonsmokers. Light smokers showed increased dALFF variability in the left prefrontal cortex. Heavy smokers showed increased dynamics in specific brain regions, including the right postcentral gyrus, right insula and left precentral gyrus. Furthermore, the temporal variability in dALFF in the left superior/medial frontal gyrus, left superior/middle frontal gyrus, right middle frontal gyrus and right insula was positively correlated with pack-years or FTND. Combined, these results suggest that smokers increase stable and persistent spontaneous brain activity in prefrontal cortex, involved impaired gold-directed action and value-based decision-making. In addition, individuals with heavier smoking severity show increased perturbance on spontaneous brain activity of perception and sensorimotor, related to increased reliance.

The Role of the Posterior Cerebellum in Dysfunctional Social Sequencing

Recent advances in social neuroscience have highlighted the critical role of the cerebellum in social cognition, and especially the posterior cerebellum. Studies have supported the view that the posterior cerebellum builds internal action models of our social interactions to predict how other people's actions will be executed and what our most likely responses are to these actions. This mechanism allows to better anticipate action sequences during social interactions in an automatic and intuitive way and to fine-tune these anticipations, making it easier to understand other's social behaviors and mental states (e.g., beliefs, intentions, traits). In this paper, we argue that the central role of the posterior cerebellum in identifying and automatizing social action sequencing provides a fruitful starting point for investigating social dysfunctions in a variety of clinical pathologies, such as autism, obsessive-compulsive and bipolar disorder, depression, and addiction. Our key hypothesis is that dysfunctions of the posterior cerebellum lead to under- or overuse of inflexible social routines and lack of plasticity for learning new, more adaptive, social automatisms. We briefly review past research supporting this view and propose a program of research to test our hypothesis. This approach might alleviate a variety of mental problems of individuals who suffer from inflexible automatizations that stand in the way of adjustable and intuitive social behavior, by increasing posterior cerebellar plasticity using noninvasive neurostimulation or neuro-guided training programs.

Impaired glutamate homeostasis in the nucleus accumbens in human cocaine addiction

Cocaine addiction is characterized by overwhelming craving for the substance, which drives its escalating use despite adverse consequences. Animal models suggest a disrupted glutamate homeostasis in the nucleus accumbens to underlie addiction-like behavior. After chronic administration of cocaine, rodents show decreased levels of accumbal glutamate, whereas drug-seeking reinstatement is associated with enhanced glutamatergic transmission. However, due to technical obstacles, the role of disturbed glutamate homeostasis for cocaine addiction in humans remains only partially understood, and accordingly, no approved pharmacotherapy exists. Here, we applied a tailored proton magnetic resonance spectroscopy protocol that allows glutamate quantification within the human nucleus accumbens. We found significantly reduced basal glutamate concentrations in the nucleus accumbens in cocaine-addicted (N = 26) compared with healthy individuals (N = 30), and increased glutamate levels during cue-induced craving in cocaine-addicted individuals compared with baseline. These glutamatergic alterations, however, could not be significantly modulated by a short-term challenge of N-acetylcysteine (2400 mg/day on 2 days). Taken together, our findings reveal a disturbed accumbal glutamate homeostasis as a key neurometabolic feature of cocaine addiction also in humans. Therefore, we suggest the glutamatergic system as a promising target for the development of novel pharmacotherapies, and in addition, as a potential biomarker for a personalized medicine approach in addiction.

Empathy deficits and their behavioral, neuroanatomical, and functional connectivity correlates in smoked cocaine users

Reduced empathic abilities are frequently observed in drug abusers. These deficits may compromise interpersonal interactions and contribute to diminished social functioning. However, previous evidence regarding empathy and addiction is behaviorally unspecific and virtually null in terms of their brain structural or functional correlates. Moreover, no previous study has investigated how empathy is affected by drugs whose consumption is particularly characterized by counter-empathic behaviors. Here, we conducted the first assessment of neurocognitive correlates of empathy for pain in dependent users (predominantly men) of smoked cocaine (SC, coca paste, n = 37). We compared their performance in the empathy task with that of two groups matched in relevant demographic variables: 24 dependent users of insufflated cocaine hydrochloride (CC) and 21 healthy controls. In addition, we explored the structural anatomy and functional connectivity (FC) correlates of empathic impairments across groups. Our results showed that, compared to CC and controls, SC users exhibited a selective reduction of empathic concern for intentional harms. These impairments were associated with lower gray matter volumes in regions subserving social cognition (i.e., right inferior parietal lobule, supramarginal and angular gyri). Furthermore, reduced empathic concern correlated with FC within affective empathy and social cognition networks, which are also linked to cognitive changes reported in addiction (i.e., inferior frontal and orbital gyri, posterior insula, supplementary motor area, cingulate cortex). Our findings suggest that chronic consumption of SC may involve reduced empathic concern and relevant neuroanatomical and FC abnormalities, which, in turn, may result in social interaction dysfunction. These results can inform theoretical and applied developments in neuropsychopharmacology.

Effective connectivity predicts cognitive empathy in cocaine addiction: a spectral dynamic causal modeling study

Social cognition plays a crucial role in the development and treatment of cocaine dependence. However, studies investigating social cognition, such as empathy and its underlying neural basis, are lacking. To explore the neural interactions among reward and memory circuits, we applied effective connectivity analysis on resting-state fMRI data collected from cocaine-dependent subjects. The relationship between effective connectivity within these two important circuits and empathy ability - evaluated with the Interpersonal Reactivity Index (IRI) - was assessed by machine learning algorithm using multivariate regression analysis. In accordance with the neurocircuitry disruptions of cocaine addiction, the results showed that cocaine-dependent subjects relative to healthy controls had altered resting state effective connectivity between parts of the memory and reward systems. Furthermore, effective connectivity between the memory and reward system could predict the fantasy empathy (FE) subscale scores in cocaine dependence. Overall, our findings provide further evidence for the neural substrates of social cognition in cocaine-dependent patients. These new insights could be useful for the development of new treatment programs for this substance dependency disorder.

Functional connectivity of dorsolateral prefrontal cortex predicts cocaine relapse: implications for neuromodulation treatment

Relapse is one of the most perplexing problems of addiction. The dorsolateral prefrontal cortex is crucially involved in numerous cognitive and affective processes that are implicated in the phenotypes of both substance use disorders and other neuropsychiatric diseases and has become the principal site to deliver transcranial magnetic stimulation for their treatment. However, the dorsolateral prefrontal cortex is an anatomically large and functionally heterogeneous region, and the specific dorsolateral prefrontal cortex locus and dorsolateral prefrontal cortex-based functional circuits that contribute to drug relapse and/or treatment outcome remain unknown. We systematically investigated the relationship of cocaine relapse with functional circuits from 98 dorsolateral prefrontal cortex regions-of-interest defined by evenly sampling the entire surface of bilateral dorsolateral prefrontal cortex in a cohort of cocaine dependent patients (n = 43, 5 Fr) following a psychosocial treatment intervention. Cox regression models were utilized to predict relapse likelihood based on dorsolateral prefrontal cortex functional connectivity strength. Functional connectivity from only 3 of the 98 dorsolateral prefrontal cortex loci, one in the left and two in the right hemisphere, significantly predicted cocaine relapse with an accuracy of 83.9%, 84.6% and 85.4%, respectively. Combining all three loci significantly improved prediction validity to 87.5%. Protective and risk circuits related to these dorsolateral prefrontal cortex loci were identified that have previously been implicated to support 'bottom up' drive to use drug and 'top down' control over behaviour together with social emotional, learning and memory processing. Three dorsolateral prefrontal cortex-centric circuits were identified that predict relapse to cocaine use with high accuracy. These functionally distinct dorsolateral prefrontal cortex-based circuits provide insights into the multiple roles played by the dorsolateral prefrontal cortex in cognitive and affective functioning that affects treatment outcome. The identified dorsolateral prefrontal cortex loci may serve as potential neuromodulation targets to be tested in subsequent clinical studies for addiction treatment and as clinically relevant biomarkers of its efficacy. Zhai et al. identify three dorsolateral prefrontal cortex (dlPFC)-centric circuits that predict cocaine relapse with high accuracy, providing insights into the multiple roles of the dlPFC in brain functioning that affects treatment outcome and suggesting the dlPFC loci as potential neuromodulation targets for addiction treatment.

Classical Psychedelics as Therapeutics in Psychiatry - Current Clinical Evidence and Potential Therapeutic Mechanisms in Substance Use and Mood Disorders

Classical psychedelics, primarily psilocybin and lysergic acid diethylamide (LSD), have been used and extensively studied in Western medicine as part of substance-assisted psychotherapy in the 1950s and 1960s. Modern clinical research is currently gaining momentum and provides new evidence for the safety and efficacy of classical psychedelics (primarily psilocybin, but also LSD and ayahuasca) in the treatment of different psychiatric conditions, including substance use and mood disorders.In this review article, we outline common pathological mechanisms of substance use disorders (SUD) and unipolar depression. Next, the current literature on the effects of psychedelics is summarized in order to generate hypotheses regarding their potential therapeutic mechanisms of action in treating these psychiatric conditions. Finally, we review and discuss clinical trials published since 2011 investigating the effects of psychedelics in SUD and depression.While results from those modern clinical trials are promising, most of them do not meet the methodological requirements to allow firm conclusions on the clinical efficacy of psychedelics. Larger, blinded, randomized controlled trials (RCT) with clearly defined patient groups and well-defined primary endpoints are needed. Additionally, the therapeutic mechanisms of classical psychedelics are currently unknown. This review presents hypotheses derived from preclinical and human studies that need to be tested in future trials to better understand the clinical potential of psychedelic substances in modern psychiatry.

Using second-person neuroscience to elucidate the mechanisms of social interaction

Although a large proportion of our lives are spent participating in social interactions, the investigation of the neural mechanisms supporting these interactions has largely been restricted to situations of social observation - that is, situations in which an individual observes a social stimulus without opportunity for interaction. In recent years, efforts have been made to develop a truly social, or 'second-person', neuroscientific approach to these investigations in which neural processes are examined within the context of a real-time reciprocal social interaction. These developments have helped to elucidate the behavioural and neural mechanisms of social interactions; however, further theoretical and methodological innovations are still needed. Findings to date suggest that the neural mechanisms supporting social interaction differ from those involved in social observation and highlight a role of the so-called 'mentalizing network' as important in this distinction. Taking social interaction seriously may also be particularly important for the advancement of the neuroscientific study of different psychiatric conditions.

Social Incentives Anticipation and Consummation: Investigating Neural Activity in Women Using Methamphetamine

Individuals with methamphetamine use disorder are considered to have enhanced reactivity to rewards or drug cues. However, whether this holds true in the social incentives processing is still unclear. The current study investigated the electroencephalographical (EEG) evidence of social incentives processing in women with methamphetamine use disorder (MA group, n = 19) and in a healthy control group (HC group, n = 20) using social incentive delay (SID) tasks. In the SID, participants received a "Like" (e.g., thumbs up) or "Unlike" (e.g., thumbs down) from WeChat emojis as social incentives, or neutral feedback. During the anticipation stage, the Cue-P3 and stimulus-preceding negativity (SPN) were larger for the social incentives condition than for the neutral condition. During the consummation stage, the feedback-related negativity (FRN) was marginally significantly larger in the HC group than the MA group for the social incentive condition, whereas there was no significant difference between the groups for neutral condition. Interestingly, the FB-P3 was larger for social positive feedback than for social negative feedback in the MA group, but not in HC group. Furthermore, only the HC group showed significant positive correlation between the anticipatory event-related brain potential (ERP, such as Cue-P3) and the consummatory ERP (FB-P3) in the social incentive condition. The findings suggest that women with MA use disorder have a blunted neural response to the processing of social incentives and a blunted neural response to negative social feedback, which helps to elucidate the neural mechanisms of social incentives processing in individuals with MA use disorder.

Sensitivity to gains during risky decision-making differentiates chronic cocaine users from stimulant-naïve controls

BACKGROUND

Chronic cocaine use has been consistently associated with decision-making impairments that contribute to the development and maintenance of drug-taking. However, the underlying cognitive processes of risk-seeking behaviours observed in chronic cocaine users (CU) have so far remained unclear. Here we therefore tested whether CU differ from stimulant-naïve controls in their sensitivity to gain, loss, and probability of loss information when making decisions under risk.

METHOD

A sample of 96 participants (56 CU and 40 controls) performed the no-feedback version of the Columbia Card Task, designed to assess risk-taking in relation to gain, loss, and probability of loss information. Additionally, cognitive performance and impulsivity were determined. Current and recent substance use was objectively assessed by toxicological urine and hair analysis.

RESULTS

Compared to controls, CU showed increased risk-seeking in unfavourable decision scenarios in which the loss probability was high and the returns were low, and a tendency for increased risk aversion in more favourable decision scenarios. In comparison to controls, CU were less sensitive to gain, but similarly sensitive to loss and probability of loss information. Further analysis revealed that individual differences in sensitivity to loss and probability of loss information were related to cognitive performance and impulsivity.

CONCLUSION

Reduced sensitivity to gains in people with CU may contribute to their propensity for making risky decisions. While these alterations in gain sensitivity might directly relate to cocaine use per se, the individual psychopathological profile of CU might moderate sensitivity to loss information.

Psychiatric symptoms and expression of glucocorticoid receptor gene in cocaine users: A longitudinal study

BACKGROUND

Chronic cocaine users (CU) display reduced peripheral expression of the glucocorticoid receptor gene (NR3C1), which is potentially involved in stress-related psychiatric symptoms frequently occurring in CU. However, it is unknown whether psychiatric symptoms and lower NR3C1 expression are related to each other and whether reduction of drug consumption reverse them.

METHOD

At baseline, NR3C1 mRNA expression was measured in 68 recreational CU, 30 dependent CU, and 68 stimulant-naïve controls. Additionally, the Revised Symptom Checklist (SCL-90R) and the Barratt Impulsiveness Scale (BIS) were assessed. At a one-year follow-up, the association between change in NR3C1 expression and psychiatric symptoms was examined in 48 stimulant-naïve controls, 19 CU who increased and 19 CU who decreased their consumption. At both test sessions, cocaine concentrations in hair samples were determined. Mixed-effects models were used to investigate how changes in drug use intensity affect severity of psychiatric symptoms and NR3C1 expression over time.

RESULTS

At baseline, recreational and dependent CU displayed elevated impulsivity and considerable symptom burden across most of the SCL-90R subscales. Time-group interaction effects were found for several impulsivity scores, SCL-90R Global Severity Index, Paranoid Thoughts, and Depression subscales as well as for NR3C1 expression. Pairwise comparisons showed that decreasing CU specifically improved in these SCL-90R subscales, while their NR3C1 expression was adapted. Finally, changes in NR3C1 expression were negatively correlated with changes in impulsivity but not SCL-90R scores.

CONCLUSION

Our findings suggest that NR3C1 expression changes and some psychiatric symptoms are reversible upon reduction of cocaine intake, thus favouring abstinence-oriented treatment approaches.

Substance related disorders are associated with impaired valuation of delayed gratification and feedback processing: A multilevel meta-analysis and meta-regression

Across numerous studies, individuals with substance use disorders (SUDs) differed from non-using controls regarding valuation of delayed gratification and feedback processing. However, it remains unclear whether the magnitude of the effect sizes is different across these two cognitive processes and how specific SUDs as well as demographic and clinical moderators influence these effects. In this study we thus performed multilevel linear mixed-effects meta-analyses and meta-regressions to examine the effects of SUDs on the Delay Discounting Task (DD) and on the Iowa Gambling Task (IGT). We found a moderate to large effect for SUD on both, the IGT and DD. While the effect on the DD was generalized to all substance classes, a smaller effect for cannabis-related disorder when compared to other SUDs was found with regard to the IGT. Early onset of substance use and psychiatric comorbidities were associated with stronger effects on the DD. Our findings suggest that feedback processing is more vulnerable to specific substance effects, while valuation of delayed gratification depends more on developmental and clinical factors.

Social motivational processing and interpersonal function in aging cocaine smokers

Illicit drug use among aging cohorts is increasing, yet little is known about functional impairments in older drug users. Given the importance of social integration for aging and documented social decrements in cocaine users, we examined social function and its neurocognitive substrates in aging cocaine users relative to carefully matched non-cocaine users. Regular (≥twice/week), long-term (≥15 years) cocaine smokers 50-60 years old (COCs; n = 22; four women) and controls (CTRLs; n = 19; four women) underwent standardized probes of social reward and threat processing during functional magnetic resonance imaging and a behavioral facial affect recognition task. Self-report and peer-report of daily interpersonal function were also collected. COCs, and CTRLs reporting current marijuana or alcohol use, were tested after four drug-free inpatient days. COCs had pronounced problems in daily social function relative to CTRLs indicated by both their own and their peers' reports. Compared with CTRLs, COCs had stronger amygdala responses to social threat versus control stimuli, with no other differences in social processing or cognition. Aging cocaine users appear to have marked, generalized difficulties in 'real-world' interpersonal function but largely intact social processing on laboratory-based measures when compared with appropriately matched controls and tested under well-controlled conditions. Daily social difficulties may be related to transient factors such as acute/residual drug effects or cocaine-related changes in health behaviors (e.g. disrupted sleep and poor diet). These data suggest that interpersonal function may be a valid intervention target for aging cocaine users and warrants further study in older drug users.

Using second-person neuroscience to elucidate the mechanisms of social interaction

Although a large proportion of our lives are spent participating in social interactions, the investigation of the neural mechanisms supporting these interactions has largely been restricted to situations of social observation - that is, situations in which an individual observes a social stimulus without opportunity for interaction. In recent years, efforts have been made to develop a truly social, or 'second-person', neuroscientific approach to these investigations in which neural processes are examined within the context of a real-time reciprocal social interaction. These developments have helped to elucidate the behavioural and neural mechanisms of social interactions; however, further theoretical and methodological innovations are still needed. Findings to date suggest that the neural mechanisms supporting social interaction differ from those involved in social observation and highlight a role of the so-called 'mentalizing network' as important in this distinction. Taking social interaction seriously may also be particularly important for the advancement of the neuroscientific study of different psychiatric conditions.

Cocaine use disorder in females is associated with altered social decision-making: a study with the prisoner's dilemma and the ultimatum game

BACKGROUND

Chronic cocaine use is associated with cognitive deficits, including poor performance on neuropsychological tasks of memory, executive functions, theory of mind and decision-making. However, the relationship between cocaine use disorder and social decision-making remains unclear. This is particularly relevant given the fact that many cocaine abusers present impairments in social functioning. In this sense, game theory paradigms have been helping to comprehend the behavior of psychiatric patients when they directly engage in social situations, which may better approximate many of their real-life choices.

METHODS

The present study investigated social decision-making in individuals with or without cocaine use disorder, examining their behavior in the Prisoner's Dilemma and in the Ultimatum Game. Thus, 129 females diagnosed with cocaine use disorder and 55 females with no history of substance abuse were recruited and performed both social decision-making tasks. Additional assessments included information about demographics, patterns of substance consumption and executive function performance.

RESULTS

Females with cocaine use disorder opted more often to not defect in the Prisoner's Dilemma, while in the Ultimatum Game they frequently chose to accept the first and unfair offer as responders. These effects were more pronounced within females with long-term history of cocaine use. Associations between cocaine use disorder and altered social decision-making were independent from demographic and executive function variables.

CONCLUSIONS

The influence of cocaine use disorder on social decision-making was detected in both game paradigms, resulting in more cooperative behavior in the Prisoner's Dilemma and higher acceptance rate of unfair offers in the Ultimatum Game. Further studies should focus on investigating these associations to shed light on the putative biopsychosocial factors underlying the observed effects.

Effects of methamphetamine on alloparental behavior in male and female prairie voles

Psychostimulant abuse is associated with a variety of impairments in social functioning, including an increased frequency of depression and aggression and deficits in social cognition. Psychostimulants reduce social investigation in rats and mice; however, it is less clear how other forms of social behavior (e.g., prosocial behavior) are affected. Females are also generally more sensitive to the effects of psychostimulants on locomotion and stereotyped behavior, which suggests that females might also display greater disruption of prosocial behavior. In order to test the hypothesis that psychostimulants reduce prosocial behavior and that females are more vulnerable, we treated adult male and female prairie voles with methamphetamine for three days (0, 0.2 or 2.0mg/kg, i.p.) and examined effects on locomotion and alloparental behavior. The lower methamphetamine dose increased activity in the open field in males and reduced locomotion in females. Methamphetamine-treated males took longer to enter the pup chamber, but both sexes displayed reduced pup contact following treatment with the lower methamphetamine dose. The methamphetamine-induced reduction in prosocial behavior was not associated with changes in pup-directed aggression in males or females. In order to investigate potential mechanisms underlying these changes in behavior, we measured adrenal weights as a proxy for activation of the hypothalamic-pituitary-adrenal (HPA) axis. The higher methamphetamine dose increased adrenal weights. Collectively, these data demonstrate that methamphetamine administration reduces alloparental behavior in both sexes and that females are more sensitive to some of the effects of this drug (e.g., locomotion/stereotyped behavior and possibly stimulation of the HPA axis).

A Patient-Tailored Evidence-Based Approach for Developing Early Neuropsychological Training Programs in Addiction Settings

Substance use disorders (SUDs) are associated with impairments of cognitive functions, and cognitive training programs are thus rapidly developing in SUD treatment. However, neuropsychological impairments observed early after withdrawal (i.e., early impairments), that is, approximately in the first six months, may be widespread. Consequently, it might not be possible to train all the identified early impairments. In these situations, we propose that the priority of cognitive training should be given to the early impairments found to be associated with early dropout or relapse (i.e., relapse-related impairments). However, substance-specific relapse-related impairments have not been singled out among all early impairments so far. Using a systematic literature search, we identified the types of established early impairments for all SUDs, and we assessed the extent to which these early impairments were found to be associated with relapse-related impairments. All cognitive functions were investigated according to a classification based on current neuropsychological models, distinguishing classical cognitive, substance-bias, and social cognition systems. According to the current evidence, demonstrated relapse-related impairments in alcohol use disorder comprised impulsivity, long-term memory, and higher-order executive functions. For cannabis use disorder, the identified relapse-related impairments were impulsivity and working memory. For stimulant use disorder, the identified relapse-related impairments were attentional abilities and higher-order executive functions. For opioid use disorder, the only identified relapse-related impairments were higher executive functions. However, many early impairments were not explored with respect to dropout/relapse, particularly for stimulant and opioid use disorders. The current literature reveals substance-specific relapse-related impairments, which supports a pragmatic patient-tailored approach for defining which early impairments should be prioritized in terms of training among patients with SUDs.

Modulation of Social Cognition via Hallucinogens and "Entactogens"

Social cognition is a fundamental ability in human everyday lives. Deficits in social functioning also represent a core aspect of many psychiatric disorders. Yet, despite its significance, deficits in social cognition skills are insufficiently targeted by current treatments. Hallucinogens and entactogens have been shown to have the potential to modulate social processing. This article reviews the literature on the influence of hallucinogens and entactogens on social processing in controlled experimental studies in humans and elucidates the underlying neurobiological and neuropharmacological mechanisms. Furthermore, it identifies current knowledge gaps and derives implications for hallucinogen-assisted treatment approaches as well as the development of novel medication for trans-diagnostic impairments in social cognition.

Improvement of Emotional Empathy and Cluster B Personality Disorder Symptoms Associated With Decreased Cocaine Use Severity

Aims: Chronic cocaine users display impaired social cognitive abilities, reduced prosocial behavior, and pronounced cluster B personality disorder (PD) symptoms all contributing to their social dysfunctions in daily life. These social dysfunctions have been proposed as a major factor for maintenance and relapse of stimulant use disorders in general. However, little is known about the reversibility of social cognitive deficits and socially problematic personality facets when stimulant use is reduced or ceased. Therefore, we examined the relation between changing intensity of cocaine use and the development of sociocognitive functioning and cluster B PD symptomatology over the course of 1 year. Methods: Social cognition, social decision-making, and cluster B PD symptoms were assessed in 38 cocaine users (19 with increased and 19 with decreased use) and 48 stimulant-naive healthy controls at baseline and at 1-year follow-up. Cocaine use severity was objectively determined by quantitative 6-month hair analyses. The categorization of the two cocaine user groups was based on a combination of absolute (± 0.5 ng/mg) and relative (± 10%) changes in the cocaine hair concentration between baseline and the 1-year follow-up. Social cognition was assessed using the Multifaceted Empathy Test (MET) and the Movie for the Assessment of Social Cognition (MASC). A combined Distribution/Dictator Game was applied for assessing social decision-making. Cluster B PD symptoms were measured by a Structured Clinical Interview for DSM-IV Axis II Disorders (SCID-II) PD questionnaire according to Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV). Results: Increased cocaine use was linked to worsened empathy, while decreased cocaine use went along with improved emotional empathy. Moreover, whereas decreased cocaine use was associated with reduced severity of self-reported cluster B PD symptoms, these symptoms remained largely stable in increasers. In contrast to a significant reduction of prosocial behavior at baseline in the combined cocaine user group, specifically decreasers were not statistically distinguishable from controls at the follow-up. Conclusions: Sociocognitive deficits and cluster B PD symptoms of chronic cocaine users are adaptable over time as they covary with the increase or decrease in cocaine use. Hence, abstinence orientation and training of social cognition and interaction might improve social functioning, and should therefore be important therapeutic elements in cocaine addiction treatment.

Markers for Severity of Problems in Interpersonal Relationships of Crack Cocaine Users from a Brazilian Multicenter Study

Crack cocaine users frequently report difficulties regarding having healthy and rewarding relationships. Factors other than the use of crack cocaine itself may be at play when it comes to being able to develop healthier connections with partners, adult relatives and close friends. To verify which factors, including demographics, substance abuse related factors and psychiatric comorbidities could be markers for a higher severity of problems in interpersonal relationships of crack cocaine users seeking for treatment. This was a cross-sectional study, conducted between April 2011 and November 2012. Participants were 407 crack cocaine users seeking treatment in specialized public facilities of six Brazilian capitals. The relationship of severity of problems in the family/social area and the prevalence of psychiatric disorders, exposure to stressful events, substance use related factors and practice of illicit activities were explored through multivariate analyses. Number of days using crack cocaine in the last 30 days, age of first time using alcohol and feeling its effects, a diagnosis of alcohol abuse, posttraumatic stress disorder, antisocial personality disorder and attention-deficit/hyperactivity disorder were significantly associated with a higher severity of problems in interpersonal relationships with partners, adult relatives and friends. Problems in interpersonal relationships are strongly related to specific psychiatric comorbidities and the frequency of crack cocaine use. Factors identified by this study can make the paths to recovery more challenging. These results support psychosocial interventions that focus in the improvement of interpersonal relationships of crack cocaine users.

Self-regulation of the dopaminergic reward circuit in cocaine users with mental imagery and neurofeedback

BACKGROUND

Enhanced drug-related reward sensitivity accompanied by impaired sensitivity to non-drug related rewards in the mesolimbic dopamine system are thought to underlie the broad motivational deficits and dysfunctional decision-making frequently observed in cocaine use disorder (CUD). Effective approaches to modify this imbalance and reinstate non-drug reward responsiveness are urgently needed. Here, we examined whether cocaine users (CU) can use mental imagery of non-drug rewards to self-regulate the ventral tegmental area and substantia nigra (VTA/SN). We expected that obsessive and compulsive thoughts about cocaine consumption would hamper the ability to self-regulate the VTA/SN activity and tested if real-time fMRI (rtfMRI) neurofeedback (NFB) can improve self-regulation of the VTA/SN.

METHODS

Twenty-two CU and 28 healthy controls (HC) were asked to voluntarily up-regulate VTA/SN activity with non-drug reward imagery alone, or combined with rtfMRI NFB.

RESULTS

On a group level, HC and CU were able to activate the dopaminergic midbrain and other reward regions with reward imagery. In CU, the individual ability to self-regulate the VTA/SN was reduced in those with more severe obsessive-compulsive drug use. NFB enhanced the effect of reward imagery but did not result in transfer effects at the end of the session.

CONCLUSION

CU can voluntary activate their reward system with non-drug reward imagery and improve this ability with rtfMRI NFB. Combining mental imagery and rtFMRI NFB has great potential for modifying the maladapted reward sensitivity and reinstating non-drug reward responsiveness. This motivates further work to examine the use of rtfMRI NFB in the treatment of CUD.

Frontostriatal pathways gate processing of behaviorally relevant reward dimensions

The value of rewards arises from multiple hedonic and motivational dimensions. Reward-encoding brain regions such as the ventral striatum (VS) are known to process these dimensions. However, the mechanism whereby distinct reward dimensions are selected for neural processing and guiding behavior remains unclear. Here, we used functional imaging to investigate how human individuals make either hedonic (liking) or motivational (wanting) evaluations of everyday items. We found that the two types of evaluations were differently modulated depending on whether participants won or lost these items. Neural activity in the VS encoded both hedonic and motivational dimensions of reward, whereas ventromedial prefrontal activity encoded primarily motivational evaluations and central orbitofrontal activity encoded predominantly hedonic evaluations. These distinct prefrontal representations arose regardless of which judgment was currently relevant for behavior. Critically, the VS preferentially processed the reward dimension currently being evaluated and showed judgment-specific functional connectivity with the dimension-specific prefrontal areas. Thus, our data are in line with a gating mechanism by which prefrontal cortex (PFC)-VS pathways flexibly encode reward dimensions depending on their behavioral relevance. These findings provide a prototype for a generalized information selection mechanism through content-tailored frontostriatal communication.

Neuroimaging Studies Reveal the Subtle Difference Among Social Network Size Measurements and Shed Light on New Directions

Social network size is a key feature when we explore the constructions of human social networks. Despite the disparate understanding of individuals’ social networks, researchers have reached a consensus that human’s social networks are hierarchically organized with different layers, which represent emotional bonds and interaction frequency. Social brain hypothesis emphasizes the significance of complex and demanding social interaction environments and assumes that the cognitive constraints may have an impact on the social network size. This paper reviews neuroimaging studies on social networks that explored the connection between individuals’ social network size and neural mechanisms and finds that Social Network Index (SNI) and Social Network Questionnaires (SNQs) are the mostly-adopted measurements of one’s social network size. The two assessments have subtle difference in essence as they measure the different sublayers of one’s social network. The former measures the relatively outer sub-layer of one’s stable social relationship, similar to the sympathy group, while the latter assesses the innermost layer—the core of one’s social network, often referred to as support clique. This subtle difference is also corroborated by neuroimaging studies, as SNI-measured social network size is largely correlated with the amygdala, while SNQ-assessed social network size is closely related to both the amygdala and the orbitofrontal cortex. The two brain regions respond to disparate degrees of social closeness, respectively. Finally, it proposes a careful choice among the measurements for specific purposes and some new approaches to assess individuals’ social network size.

Agent-specific learning signals for self-other distinction during mentalising

Humans have a remarkable ability to simulate the minds of others. How the brain distinguishes between mental states attributed to self and mental states attributed to someone else is unknown. Here, we investigated how fundamental neural learning signals are selectively attributed to different agents. Specifically, we asked whether learning signals are encoded in agent-specific neural patterns or whether a self–other distinction depends on encoding agent identity separately from this learning signal. To examine this, we tasked subjects to learn continuously 2 models of the same environment, such that one was selectively attributed to self and the other was selectively attributed to another agent. Combining computational modelling with magnetoencephalography (MEG) enabled us to track neural representations of prediction errors (PEs) and beliefs attributed to self, and of simulated PEs and beliefs attributed to another agent. We found that the representational pattern of a PE reliably predicts the identity of the agent to whom the signal is attributed, consistent with a neural self–other distinction implemented via agent-specific learning signals. Strikingly, subjects exhibiting a weaker neural self–other distinction also had a reduced behavioural capacity for self–other distinction and displayed more marked subclinical psychopathological traits. The neural self–other distinction was also modulated by social context, evidenced in a significantly reduced decoding of agent identity in a nonsocial control task. Thus, we show that self–other distinction is realised through an encoding of agent identity intrinsic to fundamental learning signals. The observation that the fidelity of this encoding predicts psychopathological traits is of interest as a potential neurocomputational psychiatric biomarker.

In order for people to have meaningful social interactions, they need to infer each other’s beliefs. Converging evidence from humans and nonhuman primates suggests that a person’s brain can represent a second person’s beliefs by simulating that second person’s brain activity. However, it is not known how the outputs of those simulations are identified as ‘yours and not mine’. This ability to distinguish self from other is required for social cognition, and it may be impaired in mental health disorders with social cognitive deficits. We investigated self–other distinction in healthy adults learning about an environment both from their own point of view and the point of view of another person. We used computationally identified learning variables and then detected how these variables are represented by measuring magnetic fields in the brain. We found that the human brain can distinguish self from other by expressing these signals in dissociable activity patterns. Subjects who showed the largest difference between self signals and other signals were better at distinguishing self from other in the task and also showed fewer traits of mental health disorders.

The long-term effects of cocaine use on cognitive functioning: A systematic critical review

BACKGROUND

The predominant view of chronic cocaine use maintains that it causes a broad range of cognitive deficits. However, concerns about the possibly deleterious impact of cocaine on cognitive functioning have yet to be thoroughly vetted. This review addresses the impact of cocaine use on such cognitive domains as executive function, memory, language, and psychomotor speed. Additionally, relevant neuroimaging data is considered to understand the neural basis underlying cocaine-related effects on cognitive functioning.

METHODS

We searched PubMed, Google Scholar, and Embase using the search terms "cocaine and cognition," "cocaine and cognitive functioning," and "cocaine and cognitive deficits or impairment." To meet inclusion criteria we evaluated only cognitive and neuroimaging studies describing the long-term effects of cocaine on cognitive functioning published from 1999 to 2016.

RESULTS

The majority of studies reported statistically significant differences between cocaine users and non-drug-using controls in brain structures, blood-oxygen-level dependent signals, and brain metabolism. However, differences in cognitive performance were observed on a minority of measures. Additionally, the majority of studies were not compared against normative data.

CONCLUSIONS

The current evidence does not support the view that chronic cocaine use is associated with broad cognitive deficits. The view that cocaine users have broad cognitive deficits is inaccurate based upon current evidence, and the perpetuation of this view may have negative implications for treatment programs and development of public policies.

Role of the 5-HT2A Receptor in Self- and Other-Initiated Social Interaction in Lysergic Acid Diethylamide-Induced States: A Pharmacological fMRI Study

Distortions of self-experience are critical symptoms of psychiatric disorders and have detrimental effects on social interactions. In light of the immense need for improved and targeted interventions for social impairments, it is important to better understand the neurochemical substrates of social interaction abilities. We therefore investigated the pharmacological and neural correlates of self- and other-initiated social interaction. In a double-blind, randomized, counterbalanced, crossover study 24 healthy human participants (18 males and 6 females) received either (1) placebo + placebo, (2) placebo + lysergic acid diethylamide (LSD; 100 μg, p.o.), or (3) ketanserin (40 mg, p.o.) + LSD (100 μg, p.o.) on three different occasions. Participants took part in an interactive task using eye-tracking and functional magnetic resonance imaging completing trials of self- and other-initiated joint and non-joint attention. Results demonstrate first, that LSD reduced activity in brain areas important for self-processing, but also social cognition; second, that change in brain activity was linked to subjective experience; and third, that LSD decreased the efficiency of establishing joint attention. Furthermore, LSD-induced effects were blocked by the serotonin 2A receptor (5-HT_2AR) antagonist ketanserin, indicating that effects of LSD are attributable to 5-HT_2AR stimulation. The current results demonstrate that activity in areas of the "social brain" can be modulated via the 5-HT_2AR thereby pointing toward this system as a potential target for the treatment of social impairments associated with psychiatric disorders.SIGNIFICANCE STATEMENT Distortions of self-representation and, potentially related to this, dysfunctional social cognition are central hallmarks of various psychiatric disorders and critically impact disease development, progression, treatment, as well as real-world functioning. However, these deficits are insufficiently targeted by current treatment approaches. The administration of lysergic acid diethylamide (LSD) in combination with functional magnetic resonance imaging and real-time eye-tracking offers the unique opportunity to study alterations in self-experience, their relation to social cognition, and the underlying neuropharmacology. Results demonstrate that LSD alters self-experience as well as basic social cognition processing in areas of the "social brain". Furthermore, these alterations are attributable to 5-HT_2A receptor stimulation, thereby pinpointing toward this receptor system in the development of pharmacotherapies for sociocognitive deficits in psychiatric disorders.

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

BACKGROUND AND PURPOSE

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

EXPERIMENTAL APPROACH

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

KEY RESULTS

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

CONCLUSIONS AND IMPLICATIONS

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