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Regier PS, Hager NM, Gawrysiak M, Ehmann S, Ayaz H, Childress AR, Fan Y. Differential large-scale network functional connectivity in cocaine-use disorder associates with drug-use outcomes. Sci Rep 2025; 15:9636. [PMID: 40113802 PMCID: PMC11926260 DOI: 10.1038/s41598-025-91465-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2024] [Accepted: 02/20/2025] [Indexed: 03/22/2025] Open
Abstract
Cocaine-use disorder (CUD) affects both structure and function of the brain. A triple network model of large-scale brain networks has been useful for identifying aberrant resting-state functional connectivity (rsFC) associated with mental health disorders including addiction. The present study investigated differences between people with CUD vs. controls (CONs) and whether putative differences were associated with drug-use outcomes. Participants with CUD (n = 38) and CONs (n = 34) completed a resting functional magnetic resonance imaging (fMRI) scan. Participants with CUD completed several mental health measures and participated in an 8-week, drug-use outcomes phase. A classification framework based on the triple network model was built, and triple networks (salience [SN], executive control [ECN], default mode [DMN]) and subcortical (striatum [ST], hippocampus/amygdala) regions were identified with the algorithm of group-information-guided independent components analysis (GIG-ICA) and subsequent support-vector machines. This classifier achieved 77.1% accuracy, 73.8% sensitivity, and 80.0% specificity, with an area under the curve of 0.87 for distinguishing CUD vs. CON. The two groups differed in SN-anterior DMN (aDMN) and ECN-aDMN rsFC, with the CUD group exhibiting stronger rsFC compared to CONs. They also differed in rsFC between several subcortical and triple networks, with CUD generally showing a lack of rsFC. Within the CUD group, ST-aDMN and ST-rECN rsFC were associated with differential drug-use outcomes. Exploratory results suggested SN-aDMN rsFC was associated with anxiety symptoms. These results add to the growing literature showing aberrant triple network and subcortical rsFC associated with substance use disorders. They suggest the aDMN specifically may underlie important differences between people with CUD and CONs and may be a potential target for intervention.
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Affiliation(s)
- Paul S Regier
- Perelman School of Medicine, Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, 19104, USA.
| | - Nathan M Hager
- Perelman School of Medicine, Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Michael Gawrysiak
- Perelman School of Medicine, Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, 19104, USA
- Department of Psychology, West Chester University of Pennsylvania, West Chester, PA, 19383, USA
| | - Sebastian Ehmann
- Department of Psychology, West Chester University of Pennsylvania, West Chester, PA, 19383, USA
- Department of Psychology, University of Arizona, Tuscon, AZ, 85721, USA
| | - Hasan Ayaz
- School of Biomedical Engineering, Science and Health Systems, Drexel University, Philadelphia, PA, 19104, USA
- Department of Psychological and Brain Sciences, Drexel University, Philadelphia, PA, 19104, USA
- Center for Injury Research and Prevention, Children's Hospital of Philadelphia, Philadelphia, PA, 19104, USA
- A.J. Drexel Autism Institute, Drexel University, Philadelphia, PA, 19104, USA
- Drexel Solutions Institute, Drexel University, Philadelphia, PA, 19104, USA
| | - Anna Rose Childress
- Perelman School of Medicine, Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Yong Fan
- Perelman School of Medicine, Department of Radiology, University of Pennsylvania, Philadelphia, PA, 19104, USA
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Letkiewicz AM, Suor JH, Glazer JE, Li LY, Bernat EM, Burkhouse KL, Shankman SA. Severe sexual abuse in childhood and altered neurophysiological response to reward in female adults. CHILD ABUSE & NEGLECT 2024; 154:106945. [PMID: 39013306 PMCID: PMC11316651 DOI: 10.1016/j.chiabu.2024.106945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2024] [Revised: 06/28/2024] [Accepted: 07/10/2024] [Indexed: 07/18/2024]
Abstract
BACKGROUND A relatively understudied but growing body of research indicates that individuals with a history of childhood trauma exhibit altered reward processing in adulthood. Research to date has focused on adversity broadly, with studies typically finding evidence of blunted response to rewards in adults with a history of childhood trauma. OBJECTIVE Given the role of reward processing in risk for psychopathology and the particularly pathogenic nature of sexual abuse (SA), the present study sought to assess whether adults with a history of severe childhood SA exhibit altered neurophysiological response to rewards. PARTICIPANTS AND SETTING Female adults (N = 105) were included from two study sites that used the same measures of childhood trauma (Childhood Trauma Questionnaire, CTQ), reward processing (Doors Task), and psychopathology (SCID). METHODS Based on participants' CTQ and SCID responses, three groups were created: Severe SA (n = 36), Clinical Match (with comparable lifetime psychopathology but no-to-minimal SA history; n = 35), and Healthy Controls (n = 34). Group differences in RewP amplitude were assessed. RESULTS The Severe SA group exhibited larger reward positivity (RewP) amplitude to monetary rewards than the Clinical Match and Healthy Control groups (partial ƞ2 = 0.06, p = .047). This effect remained after covarying for severity of other forms of childhood trauma. CONCLUSIONS Our study found that severe SA in childhood was related to a heightened response to reward in adulthood. Furthermore, this was not attributable to the severity of other forms of early trauma or comorbid psychopathology. Future studies are needed to identify how heightened reward processing following severe childhood SA may be implicated in the onset and course of psychopathology.
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Affiliation(s)
- Allison M Letkiewicz
- Department of Psychiatry and Behavioral Sciences, Northwestern University, Chicago, IL, USA.
| | - Jennifer H Suor
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA
| | - James E Glazer
- Department of Psychiatry and Behavioral Sciences, Northwestern University, Chicago, IL, USA
| | - Lilian Y Li
- Department of Psychiatry and Behavioral Sciences, Northwestern University, Chicago, IL, USA
| | - Edward M Bernat
- Department of Psychology, University of Maryland, College Park, MD, USA
| | - Katie L Burkhouse
- The Research Institute, Nationwide Children's Hospital, Columbus, OH, USA; Department of Psychiatry and Behavioral Health, The Ohio State University, Columbus, OH, USA
| | - Stewart A Shankman
- Department of Psychiatry and Behavioral Sciences, Northwestern University, Chicago, IL, USA; Department of Psychology, Northwestern University, Chicago, IL, USA
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Scala SG, Kang MS, Cox SML, Rosa‐Neto P, Massarweh G, Leyton M. Mesocorticolimbic function in cocaine polydrug users: A multimodal study of drug cue reactivity and cognitive regulation. Addict Biol 2024; 29:e13358. [PMID: 38221806 PMCID: PMC10898841 DOI: 10.1111/adb.13358] [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: 01/05/2023] [Revised: 11/06/2023] [Accepted: 11/11/2023] [Indexed: 01/16/2024]
Abstract
Addictions are thought to be fostered by the emergence of poorly regulated mesocorticolimbic responses to drug-related cues. The development and persistence of these responses might be promoted by altered glutamate transmission, including changes to type 5 metabotropic glutamate receptors (mGluR5s). Unknown, however, is when these changes arise and whether the mGluR5 and mesocorticolimbic alterations are related. To investigate, non-dependent cocaine polydrug users and cocaine-naïve healthy controls underwent a positron emission tomography scan (15 cocaine users and 14 healthy controls) with [11 C]ABP688, and a functional magnetic resonance imaging scan (15/group) while watching videos depicting activities with and without cocaine use. For some drug videos, participants were instructed to use a cognitive strategy to lower craving. Both groups exhibited drug cue-induced mesocorticolimbic activations and these were larger in the cocaine polydrug users than healthy controls during the session's second half. During the cognitive regulation trials, the cocaine users' corticostriatal responses were reduced. [11 C]ABP688 binding was unaltered in cocaine users, relative to healthy controls, but post hoc analyses found reductions in those with 75 or more lifetime cocaine use sessions. Finally, among cocaine users (n = 12), individual differences in prefrontal [11 C]ABP688 binding were associated with midbrain and limbic region activations during the regulation trials. Together, these preliminary findings raise the possibility that (i) recreational polydrug cocaine users show biased brain processes towards cocaine-related cues and (ii) repeated cocaine use can lower cortical mGluR5 levels, diminishing the ability to regulate drug cue responses. These alterations might promote susceptibility to addiction and identify early intervention targets.
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Affiliation(s)
| | - Min Su Kang
- Integrated Program in NeuroscienceMcGill UniversityMontrealQuebecCanada
- Sunnybrook Research InstituteUniversity of TorontoTorontoOntarioCanada
| | | | - Pedro Rosa‐Neto
- Integrated Program in NeuroscienceMcGill UniversityMontrealQuebecCanada
- Department of PsychiatryMcGill UniversityMontrealQuebecCanada
- Department of Neurology & Neurosurgery, Montreal Neurological InstituteMcGill UniversityMontrealQuebecCanada
| | - Gassan Massarweh
- McConnell Brain Imaging CentreMontreal Neurological InstituteMontrealQuebecCanada
| | - Marco Leyton
- Integrated Program in NeuroscienceMcGill UniversityMontrealQuebecCanada
- Department of PsychiatryMcGill UniversityMontrealQuebecCanada
- Department of Neurology & Neurosurgery, Montreal Neurological InstituteMcGill UniversityMontrealQuebecCanada
- McConnell Brain Imaging CentreMontreal Neurological InstituteMontrealQuebecCanada
- Department of PsychologyMcGill UniversityMontrealQuebecCanada
- Center for Studies in Behavioral NeurobiologyConcordia UniversityMontrealQuebecCanada
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Regier PS, Gawrysiak MJ, Jagannathan K, Childress AR, Franklin TR, Wetherill RR. Trauma exposure among cannabis use disorder individuals was associated with a craving-correlated non-habituating amygdala response to aversive cues. DRUG AND ALCOHOL DEPENDENCE REPORTS 2022; 5:100098. [PMID: 36844163 PMCID: PMC9948813 DOI: 10.1016/j.dadr.2022.100098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 09/09/2022] [Accepted: 09/19/2022] [Indexed: 10/14/2022]
Abstract
The relationship of cannabis-use disorder and trauma exposure at the level of the brain is not well-understood. Cue-reactivity paradigms have largely focused on characterizing aberrant subcortical function by averaging across the entire task. However, changes across the task, including a non-habituating amygdala response (NHAR), may be a useful biomarker for relapse vulnerability and other pathology. This secondary analysis utilized existing fMRI data from a CUD population with (TR-Y, n = 18) or without trauma (TR-N, n = 15). Amygdala reactivity to novel and repeated aversive cues was examined between TR-Y vs. TR-N groups, using a repeated measures ANOVA. Analysis revealed a significant interaction between TR-Y vs. TR-N and amygdala response to novel vs. repeated cues in the amygdala (right: F (1,31) = 5.31, p = 0.028; left: F (1,31) = 7.42, p = 0.011). In the TR-Y group, a NHAR was evident, while the TR-N group exhibited amygdala habituation, resulting in a significant difference between groups of amygdala reactivity to repeated cues (right: p = 0.002; left: p < 0.001). The NHAR in the TR-Y (but not TR-N) group was significantly correlated with higher cannabis craving scores, yielding a significant group difference (z = 2.1, p = 0.018). Results suggest trauma interacts with the brain's sensitivity to aversive cues, offering a neural explanation for the relationship between trauma and CUD vulnerability. These findings suggest the importance of considering the temporal dynamics of cue reactivity and trauma history in future studies and treatment planning, as this distinction may help decrease relapse vulnerability.
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Affiliation(s)
- Paul S. Regier
- University of Pennsylvania, Perelman School of Medicine, 3535 Market Street, Philadelphia, PA, 19104, United States,Corresponding author.
| | - Michael J. Gawrysiak
- University of Pennsylvania, Perelman School of Medicine, 3535 Market Street, Philadelphia, PA, 19104, United States,West Chester University of Pennsylvania, 125 West Rosedale Avenue, 19383, United States
| | - Kanchana Jagannathan
- University of Pennsylvania, Perelman School of Medicine, 3535 Market Street, Philadelphia, PA, 19104, United States
| | - Anna Rose Childress
- University of Pennsylvania, Perelman School of Medicine, 3535 Market Street, Philadelphia, PA, 19104, United States
| | - Teresa R. Franklin
- University of Pennsylvania, Perelman School of Medicine, 3535 Market Street, Philadelphia, PA, 19104, United States
| | - Reagan R. Wetherill
- University of Pennsylvania, Perelman School of Medicine, 3535 Market Street, Philadelphia, PA, 19104, United States
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Regier PS, Sinko L, Jagannathan K, Aryal S, Teitelman AM, Childress AR. In young women, a link between childhood abuse and subliminal processing of aversive cues is moderated by impulsivity. BMC Psychiatry 2022; 22:159. [PMID: 35236322 PMCID: PMC8889687 DOI: 10.1186/s12888-022-03770-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Accepted: 01/31/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Childhood maltreatment is a serious public health concern. The association between child maltreatment, adverse behaviors, mental health outcomes, and alterations to brain function and structure have begun to be characterized. Less is known about the specific associations of maltreatment subtypes with cue-response to evocative cues and the moderating effects of confounding mental health/behavioral variables. METHODS Fifty-four emerging adult women (aged 18-24) completed assessments for behaviors, mental health, and childhood maltreatment. They participated in a fMRI task featuring passive viewing of evocative (33 ms) cues presented by "backward masking" to prevent conscious processing. Correlations of abuse/neglect scores, behavioral/mental health factors, and brain function were assessed. Follow-up analyses investigated the moderating effects of behavioral/mental health factors on maltreatment and brain relationships. RESULTS Greater frequency of childhood abuse and neglect were correlated with higher scores of impulsivity, depressive symptoms, and anxious attachment. Childhood abuse was positively associated with increased medial orbitofrontal cortical (mOFC) response to aversive (vs. neutral) cues. Among the behavioral/mental health variables, only impulsivity appeared to have a moderating effect on the relationship between childhood abuse and brain response to aversive cues. CONCLUSIONS The link between childhood abuse and a heightened mOFC response to "unseen" aversive stimuli, moderated by impulsivity, adds to the growing literature on the impact of prior adversity on brain function. These findings offer further understanding for the way in which childhood maltreatment affects the brain processing of negative stimuli, helping to explain the well-documented link between childhood maltreatment and a variety of adverse outcomes in adulthood.
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Affiliation(s)
- P. S. Regier
- grid.25879.310000 0004 1936 8972Perelman School of Medicine, Department of Psychiatry, University of Pennsylvania, Philadelphia, PA USA
| | - L. Sinko
- grid.25879.310000 0004 1936 8972School of Nursing, University of Pennsylvania, Philadelphia, PA USA ,grid.264727.20000 0001 2248 3398College of Public Health, Temple University, Philadelphia, USA
| | - K. Jagannathan
- grid.25879.310000 0004 1936 8972Perelman School of Medicine, Department of Psychiatry, University of Pennsylvania, Philadelphia, PA USA
| | - S. Aryal
- grid.25879.310000 0004 1936 8972School of Nursing, University of Pennsylvania, Philadelphia, PA USA
| | - A. M. Teitelman
- grid.25879.310000 0004 1936 8972School of Nursing, University of Pennsylvania, Philadelphia, PA USA
| | - A. R. Childress
- grid.25879.310000 0004 1936 8972Perelman School of Medicine, Department of Psychiatry, University of Pennsylvania, Philadelphia, PA USA
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Thomson ND, Bozgunov K, Psederska E, Aboutanos M, Vasilev G, Vassileva J. Physical Abuse Explains Sex Differences in the Link Between Psychopathy and Aggression. JOURNAL OF INTERPERSONAL VIOLENCE 2021; 36:9208-9231. [PMID: 31364486 PMCID: PMC8846549 DOI: 10.1177/0886260519865956] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
Psychopathy has long been associated with aggression. However, few studies have looked at differences between men and women. Studies that do exist demonstrate that psychopathy differentially relates to aggression in men and women and indicate that environmental factors may play a significant role in influencing these associations. A key environmental factor is a history of lifetime physical abuse (LPA), which has been linked to aggressive behavior in both men and women. The aim of the present study was to test if psychopathy differentially predicted physical, verbal, and indirect aggression in men and women, and if these associations were moderated by LPA. In a large community sample of men (n = 369) and women (n = 204), we assessed the 4-facet model of psychopathy (Interpersonal, Affective, Lifestyle, Antisocial) with the Psychopathy Checklist: Screening Version, LPA with the Addiction Severity Index, and self-report aggression with the Aggression Questionnaire. Results revealed sex differences and similarities. Physical aggression was associated with the affective facet of psychopathy in both men and women, though in different directions based on the moderating effects of LPA. Verbal aggression was associated with higher antisocial facet scores and LPA for men and not women. Finally, indirect aggression was associated with the antisocial facet of psychopathy for men, and the interpersonal facet for women, and these associations were not moderated by LPA. In women, low antisocial facet scores and no LPA were found to be protective for indirect aggression. These results show that LPA and psychopathy generally increase the risk of aggression, but the interaction between LPA and psychopathy differentiates the risk of aggression forms for men and women. These sex differences highlight the need for female-responsive interventions to target sex-specific risk factors for aggressive behavior.
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Affiliation(s)
| | | | - Elena Psederska
- Bulgarian Addictions Institute, Sofia, Bulgaria
- Department of Cognitive Science and Psychology, New Bulgarian University, Sofia, Bulgaria
| | - Michel Aboutanos
- Division of Acute Care Surgical Services, Department of Surgery, Virginia Commonwealth University Health
| | | | - Jasmin Vassileva
- Departments of Psychiatry and Psychology, Institute for Drug and Alcohol Studies, Virginia Commonwealth University
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Webber HE, Kessler DA, Lathan EC, Wardle MC, Green CE, Schmitz JM, Lane SD, Vujanovic AA. Posttraumatic stress symptom clusters differentially predict late positive potential to cocaine imagery cues in trauma-exposed adults with cocaine use disorder. Drug Alcohol Depend 2021; 227:108929. [PMID: 34340161 PMCID: PMC8464512 DOI: 10.1016/j.drugalcdep.2021.108929] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 06/17/2021] [Accepted: 06/22/2021] [Indexed: 12/21/2022]
Abstract
BACKGROUND While studies have investigated the effects of posttraumatic stress disorder (PTSD) symptoms on substance use, information on these associations in the context of drug cue reactivity is lacking, which can provide meaningful information about risk for relapse. The current study assessed the associations between PTSD symptom clusters and reactivity to cues in trauma-exposed adults with cocaine use disorder. METHODS We recorded electroencephalogram on 52 trauma-exposed participants (Mage = 51.3; SD = 7.0; 15.4 % women) diagnosed with cocaine use disorder while they viewed pleasant (i.e., erotic, romantic, sweet foods), unpleasant (i.e., mutilations, violence, accidents), neutral, and cocaine-related images. Reactivity was measured with the late positive potential (LPP), an indicator of motivational relevance. It was hypothesized that individuals with greater PTSD avoidance and negative alterations in cognition and mood (NACM) symptoms, as determined by the PTSD Checklist for DSM-5 (PCL-5), would have higher LPPs to cocaine-related images, indicating greater cue reactivity. RESULTS Linear mixed modeling indicated that higher NACM symptomatology was associated with higher LPPs to cocaine cues and higher arousal/reactivity was associated with lower LPPs to cocaine cues. CONCLUSIONS These results highlight the potential clinical utility of the LPP in assessing drug cue reactivity in trauma-exposed adults with substance use disorder.
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Affiliation(s)
- Heather E. Webber
- Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX
| | | | - Emma C. Lathan
- Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX
| | - Margaret C. Wardle
- Department of Psychology, University of Illinois at Chicago, Chicago, IL
| | - Charles E. Green
- Department of Pediatrics, McGovern Medical School, University of Texas Health Science, Center at Houston, Houston, TX
| | - Joy M. Schmitz
- Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX
| | - Scott D. Lane
- Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX
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Matto HC, Seshaiyer P, Carmack S, Peixoto N, Scherbel M. When Triggers Become Tigers: Taming the Autonomic Nervous System via Sensory Support System Modulation. JOURNAL OF SOCIAL WORK PRACTICE IN THE ADDICTIONS 2021; 21:382-395. [PMID: 34621139 PMCID: PMC8491990 DOI: 10.1080/1533256x.2021.1973833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 07/27/2020] [Accepted: 09/06/2020] [Indexed: 06/13/2023]
Abstract
Personalized recovery technologies may enable individuals with Substance Use Disorder (SUD) to monitor and manage acute craving and drug use urges in ways that improve drug-seeking decisions in real-time. Direct and indirect regulation of the autonomic nervous system through sensory input monitoring and modulation may enhance control over behavioral decisions and prevent relapse. A personalized sensory support system that monitors neurophysiological reactivity and offers non-pharmacological point-in-time personalized digital interventions may increase awareness of and control over craving reactivity. It is critical to be able to detect these warning signs and intervene early and effectively. The use of wearable technologies that assess point-in-time neurophysiological escalation and shape behavioral response through personalized interventions could be transformative in allowing individuals to better manage their recovery as they transition out of institutions and move back into community settings.
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Affiliation(s)
- Holly C Matto
- Department of Social Work ∣ Center for Adaptive Systems of Brain-Body Interactions, George Mason University, Fairfax, VA, USA
| | - Padmanabhan Seshaiyer
- Department of Mathematical Sciences ∣ ∣ Center for Adaptive Systems of Brain-Body Interactions, George Mason University, Fairfax, VA, USA
| | - Stephanie Carmack
- Research Operations, Center for Adaptive Systems of Brain-Body Interactions, George Mason University, Fairfax, VA, USA
| | - Nathalia Peixoto
- Electrical and Computer Engineering ∣ Center for Adaptive Systems of Brain-Body Interactions, George Mason University, Fairfax, VA, USA
| | - Matthew Scherbel
- Department of Social Work, George Mason University, Fairfax, VA, USA
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Zeng J, Yu S, Cao H, Su Y, Dong Z, Yang X. Neurobiological correlates of cue-reactivity in alcohol-use disorders: A voxel-wise meta-analysis of fMRI studies. Neurosci Biobehav Rev 2021; 128:294-310. [PMID: 34171325 DOI: 10.1016/j.neubiorev.2021.06.031] [Citation(s) in RCA: 58] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 05/31/2021] [Accepted: 06/19/2021] [Indexed: 02/08/2023]
Abstract
Altered brain responses to alcohol-associated stimuli are a neural hallmark of alcohol-use disorder (AUD) and a promising target for pharmacotherapy. However, findings in cue-reactivity based functional MRI (fMRI) studies are inconclusive. To investigate the neural substrates of cue-reactivity and their relevance to treatment outcomes, alcohol craving and relapse in AUD patients, we performed five meta-analyses using signed differential mapping software. Our meta-analysis revealed that alcohol cues evoke greater cue-reactivity than neutral cues in the mesocorticolimbic circuit and lower reactivity in the parietal and temporal regions in AUD patients. Compared to controls, AUD individuals displayed hyperactivations in the medial prefrontal cortex and anterior/middle part of the cingulate cortex. After receiving AUD treatment, AUD patients exhibited greater activations in the precentral gyrus but reduced activations in the bilateral caudate nucleus, insula, right DLPFC, and left superior frontal gyrus. No significant results were found in cue-reactivity correlates of alcohol craving and relapse. Our results implicate cue-induced abnormalities in corticostriatal-limbic circuits may underline the pathophysiology of AUD, and have translational value for treatment development.
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Affiliation(s)
- Jianguang Zeng
- School of Economics and Business Administration, Chongqing University, Chongqing, 400044, China
| | - Shuxian Yu
- School of Economics and Business Administration, Chongqing University, Chongqing, 400044, China
| | - Hengyi Cao
- Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Hempstead, NY, USA; Division of Psychiatry Research, Zucker Hillside Hospital, Glen Oaks, NY, USA
| | - Yueyue Su
- School of Public Policy and Administration, Chongqing University, Chongqing, 400044, China
| | - Zaiquan Dong
- Department of Psychiatry, State Key Lab of Biotherapy, West China Hospital of Sichuan University, Chengdu, 610041, China
| | - Xun Yang
- School of Public Policy and Administration, Chongqing University, Chongqing, 400044, China.
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Wetherill RR, Spilka NH, Maron M, Keyser H, Jagannathan K, Ely AV, Franklin TR. Influence of the natural hormonal milieu on brain and behavior in women who smoke cigarettes: Rationale and methodology. Contemp Clin Trials Commun 2021; 21:100738. [PMID: 33718654 PMCID: PMC7932892 DOI: 10.1016/j.conctc.2021.100738] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 01/19/2021] [Accepted: 02/05/2021] [Indexed: 12/19/2022] Open
Abstract
Women experience more severe health consequences from smoking, have greater difficulty quitting, and respond less favorably to nicotine replacement therapy than men. The influence of fluctuating ovarian hormones, specifically estradiol (E) and progesterone (P), on brain and behavioral responses during exposure to smoking reminders (i.e., cues) may be a contributing factor. Results from our laboratory suggest that women in the late follicular phase of their menstrual cycle (MC) have enhanced smoking cue (SC) vulnerabilities and reduced functional connectivity in neurocircuitry underlying cognitive control, potentially placing them at greater risk for continued smoking and relapse. The primary aim of this study is to examine and link hormonal status with brain and behavioral responses to SCs over the course of three monthly MCs in naturally cycling women who are chronic cigarette smokers. This longitudinal, counterbalanced study collects brain and behavioral responses to SCs at three time points during a woman's MC. Participants complete psychological and physical examinations, biochemical hormonal verification visits, and at least three laboratory/neuroimaging scan visits. The scan visits include a 10-min SC task during blood oxygen level-dependent (BOLD) data acquisition and are timed to occur during the early follicular phase (low E and P), late follicular phase (high E, unopposed by P), and mid-luteal phase (high P, high E). The primary outcomes include brain responses to SCs (compared to non-SCs), subjective craving, E and P hormone levels, and behavioral responses to SCs. This study addresses a critical gap in our knowledge: namely, the impact of the natural hormonal milieu on brain and behavioral responses to SCs, a powerful relapse trigger. Additionally, this study will provide a roadmap for human sex differences researchers who are obliged to consider the often confounding cyclic hormonal fluctuations of women.
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Affiliation(s)
| | | | - Melanie Maron
- Perelman School of Medicine, The University of Pennsylvania, The Department of Psychiatry, 3535 Market Street Suite 500, Philadelphia, PA, 19104, USA
| | - Heather Keyser
- Perelman School of Medicine, The University of Pennsylvania, The Department of Psychiatry, 3535 Market Street Suite 500, Philadelphia, PA, 19104, USA
| | - Kanchana Jagannathan
- Perelman School of Medicine, The University of Pennsylvania, The Department of Psychiatry, 3535 Market Street Suite 500, Philadelphia, PA, 19104, USA
| | - Alice V. Ely
- Perelman School of Medicine, The University of Pennsylvania, The Department of Psychiatry, 3535 Market Street Suite 500, Philadelphia, PA, 19104, USA
| | - Teresa R. Franklin
- Perelman School of Medicine, The University of Pennsylvania, The Department of Psychiatry, 3535 Market Street Suite 500, Philadelphia, PA, 19104, USA
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Brodnik ZD, Black EM, España RA. Accelerated development of cocaine-associated dopamine transients and cocaine use vulnerability following traumatic stress. Neuropsychopharmacology 2020; 45:472-481. [PMID: 31539899 PMCID: PMC6969179 DOI: 10.1038/s41386-019-0526-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 09/06/2019] [Accepted: 09/11/2019] [Indexed: 12/21/2022]
Abstract
Post-traumatic stress disorder and cocaine use disorder are highly co-morbid psychiatric conditions. The onset of post-traumatic stress disorder generally occurs prior to the development of cocaine use disorder, and thus it appears that the development of post-traumatic stress disorder drives cocaine use vulnerability. We recently characterized a rat model of post-traumatic stress disorder with segregation of rats as susceptible and resilient based on anxiety-like behavior in the elevated plus maze and context avoidance. We paired this model with in vivo fast scan cyclic voltammetry in freely moving rats to test for differences in dopamine signaling in the nucleus accumbens core at baseline, in response to a single dose of cocaine, and in response to cocaine-paired cues. Further, we examined differences in the acquisition of cocaine self-administration across groups. Results indicate that susceptibility to traumatic stress is associated with alterations in phasic dopamine signaling architecture that increase the rate at which dopamine signals entrain to cocaine-associated cues and increase the magnitude of persistent cue-evoked dopamine signals following training. These changes in phasic dopamine signaling correspond with increases in the rate at which susceptible rats develop excessive cocaine-taking behavior. Together, our studies demonstrate that susceptibility to traumatic stress is associated with a cocaine use-vulnerable phenotype and suggests that differences in phasic dopamine signaling architecture may contribute to the process by which this vulnerability occurs.
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Affiliation(s)
- Zachary D. Brodnik
- 0000 0001 2181 3113grid.166341.7Department of Neurobiology and Anatomy, Drexel University College of Medicine, 2900W Queen Lane, Philadelphia, PA 19129 USA
| | - Emily M. Black
- 0000 0001 2181 3113grid.166341.7Department of Neurobiology and Anatomy, Drexel University College of Medicine, 2900W Queen Lane, Philadelphia, PA 19129 USA
| | - Rodrigo A. España
- 0000 0001 2181 3113grid.166341.7Department of Neurobiology and Anatomy, Drexel University College of Medicine, 2900W Queen Lane, Philadelphia, PA 19129 USA
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12
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Regier PS, Teitelman AM, Jagannathan K, Monge ZA, McCondochie C, Elkind J, Childress AR. Women at Greater Sexual Risk for STIs/HIV Have a Lower Mesolimbic and Affective Bias Response to Sexual Stimuli. Front Behav Neurosci 2020; 13:279. [PMID: 31998091 PMCID: PMC6965060 DOI: 10.3389/fnbeh.2019.00279] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Accepted: 12/09/2019] [Indexed: 01/29/2023] Open
Abstract
Young adult women in the United States have high rates of sexually transmitted infections, increasing the risk of human immunodeficiency virus (HIV). The underlying neurobiology of behaviors that increase the probability of contracting sexually-transmitted diseases (STIs) and HIV is just beginning to be explored. The current study assessed the link between sexual risk and the brain and behavioral response to sexual cues in emerging adult women. Our hypothesis was that women with more activity in reward/motivational circuitry would report higher sexual risk behaviors and would evidence higher positive affective bias to visual sexual stimuli. Women (n = 52; age = 18–24 years) who had protected sex 100% of the time (n = 17) vs. those who did not (n = 35), in the past 3 months, were compared on their brain response to 500 ms evocative (sex, aversive, food) vs. neutral cues in a blood-oxygen-level-dependent (BOLD) functional magnetic resonance imaging (fMRI) fast event-related design. Based on existing literature, an a priori anatomical “cue-reactive” mask was used to constrain the analyses. Self-reported sexual activity and the affective bias scores to sexual cues were examined as correlates with the brain response to cues. In contrast to our initial hypothesis, the higher sexual risk (Unprotected) group had significantly less activation in mesolimbic brain regions and lower (less positive) affective bias scores to sexual cues compared to the lower risk (Protected) group. As predicted, the brain response was positively correlated with sexual bias. Follow-up analyses showed an effect of partner “risk” (e.g., more vs. less knowledge of partner’s STIs/HIV status). This evidence suggests that women who have protected sex may view sexual-related stimuli more positively, reflected by a neural response in reward/motivational regions and more positive sexual bias scores. In contrast, young women at increased risk for STIs/HIV may feel more negatively about sexual-related stimuli, evidenced by a lower mesolimbic response and a less positive affective bias to sexual cues. These data may help identify young women who are at greatest risk for acquiring STIs and/or HIV, which carries added importance with the availability of new medications that can prevent HIV.
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Affiliation(s)
- Paul S Regier
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Anne M Teitelman
- School of Nursing, University of Pennsylvania, Philadelphia, PA, United States
| | - Kanchana Jagannathan
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Zachary A Monge
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Calumina McCondochie
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Jaclynn Elkind
- School of Nursing, University of Pennsylvania, Philadelphia, PA, United States
| | - Anna Rose Childress
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
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13
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Wilcox CE, Adinoff B, Clifford J, Ling J, Witkiewitz K, Mayer AR, Boggs KM, Eck M, Bogenschutz M. Brain activation and subjective anxiety during an anticipatory anxiety task is related to clinical outcome during prazosin treatment for alcohol use disorder. NEUROIMAGE-CLINICAL 2020; 26:102162. [PMID: 32037283 PMCID: PMC7229347 DOI: 10.1016/j.nicl.2020.102162] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 12/15/2019] [Accepted: 01/02/2020] [Indexed: 02/03/2023]
Abstract
BACKGROUND Higher levels of anxiety, negative affect, and impaired emotion regulation are associated with alcohol use disorder (AUD) and contribute to relapse and worse treatment outcomes. Prazosin, while typically used to treat post-traumatic stress disorder (PTSD) and other anxiety disorders, has shown promise for treating AUD. In order to better understand these underlying neural processes in individuals with AUD, our aims in this study were to measure brain activation during an anticipatory anxiety task before treatment to determine whether observed patterns supported previous work. We then aimed to measure the effects of prazosin on patients with AUD and explore whether greater baseline anticipatory anxiety (as measured by subjective and neural measures) predicts better treatment outcomes. METHODS Thirty-four individuals seeking treatment for AUD participated in a six-week placebo-controlled study of prazosin and underwent an anticipatory anxiety task during fMRI scans at baseline and three weeks. Alcohol use over six weeks was measured. RESULTS Greater levels of subjective anxiety and deactivation in posterior cingulate cortex (PCC) and ventromedial prefrontal cortex (vmPFC) were observed during high-threat stimuli compared to low-threat stimuli. Compared to placebo, prazosin reduced subjective anxiety to high-threat stimuli but there were no observed significant effects of prazosin on brain activation during the task. However, AUD patients with greater vmPFC deactivation during high threat relative to low threat and patients with low baseline anticipatory anxiety during the task had worse clinical outcomes on prazosin. CONCLUSIONS Deactivation in PCC and vmPFC to high-threat stimuli replicated previous work and shows promise for further study as a marker for AUD. Although prazosin did not affect brain activation in the regions of interest during the anticipatory anxiety task, subjective levels of anxiety and brain activation in vmPFC predicted treatment outcomes in individuals with AUD undergoing treatment with prazosin, highlighting individuals more likely to benefit from prazosin than others.
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Affiliation(s)
- Claire E Wilcox
- Mind Research Network, 1101 Yale Blvd. NE, Albuquerque, NM 87106, USA.
| | - Bryon Adinoff
- Department of Psychiatry, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX 75390, USA; VA North Texas Health Care System, 4500 S Lancaster Rd, Dallas, TX 75216, USA; Department of Psychiatry, School of Medicine, University of Colorado, 13001 E 17th Place, Aurora, CO 80045, USA
| | - Joshua Clifford
- Department of Psychiatry, University of New Mexico, 2400 Tucker NE, Albuquerque, NM 87131, USA
| | - Josef Ling
- Mind Research Network, 1101 Yale Blvd. NE, Albuquerque, NM 87106, USA
| | - Katie Witkiewitz
- Department of Psychology, Center on Alcoholism, Substance Abuse & Addictions, University of New Mexico, 2650 Yale Blvd. SE, Albuquerque, NM 87106, USA
| | - Andrew R Mayer
- Mind Research Network, 1101 Yale Blvd. NE, Albuquerque, NM 87106, USA
| | - Kylar M Boggs
- Mind Research Network, 1101 Yale Blvd. NE, Albuquerque, NM 87106, USA
| | - Matthew Eck
- Mind Research Network, 1101 Yale Blvd. NE, Albuquerque, NM 87106, USA; University of Southern California, USA
| | - Michael Bogenschutz
- Department of Psychiatry, New York University School of Medicine, New York, NY 10016, USA
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14
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Regier PS, Kampman KM, Childress AR. Clinical Trials for Stimulant Use Disorders: Addressing Heterogeneities That May Undermine Treatment Outcomes. Handb Exp Pharmacol 2020; 258:299-322. [PMID: 32193666 DOI: 10.1007/164_2019_303] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
In recent years, use of cocaine and amphetamines and deaths associated with stimulants have been on the rise, and there are still no FDA-approved medications for stimulant use disorders. One contributing factor may involve heterogeneity. At the neurobiological level, dual dopamine dysfunction may be undermining medication efficacy, suggesting a need for combination pharmacotherapies. At the population level, individual variability is expressed in a number of ways and, if left unaddressed, may interfere with medication efficacy. This chapter reviews studies investigating medications to address dopamine dysfunction, and it also identifies several prominent heterogeneities associated with stimulant (and other substance) use disorders. The chapter has implications for improving interventions to treat stimulant use disorders, and the theme of individual heterogeneity may have broader application across substance use disorders.
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Affiliation(s)
- Paul S Regier
- Department of Psychiatry, Perelman School of Medicine, Center for Studies of Addiction, University of Pennsylvania, Philadelphia, PA, USA.
| | - Kyle M Kampman
- Department of Psychiatry, Perelman School of Medicine, Center for Studies of Addiction, University of Pennsylvania, Philadelphia, PA, USA
| | - Anna Rose Childress
- Department of Psychiatry, Perelman School of Medicine, Center for Studies of Addiction, University of Pennsylvania, Philadelphia, PA, USA
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15
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Zhang S, Zhornitsky S, Angarita GA, Li CSR. Hypothalamic response to cocaine cues and cocaine addiction severity. Addict Biol 2020; 25:e12682. [PMID: 30295396 PMCID: PMC6453736 DOI: 10.1111/adb.12682] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Revised: 08/29/2018] [Accepted: 09/02/2018] [Indexed: 12/22/2022]
Abstract
The dopaminergic motive system is compromised in cocaine addiction. Abundant research has examined the roles of the dopaminergic midbrain and ventral striatum (VS) in cue-induced craving and habitual drug consumption. Interconnected with the dopaminergic circuits, the hypothalamus is widely implicated in motivated behavior, including food and drug seeking. However, very few studies have investigated how the hypothalamus responds to drug cues and whether hypothalamic responses are related to clinical features such as craving and addiction severity. Here, in 23 cocaine-dependent individuals (CD) exposed to cocaine vs neutral cues during functional magnetic resonance imaging (fMRI), we examined regional responses using established routines. At a corrected threshold, CD demonstrated increased activation to cocaine vs neutral cues in bilateral visual cortex, inferior parietal and middle frontal gyri, and the hypothalamus. The extent of hypothalamus but not other regional response was correlated with craving and cocaine addiction severity, each as assessed by the Cocaine Craving Questionnaire (CCQ) and Cocaine Selective Severity Assessment (CSSA). In contrast, subjective "acute" craving as elicited by cocaine cues during fMRI involved deactivation of bilateral orbitofrontal cortex (OFC) and angular gyri (AG), and the OFC and AG responses were not related to CCQ or CSSA score. These findings distinguished tonic craving as a critical factor in capturing cocaine addiction severity and substantiated a role of the hypothalamus in motivational dysfunction in cocaine addiction.
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Affiliation(s)
- Sheng Zhang
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
| | - Simon Zhornitsky
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
| | - Gustavo A. Angarita
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
| | - Chiang-shan R. Li
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
- Department of Neuroscience, Yale University School of Medicine, New Haven, Connecticut
- Interdepartmental Neuroscience Program, Yale University, New Haven, Connecticut
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16
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Poppa T, Droutman V, Amaro H, Black D, Arnaudova I, Monterosso J. Sexual trauma history is associated with reduced orbitofrontal network strength in substance-dependent women. Neuroimage Clin 2019; 24:101973. [PMID: 31472330 PMCID: PMC6728879 DOI: 10.1016/j.nicl.2019.101973] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Revised: 06/29/2019] [Accepted: 08/03/2019] [Indexed: 12/19/2022]
Abstract
AIM Substance use disorders (SUDs) are highly comorbid with post-traumatic stress disorder (PTSD). PTSD-SUD comorbidity is associated with greater functional impairments and relapse risk. Women with SUDs experience markedly higher rates of trauma and PTSD compared to men with SUDs, particularly due to sexual and domestic abuse. Despite the strong association between trauma exposure and SUDs, the neurobiological correlates are understudied, particularly among females with SUDs. However, there is indication of abnormal somatic and interoceptive processing in women with PTSD. The present study examines interoception-linked differences in intrinsic brain networks in a group of women with SUDs and varying histories of trauma exposure, some of whom have a current PTSD diagnosis. METHODS Pre-intervention data were analyzed from a subset (N = 43) of women in SUD residential treatment recruited for a mindfulness-based intervention efficacy clinical trial. Participants diagnosed with PTSD (n = 14) or not (n = 29) performed a task which involved attending to the somatic and visceral sensations of the breathing cycle (interoception) while undergoing a functional MRI (fMRI) scan. FMRI analysis employed independent components analysis and dual regression. First, we assessed differences in functional connectivity of interoception-modulated functional networks among those with and without PTSD. Second, we tested associations between network strength and lifetime sexual violence exposure across all participants on networks that showed significant group differences. RESULTS PTSD diagnosis was associated with reduced functional connectivity of an orbitofrontal network with the precuneus, mid-posterior insula, lateral prefrontal cortex and angular gyrus. OFC network strength was inversely associated with sexual violence exposure over-and-above the contribution of PTSD status alone. CONCLUSIONS Our findings provide a novel network-level account of brain activity associated with PTSD among women with SUDs, which may inform treatment response in this subpopulation.
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Affiliation(s)
- Tasha Poppa
- Department of Psychology, University of Southern California, Los Angeles, United States of America.
| | - Vita Droutman
- Department of Psychology, University of Southern California, Los Angeles, United States of America
| | - Hortensia Amaro
- Herbert Wertheim College of Medicine, Robert Stempel College of Public Health and Social Work, Florida International University, Los Angeles, United States of America
| | - David Black
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, United States of America
| | - Inna Arnaudova
- Department of Psychiatry, University of California, Los Angeles, United States of America
| | - John Monterosso
- Department of Psychology, University of Southern California, Los Angeles, United States of America
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17
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Moreno-Rius J. The cerebellum under stress. Front Neuroendocrinol 2019; 54:100774. [PMID: 31348932 DOI: 10.1016/j.yfrne.2019.100774] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Revised: 07/19/2019] [Accepted: 07/20/2019] [Indexed: 12/22/2022]
Abstract
Stress-related psychiatric conditions are one of the main causes of disability in developed countries. They account for a large portion of resource investment in stress-related disorders, become chronic, and remain difficult to treat. Research on the neurobehavioral effects of stress reveals how changes in certain brain areas, mediated by a number of neurochemical messengers, markedly alter behavior. The cerebellum is connected with stress-related brain areas and expresses the machinery required to process stress-related neurochemical mediators. Surprisingly, it is not regarded as a substrate of stress-related behavioral alterations, despite numerous studies that show cerebellar responsivity to stress. Therefore, this review compiles those studies and proposes a hypothesis for cerebellar function in stressful conditions, relating it to stress-induced psychopathologies. It aims to provide a clearer picture of stress-related neural circuitry and stimulate cerebellum-stress research. Consequently, it might contribute to the development of improved treatment strategies for stress-related disorders.
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18
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Huang AS, Mitchell JA, Haber SN, Alia-Klein N, Goldstein RZ. The thalamus in drug addiction: from rodents to humans. Philos Trans R Soc Lond B Biol Sci 2019; 373:rstb.2017.0028. [PMID: 29352027 DOI: 10.1098/rstb.2017.0028] [Citation(s) in RCA: 78] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/24/2017] [Indexed: 02/07/2023] Open
Abstract
Impairments in response inhibition and salience attribution (iRISA) have been proposed to underlie the clinical symptoms of drug addiction as mediated by cortico-striatal-thalamo-cortical networks. The bulk of evidence supporting the iRISA model comes from neuroimaging research that has focused on cortical and striatal influences with less emphasis on the role of the thalamus. Here, we highlight the importance of the thalamus in drug addiction, focusing on animal literature findings on thalamic nuclei in the context of drug-seeking, structural and functional changes of the thalamus as measured by imaging studies in human drug addiction, particularly during drug cue and non-drug reward processing, and response inhibition tasks. Findings from the animal literature suggest that the paraventricular nucleus of the thalamus, the lateral habenula and the mediodorsal nucleus may be involved in the reinstatement, extinction and expression of drug-seeking behaviours. In support of the iRISA model, the human addiction imaging literature demonstrates enhanced thalamus activation when reacting to drug cues and reduced thalamus activation during response inhibition. This pattern of response was further associated with the severity of, and relapse in, drug addiction. Future animal studies could widen their field of focus by investigating the specific role(s) of different thalamic nuclei in different phases of the addiction cycle. Similarly, future human imaging studies should aim to specifically delineate the structure and function of different thalamic nuclei, for example, through the application of advanced imaging protocols at higher magnetic fields (7 Tesla).This article is part of a discussion meeting issue 'Of mice and mental health: facilitating dialogue between basic and clinical neuroscientists'.
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Affiliation(s)
- Anna S Huang
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | - Suzanne N Haber
- Department of Pharmacology and Physiology, School of Medicine, University of Rochester, Rochester, NY, USA
| | - Nelly Alia-Klein
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Rita Z Goldstein
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA .,Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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19
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Liu Y, Williamson V, Setlow B, Cottler LB, Knackstedt LA. The importance of considering polysubstance use: lessons from cocaine research. Drug Alcohol Depend 2018; 192:16-28. [PMID: 30195242 PMCID: PMC7450360 DOI: 10.1016/j.drugalcdep.2018.07.025] [Citation(s) in RCA: 101] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Revised: 07/11/2018] [Accepted: 07/12/2018] [Indexed: 02/07/2023]
Abstract
BACKGROUND Polysubstance use (PSU) is prevalent among individuals with substance use disorders, but the vast majority of preclinical substance use research has focused on individual substances in isolation. Cocaine has been prevalent in the repertoire of persons who use more than one illicit substance. METHODS We conducted a meta-analysis combining results from literature searches and secondary data analyses to estimate the prevalence of simultaneous and concurrent cocaine + alcohol and cocaine + cannabis use among cocaine users. We next summarized the small body of literature on behavioral, cognitive and neurobiological consequences of cocaine PSU across species, with a focus on alcohol and cannabis. Finally, we used systematic literature searches to assess the extent to which human and animal studies on the neurobiological consequences of cocaine include PSU subjects. RESULTS The estimated prevalence of simultaneous and concurrent alcohol use among human cocaine users was 74% and 77%, respectively. The estimated prevalence of simultaneous and concurrent cannabis use among cocaine users was 38% and 64%, respectively. Consumption of alcohol or cannabis with cocaine enhances subjective responses to cocaine, concomitant with changes in cocaine metabolism that increase blood cocaine levels, and, in the case of alcohol, produce the psychoactive metabolite cocaethylene. There is also consistent evidence for neurobiological effects of cocaine + alcohol combinations. However, animal PSU research with cocaine lags behind human research. CONCLUSION Based on the prevalence and known consequences of PSU, consideration of PSU in both human and animal research is vital for understanding patterns of substance use.
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Affiliation(s)
- Yiyang Liu
- Department of Epidemiology, College of Public Health and Health Professions, College of Medicine, 2004 Mowry Road, PO Box 100231, USA
| | - Victoria Williamson
- Department of Psychology, University of Florida, 945 Center Dr., P.O. Box 112250, Gainesville, FL 32611, USA
| | - Barry Setlow
- Department of Psychology, University of Florida, 945 Center Dr., P.O. Box 112250, Gainesville, FL 32611, USA,Department of Psychiatry, University of Florida College of Medicine, PO Box 100256, Gainesville, FL 32610-0256, USA,Department of Neuroscience, 1149 Newell Drive, Room L1-100, Gainesville, FL 32611, USA,Center for Addiction Research and Education, Gainesville, FL 32611, USA
| | - Linda B. Cottler
- Department of Epidemiology, College of Public Health and Health Professions, College of Medicine, 2004 Mowry Road, PO Box 100231, USA,Center for Addiction Research and Education, Gainesville, FL 32611, USA
| | - Lori A. Knackstedt
- Department of Psychology, University of Florida, 945 Center Dr., P.O. Box 112250, Gainesville, FL 32611, USA,Center for Addiction Research and Education, Gainesville, FL 32611, USA,Corresponding author at: Department of Psychology, University of Florida, 945 Center Dr., Room Psy 114, Gainesville, FL 32611, USA. (L.A. Knackstedt)
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20
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Leveraging translational neuroscience to inform early intervention and addiction prevention for children exposed to early life stress. Neurobiol Stress 2018; 9:231-240. [PMID: 30450387 PMCID: PMC6236514 DOI: 10.1016/j.ynstr.2018.10.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Revised: 09/08/2018] [Accepted: 10/23/2018] [Indexed: 12/03/2022] Open
Abstract
Substance use and addiction are disproportionately experienced by individuals with a history of exposure to early life stress (ELS), such as maltreatment, domestic violence and parent psychopathology. Unfortunately, extant interventions have mixed effectiveness at improving outcome trajectories for ELS-exposed children, who are often underserved by evidenced-based programs. Here, we employ a translational neuroscience framework to delineate how neuroscience can deepen our understanding of ELS-linked alterations in children's function to inform the development of more targeted, effective early intervention and addiction prevention programs. Candidate neural pathways altered by ELS and linked to addiction are described across sensory, affective, motivational, and executive function domains. Next, we provide an example of the application of translational neuroscience principles in a family of early interventions (i.e. Multidimensional Treatment Foster Care – Preschool, Kids in Transition to School) focused on improving self-regulation in ELS-exposed children. Future directions and areas of unmet need in intervention research detail the significant potential of translational neuroscience to advance interventionists' ability to support positive adjustment in ELS-exposed children and prevent harmful addiction outcomes.
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21
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McReynolds JR, Doncheck EM, Li Y, Vranjkovic O, Graf EN, Ogasawara D, Cravatt BF, Baker DA, Liu QS, Hillard CJ, Mantsch JR. Stress Promotes Drug Seeking Through Glucocorticoid-Dependent Endocannabinoid Mobilization in the Prelimbic Cortex. Biol Psychiatry 2018; 84:85-94. [PMID: 29100630 PMCID: PMC5889367 DOI: 10.1016/j.biopsych.2017.09.024] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Revised: 09/15/2017] [Accepted: 09/20/2017] [Indexed: 12/29/2022]
Abstract
BACKGROUND Clinical reports suggest that rather than directly driving cocaine use, stress may create a biological context within which other triggers for drug use become more potent. We hypothesize that stress-induced increases in corticosterone "set the stage" for relapse by promoting endocannabinoid-induced attenuation of inhibitory transmission in the prelimbic cortex (PL). METHODS We have established a rat model for these stage-setting effects of stress. In this model, neither a stressor (electric footshock) nor stress-level corticosterone treatment alone reinstates cocaine seeking following self-administration and extinction, but each treatment potentiates reinstatement in response to an otherwise subthreshold cocaine priming dose (2.5 mg/kg, intraperitoneal). The contributions of endocannabinoid signaling in the PL to the effects of stress-level corticosterone on PL neurotransmission and cocaine seeking were determined using intra-PL microinfusions. Endocannabinoid-dependent effects of corticosterone on inhibitory synaptic transmission in the rat PL were determined using whole-cell recordings in layer V pyramidal neurons. RESULTS Corticosterone application attenuated inhibitory synaptic transmission in the PL via cannabinoid receptor type 1 (CB1R)- and 2-arachidonoylglycerol-dependent inhibition of gamma-aminobutyric acid release without altering postsynaptic responses. The ability of systemic stress-level corticosterone treatment to potentiate cocaine-primed reinstatement was recapitulated by intra-PL injection of corticosterone, the CB1R agonist WIN 55,212-2, or the monoacylglycerol lipase inhibitor URB602. Corticosterone effects on reinstatement were attenuated by intra-PL injections of either the CB1R antagonist, AM251, or the diacylglycerol lipase inhibitor, DO34. CONCLUSIONS These findings suggest that stress-induced increases in corticosterone promote cocaine seeking by mobilizing 2-arachidonoylglycerol in the PL, resulting in CB1R-mediated attenuation of inhibitory transmission in this brain region.
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Affiliation(s)
- Jayme R. McReynolds
- Department of Biomedical Sciences, Marquette University, Milwaukee, WI, 53233, USA
| | | | - Yan Li
- Department of Pharmacology and Toxicology and Neuroscience Research Center, Medical College of Wisconsin, Milwaukee, WI, 53226, USA
| | - Oliver Vranjkovic
- Department of Biomedical Sciences, Marquette University, Milwaukee, WI, 53233, USA
| | - Evan N. Graf
- Department of Biomedical Sciences, Marquette University, Milwaukee, WI, 53233, USA
| | - Daisuke Ogasawara
- Department of Chemical Physiology, The Scripps Research Institute, La Jolla, CA, 92037, USA
| | - Benjamin F. Cravatt
- Department of Chemical Physiology, The Scripps Research Institute, La Jolla, CA, 92037, USA
| | - David A. Baker
- Department of Biomedical Sciences, Marquette University, Milwaukee, WI, 53233, USA
| | - Qing-song Liu
- Department of Pharmacology and Toxicology and Neuroscience Research Center, Medical College of Wisconsin, Milwaukee, WI, 53226, USA
| | - Cecilia J. Hillard
- Department of Pharmacology and Toxicology and Neuroscience Research Center, Medical College of Wisconsin, Milwaukee, WI, 53226, USA
| | - John R. Mantsch
- Department of Biomedical Sciences, Marquette University, Milwaukee, WI, 53233, USA
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Gawrysiak MJ, Jagannathan K, Regier P, Suh JJ, Kampman K, Vickery T, Childress AR. Unseen scars: Cocaine patients with prior trauma evidence heightened resting state functional connectivity (RSFC) between the amygdala and limbic-striatal regions. Drug Alcohol Depend 2017; 180:363-370. [PMID: 28957777 PMCID: PMC5648604 DOI: 10.1016/j.drugalcdep.2017.08.035] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Revised: 08/23/2017] [Accepted: 08/28/2017] [Indexed: 12/15/2022]
Abstract
BACKGROUND Substance use disorder (SUD) patients with a history of trauma exhibit poorer treatment outcome, greater functional impairment and higher risk for relapse. Endorsement of prior trauma has, in several SUD populations, been linked to abnormal functional connectivity (FC) during task-based studies. We examined amygdala FC in the resting state (RS), testing for differences between cocaine patients with and without prior trauma. METHODS Patients with cocaine use disorder (CUD; n=34) were stabilized in an inpatient setting prior to a BOLD fMRI scan. Responses to Addiction Severity Index and the Mini-International Neuropsychiatric Interview were used to characterize the No-Trauma (n=16) and Trauma (n=18) groups. Seed-based RSFC was conducted using the right and left amygdala as regions of interest. Examination of amygdala RSFC was restricted to an a priori anatomical mask that incorporated nodes of the limbic-striatal motivational network. RESULTS RSFC was compared for the Trauma versus No-Trauma groups. The Trauma group evidenced greater connectivity between the amygdala and the a priori limbic-striatal mask. Peaks within the statistically significant limbic-striatal mask included the amygdala, putamen, pallidum, caudate, thalamus, insula, hippocampus/parahippocampus, and brain stem. CONCLUSIONS Results suggest that cocaine patients with prior trauma (versus without) have heightened communication within nodes of the motivational network, even at rest. To our knowledge, this is the first fMRI study to examine amygdala RSFC among those with CUD and trauma history. Heightened RSFC intralimbic connectivity for the Trauma group may reflect a relapse-relevant brain vulnerability and a novel treatment target for this clinically-challenging population.
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Affiliation(s)
- Michael J Gawrysiak
- Department of Psychology, Delaware State University, Dover, DE, USA; Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.
| | - Kanchana Jagannathan
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Paul Regier
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Jesse J Suh
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Kyle Kampman
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Timothy Vickery
- Department of Psychological and Brain Sciences, University of Delaware, Newark, DE, USA
| | - Anna Rose Childress
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
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Savulich G, Riccelli R, Passamonti L, Correia M, Deakin JFW, Elliott R, Flechais RSA, Lingford-Hughes AR, McGonigle J, Murphy A, Nutt DJ, Orban C, Paterson LM, Reed LJ, Smith DG, Suckling J, Tait R, Taylor EM, Sahakian BJ, Robbins TW, Ersche KD, ICCAM Platform. Effects of naltrexone are influenced by childhood adversity during negative emotional processing in addiction recovery. Transl Psychiatry 2017; 7:e1054. [PMID: 28267152 PMCID: PMC5416677 DOI: 10.1038/tp.2017.34] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Revised: 01/25/2017] [Accepted: 01/25/2017] [Indexed: 12/12/2022] Open
Abstract
Naltrexone is an opioid receptor antagonist used in the management of alcohol dependence. Although the endogenous opioid system has been implicated in emotion regulation, the effects of mu-opioid receptor blockade on brain systems underlying negative emotional processing are not clear in addiction. Individuals meeting criteria for alcohol dependence alone (n=18, alcohol) and in combination with cocaine and/or opioid dependence (n=21, alcohol/drugs) and healthy individuals without a history of alcohol or drug dependence (n=21) were recruited. Participants were alcohol and drug abstinent before entered into this double-blind, placebo-controlled, randomized, crossover study. Functional magnetic resonance imaging was used to investigate brain response while viewing aversive and neutral images relative to baseline on 50 mg of naltrexone and placebo. We found that naltrexone modulated task-related activation in the medial prefrontal cortex and functional connectivity between the anterior cingulate cortex and the hippocampus as a function of childhood adversity (for aversive versus neutral images) in all groups. Furthermore, there was a group-by-treatment-by-condition interaction in the right amygdala, which was mainly driven by a normalization of response for aversive relative to neutral images under naltrexone in the alcohol/drugs group. We conclude that early childhood adversity is one environmental factor that influences pharmacological response to naltrexone. Pharmacotherapy with naltrexone may also have some ameliorative effects on negative emotional processing in combined alcohol and drug dependence, possibly due to alterations in endogenous opioid transmission or the kappa-opioid receptor antagonist actions of naltrexone.
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Affiliation(s)
- G Savulich
- Department of Psychiatry, University of Cambridge, Cambridge, UK,Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK
| | - R Riccelli
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK,Department of Medical and Surgical Sciences, University Magna Graecia, Catanzaro, Italy
| | - L Passamonti
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - M Correia
- Cognition and Brain Sciences Unit, Medical Research Council, Cambridge, UK
| | - J F W Deakin
- Institute of Brain, Behaviour and Mental Health, University of Manchester, Manchester, UK
| | - R Elliott
- Institute of Brain, Behaviour and Mental Health, University of Manchester, Manchester, UK
| | - R S A Flechais
- Centre for Neuropsychopharmacology, Imperial College London, London, UK
| | | | - J McGonigle
- Centre for Neuropsychopharmacology, Imperial College London, London, UK
| | - A Murphy
- Institute of Brain, Behaviour and Mental Health, University of Manchester, Manchester, UK
| | - D J Nutt
- Centre for Neuropsychopharmacology, Imperial College London, London, UK
| | - C Orban
- Centre for Neuropsychopharmacology, Imperial College London, London, UK
| | - L M Paterson
- Centre for Neuropsychopharmacology, Imperial College London, London, UK
| | - L J Reed
- Centre for Neuropsychopharmacology, Imperial College London, London, UK
| | - D G Smith
- Department of Psychiatry, University of Cambridge, Cambridge, UK,Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK
| | - J Suckling
- Department of Psychiatry, University of Cambridge, Cambridge, UK,Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK
| | - R Tait
- Department of Psychiatry, University of Cambridge, Cambridge, UK,Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK
| | - E M Taylor
- Institute of Brain, Behaviour and Mental Health, University of Manchester, Manchester, UK
| | - B J Sahakian
- Department of Psychiatry, University of Cambridge, Cambridge, UK,Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK
| | - T W Robbins
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK,Department of Psychology, University of Cambridge, Cambridge, UK
| | - K D Ersche
- Department of Psychiatry, University of Cambridge, Cambridge, UK,Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK,Department of Psychiatry, University of Cambridge, Herchel Smith Building for Brain and Mind Sciences, Forvie Site, Robinson Way, Cambridge CB2 0SZ, UK. E-mail:
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