Structural integrity of the prefrontal cortex modulates electrocortical sensitivity to reward

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.

The pornography use and its addiction among emerging adults in Malaysia: Perceived realism as a mediator

Past studies have demonstrated a link between pornography use and addiction to pornography, the underlying mechanism of the association is still unclear. This study intended to examine the mediating role of perceived realism of pornography in the association between pornography use and addiction among emerging adults in Malaysia. This study recruited 222 self-identified pornography users (M age = 21.05; SD Age = 1.68; 75.1% male respondents) via the purposive sampling method. The correlation results indicated positive associations among pornography use, addiction to pornography, and perceived realism of pornography. Further, the perceived realism of pornography significantly mediated the association between pornography use and addiction to pornography after controlling for gender. Thus, this study has provided a fundamental understanding on the perceived realism role of pornography in explaining the association between its use and addiction. Although it is unlikely to stop illegal pornography use, the results pointed out a need to guide emerging adults in pornography use via media literacy programmes.

Relationships between Personality Traits and Brain Gray Matter Are Different in Risky and Non-risky Drivers

Personality traits such as impulsivity or sensitivity to rewards and punishments have been associated with risky driving behavior, but it is still unclear how brain anatomy is related to these traits as a function of risky driving. In the present study, we explore the neuroanatomical basis of risky driving behavior and how the level of risk-taking influences the relationship between the traits of impulsivity and sensitivity to rewards and punishments and brain gray matter volume. One hundred forty-four participants with different risk-taking tendencies assessed by real-life driving situations underwent MRI. Personality traits were assessed with self-report measures. We observed that the total gray matter volume varied as a function of risky driving tendencies, with higher risk individuals showing lower gray matter volumes. Similar results were found for volumes of brain areas involved in the reward and cognitive control networks, such as the frontotemporal, parietal, limbic, and cerebellar cortices. We have also shown that sensitivity to reward and punishment and impulsivity are differentially related to gray matter volumes as a function of risky driving tendencies. Highly risky individuals show lower absolute correlations with gray matter volumes than less risk-prone individuals. Taken together, our results show that risky drivers differ in the brain structure of the areas involved in reward processing, cognitive control, and behavioral modulation, which may lead to dysfunctional decision-making and riskier driving behavior.

Differential Impact of Social and Monetary Reward on Procedural Learning and Consolidation in Aging and Its Structural Correlates

In young (n = 36, mean ± SD: 24.8 ± 4.5 years) and older (n = 34, mean ± SD: 65.1 ± 6.5 years) healthy participants, we employed a modified version of the Serial Reaction Time task to measure procedural learning (PL) and consolidation while providing monetary and social reward. Using voxel-based morphometry (VBM), we additionally determined the structural correlates of reward-related motor performance (RMP) and PL. Monetary reward had a beneficial effect on PL in the older subjects only. In contrast, social reward significantly enhanced PL in the older and consolidation in the young participants. VBM analyses revealed that motor performance related to monetary reward was associated with larger grey matter volume (GMV) of the left striatum in the young, and motor performance related to social reward with larger GMV of the medial orbitofrontal cortex in the older group. The differential effects of social reward in young (improved consolidation) and both social and monetary rewards in older (enhanced PL) healthy subjects point to the potential of rewards for interventions targeting aging-associated motor decline or stroke-induced motor deficits.

Neural mechanisms of extinguishing drug and pleasant cue associations in human addiction: role of the VMPFC

The neurobiological mechanisms that underlie the resistance of drug cue associations to extinction in addiction remain unknown. Fear extinction critically depends on the ventromedial prefrontal cortex (VMPFC). Here, we tested if this same region plays a role in extinction of non-fear, drug and pleasant cue associations. Eighteen chronic cocaine users and 15 matched controls completed three functional MRI scans. Participants first learned to associate an abstract cue (the conditioned stimulus, CS) with a drug-related (CS_D+ ) or pleasant (CS_P+ ) image. Extinction immediately followed where each CS was repeatedly presented without the corresponding image. Participants underwent a second identical session 24 hours later to assess retention of extinction learning. Results showed that like fear extinction, non-fear-based extinction relies on the VMPFC. However, extinction-related changes in the VMPFC differed by cue valence and diagnosis. In controls, VMPFC activation to the CS_D+ (which was unpleasant for participants) gradually increased as in fear extinction, while it decreased to the CS_P+ , consistent with a more general role of the VMPFC in flexible value updating. Supporting a specific role in extinction retention, we further observed a cross-day association between VMPFC activation and skin conductance, a classic index of conditioned responses. Finally, cocaine users showed VMPFC abnormalities for both CSs, which, in the case of the CS_D+ , correlated with craving. These data suggest a global deficit in extinction learning in this group that may hinder extinction-based treatment efforts. More broadly, these data show that the VMPFC, when functionally intact, supports extinction learning in diverse contexts in humans.

Neural correlates of impaired self-awareness of apathy, disinhibition and dysexecutive deficits in cocaine-dependent individuals

Cocaine addiction is characterized by impaired self-awareness about cognitive and motivational deficits, leading to poor treatment outcomes. However, there is still limited understanding of the neurophysiological underpinnings of this impairment. We aimed to establish if impaired self-awareness is underpinned by brain structural phenotypes among cocaine-dependent individuals (CDI). Sixty-five CDI and 65 designated informants completed the Frontal Systems Behavior Scale, and a subsample of 40 CDI were scanned via magnetic resonance imaging. We applied multiple regression models to establish the association between levels of self-awareness indexed by Frontal Systems Behavior Scale's discrepancy scores (i.e. informant ratings minus self-reports of apathy, disinhibition and dysexecutive deficits) and gray matter volumes indexed by magnetic resonance imaging voxel-based measures within five brain regions of interest: anterior cingulate cortex, orbitofrontal cortex (OFC), striatum, insula and dorsolateral prefrontal cortex (DLPFC). We also examined the neural underpinnings of underestimation versus overestimation of deficits, by splitting the CDI group according to the positive or negative value of their discrepancy scores. We found that poorer self-awareness of apathy deficits was associated with greater gray matter volume in the dorsal striatum, and poorer self-awareness of disinhibition deficits was associated with greater gray matter volume in the OFC in the whole sample. More underestimation and more overestimation of executive deficits were linked to lower DLPFC volume. We show that impaired self-awareness of cognitive and motivational deficits in cocaine addiction has a neural underpinning, implicating striatum, OFC and DLPFC structural phenotypes.

Gene Network Dysregulation in Dorsolateral Prefrontal Cortex Neurons of Humans with Cocaine Use Disorder

Metabolic and functional alterations of neurons in the dorsolateral prefrontal cortex (dlPFC) are thought to contribute to impulsivity, which is a hallmark of addictive behaviors that underlie compulsive drug seeking and taking in humans. To determine if there is a transcriptional signature in dlPFC neurons of humans with cocaine use disorder, we performed total RNA-sequencing on neuronal nuclei isolated from post-mortem dlPFC of cocaine addicts and healthy controls. Our results point toward a transcriptional mechanism whereby cocaine alters specific gene networks in dlPFC neurons. In particular, we identified an AP-1 regulated transcriptional network in dlPFC neurons associated with cocaine use disorder that contains several differentially expressed hub genes. Several of these hub genes are GWAS hits for traits that might involve dysfunction of brain reward circuitry (Body-Mass Index, Obesity) or dlPFC (Bipolar disorder, Schizophrenia). Further study is warranted to determine their potential pathophysiological role in cocaine addiction.

Decreased Central Nervous System Grey Matter Volume (GMV) in Smokers Affects Cognitive Abilities: A Systematic Review

Although cigarette smoking is a leading cause of preventable mortality, tobacco is consumed by approximately 22% of the adult population worldwide. Smoking is also a risk factor for cardiovascular disease, affects brain processing, and is a recognized risk factor for Alzheimer disease (AD). Tobacco toxins (e.g., nicotine at high levels) inhaled in smoke may cause disorders resulting in preclinical brain changes. Researchers suggest that there are differences in brain volume between smokers and non-smokers. This review examines these differences in brain grey matter volume (GMV). In March/April 2015, MedLine, Embase, and PsycINFO were searched using the terms: "grey matter" AND "voxel-based" AND "smoking" AND "cigarette". The 4 studies analyzed found brain GMV decreases in smokers compared to non-smokers. Furthermore, sex-specific differences were found; while the thalamus and cerebellum were affected in both sexes, decreased GMV in the olfactory gyrus was found only in male smokers. Age-group differences were also found, and these may suggest pre-existing abnormalities that lead to nicotine dependence in younger individuals. Only 1 study found a positive correlation between number of pack-years smoked and GMV. Smoking decreases GMV in most brain areas. This decrease may be responsible for the cognitive impairment and difficulties with emotional regulation found in smokers compared with non-smokers.

Neuroimaging the Effectiveness of Substance Use Disorder Treatments

Neuroimaging techniques to measure the function and biochemistry of the human brain such as positron emission tomography (PET), proton magnetic resonance spectroscopy ((1)H MRS), and functional magnetic resonance imaging (fMRI), are powerful tools for assessing neurobiological mechanisms underlying the response to treatments in substance use disorders. Here, we review the neuroimaging literature on pharmacological and behavioral treatment in substance use disorder. We focus on neural effects of medications that reduce craving (e.g., naltrexone, bupropion hydrochloride, baclofen, methadone, varenicline) and that improve cognitive control (e.g., modafinil, N-acetylcysteine), of behavioral treatments for substance use disorders (e.g., cognitive bias modification training, virtual reality, motivational interventions) and neuromodulatory interventions such as neurofeedback and transcranial magnetic stimulation. A consistent finding for the effectiveness of therapeutic interventions identifies the improvement of executive control networks and the dampening of limbic activation, highlighting their values as targets for therapeutic interventions in substance use disorders.

Multimodal evidence of regional midcingulate gray matter volume underlying conflict monitoring

Functional neuroimaging studies have long implicated the mid-cingulate cortex (MCC) in conflict monitoring, but it is not clear whether its structural integrity (i.e., the gray matter volume) influences its conflict monitoring function. In this multimodal study, we used T1-weighted MRI scans as well as event-related potentials (ERPs) to test whether the MCC gray matter volume is associated with the electrocortical marker (i.e., No-go N200 ERP component) of conflict monitoring in healthy individuals. The specificity of such a relationship in health was determined in two ways: by (A) acquiring the same data from individuals with cocaine use disorder (CUD), known to have deficits in executive function including behavioral monitoring; and (B) acquiring the P300 ERP component that is linked with attention allocation and not specifically with conflict monitoring. Twenty-five (39.1 ± 8.4 years; 8 females) healthy individuals and 25 (42.7 ± 5.9 years; 6 females) individuals with CUD underwent a rewarded Go/No-go task during which the ERP data was collected, and they also underwent a structural MRI scan. The whole brain regression analysis showed a significant correlation between MCC structural integrity and the well-known ERP measure of conflict monitoring (N200, but not the P300) in healthy individuals, which was absent in CUD who were characterized by reduced MCC gray matter volume, N200 abnormalities as well as reduced task accuracy. In individuals with CUD instead, the N200 amplitude was associated with drug addiction symptomatology. These results show that the integrity of MCC volume is directly associated with the electrocortical correlates of conflict monitoring in healthy individuals, and such an association breaks down in psychopathologies that impact these brain processes. Taken together, this MCC–N200 association may serve as a biomarker of improved behavioral monitoring processes in diseased populations.

•

No-go N200 amplitude is correlated with gray matter volume of the midcingulate cortex in controls.

•

Such N200-midcingulate association is absent in individuals with cocaine use disorder (CUD).

•

In the CUD group, No-go N200 amplitude is correlated with withdrawal symptoms.

•

N200-midcingulate association can serve as a biomarker of intact conflict monitoring.

A new window to understanding individual differences in reward sensitivity from attentional networks

Existing evidence suggests that the presence of reward cues modifies the activity in attentional networks, however, the nature of these influences remains poorly understood. Here, we performed independent component analysis (ICA) in two fMRI datasets corresponding to two incentive delay tasks, which compared the response to reward (money and erotic pictures) and neutral cues, and yielded activations in the ventral striatum using a general linear model approach. Across both experiments, ICA revealed that both the right frontoparietal network and default mode network time courses were positively and negatively modulated by reward cues, respectively. Moreover, this dual neural response pattern was enhanced in individuals with strong reward sensitivity. Therefore, ICA may be a complementary tool to investigate the relevant role of attentional networks on reward processing, and to investigate reward sensitivity in normal and pathological populations.

Prenatal cocaine exposure and gray matter volume in adolescent boys and girls: relationship to substance use initiation

BACKGROUND

Studies of prenatal cocaine exposure have primarily examined childhood populations. Studying adolescents is especially important because adolescence is a time of changing motivations and initiation of substance use.

METHODS

Using magnetic resonance imaging and whole-brain voxel-based morphometry, we assessed gray matter volume (GMV) differences in 42 prenatally cocaine exposed (PCE) and 21 noncocaine-exposed (NCE) adolescents, aged 14 to 17 years. Associations between GMV differences in significant clusters and the probability of substance use initiation were examined.

RESULTS

PCE relative to NCE adolescents demonstrated three clusters of lower GMV involving a limbic and paralimbic (p < .001, family-wise error [FWE] corrected), superior frontal gyrus (p = .001, FWE corrected), and precuneus (p = .019, FWE corrected) cluster. GMVs in the superior frontal and precuneus clusters were associated with initiation of substance use. Each 1-mL decrease in GMV increased the probability of initiating substance use by 69.6% (p = .01) in the superior frontal cluster and 83.6% (p = .02) in the precuneus cluster.

CONCLUSIONS

PCE is associated with structural differences in cortical and limbic regions. Lower GMVs in frontal cortical and posterior regions are associated with substance use initiation and may represent biological risk markers for substance use.

Characterizing the cognitive effects of cocaine: a comprehensive review

Understanding the cognitive sequela of repeated cocaine use is a growing area of research and is crucial to the development of cognitive models of addiction. We systematically reviewed all available placebo-controlled and case-controlled studies on the acute and long-term effects of cocaine on cognitive functioning. In order to compare the magnitude of cognitive effects across cognitive domains we conducted several meta-analyses on a subset of data from long-term effect studies. Studies on acute cocaine administration suggest enhancement of response inhibition and psychomotor speed, while all other domains appear to be unaffected or not investigated adequately. Long-term effects of cocaine show a wide array of deteriorated cognitive functions, indicating that long term cocaine use is characterized by a general cognitive impairment across functions, rather than by specific cognitive deficits. Literature on long-term cocaine effects is more substantial than literature on acute effects. This comprehensive review outlines possible dissociations and similarities of acute vs. long-term cocaine effects in the human brain. Atherosclerosis after cocaine exposure may underlie cognitive dysfunction, suggesting involvement of multiple brain areas. Acute drug studies are important to the future development of addiction models.

Distinctive personality traits and neural correlates associated with stimulant drug use versus familial risk of stimulant dependence

BACKGROUND

Stimulant drugs such as cocaine and amphetamine have a high abuse liability, but not everyone who uses them develops dependence. However, the risk for dependence is increased for individuals with a family history of addiction. We hypothesized that individuals without a family history of dependence who have been using cocaine recreationally for several years but have not made the transition to dependence will differ in terms of personality traits and brain structure from individuals who are either dependent on stimulants or at risk for dependence.

METHODS

We compared 27 individuals without a familial risk of dependence who had been using cocaine recreationally with 50 adults with stimulant dependence, their nondependent siblings (n = 50), and unrelated healthy volunteers (n = 52) who had neither a personal nor a family history of dependence. All participants underwent a magnetic resonance imaging brain scan and completed a selection of personality measures that have been associated with substance abuse.

RESULTS

Increased sensation-seeking traits and abnormal orbitofrontal and parahippocampal volume were shared by individuals who were dependent on stimulant drugs or used cocaine recreationally. By contrast, increased levels of impulsive and compulsive personality traits and limbic-striatal enlargement were shared by stimulant-dependent individuals and their unaffected siblings.

CONCLUSIONS

We provide evidence for distinct neurobiological phenotypes that are either associated with familial vulnerability for dependence or with regular stimulant drug use. Our findings further suggest that some individuals with high sensation-seeking traits but no familial vulnerability for dependence are likely to use cocaine but may have relatively low risk for developing dependence.

On the relationship between learning strategy and feedback processing in the weather prediction task--Evidence from event-related potentials

Previous work has shown that both declarative and non-declarative strategies can be engaged in probabilistic classification learning. With respect to the neural correlates of these strategies, earlier studies have focused on the classification process itself. In the present experiment, we asked whether the feedback for classification performance is processed differently by declarative and non-declarative learners. We recorded event-related potentials (ERPs) while participants performed a modified version of the weather prediction task, a well-known probabilistic classification learning task. ERP analysis focused on two ERP components typically associated with feedback processing, the feedback-related negativity (FRN) and the P300. FRN amplitude was not affected by learning strategy. The P300, however, was more pronounced in declarative learners, particularly at frontal electrode site Fz. In addition, P300 topography was different in declarative learners, with amplitude differences between negative and positive feedback being more pronounced over the frontal than the parietal cortex. Differences in feedback processing between groups were still seen after declarative learners had switched to a non-declarative strategy in later phases of the task. Our findings provide evidence for different neural mechanisms of feedback processing in declarative and non-declarative learning. This difference emerges at later stages of feedback processing, after the typical time window of the FRN.

Acute cocaine induced deficits in cognitive performance in rhesus macaque monkeys treated with baclofen

RATIONALE

Acute and/or chronic exposure to cocaine can affect cognitive performance, which may influence rate of recovery during treatment.

OBJECTIVE

Effects of the GABA-B receptor agonist baclofen were assessed for potency to reverse the negative influence of acute, pre-session, intravenous (IV) injection of cocaine on cognitive performance in Macaca mulatta nonhuman primates.

METHODS

Animals were trained to perform a modified delayed match to sample (DMS) task incorporating two types of trials with varying degrees of cognitive load that had different decision requirements in order to correctly utilize information retained over the delay interval. The effects of cocaine (0.2, 0.4, and 0.6 mg/kg, IV) alone and in combination with baclofen (0.29 and 0.40 mg/kg, IV) were examined with respect to sustained performance levels. Brain metabolic activity during performance of the task was assessed using PET imaged uptake of [(18) F]-fluorodeoxyglucose.

RESULTS

Acute cocaine injections produced a dose-dependent decline in DMS performance selective for trials of high cognitive load. The GABA-receptor agonist baclofen, co-administered with cocaine, reversed task performance back to nondrug (saline IV) control levels. Simultaneous assessment of PET-imaged brain metabolic activity in prefrontal cortex (PFC) showed alterations by cocaine compared to PFC metabolic activation in nondrug (saline, IV) control DMS sessions, but like performance, PFC activation was returned to control levels by baclofen (0.40 mg/kg, IV) injected with cocaine.

CONCLUSIONS

The results show that baclofen, administered at a relatively high dose, reversed the cognitive deficits produced by acute cocaine intoxication that may have implications for use in chronic drug exposure.