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de la Fuente A, Vignaga SS, Prado P, Figueras R, Lizaso L, Manes F, Cetkovich M, Tagliazucchi E, Torralva T. Early onset consumption of coca paste associated with executive-attention vulnerability markers linked to caudate-frontal structural and functional abnormalities. Drug Alcohol Depend 2021; 227:108926. [PMID: 34364191 DOI: 10.1016/j.drugalcdep.2021.108926] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 06/07/2021] [Accepted: 06/22/2021] [Indexed: 10/20/2022]
Abstract
Coca paste is the most popular form of smoked cocaine (SC) in Latin America and also the most widespread among adolescents in vulnerable sectors of society, thus representing a significant public health concern. Despite evidence suggesting that abnormal executive-attention function is predictive of addiction to stimulant drugs, no study to date has compared clinically relevant neuropsychological (NPS) and physiological variables between individuals with histories of smoked cocaine dependence (SCD) and insufflated cocaine hydrochloride dependence (ICD). In this study we evaluated 25 SCD and 22 ICD subjects matched by poly-consumption profiles, and 25 healthy controls (CTR) matched by age, gender, education, and socioeconomic status. An exhaustive NPS battery was used to assess cognitive domains (attention, executive functions, fluid intelligence, memory, language and social cognition). We complemented this assessment with structural (MRI) and functional (fMRI) neuroimaging data. We found that executive function and attention impairments could be explained by the administration route of cocaine, with strongest impairments for the SCD group. SCD also presented reduced grey matter density relative to ICD and CTR in the bilateral caudate, a key area for executive and attentional function. Functional connectivity between left caudate and inferior frontal regions mediated the association between brain structure and behavioral performance. Our results highlight the relevance of assessing the route of administration of stimulants, both in clinical and research settings.
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Affiliation(s)
- Alethia de la Fuente
- Buenos Aires Physics Institute (IFIBA) and Physics Department, University of Buenos Aires, Argentina; Institute of Cognitive and Translational Neuroscience (INCYT), INECO Foundation, Favaloro University, Buenos Aires, Argentina; National Scientific and Technical Research Council, Buenos Aires, Argentina.
| | - Sofía Schurmann Vignaga
- Institute of Cognitive and Translational Neuroscience (INCYT), INECO Foundation, Favaloro University, Buenos Aires, Argentina
| | - Pilar Prado
- Institute of Cognitive and Translational Neuroscience (INCYT), INECO Foundation, Favaloro University, Buenos Aires, Argentina
| | - Rosario Figueras
- Institute of Cognitive and Translational Neuroscience (INCYT), INECO Foundation, Favaloro University, Buenos Aires, Argentina
| | - Lucia Lizaso
- Institute of Cognitive and Translational Neuroscience (INCYT), INECO Foundation, Favaloro University, Buenos Aires, Argentina
| | - Facundo Manes
- Institute of Cognitive and Translational Neuroscience (INCYT), INECO Foundation, Favaloro University, Buenos Aires, Argentina; National Scientific and Technical Research Council, Buenos Aires, Argentina
| | - Marcelo Cetkovich
- Institute of Cognitive and Translational Neuroscience (INCYT), INECO Foundation, Favaloro University, Buenos Aires, Argentina
| | - Enzo Tagliazucchi
- Buenos Aires Physics Institute (IFIBA) and Physics Department, University of Buenos Aires, Argentina; National Scientific and Technical Research Council, Buenos Aires, Argentina; Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibanez, Santiago, Chile
| | - Teresa Torralva
- Institute of Cognitive and Translational Neuroscience (INCYT), INECO Foundation, Favaloro University, Buenos Aires, Argentina
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de la Fuente A, Sedeño L, Vignaga SS, Ellmann C, Sonzogni S, Belluscio L, García-Cordero I, Castagnaro E, Boano M, Cetkovich M, Torralva T, Cánepa ET, Tagliazucchi E, Garcia AM, Ibañez A. Multimodal neurocognitive markers of interoceptive tuning in smoked cocaine. Neuropsychopharmacology 2019; 44:1425-1434. [PMID: 30867552 PMCID: PMC6784987 DOI: 10.1038/s41386-019-0370-3] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Revised: 02/22/2019] [Accepted: 03/02/2019] [Indexed: 12/21/2022]
Abstract
Contemporary neurocognitive models of drug addiction have associated this condition with changes in interoception -namely, the sensing and processing of body signals that fulfill homeostatic functions relevant for the onset and maintenance of addictive behavior. However, most previous evidence is inconsistent, behaviorally unspecific, and virtually null in terms of direct electrophysiological and multimodal markers. To circumvent these limitations, we conducted the first assessment of the relation between cardiac interoception and smoked cocaine dependence (SCD) in a sample of (a) 25 participants who fulfilled criteria for dependence on such a drug, (b) 22 participants addicted to insufflated clorhidrate cocaine (only for behavioral assessment), and (c) 25 healthy controls matched by age, gender, education, and socioeconomic status. We use a validated heartbeat-detection (HBD) task and measured modulations of the heart-evoked potential (HEP) during interoceptive accuracy and interoceptive learning conditions. We complemented this behavioral and electrophysiological data with offline structural (MRI) and functional connectivity (fMRI) analysis of the main interoceptive hubs. HBD and HEP results convergently showed that SCD subjects presented ongoing psychophysiological measures of enhanced interoceptive accuracy. This pattern was associated with a structural and functional tuning of interoceptive networks (reduced volume and specialized network segregation). Taken together, our findings provide the first evidence of an association between cardiac interoception and smoked cocaine, partially supporting models that propose hyper-interoception as a key aspect of addiction. More generally, our study shows that multimodal assessments of interoception could substantially inform the clinical and neurocognitive characterization of psychophysiological and neurocognitive adaptations triggered by addiction.
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Affiliation(s)
- Alethia de la Fuente
- 0000 0004 0608 3193grid.411168.bInstitute of Cognitive and Translational Neuroscience (INCYT), INECO Foundation, Favaloro University, Buenos Aires, Argentina ,0000 0001 1945 2152grid.423606.5National Scientific and Technical Research Council, Buenos Aires, Argentina
| | - Lucas Sedeño
- 0000 0004 0608 3193grid.411168.bInstitute of Cognitive and Translational Neuroscience (INCYT), INECO Foundation, Favaloro University, Buenos Aires, Argentina ,0000 0001 1945 2152grid.423606.5National Scientific and Technical Research Council, Buenos Aires, Argentina
| | - Sofia Schurmann Vignaga
- 0000 0004 0608 3193grid.411168.bInstitute of Cognitive and Translational Neuroscience (INCYT), INECO Foundation, Favaloro University, Buenos Aires, Argentina
| | - Camila Ellmann
- 0000 0004 0608 3193grid.411168.bInstitute of Cognitive and Translational Neuroscience (INCYT), INECO Foundation, Favaloro University, Buenos Aires, Argentina
| | - Silvina Sonzogni
- 0000 0001 1945 2152grid.423606.5National Scientific and Technical Research Council, Buenos Aires, Argentina ,0000 0001 1945 2152grid.423606.5Laboratorio de Neuroepigenética, Departamento de Química Biológica, Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires e IQUIBICEN, CONICET, Buenos Aires, Argentina
| | - Laura Belluscio
- 0000 0001 1945 2152grid.423606.5National Scientific and Technical Research Council, Buenos Aires, Argentina ,0000 0001 1945 2152grid.423606.5Laboratorio de Neuroepigenética, Departamento de Química Biológica, Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires e IQUIBICEN, CONICET, Buenos Aires, Argentina
| | - Indira García-Cordero
- 0000 0004 0608 3193grid.411168.bInstitute of Cognitive and Translational Neuroscience (INCYT), INECO Foundation, Favaloro University, Buenos Aires, Argentina ,0000 0001 1945 2152grid.423606.5National Scientific and Technical Research Council, Buenos Aires, Argentina
| | - Eugenia Castagnaro
- 0000 0004 0608 3193grid.411168.bInstitute of Cognitive and Translational Neuroscience (INCYT), INECO Foundation, Favaloro University, Buenos Aires, Argentina
| | - Magdalena Boano
- 0000 0004 0608 3193grid.411168.bInstitute of Cognitive and Translational Neuroscience (INCYT), INECO Foundation, Favaloro University, Buenos Aires, Argentina
| | - Marcelo Cetkovich
- 0000 0004 0608 3193grid.411168.bInstitute of Cognitive and Translational Neuroscience (INCYT), INECO Foundation, Favaloro University, Buenos Aires, Argentina
| | - Teresa Torralva
- 0000 0004 0608 3193grid.411168.bInstitute of Cognitive and Translational Neuroscience (INCYT), INECO Foundation, Favaloro University, Buenos Aires, Argentina
| | - Eduardo T. Cánepa
- 0000 0001 1945 2152grid.423606.5National Scientific and Technical Research Council, Buenos Aires, Argentina ,0000 0001 1945 2152grid.423606.5Laboratorio de Neuroepigenética, Departamento de Química Biológica, Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires e IQUIBICEN, CONICET, Buenos Aires, Argentina
| | - Enzo Tagliazucchi
- 0000 0001 1945 2152grid.423606.5National Scientific and Technical Research Council, Buenos Aires, Argentina ,0000 0001 0056 1981grid.7345.5Buenos Aires Physics Institute (IFIBA) and Physics Department, University of Buenos Aires, Buenos Aires, Argentina
| | - Adolfo M. Garcia
- 0000 0004 0608 3193grid.411168.bInstitute of Cognitive and Translational Neuroscience (INCYT), INECO Foundation, Favaloro University, Buenos Aires, Argentina ,0000 0001 1945 2152grid.423606.5National Scientific and Technical Research Council, Buenos Aires, Argentina ,0000 0001 2185 5065grid.412108.eFaculty of Education, National University of Cuyo (UNCuyo), Mendoza, M5502JMA Argentina
| | - Agustín Ibañez
- Institute of Cognitive and Translational Neuroscience (INCYT), INECO Foundation, Favaloro University, Buenos Aires, Argentina. .,National Scientific and Technical Research Council, Buenos Aires, Argentina. .,Universidad Autónoma del Caribe, Barranquilla, Colombia. .,Center for Social and Cognitive Neuroscience, School of Psychology, Universidad Adolfo Ibáñez, Santiago, Chile. .,Australian Research Council, Centre of Excellence in Cognition and its Disorders, Macquarie University, Sydney, NSW, Australia.
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Johnson KW, Young L, Shamblen S, Suresh G, Browne T, Chookhare KW. Evaluation of the therapeutic community treatment model in Thailand: policy implications for compulsory and prison-based treatment. Subst Use Misuse 2012; 47:889-909. [PMID: 22676561 DOI: 10.3109/10826084.2012.663279] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
This study, conducted in 2005 to 2007, presents results that are based on a proscriptive cohort design. The sample consisted of 769 residents in 22 drug user treatment programs who stayed in treatment for at least 30 days to one year; 510 former residents (66%) from 21 programs (95%) were interviewed again at a 6-month post-treatment follow-up assessment. A majority of the participants were male, lived with family or relatives, had completed only primary school, and had a full-time or a part-time job prior to entering treatment. The participating therapeutic community (TC) programs were a mixture of volunteer, compulsory-probation, and prison-based programs. In-person interview data and urine testing showed that the self-reported drug use prevalence rates are reliable. The results show large positive treatment effects on 30-day and 6-month illegal drug use and small to medium effects on the severity of alcohol use and related problems. A multilevel regression analysis suggests that residents' reduced stigma, adaptation of the TC model, and frequency of alcohol and drug use-related consequences partially predict treatment success. Study limitations and policy implications are discussed.
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Affiliation(s)
- Knowlton W Johnson
- Pacific Institute for Research and Evaluation, Inc., Louisville Center, 400 So. 4th St., Louisville, KY 40208, USA.
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Attas JD, de Pabón EV, Cueva RN. Current challenges and future perspectives in the field of addiction psychiatry in Latin America. Int Rev Psychiatry 2011; 22:347-54. [PMID: 20874064 DOI: 10.3109/09540261.2010.500866] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
This paper provides a brief review of the addictions field in Latin America. Epidemiology, legal aspects, dual pathology, treatment, prevention and future directions are discussed. This increasing disease is one of the major contributors for mental health problems in the region. Efforts have been made in treatment and prevention but results and budgets are scarce. Dual pathology, new modalities such as injected heroin in countries such as Colombia, low coverage of programmes, training resources, research and publications are important challenges. The tendency to liberalize legal terms of use would require more effort for prevention and education. Based on relevant literature and a long and current experience in the area, the authors summarize this important theme.
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Johnson K, Pan Z, Young L, Vanderhoff J, Shamblen S, Browne T, Linfield K, Suresh G. Therapeutic community drug treatment success in Peru: a follow-up outcome study. SUBSTANCE ABUSE TREATMENT PREVENTION AND POLICY 2008; 3:26. [PMID: 19055774 PMCID: PMC2631528 DOI: 10.1186/1747-597x-3-26] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/20/2008] [Accepted: 12/03/2008] [Indexed: 11/30/2022]
Abstract
Background The purpose of this study was to assess the impact of drug abuse treatment in Peru that used the therapeutic community (TC) model. Program directors and several staff members from all study treatment facilities received two to eight weeks of in-country training on how to implement the TC treatment model prior to the follow-up study. Methods This outcome study involved 33 TC treatment facilities and 509 former clients in Lima and other cities in five providences across Peru. A retrospective pre-test (RPT) follow-up design was employed in which 30-day use of illegal drugs and alcohol to intoxication was measured at baseline retrospectively, at the same time of the six-month follow-up. In-person interview data were collected from directors of 73 percent of the eligible TC organizations in January and February 2003 and from former 58 percent of the eligible TC former clients between October 2003 and October 2004. Drug testing was conducted on a small sample of former clients to increase the accuracy of the self-reported drug use data. Results Medium to large positive treatment effects were found when comparing 30-day illegal drug and alcohol use to intoxication before and six months after receiving treatment. As a supplemental analysis, we assumed the 42 percent of the former clients who were not interviewed at the six month assessment had returned to drugs. These results showed medium treatment effects as well. Hierarchical Generalized Linear Modeling (HGLM) results showed higher implementation fidelity, less stigma after leaving treatment, and older clients, singly or in combination are key predictors of treatment success. Conclusion This study found that former clients of drug and alcohol treatment in facilities using the TC model reported substantial positive change in use of illegal drugs and alcohol to intoxication at a six-month follow-up. The unique contribution of this study is that the results also suggest attention should be placed on the importance of implementing the TC drug abuse treatment model with fidelity. Further, the results strongly suggest that TC drug abuse treatment programs should incorporate follow-up activities that attempt to neutralize community negative reactions (perceived stigma) independent of other factors.
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Affiliation(s)
- Knowlton Johnson
- Pacific Institute for Research and Evaluation, Inc,, 1300 S, Fourth Street, Ste, 300, Louisville, KY 40208, USA.
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