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Sangchooli A, Zare-Bidoky M, Fathi Jouzdani A, Schacht J, Bjork JM, Claus ED, Prisciandaro JJ, Wilson SJ, Wüstenberg T, Potvin S, Ahmadi P, Bach P, Baldacchino A, Beck A, Brady KT, Brewer JA, Childress AR, Courtney KE, Ebrahimi M, Filbey FM, Garavan H, Ghahremani DG, Goldstein RZ, Goudriaan AE, Grodin EN, Hanlon CA, Haugg A, Heilig M, Heinz A, Holczer A, Van Holst RJ, Joseph JE, Juliano AC, Kaufman MJ, Kiefer F, Khojasteh Zonoozi A, Kuplicki RT, Leyton M, London ED, Mackey S, McClernon FJ, Mellick WH, Morley K, Noori HR, Oghabian MA, Oliver JA, Owens M, Paulus MP, Perini I, Rafei P, Ray LA, Sinha R, Smolka MN, Soleimani G, Spanagel R, Steele VR, Tapert SF, Vollstädt-Klein S, Wetherill RR, Witkiewitz K, Yuan K, Zhang X, Verdejo-Garcia A, Potenza MN, Janes AC, Kober H, Zilverstand A, Ekhtiari H. Parameter Space and Potential for Biomarker Development in 25 Years of fMRI Drug Cue Reactivity: A Systematic Review. JAMA Psychiatry 2024; 81:414-425. [PMID: 38324323 DOI: 10.1001/jamapsychiatry.2023.5483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2024]
Abstract
Importance In the last 25 years, functional magnetic resonance imaging drug cue reactivity (FDCR) studies have characterized some core aspects in the neurobiology of drug addiction. However, no FDCR-derived biomarkers have been approved for treatment development or clinical adoption. Traversing this translational gap requires a systematic assessment of the FDCR literature evidence, its heterogeneity, and an evaluation of possible clinical uses of FDCR-derived biomarkers. Objective To summarize the state of the field of FDCR, assess their potential for biomarker development, and outline a clear process for biomarker qualification to guide future research and validation efforts. Evidence Review The PubMed and Medline databases were searched for every original FDCR investigation published from database inception until December 2022. Collected data covered study design, participant characteristics, FDCR task design, and whether each study provided evidence that might potentially help develop susceptibility, diagnostic, response, prognostic, predictive, or severity biomarkers for 1 or more addictive disorders. Findings There were 415 FDCR studies published between 1998 and 2022. Most focused on nicotine (122 [29.6%]), alcohol (120 [29.2%]), or cocaine (46 [11.1%]), and most used visual cues (354 [85.3%]). Together, these studies recruited 19 311 participants, including 13 812 individuals with past or current substance use disorders. Most studies could potentially support biomarker development, including diagnostic (143 [32.7%]), treatment response (141 [32.3%]), severity (84 [19.2%]), prognostic (30 [6.9%]), predictive (25 [5.7%]), monitoring (12 [2.7%]), and susceptibility (2 [0.5%]) biomarkers. A total of 155 interventional studies used FDCR, mostly to investigate pharmacological (67 [43.2%]) or cognitive/behavioral (51 [32.9%]) interventions; 141 studies used FDCR as a response measure, of which 125 (88.7%) reported significant interventional FDCR alterations; and 25 studies used FDCR as an intervention outcome predictor, with 24 (96%) finding significant associations between FDCR markers and treatment outcomes. Conclusions and Relevance Based on this systematic review and the proposed biomarker development framework, there is a pathway for the development and regulatory qualification of FDCR-based biomarkers of addiction and recovery. Further validation could support the use of FDCR-derived measures, potentially accelerating treatment development and improving diagnostic, prognostic, and predictive clinical judgments.
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Affiliation(s)
- Arshiya Sangchooli
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia
| | - Mehran Zare-Bidoky
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis
- Iranian National Center for Addiction Studies (INCAS), Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Fathi Jouzdani
- Iranian National Center for Addiction Studies (INCAS), Tehran University of Medical Sciences, Tehran, Iran
| | - Joseph Schacht
- Department of Psychiatry, University of Colorado School of Medicine, Aurora
| | - James M Bjork
- Institute for Drug and Alcohol Studies, Department of Psychiatry, Virginia Commonwealth University, Richmond
| | - Eric D Claus
- Department of Biobehavioral Health, The Pennsylvania State University, University Park
| | - James J Prisciandaro
- Addiction Sciences Division, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston
| | - Stephen J Wilson
- Department of Psychology, The Pennsylvania State University, State College
| | - Torsten Wüstenberg
- Field of Focus IV, Core Facility for Neuroscience of Self-Regulation (CNSR), Heidelberg University, Heidelberg, Germany
| | - Stéphane Potvin
- Department of Psychiatry and Addiction, Université de Montréal, Montréal, Quebec, Canada
| | - Pooria Ahmadi
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
| | - Patrick Bach
- Department of Addictive Behaviour and Addiction Medicine, Central Institute of Mental Health (CIMH), Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Alex Baldacchino
- School of Medicine, University of St Andrews, St Andrews, Scotland
| | - Anne Beck
- Faculty of Health, Health and Medical University, Potsdam, Germany
- Department of Psychiatry and Neurosciences, Charité Campus Mitte, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Kathleen T Brady
- Addiction Sciences Division, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston
| | - Judson A Brewer
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, Rhode Island
| | | | | | - Mohsen Ebrahimi
- Iranian National Center for Addiction Studies (INCAS), Tehran University of Medical Sciences, Tehran, Iran
| | - Francesca M Filbey
- Center for BrainHealth, School of Behavioral and Brain Sciences, University of Texas at Dallas
| | - Hugh Garavan
- Department of Psychiatry, University of Vermont, Burlington
| | - Dara G Ghahremani
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles
| | - Rita Z Goldstein
- Departments of Psychiatry and Neuroscience, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Anneke E Goudriaan
- Department of Psychiatry, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, the Netherlands
- Amsterdam Neuroscience, Amsterdam, the Netherlands
| | - Erica N Grodin
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles
| | - Colleen A Hanlon
- Department of Cancer Biology, Wake Forest School of Medicine, Winston-Salem, North Carolina
- BrainsWay Inc, Winston-Salem, North Carolina
| | - Amelie Haugg
- Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Markus Heilig
- Center for Social and Affective Neuroscience, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Andreas Heinz
- Department of Psychiatry and Neurosciences, Charité Campus Mitte, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Adrienn Holczer
- Department of Neurology, Albert Szent-Györgyi Health Centre, University of Szeged, Szeged, Hungary
| | - Ruth J Van Holst
- Amsterdam Institute for Addiction Research, Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Jane E Joseph
- Department of Neuroscience, Medical University of South Carolina, Charleston
| | | | - Marc J Kaufman
- McLean Hospital, Harvard Medical School, Belmont, Massachusetts
| | - Falk Kiefer
- Department of Addictive Behaviour and Addiction Medicine, Central Institute of Mental Health (CIMH), Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Arash Khojasteh Zonoozi
- Iranian National Center for Addiction Studies (INCAS), Tehran University of Medical Sciences, Tehran, Iran
| | | | - Marco Leyton
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Edythe D London
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles
| | - Scott Mackey
- Department of Psychiatry, University of Vermont, Burlington
| | - F Joseph McClernon
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, North Carolina
| | - William H Mellick
- Addiction Sciences Division, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston
| | - Kirsten Morley
- Specialty of Addiction Medicine, Faculty of Medicine and Health, Sydney Medical School, University of Sydney, Sydney, Australia
| | - Hamid R Noori
- McGovern Institute for Brain Research, Massachusetts Institute of Technology, Cambridge
| | - Mohammad Ali Oghabian
- Neuroimaging and Analysis Group, Research Center for Molecular and Cellular Imaging, Tehran University of Medical Sciences, Tehran, Iran
| | - Jason A Oliver
- TSET Health Promotion Research Center, University of Oklahoma Health Sciences Center, Oklahoma City
| | - Max Owens
- Department of Psychiatry, University of Vermont, Burlington
| | | | - Irene Perini
- Center for Social and Affective Neuroscience, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Parnian Rafei
- Iranian National Center for Addiction Studies (INCAS), Tehran University of Medical Sciences, Tehran, Iran
| | - Lara A Ray
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles
| | - Rajita Sinha
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut
| | - Michael N Smolka
- Department of Psychiatry, Technische Universität Dresden, Dresden, Germany
| | - Ghazaleh Soleimani
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis
| | - Rainer Spanagel
- Institute of Psychopharmacology, Central Institute of Mental Health, Mannheim, Germany
| | - Vaughn R Steele
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut
| | - Susan F Tapert
- Department of Psychiatry, University of California, San Diego
| | - Sabine Vollstädt-Klein
- Department of Addictive Behaviour and Addiction Medicine, Central Institute of Mental Health (CIMH), Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | | | | | - Kai Yuan
- School of Life Science and Technology, Xidian University, Xi'an, China
| | - Xiaochu Zhang
- Department of Psychology, School of Humanities and Social Science, University of Science and Technology of China, Anhui, China
| | | | - Marc N Potenza
- Department of Psychiatry, Technische Universität Dresden, Dresden, Germany
| | - Amy C Janes
- Cognitive and Pharmacological Neuroimaging Unit, National Institute on Drug Abuse, Baltimore, Maryland
| | - Hedy Kober
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut
| | - Anna Zilverstand
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis
| | - Hamed Ekhtiari
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis
- Laureate Institute for Brain Research, Tulsa, Oklahoma
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Petzold J, Pochon JBF, Ghahremani DG, London ED. Structural indices of brain aging in methamphetamine use disorder. Drug Alcohol Depend 2024; 256:111107. [PMID: 38330525 DOI: 10.1016/j.drugalcdep.2024.111107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 01/01/2024] [Accepted: 01/17/2024] [Indexed: 02/10/2024]
Abstract
BACKGROUND Methamphetamine use is surging globally. It has been linked to premature stroke, Parkinsonism, and dementia, suggesting that it may accelerate brain aging. METHODS We performed a retrospective study to determine if structural indices of brain aging were more prevalent prior to old age (26 - 54 years) in individuals with Methamphetamine Use Disorder (MUD), who were in early abstinence (M ± SD = 22.1 ± 25.6 days) than in healthy control (HC) participants. We compared T1-weighted MRI brain scans in age- and sex-matched groups (n = 89/group) on three structural features of brain aging: the brain volume/cerebrospinal fluid (BV/CSF) index, volume of white matter hypointensities/lesions, and choroid plexus volume. RESULTS The MUD group had a lower mean BV/CSF index and larger volumes of white matter hypointensities and choroid plexus (p-values < 0.01). Regression analyses showed significant age-by-group effects, indicating different age trajectories of the BV/CSF index and choroid plexus volume, consistent with abnormal global brain atrophy and choroid plexus pathology in the MUD group. Significant age and group main effects reflected a larger volume of white matter hypointensities for older participants across groups and for the MUD group irrespective of age. None of the three measures of brain aging correlated significantly with recent use or duration of recent abstinence from methamphetamine. CONCLUSIONS Premature brain pathology, which may reflect cerebrovascular damage and dysfunction of the choroid plexus, occurs in people with MUD. Such pathology may affect cognition and thereby efficacy of behavioral treatments for MUD.
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Affiliation(s)
- Johannes Petzold
- Jane and Terry Semel Institute of Neuroscience and Human Behavior, and Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, Los Angeles, CA, USA; Department of Psychiatry and Psychotherapy, Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Jean-Baptiste F Pochon
- Jane and Terry Semel Institute of Neuroscience and Human Behavior, and Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, Los Angeles, CA, USA
| | - Dara G Ghahremani
- Jane and Terry Semel Institute of Neuroscience and Human Behavior, and Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, Los Angeles, CA, USA
| | - Edythe D London
- Jane and Terry Semel Institute of Neuroscience and Human Behavior, and Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, Los Angeles, CA, USA; The Brain Research Institute, University of California at Los Angeles, Los Angeles, CA, USA; Department of Molecular and Medical Pharmacology, University of California at Los Angeles, Los Angeles, CA, USA.
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Cao Z, McCabe M, Callas P, Cupertino RB, Ottino-González J, Murphy A, Pancholi D, Schwab N, Catherine O, Hutchison K, Cousijn J, Dagher A, Foxe JJ, Goudriaan AE, Hester R, Li CSR, Thompson WK, Morales AM, London ED, Lorenzetti V, Luijten M, Martin-Santos R, Momenan R, Paulus MP, Schmaal L, Sinha R, Solowij N, Stein DJ, Stein EA, Uhlmann A, van Holst RJ, Veltman DJ, Wiers RW, Yücel M, Zhang S, Conrod P, Mackey S, Garavan H. Recalibrating single-study effect sizes using hierarchical Bayesian models. Front Neuroimaging 2023; 2:1138193. [PMID: 38179200 PMCID: PMC10764546 DOI: 10.3389/fnimg.2023.1138193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 11/27/2023] [Indexed: 01/06/2024]
Abstract
Introduction There are growing concerns about commonly inflated effect sizes in small neuroimaging studies, yet no study has addressed recalibrating effect size estimates for small samples. To tackle this issue, we propose a hierarchical Bayesian model to adjust the magnitude of single-study effect sizes while incorporating a tailored estimation of sampling variance. Methods We estimated the effect sizes of case-control differences on brain structural features between individuals who were dependent on alcohol, nicotine, cocaine, methamphetamine, or cannabis and non-dependent participants for 21 individual studies (Total cases: 903; Total controls: 996). Then, the study-specific effect sizes were modeled using a hierarchical Bayesian approach in which the parameters of the study-specific effect size distributions were sampled from a higher-order overarching distribution. The posterior distribution of the overarching and study-specific parameters was approximated using the Gibbs sampling method. Results The results showed shrinkage of the posterior distribution of the study-specific estimates toward the overarching estimates given the original effect sizes observed in individual studies. Differences between the original effect sizes (i.e., Cohen's d) and the point estimate of the posterior distribution ranged from 0 to 0.97. The magnitude of adjustment was negatively correlated with the sample size (r = -0.27, p < 0.001) and positively correlated with empirically estimated sampling variance (r = 0.40, p < 0.001), suggesting studies with smaller samples and larger sampling variance tended to have greater adjustments. Discussion Our findings demonstrate the utility of the hierarchical Bayesian model in recalibrating single-study effect sizes using information from similar studies. This suggests that Bayesian utilization of existing knowledge can be an effective alternative approach to improve the effect size estimation in individual studies, particularly for those with smaller samples.
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Affiliation(s)
- Zhipeng Cao
- Shanghai Xuhui Mental Health Center, Shanghai, China
- Department of Psychiatry, University of Vermont College of Medicine, Burlington, VT, United States
| | - Matthew McCabe
- Department of Psychiatry, University of Vermont College of Medicine, Burlington, VT, United States
| | - Peter Callas
- Department of Mathematics and Statistics, University of Vermont College of Engineering and Mathematical Sciences, Burlington, VT, United States
| | - Renata B. Cupertino
- Department of Psychiatry, University of Vermont College of Medicine, Burlington, VT, United States
| | - Jonatan Ottino-González
- Department of Psychiatry, University of Vermont College of Medicine, Burlington, VT, United States
| | - Alistair Murphy
- Department of Psychiatry, University of Vermont College of Medicine, Burlington, VT, United States
| | - Devarshi Pancholi
- Department of Psychiatry, University of Vermont College of Medicine, Burlington, VT, United States
| | - Nathan Schwab
- Department of Psychiatry, University of Vermont College of Medicine, Burlington, VT, United States
| | - Orr Catherine
- Department of Psychological Sciences, School of Health Sciences, Swinburne University, Melbourne, VIC, Australia
| | - Kent Hutchison
- Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, CO, United States
| | - Janna Cousijn
- Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, Rotterdam, Netherlands
| | - Alain Dagher
- Department of Neurology and Neurosurgery, Montreal Neurological Institute, McGill University, Montreal, QC, Canada
| | - John J. Foxe
- Department of Neuroscience, The Ernest J. Del Monte Institute for Neuroscience, University of Rochester School of Medicine and Dentistry, Rochester, NY, United States
| | - Anna E. Goudriaan
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Robert Hester
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, VIC, Australia
| | - Chiang-Shan R. Li
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | | | - Angelica M. Morales
- Department of Psychiatry at Oregon Health and Science University, Portland, OR, United States
| | - Edythe D. London
- David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA, United States
| | - Valentina Lorenzetti
- Neuroscience of Addiction and Mental Health Program, Healthy Brain and Mind Research Centre, School of Behavioural & Health Sciences, Faculty of Health Sciences, Australian Catholic University, Australia
| | - Maartje Luijten
- Behavioural Science Institute, Radboud University, Nijmegen, Netherlands
| | - Rocio Martin-Santos
- Department of Psychiatry and Psychology, University of Barcelona, Barcelona, Spain
| | - Reza Momenan
- Clinical NeuroImaging Research Core, Division of Intramural Clinical and Biological Research, National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, United States
| | - Martin P. Paulus
- Laureate Institute for Brain Research, Tulsa, OK, United States
- VA San Diego Healthcare System and Department of Psychiatry, University of California San Diego, La Jolla, CA, United States
| | - Lianne Schmaal
- Orygen, Parkville, VIC, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Rajita Sinha
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Nadia Solowij
- School of Psychology and Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, NSW, Australia
| | - Dan J. Stein
- SA MRC Unit on Risk and Resilience in Mental Disorders, Department of Psychiatry and Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Elliot A. Stein
- Neuroimaging Research Branch, Intramural Research Program, National Institute on Drug Abuse, Baltimore, MD, United States
| | - Anne Uhlmann
- Department of Child and Adolescent Psychiatry and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Ruth J. van Holst
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Dick J. Veltman
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Reinout W. Wiers
- Addiction Development and Psychopathology (ADAPT)-Lab, Department of Psychology and Center for Urban Mental Health, University of Amsterdam, Amsterdam, Netherlands
| | - Murat Yücel
- BrainPark, Turner Institute for Brain and Mental Health, School of Psychological Sciences, and Monash Biomedical Imaging Facility, Monash University, Melbourne, VIC, Australia
| | - Sheng Zhang
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Patricia Conrod
- Department of Psychiatry, Université de Montreal, CHU Ste Justine Hospital, Montreal, QC, Canada
| | - Scott Mackey
- Department of Psychiatry, University of Vermont College of Medicine, Burlington, VT, United States
| | - Hugh Garavan
- Department of Psychiatry, University of Vermont College of Medicine, Burlington, VT, United States
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Abstract
BACKGROUND Alcohol consumption is a leading cause of morbidity and mortality worldwide, disproportionately affecting young men. Heavy episodic drinking is particularly prevalent among men, with this behavior peaking between the ages of 20 and 24. AIMS We sought to identify dimensions of decision-making in men that would predict the development of hazardous alcohol use through emerging adulthood. METHODS This prospective observational study profiled value-based decision-making in 198 healthy men at age 18 and assessed their alcohol involvement annually until age 24. Latent growth curve modeling estimated individual variability in trajectories of alcohol involvement and regressed this variability on five choice dimensions. RESULTS Low loss aversion predicted sustained heavy episodic drinking from age 18 to 24. Both high delay discounting and risk-seeking for gains independently predicted a considerably higher cumulative alcohol use during these 6 years, with high delay discounting indicating escalating consumption from age 21. Risk-seeking for gains additionally predicted meeting more criteria for Alcohol Use Disorder in these 6 years. Risk-seeking for losses was not significantly related to alcohol outcomes. Choice preferences were largely independent of each other but were correlated with choice consistency, with low consistency predicting heavy episodic drinking from age 18 to 24 beyond these associations. CONCLUSIONS The predictive effects collectively suggest that overvaluing immediate and probabilistic incentives, rather than underestimating harm, drives hazardous drinking in young men. The differential relations of choice preferences and consistency to alcohol involvement through emerging adulthood provide distinct cognitive-behavioral patterns that warrant consideration in the development of harm reduction interventions.
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Affiliation(s)
- Johannes Petzold
- Department of Psychiatry and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Angela Hentschel
- Department of Psychiatry and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Hao Chen
- Department of Psychiatry and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Sören Kuitunen-Paul
- Institute of Clinical Psychology and Psychotherapy, and Department of Child and Adolescent Psychiatry, Technische Universität Dresden, Dresden, Germany
- Chair of Clinical Psychology and Psychotherapy, Technische Universität Chemnitz, Chemnitz, Germany
| | - Edythe D London
- Department of Psychiatry and Biobehavioral Sciences, Department of Molecular and Medical Pharmacology, and the Brain Research Institute, University of California at Los Angeles, Los Angeles, CA, USA
| | - Andreas Heinz
- Department of Psychiatry and Neurosciences at Charité Campus Mitte, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Michael N Smolka
- Department of Psychiatry and Psychotherapy, Technische Universität Dresden, Dresden, Germany
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Jarrett O, London ED, Mahmoudie T, Suh J, Ghahremani D, Dean AC. Mindfulness and clinical correlates in methamphetamine use disorder. Drug Alcohol Depend 2023; 253:111029. [PMID: 38006669 DOI: 10.1016/j.drugalcdep.2023.111029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 10/30/2023] [Accepted: 11/10/2023] [Indexed: 11/27/2023]
Abstract
BACKGROUND Mindfulness-based interventions are increasingly used for the treatment of substance use disorders, including methamphetamine use disorder (MUD). Literature indicates that trait mindfulness may play a key role in the effectiveness of these treatments on therapeutic outcome, yet no prior studies have tested for differences in trait mindfulness between individuals with MUD and healthy control participants. Such differences are important for treatment implementation. OBJECTIVES The goals of this study were to evaluate trait mindfulness and to determine its clinical correlates in individuals with MUD. METHODS A group of participants with MUD at varying lengths of abstinence from methamphetamine (< 1h to 90 days; mean 5.4 ± 12.5 days; N=95, 53 female, 42 male) and a healthy control group (N=65, 30 female, 35 male) completed the Mindfulness Attention Awareness Scale (MAAS). Group differences and relationships between trait mindfulness and several measures of drug use and psychiatric symptoms were evaluated. RESULTS In participants with MUD, trait mindfulness was 10% lower than in healthy controls (p < 0.001), but it was not significantly correlated with measures of drug use or craving. Across both groups, trait mindfulness was negatively correlated with state anxiety, depression, emotional dysregulation, impulsivity, and a history of childhood trauma, while it was positively correlated with self-compassion (ps < 0.001). CONCLUSION The deficit in trait mindfulness in MUD presents a capacity that can be targeted for improved treatment outcome with mindfulness-based therapies. Trait mindfulness is inversely related to mood dysregulation.
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Affiliation(s)
- Olivia Jarrett
- Department of Psychiatry and Biobehavioral Sciences, Jane and Terry Semel Institute for Neuroscience and human Behavior, David Geffen School of Medicine, USA
| | - Edythe D London
- Department of Psychiatry and Biobehavioral Sciences, Jane and Terry Semel Institute for Neuroscience and human Behavior, David Geffen School of Medicine, USA; Department of Molecular and Medical Pharmacology, USA; Brain Research Institute, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90024, USA
| | - Tarannom Mahmoudie
- Department of Psychiatry and Biobehavioral Sciences, Jane and Terry Semel Institute for Neuroscience and human Behavior, David Geffen School of Medicine, USA
| | - Jaymee Suh
- Department of Psychiatry and Biobehavioral Sciences, Jane and Terry Semel Institute for Neuroscience and human Behavior, David Geffen School of Medicine, USA
| | - Dara Ghahremani
- Department of Psychiatry and Biobehavioral Sciences, Jane and Terry Semel Institute for Neuroscience and human Behavior, David Geffen School of Medicine, USA; Brain Research Institute, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90024, USA
| | - Andy C Dean
- Department of Psychiatry and Biobehavioral Sciences, Jane and Terry Semel Institute for Neuroscience and human Behavior, David Geffen School of Medicine, USA; Brain Research Institute, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90024, USA.
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O'Neill J, Diaz MP, Alger JR, Pochon JB, Ghahremani D, Dean AC, Tyndale RF, Petersen N, Marohnic S, Karaiskaki A, London ED. Smoking, tobacco dependence, and neurometabolites in the dorsal anterior cingulate cortex. Mol Psychiatry 2023; 28:4756-4765. [PMID: 37749232 PMCID: PMC10914613 DOI: 10.1038/s41380-023-02247-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 08/24/2023] [Accepted: 08/29/2023] [Indexed: 09/27/2023]
Abstract
Cigarette smoking has a major impact on global health and morbidity, and positron emission tomographic research has provided evidence for reduced inflammation in the human brain associated with cigarette smoking. Given the consequences of inflammatory dysfunction for health, the question of whether cigarette smoking affects neuroinflammation warrants further investigation. The goal of this project therefore was to validate and extend evidence of hypoinflammation related to smoking, and to examine the potential contribution of inflammation to clinical features of smoking. Using magnetic resonance spectroscopy, we measured levels of neurometabolites that are putative neuroinflammatory markers. N-acetyl compounds (N-acetylaspartate + N-acetylaspartylglutamate), glutamate, creatine, choline-compounds (phosphocholine + glycerophosphocholine), and myo-inositol, have all been linked to neuroinflammation, but they have not been examined as such with respect to smoking. We tested whether people who smoke cigarettes have brain levels of these metabolites consistent with decreased neuroinflammation, and whether clinical features of smoking are associated with levels of these metabolites. The dorsal anterior cingulate cortex was chosen as the region-of-interest because of previous evidence linking it to smoking and related states. Fifty-four adults who smoked daily maintained overnight smoking abstinence before testing and were compared with 37 nonsmoking participants. Among the smoking participants, we tested for associations of metabolite levels with tobacco dependence, smoking history, craving, and withdrawal. Levels of N-acetyl compounds and glutamate were higher, whereas levels of creatine and choline compounds were lower in the smoking group as compared with the nonsmoking group. In the smoking group, glutamate and creatine levels correlated negatively with tobacco dependence, and creatine correlated negatively with lifetime smoking, but none of the metabolite levels correlated with craving or withdrawal. The findings indicate a link between smoking and a hypoinflammatory state in the brain, specifically in the dorsal anterior cingulate cortex. Smoking may thereby increase vulnerability to infection and brain injury.
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Affiliation(s)
- Joseph O'Neill
- Division of Child & Adolescent Psychiatry, Department of Psychiatry, University of California at Los Angeles, Los Angeles, CA, USA
- Brain Research Institute, University of California at Los Angeles, Los Angeles, CA, USA
| | - Maylen Perez Diaz
- Jane and Terry Semel Institute for Neuroscience and Human Behavior and the Department of Psychiatry, University of California at Los Angeles, Los Angeles, CA, USA
- Biogen, Inc., Nashville, TN, USA
| | - Jeffry R Alger
- Department of Neurology, University of California at Los Angeles, Los Angeles, CA, USA
| | - Jean-Baptiste Pochon
- Jane and Terry Semel Institute for Neuroscience and Human Behavior and the Department of Psychiatry, University of California at Los Angeles, Los Angeles, CA, USA
| | - Dara Ghahremani
- Jane and Terry Semel Institute for Neuroscience and Human Behavior and the Department of Psychiatry, University of California at Los Angeles, Los Angeles, CA, USA
| | - Andrew C Dean
- Jane and Terry Semel Institute for Neuroscience and Human Behavior and the Department of Psychiatry, University of California at Los Angeles, Los Angeles, CA, USA
| | - Rachel F Tyndale
- Department of Pharmacology & Toxicology, and Department of Psychiatry, University of Toronto, and Campbell Family Mental Health Research Institute, Centre for Addiction & Mental Health, Toronto, ON, Canada
| | - Nicole Petersen
- Jane and Terry Semel Institute for Neuroscience and Human Behavior and the Department of Psychiatry, University of California at Los Angeles, Los Angeles, CA, USA
| | - Shane Marohnic
- Jane and Terry Semel Institute for Neuroscience and Human Behavior and the Department of Psychiatry, University of California at Los Angeles, Los Angeles, CA, USA
| | - Andrea Karaiskaki
- Jane and Terry Semel Institute for Neuroscience and Human Behavior and the Department of Psychiatry, University of California at Los Angeles, Los Angeles, CA, USA
| | - Edythe D London
- Brain Research Institute, University of California at Los Angeles, Los Angeles, CA, USA.
- Jane and Terry Semel Institute for Neuroscience and Human Behavior and the Department of Psychiatry, University of California at Los Angeles, Los Angeles, CA, USA.
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7
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Nurmi EL, Laughlin CP, de Wit H, Palmer AA, MacKillop J, Cannon TD, Bilder RM, Congdon E, Sabb FW, Seaman LC, McElroy JJ, Libowitz MR, Weafer J, Gray J, Dean AC, Hellemann GS, London ED. Polygenic contributions to performance on the Balloon Analogue Risk Task. Mol Psychiatry 2023; 28:3524-3530. [PMID: 37582857 PMCID: PMC10618088 DOI: 10.1038/s41380-023-02123-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 05/03/2023] [Accepted: 06/07/2023] [Indexed: 08/17/2023]
Abstract
Risky decision-making is a common, heritable endophenotype seen across many psychiatric disorders. Its underlying genetic architecture is incompletely explored. We examined behavior in the Balloon Analogue Risk Task (BART), which tests risky decision-making, in two independent samples of European ancestry. One sample (n = 1138) comprised healthy participants and some psychiatric patients (53 schizophrenia, 42 bipolar disorder, 47 ADHD); the other (n = 911) excluded for recent treatment of various psychiatric disorders but not ADHD. Participants provided DNA and performed the BART, indexed by mean adjusted pumps. We constructed a polygenic risk score (PRS) for discovery in each dataset and tested it in the other as replication. Subsequently, a genome-wide MEGA-analysis, combining both samples, tested genetic correlation with risk-taking self-report in the UK Biobank sample and psychiatric phenotypes characterized by risk-taking (ADHD, Bipolar Disorder, Alcohol Use Disorder, prior cannabis use) in the Psychiatric Genomics Consortium. The PRS for BART performance in one dataset predicted task performance in the replication sample (r = 0.13, p = 0.000012, pFDR = 0.000052), as did the reciprocal analysis (r = 0.09, p = 0.0083, pFDR=0.04). Excluding participants with psychiatric diagnoses produced similar results. The MEGA-GWAS identified a single SNP (rs12023073; p = 3.24 × 10-8) near IGSF21, a protein involved in inhibitory brain synapses; replication samples are needed to validate this result. A PRS for self-reported cannabis use (p = 0.00047, pFDR = 0.0053), but not self-reported risk-taking or psychiatric disorder status, predicted behavior on the BART in our MEGA-GWAS sample. The findings reveal polygenic architecture of risky decision-making as measured by the BART and highlight its overlap with cannabis use.
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Affiliation(s)
- E L Nurmi
- Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, Los Angeles, CA, 90024, USA.
| | - C P Laughlin
- Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, Los Angeles, CA, 90024, USA
| | - H de Wit
- Department of Psychiatry, University of Chicago, Chicago, IL, 60637, USA
| | - A A Palmer
- Department of Psychiatry, University of California at San Diego, La Jolla, CA, 92093, USA
- Institute for Genomic Medicine, University of California San Diego, La Jolla, CA, 92093, USA
| | - J MacKillop
- Peter Boris Centre for Addictions Research, McMaster University and St. Joseph's Healthcare Hamilton, Hamilton, ON, L8S4L8, Canada
| | - T D Cannon
- Departments of Psychology and Psychiatry, Yale University, New Haven, CT, 06520, USA
| | - R M Bilder
- Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, Los Angeles, CA, 90024, USA
| | - E Congdon
- Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, Los Angeles, CA, 90024, USA
| | - F W Sabb
- Prevention Science Institute, University of Utah, Salt Lake City, UT, 84112, USA
| | - L C Seaman
- Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, Los Angeles, CA, 90024, USA
| | - J J McElroy
- Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, Los Angeles, CA, 90024, USA
| | - M R Libowitz
- Department of Neurobiology, University of Kentucky, Lexington, KY, 40506, USA
| | - J Weafer
- Department of Psychology, University of Kentucky, Lexington, KY, 40506, USA
| | - J Gray
- Department of Psychology, University of Georgia, Athens, GA, 30602, USA
| | - A C Dean
- Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, Los Angeles, CA, 90024, USA
| | - G S Hellemann
- Department of Public Health, University of Alabama at Birmingham, Birmingham, AL, 35294, USA
| | - E D London
- Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, Los Angeles, CA, 90024, USA
- Department of Molecular and Medical Pharmacology, University of California at Los Angeles, Los Angeles, CA, 90024, USA
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Tabibnia G, Ghahremani DG, Pochon JBF, Diaz MP, London ED. Negative affect and craving during abstinence from smoking are both linked to default mode network connectivity. Drug Alcohol Depend 2023; 249:109919. [PMID: 37270935 PMCID: PMC10516582 DOI: 10.1016/j.drugalcdep.2023.109919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 04/11/2023] [Accepted: 05/09/2023] [Indexed: 06/06/2023]
Abstract
BACKGROUND Negative affect and craving during abstinence from cigarettes predict resumption of smoking. Therefore, understanding their neural substrates may guide development of new interventions. Negative affect and craving have traditionally been linked to functions of the brain's threat and reward networks, respectively. However, given the role of default mode network (DMN), particularly the posterior cingulate cortex (PCC), in self-related thought, we examined whether DMN activity underlies both craving and negative affective states in adults who smoke. METHODS 46 adults who smoke abstained from smoking overnight and underwent resting-state fMRI, after self-reporting their psychological symptoms (negative affect) and craving on the Shiffman-Jarvik Withdrawal Scale and state anxiety (negative affect) on the Spielberger State-Trait Anxiety Inventory. Within-DMN functional connectivity using 3 different anterior PCC seeds was tested for correlations with self-report measures. Additionally, independent component analysis with dual regression was performed to measure associations of self-report with whole-brain connectivity of the DMN component. RESULTS Craving correlated positively with connectivity of all three anterior PCC seeds with posterior PCC clusters (pcorr<0.04). The measures of negative affective states correlated positively with connectivity of the DMN component to various brain regions, including posterior PCC (pcorr=0.02) and striatum (pcorr<0.008). Craving and state anxiety were correlated with connectivity of an overlapping region of PCC (pcorr=0.003). Unlike the state measures, nicotine dependence and trait anxiety were not associated with PCC connectivity within DMN. CONCLUSIONS Although negative affect and craving are distinct subjective states, they appear to share a common neural pathway within the DMN, particularly involving the PCC.
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Affiliation(s)
- Golnaz Tabibnia
- Department of Psychological Science, University of California, Irvine, CA, USA.
| | - Dara G Ghahremani
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
| | - Jean-Baptiste F Pochon
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
| | - Maylen Perez Diaz
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
| | - Edythe D London
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
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9
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Guttman Z, Mandelkern M, Ghahremani DG, Kohno M, Dean AC, London ED. Decomposing risky decision-making in methamphetamine use disorder: Behavioral updating and D2 dopamine receptors. Drug Alcohol Depend 2023; 246:109860. [PMID: 37004462 PMCID: PMC10814877 DOI: 10.1016/j.drugalcdep.2023.109860] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 03/17/2023] [Accepted: 03/25/2023] [Indexed: 04/04/2023]
Abstract
BACKGROUND Escalating misuse of amphetamine-type stimulants, mainly methamphetamine, has led to a staggering rise in associated overdose deaths and a pressing need to understand the basis of methamphetamine use disorder (MUD). MUD is characterized by disadvantageous decision-making, and people with MUD perform below controls on the Balloon Analogue Risk Task (BART), a laboratory test of decision-making under uncertainty. The BART presents a series of choices with progressively higher stakes-greater risk of loss and greater potential monetary reward. This research aimed to clarify whether impaired behavioral updating contributes to maladaptive performance on the BART. METHODS Two groups (28 drug-abstinent participants with MUD and 16 healthy control participants) were compared on BART performance. Using a computational model, we deconstructed behavior into risk-taking and behavioral updating. A subset of participants (22 MUD, 15 healthy control) underwent [18F]fallypride positron emission tomography scans to measure dopamine D2-type receptor availability (BPND) in the striatum (caudate and accumbens nuclei and putamen) and the globus pallidus. RESULTS Participants with MUD exhibited slower behavioral updating than the healthy controls (p = 0.0004, d=1.77). BPND in all four bilateral volumes of interest were higher in the healthy control group (ps < 0.005, ds < 2.16), and updating rate correlated positively with BPND in the caudate nucleus (p = 0.002), putamen (p = 0.002), and globus pallidus (p = 0.03). CONCLUSIONS The findings indicate that behavioral updating contributes to maladaptive decision-making in MUD and suggest that dysregulation of D2-type receptor signaling in the striatum and globus pallidus contributes to this behavioral deficit.
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Affiliation(s)
- Zoe Guttman
- Department of Psychiatry and Biobehavioral Sciences and Jane and Terry Semel Institute of Neuroscience and Human Behavior, University of California Los Angeles, Los Angeles, CA 90024, USA
| | - Mark Mandelkern
- Veterans Administration of Greater Los Angeles Health System, Los Angeles, CA 90073, USA; Department of Physics, University of California at Irvine, Irvine, CA 92697, USA
| | - Dara G Ghahremani
- Department of Psychiatry and Biobehavioral Sciences and Jane and Terry Semel Institute of Neuroscience and Human Behavior, University of California Los Angeles, Los Angeles, CA 90024, USA
| | - Milky Kohno
- Department of Psychiatry, Oregon Health & Science University, Oregon Health Sciences University, Portland, OR 97239, USA
| | - Andy C Dean
- Department of Psychiatry and Biobehavioral Sciences and Jane and Terry Semel Institute of Neuroscience and Human Behavior, University of California Los Angeles, Los Angeles, CA 90024, USA
| | - Edythe D London
- Department of Psychiatry and Biobehavioral Sciences and Jane and Terry Semel Institute of Neuroscience and Human Behavior, University of California Los Angeles, Los Angeles, CA 90024, USA; Veterans Administration of Greater Los Angeles Health System, Los Angeles, CA 90073, USA; Department of Molecular and Medical Pharmacology, University of California Los Angeles, Los Angeles, CA 90024, USA; Brain Research Institute, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90024, USA.
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10
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Nestor LJ, Ghahremani DG, London ED. Reduced neural functional connectivity during working memory performance in methamphetamine use disorder. Drug Alcohol Depend 2023; 243:109764. [PMID: 36610253 DOI: 10.1016/j.drugalcdep.2023.109764] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 11/20/2022] [Accepted: 01/01/2023] [Indexed: 01/06/2023]
Abstract
BACKGROUND Methamphetamine misuse, a surging cause of morbidity and mortality worldwide, identifies Methamphetamine Use Disorder (MUD) as a critical public health problem. Treatment for MUD typically is sought during early abstinence when patients are experiencing cognitive difficulties that may hamper their engagement in treatment and recovery. Cognitive difficulties, particularly those that involve executive functions, likely reflect disruptions in neural functioning involving multiple brain areas and circuits. METHODS To extend knowledge in this area, we compared individuals with MUD (MUD group, n = 30) in early abstinence (3-11 days abstinent) with a healthy control group (HC, n = 33) on brain activation and network connectivity and topology, using functional magnetic resonance imaging (fMRI) during performance on an N-back working memory task. The N-back task involves the maintenance and manipulation of information in short-term memory and engages multiple neural processes related to executive functioning. The task was administered at two working-memory difficulty loads (1-back and 2-back). RESULTS Compared with the HC group, the MUD group had worse task performance but no differences in task-related brain activation. Network-based statistics analyses, however, revealed that the MUD group exhibited less functional network connectivity at both difficulty loads of the N-back task than the HC group. Additional graph theory analyses showed that path lengths were longer, and clustering was lower across these networks, which also exhibited disrupted small-world properties in the MUD group. CONCLUSION These results suggest a decoupling in network dynamics that may underlie deficits in cognition during early abstinence in MUD patients.
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Affiliation(s)
- Liam J Nestor
- Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, USA
| | - Dara G Ghahremani
- Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, USA
| | - Edythe D London
- Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, USA; Brain Research Institute, University of California at Los Angeles, USA; Department of Molecular and Medical Pharmacology, University of California at Los Angeles, USA.
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11
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Petzold J, Dean AC, Pochon JB, Ghahremani DG, De La Garza R, London ED. Cortical thickness and related depressive symptoms in early abstinence from chronic methamphetamine use. Addict Biol 2022; 27:e13205. [PMID: 36001419 PMCID: PMC9413352 DOI: 10.1111/adb.13205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Revised: 05/28/2022] [Accepted: 06/19/2022] [Indexed: 11/30/2022]
Abstract
Methamphetamine use is surging globally as a cause of morbidity and mortality. Treatment is typically sought in early abstinence, when craving and depressive symptoms are intense, contributing to relapse and poor outcomes. To advance an understanding of this problem and identify therapeutic targets, we conducted a retrospective analysis of brain structure in 89 adults with Methamphetamine Use Disorder who were in early abstinence and 89 healthy controls. Unlike most prior research, the participants did not significantly differ in age, sex and recent use of alcohol and tobacco (p-values ≥ 0.400). We analysed thickness across the entire cerebral cortex by fitting a general linear model to identify differences between groups. Follow-up regressions were performed to determine whether cortical thickness in regions showing group differences was related to craving, measured on a visual analogue scale, or to the Beck Depression Inventory score. Participants in early methamphetamine abstinence (M ± SD = 22.1 ± 25.6 days) exhibited thinner cortex in clusters within bilateral frontal, parietal, temporal, insular, and right cingulate cortices relative to controls (p-values < 0.001, corrected for multiple comparisons). Unlike craving (β = 0.007, p = 0.947), depressive symptoms were positively correlated with cortical thickness across clusters (β = 0.239, p = 0.030) and with thickness in the anterior cingulate cluster (β = 0.246, p = 0.027) in the methamphetamine-dependent group. Inasmuch as anterior cingulate pathology predicts response to antidepressants for Major Depressive Disorder, cingulate structure may also identify patients with Methamphetamine Use Disorder who can benefit from antidepressant medication.
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Affiliation(s)
- Johannes Petzold
- Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, Los Angeles, CA, USA
- Department of Psychiatry and Psychotherapy, Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Andy C. Dean
- Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, Los Angeles, CA, USA
- The Brain Research Institute, University of California at Los Angeles, Los Angeles, CA, USA
| | - Jean-Baptiste Pochon
- Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, Los Angeles, CA, USA
| | - Dara G. Ghahremani
- Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, Los Angeles, CA, USA
| | - Richard De La Garza
- Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, Los Angeles, CA, USA
| | - Edythe D. London
- Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, Los Angeles, CA, USA
- The Brain Research Institute, University of California at Los Angeles, Los Angeles, CA, USA
- Department of Molecular and Medical Pharmacology, University of California at Los Angeles, Los Angeles, CA, USA
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12
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Grodin EN, Nieto SJ, Meredith LR, Burnette E, O’Neill J, Alger J, London ED, Miotto K, Evans CJ, Irwin MR, Ray LA. Effects of ibudilast on central and peripheral markers of inflammation in alcohol use disorder: A randomized clinical trial. Addict Biol 2022; 27:e13182. [PMID: 35754106 PMCID: PMC9888600 DOI: 10.1111/adb.13182] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 04/14/2022] [Accepted: 04/27/2022] [Indexed: 02/02/2023]
Abstract
Ibudilast, a neuroimmune modulator, shows promise as a pharmacotherapy for alcohol use disorder (AUD). In vivo administration of ibudilast reduces the expression of pro-inflammatory cytokines in animal models, but its effects on markers of inflammation in humans are unknown. This preliminary study examined the effect of ibudilast on peripheral and potential central markers of inflammation in individuals with AUD. This study also explored the predictive relationship of neurometabolite markers with subsequent drinking in the trial. Non-treatment-seeking individuals with an AUD (n = 52) were randomized to receive oral ibudilast (n = 24) or placebo (n = 28) for 2 weeks. Plasma levels of peripheral inflammatory markers were measured at baseline and after 1 and 2 weeks of medication. At study mid-point, proton magnetic resonance spectroscopy was performed to measure potential neurometabolite markers of inflammation: choline-compounds (Cho), myo-inositol (MI) and creatine + phosphocreatine (Cr) in frontal and cingulate cortices from 43 participants (ibudilast: n = 20; placebo: n = 23). The treatment groups were compared on peripheral and central markers. Ibudilast-treated participants had lower Cho in superior frontal white matter and nominally lower MI in pregenual anterior cingulate cortex. Ibudilast-treated participants had nominally lower C-reactive protein levels at visit 2 and nominally lower TNF-α/IL-10 ratios, relative to placebo. C-reactive protein and Cho levels were correlated, controlling for medication. Superior frontal white matter Cho predicted drinking in the following week. Micro-longitudinal ibudilast treatment may induce peripheral and putative central anti-inflammatory responses in patients with AUD. The neurometabolite responses may be associated with reduction in drinking, suggesting an anti-inflammatory component to the therapeutic action of ibudilast.
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Affiliation(s)
- Erica N. Grodin
- Department of Psychology, University of California at Los Angeles, Los Angeles, CA
| | - Steven J. Nieto
- Department of Psychology, University of California at Los Angeles, Los Angeles, CA
| | - Lindsay R. Meredith
- Department of Psychology, University of California at Los Angeles, Los Angeles, CA
| | - Elizabeth Burnette
- Department of Psychology, University of California at Los Angeles, Los Angeles, CA,Neuroscience Interdepartmental Program, University of California at Los Angeles, Los Angeles, CA
| | - Joseph O’Neill
- Jane & Terry Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA
| | - Jeffry Alger
- Department of Neurology, University of California Los Angeles, MC 708522, Los Angeles, CA
| | - Edythe D. London
- Brain Research Institute, University of California, Los Angeles, CA,Department of Molecular and Medical Pharmacology, University of California, Los Angeles, CA
| | - Karen Miotto
- Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, Los Angeles, CA
| | - Christopher J. Evans
- Brain Research Institute, University of California, Los Angeles, CA,Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, Los Angeles, CA
| | - Michael R. Irwin
- Department of Psychology, University of California at Los Angeles, Los Angeles, CA,Jane & Terry Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA,Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, Los Angeles, CA,Cousins Center for Psychoneuroimmunology, University of California at Los Angeles, Los Angeles, CA
| | - Lara A. Ray
- Department of Psychology, University of California at Los Angeles, Los Angeles, CA,Brain Research Institute, University of California, Los Angeles, CA,Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, Los Angeles, CA
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Ekhtiari H, Zare-Bidoky M, Sangchooli A, Janes AC, Kaufman MJ, Oliver JA, Prisciandaro JJ, Wüstenberg T, Anton RF, Bach P, Baldacchino A, Beck A, Bjork JM, Brewer J, Childress AR, Claus ED, Courtney KE, Ebrahimi M, Filbey FM, Ghahremani DG, Azbari PG, Goldstein RZ, Goudriaan AE, Grodin EN, Hamilton JP, Hanlon CA, Hassani-Abharian P, Heinz A, Joseph JE, Kiefer F, Zonoozi AK, Kober H, Kuplicki R, Li Q, London ED, McClernon J, Noori HR, Owens MM, Paulus MP, Perini I, Potenza M, Potvin S, Ray L, Schacht JP, Seo D, Sinha R, Smolka MN, Spanagel R, Steele VR, Stein EA, Steins-Loeber S, Tapert SF, Verdejo-Garcia A, Vollstädt-Klein S, Wetherill RR, Wilson SJ, Witkiewitz K, Yuan K, Zhang X, Zilverstand A. A methodological checklist for fMRI drug cue reactivity studies: development and expert consensus. Nat Protoc 2022; 17:567-595. [PMID: 35121856 PMCID: PMC9063851 DOI: 10.1038/s41596-021-00649-4] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 10/21/2021] [Indexed: 12/23/2022]
Abstract
Cue reactivity is one of the most frequently used paradigms in functional magnetic resonance imaging (fMRI) studies of substance use disorders (SUDs). Although there have been promising results elucidating the neurocognitive mechanisms of SUDs and SUD treatments, the interpretability and reproducibility of these studies is limited by incomplete reporting of participants' characteristics, task design, craving assessment, scanning preparation and analysis decisions in fMRI drug cue reactivity (FDCR) experiments. This hampers clinical translation, not least because systematic review and meta-analysis of published work are difficult. This consensus paper and Delphi study aims to outline the important methodological aspects of FDCR research, present structured recommendations for more comprehensive methods reporting and review the FDCR literature to assess the reporting of items that are deemed important. Forty-five FDCR scientists from around the world participated in this study. First, an initial checklist of items deemed important in FDCR studies was developed by several members of the Enhanced NeuroImaging Genetics through Meta-Analyses (ENIGMA) Addiction working group on the basis of a systematic review. Using a modified Delphi consensus method, all experts were asked to comment on, revise or add items to the initial checklist, and then to rate the importance of each item in subsequent rounds. The reporting status of the items in the final checklist was investigated in 108 recently published FDCR studies identified through a systematic review. By the final round, 38 items reached the consensus threshold and were classified under seven major categories: 'Participants' Characteristics', 'General fMRI Information', 'General Task Information', 'Cue Information', 'Craving Assessment Inside Scanner', 'Craving Assessment Outside Scanner' and 'Pre- and Post-Scanning Considerations'. The review of the 108 FDCR papers revealed significant gaps in the reporting of the items considered important by the experts. For instance, whereas items in the 'General fMRI Information' category were reported in 90.5% of the reviewed papers, items in the 'Pre- and Post-Scanning Considerations' category were reported by only 44.7% of reviewed FDCR studies. Considering the notable and sometimes unexpected gaps in the reporting of items deemed to be important by experts in any FDCR study, the protocols could benefit from the adoption of reporting standards. This checklist, a living document to be updated as the field and its methods advance, can help improve experimental design, reporting and the widespread understanding of the FDCR protocols. This checklist can also provide a sample for developing consensus statements for protocols in other areas of task-based fMRI.
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Affiliation(s)
- Hamed Ekhtiari
- Laureate Institute for Brain Research, Tulsa, OK, USA. .,Department of Psychiatry & Behavioral Sciences, University of Minnesota, Minneapolis, MN, USA.
| | - Mehran Zare-Bidoky
- Iranian National Center for Addiction Studies (INCAS), Tehran University of Medical Sciences, Tehran, Iran.,Shahid-Sadoughi University of Medical Sciences, Yazd, Iran.,These authors contributed equally: Mehran Zare-Bidoky, Arshiya Sangchooli
| | - Arshiya Sangchooli
- Iranian National Center for Addiction Studies (INCAS), Tehran University of Medical Sciences, Tehran, Iran.,These authors contributed equally: Mehran Zare-Bidoky, Arshiya Sangchooli
| | - Amy C. Janes
- Department of Psychiatry, McLean Hospital, Harvard Medical School, Belmont, MA, USA
| | - Marc J. Kaufman
- Department of Psychiatry, McLean Hospital, Harvard Medical School, Belmont, MA, USA
| | - Jason A. Oliver
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA.,TSET Health Promotion Research Center, Stephenson Cancer Center, Oklahoma City, OK, USA.,Department of Psychiatry & Behavioral Sciences, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
| | - James J. Prisciandaro
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Torsten Wüstenberg
- Department of Psychiatry and Neurosciences, Charité Campus Mitte, Charité–Universitätsmedizin Berlin, Berlin, Germany
| | - Raymond F. Anton
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Patrick Bach
- Department of Addictive Behaviour and Addiction Medicine, Central Institute of Mental Health (CIMH), Heidelberg University, Mannheim, Germany
| | - Alex Baldacchino
- Division of Population Studies and Behavioural Sciences, St Andrews University Medical School, University of St Andrews, Scotland, UK
| | - Anne Beck
- Department of Psychiatry and Neurosciences, Charité Campus Mitte, Charité–Universitätsmedizin Berlin, Berlin, Germany.,Faculty of Health, Health and Medical University, Campus Potsdam, Potsdam, Germany
| | - James M. Bjork
- Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA
| | - Judson Brewer
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, USA
| | - Anna Rose Childress
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Eric D. Claus
- Department of Biobehavioral Health, The Pennsylvania State University, University Park, PA, USA
| | - Kelly E. Courtney
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
| | - Mohsen Ebrahimi
- Iranian National Center for Addiction Studies (INCAS), Tehran University of Medical Sciences, Tehran, Iran
| | - Francesca M. Filbey
- Center for BrainHealth, School of Behavioral and Brain Sciences, University of Texas at Dallas, Dallas, TX, USA
| | - Dara G. Ghahremani
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, USA
| | - Peyman Ghobadi Azbari
- Iranian National Center for Addiction Studies (INCAS), Tehran University of Medical Sciences, Tehran, Iran.,Department of Biomedical Engineering, Shahed University, Tehran, Iran
| | - Rita Z. Goldstein
- Departments of Psychiatry & Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Anna E. Goudriaan
- Department of Psychiatry, Amsterdam University Medical Center, University of Amsterdam and Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Erica N. Grodin
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, USA
| | - J. Paul Hamilton
- Center for Social and Affective Neuroscience, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.,Center for Medical Image Science and Visualization, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Colleen A. Hanlon
- Department of Cancer Biology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | | | - Andreas Heinz
- Department of Psychiatry and Neurosciences, Charité Campus Mitte, Charité–Universitätsmedizin Berlin, Berlin, Germany
| | - Jane E. Joseph
- Department of Neuroscience, Medical University of South Carolina, Charleston, SC, USA
| | - Falk Kiefer
- Department of Addictive Behaviour and Addiction Medicine, Central Institute of Mental Health (CIMH), Heidelberg University, Mannheim, Germany
| | - Arash Khojasteh Zonoozi
- Iranian National Center for Addiction Studies (INCAS), Tehran University of Medical Sciences, Tehran, Iran.,Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hedy Kober
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | | | - Qiang Li
- Department of Radiology, Tangdu Hospital, Fourth Military Medical University, Xi’an, China
| | - Edythe D. London
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, USA
| | - Joseph McClernon
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA
| | - Hamid R. Noori
- International Center for Primate Brain Research, Center for Excellence in Brain Science and Intelligence Technology (CEBSIT)/Institute of Neuroscience (ION), Chinese Academy of Sciences, Shanghai, China.,McGovern Institute for Brain Research, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Max M. Owens
- Department of Psychiatry, University of Vermont, Burlington, VT, USA
| | | | - Irene Perini
- Center for Social and Affective Neuroscience, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.,Center for Medical Image Science and Visualization, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Marc Potenza
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA.,Connecticut Mental Health Center, New Haven, CT, USA.,Connecticut Council on Problem Gambling, Wethersfield, CT, USA.,Department of Neuroscience, Child Study Center and Wu Tsai Institute, Yale School of Medicine, New Haven, CT, USA
| | - Stéphane Potvin
- Centre de recherche de l’Institut Universitaire en Santé Mentale de Montréal, University of Montreal, Montreal, Canada
| | - Lara Ray
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, USA
| | | | - Dongju Seo
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Rajita Sinha
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Michael N. Smolka
- Department of Psychiatry, Technische Universität Dresden, Dresden, Germany
| | - Rainer Spanagel
- Institute of Psychopharmacology, Central Institute of Mental Health, Mannheim, Germany
| | - Vaughn R. Steele
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Elliot A. Stein
- Intramural Research Program, National Institute on Drug Abuse, Baltimore, MD, USA
| | - Sabine Steins-Loeber
- Department of Clinical Psychology and Psychotherapy, Otto-Friedrich-University of Bamberg, Bamberg, Germany
| | - Susan F. Tapert
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
| | | | - Sabine Vollstädt-Klein
- Department of Addictive Behaviour and Addiction Medicine, Central Institute of Mental Health (CIMH), Heidelberg University, Mannheim, Germany
| | - Reagan R. Wetherill
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Stephen J. Wilson
- Department of Psychology, The Pennsylvania State University, University Park, PA, USA
| | - Katie Witkiewitz
- Department of Psychology, University of New Mexico, Albuquerque, NM, USA
| | - Kai Yuan
- School of Life Science and Technology, Xidian University, Xi’an, China
| | - Xiaochu Zhang
- Department of Psychology, School of Humanities and Social Science, University of Science and Technology of China, Anhui, China.,Department of Radiology, First Affiliated Hospital of USTC, Hefei National Laboratory for Physical Science at the Microscale and School of Life Science, Division of Life Science and Medicine, University of Science and Technology of China, Anhui, China
| | - Anna Zilverstand
- Department of Psychiatry & Behavioral Sciences, University of Minnesota, Minneapolis, MN, USA
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14
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Rice M, Dean AC, Suh J, London ED. Denial and Diagnosis of Methamphetamine Dependence Severity. Subst�Abuse 2022; 16:11782218221135721. [DOI: 10.1177/11782218221135721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 09/12/2022] [Indexed: 11/10/2022]
Abstract
Introduction: Denial, or lack of awareness of problems related to substance misuse, is a common feature of drug use disorders and can affect engagement in treatment and recovery. This study tested for association of denial with severity of symptoms used in the diagnosis of Methamphetamine Dependence. Methods: This secondary analysis used data from 69 participants (52.2% male) who met criteria for the diagnosis of Methamphetamine Dependence on the Structured Clinical Interview for DSM-IV (SCID). The association between diagnostic severity, determined from a SCID summary score (8 items), and denial, measured by the University of Rhode Island Change Assessment Scale (URICA) Precontemplation score, was tested by Pearson correlation. In post hoc t-tests, participants who differed on individual SCID items were compared on the Precontemplation score. The additional URICA subscales (Contemplation, Maintenance, Action) were also tested on a secondary basis. Results: SCID summary scores were negatively correlated with URICA Precontemplation scores ( P = .003). Post-hoc tests revealed that participants who denied continued methamphetamine use despite persistent or recurrent problems (SCID item 6) had significantly higher Precontemplation scores than those who endorsed these problems ( t = 3.066, P = .003). In contrast, positive correlations were observed between diagnostic severity and greater openness/willingness to change on the URICA (eg, Maintenance, r = .26; P = .01). Conclusions: The findings highlight the importance of a patient’s insight regarding their addiction in clinical diagnosis. Because minimizing the impact of methamphetamine use may preclude or delay treatment, it is advised that self-report be supplemented to improve accuracy of diagnosis.
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Affiliation(s)
- Myra Rice
- Neuroscience Interdepartmental Graduate Program, University of California, Los Angeles, CA, USA
| | - Andy C Dean
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, USA
- Brain Research Institute, University of California, Los Angeles, Los Angeles, CA, USA
| | - Jaymee Suh
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, USA
| | - Edythe D London
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, USA
- Brain Research Institute, University of California, Los Angeles, Los Angeles, CA, USA
- Department of Molecular and Medical Pharmacology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
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15
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Ottino-González J, Uhlmann A, Hahn S, Cao Z, Cupertino RB, Schwab N, Allgaier N, Alia-Klein N, Ekhtiari H, Fouche JP, Goldstein RZ, Li CSR, Lochner C, London ED, Luijten M, Masjoodi S, Momenan R, Oghabian MA, Roos A, Stein DJ, Stein EA, Veltman DJ, Verdejo-García A, Zhang S, Zhao M, Zhong N, Jahanshad N, Thompson PM, Conrod P, Mackey S, Garavan H. White matter microstructure differences in individuals with dependence on cocaine, methamphetamine, and nicotine: Findings from the ENIGMA-Addiction working group. Drug Alcohol Depend 2022; 230:109185. [PMID: 34861493 PMCID: PMC8952409 DOI: 10.1016/j.drugalcdep.2021.109185] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 10/27/2021] [Accepted: 11/14/2021] [Indexed: 01/03/2023]
Abstract
BACKGROUND Nicotine and illicit stimulants are very addictive substances. Although associations between grey matter and dependence on stimulants have been frequently reported, white matter correlates have received less attention. METHODS Eleven international sites ascribed to the ENIGMA-Addiction consortium contributed data from individuals with dependence on cocaine (n = 147), methamphetamine (n = 132) and nicotine (n = 189), as well as non-dependent controls (n = 333). We compared the fractional anisotropy (FA), axial diffusivity (AD), radial diffusivity (RD) and mean diffusivity (MD) of 20 bilateral tracts. Also, we compared the performance of various machine learning algorithms in deriving brain-based classifications on stimulant dependence. RESULTS The cocaine and methamphetamine groups had lower regional FA and higher RD in several association, commissural, and projection white matter tracts. The methamphetamine dependent group additionally showed lower regional AD. The nicotine group had lower FA and higher RD limited to the anterior limb of the internal capsule. The best performing machine learning algorithm was the support vector machine (SVM). The SVM successfully classified individuals with dependence on cocaine (AUC = 0.70, p < 0.001) and methamphetamine (AUC = 0.71, p < 0.001) relative to non-dependent controls. Classifications related to nicotine dependence proved modest (AUC = 0.62, p = 0.014). CONCLUSIONS Stimulant dependence was related to FA disturbances within tracts consistent with a role in addiction. The multivariate pattern of white matter differences proved sufficient to identify individuals with stimulant dependence, particularly for cocaine and methamphetamine.
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Affiliation(s)
- Jonatan Ottino-González
- Department of Psychiatry, University of Vermont College of Medicine, Burlington, Vermont, United States.
| | - Anne Uhlmann
- Department of Child & Adolescent Psychiatry and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Sage Hahn
- Department of Psychiatry, University of Vermont College of Medicine, Burlington, Vermont, United States
| | - Zhipeng Cao
- Department of Psychiatry, University of Vermont College of Medicine, Burlington, Vermont, United States
| | - Renata B. Cupertino
- Department of Psychiatry, University of Vermont College of Medicine, Burlington, Vermont, United States
| | - Nathan Schwab
- Department of Psychiatry, University of Vermont College of Medicine, Burlington, Vermont, United States
| | - Nicholas Allgaier
- Department of Psychiatry, University of Vermont College of Medicine, Burlington, Vermont, United States
| | - Nelly Alia-Klein
- Department of Psychiatry & Neuroscience, Icahn School of Medicine at Mount Sinai, New York City, New York, United States
| | - Hamed Ekhtiari
- Institute for Cognitive Sciences Studies, University of Tehran, Tehran, Iran,Iranian National Center for Addiction Studies, Tehran University of Medical Sciences, Tehran, Iran
| | - Jean-Paul Fouche
- SA MRC Genomics and Brain Disorders Unit, Department of Psychiatry, Stellenbosch University, Stellenbosch, South Africa
| | - Rita Z. Goldstein
- Department of Psychiatry & Neuroscience, Icahn School of Medicine at Mount Sinai, New York City, New York, United States
| | - Chiang-Shan R. Li
- Department of Psychiatry, Yale University, New Haven, Connecticut, United States
| | - Christine Lochner
- SA MRC Unit on Risk & Resilience in Mental Disorders, Department of Psychiatry, Stellenbosch University, Stellenbosch, South Africa
| | - Edythe D. London
- Department of Psychiatry and Biobehavioural Sciences, University of California, Los Angeles, California, United States
| | - Maartje Luijten
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
| | - Sadegh Masjoodi
- Shiraz Neuroscience Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Reza Momenan
- Clinical Neuroimaging Research Core, National Institutes on Alcohol Abuse & Alcoholism, National Institutes of Health, Bethesda, Maryland, United States
| | - Mohammad Ali Oghabian
- Neuroimaging & Analysis Group, Research Center for Molecular and Cellular Imaging, Tehran University of Medical Sciences, Tehran, Iran
| | - Annerine Roos
- SA MRC Unit on Risk & Resilience in Mental Disorders, Department of Psychiatry, Stellenbosch University, Stellenbosch, South Africa,SA MRC Unit on Risk & Resilience in Mental Disorders, Department of Psychiatry & Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Dan J. Stein
- SA MRC Unit on Risk & Resilience in Mental Disorders, Department of Psychiatry & Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Elliot A. Stein
- Neuroimaging Research Branch, Intramural Research Program, National Institute of Drug Abuse, Baltimore, Maryland, United States
| | - Dick J. Veltman
- Department of Psychiatry, Amsterdam UMC – location VUMC, Amsterdam, the Netherlands
| | - Antonio Verdejo-García
- School of Psychological Sciences & Turner Institute for Brain & Mental Health, Monash University, Melbourne, Australia
| | - Sheng Zhang
- Department of Psychiatry, Yale University, New Haven, Connecticut, United States
| | - Min Zhao
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Na Zhong
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Neda Jahanshad
- Stevens Institute for Neuroimaging & Informatics, Keck School of Medicine, University of Southern California, San Diego, California, United States
| | - Paul M. Thompson
- Stevens Institute for Neuroimaging & Informatics, Keck School of Medicine, University of Southern California, San Diego, California, United States
| | - Patricia Conrod
- Department of Psychiatry, Université de Montreal, Montreal, Quebec, Canada
| | - Scott Mackey
- Department of Psychiatry, University of Vermont College of Medicine, Burlington, Vermont, United States
| | - Hugh Garavan
- Department of Psychiatry, University of Vermont College of Medicine, Burlington, Vermont, United States
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16
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Ghahremani DG, Pochon JB, Perez Diaz M, Tyndale RF, Dean AC, London ED. Functional connectivity of the anterior insula during withdrawal from cigarette smoking. Neuropsychopharmacology 2021; 46:2083-2089. [PMID: 34035468 PMCID: PMC8505622 DOI: 10.1038/s41386-021-01036-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 04/27/2021] [Accepted: 05/04/2021] [Indexed: 12/18/2022]
Abstract
Currently available therapies for smoking cessation have limited efficacy, and potential treatments that target specific brain regions are under evaluation, with a focus on the insula. The ventral and dorsal anterior subregions of the insula serve distinct functional networks, yet our understanding of how these subregions contribute to smoking behavior is unclear. Resting-state functional connectivity (RSFC) provides a window into network-level function associated with smoking-related internal states. The goal of this study was to determine potentially distinct relationships of ventral and dorsal anterior insula RSFC with cigarette withdrawal after brief abstinence from smoking. Forty-seven participants (24 women; 18-45 years old), who smoked cigarettes daily and were abstinent from smoking overnight (~12 h), provided self-reports of withdrawal and underwent resting-state fMRI before and after smoking the first cigarette of the day. Correlations between withdrawal and RSFC were computed separately for ventral and dorsal anterior insula seed regions in whole-brain voxel-wise analyses. Withdrawal was positively correlated with RSFC of the right ventral anterior insula and dorsal anterior cingulate cortex (dACC) before but not after smoking. The correlation was mainly due to a composite effect of craving and physical symptoms of withdrawal. These results suggest a role of right ventral anterior insula-dACC connectivity in the internal states that maintain smoking behavior (e.g., withdrawal) and present a specific neural target for brain-based therapies seeking to attenuate withdrawal symptoms in the critical early stages of smoking cessation.
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Affiliation(s)
- Dara G. Ghahremani
- grid.19006.3e0000 0000 9632 6718Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA USA
| | - Jean-Baptiste Pochon
- grid.19006.3e0000 0000 9632 6718Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA USA
| | - Maylen Perez Diaz
- grid.19006.3e0000 0000 9632 6718Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA USA
| | - Rachel F. Tyndale
- grid.17063.330000 0001 2157 2938Department of Pharmacology & Toxicology, University of Toronto, Toronto, ON Canada ,grid.17063.330000 0001 2157 2938Department of Psychiatry, University of Toronto, Toronto, ON Canada ,grid.155956.b0000 0000 8793 5925Campbell Family Mental Health Research Institute, Centre for Addiction & Mental Health, Toronto, ON Canada
| | - Andy C. Dean
- grid.19006.3e0000 0000 9632 6718Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA USA ,grid.19006.3e0000 0000 9632 6718Brain Research Institute, University of California, Los Angeles, CA USA
| | - Edythe D. London
- grid.19006.3e0000 0000 9632 6718Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA USA ,grid.19006.3e0000 0000 9632 6718Brain Research Institute, University of California, Los Angeles, CA USA ,grid.19006.3e0000 0000 9632 6718Department of Molecular and Medical Pharmacology, University of California, Los Angeles, CA USA
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17
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Cao Z, Ottino‐Gonzalez J, Cupertino RB, Schwab N, Hoke C, Catherine O, Cousijn J, Dagher A, Foxe JJ, Goudriaan AE, Hester R, Hutchison K, Li CR, London ED, Lorenzetti V, Luijten M, Martin‐Santos R, Momenan R, Paulus MP, Schmaal L, Sinha R, Sjoerds Z, Solowij N, Stein DJ, Stein EA, Uhlmann A, Holst RJ, Veltman DJ, Wiers RW, Yücel M, Zhang S, Jahanshad N, Thompson PM, Conrod P, Mackey S, Garavan H. Mapping cortical and subcortical asymmetries in substance dependence: Findings from the ENIGMA Addiction Working Group. Addict Biol 2021; 26:e13010. [PMID: 33508888 DOI: 10.1111/adb.13010] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 12/21/2020] [Accepted: 01/14/2021] [Indexed: 02/03/2023]
Abstract
Brain asymmetry reflects left-right hemispheric differentiation, which is a quantitative brain phenotype that develops with age and can vary with psychiatric diagnoses. Previous studies have shown that substance dependence is associated with altered brain structure and function. However, it is unknown whether structural brain asymmetries are different in individuals with substance dependence compared with nondependent participants. Here, a mega-analysis was performed using a collection of 22 structural brain MRI datasets from the ENIGMA Addiction Working Group. Structural asymmetries of cortical and subcortical regions were compared between individuals who were dependent on alcohol, nicotine, cocaine, methamphetamine, or cannabis (n = 1,796) and nondependent participants (n = 996). Substance-general and substance-specific effects on structural asymmetry were examined using separate models. We found that substance dependence was significantly associated with differences in volume asymmetry of the nucleus accumbens (NAcc; less rightward; Cohen's d = 0.15). This effect was driven by differences from controls in individuals with alcohol dependence (less rightward; Cohen's d = 0.10) and nicotine dependence (less rightward; Cohen's d = 0.11). These findings suggest that disrupted structural asymmetry in the NAcc may be a characteristic of substance dependence.
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Affiliation(s)
- Zhipeng Cao
- Department of Psychiatry University of Vermont College of Medicine Burlington Vermont USA
| | | | - Renata B. Cupertino
- Department of Psychiatry University of Vermont College of Medicine Burlington Vermont USA
| | - Nathan Schwab
- Department of Psychiatry University of Vermont College of Medicine Burlington Vermont USA
| | - Colin Hoke
- Department of Psychiatry University of Vermont College of Medicine Burlington Vermont USA
| | - Orr Catherine
- Department of Psychological Sciences, School of Health Sciences Swinburne University Melbourne Australia
| | - Janna Cousijn
- Departments of Psychology University of Amsterdam Amsterdam Netherlands
| | - Alain Dagher
- Department of Neurology and Neurosurgery, Montreal Neurological Institute McGill University Montreal Quebec Canada
| | - John J. Foxe
- Department of Neuroscience and The Ernest J. Del Monte Institute for Neuroscience University of Rochester School of Medicine and Dentistry Rochester New York USA
| | - Anna E. Goudriaan
- Department of Psychiatry, Amsterdam UMC, Location AMC University of Amsterdam Amsterdam Netherlands
| | - Robert Hester
- Melbourne School of Psychological Sciences University of Melbourne Melbourne Australia
| | - Kent Hutchison
- Department of Psychology and Neuroscience University of Colorado Boulder Boulder Colorado USA
| | - Chiang‐Shan R. Li
- Department of Psychiatry Yale University School of Medicine New Haven Connecticut USA
| | - Edythe D. London
- David Geffen School of Medicine University of California at Los Angeles Los Angeles California USA
| | - Valentina Lorenzetti
- Neuroscience of Addiction and Mental Health Program, Healthy Brain and Mind Research Centre, School of Behavioural and Health Sciences, Faculty of Health Sciences Australian Catholic University Sydney Australia
| | - Maartje Luijten
- Behavioural Science Institute Radboud University Nijmegen Netherlands
| | - Rocio Martin‐Santos
- Department of Psychiatry and Psychology University of Barcelona Barcelona Spain
| | - Reza Momenan
- Clinical NeuroImaging Research Core, Division of Intramural Clinical and Biological Research National Institute on Alcohol Abuse and Alcoholism Bethesda Maryland USA
| | - Martin P. Paulus
- VA San Diego Healthcare System and Department of Psychiatry University of California San Diego La Jolla California USA
- Laureate Institute for Brain Research Tulsa Oklahoma USA
| | - Lianne Schmaal
- Orygen Parkville Australia
- Centre for Youth Mental Health University of Melbourne Melbourne Australia
| | - Rajita Sinha
- Department of Psychiatry Yale University School of Medicine New Haven Connecticut USA
| | - Zsuzsika Sjoerds
- Institute of Psychology and Leiden Institute for Brain and Cognition Leiden University Leiden Netherlands
| | - Nadia Solowij
- School of Psychology and Illawarra Health and Medical Research Institute University of Wollongong Wollongong Australia
| | - Dan J. Stein
- SA MRC Unit on Risk & Resilience in Mental Disorders, Department of Psychiatry and Neuroscience Institute University of Cape Town Cape Town South Africa
| | - Elliot A. Stein
- Neuroimaging Research Branch, Intramural Research Program National Institute on Drug Abuse Baltimore Maryland USA
| | - Anne Uhlmann
- Department of Child and Adolescent Psychiatry and Psychotherapy Technische Universität Dresden Dresden Germany
| | - Ruth J. Holst
- Department of Psychiatry, Amsterdam UMC, Location AMC University of Amsterdam Amsterdam Netherlands
| | - Dick J. Veltman
- Department of Psychiatry, Amsterdam UMC, Location AMC University of Amsterdam Amsterdam Netherlands
| | - Reinout W. Wiers
- Addiction Development and Psychopathology (ADAPT)‐lab, Department of Psychology and Center for Urban Mental Health University of Amsterdam Amsterdam Netherlands
| | - Murat Yücel
- BrainPark, Turner Institute for Brain and Mental Health, School of Psychological Sciences, and Monash Biomedical Imaging Facility Monash University Melbourne Victoria Australia
| | - Sheng Zhang
- Department of Psychiatry Yale University School of Medicine New Haven Connecticut USA
| | - Neda Jahanshad
- Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC University of Southern California Marina del Rey California USA
| | - Paul M. Thompson
- Imaging Genetics Center, Stevens Institute for Neuroimaging and Informatics, Keck School of Medicine University of Southern California Marina del Rey Californis USA
| | - Patricia Conrod
- Department of Psychiatry Université de Montreal, CHU Ste Justine Hospital Montreal Quebec Canada
| | - Scott Mackey
- Department of Psychiatry University of Vermont College of Medicine Burlington Vermont USA
| | - Hugh Garavan
- Department of Psychiatry University of Vermont College of Medicine Burlington Vermont USA
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18
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Perez Diaz M, Pochon JB, Ghahremani DG, Dean AC, Faulkner P, Petersen N, Tyndale RF, Donis A, Paez D, Cahuantzi C, Hellemann GS, London ED. Sex Differences in the Association of Cigarette Craving With Insula Structure. Int J Neuropsychopharmacol 2021; 24:624-633. [PMID: 33830218 PMCID: PMC8378076 DOI: 10.1093/ijnp/pyab015] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 03/01/2021] [Accepted: 04/05/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Cigarette craving, which can negatively impact smoking cessation, is reportedly stronger in women than in men when they initiate abstinence from smoking. Identifying approaches to counteract craving in people of different sexes may facilitate the development of personalized treatments for Tobacco Use Disorder, which disproportionately affects women. Because cigarette craving is associated with nicotine dependence and structure of the insula, this study addressed whether a person's sex influences these associations. METHODS The research participants (n = 99, 48 women) reported daily cigarette smoking and provided self-reports of nicotine dependence. After overnight abstinence from smoking, they underwent structural magnetic resonance imaging scanning to determine cortical thickness of the left and right anterior circular insular sulcus, and self-rated their cigarette craving before and after their first cigarette of the day. RESULTS Women reported stronger craving than men irrespective of smoking condition (i.e., pre- and post-smoking) (P = .048), and smoking reduced craving irrespective of sex (P < .001). A 3-way interaction of sex, smoking condition, and right anterior circular insular sulcus thickness on craving (P = .033) reflected a negative association of cortical thickness with pre-smoking craving in women only (P = .012). No effects of cortical thickness in the left anterior circular insular sulcus were detected. Nicotine dependence was positively associated with craving (P < .001) across groups and sessions, with no sex differences in this association. CONCLUSIONS A negative association of right anterior insula thickness with craving in women only suggests that this region may be a relevant therapeutic target for brain-based smoking cessation interventions in women.
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Affiliation(s)
- Maylen Perez Diaz
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, California, USA
| | - Jean-Baptiste Pochon
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, California, USA
| | - Dara G Ghahremani
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, California, USA
| | - Andy C Dean
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, California, USA
| | - Paul Faulkner
- Department of Psychology, University of Roehampton, London, UK
| | - Nicole Petersen
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, California, USA
| | - Rachel F Tyndale
- Department of Pharmacology and Toxicology and Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction & Mental Health, Toronto, ON, Canada
| | - Andrea Donis
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, California, USA
| | - Diana Paez
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, California, USA
| | - Citlaly Cahuantzi
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, California, USA
| | - Gerhard S Hellemann
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, California, USA
| | - Edythe D London
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, California, USA
- Department of Molecular and Medical Pharmacology
- Brain Research Institute, University of California, Los Angeles, California, USA
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19
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Guttman ZR, Ghahremani DG, Pochon JB, Dean AC, London ED. Age Influences Loss Aversion Through Effects on Posterior Cingulate Cortical Thickness. Front Neurosci 2021; 15:673106. [PMID: 34321994 PMCID: PMC8311492 DOI: 10.3389/fnins.2021.673106] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 06/15/2021] [Indexed: 12/05/2022] Open
Abstract
Decision-making strategies shift during normal aging and can profoundly affect wellbeing. Although overweighing losses compared to gains, termed "loss aversion," plays an important role in choice selection, the age trajectory of this effect and how it may be influenced by associated changes in brain structure remain unclear. We therefore investigated the relationship between age and loss aversion, and tested for its mediation by cortical thinning in brain regions that are susceptible to age-related declines and are implicated in loss aversion - the insular, orbitofrontal, and anterior and posterior cingulate cortices. Healthy participants (n = 106, 17-54 years) performed the Loss Aversion Task. A subgroup (n = 78) provided structural magnetic resonance imaging scans. Loss aversion followed a curvilinear trajectory, declining in young adulthood and increasing in middle-age, and thinning of the posterior cingulate cortex mediated this trajectory. The findings suggest that beyond a threshold in middle adulthood, atrophy of the posterior cingulate cortex influences loss aversion.
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Affiliation(s)
- Zoe R. Guttman
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, United States
| | - Dara G. Ghahremani
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, United States
| | - Jean-Baptiste Pochon
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, United States
| | - Andy C. Dean
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, United States
- Brain Research Institute, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
| | - Edythe D. London
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, United States
- Brain Research Institute, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
- Department of Molecular and Medical Pharmacology, University of California, Los Angeles, Los Angeles, CA, United States
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20
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Petersen N, Rapkin AJ, Okita K, Kinney KR, Mizuno T, Mandelkern MA, London ED. Striatal dopamine D 2-type receptor availability and peripheral 17β-estradiol. Mol Psychiatry 2021; 26:2038-2047. [PMID: 33420479 PMCID: PMC9196143 DOI: 10.1038/s41380-020-01000-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 11/16/2020] [Accepted: 12/10/2020] [Indexed: 12/15/2022]
Abstract
Research using rodent models has established a relationship between the steroid hormone estrogen and dopamine function, by revealing changes throughout the estrous cycle and by directly manipulating neuroendocrine signaling through ovariectomy and administration of estrogen. However, a direct link between estrogen levels and dopamine signaling had not been established in humans. The goal of this study, therefore, was to assess the relationship between circulating 17β-estradiol and dopamine signaling in the human brain by testing for a relationship between two proxies for these variables: peripheral 17β-estradiol and striatal dopamine D2-type receptor availability, measured with [18F]fallypride and positron emission tomography (PET). Sixteen (23-45 years of age) women were tested on 2 days of the menstrual cycle estimated prospectively to occur during (a) the early follicular phase, when estrogen levels are near their nadir, and (b) the periovulatory phase, when estrogen levels peak. PET scans with [18F]fallypride were performed on these 2 days, and serum 17β-estradiol was measured using radioimmunoassay. Dopamine D2-type receptor availability did not differ significantly in the whole striatum or the caudate, putamen, or accumbens subregions during the high-estrogen vs. the low-estrogen phases of the menstrual cycle. We conclude that circulating estrogen levels do not affect dopamine D2-type receptor availability in the human striatum although other indices of dopaminergic function may be affected.
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Affiliation(s)
- Nicole Petersen
- Jane and Terry Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, 90095, USA. .,Department of Psychiatry and Biobehavioral Sciences, UCLA, Los Angeles, CA, 90095, USA. .,Veterans Administration of Greater Los Angeles Health System, Los Angeles, CA, 90073, USA.
| | - Andrea J. Rapkin
- Department of Obstetrics and Gynecology, David Geffen School of Medicine, UCLA, Los Angeles, CA 90095, USA
| | - Kyoji Okita
- Department of Clinical Neuroimaging, Integrative Brain Imaging Center, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo 187-8551, Japan,Department of Drug Dependence, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo 187-8551, Japan
| | - Kaitlin R. Kinney
- Jane and Terry Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA 90095, USA,Department of Psychiatry and Biobehavioral Sciences, UCLA, Los Angeles, CA 90095, USA,Veterans Administration of Greater Los Angeles Health System, Los Angeles, CA 90073, USA
| | - Tomi Mizuno
- Jane and Terry Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA 90095, USA,Department of Psychiatry and Biobehavioral Sciences, UCLA, Los Angeles, CA 90095, USA
| | - Mark A. Mandelkern
- Veterans Administration of Greater Los Angeles Health System, Los Angeles, CA 90073, USA,Department of Physics, University of California at Irvine, Irvine, CA 92697, USA
| | - Edythe D. London
- Jane and Terry Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA 90095, USA,Department of Psychiatry and Biobehavioral Sciences, UCLA, Los Angeles, CA 90095, USA,Veterans Administration of Greater Los Angeles Health System, Los Angeles, CA 90073, USA,Department of Molecular and Medical Pharmacology, UCLA, Los Angeles, CA 90095, USA
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21
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Dean AC, Nurmi EL, Morales AM, Cho AK, Seaman LC, London ED. CYP2D6 genotype may moderate measures of brain structure in methamphetamine users. Addict Biol 2021; 26:e12950. [PMID: 32767519 PMCID: PMC7865018 DOI: 10.1111/adb.12950] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 06/19/2020] [Accepted: 07/17/2020] [Indexed: 01/04/2023]
Abstract
Chronic methamphetamine use is linked to abnormalities in brain structure, which may reflect neurotoxicity related to metabolism of the drug. As the cytochrome P450 2D6 (CYP2D6) enzyme is central to the metabolism of methamphetamine, genotypic variation in its activity may moderate effects of methamphetamine on brain structure and function. This study explored the relationship between CYP2D6 genotype and measures of brain structure and cognition in methamphetamine users. Based on the function of genetic variants, a CYP2D6 activity score was determined in 82 methamphetamine-dependent (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition [DSM-IV] criteria) and 79 healthy-control participants who completed tests of cognitive function (i.e., attention, memory, and executive function); most were also evaluated with structural magnetic resonance imaging (MRI) (66 methamphetamine-dependent and 52 controls). The relationship between CYP2D6 activity score and whole brain cortical thickness differed by group (interaction p = 0.024), as increasing CYP2D6 activity was associated with thinner cortical thickness in the methamphetamine users (β = -0.254; p = 0.035), but not in control subjects (β = 0.095; p = 0.52). Interactions between CYP2D6 activity and group were nonsignificant for hippocampal volume (ps > 0.05), but both hippocampi showed trends similar to those observed for cortical thickness (negative relationships in methamphetamine users [ps < 0.05], and no relationships in controls [ps > 0.50]). Methamphetamine users had lower cognitive scores than control subjects (p = 0.007), but there was no interaction between CYP2D6 activity score and group on cognition (p > 0.05). Results suggest that CYP2D6 genotypes linked to higher enzymatic activity may confer risk for methamphetamine-induced deficits in brain structure. The behavioral consequences of these effects are unclear and warrant additional investigation.
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Affiliation(s)
- Andy C. Dean
- Department of Psychiatry and Biobehavioral Sciences, UCLA Semel Institute for Neuroscience, David Geffen School of Medicine, Los Angeles, CA, 90024, USA
- Brain Research Institute, David Geffen School of Medicine, Los Angeles, CA, 90024, USA
| | - Erika L. Nurmi
- Department of Psychiatry and Biobehavioral Sciences, UCLA Semel Institute for Neuroscience, David Geffen School of Medicine, Los Angeles, CA, 90024, USA
- Brain Research Institute, David Geffen School of Medicine, Los Angeles, CA, 90024, USA
- Department of Mental Health, VA Greater Los Angeles Healthcare System, Los Angeles, CA, 90073, USA
| | - Angelica M. Morales
- Department of Psychiatry, Oregon Health & Science University, Portland, OR 97239, USA
| | - Arthur K. Cho
- Environmental Health Sciences, UCLA Fielding School of Public Health, Los Angeles, CA 90024, USA
| | - Lauren C. Seaman
- Department of Psychiatry and Biobehavioral Sciences, UCLA Semel Institute for Neuroscience, David Geffen School of Medicine, Los Angeles, CA, 90024, USA
| | - Edythe D. London
- Department of Psychiatry and Biobehavioral Sciences, UCLA Semel Institute for Neuroscience, David Geffen School of Medicine, Los Angeles, CA, 90024, USA
- Brain Research Institute, David Geffen School of Medicine, Los Angeles, CA, 90024, USA
- Department of Molecular and Medical Pharmacology, David Geffen School of Medicine, Los Angeles, CA, 90024 USA
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22
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Nie L, Ghahremani DG, Mandelkern MA, Dean AC, Luo W, Ren A, Li J, London ED. The relationship between duration of abstinence and gray-matter brain structure in chronic methamphetamine users. Am J Drug Alcohol Abuse 2021; 47:65-73. [PMID: 33426968 DOI: 10.1080/00952990.2020.1778712] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Background: Brain structural findings in chronic methamphetamine users have been inconsistent. Identifying contributing influences (e.g., sex, abstinence duration) can help clarify the clinical course of recovery.Objectives: We studied the effects of long-term methamphetamine abstinence on gray-matter volume. Our hypothesis was that smaller volume early in abstinence would precede long-term recovery.Methods: Individuals who used methamphetamine (≥100 g lifetime use, mandated to residential treatment for methamphetamine-positive urine; 40 men, 21 women), undergoing supervised abstinence (men: 12-400 days; women: 130-594 days), were compared to healthy controls (49 men, 36 women) using T1-weighted MRI. Volumes of orbitofrontal, anterior cingulate and parietal cortex, hippocampus, and striatum were measured using Freesurfer software. Associations of volumes with abstinence duration were tested in males and females separately because their abstinence times differed (121.5 ± 124.5 vs. 348.0 ± 128.6 days, p < 0.001); only males were studied in early abstinence. The General Linear Model was used to test effects of abstinence duration and group (methamphetamine users vs. controls).Results: In males, duration of abstinence was multivariate significant for gray-matter volumes (p = 0.017). Abstinence duration was associated with increases in volumes of the orbitofrontal and parietal cortices (ps = 0.031, 0.016) and hippocampi (ps = 0.044). Irrespective of abstinence, male methamphetamine users had smaller hippocampi than male controls (p = 0.008). Females showed no significant effects of group or abstinence.Conclusions: In males, abstinence from methamphetamine appears to result in volumetric increases in regions important for cognitive function, which may affect recovery during the course of treatment. Data from the period of early abstinence are required to evaluate volumetric changes in females.
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Affiliation(s)
- Lili Nie
- Mental Health Center, West China Hospital of Sichuan University, Chengdu, China.,Department of Psychiatry and Biobehavioral Sciences, UCLA Semel Institute for Neuroscience, David Geffen School of Medicine, Los Angeles, CA, USA
| | - Dara G Ghahremani
- Department of Psychiatry and Biobehavioral Sciences, UCLA Semel Institute for Neuroscience, David Geffen School of Medicine, Los Angeles, CA, USA
| | | | - Andy C Dean
- Department of Psychiatry and Biobehavioral Sciences, UCLA Semel Institute for Neuroscience, David Geffen School of Medicine, Los Angeles, CA, USA
| | - Wei Luo
- Sichuan Provincial Compulsory Drug Addiction Treatment Agency for Females, Deyang, China
| | - Anlian Ren
- Sichuan Provincial Compulsory Drug Addiction Treatment Agency for Males, Ziyang, China
| | - Jing Li
- Mental Health Center, West China Hospital of Sichuan University, Chengdu, China
| | - Edythe D London
- Department of Psychiatry and Biobehavioral Sciences, UCLA Semel Institute for Neuroscience, David Geffen School of Medicine, Los Angeles, CA, USA.,Department of Molecular and Medical Pharmacology, University of California Los Angeles, Los Angeles, CA, USA
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23
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van Nunen LJ, Lake MT, Ipser JC, Stein DJ, Shoptaw SJ, London ED. Executive Function and Contingency Management in Methamphetamine Use Disorder. J Alcohol Drug Depend 2021; 9:342. [PMID: 34423073 PMCID: PMC8378238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVES Contingency management is a promising intervention for Methamphetamine Use Disorder (MUD).Impaired executive function may decrease adherence to such treatment, but there are few data on whether impairment in executive function predicts treatment outcomes. We therefore evaluated whether baseline performance on tests of executive function predicted treatment response in a trial of contingency management for MUD. METHODS Thirty participants with MUD and 23 healthy controls performed the Connors Continuous Performance Task (CPT) and the Trail Making Task. MUD participants then entered an 8-week contingency management trial. Participants were categorized as responders (n=17; no methamphetamine-positive urine tests) or non-responders (n=13; >1 positive test). The Kruskal-Wallis test was used to compare scores in participants with MUD and healthy controls, and in responders versus non-responders. RESULTS Participants withMUD performed worse than controls on the CPT (d-prime) (p=0.012); non-responders performed worse than responders (p = 0.034). Performance of MUD participants did not differ significantly from controls on the Trail Making Task B (time to completion), but variation was high with non-responders performing worse than responders (p=0.013). CONCLUSION These findings suggest that tests of executive function at baseline may be useful in predicting treatment response in MUD. Future work in larger samples may ultimately allow a more personalized treatment approach to methamphetamine use disorder.
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Affiliation(s)
- Lara J van Nunen
- Department of Psychiatry and Mental Health, University of Cape Town, Neuroscience Institute, South Africa,Correspondence to: Lara J van Nunen, Department of Psychiatry and Mental Health, University of Cape Town, Neuroscience Institute, Anzio Road, Cape Town,7925, South Africa, Tel:+27 (0)72 148 0884;
| | - Marilyn T Lake
- Department of Psychiatry and Mental Health, University of Cape Town, Neuroscience Institute, South Africa,Department of Paediatrics and Child Health, University of Cape Town, Neuroscience Institute, South Africa
| | - Jonathan C Ipser
- Department of Psychiatry and Mental Health, University of Cape Town, Neuroscience Institute, South Africa
| | - Dan J Stein
- South African Medical Research Council Unit on Risk & Resilience in Mental Disorders,Department of Psychiatry and Neuroscience Institute,University of Cape Town, Cape Town, South Africa
| | - Steven J Shoptaw
- Department of Psychiatry and Mental Health, University of Cape Town, Neuroscience Institute, South Africa,Department of Family Medicine, University of California at Los Angeles, Los Angeles, California, United States of America
| | - Edythe D London
- Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, Los Angeles, California, United States of America,Department of Molecular and Medical Pharmacology, University of California at Los Angeles, Los Angeles, California, United States of America,The Brain Research Institute, University of California at Los Angeles, Los Angeles, California, United States of America
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24
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Burnette EM, Grodin EN, Ghahremani DG, Galván A, Kohno M, Ray LA, London ED. Diminished cortical response to risk and loss during risky decision making in alcohol use disorder. Drug Alcohol Depend 2021; 218:108391. [PMID: 33153830 PMCID: PMC7750289 DOI: 10.1016/j.drugalcdep.2020.108391] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 10/23/2020] [Accepted: 10/26/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Risky decision-making is an important facet of addiction. Individuals with alcohol dependence show abnormalities in gambling and other risk-taking tasks. In one such measure, the Balloon Analogue Risk Task (BART), participants sequentially choose to pump a virtual balloon to increase potential reward while the risk of explosion increases, or to cash-out and take earnings. In a prior study, alcohol-dependent participants differed from controls in brain activation during decision-making on the BART, but the relationship between risk/reward magnitude and brain activation was not studied, nor were participants compared to controls. Here we compared the degree to which risk and magnitude of reward influenced brain activation in alcohol-dependent participants vs. controls during decision-making on the BART. METHODS Thirty-two participants (16 alcohol-dependent, 16 control; 5 females/group) performed the BART during fMRI. A parametric analysis tested for a relationship between risk/reward magnitude and activation in rDLPFC and bilateral striatum regions of interest when participants chose to take risk or to cash out. An exploratory whole-brain voxel-wise analysis of mean activation during pumping, cash-out, and explosion events was also conducted. RESULTS Compared with controls, alcohol-dependent participants displayed less modulation of activation in the rDLPFC when taking risk. Exploratory analyses found that alcohol-dependent participants showed less activation than controls during explosions in a cluster including the insula. No differences were seen in striatal activation. CONCLUSIONS Insensitivity of the rDLPFC to risk and of the insula to loss may contribute to decision-making deficits in alcohol dependence.
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Affiliation(s)
- Elizabeth M. Burnette
- Department of Psychology, University of California, Los Angeles, CA,Neuroscience Interdepartmental Program, University of California, Los Angeles, CA
| | - Erica N. Grodin
- Department of Psychology, University of California, Los Angeles, CA,Department of Psychiatry and Biobehavioral Sciences, UCLA School of Medicine, Los Angeles, CA
| | - Dara G. Ghahremani
- Department of Psychiatry and Biobehavioral Sciences, UCLA School of Medicine, Los Angeles, CA
| | - Adriana Galván
- Department of Psychology, University of California, Los Angeles, CA,Neuroscience Interdepartmental Program, University of California, Los Angeles, CA,Brain Research Institute, University of California, Los Angeles, CA
| | - Milky Kohno
- Department of Psychiatry, Oregon Health and Sciences University, Portland, OR
| | - Lara A. Ray
- Department of Psychology, University of California, Los Angeles, CA,Neuroscience Interdepartmental Program, University of California, Los Angeles, CA,Department of Psychiatry and Biobehavioral Sciences, UCLA School of Medicine, Los Angeles, CA,Brain Research Institute, University of California, Los Angeles, CA
| | - Edythe D. London
- Neuroscience Interdepartmental Program, University of California, Los Angeles, CA,Department of Psychiatry and Biobehavioral Sciences, UCLA School of Medicine, Los Angeles, CA,Brain Research Institute, University of California, Los Angeles, CA,Department of Molecular and Medical Pharmacology, University of California, Los Angeles, CA
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25
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Chye Y, Mackey S, Gutman BA, Ching CR, Batalla A, Blaine S, Brooks S, Caparelli EC, Cousijn J, Dagher A, Foxe JJ, Goudriaan AE, Hester R, Hutchison K, Jahanshad N, Kaag AM, Korucuoglu O, Li CR, London ED, Lorenzetti V, Luijten M, Martin‐Santos R, Meda SA, Momenan R, Morales A, Orr C, Paulus MP, Pearlson G, Reneman L, Schmaal L, Sinha R, Solowij N, Stein DJ, Stein EA, Tang D, Uhlmann A, Holst R, Veltman DJ, Verdejo‐Garcia A, Wiers RW, Yücel M, Thompson PM, Conrod P, Garavan H. Subcortical surface morphometry in substance dependence: An ENIGMA addiction working group study. Addict Biol 2020; 25:e12830. [PMID: 31746534 DOI: 10.1111/adb.12830] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Revised: 07/25/2019] [Accepted: 08/26/2019] [Indexed: 11/27/2022]
Abstract
While imaging studies have demonstrated volumetric differences in subcortical structures associated with dependence on various abused substances, findings to date have not been wholly consistent. Moreover, most studies have not compared brain morphology across those dependent on different substances of abuse to identify substance-specific and substance-general dependence effects. By pooling large multinational datasets from 33 imaging sites, this study examined subcortical surface morphology in 1628 nondependent controls and 2277 individuals with dependence on alcohol, nicotine, cocaine, methamphetamine, and/or cannabis. Subcortical structures were defined by FreeSurfer segmentation and converted to a mesh surface to extract two vertex-level metrics-the radial distance (RD) of the structure surface from a medial curve and the log of the Jacobian determinant (JD)-that, respectively, describe local thickness and surface area dilation/contraction. Mega-analyses were performed on measures of RD and JD to test for the main effect of substance dependence, controlling for age, sex, intracranial volume, and imaging site. Widespread differences between dependent users and nondependent controls were found across subcortical structures, driven primarily by users dependent on alcohol. Alcohol dependence was associated with localized lower RD and JD across most structures, with the strongest effects in the hippocampus, thalamus, putamen, and amygdala. Meanwhile, nicotine use was associated with greater RD and JD relative to nonsmokers in multiple regions, with the strongest effects in the bilateral hippocampus and right nucleus accumbens. By demonstrating subcortical morphological differences unique to alcohol and nicotine use, rather than dependence across all substances, results suggest substance-specific relationships with subcortical brain structures.
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Affiliation(s)
- Yann Chye
- Turner Institute for Brain and Mental Health, School of Psychological Sciences Monash University Clayton Victoria Australia
| | - Scott Mackey
- Departments of Psychiatry University of Vermont Burlington VT USA
| | - Boris A. Gutman
- Biomedical Engineering Illinois Institute of Technology Chicago IL USA
| | - Christopher R.K. Ching
- Department of Neurology, Keck School of Medicine, Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute University of Southern California Los Angeles CA USA
| | - Albert Batalla
- Department of Psychiatry University Medical Centre Utrecht Brain Center, Utrecht University Utrecht The Netherlands
- Department of Psychiatry and Psychology, Hospital Clinic, IDIBAPS, CIBERSAM, Institute of Neuroscience University of Barcelona Barcelona Spain
| | - Sara Blaine
- Departments of Psychiatry and Neuroscience Yale University School of Medicine CT USA
| | - Samantha Brooks
- Faculty of Health, School of Psychology Liverpool John Moores University L3 3AF Liverpool UK
- Department of Neuroscience, Section of Functional Pharmacology Uppsala University 75240 Sweden
| | - Elisabeth C. Caparelli
- Neuroimaging Research Branch, Intramural Research Program National Institute of Drug Abuse Baltimore MD USA
| | - Janna Cousijn
- Department of Developmental Psychology University of Amsterdam The Netherlands
| | - Alain Dagher
- McConnell Brain Imaging Center, Montreal Neurological Institute McGill University Montreal Quebec Canada
| | - John J. Foxe
- Department of Neuroscience & The Ernest J. Del Monte Institute for Neuroscience University of Rochester School of Medicine and Dentistry Rochester NY USA
| | - Anna E. Goudriaan
- Amsterdam UMC, Department of Psychiatry, Amsterdam Institute for Addiction Research University of Amsterdam Amsterdam The Netherlands
- Department of Research and Quality of Care Arkin Mental Health Care Amsterdam The Netherlands
| | - Robert Hester
- Melbourne School of Psychological Sciences University of Melbourne Melbourne Victoria Australia
| | - Kent Hutchison
- Department of Psychology and Neuroscience University of Colorado Boulder Boulder CO USA
| | - Neda Jahanshad
- Department of Neurology, Keck School of Medicine, Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute University of Southern California Los Angeles CA USA
| | - Anne M. Kaag
- Department of Developmental Psychology University of Amsterdam The Netherlands
| | - Ozlem Korucuoglu
- Department of Psychiatry Washington University School of Medicine Saint Louis MO USA
| | - Chiang‐Shan R. Li
- Departments of Psychiatry and Neuroscience Yale University School of Medicine CT USA
| | - Edythe D. London
- Jane and Terry Semel Institute of Neuroscience and Human Behavior, David Geffen School of Medicine Universityof California at Los Angeles Los Angeles CA USA
| | - Valentina Lorenzetti
- Turner Institute for Brain and Mental Health, School of Psychological Sciences Monash University Clayton Victoria Australia
- School of Psychology, Faculty of Health Sciences Australian Catholic University Melbourne Victoria Australia
| | - Maartje Luijten
- Behavioural Science Institute Radboud University Nijmegen The Netherlands
| | - Rocio Martin‐Santos
- Department of Psychiatry and Psychology, Hospital Clinic, IDIBAPS, CIBERSAM, Institute of Neuroscience University of Barcelona Barcelona Spain
| | - Shashwath A. Meda
- Olin Neuropsychiatry Research Center Hartford Hospital/IOL Hartford CT USA
| | - Reza Momenan
- Clinical NeuroImaging Research Core, Division of Intramural Clinical and BiologicalResearch National Institute of Alcohol Abuse and Alcoholism Bethesda MD USA
| | - Angelica Morales
- Jane and Terry Semel Institute of Neuroscience and Human Behavior, David Geffen School of Medicine Universityof California at Los Angeles Los Angeles CA USA
| | - Catherine Orr
- Departments of Psychiatry University of Vermont Burlington VT USA
| | - Martin P. Paulus
- VA San Diego Healthcare System and Department of Psychiatry University of California San Diego CA USA
- Laureate Institute for Brain Research Tulsa OK USA
| | - Godfrey Pearlson
- Departments of Psychiatry and Neuroscience Yale University School of Medicine CT USA
| | - Liesbeth Reneman
- Department of Radiology and Nuclear Medicine Amsterdam UMC, location AMC Amsterdam The Netherlands
| | - Lianne Schmaal
- Orygen The National Centre of Excellence in Youth Mental Health Parkville Australia
- Centre for Youth Mental Health The University of Melbourne Parkville Australia
| | - Rajita Sinha
- Departments of Psychiatry and Neuroscience Yale University School of Medicine CT USA
| | - Nadia Solowij
- School of Psychology and Illawarra Health and Medical Research Institute University of Wollongong Wollongong New South Wales Australia
- The Australian Centre for Cannabinoid Clinical and Research Excellence (ACRE) New Lambton Heights New South Wales Australia
| | - Dan J. Stein
- SA MRC Unit on Risk & Resilience in Mental Disorders, Department of Psychiatry and Neuroscience Institute University of Cape Town Cape Town South Africa
| | - Elliot A. Stein
- Neuroimaging Research Branch, Intramural Research Program National Institute of Drug Abuse Baltimore MD USA
| | - Deborah Tang
- McConnell Brain Imaging Center, Montreal Neurological Institute McGill University Montreal Quebec Canada
| | - Anne Uhlmann
- Department of Psychiatry and Mental Health Faculty of Health Sciences University of Cape Town South Africa
| | - Ruth Holst
- Department of Psychiatry University of Amsterdam Amsterdam The Netherlands
| | - Dick J. Veltman
- Department of Psychiatry VU University Medical Center Amsterdam The Netherlands
| | - Antonio Verdejo‐Garcia
- Turner Institute for Brain and Mental Health, School of Psychological Sciences Monash University Clayton Victoria Australia
| | - Reinout W. Wiers
- Addiction Development and Psychopathology (ADAPT) Lab University of Amsterdam Amsterdam The Netherlands
| | - Murat Yücel
- Turner Institute for Brain and Mental Health, School of Psychological Sciences Monash University Clayton Victoria Australia
| | - Paul M. Thompson
- Department of Neurology, Keck School of Medicine, Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute University of Southern California Los Angeles CA USA
| | - Patricia Conrod
- Department of Psychiatry Université de Montreal, CHU Ste Justine Hospital Canada
| | - Hugh Garavan
- Departments of Psychiatry University of Vermont Burlington VT USA
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Lim AC, Grodin EN, Green R, Venegas A, Meredith LR, Courtney KE, Moallem NR, Sayegh P, London ED, Ray LA. Executive function moderates naltrexone effects on methamphetamine-induced craving and subjective responses. Am J Drug Alcohol Abuse 2020; 46:565-576. [PMID: 32343625 PMCID: PMC7920534 DOI: 10.1080/00952990.2020.1741002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 02/28/2020] [Accepted: 02/29/2020] [Indexed: 10/24/2022]
Abstract
Background: Emerging evidence suggests that opioid receptor antagonists, such as naltrexone, are effective pharmacotherapies for alcohol, opioid, and possibly stimulant use disorders. It is posited that naltrexone exerts its effects, in part, by increasing functional connectivity between neural reward circuitry and frontal systems implicated in executive function. Yet no studies had examined whether executive function moderates these effects. Objectives: This study examined whether a composite measure of executive function (EF) moderates the effect of naltrexone on craving for methamphetamine and subjective responses following infusion of the drug. Methods: Individuals with methamphetamine use disorder (N = 30; 27% female) completed baseline neurocognitive assessments of premorbid and executive function, and an executive function factor was computed. Participants then underwent a randomized, double-blind, cross-over study of titration with naltrexone and placebo. Participants then received a 30-mg intravenous methamphetamine infusion and completed subjective response questionnaires at 8 times in the 120 minutes post-infusion. Results: Multilevel mixed models indicated a significant EF × medication interaction, reflecting greater effects of naltrexone to decrease "desire to access the drug", "want more of the drug", "crave the drug", "feel drug effects" and "feel high" in participants with low EF compared to those with high EF (Bs = .36-1.29, SEs = .14-.17, ps<0.01). These effects remained significant after controlling for premorbid cognitive functioning, baseline responses to methamphetamine, severity of methamphetamine use, and methamphetamine-related functional problems. Conclusion: Naltrexone may be especially effective in methamphetamine-dependent individuals with low EF. Neuropsychological assessments may also provide predictive clinical utility not captured by traditional measures of substance use severity.
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Affiliation(s)
- Aaron C. Lim
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA
| | - Erica N. Grodin
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA
| | - ReJoyce Green
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA
| | - Alexandra Venegas
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA
| | - Lindsay R. Meredith
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA
| | - Kelly E. Courtney
- Department of Psychology, University of California, San Diego, San Diego, CA, USA
| | - Nathasha R. Moallem
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA
| | - Philip Sayegh
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA
| | - Edythe D. London
- Department of Psychiatry and Biobehavioral Sciences
- Department of Molecular and Medical Pharmacology, David Geffen School of Medicine at the University of California Los Angeles, Los Angeles, CA, USA
| | - Lara A. Ray
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences
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Faulkner P, Dean AC, Ghahremani DG, London ED. Neural Basis of Smoking-Related Difficulties in Emotion Regulation. Int J Neuropsychopharmacol 2020; 23:409-416. [PMID: 32221527 PMCID: PMC7387763 DOI: 10.1093/ijnp/pyaa015] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Revised: 02/05/2020] [Accepted: 03/16/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Negative emotional states contribute to cigarette smoking, and difficulties in regulating these states can hinder smoking cessation. Understanding the neural bases of these difficulties in smokers may facilitate development of novel therapies for Tobacco Use Disorder. METHODS Thirty-seven participants (18 smokers, 19 nonsmokers; 16-21 years old) completed the Difficulties in Emotion Regulation Scale (DERS), which is comprised of 6 subscales (lack of emotional clarity, lack of emotional awareness, limited access to emotion regulation strategies, nonacceptance of emotional responses, difficulties engaging in goal-directed behaviors, and impulse control difficulties) that combine to provide a total score. Participants also underwent functional magnetic resonance imaging to determine resting-state functional connectivity of the amygdala. Separate ANOVAs were used to determine group differences in self-reports on the DERS. Voxel-wise linear mixed models were performed to determine whether group influenced relationships between whole-brain functional connectivity of the amygdala and scores on the DERS. RESULTS Compared with nonsmokers, smokers reported greater difficulties in emotion regulation, denoted by higher total scores on the DERS. Group differences were observed on a subscale of lack of emotional clarity, but no other subscale differences on the DERS were observed. Nonsmokers exhibited a greater negative correlation than smokers between lack of emotional clarity scores and connectivity of the amygdala with the left inferior frontal gyrus. Finally, this amygdala-to-left inferior frontal gyrus connectivity was weaker in smokers than in nonsmokers. CONCLUSIONS These findings suggest that difficulties in emotion regulation in smokers are at least partially due to lack of emotional clarity. Given the role of the inferior frontal gyrus in understanding emotional states, strengthening connectivity between the amygdala and the inferior frontal gyrus may improve emotional clarity to help smokers regulate their negative emotions, thereby improving their ability to quit smoking.
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Affiliation(s)
- Paul Faulkner
- Department of Psychology, University of Roehampton, London, United Kingdom.,Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, Los Angeles, California
| | - Andy C Dean
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, Los Angeles, California.,The Brain Research Institute, Los Angeles, California
| | - Dara G Ghahremani
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, Los Angeles, California
| | - Edythe D London
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, Los Angeles, California.,The Brain Research Institute, Los Angeles, California.,Department of Molecular and Medical Pharmacology, University of California, Los Angeles, California
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Bari AA, Sparks H, Levinson S, Wilson B, London ED, Langevin JP, Pouratian N. Amygdala Structural Connectivity Is Associated With Impulsive Choice and Difficulty Quitting Smoking. Front Behav Neurosci 2020; 14:117. [PMID: 32714164 PMCID: PMC7351509 DOI: 10.3389/fnbeh.2020.00117] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Accepted: 06/11/2020] [Indexed: 11/24/2022] Open
Abstract
Introduction: The amygdala is known to play a role in mediating emotion and possibly addiction. We used probabilistic tractography (PT) to evaluate whether structural connectivity of the amygdala to the brain reward network is associated with impulsive choice and tobacco smoking. Methods: Diffusion and structural MRI scans were obtained from 197 healthy subjects (45 with a history of tobacco smoking) randomly sampled from the Human Connectome database. PT was performed to assess amygdala connectivity with several brain regions. Seed masks were generated, and statistical maps of amygdala connectivity were derived. Connectivity results were correlated with a subject performance both on a delayed discounting task and whether they met specified criteria for difficulty quitting smoking. Results: Amygdala connectivity was spatially segregated, with the strongest connectivity to the hippocampus, orbitofrontal cortex (OFC), and brainstem. Connectivity with the hippocampus was associated with preference for larger delayed rewards, whereas connectivity with the OFC, rostral anterior cingulate cortex (rACC), and insula were associated with preference for smaller immediate rewards. Greater nicotine dependence with difficulty quitting was associated with less hippocampal and greater brainstem connectivity. Scores on the Fagerstrom Test for Nicotine Dependence (FTND) correlated with rACC connectivity. Discussion: These findings highlight the importance of the amygdala-hippocampal-ACC network in the valuation of future rewards and substance dependence. These results will help to identify potential targets for neuromodulatory therapies for addiction and related disorders.
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Affiliation(s)
- Ausaf A Bari
- Department of Neurosurgery, University of California, Los Angeles, Los Angeles, CA, United States
| | - Hiro Sparks
- Department of Neurosurgery, University of California, Los Angeles, Los Angeles, CA, United States
| | - Simon Levinson
- Department of Neurosurgery, University of California, Los Angeles, Los Angeles, CA, United States
| | - Bayard Wilson
- Department of Neurosurgery, University of California, Los Angeles, Los Angeles, CA, United States
| | - Edythe D London
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine and Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, United States
| | - Jean-Philippe Langevin
- Department of Neurosurgery, University of California, Los Angeles, Los Angeles, CA, United States
| | - Nader Pouratian
- Department of Neurosurgery, University of California, Los Angeles, Los Angeles, CA, United States
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London ED, Okita K, Kinney KR, Dean AC, McClintick MN, Rizor EJ, Johnson MC, Mahmoudie T, Brody AL, Nurmi EL, Seaman LC, Farahi J, Ginder N, Mandelkern MA. No significant elevation of translocator protein binding in the brains of recently abstinent methamphetamine users. Drug Alcohol Depend 2020; 213:108104. [PMID: 32570138 PMCID: PMC9059651 DOI: 10.1016/j.drugalcdep.2020.108104] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 05/22/2020] [Accepted: 05/26/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND Radioligands for the translocator protein (TSPO) 18 kDa have been used with positron emission tomography (PET) to assess neuroinflammation and microglial activation in psychiatric disorders. One study using this approach showed substantial TSPO elevation throughout the brain in chronic methamphetamine users following long-term abstinence (0.5-4 years), but clients typically present for treatment earlier in abstinence. METHODS We used PET with [11C]DAA1106 to compare standardized uptake values (SUVs) as an index of TSPO binding in the brains of methamphetamine-dependent participants who were abstinent for < 6 months (n = 11) and healthy controls (n = 12). We also assayed other typical correlates of Methamphetamine Dependence (e.g., striatal D2-type dopamine receptor deficits, depressed mood, anxiety and impaired emotion regulation). RESULTS Methamphetamine users exhibited depression (p < 0.0001), anxiety (p = 0.002), difficulties in emotional regulation (p = 0.01), and lower striatal dopamine D2-type receptor availability vs. controls (p = 0.02). SUVs for [11C]DAA1106 were larger in all brain regions of methamphetamine-dependent participants vs. controls, but the effect size was small to medium and not statistically significant. CONCLUSIONS The discrepancy between the lack of significant difference in TSPO binding in early-abstinent methamphetamine users vs. controls in this study and a previous report of elevated binding in longer-abstinent methamphetamine users may reflect methodological differences or limitations of TSPO binding as an index of neuroinflammation. It also seems possible that gliosis increases over time during the first 6 months of abstinence; longitudinal studies could clarify this possibility.
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Affiliation(s)
- Edythe D. London
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles (UCLA), Los Angeles, CA, 90024, USA,Department of Molecular and Medical Pharmacology, University of California Los Angeles (UCLA), Los Angeles, CA, 90024, USA,Brain Research Institute, University of California Los Angeles (UCLA), Los Angeles, CA, 90024, USA,Department of Research, Veterans Administration Greater Los Angeles Healthcare System (VAGLAHS), Los Angeles, CA, 90073, USA,Corresponding author at: Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, 760 Westwood Plaza, PO Box 175919, Los Angeles, CA, 90095, USA. (E.D. London)
| | - Kyoji Okita
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles (UCLA), Los Angeles, CA, 90024, USA,Department of Research, Veterans Administration Greater Los Angeles Healthcare System (VAGLAHS), Los Angeles, CA, 90073, USA,Department of Clinical Neuroimaging, Integrative Brain Imaging Center, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, 187-8551, Japan,Department of Drug Dependence, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, 187-8551, Japan
| | - Kaitlin R. Kinney
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles (UCLA), Los Angeles, CA, 90024, USA,Department of Research, Veterans Administration Greater Los Angeles Healthcare System (VAGLAHS), Los Angeles, CA, 90073, USA
| | - Andrew C. Dean
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles (UCLA), Los Angeles, CA, 90024, USA
| | - Megan N. McClintick
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles (UCLA), Los Angeles, CA, 90024, USA,Department of Research, Veterans Administration Greater Los Angeles Healthcare System (VAGLAHS), Los Angeles, CA, 90073, USA
| | - Elizabeth J. Rizor
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles (UCLA), Los Angeles, CA, 90024, USA,Department of Research, Veterans Administration Greater Los Angeles Healthcare System (VAGLAHS), Los Angeles, CA, 90073, USA
| | - Maritza C. Johnson
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles (UCLA), Los Angeles, CA, 90024, USA,Department of Research, Veterans Administration Greater Los Angeles Healthcare System (VAGLAHS), Los Angeles, CA, 90073, USA
| | - Tarannom Mahmoudie
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles (UCLA), Los Angeles, CA, 90024, USA,Department of Research, Veterans Administration Greater Los Angeles Healthcare System (VAGLAHS), Los Angeles, CA, 90073, USA
| | - Arthur L. Brody
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles (UCLA), Los Angeles, CA, 90024, USA,Department of Research, Veterans Administration Greater Los Angeles Healthcare System (VAGLAHS), Los Angeles, CA, 90073, USA
| | - Erika L. Nurmi
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles (UCLA), Los Angeles, CA, 90024, USA
| | - Lauren C. Seaman
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles (UCLA), Los Angeles, CA, 90024, USA
| | - Judah Farahi
- Department of Research, Veterans Administration Greater Los Angeles Healthcare System (VAGLAHS), Los Angeles, CA, 90073, USA
| | - Nathaniel Ginder
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles (UCLA), Los Angeles, CA, 90024, USA
| | - Mark A. Mandelkern
- Department of Research, Veterans Administration Greater Los Angeles Healthcare System (VAGLAHS), Los Angeles, CA, 90073, USA,Department of Physics, University of California Irvine, Irvine, CA, 92697, USA
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Thorberg FA, Hasking P, Huang YL, Lyvers M, Young RM, Connor JP, London ED, Feeney GFX. The Influence of Alexithymia on Alcohol Craving, Health-Related Quality of Life and Gender in Alcohol-Dependent Outpatients. J Psychoactive Drugs 2020; 52:366-376. [PMID: 32429771 DOI: 10.1080/02791072.2020.1762022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Alexithymia is a vulnerability factor for physical and mental illness that can significantly influence the daily function of alcohol-dependent patients. The aim of this study was to examine the indirect effect of obsessive thoughts and compulsive behaviors involving alcohol craving on the relationship between alexithymia, quality of life (QoL) of psychological well-being and health status. Three hundred and eighty-one outpatients (263 males and 118 females) in treatment for alcohol dependence completed self-report measures of alexithymia, alcohol craving, GHQ-28 (QoL-psychological well-being) and SF-36 (QoL-health status). Males scored significantly higher than females on aspects of alexithymia, and females reported significantly higher levels of alcohol craving. Path analysis showed an indirect effect of alcohol craving on the relationship between alexithymia, QoL-psychological well-being and self-reported QoL-health status for males only. The current study provides important new information about impaired self-reported health status and well-being among male alcohol-dependent treatment seekers with alexithymia.
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Affiliation(s)
- Fred Arne Thorberg
- School of Psychology and Counselling, Queensland University of Technology , Brisbane, QLD, Australia.,School of Psychology, Bond University , Gold Coast, QLD, Australia.,School of Psychology, The University of Queensland , Brisbane, QLD, Australia.,Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles , Los Angeles, CA, USA
| | | | - Ya-Ling Huang
- Department of Emergency Medicine, Gold Coast Hospital and Health Service, Gold Coast University Hospital , Gold Coast, QLD, Australia.,Department of Respiratory Medicine, Gold Coast Hospital and Health Service, Gold Coast University Hospital , Gold Coast, QLD, Australia
| | - Michael Lyvers
- School of Psychology, Bond University , Gold Coast, QLD, Australia
| | - Ross McD Young
- Faculty of Health, Queensland University of Technology , Brisbane, QLD, Australia
| | - Jason P Connor
- Centre for Youth Substance Abuse Research, Faculty of Health, The University of Queensland , Brisbane, QLD, Australia.,Discipline of Psychiatry, The University of Queensland , Brisbane, QLD, Australia.,Alcohol & Drug Assessment Unit, The Princess Alexandra Hospital , Brisbane, QLD, Australia
| | - Edythe D London
- Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles , Los Angeles, CA, USA
| | - Gerald F X Feeney
- Centre for Youth Substance Abuse Research, Faculty of Health, The University of Queensland , Brisbane, QLD, Australia.,Alcohol & Drug Assessment Unit, The Princess Alexandra Hospital , Brisbane, QLD, Australia
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Moeller SJ, Kundu P, Bachi K, Maloney T, Malaker P, Parvaz MA, Alia-Klein N, London ED, Goldstein RZ. Self-awareness of problematic drug use: Preliminary validation of a new fMRI task to assess underlying neurocircuitry. Drug Alcohol Depend 2020; 209:107930. [PMID: 32145661 PMCID: PMC7170015 DOI: 10.1016/j.drugalcdep.2020.107930] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2019] [Revised: 01/14/2020] [Accepted: 02/14/2020] [Indexed: 11/15/2022]
Abstract
BACKGROUND Multiple psychopathologies feature impaired clinical insight. Emerging evidence suggests that insight problems may similarly characterize addiction, perhaps due to aberrant functioning of self-referential brain circuitry, including the rostral anterior cingulate and ventromedial prefrontal cortices (rACC/vmPFC). We developed a new fMRI task to probe whether rACC/vmPFC abnormalities in cocaine use disorder (CUD) constitute neural correlates of readiness to change, one facet of insight. METHODS Eighteen individuals with current CUD and 15 healthy controls responded about their own need to change their drug use and eating behavior (control condition) and the need for a named acquaintance to do the same (two additional control conditions). Measures of simulated drug-choice behavior, addiction severity, and neuropsychological function were collected outside the scanner. RESULTS CUD participants perceived a greater need for behavior change than controls (as expected, given their diagnosis), but fell short of "agreeing" to a need for change; in CUD, lower perceived need correlated with higher simulated drug-choice behavior, a proxy measure of drug-seeking. During drug-related insight judgments, CUD participants had higher activation than controls in an anatomically-defined region of interest (ROI) in the medial orbitofrontal cortex, part of the rACC/vmPFC. Although not showing group differences, activation in an anatomically-defined ACC ROI correlated with insight-related task behavior (in all participants) and memory performance (in CUD). CONCLUSIONS As a group, individuals with current CUD appear to show mild insight problems and rACC/vmPFC abnormalities vis-à-vis readiness to change behavior. With replication and extension of these results, insight-related circuitry may emerge as a novel therapeutic target.
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Affiliation(s)
- Scott J. Moeller
- Renaissance School of Medicine at Stony Brook University, Stony Brook, NY 11794;,Icahn School of Medicine at Mount Sinai, New York, NY 10029;,Correspondence should be addressed to: Scott J. Moeller, Health Sciences Center 10-087F; 101 Nicolls Road, Stony Brook, NY 11794; Tel: 631-638-3223; Fax: 631-444-7534; . Or to: Rita Z. Goldstein, Icahn School of Medicine at Mount Sinai, Psychiatry and Neuroscience Departments,
| | - Prantik Kundu
- Icahn School of Medicine at Mount Sinai, New York, NY 10029
| | - Keren Bachi
- Icahn School of Medicine at Mount Sinai, New York, NY 10029
| | - Thomas Maloney
- Icahn School of Medicine at Mount Sinai, New York, NY 10029
| | - Pias Malaker
- Icahn School of Medicine at Mount Sinai, New York, NY 10029
| | | | | | - Edythe D. London
- Icahn School of Medicine at Mount Sinai, New York, NY 10029;,University of California Los Angeles (UCLA), Los Angeles, CA, 90095
| | - Rita Z. Goldstein
- Icahn School of Medicine at Mount Sinai, New York, NY 10029;,Correspondence should be addressed to: Scott J. Moeller, Health Sciences Center 10-087F; 101 Nicolls Road, Stony Brook, NY 11794; Tel: 631-638-3223; Fax: 631-444-7534; . Or to: Rita Z. Goldstein, Icahn School of Medicine at Mount Sinai, Psychiatry and Neuroscience Departments,
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Abstract
Objectives: Despite the prevalence of methamphetamine-associated psychosis, how characteristics of drug use affect the severity and clinical course, and its optimal treatments have not been established. We addressed these questions, assessing clinical features of methamphetamine-associated psychosis, and compared it with primary psychosis.Methods: Hospitalised patients with methamphetamine-associated (n = 70) or primary schizophrenic psychosis (n = 70) were matched on sex, age and duration of psychosis. Association of drug use variables (age at initiation, duration of methamphetamine use) with the Brief Psychiatric Rating Scale (BPRS) scores and psychosis duration were examined for patients with methamphetamine-associated psychosis, and the groups were compared on the BPRS scores.Results: Methamphetamine use initiation age correlated negatively with the BPRS total score and the Activation subscale score; methamphetamine use duration correlated positively with psychosis duration. Methamphetamine-associated psychosis group scored lower on the Hostility-Suspiciousness and Anergia subscales of the BPRS (adjusted p values < .05).Conclusions: Association of early initiation of methamphetamine with psychosis severity may suggest a lasting effect on brain development. Correlation of drug use and psychosis durations may suggest a cumulative effect of methamphetamine exposure. Less severe paranoia and negative symptoms in the methamphetamine-using group could implicate better social functioning of these patients. Further mechanistic studies are warranted.Key pointsEarly initiation of methamphetamine use is associated with psychosis severity.Methamphetamine use duration associates with psychosis duration.Methamphetamine-associated and primary schizophrenic psychoses were similar in symptoms.Methamphetamine psychosis patients were less severe in paranoia and negative symptoms.
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Affiliation(s)
- Mei Yang
- Department of Drug Dependence, Shenzhen Kangning Hospital, Medicine Division of Shenzhen University, Shenzhen, Guangdong, China.,Department of Psychiatry & Biobehavioral Sciences, University of California, Los Angeles, CA, USA
| | - Chuanqing Yang
- Department of Drug Dependence, Shenzhen Kangning Hospital, Medicine Division of Shenzhen University, Shenzhen, Guangdong, China
| | - Tiebang Liu
- Department of Administration, Shenzhen Kangning Hospital, Medicine Division of Shenzhen University, Shenzhen, Guangdong, China
| | - Edythe D London
- Department of Psychiatry & Biobehavioral Sciences, University of California, Los Angeles, CA, USA.,Department of Molecular & Medical Pharmacology, University of California, Los Angeles, CA, USA
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Lake MT, Shoptaw S, Ipser JC, Takada S, van Nunen LJ, Lipinska G, Stein DJ, London ED. Decision-Making by Patients With Methamphetamine Use Disorder Receiving Contingency Management Treatment: Magnitude and Frequency Effects. Front Psychiatry 2020; 11:22. [PMID: 32180733 PMCID: PMC7058183 DOI: 10.3389/fpsyt.2020.00022] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Accepted: 01/10/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Individuals with substance use disorders exhibit maladaptive decision-making on the Iowa Gambling Task (IGT), which involves selecting from card decks differing in the magnitudes of rewards, and the frequency and magnitude of losses. We investigated whether baseline IGT performance could predict responses to contingency management (CM) by treatment-seeking individuals with methamphetamine use disorder (MA Use Disorder) in Cape Town, South Africa. METHODS Twenty-nine individuals with MA Use Disorder underwent an 8-week, escalating reinforcement, voucher-based CM treatment in a study on the suitability of CM therapy for the South African context. Along with 20 healthy control participants, they performed a computerized version of the IGT before starting CM treatment. Seventeen participants maintained abstinence from methamphetamine throughout the trial (full responders), and 12 had an incomplete response (partial responders). Performance on the IGT was scored for magnitude effect (selection of large immediate rewards with high long-term loss) and for frequency effect (preference for frequent rewards and avoidance of frequent losses). Group differences were investigated using linear mixed-effect modeling. RESULTS Partial responders made more selections from decks providing large, immediate rewards and long-term losses than healthy controls [p = 0.038, g = -0.77 (-1.09: -0.44)]. Full responders showed a greater, nonsignificant preference for frequent rewards and aversion to frequent losses than partial responders [p = 0.054, g = -0.63 (-0.95: -0.29)]. CONCLUSIONS A predilection for choices based on the size and immediacy of reward may reflect a cognitive strategy that works against CM. Pretesting with a decision-making task, such as the IGT, may help in matching cognitive therapies to clients with MA Use Disorder.
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Affiliation(s)
- Marilyn T Lake
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa.,Department of Psychology, University of Cape Town, Cape Town, South Africa
| | - Steven Shoptaw
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa.,Department of Family Medicine, University of California, Los Angeles, Los Angeles, CA, United States
| | - Jonathan C Ipser
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Sae Takada
- Division of General Internal Medicine and Health Services Research, Department of Medicine, University of California, Los Angeles, Los Angeles, CA, United States.,Veterans Health Services Research and Development Service (VA HSR&D) Center for Study of Healthcare Innovation, Implementation, & Policy, Los Angeles, CA, United States
| | - Lara J van Nunen
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Gosia Lipinska
- Department of Psychology, University of Cape Town, Cape Town, South Africa
| | - Dan J Stein
- SA MRC Unit on Risk & Resilience in Mental Disorders, Department of Psychiatry and Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Edythe D London
- Department of Psychiatry and Biobehavioral Sciences, Department of Molecular and Medical Pharmacology, and the Brain Research Institute, University of California, Los Angeles, Los Angeles, CA, United States
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Abstract
Molecular and functional imaging techniques have been used and combined with pharmacological probes to evaluate the role of dopamine in impulsivity. Overall, strong evidence links striatal dopaminergic function with impulsivity, measured by self-reports and laboratory tests of cognitive control and reward-based decision-making. The combination of molecular imaging using positron emission tomography (PET) with functional magnetic resonance imaging (fMRI) specifically implicates striatal D2-type dopamine receptors (i.e., D2 and D3) and corticostriatal connectivity in cognitive control. Low levels of striatal and midbrain D2-type receptor availability correlate with self-reported impulsivity, whereas striatal D2-type receptor availability shows positive correlation with motor response inhibition and cognitive flexibility. Impulsive choice on reward-based decision-making tasks also is related to deficits in striatal D2-type dopamine receptor availability, and there is evidence for an inverted U-shaped function in this relationship, reflecting an optimum of striatal dopaminergic activity. Findings from studies of clinical populations that present striatal dopamine D2-type receptor deficits as well as healthy control research participants identify D2-type receptors as therapeutic targets to improve cognitive control.
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Affiliation(s)
- Edythe D London
- Jane and Terry Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, Department of Molecular and Medical Pharmacology, and the Brain Research Institute, University of California at Los Angeles, Los Angeles, CA, USA.
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35
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Okafor CN, Stein DJ, Dannatt L, Ipser J, van Nunen LJ, Lake MT, Krishnamurti T, London ED, Shoptaw S. Contingency management treatment for methamphetamine use disorder in South Africa. Drug Alcohol Rev 2019; 39:216-222. [PMID: 31863530 DOI: 10.1111/dar.13019] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Revised: 09/26/2019] [Accepted: 11/19/2019] [Indexed: 11/28/2022]
Abstract
INTRODUCTION AND AIMS As South Africa, especially the Western Cape Province, faces an epidemic of methamphetamine use disorder, therapeutic approaches suited to the South African context are needed. This secondary analysis assessed retention and methamphetamine abstinence outcomes in response to an 8-week pilot contingency management (CM) intervention trial of neural correlates of methamphetamine abstinence, exploring sociodemographic and clinical differences between responders and non-responders. DESIGN AND METHODS Research participants provided thrice-weekly monitored urine samples, which were analysed by qualitative radioimmunoassay. The primary outcome for this analysis was therapeutic response, defined as abstinence from methamphetamine (≥23 of 24 possible methamphetamine-negative urine samples). RESULTS Data from 30 adults living in Cape Town, South Africa (34 ± 6.1 years of age, mean age ± SD, 21 men) were included. Sixty-three percent (12 men) were responders. In bivariate comparisons, baseline measurements showed fewer responders reported monthly household income ≥25 000+ South African Rand (ZAR; ~USD $1880; vs. ZAR < 25 000) than non-responders (15.8% vs. 63.6%; P = 0.007). Furthermore, responders had higher median years of education (12 vs. 10; Kruskal-Wallis χ2 = 4.25, DF = 1, P = 0.039) and lower median body mass index than non-responders (19 vs. 24; Kruskal-Wallis χ2 = 6.84, P = 0.008). DISCUSSION AND CONCLUSIONS Therapeutic response in this study were comparable to those obtained with CM for methamphetamine use disorder in North America and Europe. Our findings suggest that CM may be a useful component of treatment strategies to boost retention and continuous abstinence from methamphetamine in Cape Town, South Africa. Larger efficacy studies are needed in this setting.
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Affiliation(s)
- Chukwuemeka N Okafor
- Division of Infectious Diseases, David Geffen School of Medicine at University of California, Los Angeles, USA
| | - Dan J Stein
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa.,South African Medical Research Council Unit on Risk and Resilience in Mental Disorders, Cape Town, South Africa
| | - Lisa Dannatt
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Jonathan Ipser
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Lara J van Nunen
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Marilyn T Lake
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa.,Department of Psychology, University of Cape Town, Cape Town, South Africa
| | - Tamar Krishnamurti
- Division of General Internal Medicine, University of Pittsburgh School of Medicine, University of Pittsburgh, Pittsburgh, USA
| | - Edythe D London
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, USA
| | - Steve Shoptaw
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa.,Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, USA.,Department of Family Medicine, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, USA
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Petersen N, Ghahremani DG, Rapkin AJ, Berman SM, Wijker N, Liang L, London ED. Resting-state functional connectivity in women with PMDD. Transl Psychiatry 2019; 9:339. [PMID: 31827073 PMCID: PMC6906514 DOI: 10.1038/s41398-019-0670-8] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 11/11/2019] [Accepted: 11/26/2019] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Premenstrual dysphoric disorder (PMDD) is an understudied, debilitating disorder of women. Given evidence for prefrontal cortical and limbic dysfunction in PMDD, we compared intrinsic connectivity of the executive control network (ECN), default mode network (DMN), and amygdala in women with PMDD vs. controls. METHODS Thirty-six women (18 PMDD, 18 control) participated in fMRI during the follicular and luteal phases of the menstrual cycle. At each time, resting-state functional connectivity was evaluated both before and after participants performed an emotion regulation task. The ECN was identified using independent components analysis, and connectivity of left and right amygdala seeds was also evaluated. RESULTS Nonparametric permutation testing identified a cluster in the left middle temporal gyrus (MTG) with significantly stronger connectivity to the left ECN in women with PMDD vs. controls in all four fMRI sessions. Women with PMDD exhibited no difference in functional connectivity between menstrual cycle phases. Amygdala connectivity did not differ between the groups but differed significantly with menstrual phase, with left amygdala connectivity to cingulate cortex being significantly stronger during the follicular vs. luteal phase. Right amygdala connectivity to the middle frontal gyrus was also stronger during the follicular vs. luteal phase, with no group differences. These findings suggest that women with PMDD have different intrinsic network dynamics in the left executive control network compared to healthy controls.
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Affiliation(s)
- Nicole Petersen
- 0000 0000 9632 6718grid.19006.3eDepartment of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA 90024 USA
| | - Dara G. Ghahremani
- 0000 0000 9632 6718grid.19006.3eDepartment of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA 90024 USA
| | - Andrea J. Rapkin
- 0000 0000 9632 6718grid.19006.3eDepartment of Obstetrics and Gynecology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA 90024 USA
| | - Steven M. Berman
- 0000 0000 9632 6718grid.19006.3eDepartment of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA 90024 USA
| | - Noor Wijker
- 0000 0000 9632 6718grid.19006.3eDepartment of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA 90024 USA
| | - Letty Liang
- 0000 0000 9632 6718grid.19006.3eDepartment of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA 90024 USA
| | - Edythe D. London
- 0000 0000 9632 6718grid.19006.3eDepartment of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA 90024 USA ,0000 0000 9632 6718grid.19006.3eDepartment of Molecular and Medical Pharmacology, University of California, Los Angeles, Los Angeles, CA 90024 USA ,0000 0000 9632 6718grid.19006.3eBrain Research Institute, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90024 USA
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Nie L, Zhaom Z, Wen X, Luo W, Ju T, Ren A, Wu B, London ED, Li J. Factors affecting the occurrence of psychotic symptoms in chronic methamphetamine users. J Addict Dis 2019; 37:202-210. [PMID: 31682200 DOI: 10.1080/10550887.2019.1661752] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Studies of risk for psychotic symptoms in methamphetamine users have focused primarily on drug use immediately before symptoms had appeared. Here we assessed factors reflecting characteristics of lifetime methamphetamine use before the appearance of psychotic symptoms. Four hundred ninety-five methamphetamine users (322 men, 173 women) were studied with consideration of the following features of methamphetamine use: age of initiation, maximum single dose, number of uses at or near the maximum dose, longest period of daily use, average dosage during that period, number of heavy use periods, and number of sustained abstinence periods (>1 month). Use of drugs other than methamphetamine and family history of schizophrenia were also considered. Retrospective self-reports of psychotic symptoms were obtained on the Brief Psychiatric Rating Scale. Factors associated with the occurrence of initial psychotic symptom(s) were identified using logistic regression. Later age of initiation, more uses at maximal or near maximal dosage, and more periods of prolonged abstinence were identified as protective factors. We conclude that early methamphetamine use can promote psychotic symptoms, possibly by altering neurodevelopment, whereas long abstinence periods may protect by allowing recovery. Negative associations of the appearance of psychotic symptom(s) with frequent high-dose administration suggest protection through tolerance.
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Affiliation(s)
- Lili Nie
- Mental Health Center, West China Hospital of Sichuan University, Chengdu, China
| | - Zeyong Zhaom
- Detoxification and Narcotics Control Department of Sichuan Province, Chengdu, China
| | - Xiantao Wen
- Sichuan provincial Compulsory Drug Addiction Treatment Agency for Males, Ziyang, China
| | - Wei Luo
- Sichuan provincial Compulsory Drug Addiction Treatment Agency for Females, Deyang, China
| | - Tao Ju
- Hospital of Sichuan provincial Compulsory Drug Addiction Treatment Agency for Females, Deyang, China
| | - Anlian Ren
- Sichuan provincial Compulsory Drug Addiction Treatment Agency for Males, Ziyang, China
| | - Binbin Wu
- Hospital of Sichuan provincial Compulsory Drug Addiction Treatment Agency for Females, Deyang, China
| | - Edythe D London
- Department of Psychiatry and Biobehavioral Sciences, Department of Molecular and Medical Pharmacology, Brain Research Institute, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA, USA
| | - Jing Li
- Mental Health Center, West China Hospital of Sichuan University, Chengdu, China
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Faulkner P, Ghahremani DG, Tyndale RF, Paterson NE, Cox C, Ginder N, Hellemann G, London ED. Neural basis of smoking-induced relief of craving and negative affect: Contribution of nicotine. Addict Biol 2019; 24:1087-1095. [PMID: 30307083 DOI: 10.1111/adb.12679] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Revised: 08/23/2018] [Accepted: 08/24/2018] [Indexed: 01/22/2023]
Abstract
Smoking-induced relief of craving and withdrawal promotes continued cigarette use. Understanding how relief is produced and the role of nicotine in this process may facilitate development of new smoking-cessation therapies. As the US Food and Drug Administration considers setting a standard for reduced nicotine content in cigarettes to improve public health, knowledge of how nicotine contributes to relief also can inform policy. We assessed effects of nicotine using resting state functional magnetic resonance imaging (MRI) and behavioral assessments of craving and negative affect. Twenty-one young (18-25 years old) daily smokers underwent overnight abstinence on 4 days. On each of the following mornings, they self-rated their cigarette craving and negative affect and underwent resting-state functional MRI (fMRI) before and after smoking a cigarette that delivered 0.027, 0.110, 0.231, or 0.763 mg of nicotine. Functional connectivity between the anterior insula and anterior cingulate cortex (ACC) and between the nucleus accumbens and orbitofrontal cortex (OFC) was assessed. Smoking reduced craving, negative affect, and nucleus accumbens-OFC connectivity irrespective of nicotine dose, with positive correlations of the effects on behavioral and connectivity measures. Only the highest nicotine dose (0.763 mg) reduced right anterior insula-ACC connectivity; this reduction was positively correlated with the behavioral effects of the 0.763-mg dose only. While nicotine-based therapies may act on right anterior insula-ACC functional circuits to facilitate smoking cessation, non-nicotine (eg, the conditioned and sensorimotor) aspects of smoking may promote cessation by reducing OFC-accumbens connectivity to alleviate withdrawal.
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Affiliation(s)
- Paul Faulkner
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior; University of California, Los Angeles; Los Angeles California
| | - Dara G. Ghahremani
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior; University of California, Los Angeles; Los Angeles California
| | - Rachel F. Tyndale
- Campbell Family Mental Health Research Institute, Centre for Addiction & Mental Health (CAMH), Departments of Pharmacology & Toxicology and Psychiatry; University of Toronto; Toronto Ontario Canada
| | - Neil E. Paterson
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior; University of California, Los Angeles; Los Angeles California
| | - Chelsea Cox
- Department of Psychology; University of Illinois; Chicago Illinois
| | - Nathaniel Ginder
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior; University of California, Los Angeles; Los Angeles California
| | - Gerhard Hellemann
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior; University of California, Los Angeles; Los Angeles California
| | - Edythe D. London
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior; University of California, Los Angeles; Los Angeles California
- Department of Molecular and Medical Pharmacology; University of California, Los Angeles; Los Angeles California
- The Brain Research Institute; University of California, Los Angeles; Los Angeles California
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Burggren AC, Shirazi A, Ginder N, London ED. Cannabis effects on brain structure, function, and cognition: considerations for medical uses of cannabis and its derivatives. Am J Drug Alcohol Abuse 2019; 45:563-579. [PMID: 31365275 PMCID: PMC7027431 DOI: 10.1080/00952990.2019.1634086] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Revised: 06/14/2019] [Accepted: 06/17/2019] [Indexed: 12/16/2022]
Abstract
Background: Cannabis is the most widely used illicit substance worldwide, and legalization for recreational and medical purposes has substantially increased its availability and use in the United States.Objectives: Decades of research have suggested that recreational cannabis use confers risk for cognitive impairment across various domains, and structural and functional differences in the brain have been linked to early and heavy cannabis use.Methods: With substantial evidence for the role of the endocannabinoid system in neural development and understanding that brain development continues into early adulthood, the rising use of cannabis in adolescents and young adults raises major concerns. Yet some formulations of cannabinoid compounds are FDA-approved for medical uses, including applications in children.Results: Potential effects on the trajectory of brain morphology and cognition, therefore, should be considered. The goal of this review is to update and consolidate relevant findings in order to inform attitudes and public policy regarding the recreational and medical use of cannabis and cannabinoid compounds.Conclusions: The findings point to considerations for age limits and guidelines for use.
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Affiliation(s)
- Alison C Burggren
- Robert and Beverly Lewis Center for Neuroimaging, University of Oregon, Eugene, OR, USA
| | - Anaheed Shirazi
- Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, Los Angeles, CA, USA
| | - Nathaniel Ginder
- Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, Los Angeles, CA, USA
| | - Edythe D. London
- Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, Los Angeles, CA, USA
- Department of Molecular and Medical Pharmacology, and the Brain Research Institute, University of California at Los Angeles, Los Angeles, CA, USA
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Petzold J, Kienast A, Lee Y, Pooseh S, London ED, Goschke T, Smolka MN. Baseline impulsivity may moderate L-DOPA effects on value-based decision-making. Sci Rep 2019; 9:5652. [PMID: 30948756 PMCID: PMC6449394 DOI: 10.1038/s41598-019-42124-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Accepted: 03/13/2019] [Indexed: 12/16/2022] Open
Abstract
Research has indicated a major role of dopamine in decision-making processes, but the underlying mechanisms remain largely unknown due to inconsistency in effects of dopaminergic drugs. To clarify the impact of dopamine on impulsive choice, we administered 150 mg L-DOPA to 87 healthy adults in a randomized, placebo-controlled, double-blind, crossover study, evaluating performance in four value-based decision-making tasks. We predicted that baseline impulsivity would moderate L-DOPA effects. In support of our hypothesis, L-DOPA had no main effect on impulsive choice, but reduced risk-seeking for gains in more-impulsive subjects. Because L-DOPA effects may be influenced by body weight, we repeated our analyses on data from half of the sample (n = 44) with lower weight, anticipating a stronger effect. In addition to the effect on risk-seeking for gains, low-weight participants also exhibited baseline-dependent effects of L-DOPA on loss aversion and delay discounting. Our results are consistent with the hypothesis of an inverted U-shaped dopamine function in which both low and high extremes of dopamine signaling are associated with high-impulsive choice. Consideration of differential baseline impulsivity and body weight may resolve previous seemingly paradoxical pharmacological results and might deepen our understanding of dopaminergic mechanisms underlying impulsivity.
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Affiliation(s)
- Johannes Petzold
- Department of Psychiatry and Neuroimaging Center, Technische Universität Dresden, Dresden, Germany
| | - Annika Kienast
- Department of Psychiatry and Neuroimaging Center, Technische Universität Dresden, Dresden, Germany.,Department of Experimental Psychology, University of Oxford, Oxford, United Kingdom
| | - Ying Lee
- Department of Psychiatry and Neuroimaging Center, Technische Universität Dresden, Dresden, Germany
| | - Shakoor Pooseh
- Department of Psychiatry and Neuroimaging Center, Technische Universität Dresden, Dresden, Germany.,Freiburg Center for Data Analysis and Modeling, Albert-Ludwigs-Universität Freiburg, Freiburg, Germany
| | - Edythe D London
- Department of Psychiatry and Biobehavioral Sciences, Department of Molecular and Medical Pharmacology and the Brain Research Institute, University of California at Los Angeles, Los Angeles, CA, USA
| | - Thomas Goschke
- Department of Psychology and Neuroimaging Center, Technische Universität Dresden, Dresden, Germany
| | - Michael N Smolka
- Department of Psychiatry and Neuroimaging Center, Technische Universität Dresden, Dresden, Germany.
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Zorick T, Okita K, Mandelkern MA, London ED, Brody AL. Effects of Citalopram on Cue-Induced Alcohol Craving and Thalamic D2/3 Dopamine Receptor Availability. Int J Neuropsychopharmacol 2019; 22:286-291. [PMID: 30753467 PMCID: PMC6441125 DOI: 10.1093/ijnp/pyz010] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Revised: 01/13/2019] [Accepted: 02/07/2019] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Selective serotonin reuptake inhibitors are often used in alcohol use disorders. Clinical trials with selective serotonin reuptake inhibitors for alcohol use disorders, however, have yielded mixed results. The goal of this project was to assess whether a single i.v. dose of a selective serotonin reuptake inhibitor reduces craving for alcohol and/or simultaneously increases striatal dopamine concentration in individuals with alcohol dependence. METHODS Alcohol-dependent (DSM-IV-TR criteria) volunteers and matched controls (n = 10/group) underwent a double-blind, placebo-controlled, within-subjects study. Participants received i.v. citalopram (40 mg) or saline (counter-balanced) followed by a cue-induced craving assessment and [18F]-fallypride positron emission tomography scanning. RESULTS In the alcohol-dependent individuals, the citalopram (compared with saline) resulted in decreased cue-induced craving for alcohol. For the whole study group, cue-induced alcohol craving was inversely correlated with thalamic (but not striatal) dopamine D2/3 receptor availability. CONCLUSIONS Acute serotonin reuptake inhibition reduces cue-induced alcohol craving. Furthermore, thalamic dopamine abnormalities and the striatal hyperdopaminergic hypothesis of alcohol use disorder are supported.
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Affiliation(s)
- Todd Zorick
- Department of Psychiatry, Harbor-UCLA Medical Center, Los Angeles, California,Department of Psychiatry and Biobehavioral Science, UCLA, Los Angeles, California,Correspondence: Todd Zorick, MD, PhD, Department of Psychiatry, Harbor-UCLA Medical Center, 1000 W. Carson Blvd, Torrance, CA 90509 ()
| | - Kyoji Okita
- Department of Psychiatry and Biobehavioral Science, UCLA, Los Angeles, California
| | - Mark A Mandelkern
- Department of Psychiatry, Harbor-UCLA Medical Center, Los Angeles, California,Department of Physics, University of California, Irvine, California
| | - Edythe D London
- Department of Psychiatry, Harbor-UCLA Medical Center, Los Angeles, California,Department of Psychiatry and Biobehavioral Science, UCLA, Los Angeles, California,Department of Molecular and Medical Pharmacology, UCLA, Los Angeles, California
| | - Arthur L Brody
- Department of Psychiatry, Harbor-UCLA Medical Center, Los Angeles, California,Department of Psychiatry and Biobehavioral Science, UCLA, Los Angeles, California,UCSD/VA San Diego Departments of Psychiatry, San Diego, California
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Thorberg FA, Young RM, Hasking P, Lyvers M, Connor JP, London ED, Huang YL, Feeney GFX. Alexithymia and Alcohol Dependence: The Roles of Negative Mood and Alcohol Craving. Subst Use Misuse 2019; 54:2380-2386. [PMID: 31429362 DOI: 10.1080/10826084.2019.1650773] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Background: Alexithymia is a personality trait associated with emotion regulation difficulties. Up to 67% of alcohol-dependent patients in treatment have alexithymia. Objectives: The objective of this study was to investigate the direct and indirect effects of alexithymia, negative mood (stress, anxiety, and depression) and alcohol craving on alcohol dependence severity. Methods: Three hundred and fifty-five outpatients (mean age = 38.70, SD = 11.00, 244 males, range 18-71 years) undergoing Cognitive-Behavioral Therapy for alcohol dependence completed the Toronto Alexithymia Scale (TAS-20), Depression Anxiety Stress Scales (DASS-21), Obsessive Compulsive Drinking Scale (OCDS), and Alcohol Use Disorders Identification Test (AUDIT) prior to the first treatment session. Results: Alexithymia had an indirect effect on alcohol dependence severity, via both negative mood and alcohol craving (b = 0.03, seb = 0.008, 95% CI: 0.02-0.05). An indirect effect of negative mood on alcohol dependence via alcohol craving was also observed (b = 0.12, seb = 0.03, 95% CI: 0.07-0.16). Conclusions/importance: Alexithymia worked through negative mood and alcohol craving leading to increased alcohol dependence severity, indicating that craving had an indirect effect on the relationship between alexithymia and alcohol dependence severity. Targeting alcohol craving and negative mood for alcohol-dependent patients with alexithymia seems warranted.
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Affiliation(s)
- Fred Arne Thorberg
- National Centre for Dual Diagnosis, Innlandet Hospital Trust, Brumunddal, Norway.,Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia.,School of Psychology and Counseling, Queensland University of Technology, Brisbane, QLD, Australia.,Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, Los Angeles, CA, USA.,School of Psychology, University of Queensland, Brisbane, QLD, Australia.,Department of Psychology, Bond University, Gold Coast, QLD, Australia
| | - Ross McD Young
- Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia
| | | | - Michael Lyvers
- Department of Psychology, Bond University, Gold Coast, QLD, Australia
| | - Jason P Connor
- Centre for Youth Substance Abuse Research, Faculty of Health, The University of Queensland, Brisbane, QLD, Australia.,Discipline of Psychiatry, The University of Queensland, Brisbane, QLD, Australia.,Alcohol & Drug Assessment Unit, Princess Alexandra Hospital, Brisbane, QLD, Australia
| | - Edythe D London
- Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, Los Angeles, CA, USA
| | - Ya-Ling Huang
- Department of Emergency Medicine, Gold Coast Hospital and Health Service, Gold Coast University Hospital, Gold Coast, QLD, Australia.,Department of Respiratory Medicine, Gold Coast Hospital and Health Service, Gold Coast University Hospital, Gold Coast, QLD, Australia
| | - Gerald F X Feeney
- Centre for Youth Substance Abuse Research, Faculty of Health, The University of Queensland, Brisbane, QLD, Australia.,Alcohol & Drug Assessment Unit, Princess Alexandra Hospital, Brisbane, QLD, Australia
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Tang J, O’Neill J, Alger JR, Shen Z, Johnson MC, London ED. N-Acetyl and Glutamatergic Neurometabolites in Perisylvian Brain Regions of Methamphetamine Users. Int J Neuropsychopharmacol 2019; 22:1-9. [PMID: 29788422 PMCID: PMC6313110 DOI: 10.1093/ijnp/pyy042] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Revised: 03/21/2018] [Accepted: 05/15/2018] [Indexed: 02/05/2023] Open
Abstract
Background Methamphetamine induces neuronal N-acetyl-aspartate synthesis in preclinical studies. In a preliminary human proton magnetic resonance spectroscopic imaging investigation, we also observed that N-acetyl-aspartate+N-acetyl-aspartyl-glutamate in right inferior frontal cortex correlated with years of heavy methamphetamine abuse. In the same brain region, glutamate+glutamine is lower in methamphetamine users than in controls and is negatively correlated with depression. N-acetyl and glutamatergic neurochemistries therefore merit further investigation in methamphetamine abuse and the associated mood symptoms. Methods Magnetic resonance spectroscopic imaging was used to measure N-acetyl-aspartate+N-acetyl-aspartyl-glutamate and glutamate+glutamine in bilateral inferior frontal cortex and insula, a neighboring perisylvian region affected by methamphetamine, of 45 abstinent methamphetamine-dependent and 45 healthy control participants. Regional neurometabolite levels were tested for group differences and associations with duration of heavy methamphetamine use, depressive symptoms, and state anxiety. Results In right inferior frontal cortex, N-acetyl-aspartate+N-acetyl-aspartyl-glutamate correlated with years of heavy methamphetamine use (r = +0.45); glutamate+glutamine was lower in methamphetamine users than in controls (9.3%) and correlated negatively with depressive symptoms (r = -0.44). In left insula, N-acetyl-aspartate+N-acetyl-aspartyl-glutamate was 9.1% higher in methamphetamine users than controls. In right insula, glutamate+glutamine was 12.3% lower in methamphetamine users than controls and correlated negatively with depressive symptoms (r = -0.51) and state anxiety (r = -0.47). Conclusions The inferior frontal cortex and insula show methamphetamine-related abnormalities, consistent with prior observations of increased cortical N-acetyl-aspartate in methamphetamine-exposed animal models and associations between cortical glutamate and mood in human methamphetamine users.
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Affiliation(s)
- Jinsong Tang
- Laboratory of Molecular Neuroimaging, Semel Institute for Neuroscience and Human Behavior and Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, California
- Second Xiangya Hospital, Central South University, Changsha, China
| | - Joseph O’Neill
- Division of Child and Adolescent Psychiatry, Semel Institute for Neuroscience and Human Behavior and Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, California
| | | | - Zhiwei Shen
- The Second Affiliated Hospital of Shantou University Medical College, Shantou, China
| | - Maritza C Johnson
- Laboratory of Molecular Neuroimaging, Semel Institute for Neuroscience and Human Behavior and Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, California
| | - Edythe D London
- Laboratory of Molecular Neuroimaging, Semel Institute for Neuroscience and Human Behavior and Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, California
- Department of Molecular and Medical Pharmacology, University of California, Los Angeles, California
- Brain Research Institute, University of California, Los Angeles, California
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Burggren AC, Siddarth P, Mahmood Z, London ED, Harrison TM, Merrill DA, Small GW, Bookheimer SY. Subregional Hippocampal Thickness Abnormalities in Older Adults with a History of Heavy Cannabis Use. Cannabis Cannabinoid Res 2018; 3:242-251. [PMID: 30547094 PMCID: PMC6290479 DOI: 10.1089/can.2018.0035] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Background and Aims: Legalization of cannabis (CB) for both medicinal and, in some states, recreational use, has given rise to increasing usage rates across the country. Of particular concern are indications that frequent CB use may be selectively harmful to the developing adolescent brain compared with adult-onset usage. However, the long-term effects of heavy, adolescent CB use on brain structure and cognitive performance in late-life remain unknown. A critical brain region is the hippocampus (HC), where there is a striking intersection between high concentrations of cannabinoid 1 (CB1) receptors and age-related pathology. Design: We investigated whether older adults (average age=66.6+7.2 years old) with a history of early life CB use show morphological differences in hippocampal subregions compared with older, nonusers. Methods: We performed high-resolution magnetic resonance imaging combined with computational techniques to assess cortical thickness of the medial temporal lobe, neuropsychological testing, and extensive drug use histories on 50 subjects (24 formerly heavy cannabis users [CB+ group] abstinent for an average of 28.7 years, 26 nonusers [CB− group]). We investigated group differences in hippocampal subregions, controlling for age, sex, and intelligence (as measured by the Wechsler Test of Adult Reading), years of education, and cigarette use. Results: The CB+ subjects exhibited thinner cortices in subfields cornu ammonis 1 [CA1; F(1,42)=9.96, p=0.0003], and CA2, 3, and the dentate gyrus [CA23DG; F(1,42)=23.17, p<0.0001], and in the entire HC averaged over all subregions [F(1,42)=8.49, p=0.006]. Conclusions: Negative effects of chronic adolescent CB use on hippocampal structure are maintained well into late life. Because hippocampal cortical loss underlies and exacerbates age-related cognitive decline, these findings have profound implications for aging adults with a history of early life usage. Clinical Trial Registration: ClinicalTrials.gov # NCT01874886.
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Affiliation(s)
- Alison C Burggren
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, California.,Center for Cognitive Neurosciences, University of California, Los Angeles, California
| | - Prabha Siddarth
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, California
| | - Zanjbeel Mahmood
- San Diego Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California, San Diego, California
| | - Edythe D London
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, California.,Department of Molecular and Medical Pharmacology, University of California, Los Angeles, California
| | - Theresa M Harrison
- Helen Wills Neuroscience Institute, University of California, Berkeley, California
| | - David A Merrill
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, California
| | - Gary W Small
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, California
| | - Susan Y Bookheimer
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, California.,Center for Cognitive Neurosciences, University of California, Los Angeles, California
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Abstract
Background Opioid use disorder is one of the most prevalent addiction problems worldwide. Buprenorphine is used as a medication to treat this disorder, but in countries where buprenorphine is unavailable in combination with naloxone, diversion can be a problem if the medication is given outside a hospital setting. Objective The objective of this research is to evaluate the effect of a single, high dose of buprenorphine on craving in opioid-dependent patients over 5 days of abstinence from use of other opioids. The primary goal was to determine the safety and efficacy of buprenorphine during withdrawal in a hospital setting. Methods Ninety men who used opium, heroin, or prescribed opioids and met DSM-5 criteria for opioid use disorder (severe form) were randomized to three groups (n = 30 per group) to receive a single, sublingual dose of buprenorphine (32, 64, or 96 mg). The study was conducted in an inpatient psychiatric ward, with appropriate precautions and monitoring of respiratory and cardiovascular measures. Buprenorphine was administered when the patients were in moderate opiate withdrawal, as indicated by the presence of four to five symptoms. A structured clinical interview was conducted, and urine toxicology testing was performed at baseline. Self-reports of craving were obtained at baseline and on each of the 5 days after buprenorphine administration. Findings Craving decreased from baseline in each of the three groups (p < 0.0001), with a significant interaction between group and time (p < 0.038), indicating that groups with higher doses of buprenorphine had greater reduction. Conclusions A single, high dose of buprenorphine can reduce craving during opioid withdrawal; additional studies with follow-up are warranted to evaluate safety.
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Affiliation(s)
- Jamshid Ahmadi
- Substance Abuse Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
| | | | - Dara Ghahremani
- Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, Los Angeles, California, USA
| | - Edythe D London
- Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, Los Angeles, California, USA.,Department of Molecular and Medical Pharmacology, University of California at Los Angeles, Los Angeles, California, USA.,Brain Research Institute, University of California at Los Angeles, Los Angeles, California, USA
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46
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Abstract
Mesolimbic dopaminergic function influences addiction through effects on reinforcement learning, decision-making, and impulsivity. This review covers sex differences in dopaminergic neurochemistry, their hormonal and genetic determinants, and how differences in dopaminergic tone interact with sex and/or ovarian hormone status to affect cognitive functions. Findings from research on cigarette smoking reveal sex differences in striatal and midbrain dopamine D2-type receptor availability and striatal dopamine release that suggest mechanisms of nicotine dependence, and stronger subjective responses to nicotine and efficacy of nicotine replacement therapies in male smokers than in their female counterparts. Opportunities exist to extend such efforts in studies of how sex and hormone status influence other addictions.
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Affiliation(s)
- Nicole Petersen
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, USA, 90024
| | - Edythe D. London
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, USA, 90024,Department of Molecular and Medical Pharmacology, University of California Los Angeles, Los Angeles, CA, USA, 90024,Brain Research Institute, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA, 90024,Corresponding author: Dr. Edythe D. London, Department of Psychiatry and Biobehavioral Sciences, Semel Institute, University of California Los Angeles, 760 Westwood Plaza, Los Angeles, CA 90025, USA, Tel: 310 825 0606, Fax: 310 825-0812,
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47
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Abstract
BACKGROUND Difficulties in regulating emotions are linked to the core symptoms of premenstrual dysphoric disorder (PMDD). We therefore investigated the neural substrates of emotion-regulation problems in women with PMDD. METHODS On the basis of self-evaluations over 2 months on the Daily Record of Severity of Problems, eligible participants were assigned to two groups: PMDD and control (18 per group). Functional magnetic resonance imaging (fMRI) and a well-validated task were used to assess brain function during emotion regulation. Participants were tested twice, once during the follicular (asymptomatic) and once in the late luteal (symptomatic) phase of the menstrual cycle. RESULTS Women with PMDD gave higher ratings of negative affect in the luteal phase than in the follicular phase, and compared with healthy control participants during the luteal phase. A region-of-interest fMRI analysis indicated that during the late luteal phase, women with PMDD had hypoactivation in right dorsolateral prefrontal cortex (dlPFC) during all conditions of the emotion-regulation task, not only in the contrast that isolated emotion regulation. An exploratory whole-brain, voxel-wise analysis showed that women with PMDD had less activation in the precentral gyrus during the luteal phase than the follicular phase, and less activation in the postcentral gyrus compared with control participants. CONCLUSIONS During the luteal phase of the menstrual cycle, women with PMDD experience difficulty regulating emotions. Hypoactivation in the right dlPFC may contribute to this problem, but may be related more generally to other affective symptoms of PMDD. Hypofunction in the right pre- and postcentral gyri warrants additional study.
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Affiliation(s)
- Nicole Petersen
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, 90024, USA
| | - Dara G. Ghahremani
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, 90024, USA
| | - Andrea J. Rapkin
- Department of Obstetrics and Gynecology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, 90024, USA
| | - Steven M. Berman
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, 90024, USA
| | - Letty Liang
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, 90024, USA
| | - Edythe D. London
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, 90024, USA
- Department of Molecular and Medical Pharmacology, University of California Los Angeles, Los Angeles, CA, 90024, USA
- Brain Research Institute, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, 90024, USA
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48
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Zheutlin AB, Chekroud AM, Polimanti R, Gelernter J, Sabb FW, Bilder RM, Freimer N, London ED, Hultman CM, Cannon TD. Multivariate Pattern Analysis of Genotype-Phenotype Relationships in Schizophrenia. Schizophr Bull 2018; 44. [PMID: 29534239 PMCID: PMC6101611 DOI: 10.1093/schbul/sby005] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Genetic risk variants for schizophrenia have been linked to many related clinical and biological phenotypes with the hopes of delineating how individual variation across thousands of variants corresponds to the clinical and etiologic heterogeneity within schizophrenia. This has primarily been done using risk score profiling, which aggregates effects across all variants into a single predictor. While effective, this method lacks flexibility in certain domains: risk scores cannot capture nonlinear effects and do not employ any variable selection. We used random forest, an algorithm with this flexibility designed to maximize predictive power, to predict 6 cognitive endophenotypes in a combined sample of psychiatric patients and controls (N = 739) using 77 genetic variants strongly associated with schizophrenia. Tenfold cross-validation was applied to the discovery sample and models were externally validated in an independent sample of similar ancestry (N = 336). Linear approaches, including linear regression and task-specific polygenic risk scores, were employed for comparison. Random forest models for processing speed (P = .019) and visual memory (P = .036) and risk scores developed for verbal (P = .042) and working memory (P = .037) successfully generalized to an independent sample with similar predictive strength and error. As such, we suggest that both methods may be useful for mapping a limited set of predetermined, disease-associated SNPs to related phenotypes. Incorporating random forest and other more flexible algorithms into genotype-phenotype mapping inquiries could contribute to parsing heterogeneity within schizophrenia; such algorithms can perform as well as standard methods and can capture a more comprehensive set of potential relationships.
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Affiliation(s)
| | - Adam M Chekroud
- Department of Psychology, Yale University, New Haven, CT,Spring Health, New York, NY,Department of Psychiatry, Yale University School of Medicine, New Haven, CT
| | - Renato Polimanti
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT
| | - Joel Gelernter
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT
| | - Fred W Sabb
- Lewis Center for Neuroimaging, University of Oregon, Eugene, OR
| | - Robert M Bilder
- Department of Psychology, University of California - Los Angeles, Los Angeles, CA
| | - Nelson Freimer
- Department of Psychiatry and Biobehavioral Sciences, University of California - Los Angeles, Los Angeles, CA
| | - Edythe D London
- Department of Psychiatry and Biobehavioral Sciences, University of California - Los Angeles, Los Angeles, CA
| | - Christina M Hultman
- Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Tyrone D Cannon
- Department of Psychology, Yale University, New Haven, CT,Department of Psychiatry, Yale University School of Medicine, New Haven, CT,To whom correspondence should be addressed; Department of Psychology, Yale University, PO Box 208205, New Haven, CT 06520; tel: 203-436-1545, e-mail:
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49
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Dean AC, Morales AM, Hellemann G, London ED. Cognitive deficit in methamphetamine users relative to childhood academic performance: link to cortical thickness. Neuropsychopharmacology 2018; 43:1745-1752. [PMID: 29704001 PMCID: PMC6006320 DOI: 10.1038/s41386-018-0065-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Revised: 03/26/2018] [Accepted: 04/04/2018] [Indexed: 01/09/2023]
Abstract
Individuals with cognitive problems may be predisposed to develop substance use disorders; therefore, differences in cognitive function between methamphetamine users and control participants may be attributable to premorbid factors rather than methamphetamine use. The goal of this study was to clarify the extent to which this is the case. Childhood academic transcripts were obtained for 37 methamphetamine-dependent adults and 41 control participants of similar educational level and premorbid IQ. Each participant completed a comprehensive cognitive battery and received a structural magnetic resonance imaging scan. Data from control participants and linear regression were used to develop a normative model to describe the relationship between childhood academic performance and scores on the cognitive battery. Using this model, cognitive performance of methamphetamine users was predicted from their premorbid academic scores. Results indicated that methamphetamine users' childhood grade point average was significantly lower than that of the control group (p < 0.05). Further, methamphetamine users' overall cognitive performance was lower than was predicted from their grade point average prior to methamphetamine use (p = 0.001), with specific deficits in attention/concentration and memory (ps < 0.01). Memory deficits were associated with lower whole-brain cortical thickness (p < 0.05). Thus, in addition to having an apparent premorbid weakness in cognition, methamphetamine users exhibit subsequent cognitive function that is significantly lower than premorbid estimates would predict. The results support the view that chronic methamphetamine use causes a decline in cognition and/or a failure to develop normative cognitive abilities, although aside from methamphetamine use per se, other drug use and unidentified factors likely contribute to the observed effects.
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Affiliation(s)
- Andy C. Dean
- 0000 0000 9632 6718grid.19006.3eDepartment of Psychiatry and Biobehavioral Sciences, UCLA Semel Institute for Neuroscience, David Geffen School of Medicine, Los Angeles, CA 90024 USA ,0000 0000 9632 6718grid.19006.3eBrain Research Institute, David Geffen School of Medicine, Los Angeles, CA 90024 USA
| | - Angelica M. Morales
- 0000 0000 9632 6718grid.19006.3eDepartment of Psychiatry and Biobehavioral Sciences, UCLA Semel Institute for Neuroscience, David Geffen School of Medicine, Los Angeles, CA 90024 USA
| | - Gerhard Hellemann
- 0000 0000 9632 6718grid.19006.3eDepartment of Psychiatry and Biobehavioral Sciences, UCLA Semel Institute for Neuroscience, David Geffen School of Medicine, Los Angeles, CA 90024 USA
| | - Edythe D. London
- 0000 0000 9632 6718grid.19006.3eDepartment of Psychiatry and Biobehavioral Sciences, UCLA Semel Institute for Neuroscience, David Geffen School of Medicine, Los Angeles, CA 90024 USA ,0000 0000 9632 6718grid.19006.3eBrain Research Institute, David Geffen School of Medicine, Los Angeles, CA 90024 USA ,0000 0000 9632 6718grid.19006.3eDepartment of Molecular and Medical Pharmacology, David Geffen School of Medicine, Los Angeles, CA 90024 USA
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50
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Faulkner P, Ghahremani DG, Tyndale RF, Hellemann G, London ED. Functional Connectivity of the Raphe Nuclei: Link to Tobacco Withdrawal in Smokers. Int J Neuropsychopharmacol 2018; 21:800-808. [PMID: 29924326 PMCID: PMC6119292 DOI: 10.1093/ijnp/pyy054] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Accepted: 06/18/2018] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Although nicotine alters serotonergic neurochemistry, clinical trials of serotonergic medications for smoking cessation have provided mixed results. Understanding the role of serotonergic dysfunction in tobacco use disorder may advance development of novel pharmacotherapies. METHODS Functional magnetic resonance imaging was used to measure resting-state functional connectivity of the raphe nuclei as an indicator of serotonergic function. Connectivity of the dorsal and median raphe nuclei was compared between 18 young smokers (briefly abstinent, ~40 minutes post-smoking) and 19 young nonsmokers (16-21 years old); connectivity was also examined in a separate sample of overnight-abstinent smokers (18-25 years old), before and after smoking the first cigarette of the day. Relationships between connectivity of the raphe nuclei with psychological withdrawal and craving were tested in smokers. RESULTS Connectivity of the median raphe nucleus with the right hippocampal complex was weaker in smokers than in nonsmokers and was negatively correlated with psychological withdrawal in smokers. In overnight-abstinent smokers, smoking increased connectivity of the median raphe nucleus with the right hippocampal complex, and the increase was positively correlated with the decrease in psychological withdrawal. CONCLUSIONS Relief of withdrawal due to smoking is potentially linked to the serotonergic pathway that includes the median raphe nucleus and hippocampal complex. These results suggest that serotonergic medications may be especially beneficial for smokers who endorse strong psychological withdrawal during abstinence from smoking.
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Affiliation(s)
- Paul Faulkner
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, California
| | - Dara G Ghahremani
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, California
| | - Rachel F Tyndale
- Department of Pharmacology and Toxicology, and Department of Psychiatry, University of Toronto, Toronto, ON, Canada,Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Gerhard Hellemann
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, California
| | - Edythe D London
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, California,Department of Molecular and Medical Pharmacology, University of California, Los Angeles, California,The Brain Research Institute, University of California, Los Angeles, California,Correspondence: Edythe D. London, PhD, Semel Institute, University of California, Los Angeles, 760 Westwood Plaza, Los Angeles, CA 90095 ()
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