Cognitive control of drug craving inhibits brain reward regions in cocaine abusers
Section snippets
Subjects
Twenty four active cocaine abusers (21 M and 3 F; 46 ± 5 years of age) who responded to an advertisement were studied. Subjects fulfilled DSM- IV criteria for cocaine dependence and were active users for at least the prior 6 months (free-base or crack) with average cocaine use of 16 ± 2 days per month; 2.2 ± 1 g/day; and 17 ± 6 years of abuse. Exclusion criteria included current or past psychiatric disease other than cocaine or nicotine dependence (12 subjects were smokers); past or present history of
Effects of cocaine video NI and CI on craving and on cardiovascular measures
The behavioral assessment comparing the pre versus the post video measures of craving revealed that the cocaine-cue video elicited significant increases in subjective reports of craving in the NI condition but not in the CI condition. There was no pre–post difference in self-reports of craving for the corresponding times of assessment during the baseline condition (Fig. 1). Heart rate and blood pressure were significantly increased after watching the cocaine-cue video (NI and CI) whereas they
Discussion
Our findings provide evidence that when cocaine abusers purposefully inhibit craving when exposed to conditioned drug-cues, specific changes in brain regions that process reward and prediction of reward occur. Namely when subjects were instructed to inhibit cue-induced craving (CI), metabolic activity decreased in the right NAcc and in the right medial OFC (mOFC) when compared with the condition with no inhibition instructions (NI) or when compared with the baseline condition. The decrease with
Acknowledgments
We thank David Schlyer, David Alexoff, Don Warner, Paul Vaska, Colleen Shea, Youwen Xu, Lisa Muench, Barbara Hubbard, Pauline Carter, Karen Apelskog, Alex Reben and Linda Thomas for their contributions. Research supported by NIH’s Intramural Research Program (NIAAA), by DOE (DE-AC01-76CH00016).
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