Impulsivity and Cue Reactivity in Substance Misuse

2020 ◽  
pp. 87-100
Author(s):  
F. Gerard Moeller
Keyword(s):  
Brain Imaging ◽  
Substance Misuse ◽  
Cue Reactivity ◽  
Clinical Literature ◽  
Drug Cue ◽  
Laboratory Measures

There is a growing clinical literature linking impulsivity to drug cue reactivity in individuals with substance misuse. Evidence supporting this link comes from studies using a variety of behavioral laboratory measures of impulsivity and drug cue reactivity. This link is not surprising considering the nature of impulsivity and drug cue reactivity, which both have elements of a stimulus driven reaction to the environment. This chapter describes in detail the literature supporting this link and discusses the potential neurobiology of the overlap based on brain imaging. Last, some potential treatments that target both impulsivity and drug cue reactivity are discussed.

scholarly journals Transcranial Direct Current Stimulation to Modulate fMRI Drug Cue Reactivity in Methamphetamine Users: A Randomized Clinical Trial

2021 ◽  
Author(s):  
Hamed Ekhtiari ◽  
Ghazaleh Soleimani ◽  
Rayus Kuplicki ◽  
Hung-Wen Yeh ◽  
Yoon-Hee Cha ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Direct Current ◽  
Transcranial Direct Current Stimulation ◽  
Cue Reactivity ◽  
Methamphetamine Use ◽  
Sham Stimulation ◽  
Group Time ◽  
Methamphetamine Use Disorder ◽  
The Brain ◽  
Drug Cue

Transcranial direct current stimulation (tDCS) has been studied as an adjunctive therapeutic option to alter maladaptive cortical excitability, activity, and connectivity associated with chronic substance use via the application of a weak direct current through the brain. The underlying mechanism of action remains ambiguous, however. We present a randomized, triple-blind, sham-controlled, clinical trial with two parallel arms conducted to determine the neural substrates of tDCS effects on drug craving using an fMRI drug cue reactivity paradigm. Sixty participants with methamphetamine use disorder were randomly assigned to two groups: 30 participants to active tDCS (5x7 cm2, 2 mA, for 20 minutes, anode/cathode over the F4/Fp1 in EEG 10-20 standard system) and 30 participants to the sham group. Neuroimaging data of a methamphetamine cue reactivity (MCR) task were collected immediately before and after stimulation with subjective craving assessed before, after, and during fMRI scans. There was a significant reduction in self-reported craving after stimulation (main effect of time) without any significant effect of group, time, or by group-time interaction. Our whole-brain analysis demonstrated that brain activation decreased in all parts of the brain in the second (post-stimulation) MCR imaging session after sham stimulation (habituation) but this uniform decrease did not occur throughout the brain in the active group. There were significant interactions between the group (active vs. sham) and time (after vs. before stimulation) in five main regions; medial frontal gyrus, anterior insula, inferior parietal lobule, precuneus, and inferior frontal gyrus with higher activations after active stimulation. We simulated computational head models for each individual. There was a significant effect of group in the relationship between level of current in the above-mentioned significant clusters and changes in task-modulated activation. We also found that brain regions with the highest electric fields in the prefrontal cortex showed a significant time by group interaction in task-modulated connectivity (psychophysiological interaction during MCR) in the frontoparietal network. In this two-parallel-arms triple-blind randomized control trial, we did not find any significant effect of the one session of active F4/Fp1 tDCS on drug craving self-report compared to sham stimulation. However, connectivity differences induced by active compared to sham stimulation suggested some potential mechanisms of tDCS to modulate neural response to drug cues among people with methamphetamine use disorder.

scholarly journals Weaker Memory Performance Exacerbates Stress-Induced Cannabis Craving in Youths’ Daily Lives

2019 ◽  
Vol 7 (5) ◽  
pp. 1094-1108 ◽  
Author(s):  
Robert Miranda ◽  
Stephanie E. Wemm ◽  
Hayley Treloar Padovano ◽  
Ryan W. Carpenter ◽  
Noah N. Emery ◽  
...  
Keyword(s):  
Working Memory ◽  
Real World ◽  
Substance Misuse ◽  
Memory Performance ◽  
Laboratory Data ◽  
Cue Exposure ◽  
Moment Stress ◽  
Daily Lives ◽  
Ecological Momentary ◽  
Drug Cue

Theories of addiction posit that stimuli associated with drug use, including both exteroceptive (e.g., paraphernalia) and interoceptive (e.g., feeling tense or stressed), evoke craving and contribute to the pathogenesis of substance misuse. Control over drug cue response and stress is essential for moderating use. Building from laboratory data supporting associations between cue exposure, stress, and craving, this study tested whether these associations generalize to real-world settings and examined whether a well-vetted neurocognitive control capacity (i.e., working memory, or WM) moderated associations. Youths ( N = 85; 15–24 years old) completed baseline and ecological momentary assessments. Cue exposure and participants’ average stress predicted higher craving. Youths with weaker WM experienced stronger craving at higher-stress moments but not when faced with cues. Interactions were present for both previous-moment and same-moment stress. Craving among adolescents with stronger WM was not swayed by momentary stress. Findings suggest that stronger WM protects against craving at more stressful moments.

The role of withdrawal in mesocorticolimbic drug cue reactivity in opioid use disorder

2020 ◽  
Author(s):  
Zhenhao Shi ◽  
Kanchana Jagannathan ◽  
James H. Padley ◽  
An‐Li Wang ◽  
Victoria P. Fairchild ◽  
...  
Keyword(s):  
Cue Reactivity ◽  
Opioid Use Disorder ◽  
Opioid Use ◽  
Drug Cue

scholarly journals Brain Imaging Biomarkers for Chronic Pain

2022 ◽  
Vol 12 ◽  
Author(s):  
Zhengwu Zhang ◽  
Jennifer S. Gewandter ◽  
Paul Geha
Keyword(s):  
Chronic Pain ◽  
Brain Imaging ◽  
Substance Misuse ◽  
Clinical Applications ◽  
Imaging Biomarkers ◽  
Costs And Benefits ◽  
Brain Circuitry ◽  
Chronic Pain Conditions ◽  
The Brain

The prevalence of chronic pain has reached epidemic levels. In addition to personal suffering chronic pain is associated with psychiatric and medical co-morbidities, notably substance misuse, and a huge a societal cost amounting to hundreds of billions of dollars annually in medical cost, lost wages, and productivity. Chronic pain does not have a cure or quantitative diagnostic or prognostic tools. In this manuscript we provide evidence that this situation is about to change. We first start by summarizing our current understanding of the role of the brain in the pathogenesis of chronic pain. We particularly focus on the concept of learning in the emergence of chronic pain, and the implication of the limbic brain circuitry and dopaminergic signaling, which underly emotional learning and decision making, in this process. Next, we summarize data from our labs and from other groups on the latest brain imaging findings in different chronic pain conditions focusing on results with significant potential for translation into clinical applications. The gaps in the study of chronic pain and brain imaging are highlighted in throughout the overview. Finally, we conclude by discussing the costs and benefits of using brain biomarkers of chronic pain and compare to other potential markers.

scholarly journals Altered prefrontal signaling during inhibitory control in a salient drug context in human cocaine addiction

2021 ◽  
Author(s):  
Ahmet O. Ceceli ◽  
Muhammad A. Parvaz ◽  
Sarah King ◽  
Matthew Schafer ◽  
Pias Malaker ◽  
...  
Keyword(s):  
Drug Addiction ◽  
Inhibitory Control ◽  
Dorsolateral Prefrontal Cortex ◽  
Cue Reactivity ◽  
Self Control ◽  
Food Cues ◽  
Drug Cues ◽  
Dorsolateral Prefrontal ◽  
Valence And Arousal ◽  
Drug Cue

AbstractDrug addiction is characterized by impaired Response Inhibition and Salience Attribution (iRISA), where the salience of drug cues is postulated to overpower that of other reinforcers with a concomitant decrease in self-control. However, the neural underpinnings of the interaction between the salience of drug cues and inhibitory control in drug addiction remain unclear. We developed a novel stop-signal fMRI task where the stop-signal reaction time (SSRT—a classical inhibitory control measure) was tested under different salience conditions (modulated by drug, food, threat or neutral words) in individuals with cocaine use disorder (CUD; n=26) vs. demographically matched healthy control participants (HC; n=26). Despite similarities in drug cue-related SSRT and valence and arousal word ratings between groups, the dorsolateral prefrontal cortex (dlPFC) activity was diminished during the successful inhibition of drug versus food cues in CUD, and was correlated with lower frequency of recent use, lower craving, and longer abstinence (Z > 3.1, p < .05 corrected). Results suggest reduced involvement of cognitive control regions (e.g., dlPFC) during inhibitory control under a drug context, relative to an alternative reinforcer, in CUD. Supporting the iRISA model, these results elucidate the direct impact of drug-related cue-reactivity on the neural signature of inhibitory control in drug addiction.Significance statementExcessive salience attribution to drugs and related cues at the expense of nondrug reinforcers and cues and inhibitory control impairments are hallmark symptoms of drug addiction. Although these neuropsychological functions have been investigated independently, brain representations of their interaction are less clear. We illustrate that, despite matched behavioral performance and valence and arousal ratings, the dorsolateral prefrontal cortex—a key node of the cognitive control network also associated with craving—exhibits decreased signaling when successfully inhibiting responses to drug compared to nondrug (food) cues (words) in cocaine-addicted individuals. Modulating salience while taxing self-control permits the study of their combined impact, an ecologically valid examination of the addiction experience. Better understanding inhibitory control under drug cue-reactivity may refine targeted neuromodulatory interventions.

scholarly journals A Methodological Checklist for fMRI Drug Cue Reactivity Studies: Development and Expert Consensus

2020 ◽  
Author(s):  
Hamed Ekhtiari ◽  
Mehran Zare-Bidoky ◽  
Arshiya Sangchooli ◽  
Amy C. Janes ◽  
Marc J. Kaufman ◽  
...  
Keyword(s):  
Delphi Study ◽  
Cue Reactivity ◽  
Consensus Method ◽  
Functional Magnetic Resonance ◽  
Resonance Imaging ◽  
Delphi Consensus ◽  
Modified Delphi ◽  
Meta Analyses ◽  
Methodological Aspects ◽  
Drug Cue

AbstractBackgroundCue 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 many promising results elucidating the neurocognitive mechanisms of SUDs and SUD treatments, heterogeneities in participant characteristics, task design, craving assessment, scanning preparation and analysis decisions limit rigor and reproducibility in the field of fMRI of drug cue reactivity (FDCR), hampering clinical translation and synthesis by systematic reviews and meta-analyses. The aim of this consensus paper and Delphi study is to outline the important methodological aspects of FDCR studies and present a list of items and recommendations that should be taken into account when designing FDCR studies and reporting their results.MethodsFifty-five FDCR scientists from around the world participated. First, an initial checklist of items deemed important in FDCR studies was developed by a group of members from the ENIGMA Addiction Consortium based on a systematic review. Then, using a modified Delphi consensus method, all experts were asked to comment on, revise or add items to the initial checklist. Subsequently, experts were asked to rate the importance of the items.ResultsThirty-seven items were proposed in the first round. After the commenting phase, seven new items suggested by experts were added and six were removed. The final 38 items that reached a defined consensus threshold in the rating phase were classified under seven categories and are considered important for conducting and reporting in any FDCR study.ConclusionThis paper proposes a list of items and additional recommendations that researchers in the field of FDCR are encouraged to note and report when designing an FDCR study and reporting its results. Along with the presentation of a quality control checklist with Yes/No ratable items, various challenges in moving towards greater homogeneity in FDCR research and widespread use of FDCR to investigate SUDs and develop clinically relevant biomarkers are discussed.

BRAIN IMAGING ALCOHOL CUE-REACTIVITY.

2004 ◽  
Vol 28 (Supplement) ◽  
pp. 65A
Author(s):  
M RC Daglish ◽  
A R Lingford-Hughes ◽  
D J. Nutt
Keyword(s):  
Brain Imaging ◽  
Cue Reactivity

scholarly journals Extinction of drug cue reactivity in methamphetamine-dependent individuals

2010 ◽  
Vol 48 (9) ◽  
pp. 860-865 ◽  
Author(s):  
Kimber L. Price ◽  
Michael E. Saladin ◽  
Nathaniel L. Baker ◽  
Bryan K. Tolliver ◽  
Stacia M. DeSantis ◽  
...  
Keyword(s):  
Cue Reactivity ◽  
Drug Cue
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