Cerebral Blood Flow in Chronic Cocaine Users: A Study with Positron Emission Tomography

Volkow, Nora D.; Mullani, Nizar A.; Gould, K. Lance; Adler, S. S.; Krajewski, Kara

doi:10.1192/bjp.152.5.641

Cited by 344 publications

(181 citation statements)

References 39 publications

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“…Decreased cerebral blood flow, as measured by FDG-PET, selective to the prefrontal cortex has been reported in cocaine users (Volkow et al, 1988a). Similarly, decreased frontal brain glucose metabolism has been found in cocaine dependent subjects at baseline and at 3 months (Volkow et al, 1992).…”

Section: Discussionmentioning

confidence: 78%

Brain macrostructural and microstructural abnormalities in cocaine dependence

Lim

Wozniak

Mueller

et al. 2008

Drug and Alcohol Dependence

144

115

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Rationale-Two previous studies have utilized Diffusion Tensor Imaging (DTI) to examine microstructural integrity in cocaine abuse and found evidence of brain abnormalities in white matter.Objective-Using anatomical magnetic resonance imaging (MRI), DTI, and clinical evaluation, the macrostructural and microstructural correlates of cocaine abuse were investigated.Methods-21 men and women (mean age 42.5, mean 18.9 years of cocaine use) and 21 age/gendermatched controls were included. Fractional anisotropy (FA) was measured in frontal white matter ROIs. Gray and white matter volumes in superior and inferior frontal regions were compared.Results-DTI data revealed that cocaine users had lower FA than controls, specifically in inferior frontal white matter. FA differences were not seen in other areas. Significant volumetric differences were not seen, but both grey and white matter inferior frontal volumes trended toward smaller in the cocaine group. The data suggested that duration of use was associated with decreased grey and white matter volumes. FA and grey matter volume were correlated in cocaine users.Conclusions-Both macrostructural and microstructural abnormalities were seen in a group of cocaine abusers. Length of cocaine use was associated with severity of the brain abnormalities. Future studies of white matter tissue integrity are warranted including examination of the relationship between DTI measures and traditional volumetric measures.

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Section: Discussionmentioning

confidence: 78%

Brain macrostructural and microstructural abnormalities in cocaine dependence

Lim

Wozniak

Mueller

et al. 2008

Drug and Alcohol Dependence

144

115

View full text Add to dashboard Cite

show abstract

“…Anatomic studies of cocaine-dependent individuals have identified the following changes in the PFC: reduced gray matter (Franklin et al, 2002;Matochik et al, 2003), decreased white matter integrity (Lim et al, 2002), and increased white matter hyperintensities (Lyoo et al, 2004). Physiologic studies have shown decreased metabolism in the orbitofrontal cortex (Volkow et al, 1988) and increased cerebrovascular resistance in the arteries that supply the PFC (Herning et al, 1999). Some reports of neuropsychological testing in cocaine using subjects have identified decreased performance on tests that require the support of prefrontal structures (Ardila et al, 1991;Berry et al, 1993;Beatty et al, 1995;van Gorp et al, 1999;Di Sclafani et al, 2002).…”

Section: Discussionmentioning

confidence: 99%

Performance on the Stroop Predicts Treatment Compliance in Cocaine-Dependent Individuals

Streeter

Terhune

Whitfield

et al. 2007

Neuropsychopharmacol

170

128

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Treatment dropout is a problem of great prevalence and stands as an obstacle to recovery in cocaine-dependent (CD) individuals. Treatment attrition in CD individuals may result from impairments in cognitive control, which can be reliably measured by the Stroop color-word interference task. The present analyses contrasted baseline performance on the color-naming, word-reading, and interference subtests of the Stroop task in CD subjects who completed a cocaine treatment trial (completers: N ¼ 50) and those who dropped out of the trial before completion (non-completers: N ¼ 24). A logistic regression analysis was used to predict trial completion using three models with the following variables: the Stroop task subscale scores (Stroop model); the Hamilton depression rating scale (HDRS) scores (HDRS model); and both the Stroop task subscale scores and HDRS scores (Stroop and HDRS model). Each model was able to significantly predict group membership (completers vs non-completers) better than a model based on a simple constant (HDRS model p ¼ 0.02, Stroop model p ¼ 0.006, and Stroop and HDRS model p ¼ 0.003). Models using the Stroop preformed better than the HDRS model. These findings suggest that the Stroop task can be used to identify cocaine-dependent subjects at risk for treatment dropout. The Stroop task is a widely available, reliable, and valid instrument that can be easily employed to identify and tailor interventions of at risk individuals in the hope of improving treatment compliance.

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“…Moreover, to whatever extent delay discounting and substance abuse are causally linked, it is indeterminable from cohort comparisons in which direction the causal arrow points. It is possible, for example, that the effects of chronic drug use on the brain (Volkow et al, 1988, Volkow et al, 1991, London et al, 1990, Kosten, 1998 might affect performance on delay discounting tasks. Or, perhaps the life-style of the addict might dispose her to emphasize immediate attainment of reward (a possibility we will consider further in the context of our discussion of willpower below).…”

Section: Empirical Studies Of Discounting In Addicted Populationsmentioning

confidence: 99%

The behavioral economics of will in recovery from addiction

Monterosso

Ainslie

2007

Drug and Alcohol Dependence

101

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Behavioral economic studies demonstrate that rewards are discounted proportionally with their delay (hyperbolic discounting). Hyperbolic discounting implies temporary preference for smaller rewards when they are imminent, and this concept has been widely considered by researchers interested in the causes of addictive behavior. Far less consideration has been given to the fact that systematic preference reversal also predicts various self-control phenomena, which may also be analyzed from a behavioral economic perspective.Here we summarize self-control phenomena predicted by hyperbolic discounting, particularly with application to the field of addiction. Of greatest interest is the phenomenon of choice bundling, an increase in motivation to wait for delayed rewards that can be expected to result from making choices in whole categories. Specifically, when a person's expectations about her own future behavior are conditional upon her current behavior, the value of these expectations is added to the contingencies for the current behavior, resulting in reduced impulsivity. Hyperbolic discounting provides a bottomup basis for the intuitive learning of choice bundling, the properties of which match common descriptions of willpower. We suggest that the bundling effect can also be discerned in the advice of 12-step programs.Recovery from addiction is a distinctly human phenomenon (Logan, 1993), can be extraordinarily abrupt without any obvious changes in contingencies (Premack, 1970, Miller andC'de Baca, 2001), and is commonly described in spiritual terms (Bien and Bien, 2002). Thus it may seem that although behavioral economic and other reductionist approaches are productively applied to the onset of addiction, they are not applicable to studying recovery from addiction (for example, see Miller's 2003 discussion of his skepticism). Here we want to make the case that behavioral economics sheds new light on recovery from addiction.Address correspondence to either: John Monterosso, PhD, Department of Psychiatry, University of California at Los Angeles, 760 Westwood Plaza; Rm C8-532, Los Angeles, CA 90024, Phone: (310) 794-1736, email: jmont@ucla.edu, George Ainslie, M.D., Department of Psychiatry, Coatesville VA Medical Center, Coatesville, PA 19320, Phone (610) 384-7711, Email: george.ainslie@va.gov. With reference to formulas 1 and 2, consider the following example. If Rate is .5 and Amount is 10 the exponential value at Delays =1, 2, 3, 4, 5, 6 will be 5, 2.5, 1.25, .625, .3125, .15625; the hyperbolic value at those Delays will be 5, 3.33, 2.5, 2., 1.67, 1.43. If a subject repeatedly is presented with an alternative reward of 4, two units of Delay before each 10 is due, the 4 will win under both formulae: 4 vs. 2.5 for exponential, 4 vs. 3.33 for hyperbolic. But if these options occur three times, two units apart, and must be chosen as a category all at once, exponential → [2.5 + .

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Cerebral Blood Flow in Chronic Cocaine Users: A Study with Positron Emission Tomography

Cited by 344 publications

References 39 publications

Brain macrostructural and microstructural abnormalities in cocaine dependence

Brain macrostructural and microstructural abnormalities in cocaine dependence

Performance on the Stroop Predicts Treatment Compliance in Cocaine-Dependent Individuals

The behavioral economics of will in recovery from addiction

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