Cognitive Dysfunctions in Chronic Cocaine Users

Vonmoos, Matthias; Quednow, Boris B.

doi:10.1016/b978-0-12-803750-8.00040-3

Cited by 8 publications

(9 citation statements)

References 63 publications

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“…As consistently shown by previous studies 12,24,27,28 , we found that the SCD and ICD groups exhibited EF impairments in comparison with CTR. Here, we specifically addressed the route of administration, showing that subjects in the SCD group exhibited overall more profound deficits compared to the ICD group.…”

Section: Discussionsupporting

confidence: 91%

“…However, while the ICD group presented a trend towards the impairment of memory-related processing, then SCD group showed a stronger attentional deficit. The relative importance of executive, attentional and memory domains has been controversial in the neuropsychological study of cocaine consumption 12,24,27,28 . We suggest that these inconsistencies could arise due to incomplete matching 10 of critical variables (such as SES), polyconsumption 13 , and most critically by differences in the route of administration 12,24,27,28 , possibly the most under-investigated factor in the current literature.…”

Section: Discussionmentioning

confidence: 99%

“…The populations we investigated presented an early onset of drug abuse, and cocaine consumption during adolescence (i.e. starting before 18 years) contributing with more profound cognitive impact relative to cocaine abuse beginning during adulthood 27,29 . Our result suggests that EF-Attention deficits could represent a risk factor towards developing addiction to drugs, particularly during the adolescence, consistent with longitudinal studies of drug consumption initiation, suggesting that poor development and certain individual cognitive traits can predict early susceptibility to addiction (i.e.…”

Section: Discussionmentioning

confidence: 99%

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Structural and functional signatures of executive deficits after early use of cocaine depend upon route of administration

Fuente¹,

Vignaga²,

Prado³

et al. 2020

Preprint

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Background: There is growing evidence linking cocaine consumption with a broad spectrum of neurocognitive deficits. Despite of evidence suggesting that the route of administration should be taken into account to assess the short and long term effects of cocaine consumption, to our knowledge no study to date has characterized clinically relevant neuropsychological variables along with physiological variables separately in populations of individuals with histories of smoked cocaine dependence (SCD) and insufflated cocaine hydrochloride dependence (ICD). Methods: The present study examined a sample of (a) 25 participants who fulfilled criteria for SCD, (b) 22 participants who fulfilled criteria for ICD, and (c) 25 healthy controls matched by age, gender, education, and socioeconomic status. An exhaustive neuropsychological battery was used to assess different cognitive domains (attention, executive functions, fluid intelligence, memory, language and social cognition). We complemented this neuropsychological assessment with the acquisition and analysis of structural (MRI) and functional (fMRI) neuroimaging data. Results: Different routes of administration led to equally different profiles of neurocognitive impairment, with the SCD group being specifically associated with deficits in attention and executive functions. Consistent with risk models, executive function-attention deficit is better explained for age and age onset of consumption initiation. SCD also presented reduced grey matter density relative to ICD in the bilateral caudate, a key area for executive functions and attention. Connectivity between left caudate and inferior frontal regions mediates performance-structure association. Conclusions: Cocaine routes of administration are associated to a differential profile that may not be due direct effects of stimulant action but also driven by cognitive and biological differences in key executive functioning and attention areas. This point the critical importance of the routes of administration. This information could inform clinical management and should be taken into account in clinical research.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Structural and functional signatures of executive deficits after early use of cocaine depend upon route of administration

Fuente¹,

Vignaga²,

Prado³

et al. 2020

Preprint

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“…Here, we also found clear cocaine but no pronounced levamisole effects in the domains of attention and working memory but a significant levamisole effect on executive functions. Thus, one might speculate that at least some of the reported discrepant findings in the newer literature regarding executive function impairments 41 might be explained by differences in recent levamisole exposure. As levamisole was proposed to be metabolized into the amphetamine-like stimulant aminorex and other metabolites 1 , 6 , 7 , and previous reports showed pronounced executive function decrements in chronic amphetamine users 42 , 43 , the present effect might not be linked to levamisole alone but also to its metabolic products.…”

Section: Discussionmentioning

confidence: 95%

Cognitive and neuroanatomical impairments associated with chronic exposure to levamisole-contaminated cocaine

et al. 2018

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Currently, levamisole is the most common cocaine adulterant worldwide and it is known to induce a variety of adverse side effects. Animal studies and human case reports suggest potential neurotoxicity of the compound but neither neuroanatomical nor cognitive effects of levamisole have been systematically investigated in cocaine users so far. We examined cognitive performance and cortical structural differences between chronic cocaine users with low and high recent exposure to levamisole objectively determined by quantitative toxicological hair analyses. In Study 1, we compared 26 chronic cocaine users with low levamisole exposure (lowLevCU), 49 matched cocaine users with high levamisole exposure (highLevCU), and 78 matched stimulant-naive controls regarding cognitive functioning employing a comprehensive neuropsychological test battery. In Study 2, we investigated cortical thickness by use of T1-weighted MRI in a subgroup of 12 lowLevCU, 17 highLevCU, and 38 stimulant-naive controls. In Study 1, both cocaine user groups showed significant impairments in the cognitive domains of attention and working memory as well as in the global cognitive index. However, highLevCU showed significantly worse executive functions compared to lowLevCU although both groups did not differ in severity of cocaine consumption and other clinical dimensions. Study 2 revealed that highLevCU, displayed reduced cortical thickness specifically in the middle frontal gyrus compared to both controls and lowLevCU. Our results suggest that levamisole exposure during the last months in cocaine users is associated with increased executive function impairments and pronounced thinning of the lateral prefrontal cortex. Consequently, prevention and drug policy-making should aim to reduce levamisole contamination of street cocaine.

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“…While some studies investigated the linkage between these neurocognitive deficits and cocaine abstinence (6), only one study yet investigated the longitudinal relationship between cognitive impairments and changing cocaine use (7). In sum, these studies indicate that basal cognitive deficits in cocaine users seem to be largely drug-induced, remain stable during the first weeks of abstinence but likely improve after some months (8).…”

Section: Introductionmentioning

confidence: 91%

Improvement of Emotional Empathy and Cluster B Personality Disorder Symptoms Associated With Decreased Cocaine Use Severity

et al. 2019

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Aims: Chronic cocaine users display impaired social cognitive abilities, reduced prosocial behavior, and pronounced cluster B personality disorder (PD) symptoms all contributing to their social dysfunctions in daily life. These social dysfunctions have been proposed as a major factor for maintenance and relapse of stimulant use disorders in general. However, little is known about the reversibility of social cognitive deficits and socially problematic personality facets when stimulant use is reduced or ceased. Therefore, we examined the relation between changing intensity of cocaine use and the development of sociocognitive functioning and cluster B PD symptomatology over the course of 1 year. Methods: Social cognition, social decision-making, and cluster B PD symptoms were assessed in 38 cocaine users (19 with increased and 19 with decreased use) and 48 stimulant-naive healthy controls at baseline and at 1-year follow-up. Cocaine use severity was objectively determined by quantitative 6-month hair analyses. The categorization of the two cocaine user groups was based on a combination of absolute (± 0.5 ng/mg) and relative (± 10%) changes in the cocaine hair concentration between baseline and the 1-year follow-up. Social cognition was assessed using the Multifaceted Empathy Test (MET) and the Movie for the Assessment of Social Cognition (MASC). A combined Distribution/Dictator Game was applied for assessing social decision-making. Cluster B PD symptoms were measured by a Structured Clinical Interview for DSM-IV Axis II Disorders (SCID-II) PD questionnaire according to Diagnostic and Statistical Manual of Mental Disorders , 4th edition (DSM-IV). Results: Increased cocaine use was linked to worsened empathy, while decreased cocaine use went along with improved emotional empathy. Moreover, whereas decreased cocaine use was associated with reduced severity of self-reported cluster B PD symptoms, these symptoms remained largely stable in increasers . In contrast to a significant reduction of prosocial behavior at baseline in the combined cocaine user group, specifically decreasers were not statistically distinguishable from controls at the follow-up. Conclusions: Sociocognitive deficits and cluster B PD symptoms of chronic cocaine users are adaptable over time as they covary with the increase or decrease in cocaine use. Hence, abstinence orientation and training of social cognition and interaction might improve social functioning, and should therefore be important therapeutic elements in cocaine addiction treatment.

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Cognitive Dysfunctions in Chronic Cocaine Users

Cited by 8 publications

References 63 publications

Structural and functional signatures of executive deficits after early use of cocaine depend upon route of administration

Structural and functional signatures of executive deficits after early use of cocaine depend upon route of administration

Cognitive and neuroanatomical impairments associated with chronic exposure to levamisole-contaminated cocaine

Improvement of Emotional Empathy and Cluster B Personality Disorder Symptoms Associated With Decreased Cocaine Use Severity

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