Prefrontal–striatal pathway underlies cognitive regulation of craving

Abstract

The ability to control craving for substances that offer immediate rewards but whose long-term consumption may pose serious risks lies at the root of substance use disorders and is critical for mental and physical health. Despite its importance, the neural systems supporting this ability remain unclear. Here, we investigated this issue using functional imaging to examine neural activity in cigarette smokers, the most prevalent substance-dependent population in the United States, as they used cognitive strategies to regulate craving for cigarettes and food. We found that the cognitive down-regulation of craving was associated with (i) activity in regions previously associated with regulating emotion in particular and cognitive control in general, including dorsomedial, dorsolateral, and ventrolateral prefrontal cortices, and (ii) decreased activity in regions previously associated with craving, including the ventral striatum, subgenual cingulate, amygdala, and ventral tegmental area. Decreases in craving correlated with decreases in ventral striatum activity and increases in dorsolateral prefrontal cortex activity, with ventral striatal activity fully mediating the relationship between lateral prefrontal cortex and reported craving. These results provide insight into the mechanisms that enable cognitive strategies to effectively regulate craving, suggesting that it involves neural dynamics parallel to those involved in regulating other emotions. In so doing, this study provides a methodological tool and conceptual foundation for studying this ability across substance using populations and developing more effective treatments for substance use disorders.

Individual Differences in Attentional Bias Associated with Cocaine Dependence Are Related to Varying Engagement of Neural Processing Networks

“…This reliance of regulation of drug motivation on attentional awareness is central to recent attempts to use attentional bias modification training (Schoenmakers et al, 2010) and attention control training (Fadardi and Cox, 2009) to reduce drugrelated attentional bias and drug use. Prior studies have demonstrated that drug-dependent individuals can regulate their craving and neural responses by the effortful cognitive regulation of drug cues (Volkow et al, 2010;Kober et al, 2010). This study adds to this literature by demonstrating that engagement of a sensory-motor-dorsal insula network is associated with decreases in the attentional bias effect for implicitly processed cocaine cues.…”

Self-talk as a regulatory mechanism: How you do it matters.

“…First, converging evidence suggests that enhancing psychological distance, which we construed broadly as the capacity to transcend one's egocentric viewpoint of a stimulus, facilitates self-regulation. Research in children and adults indicates, for example, that psychological distancing strategies enhance people's capacity to exert self-control when faced with tempting options in the short term (e.g., Fujita, Trope, Liberman, & Levin-Sagi, 2006;Kober et al, 2010;Mischel & Rodriguez, 1993;Sigel & McGillicuddy-De Lisi, 2003). In a similar vein, research on self-reflection indicates that cueing people to reflect on painful past experiences from a selfdistanced or "fly-on-the-wall" visual perspective helps them reflect on their experiences without ruminating (Gruber, Harvey, & Johnson, 2009;; also see Ray, Wilhelm, & Gross, 2008;Wisco & Nolen-Hoeksema, 2011).…”

Striatal Morphology is Associated with Tobacco Cigarette Craving

“…Following scanning (3 h after smoking), participants were shown smoking and neutral images and were asked to rate the amount of craving they experienced when viewing each image on a five-point scale. Smoking and neutral images were comprised of images from various sources including the International Smoking Image Series (Gilbert and Rabinovich, 1999) and those used in our prior work (Janes et al, 2013) and by Kober et al (2010). To control for visual characteristics, all images were converted to gray scale.…”