Psychological intervention with working memory training increases basal ganglia volume: A VBM study of inpatient treatment for methamphetamine use

Abstract

BackgroundProtracted methamphetamine (MA) use is associated with decreased control over drug craving and altered brain volume in the frontostriatal network. However, the nature of volumetric changes following a course of psychological intervention for MA use is not yet known.Methods66 males (41 MA patients, 25 healthy controls, HC) between the ages of 18–50 were recruited, the MA patients from new admissions to an in-patient drug rehabilitation centre and the HC via public advertisement, both in Cape Town, South Africa. 17 MA patients received 4 weeks of treatment as usual (TAU), and 24 MA patients completed TAU plus daily 30-minute cognitive training (CT) using an N-back working memory task. Magnetic resonance imaging (MRI) at baseline and 4-week follow-up was acquired and voxel-based morphometry (VBM) was used for analysis.ResultsTAU was associated with larger bilateral striatum (caudate/putamen) volume, whereas CT was associated with more widespread increases of the bilateral basal ganglia (incorporating the amygdala and hippocampus) and reduced bilateral cerebellum volume coinciding with improvements in impulsivity scores.ConclusionsWhile psychological intervention is associated with larger volume in mesolimbic reward regions, the utilisation of additional working memory training as an adjunct to treatment may further normalize frontostriatal structure and function.

Cognition and Related Neural Findings on Methamphetamine Use Disorder: Insights and Treatment Implications From Schizophrenia Research

“…CRTs use diverse methods, such as drill and practice exercises, cognitive strategies training, and group discussions (159,162). Consistent with the present review's observations that cognitive deficits overlap in schizophrenia and meth use disorder, preliminary evidence suggests that CRTs are also beneficial in people with meth use disorder (163,164). Especially exciting are the results of two metaanalyses in schizophrenia patients that revealed CRT increased FIGURe 2 | Summary of the neurobiology underlying cognitive impairments in meth use disorder and schizophrenia.…”

“…Consistent with schizophrenia research, a pilot study in people with meth use disorder found improvement in working memory following four weeks of increasingly difficult N-back memory task training, which was also linked to improved impulse control (164). In people with meth use disorder, it is promising that working memory training has been shown to normalize frontostriatal structure and function (163).…”

The impact of cognitive training in substance use disorder: the effect of working memory training on impulse control in methamphetamine users

“…( Asterisk ) Brain scanning data (structural and functional magnetic resonance imaging) was also collected at baseline and follow-up in HC, MUD, TAU and CT groups, and this data is published elsewhere (Brooks et al 2016) with further data currently in preparation…”

“…In order to test the effects of WM training, particularly in people with MUD, which can be regarded as the most potent and prevalent drug of abuse in South Africa, associated with the contraction and spread of HIV (Plüddemann and Parry 2012), we have recently developed a smartphone-based WM training intervention in Cape Town, South Africa (Brooks et al 2016), to reach out to the need for a low-cost adjunct to treatment that can target populations whose access to standard treatment is strained but whose access to a smartphone is not (Anthes 2016). Moreover, we have demonstrated that daily patient engagement in our smartphone-based N-back WM task is easy for clinicians to implement as part of their standard treatment programme for SUD.…”

Molecular, Behavioral, and Physiological Consequences of Methamphetamine Neurotoxicity: Implications for Treatment

“…Studies have also noted impairments to working memory (Chang et al, 2002;Gonzalez et al, 2007;Rendell et al, 2009). This is interesting, as recent evidence has suggested that cognitive training using the N-back task may be an effective adjunct for treating the symptoms of METH toxicity (Brooks et al, 2016). Unlike spatial or object-memory tasks, working memory is a global process, involving multiple circuits [for review, D'Esposito and Postle (2015)].…”