Imaging studies have shown an association between dopamine increases in striatum and cue induced craving in cocaine abusers. However, the extent to which dopamine increases reflect a primary rather than a secondary response to the cues remains unclear. Here we evaluated the extent to which dopamine increases by themselves can induce craving in cocaine abusers. Using PET and [ 11 C]raclopride (D2 receptor radioligand sensitive to competition with endogenous dopamine) we show that in cocaine abusers (n = 20) oral methylphenidate (20 mg), which significantly increased dopamine in striatum, did not induce craving unless subjects were concomitantly exposed to cocaine-cues (video scenes of subjects self-administering cocaine). This suggests that dopamine increases associated with conditioned-cues are not primary responses but reflect downstream stimulation of dopamine cells (presumably glutamatergic afferents from prefrontal cortex and/or amygdala). Inasmuch as afferent stimulation of dopamine neurons results in phasic cell firing these findings suggest that "fast" dopamine increases, in contrast to the "slow" dopamine increases as achieved when using oral methylphenidate (mimicking tonic dopamine cell firing), are required for cues to trigger craving. The fact that methylphenidate induced craving only when given with the cocaine-cues highlights the context dependency of methylphenidate's effects and suggests that its use for the treatment of ADHD subjects with co-morbid drug abuse should not increase craving.
KeywordsPET imaging; raclopride; addiction; caudate; putamen; conditioned responses; D2 receptors In drug addicted subjects, exposure to places where they have taken the drug, to people with whom prior drug use occurred, or to paraphernalia used to administer the drug elicits intense * Correspondence: National Institute on Drug Abuse, 6001 Executive Boulevard, Room 5274, Bethesda, MD 20892, Tel. (301) Fax (301) 443-9127, nvolkow@nida.nih.gov . Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
NIH Public Access
Author ManuscriptNeuroimage. Author manuscript; available in PMC 2011 September 9. is clinically relevant since it is a major contributor in the cycle of relapse in addiction (O'Brien et al., 1998). Dopamine (DA), which is a neurotransmitter involved with reward and with the prediction of reward (Schultz et al., 1997;Wise and Rompre, 1989), appears to be involved with cue-elicited drug craving. Indeed, in laboratory animals when neutral stimuli are paired with a rewarding drug they will, with repeated associations, acquire the ability to increase DA in n...