Neural correlates of stress-induced and cue-induced drug craving: influences of sex and cocaine dependence - PubMed (original) (raw)

Neural correlates of stress-induced and cue-induced drug craving: influences of sex and cocaine dependence

Marc N Potenza et al. Am J Psychiatry. 2012 Apr.

Abstract

Objective: Although stress and drug cue exposure each increase drug craving and contribute to relapse in cocaine dependence, no previous research has directly examined the neural correlates of stress-induced and drug cue-induced craving in cocaine-dependent women and men relative to comparison subjects.

Method: Functional MRI was used to assess responses to individualized scripts for stress, drug/alcohol cue and neutral-relaxing-imagery conditions in 30 abstinent cocaine-dependent individuals (16 women, 14 men) and 36 healthy recreational-drinking comparison subjects (18 women, 18 men).

Results: Significant three-way interactions between diagnostic group, sex, and script condition were observed in multiple brain regions including the striatum, insula, and anterior and posterior cingulate. Within women, group-by-condition interactions were observed involving these regions and were attributable to relatively increased regional activations in cocaine-dependent women during the stress and, to a lesser extent, neutral-relaxing conditions. Within men, group main effects were observed involving these same regions, with cocaine-dependent men demonstrating relatively increased activation across conditions, with the main contributions from the drug and neutral-relaxing conditions. In men and women, subjective drug-induced craving measures correlated positively with corticostriatal-limbic activations.

Conclusions: In cocaine dependence, corticostriatal-limbic hyperactivity appears to be linked to stress cues in women, drug cues in men, and neutral-relaxing conditions in both. These findings suggest that sex should be taken into account in the selection of therapies in the treatment of addiction, particularly those targeting stress reduction.

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Figures

FIGURE 1

FIGURE 1. Brain Activation Maps for Cocaine-Dependent and Comparison Women and Men in Three Cue Conditionsa

aImages show between-diagnostic-group contrast maps highlighting regions where cocaine-dependent patients showed more activation than comparison subjects (in yellow to red color) and regions where cocaine-dependent patients showed less activation than comparison subjects (in blue to purple color) during the stress, drug, and neutral-relaxing cue conditions for women and men. Maps are thresholded at p<0.05, with a family-wise error correction. Color bars indicate the magnitudes of between-group differences. Regions are selectively labeled to highlight key findings. AC=anterior cingulate cortex; dlPFC=dorsolateral prefrontal cortex; dmPFC=dorsomedial prefrontal cortex; PC=posterior cingulate cortex; vlPFC=ventrolateral prefrontal cortex; vmPFC=ventromedial prefrontal cortex.

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References

    1. Carroll KM, Onken LS. Behavioral therapies for drug abuse. Am J Psychiatry. 2005;162:1452–1460. - PMC - PubMed
    1. Sinha R, Garcia M, Paliwal P, Kreek MJ, Rounsaville BJ. Stress-induced cocaine craving and hypothalamic-pituitary-adrenal responses are predictive of cocaine relapse outcomes. Arch Gen Psychiatry. 2006;63:324–331. - PubMed
    1. McKay JR, Lynch KG, Pettinati HM, Shepard DS. An examination of potential sex and race effects in a study of continuing care for alcohol- and cocaine-dependent patients. Alcohol Clin Exp Res. 2003;27:1321–1323. - PubMed
    1. Sinha R. The role of stress in addiction relapse. Curr Psychiatry Rep. 2007;9:388–395. - PubMed
    1. Fox HC, Hong KI, Siedlarz K, Sinha R. Enhanced sensitivity to stress and drug/alcohol craving in abstinent cocaine-dependent individuals compared to social drinkers. Neuropsychopharmacology. 2008;33:796–805. - PMC - PubMed

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