Title
Cognitive control of drug craving inhibits brain reward regions in cocaine abusers.
Abstract
Loss of control over drug taking is considered a hallmark of addiction and is critical in relapse. Dysfunction of frontal brain regions involved with inhibitory control may underlie this behavior. We evaluated whether addicted subjects when instructed to purposefully control their craving responses to drug-conditioned stimuli can inhibit limbic brain regions implicated in drug craving. We used PET and 2-deoxy-2[18F]fluoro-d-glucose to measure brain glucose metabolism (marker of brain function) in 24 cocaine abusers who watched a cocaine-cue video and compared brain activation with and without instructions to cognitively inhibit craving. A third scan was obtained at baseline (without video). Statistical parametric mapping was used for analysis and corroborated with regions of interest. The cocaine-cue video increased craving during the no-inhibition condition (pre 3±3, post 6±3; p<0.001) but not when subjects were instructed to inhibit craving (pre 3±2, post 3±3). Comparisons with baseline showed visual activation for both cocaine-cue conditions and limbic inhibition (accumbens, orbitofrontal, insula, cingulate) when subjects purposefully inhibited craving (p<0.001). Comparison between cocaine-cue conditions showed lower metabolism with cognitive inhibition in right orbitofrontal cortex and right accumbens (p<0.005), which was associated with right inferior frontal activation (r=−0.62, p<0.005). Decreases in metabolism in brain regions that process the predictive (nucleus accumbens) and motivational value (orbitofrontal cortex) of drug-conditioned stimuli were elicited by instruction to inhibit cue-induced craving. This suggests that cocaine abusers may retain some ability to inhibit craving and that strengthening fronto-accumbal regulation may be therapeutically beneficial in addiction.
Year
DOI
Venue
2010
10.1016/j.neuroimage.2009.10.088
NeuroImage
Keywords
Field
DocType
Brain imaging,Nucleus accumbens,Orbitofrontal cortex,Insula,Cingulate gyrus,Conditioned responses,Cognitive inhibition
Brain mapping,Cognitive inhibition,Craving,Developmental psychology,Neuroscience,Brain stimulation reward,Nucleus accumbens,Addiction,Psychology,Amygdala,Orbitofrontal cortex
Journal
Volume
Issue
ISSN
49
3
1053-8119
Citations 
PageRank 
References 
8
1.11
1
Authors
10
Name
Order
Citations
PageRank
Nora D Volkow16711.55
Joanna S. Fowler2387.50
Gene-Jack Wang34410.04
Frank Telang4224.24
Jean Logan5245.52
Millard Jayne6112.60
yeming ma7202.94
Kith Pradhan8112.06
Christopher Wong9276.26
James M. Swanson10122.46