Contreras-Rodríguez Oren, Albein-Urios Natalia, Perales José C, Martínez-Gonzalez José M, Vilar-López Raquel, Fernández-Serrano María J, Lozano-Rojas Oscar, Verdejo-García Antonio
Red de Trastornos Adictivos, Universidad de Granada, Granada, Spain.
Institute of Neuroscience F. Oloriz, Universidad de Granada, Granada, Spain.
Addiction. 2015 Dec;110(12):1953-62. doi: 10.1111/add.13076. Epub 2015 Sep 22.
To contrast functional connectivity on ventral and dorsal striatum networks in cocaine dependence relative to pathological gambling, via a resting-state functional connectivity approach; and to determine the association between cocaine dependence-related neuroadaptations indexed by functional connectivity and impulsivity, compulsivity and drug relapse.
Cross-sectional study of 20 individuals with cocaine dependence (CD), 19 individuals with pathological gambling (PG) and 21 healthy controls (HC), and a prospective cohort study of 20 CD followed-up for 12 weeks to measure drug relapse.
CD and PG were recruited through consecutive admissions to a public clinic specialized in substance addiction treatment (Centro Provincial de Drogodependencias) and a public clinic specialized in gambling treatment (AGRAJER), respectively; HC were recruited through community advertisement in the same area in Granada (Spain).
Seed-based functional connectivity in the ventral striatum (ventral caudate and ventral putamen) and dorsal striatum (dorsal caudate and dorsal putamen), the Kirby delay-discounting questionnaire, the reversal-learning task and a dichotomous measure of cocaine relapse indicated with self-report and urine tests.
CD relative to PG exhibit enhanced connectivity between the ventral caudate seed and subgenual anterior cingulate cortex, the ventral putamen seed and dorsomedial pre-frontal cortex and the dorsal putamen seed and insula (P≤0.001, kE=108). Connectivity between the ventral caudate seed and subgenual anterior cingulate cortex is associated with steeper delay discounting (P≤0.001, kE=108) and cocaine relapse (P≤0.005, kE=34).
Cocaine dependence-related neuroadaptations in the ventral striatum of the brain network are associated with increased impulsivity and higher rate of cocaine relapse.
通过静息态功能连接方法，对比可卡因依赖与病理性赌博患者腹侧和背侧纹状体网络的功能连接；并确定由功能连接索引的可卡因依赖相关神经适应性变化与冲动性、强迫性及药物复发之间的关联。
对20名可卡因依赖（CD）个体、19名病理性赌博（PG）个体和21名健康对照（HC）进行横断面研究，并对20名CD个体进行为期12周的前瞻性队列研究以测量药物复发情况。
CD个体和PG个体分别通过专门治疗物质成瘾的公立诊所（省级药物依赖中心）和专门治疗赌博的公立诊所（AGRAJER）的连续入院招募；HC通过在西班牙格拉纳达同一地区的社区广告招募。
基于种子点的腹侧纹状体（腹侧尾状核和腹侧壳核）和背侧纹状体（背侧尾状核和背侧壳核）功能连接、柯比延迟折扣问卷、反转学习任务以及通过自我报告和尿液检测得出的可卡因复发二分法测量指标。
与PG相比，CD患者腹侧尾状核种子点与膝下前扣带回皮层、腹侧壳核种子点与背内侧前额叶皮层以及背侧壳核种子点与脑岛之间的连接增强（P≤0.001，kE = 108）。腹侧尾状核种子点与膝下前扣带回皮层之间的连接与更陡峭的延迟折扣（P≤0.001，kE = 108）及可卡因复发相关（P≤0.005，kE = 34）。
大脑网络腹侧纹状体中与可卡因依赖相关的神经适应性变化与冲动性增加及可卡因复发率升高有关。
