McLean Imaging Center, McLean Hospital, 115 Mill St., Belmont, MA 02478, United States; Department of Psychiatry, Harvard Medical School, 115 Mill St., Belmont, MA 02478, United States.
McLean Imaging Center, McLean Hospital, 115 Mill St., Belmont, MA 02478, United States.
Drug Alcohol Depend. 2017 Dec 1;181:1-4. doi: 10.1016/j.drugalcdep.2017.09.009. Epub 2017 Oct 5.
Individuals who use cocaine have fewer cognitive resources needed to maintain abstinence. This is evidenced by blunted brain function during cognitive control tasks and reduced communication between brain regions associated with cognitive function. For instance, relapse vulnerability is heightened in individuals with less communication between the right and left frontoparietal executive control network (ECN). Given that recent cocaine use enhances such communication, it is plausible that recency of cocaine use influences interhemispheric ECN communication. However, it is unclear whether ECN communication weakens over the course of early cocaine abstinence, which may then enhance relapse risk.
In ten men with cocaine use disorder, we conducted a preliminary assessment of the relationship between the number of days since last cocaine use (1-3days) and interhemispheric ECN coupling using resting state functional magnetic resonance imaging (fMRI).
Reduced interhemispheric ECN coupling was associated with increasing days since last cocaine use; weaker coupling was also associated with lower urine cocaine metabolite concentrations. This association was more prominent in prefrontal than parietal ECN-subregions.
Preliminary results indicate that resting state interhemispheric ECN coupling weakens within the first few days following last cocaine use. Because of the known link between reduced ECN interhemispheric coupling and relapse vulnerability, these results suggest that relapse risk may increase the longer an individual abstains during an early quit attempt. Treatments focused on reversing this coupling deficit may facilitate abstinence.
使用可卡因的个体在维持戒断方面所需的认知资源较少。这可以从认知控制任务期间大脑功能减弱以及与认知功能相关的大脑区域之间的通讯减少得到证明。例如,右左额顶叶执行控制网络(ECN)之间通讯减少的个体,复发易感性更高。鉴于最近使用可卡因会增强这种通讯,可卡因使用的新近程度可能会影响大脑半球间 ECN 通讯。然而,目前尚不清楚 ECN 通讯是否会在早期可卡因戒断过程中减弱,这可能会增加复发的风险。
在 10 名患有可卡因使用障碍的男性中,我们使用静息状态功能磁共振成像(fMRI)初步评估了自最后一次可卡因使用以来的天数(1-3 天)与大脑半球间 ECN 耦合之间的关系。
大脑半球间 ECN 耦合的减少与最后一次可卡因使用后天数的增加有关;较弱的耦合也与尿液可卡因代谢物浓度降低有关。这种关联在前额 ECN 亚区比顶叶 ECN 亚区更为明显。
初步结果表明,在最后一次使用可卡因后的最初几天内,静息状态大脑半球间 ECN 耦合会减弱。由于 ECN 大脑半球间耦合减少与复发易感性之间的已知联系,这些结果表明,在早期戒断尝试期间,个体禁欲时间越长,复发风险可能会增加。专注于逆转这种耦合缺陷的治疗方法可能有助于禁欲。