Harvard Medical School, McLean Hospital, 115 Mill Street, Belmont, MA, 02478, USA.
Psychopharmacology (Berl). 2019 Jul;236(7):2143-2153. doi: 10.1007/s00213-019-05211-5. Epub 2019 Mar 15.
Cocaine use disorder (CUD) is associated with cognitive deficits that have been linked to poor treatment outcomes. An improved understanding of cocaine's deleterious effects on cognition may help optimize pharmacotherapies. Emerging evidence implicates abnormalities in glutamate neurotransmission in CUD and drugs that normalize glutamatergic homeostasis (e.g., N-acetylcysteine [NAC]) may attenuate CUD-related relapse behavior.
The present studies examined the impact of chronic cocaine exposure on touchscreen-based models of learning (repeated acquisition) and cognitive flexibility (discrimination reversal) and, also, the ability of NAC to modulate cocaine self-administration and its capacity to reinstate drug-seeking behavior.
First, stable repeated acquisition and discrimination reversal performance was established. Next, high levels of cocaine-taking behavior (2.13-3.03 mg/kg/session) were maintained for 150 sessions during which repeated acquisition and discrimination reversal performance was probed periodically. Finally, the effects of NAC treatment were examined on cocaine self-administration and, subsequently, extinction and reinstatement.
Cocaine self-administration significantly impaired performance under both cognitive tasks; however, discrimination reversal was disrupted considerably more than acquisition. Performance eventually approximated baseline levels during chronic exposure. NAC treatment did not perturb ongoing self-administration behavior but was associated with significantly quicker extinction of drug-lever responding. Cocaine-primed reinstatement did not significantly differ between groups.
The disruptive effects of cocaine on learning and cognitive flexibility are profound but performance recovered during chronic exposure. Although the effects of NAC on models of drug-taking and drug-seeking behavior in monkeys are less robust than reported in rodents, they nevertheless suggest a role for glutamatergic modulators in CUD treatment programs.
可卡因使用障碍(CUD)与认知缺陷有关,而认知缺陷与治疗效果不佳有关。深入了解可卡因对认知的有害影响可能有助于优化药物治疗。新出现的证据表明,谷氨酸能神经传递的异常与 CUD 有关,而使谷氨酸能稳态正常化的药物(例如 N-乙酰半胱氨酸[NAC])可能会减轻 CUD 相关的复发行为。
本研究探讨了慢性可卡因暴露对基于触摸屏的学习(重复获得)和认知灵活性(辨别反转)模型的影响,以及 NAC 调节可卡因自我给药的能力及其重新引发觅药行为的能力。
首先,建立稳定的重复获得和辨别反转表现。接下来,在 150 个疗程中维持高水平的可卡因摄入行为(2.13-3.03mg/kg/次),在此期间定期探测重复获得和辨别反转表现。最后,检查 NAC 治疗对可卡因自我给药的影响,然后是对药物寻求行为的消退和重新引发。
可卡因自我给药显著损害了两种认知任务的表现;然而,辨别反转的破坏程度要大得多。在慢性暴露期间,表现最终接近基线水平。NAC 治疗不会扰乱正在进行的自我给药行为,但与药物杠杆反应的更快消退有关。在两组之间,可卡因引发的重新引发没有显著差异。
可卡因对学习和认知灵活性的破坏作用是深远的,但在慢性暴露期间,表现会恢复。尽管 NAC 对猴子药物摄取和觅药行为模型的影响不如在啮齿动物中报道的那么明显,但它们仍然表明谷氨酸能调节剂在 CUD 治疗方案中的作用。