Background
Cognitive behavioral and related therapies for cocaine dependence may exert their
effects, in part, by enhancing cognitive control over drug use behavior. No prior
studies have systematically examined the neural correlates of cognitive control as
related to treatment outcomes for cocaine dependence.
Methods
Twenty treatment-seeking cocaine-dependent individuals performed a Stroop color-word
interference task while undergoing functional magnetic resonance imaging (fMRI) prior
to initiating treatment. The primary outcome measures were percent of urine drug screens
negative for cocaine, percent days abstinent, and treatment retention. Correlations
between regional brain activation during Stroop task performance and treatment outcome
measures were analyzed.
Results
During Stroop performance, individuals activated brain regions similar to those reported
in nonaddicted individuals, including the anterior cingulate cortex, dorsolateral
prefrontal cortex, parietal lobule, insula, and striatum. Activations at treatment
onset correlated differentially with specific outcomes: longer duration of self-reported
abstinence correlated with activation of ventromedial prefrontal cortex, left posterior
cingulate cortex, and right striatum; percent drug-free urine screens correlated with
striatal activation; and treatment retention correlated with diminished activation
of dorsolateral prefrontal cortex. A modest correlation between Stroop effect and
treatment retention was found.
Conclusions
The functions of specific brain regions underlying cognitive control relate differentially
to discrete outcomes for the treatment of cocaine dependence. These findings implicate
neurocircuitry underlying cognitive control in behavioral treatment outcome and provide
insight into the mechanisms of behavioral therapies for cocaine dependence. They also
suggest neural activation patterns during cognitive control tasks are more sensitive
predictors of treatment response than behavioral measures.
Key Words
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Article info
Publication history
Published online: July 21, 2008
Accepted:
May 30,
2008
Received in revised form:
May 28,
2008
Received:
April 23,
2008
Identification
Copyright
© 2008 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.
