Error processing and gender-shared and -specific neural predictors of relapse in cocaine dependence
Error processing and gender-shared and -specific neural predictors of relapse in cocaine dependence
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DOI：
10.1093/brain/awt040
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发表时间：
2013-04-01
期刊：
影响因子：
14.5
通讯作者：
Li, Chiang-shan R.
中科院分区：
文献类型：
--
作者：
Luo, Xi;Zhang, Sheng;Li, Chiang-shan R.
认知控制的缺陷与可卡因依赖有关。在此之前，结合功能磁共振成像和停止信号任务，我们证明了可卡因依赖个体的认知控制改变。然而，这些横断面研究结果的临床意义，特别是这些变化是否与药物使用复发有关，尚不清楚。在一项前瞻性研究中，我们招募了97名寻求治疗的可卡因依赖者，在功能性磁共振成像期间执行停止信号任务，并参与3个月的随访评估，在此期间，使用时间轴随访评估可卡因使用情况，并通过尿液毒理学试验确定。使用统计参数映射8中实现的一般线性模型分析功能性磁共振成像数据，对比度为“停止误差大于停止成功试验”以指示误差处理。使用逻辑和考克斯回归的体素分析，我们确定了预测复发和复发时间的错误处理的大脑激活。在女性中，丘脑和背侧前扣带皮层的错误相关激活减少预测复发和复发时间提前。在男性中，背侧前扣带皮层和左前扣带皮层的错误相关激活减少预测复发和复发时间提前。这些区域性激活通过数据恢复进行了验证，并在受试者操作特征分析中预测复发的平均曲线下面积为0.849。这些发现提供了直接的证据，在一个中等规模的可卡因依赖个体队列中，认知控制缺陷与临床结果有关。这些结果可能为今后的研究提供了一个有用的基础，以检查心理社会因素如何与认知控制相互作用，以确定药物的使用和评估药物或行为治疗在弥补可卡因成瘾者的认知控制缺陷的疗效。
Deficits in cognitive control are implicated in cocaine dependence. Previously, combining functional magnetic resonance imaging and a stop signal task, we demonstrated altered cognitive control in cocaine-dependent individuals. However, the clinical implications of these cross-sectional findings and, in particular, whether the changes were associated with relapse to drug use, were not clear. In a prospective study, we recruited 97 treatment-seeking individuals with cocaine dependence to perform the stop signal task during functional magnetic resonance imaging and participate in follow-up assessments for 3 months, during which time cocaine use was evaluated with timeline follow back and ascertained by urine toxicology tests. Functional magnetic resonance imaging data were analysed using general linear models as implemented in Statistical Parametric Mapping 8, with the contrast 'stop error greater than stop success trials' to index error processing. Using voxelwise analysis with logistic and Cox regressions, we identified brain activations of error processing that predict relapse and time to relapse. In females, decreased error-related activations of the thalamus and dorsal anterior cingulate cortex predicted relapse and an earlier time to relapse. In males, decreased error-related activations of the dorsal anterior cingulate cortex and left insula predicted relapse and an earlier time to relapse. These regional activations were validated with data resampling and predicted relapse with an average area under the curve of 0.849 in receiver operating characteristic analyses. These findings provide direct evidence linking deficits in cognitive control to clinical outcome in a moderate-sized cohort of cocaine-dependent individuals. These results may provide a useful basis for future studies to examine how psychosocial factors interact with cognitive control to determine drug use and to evaluate the efficacy of pharmacological or behavioural treatment in remediating deficits of cognitive control in cocaine addicts.