Anticipatory reward processing among cocaine-dependent individuals with and without concurrent methadone-maintenance treatment: Relationship to treatment response. (1st September 2016)

• Record Type: Journal Article
• Authors: Yip, Sarah W.; DeVito, Elise E.; Kober, Hedy; Worhunsky, Patrick D.; Carroll, Kathleen M.; Potenza, Marc N.
• Is Part Of: Drug and alcohol dependence. Volume 166(2016)
• Page Start: 134
• Page End: 142
• Publication Date: 2016-09-01
• Subjects: Medication -- Cocaine -- Heroin -- Opioids -- Methadone -- Polysubstance use; Drug abuse -- Periodicals; Alcoholism -- Periodicals; 616.86
• DOI: 10.1016/j.drugalcdep.2016.07.006
• Languages: English
• ISSNs: 0376-8716

Abstract

Highlights: fMRI study comparing cocaine dependent individuals with and without methadone treatment. Methadone-maintained (MM) individuals had reduced activity within fronto-parietal regions during reward and loss processing. Caudate activity among MM individuals was associated with later cocaine abstinence. Abstract: Background: Cocaine dependence among opioid-dependent methadone-maintained individuals is a significant public health problem and is particularly challenging to treat. The neurobiology of this clinically complex population has not been previously assessed using fMRI. Methods: fMRI data from cocaine-dependent, methadone-maintained (CD-MM) patients (n = 24), cocaine-dependent (CD) patients (n = 20) and healthy comparison (HC) participants (n = 21) were acquired during monetary incentive delay task performance. All patients were scanned prior to treatment for cocaine dependence. Between-group differences in anticipatory reward and loss processing were assessed using whole-brain ANOVAs in SPM12 (pFWE < 0.05). Correlations between durations of abstinence during treatment and BOLD responses within the insula and caudate were also explored. Results: Main effects of diagnostic group, primarily involving decreased BOLD responses among CD-MM patients in comparison to HCs, were observed during anticipatory reward and loss processing within regions of posterior cingulate cortex, precuneus, inferior frontal gyrus and dorsolateral prefrontal cortex. BOLD responses within the right caudate were negatively associated with percentage of cocaine-negative urines during treatment among CD-MM patients, but not among non-methadone-maintained CD patients. Conclusions: These data suggest neurofunctional differences that may be related to treatment outcomes for behavioral therapies between cocaine-dependent individuals with and without methadone-maintenance treatment. These findings may relate to differences in treatment efficacies and to the elevated relapse rates observed in methadone-maintained populations.