 |
|
Neural Activity Related to Drug Craving in Cocaine Addiction
Clinton D. Kilts, PhD;
Julie B. Schweitzer, PhD;
Colin K. Quinn, MD;
Robin E. Gross, BA;
Tracy L. Faber, PhD;
Faheemah Muhammad;
Timothy D. Ely, BA;
John M. Hoffman, MD;
Karen P. G. Drexler, MD
Arch Gen Psychiatry. 2001;58:334-341.
Background Crack cocaine dependence and addiction is typically associated with
frequent and intense drug wanting or craving triggered by internal or environmental
cues associated with past drug use.
Methods Water O 15 positron emission tomography (PET) studies were used to localize
alterations in synaptic activity related to cue-induced drug craving in 8
crack cocaine–dependent African American men. In a novel approach, script-guided
imagery of autobiographical memories were used as individualized cues to internally
generate a cocaine craving state and 2 control (ie, anger and neutral episodic
memory recall) states during PET image acquisition.
Results The mental imagery of personalized drug use and anger-related scripts
was associated with self-ratings of robust drug craving or anger, and comparable
alterations in heart rate. Compared with the neutral imagery control condition,
imagery-induced drug craving was associated with bilateral (right hemisphere
amygdala activation greater than left) activation of the amygdala, the left
insula and anterior cingulate gyrus, and the right subcallosal gyrus and nucleus
accumbens area. Compared with the anger control condition, internally generated
drug craving was associated with bilateral activation of the insula and subcallosal
cortex, left hippocampus, and anterior cingulate cortex and brainstem. A brain-wide
pixel-by-pixel search indicated significant positive and negative correlations
between imagery-induced cocaine craving and regional cerebral blood flow (rCBF)
in distributed sites.
Conclusions The collected findings suggest the craving-related activation of a network
of limbic, paralimbic, and striatal brain regions, including structures involved
in stimulus-reward association (amygdala), incentive motivation (subcallosal
gyrus/nucleus accumbens), and anticipation (anterior cingulate cortex).
From the Departments of Psychiatry and Behavioral Sciences (Drs Kilts,
Schweitzer, and Quinn, Ms Gross, and Mr Ely) and Radiology (Drs Faber and
Hoffman), the Emory Center for Positron Emission Tomography, School of Medicine,
Emory University, Atlanta, Ga, and the Atlanta Veterans Administration Medical
Center (Drs Quinn and Drexler and Ms Muhammad).
Corresponding author and reprints: Clinton D. Kilts, PhD, Department
of Psychiatry and Behavioral Sciences, School of Medicine, Emory University,
1639 Pierce Dr, Suite 4000, PO Drawer AF, Atlanta, GA 30322 (e-mail: sdpcdk{at}emory.edu).
RELATED ARTICLE
The Scientific Exegesis of Desire: Neuroimaging Crack Craving
Frank H. Gawin
Arch Gen Psychiatry. 2001;58(4):342-344.
EXTRACT
| FULL TEXT
|
