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    Journal Article

    Anticipatory Reward Processing Among Cocaine-Dependent Individuals With and Without Concurrent Methadone-Maintenance Treatment: Relationship to Treatment Response

    Drug and Alcohol Dependence

    Published: September 2016

    Cocaine / Crack

    Cocaine is a drug extracted from the leaves of the coca plant. It is a potent brain stimulant and one of the most powerfully addictive drugs.
    Medication-Assisted Treatment Greatly Reduces Risk of Dying From Opioid Overdose

    People with opioid use disorder who receive treatment with medications such as buprenorphine or methadone are 80% less likely to die from an opioid overdose compared with patients treated without these medications, according to a new study.

    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; n=21) participants 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<.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.

    Access Full Article

    Drug Alcohol Depend. 2016 Sep 1. doi: 10.1016/j.drugalcdep.2016.07.006.