According to a new study soon to appear in NeuroImage, active cocaine abusers were, on average, able to suppress activity in brain regions linked to drug cravings when asked to inhibit their response to a "cocaine-cues" video.
The findings suggest that clinical interventions designed to strengthen these inhibitory responses could help cocaine abusers stop using drugs and avoid relapse.
Scientists used a brain-scanning technique called positron emission tomography (PET) and a radioactively "tagged" form of glucose — the brain's main fuel — to measure brain activity in 24 active cocaine abusers during three different conditions: 1) while subjects simply lay
in the scanner with eyes open; 2) while subjects watched a "cocaine-cues" video with scenes simulating the purchase, preparation, and smoking of crack cocaine; and 3) while subjects watched the video but were told to try to inhibit their craving response. Scans were performed in random order and on separate days.
In each scan, the PET camera tracked the radioactive signal from the tagged glucose as it was taken up by various regions of the brain. A stronger signal indicates higher metabolic activity in a particular brain region where more glucose is being used. This technique allows
scientists to accurately monitor which brain regions are most active and how that activity changes with time or in response to different situations.
The scientists also monitored the research subjects' heart rate and blood pressure and asked them to describe their level of craving during the scans. Compared with the baseline condition, the cocaine-cues video triggered increases in brain activity in several brain regions
associated with drug craving, as well as increases in research subjects' self-reports of craving.
When the research subjects were asked to inhibit their response to the video, and those scans were compared with the no-inhibition condition, metabolic activity decreased dramatically in brain regions involved in experiencing and anticipating rewards, and in a part of the brain that
plays a role in assigning value, or salience, to different stimuli. During inhibition, research subjects also reported lower levels of craving compared with the no-inhibition video condition.
"Our findings provide enormous hope because they imply that cognitive interventions might be developed to maximize cocaine abusers' success in blocking the drug-craving response to help them avoid relapse," said Nora Volkow, Director of the National Institute on Drug Abuse and lead author on the paper.
"Many current drug treatment programs help addicted individuals predict when and where they might be exposed to drug cues so that they can avoid such situations," Volkow said. "While this is a very useful strategy, in real-word situations, cues may come up in unexpected ways. Our findings suggest that a clinical strategy that trains cocaine abusers to exert greater cognitive control could help them selectively inhibit the craving response whenever and wherever drug cues are encountered — whether expectedly or unexpectedly."
Because inhibitory control is crucial for regulating emotions and desires, the findings from this study could have implications for other disorders involving loss of behavioral control, such as gambling and obesity.
