Abstinence reverses EEG-indexed attention bias between drug-related and pleasant stimuli in cocaine-addicted individuals

Abstinence reverses EEG-indexed attention bias between drug-related and pleasant stimuli in cocaine-addicted individuals

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J Psychiatry Neurosci 2017;42(2):78-86

Muhammad A. Parvaz, PhD; Scott J. Moeller, PhD; Pias Malaker; Rajita Sinha, PhD; Nelly Alia-Klein, PhD; Rita Z. Goldstein, PhD


Background: Increased attention bias toward drug-related cues over non–drug-related intrinsically pleasant reinforcers is a hallmark of drug addiction. In this study we used the late positive potential (LPP) to investigate whether such increased attention bias toward drug-related relative to non–drug-related cues changes over a protracted period of reduced drug use in treatment-seeking individuals with a cocaine use disorder (CUD).

Methods: Treatment-seeking individuals with CUD and matched healthy controls passively viewed a series of pleasant, neutral and drug-related pictures while their event-related potentials were recorded at baseline (≤ 3 weeks after treatment initiation) and at 6-month follow-up (only CUD).

Results: We included 19 treatment-seeking individuals with CUD and 18 matched controls in our analyses. The results showed a reversal in attention bias (i.e., LPP amplitude) from baseline (i.e., drug > pleasant) to follow-up (i.e., pleasant > drug) driven by an increased attentional engagement with pleasant pictures; this LPP reversal was paralleled by a concomitant reduction in self-reported wanting and craving for cocaine in the CUD group. Furthermore, reduced attention bias toward drug-related cues (relative to pleasant cues) was correlated with longer duration of abstinence at baseline, and the extent of its longitudinal reversal was correlated with decreased craving at follow-up, providing support for abstinence as a putative mechanism of this bottom–up attentional change.

Limitations: A limited sample size and the use of the same set of pictures at baseline and follow-up were the major limitations of this study.

Conclusion: Results collectively indicate that, by tracking with drug abstinence, LPP in response to drug-related relative to pleasant cues may serve as an indicator of clinical progress in treatment-seeking individuals with CUD.

Submitted: Nov. 18, 2015; Revised: Mar. 15, 2016; Revised: Apr. 18, 2016; Accepted: Apr. 19, 2016; Early-released July 19, 2016

Acknowledgements:The authors gratefully thank Anna B. Konova, Tom Maloney, Patricia Woicik and Federico d’Oleire Uquillas for their help with data acquisition and analysis.

Affiliations: From the Icahn School of Medicine, Mount Sinai, New York, NY, USA (Parvaz, Moeller, Malaker, Alia-Klein, Goldstein); and Yale University School of Medicine, New Haven, Conn., USA (Sinha).

Funding: This study was supported by grants from the National Institute on Drug Abuse (F32DA033088 to M.A.P., 1K01DA037452 to S.J.M., R01DA023579 to R.Z.G., P50DA016556 to R.S.) and from the National Institute on Mental Health (R01MH090134 to N.A.K.).

Competing interests: None declared.

Contributors: M. Parvaz, S. Moeller, R. Sinha, N. Alia-Klein and R. Goldstein designed the study. M. Parvaz acquired and analyzed the data, which S. Moeller, P. Malaker and R. Goldstein also analyzed. M. Parvaz, S. Moeller and P. Malaker wrote the article, which all authors reviewed and approved for publication.

DOI: 10.1503/jpn.150358

Correspondence to: M.A. Parvaz, 1 Gustave L. Levy Place, Box 1230, New York, NY; Muhammad.Parvaz@mssm.edu