Salience and default mode network dysregulation in chronic cocaine users predict treatment outcome
X. Geng, Yuzheng Hu, H. Gu, B. Salmeron, B. Adinoff, E. Stein, Yihong Yang
Brain May 1, 2017 DOI: 10.1093/brain/awx036 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Observational case-control study with independent cohort validation Peer reviewed |
|---|---|
| Sample size | 176 |
| Population | 64 non-treatment-seeking cocaine users, 67 healthy control subjects, and an independent cohort of 45 treatment-completed cocaine-dependent individuals |
| Duration | 30-day residential treatment programme; relapse status assessed at 150 days |
| Topics | Default mode network |
| Key findings | Non-treatment-seeking cocaine users had lower cortical thickness in bilateral insula and higher thickness in bilateral temporal pole than healthy controls, along with eight weaker resting-state connectivity circuits, including salience network and temporal pole-default mode network connections. In an independent treatment cohort, right temporal pole-medial prefrontal cortex connectivity plus years of education predicted relapse at 150 days with 88% accuracy. The authors propose that social-emotional circuit alterations are important in cocaine dependence and may help identify relapse risk. |
Abstract
While chronic cocaine use is associated with abnormalities in both brain structure and function within and interactions between regions, previous studies have been limited to interrogating structure and function independently, and the detected neural differences have not been applied to independent samples to assess the clinical relevance of results. We investigated consequences of structural differences on resting-state functional connectivity in cocaine addiction and tested whether resting-state functional connectivity of the identified circuits predict relapse in an independent cohort. Subjects included 64 non-treatment-seeking cocaine users (NTSCUs) and 67 healthy control subjects and an independent treatment-completed cohort (n = 45) of cocaine-dependent individuals scanned at the end of a 30-day residential treatment programme. Differences in cortical thickness and related resting-state functional connectivity between NTSCUs and healthy control subjects were identified. Survival analysis, applying cortical thickness of the identified regions, resting-state functional connectivity of the identified circuits and clinical characteristics to the treatment cohort, was used to predict relapse. Lower cortical thickness in bilateral insula and higher thickness in bilateral temporal pole were found in NTSCUs versus healthy control subjects. Whole brain resting-state functional connectivity analyses with these four different anatomical regions as seeds revealed eight weaker circuits including within the salience network (insula seeds) and between temporal pole and elements of the default mode network in NTSCUs. Applying these circuits and clinical characteristics to the independent cocaine-dependent treatment cohort, functional connectivity between right temporal pole and medial prefrontal cortex, combined with years of education, predicted relapse status at 150 days with 88% accuracy. Deficits in the salience network suggest an impaired ability to process physiologically salient events, while abnormalities in a temporal pole-medial prefrontal cortex circuit might speak to the social-emotional functional alterations in cocaine addiction. The involvement of the temporal pole-medial prefrontal cortex circuit in a model highly predictive of relapse highlights the importance of social-emotional functions in cocaine dependence, and provides a potential underlying neural target for therapeutic interventions, and for identifying those at high risk of relapse.
Comparable studies
Other observational and cohort studies on default mode network, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| A default mode of brain function Normal adult human brain | 2001 | Observational study | |
| Resting-State Functional Connectivity Reflects Structural Connectivity in the Default Mode Network Healthy subjects | 2008 | Observational cohort | |
| Meditation experience is associated with increased cortical thickness Participants with extensive Insight meditation experience and matched controls | 2005 | Observational cohort | n = 20 |
| Meditation experience is associated with differences in default mode network activity and connectivity Experienced meditators and matched meditation-naive controls | 2011 | Observational cohort | |
| The precuneus/posterior cingulate cortex plays a pivotal role in the default mode network: Evidence from a partial correlation network analysis Healthy subjects | 2008 | Observational study |
Citations in the library
Cited by 4
- The default mode network is associated with changes in internalizing and externalizing problems differently in adolescent boys and girls. Development and psychopathology February 27, 2023
- Default mode network mechanisms of repeated transcranial magnetic stimulation in heroin addiction. Brain Imaging and Behavior February 2023
- Psychedelic-Assisted Therapy for Substance Use Disorders and Potential Mechanisms of Action. Current Topics in Behavioral Neurosciences 2022
- Subcortical Anatomy of the Default Mode Network: a functional and structural connectivity study