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Whole-brain resting-state connectivity underlying impaired inhibitory control during early versus longer-term abstinence in cocaine addiction

Molecular Psychiatry volume 28, pages 3355–3364 (2023)Cite this article

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Abstract

Lapses in inhibitory control have been linked to relapse in human drug addiction. Evidence suggests differences in inhibitory control depending on abstinence duration, but the underlying neural mechanisms remain unknown. We hypothesized that early abstinence (2–5 days) would be characterized by the strongest impairments of inhibitory control and most wide-spread deviations in resting-state functional connectivity of brain networks, while longer-term abstinence (>30 days) would be characterized by weaker impairments as compared to healthy controls. In this laboratory-based cross-sectional study, we compared individuals with Cocaine Use Disorder (iCUD) during early (cocaine urine-positive: N = 19, iCUD+; 32% female; mean age: 46.8 years) and longer-term abstinence (cocaine urine-negative: N = 29, iCUD−; 15% female; mean age: 46.6 years) to healthy controls (N = 33; 24% female; mean age: 40.9 years). We compared the groups on inhibitory control performance (Stop-Signal Task) and, using a whole-brain graph theory analysis (638 region parcellation) of functional magnetic resonance imaging (fMRI) data, we tested for group differences in resting-state brain function (local/global efficiency). We characterized how resting-state brain function was associated with inhibitory control performance within iCUD. Inhibitory control performance was worst in the early abstinence group, and intermediate in the longer-term abstinence group, as compared to the healthy control group (P < 0.01). More recent use of cocaine (CUD+ > CUD− > healthy controls) was characterized by decreased efficiency in fronto-temporal and subcortical networks (primarily in the salience, semantic, and basal ganglia networks) and increased efficiency in visual networks. Importantly, a similar functional connectivity pattern characterized impaired inhibitory control performance within iCUD (all brain analyses P < 0.05, FWE-corrected). Together, we demonstrated that a similar pattern of systematic and widespread deviations in resting-state brain efficiency, extending beyond the networks commonly investigated in human drug addiction, is linked to both abstinence duration and inhibitory control deficits in iCUD.

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Fig. 1: Inhibitory control performance and craving by abstinence duration.
Fig. 2: Resting-state local/global efficiency.
Fig. 3: Functional topography by spring-embedded networks.

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Acknowledgements

The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Funding

This work was supported by the National Institute on Drug Abuse (K01DA043615 to MAP, R01DA051420, R01DA049733, and R21DA048196 to SJM; and 1R01DA041528, R01DA023579, and R21DA034954 to RZG), National Institute of Mental Health (R01MH090134 to NA-K), Netherlands Organisation for Scientific Research Rubicon Grant No.446-14-015 (to AZ), Icahn School of Medicine at Mount Sinai (seed funds to NA-K and RZG) and the Medical Discovery Team on Addiction at the University of Minnesota (seed funds to AZ).

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Authors and Affiliations

  1. Department of Psychiatry & Behavioral Sciences, University of Minnesota, Minneapolis, MN, USA

    Anna Zilverstand

  2. Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA

    Muhammad A. Parvaz, Nelly Alia-Klein & Rita Z. Goldstein

  3. Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA

    Muhammad A. Parvaz, Nelly Alia-Klein & Rita Z. Goldstein

  4. Department of Artificial Intelligence and Human Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA

    Muhammad A. Parvaz

  5. Department of Psychiatry, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA

    Scott J. Moeller

  6. Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA

    Selim Kalayci & Zeynep H. Gümüş

  7. Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA

    Prantik Kundu

  8. Ceretype Neuromedicine, Cambridge, MA, USA

    Prantik Kundu

  9. Tom and Anne Smith MD-PhD Program, School of Medicine, University of Missouri, Columbia, MO, USA

    Pias Malaker

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  1. Anna Zilverstand
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Contributions

AZ: Conceptualization, Methodology, Data Curation, Formal analysis, Writing – Original Draft, Visualization, Funding acquisition. MAP, SJM, PM: Investigation, Writing – Review & Editing. SK: Methodology, Software, Formal Analysis, Writing – Review & Editing. PK: Methodology, Writing – Review & Editing. NA-K: Investigation, Resources, Writing – Review & Editing, Funding acquisition. ZHG: Methodology, Software, Writing – Review & Editing. RZG: Conceptualization, Resources, Writing – Review & Editing, Supervision, Project administration, Funding acquisition.

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Correspondence to Rita Z. Goldstein.

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Zilverstand, A., Parvaz, M.A., Moeller, S.J. et al. Whole-brain resting-state connectivity underlying impaired inhibitory control during early versus longer-term abstinence in cocaine addiction. Mol Psychiatry 28, 3355–3364 (2023). https://doi.org/10.1038/s41380-023-02199-5

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