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Executive dysfunction in substance dependent individuals during drug use and abstinence: An examination of the behavioral, cognitive and emotional correlates of addiction

  • ANTONIO VERDEJO-GARCÍA (a1), ANTOINE BECHARA (a2) (a3), EMILY C. RECKNOR (a3) and MIGUEL PÉREZ-GARCÍA (a1)
Abstract

Increasing evidence indicates that substance-dependent individuals (SDI) are impaired in executive control tasks relying on different systems within the prefrontal cortex (PFC). Three different functional systems have been described: the dorsolateral prefrontal cortex (DLPC), orbitofrontal cortex (OFC), and anterior cingulate cortex (ACC) circuits. Dysfunction within each PFC system is associated with different behavioral, cognitive, and emotional abnormalities. Few studies have conducted an exhaustive examination of all these different factors in SDI. In this study, SDI (including alcohol, cocaine, and methamphetamine polysubstance users, n = 35) were compared with healthy controls (n = 36) on a series of behavioral (Frontal Systems Behaviour Scale, FrSBe), cognitive (N-back, Go-No Go, and Wisconsin Card Sorting Tasks), and emotional (International Affective Picture System, IAPS) tasks, each of which was thought to tax a different component of these PFC functional systems. SDI showed greater behavioral problems in the apathy, disinhibition, and executive dysfunction subscales of the FrSBe. Behavioral deficits were significantly associated with several real-life domains in which SDI typically have problems. SDI also showed poorer performance on cognitive tests of working memory, response inhibition and mental flexibility, and abnormal processing of affective images from the IAPS. Cognitive, behavioral, and emotional measures were moderately correlated.This study was conducted in the Department of Neurology, University of Iowa, Iowa City, USA (JINS, 2006, 12, 405–415.)

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Corresponding author
Correspondence and reprint requests to: Antonio Verdejo-García, Departamento de Personalidad, Evaluación y Tratamiento Psicológico. Universidad de Granada. Campus de Cartuja S/N, 18071, Granada, Spain. E-mail: averdejo@ugr.es
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REFERENCES

Adams, K.M., Brown, G.G., & Grant, I. (1985). Analysis of covariance as a remedy for mismatch of research subject groups: Some sobering simulations. Journal of Clinical and Experimental Neuropsychology, 7, 445462.
Aguilar de Arcos, F., Verdejo-García, A., Peralta, M.I., Sánchez-Barrera, M., & Pérez-García, M. (2005). Experience of emotions in substance abusers exposed to images containing neutral, positive, and negative affective images. Drug and Alcohol Dependence, 78, 159167.
Bechara, A. (2005). Decision-making, impulse control and loss of willpower to resist drugs: A neurocognitive perspective. Nature Neuroscience, 8, 14581463.
Bechara, A. & Martin, E.M. (2004). Impaired decision making related to working memory deficits in individuals with substance addictions. Neuropsychology, 18, 152162.
Bechara, A., Damasio, H., & Damasio, A.R. (2000). Emotion, decision-making and the orbitofrontal cortex. Cerebral Cortex, 10, 295307.
Bechara, A., Dolan, S., Denburg, N., Hindes, A., Anderson, S.W., & Nathan, P.E. (2001). Decision-making deficits, linked to a dysfunctional ventromedial prefrontal cortex, revealed in alcohol and stimulant abusers. Neuropsychologia, 39, 376389.
Bolla, K.I., Eldreth, D.A., London, E.D., Kiehl, K.A., Mouraditis, M., Contoreggi, C., Matochik, J.A., Kurian, V., Cadet, J-L., Kimes, A.S., Fundeburk, F.R., & Ernst, M. (2003). Orbitofrontal cortex dysfunction in abstinent cocaine abusers performing a decision-making task. Neuroimage, 19, 10851094.
Bolla, K.I., Ernst, M., Kiehl, K.A., Mouratidis, M., Eldreth, D.A., Contoreggi, C., Matochik, J.A., Kurian, V., Cadet, J-L., Kimes, A., Fundeburk, F., & London, E. (2004). Prefrontal cortical dysfunction in abstinent cocaine abusers. The Journal of Neuropsychiatry and Clinical Neurosciences, 16, 456464.
Bolla, K.I., Funderburk, F.R., & Cadet, J.L. (2000). Differential effects of cocaine and cocaine+alcohol on neurocognitive performance. Neurology, 54, 22852292.
Castellon, S.A., Hinkin, C.H., & Myers, H.C. (2000). Neuropsychiatric disturbance is associated with executive dysfunction in HIV-1 infection. Journal of the International Neuropsychological Society, 6, 336347.
Clark, L., Cools, R., & Robbins, T.W. (2004). The neuropsychology of ventral prefrontal cortex: Decision-making and reversal learning. Brain and Cognition, 55, 4153.
Cummings, J.L. (1993). Frontal-subcortical circuits and human behavior. Annals of Neurology, 50, 873880.
Davidson, R.J. (2002). Anxiety and affective style: Role of prefrontal cortex and amygdala. Biological Psychiatry, 51, 6880.
Di Sclafani, V., Tolou-Shams, M., Price, L.J., & Fein, G. (2002). Neuropsychological performance of individuals dependent on crack-cocaine, or crack-cocaine and alcohol, at 6 weeks and 6 months of abstinence. Drug and Alcohol Dependence, 66, 161171.
Errico, A.L., King, A.C., Lovallo, W.R., & Parsons, O.A. (2002). Cortisol dysregulation and cognitive impairment in abstinent male alcoholics. Alcoholism: Clinical and Experimental Research, 26, 11981204.
Ersche, K.D., Fletcher, P.C., Lewis, S.J.G., Clark, L., Stocks-Gee, G., & London, M. (2005). Abnormal frontal activations related to decision-making in current and former amphetamine- and opiate-dependent individuals. Psychopharmacology, 180, 612623.
Fein, G., Klein, L., & Finn, P. (2004). Impairment on a simulated gambling task in long-term alcoholics. Alcohol Clinical and Experimental Research, 24, 14871491.
Fillmore, M.T. & Rush, C.R. (2002). Impaired inhibitory control of behavior in chronic cocaine users. Drug and Alcohol Dependence, 66, 265273.
Fillmore, M.T. & Weafer, J. (2004). Alcohol impairment of behavior in men and women. Addiction, 99, 12371246.
Fillmore, M.T., Rush, C.R., & Hays, L. (2002). Acute effects of oral cocaine on inhibitory control of behavior in humans. Drug and Alcohol Dependence, 67, 157167.
Finn, P.R., Justus, A., Mazas, C., & Steimetz, J.E. (1999). Working memory, executive processes and the effects of alcohol on Go/No-Go learning: Testing a model of behavioral regulation and impulsivity. Psychopharmacology, 146, 465472.
Fishbein, D.H., Eldreth, D., Hyde, C., Matchik, J.A., London, E.D., Contoreggi, C., Kurian, V., Kimes, A.S., Breeden, A., & Grant, S. (2005). Risky decision making and the anterior cingulate in abstinent drug abusers and nonusers. Cognitive Brain Research, 23, 119136.
Franklin, T.R., Acton, P.D., Maldjian, J.A., Gray, J.D., Croft, J.R., Dackis, C.A., O'Brien, C.P., & Childress, A.R. (2002). Decreased gray matter concentration in the insular, orbitofrontal, cingulate, and temporal cortices of cocaine patients. Biological Psychiatry, 51, 134142.
Garavan, H. & Stout, J.C. (2005). Neurocognitive insights into substance abuse. Trends in Cognitive Sciences, 9, 195201.
Garavan, H., Pankiewicz, J., Bloom, A., Cho, J-K., Sperry, L., & Ross, T.J. (2000). Cue-induced cocaine craving: Neuroanatomical specificity for drug users and drug stimuli. American Journal of Psychiatry, 157, 17891798.
Garavan, H., Ross, T.J., Murphy, K., Roche, R.A.P., & Stein, E.A. (2002). Dissociable executive functions in the dynamic control of behavior: Inhibition, error detection, and correction. Neuroimage, 27, 18201829.
Gerra, G., Baldaro, B., Zaimovic, A., Moi, G., Bussandri, M., Raggi, M.A., & Bambrilla, F. (2003). Neuroendocrine responses to experimentally-induced emotions among abstinent opioid-dependent subjects. Drug and Alcohol Dependence, 71, 2535.
Gerra, G., Zaimovic, A., Ferri, M., Zambelli, U., Timpano, M., Neri, E., Marzocchi, G.F., Delsignore, R., & Bambrilla, F. (2000). Long-lasting effects of 3,4-methylenedioxy methamphetamine (ecstasy) on serotonin system function in humans. Biological Psychiatry, 47, 127136.
Gonzalez, R., Rippeth, J.D., Carey, C.L., Heaton, R.K., Moore, D.J., Schweinsburg, B.C., Cherner, M., & Grant, I. (2004). Neurocognitive performance of methamphetamine users discordant for history of marijuana exposure. Drug and Alcohol Dependence, 76, 181190.
Grace, J. & Malloy, P.F. (2001). Frontal Systems Behavioral Scale (FrSBe): Professional manual. Lutz, FL: Psychological Assessment Resources.
Graham, K. (2004). Disinhibition, impulse control, arousal and gender: Understanding the mechanisms of alcohol's effects on aggression. Addiction, 99, 12471254.
Graham, K., West, P., & Wells, S. (2000). Evaluating theories of alcohol-related aggression using observation of young adults in bars. Addiction, 95, 847863.
Grant, S., Contoreggi, C., & London, E.D. (2000). Drug abusers show impaired performance in a laboratory test of decision-making. Neuropsychologia, 38, 11801187.
Hoshi, R., Bisla, J., & Curran, H.V. (2004). The acute and sub-acute effects of ‘ecstasy’ (MDMA) on processing of facial expressions: Preliminary findings. Drug and Alcohol Dependence, 76, 297304.
Kalechstein, A.D., Newton, T.F., & Leavengood, A.H. (2002). Apathy syndrome in cocaine dependence. Psychiatry Research, 109, 97100.
Klüber, A., Murphy, K., & Garavan, H. (2005). Cocaine dependence and attention switching within and between verbal and visuospatial working memory. European Journal of Neuroscience, 21, 19841992.
Lang, P.J., Bradley, M.M., & Cuthbert, B.N. (2001). International Affective Picture System (IAPS). Technical manual and affective ratings. University of Florida, Gainesville, FL: The Center for Research in Psychophysiology.
Lim, K.O., Choi, S.J., Pomara, N., Wolkin, A., & Rotrosen, J.P. (2002). Reduced frontal white matter integrity in cocaine dependence: A controlled diffusion tensor imaging study. Biological Psychiatry, 51, 890895.
Martin, E.M., Pitrak, D.L., Rains, N.A., Grbesic, S., Pursell, K., Nunnally, G., & Bechara, A. (2003). Delayed nonmatch to sample performance in HIV-seropositive and HIV-seronegative polydrug abusers. Neuropsychology, 17, 283288.
Matochik, J.A., London, E.D., Eldreth, D.A., Cadet, J-L., & Bolla, K.I. (2003). Frontal cortical tissue composition in abstinent cocaine abusers: A magnetic resonance imaging study. Neuroimage, 19, 10951102.
Mintzer, M.Z. & Stitzer, M.L. (2002). Cognitive impairment in methadone maintenance patients. Drug and Alcohol Dependence, 67, 4151.
Monterosso, J.R., Aron, A.R., Cordova, X., Xu, J., & London, E.D. (2005). Deficits in response inhibition associated with chronic methamphetamine abuse. Drug and Alcohol Dependence, 79, 273277.
Ornstein, T.J., Iddon, J.L., Baldacchino, A.M., Sahakian, B.J., London, M., Everitt, B.J., & Robbins, T.W. (2000). Profiles of cognitive dysfunction in chronic amphetamine and heroin abusers. Neuropsychopharmacology, 23, 113126.
Roberts, A.C., Robbins, T.W., & Weiskrantz, L. (1998). The prefrontal cortex: Executive and cognitive functions. New York: Oxford University Press.
Robinson, T.E. & Kolb, B. (2004). Structural plasticity associated with exposure to drugs of abuse. Neuropsychopharmacology, 47, 3346.
Rogers, R.D. & Robbins, T.W. (2001). Investigating the neurocognitive deficits associated with chronic drug misuse. Current Opinion in Neurobiology, 11, 250257.
Rolls, E.T. (2004). The functions of the orbitofrontal cortex. Brain and Cognition, 55, 1129.
Selby, M.J. & Azrin, R.L. (1998). Neuropsychological functioning in drug abusers. Drug and Alcohol Dependence, 50, 3945.
Spinella, M. (2003). Relationship between drug use and prefrontal-associated traits. Addiction Biology, 8, 6774.
Stout, J.C., Busemeyer, J.R., Lin, A., Grant, S.J., & Bonson, K.R. (2004). Cognitive modeling analysis of decision-making processes in cocaine abusers. Psychonomic Bulletin & Review, 4, 742747.
Stout, J.C., Ready, R.E., Grace, J., Malloy, P.F., & Paulsen, J.S. (2003). Factor analysis of the Frontal Systems Behavior Scale (FrSBe). Assessment, 10, 7985.
Stuss, D.T. & Knight, R.T. (2002). Principles of frontal lobe function. New York: Oxford University Press.
Tekin, S. & Cummings, J.L. (2002). Frontal-subcortical neuronal circuits and clinical neuropsychiatry: An update. Journal of Psychosomatic Research, 53, 647654.
Townshend, J.M. & Duka, T. (2003). Mixed emotions: Alcoholics' impairment in the recognition of specific facial expressions. Neuropsychologia, 41, 773782.
Velligan, D.I., Ritch, J.L., Sui, D., DiCocco, M., & Huntzinger, C.D. (2002). Frontal Systems Behavior Scale in schizophrenia: Relationship with psychiatric symptomatology, cognition and adaptive function. Psychiatry Research, 113, 227236.
Verdejo-García, A., López-Torrecillas, F., Orozco, C., & Pérez-García, M. (2004). Clinical implications and methodological challenges in the study of the neuropsychological correlates of cannabis, stimulant and opioid abuse. Neuropsychology Review, 14, 141.
Wang, G-J., Volkow, N.D., Chang, L., Miller, E., Sedler, M., Hitzemann, R., Zhu, W., Logan, J., Ma, Y., & Fowler, J.S. (2004). Partial recovery of brain metabolism in methamphetamine abusers after protracted abstinence. American Journal of Psychiatry, 161, 242248.
Whitlow, C.T., Liguori, A., Livengood, L.B., Hart, S.L., Mussat-Whitlow, B.J., & Lamborn, C.M. (2004). Long-term heavy marijuana users make costly decisions on a gambling task. Drug and Alcohol Dependence, 76, 107111.
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Journal of the International Neuropsychological Society
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