Format

Send to

Choose Destination
See comment in PubMed Commons below
JAMA Psychiatry. 2014 Jan;71(1):61-70. doi: 10.1001/jamapsychiatry.2013.2833.

Functional, structural, and emotional correlates of impaired insight in cocaine addiction.

Author information

1
Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York.
2
Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York2Department of Psychology, Stony Brook University, Stony Brook, New York.
3
National Institute on Alcohol Abuse and Alcoholism, Bethesda, Maryland.
4
Department of Psychiatry, University of Arizona, Tucson.

Abstract

IMPORTANCE:

Individuals with cocaine use disorder (CUD) have difficulty monitoring ongoing behavior, possibly stemming from dysfunction of brain regions mediating insight and self-awareness.

OBJECTIVE:

To investigate the neural correlates of impaired insight in addiction using a combined functional magnetic resonance imaging and voxel-based morphometry approach.

DESIGN, SETTING, AND PARTICIPANTS:

This multimodal imaging study was performed at the Clinical Research Center at Brookhaven National Laboratory. The study included 33 CUD cases and 20 healthy controls.

MAIN OUTCOMES AND MEASURES:

Functional magnetic resonance imaging, voxel-based morphometry, Levels of Emotional Awareness Scale, and drug use variables.

RESULTS:

Compared with the other 2 study groups, the impaired insight CUD group had lower error-induced rostral anterior cingulate cortex (rACC) activity as associated with more frequent cocaine use, less gray matter within the rACC, and lower Levels of Emotional Awareness Scale scores.

CONCLUSIONS AND RELEVANCE:

These results point to rACC functional and structural abnormalities and diminished emotional awareness in a subpopulation of CUD cases characterized by impaired insight. Because the rACC has been implicated in appraising the affective and motivational significance of errors and other types of self-referential processing, functional and structural abnormalities in this region could result in lessened concern (frequently ascribed to minimization and denial) about behavioral outcomes that could potentially culminate in increased drug use. Treatments that target this CUD subgroup could focus on enhancing the salience of errors (eg, lapses).

PMID:
24258223
PMCID:
PMC4193926
DOI:
10.1001/jamapsychiatry.2013.2833
[Indexed for MEDLINE]
Free PMC Article
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Silverchair Information Systems Icon for PubMed Central
    Loading ...
    Support Center