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Neural activity associated with stress-induced cocaine craving: a functional magnetic resonance imaging study

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Abstract

Objective

Stress is known to increase cocaine craving and relapse risk in cocaine dependence. Identifying neural activity associated with stress and stress-induced cocaine craving is important in understanding the neurobiology of cocaine craving and relapse.

Method

Blood oxygenation level dependent (BOLD) signal changes were assessed in a functional magnetic resonance imaging (fMRI) session with healthy controls and treatment-engaged, abstinent, cocaine-dependent individuals (patients) as they participated in brief guided imagery and recall of three personal stress and three personal neutral situations.

Results

During stress, patients showed significantly less BOLD activation than controls in specific frontal and para-limbic regions, such as the anterior cingulate (AC) region, left hippocampal/parahippocampal region, right fusiform gyrus, and the right postcentral gyrus. On the other hand, patients had increased activity in the caudate and dorsal striatum region during stress, activation that was significantly associated with stress-induced cocaine craving ratings.

Conclusions

Patients failed to activate AC and related circuits during stress, regions associated with control, and regulation of emotion and distress states. Instead, they exhibited greater craving-related activation in the dorsal striatum, a region related to reward pathways and part of the obsessive–compulsive circuitry. Such functional alterations in stress processing may underlie the stress-related vulnerability to cocaine relapse often observed in cocaine-dependent individuals in early recovery.

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Acknowledgements

This research was supported by the National Institutes of Health grants R01-DA11077 (RS), P50-DA09241 (BJR), P50-DA16556 (RS), K05-DA0454 (TRK), K02-DA17232 (RS), and K02-MH01296 (BEW). This study was presented in part at the 42nd Annual Meetings of the American College of Neuropsychopharmacology, San Juan, Puerto Rico, Dec 11–17. We would like to thank Hedy Sarofin, Terry Hickey, and Chekeyma Prince for their technical assistance and Dr. John Gore and Dr. R Todd Constable for their support of this research.

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Authors and Affiliations

  1. Department of Psychiatry, Yale University School of Medicine, 34 Park Street, Room S110, New Haven, CT, 06519, USA

    Rajita Sinha, Bruce J. Rounsaville, Thomas R. Kosten & Bruce E. Wexler

  2. Department of Diagnostic Radiology, Yale University School of Medicine, New Haven, CT, 06519, USA

    Cheryl Lacadie, Pawel Skudlarski & Robert K. Fulbright

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  1. Rajita Sinha
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  2. Cheryl Lacadie
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  5. Bruce J. Rounsaville
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  6. Thomas R. Kosten
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  7. Bruce E. Wexler
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Correspondence to Rajita Sinha.

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Sinha, R., Lacadie, C., Skudlarski, P. et al. Neural activity associated with stress-induced cocaine craving: a functional magnetic resonance imaging study. Psychopharmacology 183, 171–180 (2005). https://doi.org/10.1007/s00213-005-0147-8

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  • DOI: https://doi.org/10.1007/s00213-005-0147-8

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