Hostname: page-component-78c5997874-xbtfd Total loading time: 0 Render date: 2024-11-10T14:41:45.216Z Has data issue: false hasContentIssue false

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

Published online by Cambridge University Press:  17 May 2006

ANTONIO VERDEJO-GARCÍA
Affiliation:
Depto. Personalidad, Evaluación y Tratamiento Psicológico, and Institute of Neurosciences Federico Olóriz, Universidad de Granada, Granada, Spain
ANTOINE BECHARA
Affiliation:
Institute of the Neurological Study of Emotion, Decision-Making, and Creativity, University of Southern California, Los Angeles, USA Department of Neurology, University of Iowa, Iowa City, Iowa
EMILY C. RECKNOR
Affiliation:
Department of Neurology, University of Iowa, Iowa City, Iowa
MIGUEL PÉREZ-GARCÍA
Affiliation:
Depto. Personalidad, Evaluación y Tratamiento Psicológico, and Institute of Neurosciences Federico Olóriz, Universidad de Granada, Granada, Spain

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.)

Type
Research Article
Copyright
© 2006 The International Neuropsychological Society

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

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.CrossRefGoogle Scholar
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.Google Scholar
Bechara, A. (2005). Decision-making, impulse control and loss of willpower to resist drugs: A neurocognitive perspective. Nature Neuroscience, 8, 14581463.Google Scholar
Bechara, A. & Martin, E.M. (2004). Impaired decision making related to working memory deficits in individuals with substance addictions. Neuropsychology, 18, 152162.Google Scholar
Bechara, A., Damasio, H., & Damasio, A.R. (2000). Emotion, decision-making and the orbitofrontal cortex. Cerebral Cortex, 10, 295307.Google Scholar
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.Google Scholar
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.Google Scholar
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.Google Scholar
Bolla, K.I., Funderburk, F.R., & Cadet, J.L. (2000). Differential effects of cocaine and cocaine+alcohol on neurocognitive performance. Neurology, 54, 22852292.Google Scholar
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.Google Scholar
Clark, L., Cools, R., & Robbins, T.W. (2004). The neuropsychology of ventral prefrontal cortex: Decision-making and reversal learning. Brain and Cognition, 55, 4153.Google Scholar
Cummings, J.L. (1993). Frontal-subcortical circuits and human behavior. Annals of Neurology, 50, 873880.Google Scholar
Davidson, R.J. (2002). Anxiety and affective style: Role of prefrontal cortex and amygdala. Biological Psychiatry, 51, 6880.Google Scholar
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.Google Scholar
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.Google Scholar
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.Google Scholar
Fein, G., Klein, L., & Finn, P. (2004). Impairment on a simulated gambling task in long-term alcoholics. Alcohol Clinical and Experimental Research, 24, 14871491.Google Scholar
Fillmore, M.T. & Rush, C.R. (2002). Impaired inhibitory control of behavior in chronic cocaine users. Drug and Alcohol Dependence, 66, 265273.Google Scholar
Fillmore, M.T. & Weafer, J. (2004). Alcohol impairment of behavior in men and women. Addiction, 99, 12371246.Google Scholar
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.Google Scholar
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.Google Scholar
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.Google Scholar
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.Google Scholar
Garavan, H. & Stout, J.C. (2005). Neurocognitive insights into substance abuse. Trends in Cognitive Sciences, 9, 195201.CrossRefGoogle Scholar
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.Google Scholar
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.Google Scholar
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.Google Scholar
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.Google Scholar
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.Google Scholar
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.Google Scholar
Graham, K., West, P., & Wells, S. (2000). Evaluating theories of alcohol-related aggression using observation of young adults in bars. Addiction, 95, 847863.Google Scholar
Grant, S., Contoreggi, C., & London, E.D. (2000). Drug abusers show impaired performance in a laboratory test of decision-making. Neuropsychologia, 38, 11801187.Google Scholar
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.Google Scholar
Kalechstein, A.D., Newton, T.F., & Leavengood, A.H. (2002). Apathy syndrome in cocaine dependence. Psychiatry Research, 109, 97100.Google Scholar
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.Google Scholar
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.Google Scholar
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.Google Scholar
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.Google Scholar
Mintzer, M.Z. & Stitzer, M.L. (2002). Cognitive impairment in methadone maintenance patients. Drug and Alcohol Dependence, 67, 4151.Google Scholar
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.Google Scholar
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.Google Scholar
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.Google Scholar
Rogers, R.D. & Robbins, T.W. (2001). Investigating the neurocognitive deficits associated with chronic drug misuse. Current Opinion in Neurobiology, 11, 250257.Google Scholar
Rolls, E.T. (2004). The functions of the orbitofrontal cortex. Brain and Cognition, 55, 1129.Google Scholar
Selby, M.J. & Azrin, R.L. (1998). Neuropsychological functioning in drug abusers. Drug and Alcohol Dependence, 50, 3945.Google Scholar
Spinella, M. (2003). Relationship between drug use and prefrontal-associated traits. Addiction Biology, 8, 6774.Google Scholar
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.Google Scholar
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.Google Scholar
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.Google Scholar
Townshend, J.M. & Duka, T. (2003). Mixed emotions: Alcoholics' impairment in the recognition of specific facial expressions. Neuropsychologia, 41, 773782.Google Scholar
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.Google Scholar
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.Google Scholar
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.Google Scholar
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.Google Scholar