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Neural Activity Related to Drug Craving in Cocaine Addiction
Abstract
BACKGROUND: Crack cocaine dependence and addiction is typically associated with frequent and intense drug wanting or craving triggered by internal or environmental cues associated with past drug use. METHODS: Water O 15 positron emission tomography (PET) studies were used to localize alterations in synaptic activity related to cue-induced drug craving in 8 crack cocaine-dependent African American men. In a novel approach, script-guided imagery of autobiographical memories were used as individualized cues to internally generate a cocaine craving state and 2 control (ie, anger and neutral episodic memory recall) states during PET image acquisition. RESULTS: The mental imagery of personalized drug use and anger-related scripts was associated with self-ratings of robust drug craving or anger, and comparable alterations in heart rate. Compared with the neutral imagery control condition, imagery-induced drug craving was associated with bilateral (right hemisphere amygdala activation greater than left) activation of the amygdala, the left insula and anterior cingulate gyrus, and the right subcallosal gyrus and nucleus accumbens area. Compared with the anger control condition, internally generated drug craving was associated with bilateral activation of the insula and subcallosal cortex, left hippocampus, and anterior cingulate cortex and brainstem. A brain-wide pixel-by-pixel search indicated significant positive and negative correlations between imagery-induced cocaine craving and regional cerebral blood flow (rCBF) in distributed sites. CONCLUSIONS: The collected findings suggest the craving-related activation of a network of limbic, paralimbic, and striatal brain regions, including structures involved in stimulus-reward association (amygdala), incentive motivation (subcallosal gyrus/nucleus accumbens), and anticipation (anterior cingulate cortex).
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“Some of the same brain regions that are excited by the sight of drugs are also excited by thoughts of them, associated with craving (Kilts et al., 2001)”
From A motivation model of sex addiction – Relevance to the controversy over the concept (2022) · cites this paper as Kilts et al., 2001
In the citing paper
“This is supported by human neuroimaging data showing amygdala hyperactivation in response to stimuli that induce craving (Breiter et al., 1997; Childress et al., 1999; Kilts et al., 2001).”
From Impulsivity, frontal lobes and risk for addiction (2009) · cites this paper as Kilts et al., 2001
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Metadata
- Authors
- Kilts, C. D., Schweitzer, J. B., Quinn, C. K., Gross, R. E., Faber, T. L., Muhammad, F., Ely, T. D., Hoffman, J. M., & Drexler, K. P. G.
- Affiliations
- Emory University (US)
- United States Department of Veterans Affairs (US)
- Corresponding author
- Kilts, Clinton D.
- Venue
- Archives of General Psychiatry
- Publisher
- American Medical Association (AMA)
- Published
- 2001-04-01
- Volume
- 58
- Issue
- 4
- Pages
- 334
- ISSN
- 0003-990X (ISSN-L)
- OpenAlex
- W2163989393
- Cited by
- 556
- References
- 39
- Citations by year
- 2026: 5 · 2025: 6 · 2024: 8 · 2023: 15 · 2022: 10 · 2021: 12 · 2020: 10 · 2019: 17 · 2018: 23 · 2017: 15 · 2016: 27 · 2015: 16 · 2014: 22 · 2013: 34 · 2012: 29
- FWCI
- 11.65
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Archives of General Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (5r21da011771-02)
- National Institute on Drug Abuse (DA-11771)
- Topics
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Neurotransmitter Receptor Influence on Behavior
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
- Keywords
- cocaine craving, cocaine dependence, cue-induced craving, autobiographical memory, amygdala, nucleus accumbens, anterior cingulate cortex, insula, regional cerebral blood flow, limbic system, incentive motivation, African American men
- MeSH terms
- Adult, Anger, Brain, Cues, Heart Rate, Humans, Imagination, Male, Memory, Oxygen Radioisotopes, Reading, Tomography, Emission-Computed, Water, Crack Cocaine, Behavior, Addictive, Cocaine-Related Disorders
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