Cognitive control of drug craving inhibits brain reward regions in cocaine abusers
Open accessAbstract
Loss of control over drug taking is considered a hallmark of addiction and is critical in relapse. Dysfunction of frontal brain regions involved with inhibitory control may underlie this behavior. We evaluated whether addicted subjects when instructed to purposefully control their craving responses to drug-conditioned stimuli can inhibit limbic brain regions implicated in drug craving. We used PET and 2-deoxy-2[18F]fluoro-d-glucose to measure brain glucose metabolism (marker of brain function) in 24 cocaine abusers who watched a cocaine-cue video and compared brain activation with and without instructions to cognitively inhibit craving. A third scan was obtained at baseline (without video). Statistical parametric mapping was used for analysis and corroborated with regions of interest. The cocaine-cue video increased craving during the no-inhibition condition (pre 3+/-3, post 6+/-3; p<0.001) but not when subjects were instructed to inhibit craving (pre 3+/-2, post 3+/-3). Comparisons with baseline showed visual activation for both cocaine-cue conditions and limbic inhibition (accumbens, orbitofrontal, insula, cingulate) when subjects purposefully inhibited craving (p<0.001). Comparison between cocaine-cue conditions showed lower metabolism with cognitive inhibition in right orbitofrontal cortex and right accumbens (p<0.005), which was associated with right inferior frontal activation (r=-0.62, p<0.005). Decreases in metabolism in brain regions that process the predictive (nucleus accumbens) and motivational value (orbitofrontal cortex) of drug-conditioned stimuli were elicited by instruction to inhibit cue-induced craving. This suggests that cocaine abusers may retain some ability to inhibit craving and that strengthening fronto-accumbal regulation may be therapeutically beneficial in addiction.
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Successful cognitive inhibition of craving in cocaine abusers is associated with inhibition in the right medial orbitofrontal cortex and activation in the right inferior frontal cortex.
“Indeed, successful cognitive inhibition of craving in cocaine abusers has been associated with inhibition in the right medial orbitofrontal cortex and activation in the right inferior frontal cortex.135”
From Neurobiology of addiction: a neurocircuitry analysis (2016) · cites this paper as [135]
Similar inhibition of metabolic activity in OFC and NAc has been observed in cocaine abusers inhibiting drug craving upon cocaine cue exposure.
“A similar inhibition of the metabolic activity in the OFC (and also in NAc) has been observed in cocaine abusers when they were asked to inhibit their drug craving upon exposure to cocaine cues (57).”
From Obesity and addiction: Neurobiological overlaps (2013) · cites this paper as [57]
A study prompting cocaine-addicted subjects to inhibit craving when exposed to drug cues showed that those successful at inhibiting craving had decreased metabolism in medial OFC and NAc.
“In addition, a study that prompted cocaine-addicted subjects to purposefully inhibit craving when exposed to drug cues showed that those subjects who were successful at inhibiting craving displayed decreased metabolism in medial OFC (which processes the motivational value of a reinforcer) and NAc (which predicts reward) (57).”
From Obesity and addiction: Neurobiological overlaps (2013) · cites this paper as [57]
Similar inhibition of OFC and NAc activity was observed in cocaine abusers inhibiting drug craving during cocaine cues.
“A similar inhibition of OFC activity (and NAc) was observed in cocaine abusers when they were asked to inhibit their drug craving during exposure to cocaine cues (55).”
From The Addictive Dimensionality of Obesity (2013) · cites this paper as [55]
Cocaine-addicted subjects who successfully inhibited craving during drug cues decreased metabolism in medial OFC and NAc, consistent with OFC, ACC, and striatum involvement in enhanced motivation to procure drug.
“Also, when cocaine-addicted subjects purposefully inhibited craving when exposed to drug cues, those who were successful decreased metabolism in medial OFC (processes motivational value of a reinforcer) and NAc (predicts reward) (55), consistent with the involvement of OFC, ACC, and striatum in the enhanced motivation to procure the drug seen in addiction.”
From The Addictive Dimensionality of Obesity (2013) · cites this paper as [55]
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- Authors
- Volkow, N. D., Fowler, J. S., Wang, G.-J., Telang, F., Logan, J., Jayne, M., Ma, Y., Pradhan, K., Wong, C., & Swanson, J. M.
- Affiliations
- National Institute on Drug Abuse (US)
- Brookhaven National Laboratory (US)
- National Institute on Alcohol Abuse and Alcoholism (US)
- University of California, Irvine (US)
- Corresponding author
- Volkow, Nora D.
- Venue
- NeuroImage
- Publisher
- Elsevier BV
- Published
- 2010-02
- Volume
- 49
- Issue
- 3
- Pages
- 2536-2543
- ISSN
- 1053-8119 (ISSN-L)
- PMC
- PMC2818484
- OpenAlex
- W2033923862
- Semantic Scholar
- efd8b17fd0edc25055fda7b7f649a930ba2f780a
- Cited by
- 283
- References
- 54
- Citations by year
- 2026: 1 · 2025: 5 · 2024: 6 · 2023: 8 · 2022: 14 · 2021: 12 · 2020: 13 · 2019: 14 · 2018: 24 · 2017: 16 · 2016: 15 · 2015: 28 · 2014: 32 · 2013: 23 · 2012: 38
- FWCI
- 9.95
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- NeuroImage (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- NIH’s Intramural Research Program (NIAAA)
- DOE (DE-AC01-76CH00016)
- Topics
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Neurotransmitter Receptor Influence on Behavior
- Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Keywords
- cocaine dependence, drug craving, cognitive inhibition, cue-induced craving, nucleus accumbens, orbitofrontal cortex, brain glucose metabolism, limbic system, reward processing, relapse, cognitive control
- MeSH terms
- Brain, Brain Mapping, Cues, Female, Humans, Image Interpretation, Computer-Assisted, Male, Middle Aged, Reward, Fluorodeoxyglucose F18, Cocaine-Related Disorders, Positron-Emission Tomography
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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