Working memory fMRI activation in cocaine-dependent subjects: association with treatment response

Psychiatry Res. 2010 Mar 30;181(3):174-82. doi: 10.1016/j.pscychresns.2009.11.003. Epub 2010 Feb 12.


Functional magnetic resonance imaging (fMRI) studies of early abstinence cocaine users offer information about the state of the brain when most cocaine users seek treatment. This study examined the relationship between pretreatment brain function and subsequent treatment response in 19 treatment-seeking early abstinence cocaine-dependent (CD) subjects. These subjects and 14 non-drug-using control subjects underwent fMRI while performing a working memory task with three levels of difficulty. CD subjects were then randomized to treatment studies. Results showed CD subjects had significantly lower (random effects, corrected for multiple comparisons) brain activation in caudate, putamen, cingulate gyrus, middle and superior frontal gyri, inferior frontal gyrus pars triangularis and pars opercularis, precentral gyrus, and thalamus compared with non-drug-using controls. Within CD subjects, thalamic activation significantly correlated with treatment response. This study shows CD subjects in early abstinence have alterations of brain function in frontal, striatal, and thalamic brain regions known to be part of a circuit associated with motor control, reward, and cognition. Subjects with pretreatment thalamic deactivation showed the poorest treatment response, possibly related to thalamic involvement in mesocortical and mesolimbic dopamine projections.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Amphetamine / therapeutic use
  • Analysis of Variance
  • Benzhydryl Compounds / therapeutic use
  • Brain / blood supply*
  • Brain / pathology
  • Brain Mapping*
  • Carbidopa / pharmacology
  • Central Nervous System Stimulants / therapeutic use
  • Cocaine-Related Disorders* / complications
  • Cocaine-Related Disorders* / pathology
  • Cocaine-Related Disorders* / therapy
  • Cognitive Behavioral Therapy / methods
  • Dopamine Agents / therapeutic use
  • Dose-Response Relationship, Drug
  • Drug Therapy, Combination / methods
  • Female
  • Follow-Up Studies
  • Humans
  • Image Processing, Computer-Assisted / methods
  • Magnetic Resonance Imaging / methods
  • Male
  • Mathematics
  • Memory Disorders* / etiology
  • Memory Disorders* / pathology
  • Memory Disorders* / therapy
  • Memory, Short-Term / drug effects
  • Memory, Short-Term / physiology*
  • Middle Aged
  • Modafinil
  • Naltrexone / therapeutic use
  • Narcotic Antagonists / therapeutic use
  • Neuropsychological Tests
  • Oxygen / blood


  • Benzhydryl Compounds
  • Central Nervous System Stimulants
  • Dopamine Agents
  • Narcotic Antagonists
  • Naltrexone
  • Amphetamine
  • Carbidopa
  • Modafinil
  • Oxygen