Individual differences in anterior cingulate activation associated with attentional bias predict cocaine use after treatment

Neuropsychopharmacology. 2013 May;38(6):1085-93. doi: 10.1038/npp.2013.7. Epub 2013 Jan 7.


Drug-dependent patients often relapse into drug use after treatment. Behavioral studies show that enhanced attentional bias to drug cues is a precursor of relapse. The present functional magnetic resonance imaging (fMRI) study examined whether brain regions involved in attentional bias are predictive of cocaine use after treatment. Attentional bias-related brain activity was measured-with a cocaine Stroop task-in cocaine-dependent patients during their first week in detoxification treatment and was used to predict cocaine use at 3-month follow-up. The predictive value of attentional bias-related brain activity in a priori defined regions of interest, in addition to other measures such as self-reports of substance severity, craving, and behavioral attentional bias were examined. The results show that craving in the week before treatment and individual variability in attentional bias-related activity in the dorsal anterior cingulate cortex (dACC) were significant predictors of days of cocaine use at 3-month follow-up and accounted for 45% in explained variance. Brain activity in the dACC uniquely contributed 22% of explained variance to the prediction model. These findings suggest that hyperactive attentional bias-related brain activity in the dACC might be a biomarker of relapse vulnerability as early as in the first week of detoxification treatment. Ultimately, this may help to develop individually tailored treatment interventions to reduce relapse risk.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Attention / physiology*
  • Cocaine-Related Disorders / diagnosis
  • Cocaine-Related Disorders / metabolism*
  • Cocaine-Related Disorders / therapy*
  • Female
  • Follow-Up Studies
  • Gyrus Cinguli / metabolism*
  • Humans
  • Individuality*
  • Male
  • Middle Aged
  • Photic Stimulation / methods
  • Predictive Value of Tests
  • Psychomotor Performance / physiology
  • Reaction Time / physiology
  • Recurrence
  • Stroop Test
  • Treatment Outcome