The BDNF Val66Met Polymorphism Moderates the Relationship Between Posttraumatic Stress Disorder and Trauma Script-evoked Attentional Bias to Cocaine Cues Among Patients with Cocaine Dependence

J Anxiety Disord. 2020 May;72:102223. doi: 10.1016/j.janxdis.2020.102223. Epub 2020 Apr 8.


There is extensive variability in cocaine-related attentional bias (AB) following trauma script exposure among cocaine-dependent (CD) patients with posttraumatic stress disorder (PTSD). Therefore, research is needed to identify the specific PTSD-CD patients most likely to exhibit an AB to cocaine cues. A common polymorphism in brain-derived neurotrophic factor (BDNF), Val66met, is associated with risk for stimulant addiction, and thus, was examined as a moderator of the association between PTSD and cocaine-related AB following trauma script exposure in this study. Adult CD patients with (n = 17) and without (n = 28) PTSD were exposed to a personalized trauma script, followed by a visual dot-probe task assessing cocaine-related AB. Task response times were used to examine traditionally calculated AB scores, as well as trial level bias scores (TL-BS) that more accurately model the temporal dynamics of AB. PTSD-CD patients homozygous for the BDNF Val/Val genotype exhibited greater bias for attending to cocaine-related stimuli following trauma script exposure than those carrying the Met allele. The PTSD by BDNF interaction did not predict response time variability on trials for which only neutral stimuli were presented, thus increasing confidence that the observed effect is specific to cocaine-related stimuli. PTSD-CD patients homozygous for the BDNF Val/Val genotype may be at particularly high risk for negative clinical outcomes (e.g., relapse, treatment dropout) as a function of prolonged attentional engagement with cocaine cues when exposed to trauma reminders.

Keywords: BDNF; attention bias variability; attentional bias; brain derived neurotrophic factor; cocaine; posttraumatic stress disorder; substance use disorder.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Alleles
  • Attentional Bias / drug effects*
  • Brain-Derived Neurotrophic Factor / genetics*
  • Cocaine / pharmacology*
  • Cocaine-Related Disorders / complications*
  • Cocaine-Related Disorders / genetics
  • Cues*
  • Female
  • Genotype
  • Humans
  • Male
  • Middle Aged
  • Polymorphism, Genetic*
  • Stress Disorders, Post-Traumatic / complications*
  • Stress Disorders, Post-Traumatic / genetics*
  • Young Adult


  • Brain-Derived Neurotrophic Factor
  • BDNF protein, human
  • Cocaine