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Prefrontal Cortical Dysfunction in Abstinent Cocaine Abusers

Received May 27, 2003, revised September 24, 2003; accepted January 9, 2004. From the Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland; Mood and Anxiety Disorders Program, NIMH; Institute of Living at Hartford Hospital; Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut; Brain Imaging Center, NIDA Intramural Research Program; Molecular Neuropsychiatry, NIDA Intramural Research Program; In *Compass Systems; Department of Psychiatry and Biobehavioral Sciences, Department of Molecular and Medical Pharmacology, and the Brain Research Institute, David Geffen School of Medicine, University of California, Los Angeles, California. Address correspondence to Dr. Bolla, Department of Neurology, Johns Hopkins University School of Medicine, 4940 Eastern Avenue, Baltimore, Maryland 21224; kbolla{at}jhmi.edu (E-mail).

The anterior cingulate cortex (ACC) and lateral prefrontal (LPFC) cortex are brain regions important to executive cognitive functions (ECF). We determined ACC and LPFC function in 23-day abstinent cocaine abusers using positron emission tomography (PET H₂¹⁵O) during performance of a modified version of the Stroop Task. Cocaine abusers showed less activation than non-drug-using comparison subjects in the left ACC and the right LPFC and greater activation in the right ACC. Average amount of cocaine used per week was negatively correlated with activity in the rostral ACC and right LPFC. Disruption of ECF in substance abusers could interfere with attempts to stop drug use and undermine treatment. Since impairment in ECF may be a common feature of various neuropsychiatric disorders, these findings have applicability beyond the neurobiology of addiction.

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