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A team led by researchers from Massachusetts General Hospital (MGH) has used advanced imaging techniques to identify an unexpected structural difference in the brains of cocaine addicts.
The report in the Nov. 18 issue of Neuron describes how a key structure called the amygdala, which previous research has linked to the brain's reward-processing system, is smaller in cocaine addicts than in healthy volunteers. While the current study cannot determine whether this difference is a cause of addiction or results from an early event in the course of drug use, the findings suggest a need to reformulate current strategies for treating cocaine addiction.
"Work here and at other centers has identified the amygdala's fundamental role in addiction. It is important for producing drug craving, which has a powerful effect in maintaining drug abuse," says Hans Breiter, MD, co-director of the Motivation and Emotion Neuroscience Collaboration in the MGH Departments of Radiology and Psychiatry, and the senior author of the current study.
"No one anticipated such a specific pattern of volume reduction in the amygdalas of cocaine addicts – pointing to potential problems in a small number of sub-regions of this brain structure."
Earlier studies by Breiter's group and others used advanced imaging techniques to show how cocaine use affects the activity of key structures deep within the brain. Among those findings was reduced activity in the amygdala, particularly during times when addicts reported feelings of craving.
The amygdalas of cocaine addicts were found to have significantly less volume than those of the healthy controls, reductions that consistently applied to specific areas. Several characteristics of the changes observed in this study suggest that they may result from genetic differences that could underlie an increased vulnerability to cocaine addiction.
"Asymmetries that appear during the course of development often arise from the actions of specific genes" says co-first author Gregory Gasic, PhD, of the Martinos Center for Biomedical Imaging at MGH. "We cannot, however, rule out rapid changes in amygdala volumes early in the course of drug use that abolish this asymmetry."
"Until now, those of us who study addictions have been focusing on the excessive rewards addicts receive from substance abuse. But it's more complicated than that," says David Gastfriend, MD, director of Addictions Research at MGH and a co-author of the Neuron paper. "In combination with other work, this study suggests that, when the opportunity for excitement presents itself, some people cannot make good judgments– just like teenagers who take excessive risks in pursuit of thrills. It looks like this is a continuing problem for people with cocaine addiction, and now we know where in the brain that problem resides."
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