AANS Neurosurgeon | Volume 26, Number 3, 2017

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Cocaine Users’ Brains Unable to Extinguish Drug Associations

Cocaine-addicted individuals say they find the drug much less enjoyable after years of use, but they have great difficulty quitting. A new brain imaging study led by researchers at the Icahn School of Medicine at Mount Sinai reveals why this might be so, as well as why a common psychological therapy may not work in addicted cocaine users.  

Their study finds that chronic users have a “global impairment” in the ventromedial prefrontal cortex (VMPFC), an area of the brain that is linked to impulse and self-control, and is responsible for the kind of learning that assigns value to objects and behaviors. 

The Mount Sinai study investigated a specific type of learning called extinction – the process by which a new, affectively neutral, association replaces an old, affectively arousing association – to identify the neurobiological mechanism that underlies the persistence of drug seeking in addiction despite negative consequences and a reduction in the drug’s rewarding affects.  

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