Study sheds light on challenge of overcoming cocaine addiction

Researchers at the Icahn School of Medicine at Mount Sinai have identified an impairment in a brain region that might explain why it is difficult for persons with cocaine addiction to cease using the drug.

Using functional magnetic resonance imaging data, the research team found among cocaine-addicted individuals an impairment in the ventromedial prefrontal cortex, which governs impulse and self-control, possibly explaining why these individuals cannot form new associations for certain stimuli.

“Our study data suggests that it will be hard for longtime cocaine users to unlearn what once was a positive experience if this 'unlearning' or new learning relies on this brain region to be effective,” said Anna Konova, PhD, formerly with the Icahn School and now a postdoctoral fellow at New York University's Center for Neural Science.

The study compared 18 chronic cocaine users to 15 non-using controls on “extinction learning” activities resembling the exposure therapy often used to treat anxiety disorders. They found that extinction learning did not engage the ventromedial prefrontal cortex to the same degree in the cocaine-using group.

Konova said it is possible that other areas of the brain could be trained to update drug associations, or that ventromedial prefrontal cortex activity could be improved through cognitive retraining or medication.

Study results were published last week in the journal Addiction Biology.