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Sex differences in neural responses to stress and drug cues predicts future drug use in individuals with substance use disorder.
Smith, Keisha; Lacadie, Cheryl M; Milivojevic, Verica; Fogelman, Nia; Sinha, Rajita.
Afiliación
  • Smith K; Yale Stress Center, Yale School of Medicine, New Haven, CT, United States; Yale University School of Medicine, Department of Radiology and Biomedical Imaging, New Haven, CT, United States.
  • Lacadie CM; Yale School of Medicine, Department of Diagnostic Radiology, United States.
  • Milivojevic V; Yale Stress Center, Yale School of Medicine, New Haven, CT, United States.
  • Fogelman N; Yale Stress Center, Yale School of Medicine, New Haven, CT, United States.
  • Sinha R; Yale Stress Center, Yale School of Medicine, New Haven, CT, United States. Electronic address: rajita.sinha@yale.edu.
Drug Alcohol Depend ; 244: 109794, 2023 03 01.
Article en En | MEDLINE | ID: mdl-36758371
BACKGROUND: Substance use disorders (SUDs) are chronically recurring illnesses, where stress and drug cues significantly increase drug craving and risk of drug use recurrence. This study examined sex differences in functional magnetic resonance imaging (fMRI) brain responses to stress and drug cue exposure and assessed their prospective association with future drug use post-treatment. METHODS: Inpatient, treatment engaged men (N = 46) and women (N = 26) with SUDs, including alcohol, cocaine and/or cannabis use disorders, participated in an fMRI scan that assessed subjective (anxiety, drug craving), heart rate and neural responses to brief individualized script-driven imagery of stress, drug, and neutral-relaxing trials. Prospective follow-up interviews post-treatment assessed future drug use recurrence over 90 days. RESULTS: During fMRI, stress and drug versus neutral cue exposure led to increased anxiety, heart rate and craving responses (p's < 0.004) in both men and women, but greater drug cue-induced anxiety (p < .017) and higher drug use days during follow-up (p < .006) in women relative to men. In whole brain analyses of stress and drug cues (p < .05 FWE corrected), and in whole brain correlation (p < .05, FWE corrected) with drug use days, significant sex differences revealed drug cue-related striatal hyperactivation (caudate, putamen) in men, but drug cue-related cortico-limbic (insula and dorsolateral prefrontal cortex) hypoactivation and stress-related hypoactivation in the ventromedial prefrontal cortex (VmPFC) in women; and these were significantly associated with higher future drug use days. CONCLUSIONS: Findings indicate sex-specific pathophysiology of SUD recurrence and support the need for differential treatment development for men and women with SUD to improve drug use outcomes.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Trastornos Relacionados con Sustancias / Señales (Psicología) Tipo de estudio: Prognostic_studies / Risk_factors_studies Límite: Female / Humans / Male Idioma: En Revista: Drug Alcohol Depend Año: 2023 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Irlanda
Texto completo
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XML
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Trastornos Relacionados con Sustancias / Señales (Psicología) Tipo de estudio: Prognostic_studies / Risk_factors_studies Límite: Female / Humans / Male Idioma: En Revista: Drug Alcohol Depend Año: 2023 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Irlanda