Cocaine users with comorbid Cluster B personality disorders show dysfunctional brain activation and connectivity in the emotional regulation networks during negative emotion maintenance and reappraisal.
Cocaine dependence often co-occurs with Cluster B personality disorders. Since both disorders are characterized by emotion regulation deficits, we predicted that cocaine comorbid patients would exhibit dysfunctional patterns of brain activation and connectivity during reappraisal of negative emotions. We recruited 18 cocaine users with comorbid Cluster B personality disorders, 17 cocaine users without comorbidities and 21 controls to be scanned using functional magnetic resonance imaging (fMRI) during performance on a reappraisal task in which they had to maintain or suppress the emotions induced by negative affective stimuli. We followed region of interest (ROI) and whole-brain approaches to investigate brain activations and connectivity associated with negative emotion experience and reappraisal. Results showed that cocaine users with comorbid personality disorders had reduced activation of the subgenual anterior cingulate cortex during negative emotion maintenance and increased activation of the lateral orbitofrontal cortex and the amygdala during reappraisal. Amygdala activation correlated with impulsivity and antisocial beliefs in the comorbid group. Connectivity analyses showed that in the cocaine comorbid group the subgenual cingulate was less efficiently connected with the amygdala and the fusiform gyri and more efficiently connected with the anterior insula during maintenance, whereas during reappraisal the left orbitofrontal cortex was more efficiently connected with the amygdala and the right orbitofrontal cortex was less efficiently connected with the dorsal striatum. We conclude that cocaine users with comorbid Cluster B personality disorders have distinctive patterns of brain activation and connectivity during maintenance and reappraisal of negative emotions, which correlate with impulsivity and dysfunctional beliefs.
['Albein-Urios|Natalia|N|', 'Verdejo-Román|Juan|J|', 'Soriano-Mas|Carles|C|', 'Asensio|Samuel|S|', 'Martínez-González|José Miguel|JM|', 'Verdejo-García|Antonio|A|']
D000328:Adult D000704:Analysis of Variance D001921:Brain D001931:Brain Mapping D019970:Cocaine-Related Disorders D004644:Emotions D005260:Female D006801:Humans D007091:Image Processing, Computer-Assisted D007600:Judgment D008279:Magnetic Resonance Imaging D008297:Male D010100:Oxygen D010554:Personality Disorders D010555:Personality Inventory D013223:Statistics as Topic
Cocaine Negative emotion Reappraisal Anterior cingulate cortex Lateral orbitofrontal cortex Amygdala Antisocial personality disorder Borderline personality disorder Histrionic personality disorder