Outcome Related Electrophysiological Subtypes of Cocaine Dependence

Abstract

We previously described the existence of two quantitative EEG (QEEG) subtypes of cocaine dependent males, identified at baseline, displaying differential proneness to relapse. The current study expands the population to include females and enhances the measure set to include both QEEG and somatosensory EP (SEP) features. Fifty-seven cocaine dependent adults (16 F, 41 M) were evaluated 5-14 days after last cocaine use, while in residence at a drug-free therapeutic community. The median length of stay in treatment (continued abstinence) was 25 weeks. Using a small subset of QEEG and SEP baseline features, three subtypes (CLUS) were identified. CLUS 2 (n = 25) and CLUS 3 (n = 23) replicated the published subtypes, while CLUS 1 (n = 9) was previously undescribed. Cluster membership was significantly associated with length of stay in treatment (chi 2 = 13.789, P < 0.001), but not with length of exposure to crack cocaine or to any demographic or clinical features. Seventy-eight percent of CLUS 1 and 65% of CLUS 3 left treatment < or = 25 weeks, whereas 80% of CLUS 2 remained in treatment > 25 weeks. The existence of outcome related subtypes may reflect: [1] differential neurophysiological vulnerability, "traits," predisposing individuals to cocaine addiction; or [2] differential neurosensitivity, "states," due to the effects of chronic cocaine exposure, and associated differences in treatment outcome. Using Variable Resolution Electrical Tomographic Analysis (VARETA), the mathematically most probable neuroanatomical source of the scalp recorded EEG data was localized. Computation of VARETA on the baseline Cluster profiles suggest significant differences in the underlying pathophysiology of these subtypes.

EEG Biofeedback as a Treatment for Substance Use Disorders: Review, Rating of Efficacy and Recommendations for Further Research

“…This was replicated in subsequent studies with a larger number of participants (Alper, 1999;Alper, Chabot, Kim, Prichep, & John, 1990;Alper, Prichep, Kowalik, Rosenthal, & John, 1998;Costa & Bauer, 1997;Herning et al, 1985;Noldy, Santos, Politzer, Blair, & Carlen, 1994;Prichep, Alper, Kowalik, & Rosenthal, 1996;Prichep et al, 1999;Prichep et al, 2002;Roemer et al, 1995). Beside beta effects, studies have reported an increase in delta activity (Herning et al, 1985) and frontal alpha activity (Herning, Glover, Koeppl, et al, 1994), whereas others have reported an increase in alpha wave EEG associated with bursts of cocaine-induced euphoria (Lukas, 1991).…”

“…These data demonstrate the involvement of the prefrontal cortex in the qEEG response to acute cocaine and indicate that slow wave qEEG, delta and theta activity are involved in the processes related to experiencing rewarding properties of cocaine. Prichep et al (1999) and Prichep et al (2002) extended the idea of relating baseline EEG activity to outcome in cocainedependent patients in treatment programs. Participants with cocaine dependence have persistent changes in brain function assessed with qEEG methods, present when evaluated at baseline, 5 to 14 days after last reported crack cocaine use, and persistent at 1-and 6-month follow-up evaluations (Alper, 1999;Alper et al, 1990;Alper et al, 1998;Prichep et al, 1996;Prichep et al, 2002;Venneman et al, 2006).…”

“…Prichep et al (1999) and Prichep et al (2002) extended the idea of relating baseline EEG activity to outcome in cocainedependent patients in treatment programs. Participants with cocaine dependence have persistent changes in brain function assessed with qEEG methods, present when evaluated at baseline, 5 to 14 days after last reported crack cocaine use, and persistent at 1-and 6-month follow-up evaluations (Alper, 1999;Alper et al, 1990;Alper et al, 1998;Prichep et al, 1996;Prichep et al, 2002;Venneman et al, 2006). Several recent studies employing qEEG techniques have already demonstrated an association between the amount of beta activity in the spontaneous EEG and relapse in cocaine abuse (Bauer, 1997(Bauer, , 2001b.…”

“…The study group is substantially different than that reported in either the Peniston or replication studies. The rationale is based in part on reports of substantial alteration of qEEG seen in stimulant abusers associated with early treatment failure (Prichep et al, 1996;Prichep et al, 2002) likely associated with marked frontal neurotoxicity and alterations in dopamine receptor mechanisms (Alper, 1999). In addition, preexisting ADHD is associated with stimulant preference in adult substance abusers and is independent of stimulant associated qEEG changes.…”

Selected Abstracts of Conference Presentations at the 2008 International Society for Neurofeedback and Research (ISNR) 16th Annual Conference, San Antonio, Texas

“…EEG changes in beta and theta power are typical for withdrawal from cocaine. Cocaine abusers who are still taking drug often present excess amount of both low-and high-frequency EEG activity (Prichep et al, 2002). Thus cocaine users may benefit from EEG biofeedback protocol aimed on increasing sensorimotor response (SMR) (12-15 Hz) and decreasing theta (4-8 Hz) activity at the vertex that is commonly used in the treatment of attention deficit 84 JOURNAL OF NEUROTHERAPY hyperactivity disorder (Monastra et al, 2005).…”