Post-Error Behavior in Active Cocaine Users: Poor Awareness of Errors in the Presence of Intact Performance Adjustments

Abstract

Active cocaine abusers have a diminished neural response to errors, particularly in the anterior cingulate cortex thought critical to error processing. The inability to detect, or adjust performance following errors has been linked to clinical symptoms including the loss of insight and perseverative behavior. We investigated the cognitive implications of this diminished error-related activity, using response inhibition tasks that required error awareness and performance adaptation. Twenty-one active cocaine users (six female subjects, mean age ¼ 40.3) and 22 non-drug using adults (six female subjects, mean ¼ 39.9) participated. The results indicated that cocaine users consistently demonstrated poorer inhibitory control, a deficit accompanied by reduced awareness of errors. Adaptation of post-error reaction times did not differ between groups, although a different measure of adaptive behavior: exerting inhibitory control on the trial immediately after failing to inhibit, was significantly poorer in the cocaine using sample. In summary, cocaine users demonstrated a diminished capacity for monitoring their behavior, but were able to perform post-error adjustment to processes not already suffering an underlying deficit. These difficulties are consistent with previous reports of cocaine-related hypoactivity in the neural system underlying cognitive control, and highlight the potential for cognitive dysfunction to manifest as behavioral deficits that likely contribute to the maintenance of drug dependence.

Altered Neural Processing of the Need to Stop in Young Adults at Risk for Stimulant Dependence

“…Reduced ACC recruitment in the present study is consistent with previous neural investigations showing ACC hypoactivations in stimulant users in the context of inhibitory control and decision-making paradigms (Bolla et al, 2004;Hester and Garavan, 2004;Goldstein and Volkow, 2011). Similarly, recent studies have found attenuated insula responses in stimulant users Clark et al, 2012), including nondependent individuals Stewart et al, 2013).…”

“…Prior investigations have shown inhibitory control deficits in stimulant-dependent individuals, with moderate correlations with drug use indices (Simon et al, 2002;Fillmore and Rush, 2002;Salo et al, 2002;Monterosso et al, 2005;Hester et al, 2007;Tabibnia et al, 2011). Stimulant dependence has been linked to reduced functioning of dopamine transporters and hypometabolism in various regions critical to inhibitory control, including basal ganglia, anterior cingulate cortex (ACC), and other prefrontal areas (Volkow et al, 1999;Bolla et al, 2004;London et al, 2004;Kim et al, 2009).…”

“…Stimulant dependence has been linked to reduced functioning of dopamine transporters and hypometabolism in various regions critical to inhibitory control, including basal ganglia, anterior cingulate cortex (ACC), and other prefrontal areas (Volkow et al, 1999;Bolla et al, 2004;London et al, 2004;Kim et al, 2009). During inhibitory control tasks, primarily go/no-go and Stroop paradigms, cocaine abusers also show hypoactivity in the ACC, pre-SMA, superior frontal gyrus, and insula (Kaufman et al, 2003;Hester and Garavan, 2004;Li et al, 2008). In contrast to dependent users, there are relatively few studies on occasional users, although some behavioral studies suggest subtle impairments in inhibitory response and error monitoring (Colzato et al, 2007;Reske et al, 2011).…”

Acute effects of cocaine on the neurobiology of cognitive control

“…Similarly, the cocaine administration was observed to increase activation levels in fron-tal and parietal areas that responded to performance errors. Previously, we have shown that the subjective awareness of errors in one's performance is associated with increased frontoparietal activity (Hester et al 2005) and that cocaine users have poorer awareness of their errors (Hester et al 2007). Thus, an increase in error-related activity may be functionally significant insofar as error-related activation levels tend to be greater in better, more attentive performers ) and when errors are made more salient through within-subject manipulations (Taylor et al 2006).…”

Neuroscience: Rethinking rehab

“…Some have shown that people with drug addictions are poor at monitoring their own behaviour 3 , making appropriate decisions and inhibiting impulses -and these behavioural findings have been matched to functional magnetic resonance imaging (fMRI) data that show reduced activity in the corresponding prefrontal areas. Animal studies have supported the human ones by showing, for example, that monkeys given cocaine swiftly develop prefrontal impairments 4 .…”