The Neuropsychology of Cocaine Addiction: Recent Cocaine Use Masks Impairment

Abstract

Individuals with current cocaine use disorders (CUD) form a heterogeneous group, making sensitive neuropsychological (NP) comparisons with healthy individuals difficult. The current study examined the effects on NP functioning of four factors that commonly vary among CUD: urine status for cocaine (positive vs negative on study day), cigarette smoking, alcohol consumption, and dysphoria. Sixty-four cocaine abusers were matched to healthy comparison subjects on gender and race; the groups also did not differ in measures of general intellectual functioning. All subjects were administered an extensive NP battery measuring attention, executive function, memory, facial and emotion recognition, and motor function. Compared with healthy control subjects, CUD exhibited performance deficits on tasks of attention, executive function, and verbal memory (within one standard deviation of controls). Although CUD with positive urine status, who had higher frequency and more recent cocaine use, reported greater symptoms of dysphoria, these cognitive deficits were most pronounced in the CUD with negative urine status. Cigarette smoking, frequency of alcohol consumption, and dysphoria did not alter these results. The current findings replicate a previously reported statistically significant, but relatively mild NP impairment in CUD as compared with matched healthy control individuals and further suggest that frequent/recent cocaine may mask underlying cognitive (but not mood) disturbances. These results call for development of pharmacological agents targeted to enhance cognition, without negatively impacting mood in individuals addicted to cocaine.

Déficits neuropsicológicos asociados a la relación entre abuso de cocaína y violencia: mecanismos neuronales facilitadores

“…Chronic use of cocaine is related to poorer executive functioning, affecting capacity for inhibition, mental flexibility, planning ability, alternation of cognitive sets and decision-making (Colzato et al, 2009;Madoz-Gúrpide, Blasco-Fontecilla, & Baca-García, 2011;Morie, De Sanctis, & Foxe, 2014;Pike, Stoopsa, Fillmore, & Rush, 2013;Verdejo-García & Pérez-García, 2007;van der Plas et al, 2009;Woicik et al, 2009;2011). This altered functioning has not only been found in adults: children and teenagers prenatally exposed to high levels of cocaine also present such deficits (Betancourt et al, 2011;Bridgett & Mayes, 2011;Grewen et al, 2014;Landi et al, 2012).…”

Cognitive and emotional impairments in adults with attention-deficit/hyperactivity disorder and cocaine use

“…As previously published (Vonmoos et al, 2013a;, 15 predefined test parameters underwent z-transformation on the basis of means and standard deviations of the control group and were combined into four cognitive domains (Goldstein et al, 2004;Jovanovski et al, 2005;Pace-Schott et al, 2008;Vonmoos et al, 2013a;Woicik et al, 2009): attention, working memory, declarative memory, and executive functions (see Supplementary Methods S3 for details). These four domains were equally integrated into a global cognitive index (GCI).…”

Social cognition and interaction in stimulant use disorders

“…Most of these investigations showed that cocaine and methamphetamine users were largely unimpaired in their general ability to identify basic facial affect expressions [24][25][26][27][28][29][30], whereas only a single study showed general impairment of facial affect recognition in a small sample (n=12) of former methamphetamine users Interestingly, one study has shown that chronic cocaine users displayed problems in emotion recognition from voices (prosody) as well as in the detection of matches and mismatches between emotional faces and voices when both were presented together [24]. Notably, longer duration and higher cumulative doses of cocaine use were correlated with diminished integration of visual and facial emotions, indicating that the dysfunctional integration of different emotion modalities might be cocaine-induced [24].…”