Are There Neural Overlaps of Reactivity to Illegal Drugs, Tobacco, and Alcohol Cues? With Evidence From ALE and CMA

Abstract

Abuses of most illegal drugs, including methamphetamine, marijuana, cocaine, heroin, and polydrug, are usually in conjunction with alcohol and tobacco. There are similarities and associations between the behavior, gene, and neurophysiology of such abusers, but the neural overlaps of their cue-reactivity and the correlation of neural overlap with drug craving still needs to be further explored. In this study, an Activation Likelihood Estimation (ALE) was performed on brain activation under legal (tobacco, alcohol) and illegal drug cues, for identifying the similarities in brain functions between different craving states. A Comprehensive meta-analysis (CMA) on the correlation coefficient between brain activation and craving scores in the selected literatures with subjective craving reports explained the degree of the craving via brain imaging results. In ALE, co-activation areas of the three cue-reactivity (posterior cingulate, caudate, and thalamus) suggest that the three cue-reactivity may all arouse drug-use identity which is a predictor of relapse and generation of conditioned reflexes under reward memory, thus leading to illegal drug relapses. In CMA, the brain activation was significantly correlated with subjective craving, with a correlation coefficient of 0.222. The neural overlap of tobacco, alcohol and most of the prevalent illegal drug cues not only further helps us understand the neural mechanism of substance co-abuse and relapse, but also provides implications to detoxification. Furthermore, the correlation between brain activation and craving is low, suggesting the accuracy of craving-based quantitative evaluation by neuroimaging remains unclear.

Keywords: alcohol; cue-reactivity; drug; neuroimaging; tobacco.

Figure 1

ALE meta-analysis process.

Figure 2

Co-activated clusters about alcohol, nicotine, and illegal drugs. Slices taken at X = 0; Y = −18.

Figure 3

Funnel plot. The vertical axis is the log standard error of the effect size, the horizontal axis is the effect size, the inside of the funnel is the confidence interval, and the central axis is the combined effect size.