Brain Activity During Cocaine Craving and Gambling Urges: An fMRI Study

Using functional magnetic resonance imaging (fMRI), this study compared neural activity during craving/urge states in 114 women and men with cocaine dependance (CD), pathological gambling (PG), and control participants (CPs) without either disorder. Participants viewed three types of videos depicting cocaine, gambling, and sad scenarios. Cocaine and gambling scenarios were designed to induce cravings/urges for cocaine and gambling in CD and PG participants, respectively. Sad videos were included as an emotional (non-urge) active control condition and to examine emotional processing in CD and PG.

Quantitative Data Highlights

• PG participant reported urges 2x stronger with gambling imagery than CD participants with cocaine use imagery.
• CD participants showed a nearly equal intensity of gambling urges from gambling imagery as they had drug cravings from cocaine use imagery.

Identified Risk Factors

• Identifying as a woman (specific to gambling related imagery).

Qualitative Data Highlights

• As reviewed previously, craving is a key feature of both SUDs and PG that predicts drug use, gambling, and relapse to those behaviors.
• Women exhibited greater brain activity for gambling videos compared with PG men.

Gender

• Women exhibited greater brain activity for gambling videos compared with PG men.

Identified Conclusions

• The current work further suggests that craving states may be instantiated differently across genders, indicating that treatments may be made more effective by elucidating gender-specific interventions that target craving.

• Consistent with previous research, commonly practiced and effective treatments for these disorders include components on identifying triggers for craving and on regulation of craving (such as relapse prevention and cognitive-behavioral therapy).

Identified Recommendations

• The current findings highlight the need to systematically examine gender-related differences to understand the neural substrates of both disorders.