Elsevier

Biological Psychiatry

Volume 63, Issue 11, 1 June 2008, Pages 1054-1060
Biological Psychiatry

Original Article
Reduced Behavioral and Neural Activation in Stimulant Users to Different Error Rates during Decision Making

https://doi.org/10.1016/j.biopsych.2007.09.007Get rights and content

Background

Behavioral processes and neural systems dysfunctions that put individuals at risk for drug use in general, and stimulant use in particular, are poorly understood. Here, the hypothesis is examined that stimulant-using subjects adjust their decision making less as a function of errors as evidenced by attenuated behavioral and neural substrate activation patterns.

Methods

Twelve young adults who had used stimulants were compared with 12 education-matched, stimulant-naïve comparison subjects. Subjects completed the two-choice prediction task with three fixed error-rate conditions (20%, 50%, or 80% errors) during functional magnetic resonance imaging.

Results

Stimulant users relative to comparison subjects showed less strategy adjustment to different error rates, for example, they were less likely to stay with winning responses (win-stay) and to shift away from losing responses (lose-shift). These subjects also showed different activation patterns as a function of error rate in left insular and bilateral dorsolateral prefrontal cortex but not anterior cingulate. The degree to which individuals adjusted switching rate, or win-stay/lose-shift consistent responses, as a function of errors was correlated with the difference in insular cortex activation differences between high and low error rates.

Conclusions

The behavior of stimulant users is less adaptive to the frequency of errors made and fewer brain processing resources are deployed during decision making to anticipate erroneous performance. These findings could be markers for the predisposition of drug taking; however, their relevance for development of drug dependence requires further study.

Section snippets

Participants

This study was approved by the University of California San Diego (UCSD) Institutional Review Board. All subjects were interviewed face-to-face using a structured diagnostic interview (SCID) (17), modified to enable us to document the use of illicit substances. Twelve young adults (aged 20.0 years, SD 2.6) who had used stimulants at least twice in the last 6 months were compared with 12 education-matched stimulant-naïve comparison subjects (aged 18.3 years, SD .9). Stimulant users were

Drug Usage and Behavioral Assessments

Based on the Structured Clinical Interview for DSM and questionnaire lifetime assessments, stimulant users had used amphetamine-like stimulants an average of 36 times (range: 0–240) and/or cocaine an average of 14 times (range: 0–40); they had used any type of stimulants for an average of 51 times (range: 2–240). Although individuals were recruited on the basis of their stimulant use, all of these individuals had used other illicit drugs (Table 1). In particular, stimulant users had used THC an

Discussion

This investigation yielded four main results. First, stimulant users relative to comparison subjects adjusted their choices less as a function of different error rates. Second, these subjects also showed an altered activation pattern in the left insular and bilateral dorsolateral prefrontal cortex, but not the anterior cingulate, as a function of error rate. Third, brain pattern differences were associated with an attenuated change in win-stay/lose-shift consistent responses. Fourth, relatively

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