Connectome-based prediction of craving in gambling disorder and cocaine use disorder

Abstract

Introduction

Craving, involving intense and urgent desires to engage in specific behaviours, is a feature of addictions. Multiple studies implicate regions of salience/limbic networks and basal ganglia, fronto-parietal, medial frontal regions in craving in addictions. However, prior studies have not identified common neural networks that reliably predict craving across substance and behavioural addictions.

Methods

Functional magnetic resonance imaging during an audiovisual cue-reactivity task and connectome-based predictive modelling (CPM), a data-driven method for generating brain-behavioural models, were used to study individuals with cocaine-use disorder and gambling disorder. Functions of nodes and networks relevant to craving were identified and interpreted based on meta-analytic data.

Results

Craving was predicted by neural connectivity across disorders. The highest degree nodes were mostly located in the prefrontal cortex. Overall, the prediction model included complex networks including motor/sensory, fronto-parietal, and default-mode networks. The decoding revealed high functional associations with components of memory, valence ratings, physiological responses, and finger movement/motor imagery.

Conclusions

Craving could be predicted across substance and behavioural addictions. The model may reflect general neural mechanisms of craving despite specificities of individual disorders. Prefrontal regions associated with working memory and autobiographical memory seem important in predicting craving. For further validation, the model should be tested in diverse samples and contexts.

Keywords:

• Craving
• cue-reactivity
• addictive behaviours
• cocaine
• gambling
• machine learning

Disclosure statement

Dr. Potenza has consulted for and advised Game Day Data, the Addiction Policy Forum, AXA, BariaTek, Idorsia and Opiant Therapeutics; been involved in a patent application involving Novartis and Yale University; received research support from the Mohegan Sun Casino and the Connecticut Council on Problem Gambling; and consulted for law offices, the federal public defender’s office and gambling entities on issues related to impulse-control and addictive disorders. The other authors report no financial relationships with commercial interests.

Additional information

Funding

NIDA [grants K01DA039299, R01 DA019039, R01DA039136] provided support for data collection as well as Drs. Yip and Potenza and Ms. Lacadie. Dr. Antons received a scholarship from the Gustav A. Lienert Foundation for the research project. Drs. Antons and Brand work on this article was conducted in the context of the Research Unit ACSID, FOR2974, funded by the Deutsche Forschungsgemeinschaft (DFG, German Research Foundation) – [411232260]. This work was also supported by National Institute on Drug Abuse.