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A systematic review of studies exploring craving, its moderators, and the link with substance use in daily life using Ecological Momentary Assessment (EMA)
Abstracts / Drug and Alcohol Dependence 140 (2014) e169–e251
nence. While it is unclear whether these differences were due to improved attention, these results suggest that IB may help to improve cognitive function in early MA withdrawal. Data provide some support for developing MA treatments that reduce cognitive impairment. Financial support: National Institute on Drug Abuse (1R01DA029804; S. Shoptaw); National Center for Advancing Translational Sciences (UL1TR000124; S. Dubinett). http://dx.doi.org/10.1016/j.drugalcdep.2014.02.612 A systematic review of studies exploring craving, its moderators, and the link with substance use in daily life using Ecological Momentary Assessment (EMA) J. Swendsen 2 , F. Serre 1,3 , M. Fatseas 1,3 , Marc Auriacombe 1,3 1 Addiction Psychiatry, University Bordeaux/CNRS USR 3413, Bordeaux, France 2 CNRS UMR 5287 INCIA, University Bordeaux, Bordeaux, France 3 CH Ch. Perrens et CHU Bordeaux, Bordeaux, France
Aims: Studies examining the link between craving and substance use have often revealed contradictory results. Ecological Momentary Assessment (EMA) is a method particularly well-suited to assess subjective variables and episodic events in daily life, and it offers a new opportunity to examine questions concerning craving with high ecological validity. The objective of this systematic review was to examine all published studies using EMA to: (1) examine the temporal link between craving and substance use, and (2) identify relevant moderators of craving intensity among substance users. Methods: The literature search used Medline up to July 31, 2012, and was based on a systematic review methodology. Results: Fifty-seven studies were selected, of which most concerned tobacco or alcohol. The majority of studies (91%) reported a positive relationship between craving and substance use, both concurrently and prospectively, within pre- and post-quit periods, among users with different levels of use, and for both legal and illegal substances. EMA data also confirmed the influence of intra-individual variables (negative affects, social contexts, other substance use) and inter-individual variables (age, level of use) in daily life craving reports Conclusions: This review of EMA investigations demonstrates a strong link between craving and substance use, and underscores the importance of taking into account temporal and contextual considerations in the assessment of this relationship. Financial support: PHRC 2006, MILDT 2010, CRA 2009, PRACNRS-CHU 2008, CNRS ATIP. http://dx.doi.org/10.1016/j.drugalcdep.2014.02.613
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Lower Serotonin 2C receptor (5-HT2CR) expression in the ventral tegmental area (VTA) associates with elevated cue reactivity following extended forced abstinence from cocaine-taking Sarah E. Swinford, Noelle C. Anastasio, R.G. Fox, S.J. Stutz, K.A. Cunningham Ctr Addiction Res, UTMB, Galveston, TX, United States Aims: Vulnerability to environmental cues previously associated with cocaine-taking (“cue reactivity”) is thought to promote relapse. The VTA has been implicated in cue reactivity such that exposure to cocaine-associated cues has been shown to trigger activation of the VTA in neuroimaging studies of cocaine-dependent subjects. The VTA microcircuitry and afferents that control cue reactivity are under-explored. Serotonergic afferents to the VTA may regulate cue reactivity through metabotropic 5-HT2CRs that exert an overall inhibitory impact over VTA function. Impaired neuronal signal transduction in the VTA through the ERK1/2 pathway may contribute to adaptations underlying responses to cues; however, altered 5-HT2CR expression and signaling as a neurobiological driver of such events underlying cue reactivity is unknown. We tested the hypothesis that extended periods of forced abstinence (FA) from cocaine-taking results in elevated cue reactivity and shifts in the subcellular expression of the 5-HT2CR and pERK1/2. Methods: Rats (n = 20) underwent cocaine self-administration followed by 1 or 30 days of FA. Cue reactivity (presses on cocaineconditioned lever) was measured on FA Day 1 or 30. Rats were sacrificed and VTA harvested. Immunoblotting was performed to assess VTA subcellular localization (membrane, cytosolic, nuclear) of 5-HT2CR and pERK1/2 protein. Results: Cocaine-conditioned lever presses were elevated at FA Day 30 vs. FA Day 1 (p < 0.05). Expression of membrane 5-HT2CR was lower while nuclear pERK1/2 was higher in the VTA on FA Day 30 vs. FA Day 1 (p < 0.05). Cytosolic levels of pERK1/2 did not differ on FA Day 1 vs. FA Day 30. Conclusions: Collectively, these data suggest reduced VTA 5-HT2CR expression concomitant with altered pERK1/2 nuclear translocation emerges during pro- longed FA from cocaine SA to drive cue reactivity. Future directions will assess the impact of an imbalance in 5-HT2CR homeostasis as a driver of dynamic neurobiological events underlying cocaine cue reactivity. Financial support: DA07287, DA06511, DA024157. http://dx.doi.org/10.1016/j.drugalcdep.2014.02.614
nence. While it is unclear whether these differences were due to improved attention, these results suggest that IB may help to improve cognitive function in early MA withdrawal. Data provide some support for developing MA treatments that reduce cognitive impairment. Financial support: National Institute on Drug Abuse (1R01DA029804; S. Shoptaw); National Center for Advancing Translational Sciences (UL1TR000124; S. Dubinett). http://dx.doi.org/10.1016/j.drugalcdep.2014.02.612 A systematic review of studies exploring craving, its moderators, and the link with substance use in daily life using Ecological Momentary Assessment (EMA) J. Swendsen 2 , F. Serre 1,3 , M. Fatseas 1,3 , Marc Auriacombe 1,3 1 Addiction Psychiatry, University Bordeaux/CNRS USR 3413, Bordeaux, France 2 CNRS UMR 5287 INCIA, University Bordeaux, Bordeaux, France 3 CH Ch. Perrens et CHU Bordeaux, Bordeaux, France
Aims: Studies examining the link between craving and substance use have often revealed contradictory results. Ecological Momentary Assessment (EMA) is a method particularly well-suited to assess subjective variables and episodic events in daily life, and it offers a new opportunity to examine questions concerning craving with high ecological validity. The objective of this systematic review was to examine all published studies using EMA to: (1) examine the temporal link between craving and substance use, and (2) identify relevant moderators of craving intensity among substance users. Methods: The literature search used Medline up to July 31, 2012, and was based on a systematic review methodology. Results: Fifty-seven studies were selected, of which most concerned tobacco or alcohol. The majority of studies (91%) reported a positive relationship between craving and substance use, both concurrently and prospectively, within pre- and post-quit periods, among users with different levels of use, and for both legal and illegal substances. EMA data also confirmed the influence of intra-individual variables (negative affects, social contexts, other substance use) and inter-individual variables (age, level of use) in daily life craving reports Conclusions: This review of EMA investigations demonstrates a strong link between craving and substance use, and underscores the importance of taking into account temporal and contextual considerations in the assessment of this relationship. Financial support: PHRC 2006, MILDT 2010, CRA 2009, PRACNRS-CHU 2008, CNRS ATIP. http://dx.doi.org/10.1016/j.drugalcdep.2014.02.613
e221
Lower Serotonin 2C receptor (5-HT2CR) expression in the ventral tegmental area (VTA) associates with elevated cue reactivity following extended forced abstinence from cocaine-taking Sarah E. Swinford, Noelle C. Anastasio, R.G. Fox, S.J. Stutz, K.A. Cunningham Ctr Addiction Res, UTMB, Galveston, TX, United States Aims: Vulnerability to environmental cues previously associated with cocaine-taking (“cue reactivity”) is thought to promote relapse. The VTA has been implicated in cue reactivity such that exposure to cocaine-associated cues has been shown to trigger activation of the VTA in neuroimaging studies of cocaine-dependent subjects. The VTA microcircuitry and afferents that control cue reactivity are under-explored. Serotonergic afferents to the VTA may regulate cue reactivity through metabotropic 5-HT2CRs that exert an overall inhibitory impact over VTA function. Impaired neuronal signal transduction in the VTA through the ERK1/2 pathway may contribute to adaptations underlying responses to cues; however, altered 5-HT2CR expression and signaling as a neurobiological driver of such events underlying cue reactivity is unknown. We tested the hypothesis that extended periods of forced abstinence (FA) from cocaine-taking results in elevated cue reactivity and shifts in the subcellular expression of the 5-HT2CR and pERK1/2. Methods: Rats (n = 20) underwent cocaine self-administration followed by 1 or 30 days of FA. Cue reactivity (presses on cocaineconditioned lever) was measured on FA Day 1 or 30. Rats were sacrificed and VTA harvested. Immunoblotting was performed to assess VTA subcellular localization (membrane, cytosolic, nuclear) of 5-HT2CR and pERK1/2 protein. Results: Cocaine-conditioned lever presses were elevated at FA Day 30 vs. FA Day 1 (p < 0.05). Expression of membrane 5-HT2CR was lower while nuclear pERK1/2 was higher in the VTA on FA Day 30 vs. FA Day 1 (p < 0.05). Cytosolic levels of pERK1/2 did not differ on FA Day 1 vs. FA Day 30. Conclusions: Collectively, these data suggest reduced VTA 5-HT2CR expression concomitant with altered pERK1/2 nuclear translocation emerges during pro- longed FA from cocaine SA to drive cue reactivity. Future directions will assess the impact of an imbalance in 5-HT2CR homeostasis as a driver of dynamic neurobiological events underlying cocaine cue reactivity. Financial support: DA07287, DA06511, DA024157. http://dx.doi.org/10.1016/j.drugalcdep.2014.02.614