Comparison of Neural Correlates of Reactive Inhibition in Cocaine, Heroin, and Polydrug Users through a Contextual Go/No-Go Task Using Event-Related Potentials.

Abstract

Simple SummaryWitnessing the current increase in the use of substances in society and considering the associated pervasive relapse rate, the management of addictions remains a significant challenge. The identification of biomarkers that are linked to specific profiles of consumption would allow a more targeted, and therefore, more effective care. In this view, the present study evaluates and compares the cognitive performance usually associated with substance use disorder—inhibitory control, attentional bias, and error detection—of heroin, cocaine, and polydrug users to matched healthy controls. Simultaneously, the addition of measurement of the modulation of brain activity during the task (event-related potentials technique) offers a reliable representation of the neuronal mechanisms underlying cognitive functioning. The results reveal substance-specific neural patterns of response, notably a more deleterious impact on polydrug use, and, despite nonsignificant results, suggest a more drastically affected cognitive functioning in cocaine users. Such evidence refines our knowledge of the specific mode of action of each substance. Ultimately, knowing their neural signature will lead to the implementation of more targeted interventions, thereby allowing specific needs to be addressed.Recent global data indicates a worldwide increase in polydrug use associated with a shift from recreational to productive habits of consumption. Such non-responsible abuse of substances (alcohol, cocaine, heroin, etc.) is likely to lead to addictive disorders that are characterized by various neuropsychopharmacological effects. A main cognitive function involved in the onset and long-term maintenance of addiction is reactive inhibition, i.e., the ability to withhold a prepotent motor dominant response. In the present study, 63 (poly)drug user patients who were undergoing a detoxification program, in addition to 19 healthy controls matched for gender, age, and education, were subjected to a “contextual Go/No-Go task” with concomitant electroencephalography. Stimuli were superimposed on three contextual backgrounds: control (black screen), drug-unrelated (neutral pictures), or drug-related (pictures related to drug consumption). Of these patients, 23 were cocaine users (CU), 21 were heroin users (HU), and 19 were polydrug users (PDU). The main results showed that (1) at the behavioral level, more commission errors occurred with the PDU patients compared to the healthy controls; (2) at the neurophysiological level, specific alterations were found on classical event-related potentials that index reactive inhibition. Indeed, the higher rate of errors in the PDU group was subtended by both reduced amplitude and latency on the ∆N2 component and increased ∆P3 latency compared to controls. These data clearly suggest a more deleterious impact of polydrug use on inhibitory functions. In addition, our results provide evidence of reduced ERN amplitude in cocaine users, suggesting that impaired performance monitoring and error-processing may support impaired awareness, thereby preventing these patients from changing their behaviors.