Abstract
Observations of drug-related cues may induce craving in drug-dependent patients, prompting compulsive drug-seeking behavior. Sexual dysfunction is common in drug users. The aim of the study was to examine regional brain activation to drug (ketamine, cigarette smoking) associated cues and natural (sexual) rewards. A sample of 129 [40 ketamine use smokers (KUS), 45 non-ketamine use smokers (NKUS) and 44 non-ketamine use non-smoking healthy controls (HC)] participants underwent functional magnetic resonance imaging (fMRI) while viewing ketamine use related, smoking and sexual films. We found that KUS showed significant increased activation in anterior cingulate cortex and precuneus in response to ketamine cues. Ketamine users (KUS) showed lower activation in cerebellum and middle temporal cortex compared with non-ketamine users (NKUS and HC) in response to sexual cues. Smokers (KUS and NKUS) showed higher activation in the right precentral frontal cortex in response to smoking cues. Non-ketamine users (NKUS and HC) showed significantly increased activation of cerebellum and middle temporal cortex while viewing sexual cues. These findings clearly show the engagement of distinct neural circuitry for drug-related stimuli in chronic ketamine users. While smokers (both KUS and NKUS) showed overlapping differences in activation for smoking cues, the former group showed a specific neural response to relevant (i.e., ketamine-related) cues. In particular, the heightened response in anterior cingulate cortex may have important implications for how attentionally salient such cues are in this group. Ketamine users (KUS) showed lower activation in response to sexual cues may partly reflect the neural basis of sexual dysfunction.
Highlights
Over the last decade, ketamine has increasingly become a more widely used recreational drug among young people [1, 2]
In order to characterize ketamine use and cigarette smokingrelated cue-induced brain activation, we presented two types of addictive drug cues, ketamine and nicotine, during functional magnetic resonance imaging (fMRI) to investigate brain activation patterns to ketamine or smoking cues in chronic ketamine users, cigarette smokers, and non-ketamine use non-smoking healthy controls (HC)
Our study showed activation of the precuneus in ketamine users (KUS) compared with non-ketamine use smokers (NKUS) and HC
Summary
Ketamine has increasingly become a more widely used recreational drug among young people [1, 2]. The mechanisms of drug craving in chronic ketamine users are not fully understood. Given that ketamine abuse is a growing problem, which is often accompanied by serious adverse effects such as ketamine-induced ulcerative cystitis, kidney dysfunction, psychosis, depression, cognitive impairment, and neurological changes [2], it becomes exceedingly important to explore and understand how craving drives ketamine or other drug users to use drugs without consideration of negative consequences. One way to address this question is the use of functional magnetic resonance imaging (fMRI) to characterize brain responses to drug-related cues that induce craving [5]. The aim of the study was to examine regional brain activation to drug (ketamine, cigarette smoking) associated cues and natural (sexual) rewards
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