Abstract

Relapse during abstinence in cocaine use disorder (CUD) is often hastened by high impulsivity (predisposition toward rapid unplanned reactions to stimuli without regard to negative consequences) and high cue reactivity (e.g., attentional bias towards drug reward stimuli). A deeper understanding of the degree to which individual biological differences predict or promote problematic behaviors may afford opportunities for clinical refinement and optimization of CUD diagnostics and/or therapies. Preclinical evidence implicates serotonin (5-HT) neurotransmission through the 5-HT2A receptor (5-HT2AR) as a driver of individual differences in these relapse-related behaviors. Regulation of 5-HT2AR function occurs through many mechanisms, including DNA methylation of the HTR2A gene, an epigenetic modification linked with the memory of gene-environment interactions. In the present study, we tested the hypothesis that methylation of the HTR2A may associate with relapse-related behavioral vulnerability in cocaine-dependent participants versus healthy controls. Impulsivity was assessed by self-report (Barratt Impulsiveness Scale; BIS-11) and the delay discounting task, while levels of cue reactivity were determined by performance in the cocaine-word Stroop task. Genomic DNA was extracted from lymphocytes and the bisulfite-treated DNA was subjected to pyrosequencing to determine degree of methylation at four cytosine residues of the HTR2A promoter (-1439, -1420, -1224, -253). We found that the percent methylation at site -1224 after correction for age trended towards a positive correlation with total BIS-11 scores in cocaine users, but not healthy controls. Percent methylation at site -1420 negatively correlated with rates of delay discounting in healthy controls, but not cocaine users. Lastly, the percent methylation at site -253 positively correlated with attentional bias toward cocaine-associated cues. DNA methylation at these cytosine residues of the HTR2A promoter may be differentially associated with impulsivity or cocaine-associated environmental cues. Taken together, these data suggest that methylation of the HTR2A may contribute to individual differences in relapse-related behaviors in CUD.

Highlights

  • Cocaine use disorder (CUD) continues to be a significant public health problem, with rising cocaine-related overdose deaths linked to the growing opioid crisis [1]

  • We discovered in the present study that cocaine users exhibited higher levels of impulsivity as measured by the BIS-11 and delay discounting task, as expected

  • The percent methylation of CpG site -1224, but not -1439, -1420, or -235, of the HTR2A promoter trended towards a positive correlation with total BIS-11 scores in cocaine users

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Summary

Introduction

Cocaine use disorder (CUD) continues to be a significant public health problem, with rising cocaine-related overdose deaths linked to the growing opioid crisis [1]. Cocaine use begins against a background of genetics and environment, the intricate interplay between these variables is still poorly understood and differs between individuals, presenting a barrier to understanding the origins of CUD as well as moving forward toward efficacious pharmacotherapeutics. Impulsivity is interlocked with cue reactivity [6, 7] which is defined as the attentional orientation toward drug-associated stimuli that predict reward [8, 9]. Cocaine-dependent subjects often present with high levels of impulsivity [3, 4, 10] and cue reactivity [11,12,13]. CUD is a chronic relapsing disorder with no known Food and Drug Administration-approved medications

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