Neuropsychopharmacology (2009) 34, 1112–1122; doi:10.1038/npp.2008.60; published online 21 May 2008

The Neuropsychology of Cocaine Addiction: Recent Cocaine Use Masks Impairment

Patricia A Woicik1, Scott J Moeller2, Nelly Alia-Klein1, Thomas Maloney1, Tanya M Lukasik1, Olga Yeliosof1, Gene-Jack Wang1, Nora D Volkow3 and Rita Z Goldstein1

  1. 1Brookhaven National Laboratory, Medical Department, Upton, NY, USA
  2. 2Department of Psychology, University of Michigan, Ann Arbor, MI, USA
  3. 3National Institute on Drug Abuse, Bethesda, MD, USA

Correspondence: Dr PA Woicik, Brookhaven National Laboratory, Medical Department, PO Box 5000, Upton, NY 11973-5000, USA. Tel: +1 631 344 4472; Fax: +1 631 344 5260; E-mail: pwoicik@bnl.gov; Dr Rita Z Goldstein, Tel: +1 631 344 2657; Fax: +1 631 344 5260; E-mail: rgoldstein@bnl.gov

Received 18 December 2007; Revised 11 March 2008; Accepted 12 March 2008; Published online 21 May 2008.

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Abstract

Individuals with current cocaine use disorders (CUD) form a heterogeneous group, making sensitive neuropsychological (NP) comparisons with healthy individuals difficult. The current study examined the effects on NP functioning of four factors that commonly vary among CUD: urine status for cocaine (positive vs negative on study day), cigarette smoking, alcohol consumption, and dysphoria. Sixty-four cocaine abusers were matched to healthy comparison subjects on gender and race; the groups also did not differ in measures of general intellectual functioning. All subjects were administered an extensive NP battery measuring attention, executive function, memory, facial and emotion recognition, and motor function. Compared with healthy control subjects, CUD exhibited performance deficits on tasks of attention, executive function, and verbal memory (within one standard deviation of controls). Although CUD with positive urine status, who had higher frequency and more recent cocaine use, reported greater symptoms of dysphoria, these cognitive deficits were most pronounced in the CUD with negative urine status. Cigarette smoking, frequency of alcohol consumption, and dysphoria did not alter these results. The current findings replicate a previously reported statistically significant, but relatively mild NP impairment in CUD as compared with matched healthy control individuals and further suggest that frequent/recent cocaine may mask underlying cognitive (but not mood) disturbances. These results call for development of pharmacological agents targeted to enhance cognition, without negatively impacting mood in individuals addicted to cocaine.

Keywords:

cocaine addiction, neuropsychological function, alcohol, dysphoria, cigarette smoking, urine status

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