We investigated anticipatory and consummatory reward processing in cocaine addiction. In addition, we set out to assess whether task-monitoring systems were appropriately recalibrated in light of variable reward schedules. We also examined neural measures of task-monitoring and reward processing as a function of hedonic tone, since anhedonia is a vulnerability marker for addiction that is obviously germane in the context of reward processing.
High-density event-related potentials were recorded while participants performed a speeded response task that systematically varied anticipated probabilities of reward receipt. The paradigm dissociated feedback regarding task success (or failure) from feedback regarding the value of reward (or loss), so that task-monitoring and reward processing could be examined in partial isolation. Twenty-three active cocaine abusers and 23 age-matched healthy controls participated.
Cocaine abusers showed amplified anticipatory responses to reward predictive cues, but crucially, these responses were not as strongly modulated by reward probability as in controls. Cocaine users also showed blunted responses to feedback about task success or failure and did not use this information to update predictions about reward. In turn, they showed clearly blunted responses to reward feedback. In controls and users, measures of anhedonia were associated with reward motivation. In cocaine users, anhedonia was also associated with diminished monitoring and reward feedback responses.
Findings imply that reward anticipation and monitoring deficiencies in addiction are associated with increased responsiveness to reward cues but impaired ability to predict reward in light of task contingencies, compounded by deficits in responding to actual reward outcomes.
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We thank the Albert Einstein Division of Substance Abuse, Dr. Julia Arnsten, Dr. Sarah Church, Juan Martinez, Amy Greengrass, Marsha Dommel, and all of the staff at the Next Steps Addiction Treatment Centers in the Bronx for all of their help in recruitment efforts. The work would simply not have been possible without the dedication of these individuals. We would also like to express our sincere gratitude to the participants for giving their time to this effort. Additionally, we thank Dr. Ryan Bell, Ms. Sarah Ruberman, and Mr. Frantzy Acluche for their help during data collection. Participants in this study were recruited and evaluated at The Human Clinical Phenotyping Core, a facility of the Rose F. Kennedy Intellectual and Developmental Disabilities Research Center (IDDRC) which is funded through a center grant from the Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD P30 HD071593). Dr. Morie is now at the Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA.
All participants signed an informed consent document administered by HIPAA-certified staff. All procedures were approved by the Institutional Review Board of the Albert Einstein College of Medicine. The study conformed to the principles outlined in the Declaration of Helsinki.
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The authors declare that they have no competing interests.
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Morie, K.P., De Sanctis, P., Garavan, H. et al. Regulating task-monitoring systems in response to variable reward contingencies and outcomes in cocaine addicts. Psychopharmacology 233, 1105–1118 (2016). https://doi.org/10.1007/s00213-015-4191-8
- Task monitoring
- Substance abuse