Metacognitive impairment in active cocaine use disorder is associated with individual differences in brain structure

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• 作者：Scott J. Moeller^a ; ; Stephen M. Fleming^b ; Gabriela Gan^a ; Anna Zilverstand^a ; Pias Malaker^a ; Federico d׳Oleire Uquillas^a ; Kristin E. Schneider^a ; Rebecca N. Preston-Campbell^a ; Muhammad A. Parvaz^a ; Thomas Maloney^a ; Nelly Alia-Klein^a ; Rita Z. Goldstein^a ;
• 关键词：Drug addiction ; Metacognition ; Self-awareness ; Anterior cingulate cortex ; Voxel-based morphometry ; Magnetic resonance imaging
• 刊名：European Neuropsychopharmacology
• 出版年：2016
• 出版时间：April 2016
• 年：2016
• 卷：26
• 期：4
• 页码：653-662
• 全文大小：1637 K

文摘

Dysfunctional self-awareness has been posited as a key feature of drug addiction, contributing to compromised control over addictive behaviors. In the present investigation, we showed that, compared with healthy controls (n=13) and even individuals with remitted cocaine use disorder (n=14), individuals with active cocaine use disorder (n=8) exhibited deficits in basic metacognition, defined as a weaker link between objective performance and self-reported confidence of performance on a visuo-perceptual accuracy task. This metacognitive deficit was accompanied by gray matter volume decreases, also most pronounced in individuals with active cocaine use disorder, in the rostral anterior cingulate cortex, a region necessary for this function in health. Our results thus provide a direct unbiased measurement – not relying on long-term memory or multifaceted choice behavior – of metacognition deficits in drug addiction, which are further mapped onto structural deficits in a brain region that subserves metacognitive accuracy in health and self-awareness in drug addiction. Impairments of metacognition could provide a basic mechanism underlying the higher-order self-awareness deficits in addiction, particularly among recent, active users.