Elsevier

Biological Psychiatry

Volume 73, Issue 8, 15 April 2013, Pages 782-788
Biological Psychiatry

Archival Report
Error-Related Brain Activity Predicts Cocaine Use After Treatment at 3-Month Follow-up

https://doi.org/10.1016/j.biopsych.2012.12.016Get rights and content

Background

Relapse after treatment is one of the most important problems in drug dependency. Several studies suggest that lack of cognitive control is one of the causes of relapse. In this study, a relative new electrophysiologic index of cognitive control, the error-related negativity, is investigated to examine its suitability as a predictor of relapse.

Methods

The error-related negativity was measured in 57 cocaine-dependent patients during their first week in detoxification treatment. Data from 49 participants were used to predict cocaine use at 3-month follow-up. Cocaine use at follow-up was measured by means of self-reported days of cocaine use in the last month verified by urine screening.

Results

A multiple hierarchical regression model was used to examine the predictive value of the error-related negativity while controlling for addiction severity and self-reported craving in the week before treatment. The error-related negativity was the only significant predictor in the model and added 7.4% of explained variance to the control variables, resulting in a total of 33.4% explained variance in the prediction of days of cocaine use at follow-up.

Conclusions

A reduced error-related negativity measured during the first week of treatment was associated with more days of cocaine use at 3-month follow-up. Moreover, the error-related negativity was a stronger predictor of recent cocaine use than addiction severity and craving. These results suggest that underactive error-related brain activity might help to identify patients who are at risk of relapse as early as in the first week of detoxification treatment.

Section snippets

Participants

Fifty-seven cocaine-dependent patients were recruited from an addiction treatment center (Bouman GGZ) in Rotterdam, The Netherlands. Inclusion criteria were 1) age between 18 and 65 years, 2) presence of the DSM-IV diagnosis for cocaine dependence (assessed by both a physician and a research psychologist), and 3) the ability to speak, read, and write in Dutch at an eighth-grade literacy level. Exclusion criteria were 1) indications of severe psychopathology (i.e., psychosis, severe mood

Results

First, we confirmed that the cocaine-dependent patients in the current sample have a reduced ERN compared with nondependent control subjects (F1,70 = 10.03, p<.01; Figure 1), which is similar to the results of Franken and colleagues (28). Results on the behavioral measures of the flanker task are reported in Supplement 1.

Second, recent cocaine use was directly associated with total years of cocaine use, cocaine use in the 30 days before treatment, craving in the week before treatment, and the

Discussion

The current study is one of the few to link basic neurocognitive control processes directly with clinical outcome. It is the first to examine error-related brain activity as a predictor of cocaine use after treatment. In line with our hypothesis, the results showed that a reduced ERN in cocaine-dependent patients in treatment is associated with later cocaine use. The ERN seems a robust predictor of cocaine use after treatment, even when controlling for other predictors such as addiction

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