Definition of Substance and Non-substance Addiction.

Substance addiction (or drug addiction) is a neuropsychiatric disorder characterized by a recurring desire to continue taking the drug despite harmful consequences. Non-substance addiction (or behavioral addiction) covers pathological gambling, food addiction, internet addiction, and mobile phone addiction. Their definition is similar to drug addiction but they differ from each other in specific domains. This review aims to provide a brief overview of past and current definitions of substance and non-substance addiction, and also touches on the topic of diagnosing drug addiction and non-drug addiction, ultimately aiming to further the understanding of the key concepts needed for a foundation to study the biological and psychological underpinnings of addiction disorders.

Effects of psychoeducation combined with transcranial direct current stimulation on reducing cigarette craving and consumption in male smokers.

Psychoeducation (PE) has been widely used in smoking interventions, but its long-term effects are limited. Recent studies have reported that, in some fields, a combination of transcranial direct current stimulation (tDCS) and cognitive training (e.g., working memory tasks) may improve cognitive outcomes; thus, we aimed to investigate whether such a combined intervention has a better effect than a PE intervention for reducing smoking cravings and cigarette consumption. In Exp. 1, 19 male smokers received four types of interventions at one-week intervals. In each session, participants were presented with audio PE (or control) while receiving 2-mA active (or sham) tDCS of the dorsolateral prefrontal cortex (DLPFC). In Exp. 2, 48 male smokers were randomized into four experimental groups (PE + Active, Control + Active, PE + Sham, or Control + Sham). Each participant received one type of five-day intervention (i.e., watching a five-minute PE/Control video twice while receiving 2-mA active/sham tDCS) and was followed up for one week. The results showed (a) an enhancement effect of tDCS on PE's ability to reduce cigarette consumption; (b) that repeated PE has a cumulative effect on reducing both craving and cigarette consumption during the intervention period; and (c) that, compared with PE alone, PE combined with tDCS is capable of helping participants maintain a low intake of cigarettes over one week. These findings suggest that repeated interventions of PE combined with tDCS may be effective in reducing smoking consumption and that further studies are warranted to confirm its application.

Preliminary Study of a Modular MR-Compatible Robot for Image-Guided Insertion of Multiple Needles.

Percutaneous needle-based interventions such as transperineal prostate brachytherapy require the accurate placement of multiple needles to treat cancerous lesions within the target organ. To guide needle placement, magnetic resonance imaging (MRI) offers excellent visualization of the target lesion without the need for ionizing radiation. To date, multi-needle insertion relies on a grid template, which limits the ability to steer individual needles. This work describes an MR-compatible robot designed for the sequential insertion of multiple non-parallel needles under MR guidance. The 6-DOF system is designed with an articulated arm to extend the reach of the robot. This strategy presents a novel approach enabling the robot to maneuver around existing needles while minimizing the footprint of the robot. Forward kinematics as well as optimization-based inverse kinematics are presented. The impact of the robot on image quality was tested for four sequences (T1w-TSE, T2w-TSE, THRIVE and EPI) on a 3T Philips Achieva system. Quantification of the signal-to-noise ratio showed a 46% signal loss in a gelatin phantom when the system was powered on but no further adverse effects when the robot was moving. Joint level testing showed a maximum error of 2.10 ± 0.72°s for revolute joints and 0.31 ± 0.60 mm for prismatic joints. The theoretical workspace spans the proposed clinical target surface of 10 x 10 cm. Lastly, the feasibility of multi-needle insertion was demonstrated with four needles inserted under real-time MR-guidance with no visible loss in image quality.

Impaired directed forgetting in abstinent heroin addicts.

Drug-related memories persist long into abstinence and are potent elicitors of drug craving and relapse. We report two experiments examining whether heroin-dependent individuals are impaired in intentionally suppressing drug-related memories. Experiment 1 adopted the Item paradigm where addicts and healthy controls were presented with a list of words each followed by a remember or forget cue. Experiment 2 adopted the List paradigm where they studied one list of items and were then split into a remember group and a forget group. Both groups studied a second list, except that the forget group was told to forget the first list. Compared with controls, addicts showed a reduced directed forgetting effect in the Item method and a total absence of one measure of directed forgetting in the List method (List 2 benefits). Results indicate that heroin addicts are impaired in directed forgetting and that the deficits are likely associated with memory encoding as opposed to retrieval. Possible problems include reduced ability in actively suppressing/stopping encoding of irrelevant information into memory or inability in changing/resetting encoding strategies. In neither experiment did the addicts show any differential directed forgetting effects between drug-related words and neutral words, indicating the generic nature of their intentional forgetting deficits.

A Meta-Analysis of Transcranial Direct Current Stimulation on Substance and Food Craving: What Effect Do Modulators Have?

Substance addiction and food addiction are significant social problems worldwide. In previous studies of substance addiction, transcranial direct current stimulation (tDCS) has been used to influence craving of substance or food. However, the reported effects are not always consistent due to inconsistent experimental settings. The way modulators influence the effect of tDCS on substance addiction is worth exploring. This meta-analysis was conducted to estimate the effect size of tDCS on substance and food craving and to investigate the influence of potential modulators. We systemically identified and reviewed studies on substance/food craving using tDCS that were published between January 2008 to January 2020. A total of 32 eligible studies were identified. Hedges' g was computed as an indicator of the effect of tDCS and some potential moderators (substance type, stimulation sites, current intensities, number of sessions, duration of stimulation, and study design) were examined using subgroup analysis. Random effects analysis revealed a total medium effect size [Hedges' g = 0.536, 95% confidence interval (CI): 0.389-0.683, after adjusting Hedges' g = 0.416, 95% CI: 0.262-0.570] preferring active over sham stimulation to reduce craving. A significant difference was observed between the number of sessions (repeated stimulation was better than single stimulation). The duration of stimulation may have a positive influence on the effects of tDCS. No other significant differences were found in other subgroups analysis. In conclusion, our results provided evidence that tDCS can be an effective way to reduce craving of substance or food, and longer multiple stimulus durations in all can more effectively reduce craving; however, the influences of modulators still need be to be examined in depth in future.

Multislice left ventricular ejection fraction prediction from cardiac MRIs without segmentation using shared SptDenNet.

We propose a spatiotemporal model for cardiac magnetic resonance images (MRI) named SptDenNet. The proposed model is based on DenseNet and extracts spatial and temporal features simultaneously to exploit three-dimensional information on the heart over the cardiac loop cycle. To balance the model performance and efficiency, we construct a shared end-to-end framework, in which all frames of each selected short-axis (SAX) view slices are input to SptDenNet individually to extract spatiotemporal features. Then, the extracted features of all selected SAX view slices of a patient are concatenated and input to the subsequent fully connected layer and then a softmax layer to predict the left ventricular ejection fraction directly. To address the problem of class imbalance, we use FocalLoss function by reshaping the standard cross-entropy loss such that it down-weights the loss assigned to well-classified samples. We validate our proposed framework on the Second Annual Data Science Bowl dataset. Our prediction for the left ventricular ejection fraction obtains results comparable with state-of-the-art end-to-end approaches but without segmentation. The average mean absolute error of the ejection fraction is 6.84. To further verify the effectiveness of the proposed framework, we use 4-chamber view images from the same dataset to predict the cardiac function; we obtain an accuracy of 86.07%. Our approach constructs an end-to-end model to predict the ejection fraction automatically without using image segmentation, which helps reduce manual work. Moreover, the proposed approach is computationally efficient.

Negative Impact of Sadness on Response Inhibition in Females: An Explicit Emotional Stop Signal Task fMRI Study.

Response inhibition is a critical cognitive ability underlying executive control over reactions to external cues, or inner requirements. Previous studies suggest that high arousal negative emotions (e.g., anger or fear) could impair response inhibition in implicit emotional stop signal tasks (eSSTs). However, studies exploring how low arousal negative emotions (e.g., sadness) influence response inhibition remain sparse. In the current study, 20 female college students performed an explicit eSST to explore the influence of sadness on response inhibition and its neural mechanism. Participants are instructed to press a button to sad or neutral facial stimuli while inhibiting their response during the presentation of a stop signal. Results showed that compared with neutral stimuli, sad stimuli were related to increased stop signal reaction time (SSRT) (i.e., worse response inhibition). Compared with neutral condition, higher activation during sad condition was found within the right superior frontal gyrus (SFG), right insula, right middle cingulate cortex (MCC), bilateral superior temporal gyrus (STG), left lingual gyrus, and right motor cortex. These findings indicated that sadness, like other negative emotions, may impair response inhibition in an explicit way and highlight the explicit eSST as a new paradigm to investigate the subtle interaction between negative emotion processing and cognitive control.

Altered brain network organization in romantic love as measured with resting-state fMRI and graph theory.

Romantic love is a complex state that has been seen as similar to addiction. Previous task-based functional magnetic resonance imaging (fMRI) studies have shown that being in love is closely associated with functional brain changes in the reward and motivation system. However, romantic love-related functional connectivity network organization in resting-state fMRI has yet to be elucidated. To that end, here we used resting-state fMRI and graph theory to compare whole-brain functional network topology between an "in-love" group (n = 34, 16 females, currently in love and in a romantic relationship) and a "single" group (n = 32, 14 females, never in love and not in a romantic relationship). Compared to the single group, we found lower network segregation in the love group (i.e., lower small-worldness, mean clustering coefficient, and modularity), and these metrics were negatively associated with scores on the Passionate Love Scale (PLS) (an index of intense passionate/romantic love). Additionally, the love group displayed altered connectivity degree (reflecting the importance of a node): decreased degree in left angular gyrus and left medial orbitofrontal cortex, but increased degree in left fusiform gyrus. Furthermore, local efficiency or degree of these regions was significantly correlated to PLS scores. Taken together, results showed decreased overall brain functional segregation but enhanced emotional-social processing in romantic lovers. These findings provide the first evidence of love-related brain network organization changes and suggest similar but different brain network alterations between romantic love and addiction, providing new insights on the neural systems underlying romantic love.

Gray matter density negatively correlates with duration of heroin use in young lifetime heroin-dependent individuals.

Numerous studies have documented cognitive impairments and hypoactivity in the prefrontal and anterior cingulate cortices in drug users. However, the relationships between opiate dependence and brain structure changes in heroin users are largely unknown. In the present study, we measured the density of gray matter (DGM) with voxel-based morphometry in 30 lifetime heroin-dependent individuals who had abstained from drug use for 5 months, and 34 healthy participants. The DGM of the prefrontal, temporal and cingulate cortices significantly decreased in heroin addicts relative to the healthy group. Critically, partial correlation analysis, which controlled for age, education and gender factors as well as nicotine use and heroin abstinence duration, showed that the duration of heroin use negatively correlated with the DGM in heroin-dependent individuals. These results provide compelling evidence for structural abnormality in heroin-dependent individuals and further suggest that duration of heroin use is a critical factor leading to brain damage.

Cognition, emotion and reward networks associated with sex differences for romantic appraisals.

Romantic love is a cross-culturally universal phenomenon that serves as a commitment device for motivating pair bonding in human beings. Women and men may experience different feelings when viewing the same warm, romantic scenes. To determine which brain systems may be involved in romance perception and examine possible sex differences, we scanned 16 women and 16 men who were intensely in love, using functional MRI. Participants were required to rate the romance level of 60 pictures showing romantic events that may frequently occur during romantic relationship formation. The results showed that greater brain activation was found for men in the insula, PCC (posterior cingulate cortex), and prefrontal gyrus compared with women, primarily under the High-romance condition. In addition, enhanced functional connectivity between the brain regions involved in the High-romance condition in contrast to the Low-romance condition was only found for men. These data suggest that men and women differ in the processing of romantic information and that it may be  more effortful for men to perceive and evaluate romance degree.

The influence of emotional interference on cognitive control: A meta-analysis of neuroimaging studies using the emotional Stroop task.

The neural correlates underlying the influence of emotional interference on cognitive control remain a topic of discussion. Here, we assessed 16 neuroimaging studies that used an emotional Stroop task and that reported a significant interaction effect between emotion (stimulus type) and cognitive conflict. There were a total of 330 participants, equaling 132 foci for an activation likelihood estimation (ALE) analysis. Results revealed consistent brain activation patterns related to emotionally-salient stimuli (as compared to emotionally-neutral trials) during cognitive conflict trials [incongruent trials (with task-irrelevant information interfering), versus congruent/baseline trials (less disturbance from task-irrelevant information)], that span the lateral prefrontal cortex (dorsolateral prefrontal cortex and inferior frontal gyrus), the medial prefrontal cortex, and the dorsal anterior cingulate cortex. Comparing mild emotional interference trials (without semantic conflict) versus intense emotional interference trials (with semantic conflict), revealed that while concurrent activation in similar brain regions as mentioned above was found for intense emotional interference trials, activation for mild emotional interference trials was only found in the precentral/postcentral gyrus. These data provide evidence for the potential neural mechanisms underlying emotional interference on cognitive control, and further elucidate an important distinction in brain activation patterns for different levels of emotional conflict across emotional Stroop tasks.

Aerobic Exercise As a Potential Way to Improve Self-Control after Ego-Depletion in Healthy Female College Students.

PURPOSE: To test whether aerobic exercise can help build self-control stamina in healthy female young adults. Stamina in this context is defined as the capability to endure ego depletion, which can be measured with a self-control task following another activity also requiring self-control. METHODS: Forty-five healthy undergraduate women were randomized to either an experimental group or control group. Participants in the experimental group were required to run in their campus running field for 30 min for a period of 5 weeks. Individuals in the control group were required to do diary entries regarding self-control in their daily lives, also for a period of 5 weeks. Before and after the 5-week intervention, participants completed a pain threshold test, a color word Stroop task and the following Cold Pressor Task (CPT) (with and without a distraction component). RESULTS: There was significant decrease of pain tolerance in session 2 relative to session 1 in the control group, but no such decline was found in the experimental group (though the improvement of pain tolerance was not significant), possibly suggesting successful self-control against this kind of decline. CONCLUSIONS: Five weeks of aerobic exercise increased self-control after ego depletion in terms of pain tolerance. These findings suggest that aerobic exercise may serve as a potential effective intervention for enhancing self-control in a college female population.

Romantic Love vs. Drug Addiction May Inspire a New Treatment for Addiction.

Drug addiction is a complex neurological dysfunction induced by recurring drug intoxication. Strategies to prevent and treat drug addiction constitute a topic of research interest. Early-stage romantic love is characterized by some characteristics of addiction, which gradually disappear as the love relationship progresses. Therefore, comparison of the concordance and discordance between romantic love and drug addiction may elucidate potential treatments for addiction. This focused review uses the evidences from our recent studies to compare the neural alterations between romantic love and drug addiction, moreover we also compare the behavioral and neurochemical alterations between romantic love and drug addiction. From the behavioral comparisons we find that there are many similarities between the early stage of romantic love and drug addiction, and this stage romantic love is considered as a behavioral addiction, while significant differences exist between the later stage of romantic love and drug addiction, and this stage of romantic love eventually developed into a prosocial behavior. The neuroimaging comparisons suggest that romantic love and drug addiction both display the functional enhancement in reward and emotion regulation network. Except the similar neural changes, romantic love display special function enhancement in social cognition network, while drug addiction display special dysfunction in cognitive control network. The neurochemical comparisons show that there are many similarities in the dopamine (DA) system, while significant differences in oxytocin (OT) system for romantic love and drug addiction. These findings indicate that the functional alterations in reward and emotion regulation network and the DA system may be the neurophysiological basis of romantic love as a behavioral addiction, and the functional alterations in social cognition network and the OT system may be the neurophysiological basis of romantic love as a prosocial behavior. It seems that the OT system is a critical factor for the development of addiction. So we then discuss strategies to treat drug addiction with OT, and suggest that future research should further investigate OT system interventions aiming to improve cognitive control and/or social cognition functions, in order to develop strategies designed to more effectively treat drug addiction.

Romantic Love Is Associated with Enhanced Inhibitory Control in an Emotional Stop-Signal Task.

Purpose: This study explored whether romantic lovers differ in emotion-related inhibitory control capacity from those who are single. Methods: 88 healthy undergraduate college students participated in the study. Half were currently in love and in a romantic relationship (love group, LG), and half were single and had never been in a romantic relationship (single group, SG). Based on duration of romantic relationship (i.e., love duration), the LG were further divided into two subgroups: "early stage love" and "longer periods of love". All participants completed an emotional Stop Signal Task, consisting of a variety of human face stimuli displaying either sad or neutral affect. Results: Results found that relative to SG, lovers showed greater inhibitory control [shorter stop-signal reaction time (SSRT)] during negative emotion condition trials. Furthermore, in early stages of love, SSRT for negative emotion condition trials was significantly shorter compared to that in "longer periods of love" or SG individuals, with no significant differences between the two latter groups. Conclusion: Compared with individuals who were single, early stage lovers showed greater capacity for inhibiting action during presentation of negative emotional stimuli. Within a greater social context, greater inhibitory control capacity during early stages of love may be related to the successful formation of romantic relationships, particularly to the ability to persevere in goal-directed action despite negative emotional contexts such as that of sadness.

Altered Gray Matter Volume and White Matter Integrity in College Students with Mobile Phone Dependence.

Mobile phone dependence (MPD) is a behavioral addiction that has become an increasing public mental health issue. While previous research has explored some of the factors that may predict MPD, the underlying neural mechanisms of MPD have not been investigated yet. The current study aimed to explore the microstructural variations associated with MPD as measured with functional Magnetic Resonance Imaging (fMRI). Gray matter volume (GMV) and white matter (WM) integrity [four indices: fractional anisotropy (FA); mean diffusivity (MD); axial diffusivity (AD); and radial diffusivity (RD)] were calculated via voxel-based morphometry (VBM) and tract-based spatial statistics (TBSS) analysis, respectively. Sixty-eight college students (42 female) were enrolled and separated into two groups [MPD group, N = 34; control group (CG), N = 34] based on Mobile Phone Addiction Index (MPAI) scale score. Trait impulsivity was also measured using the Barratt Impulsiveness Scale (BIS-11). In light of underlying trait impulsivity, results revealed decreased GMV in the MPD group relative to controls in regions such as the right superior frontal gyrus (sFG), right inferior frontal gyrus (iFG), and bilateral thalamus (Thal). In the MPD group, GMV in the above mentioned regions was negatively correlated with scores on the MPAI. Results also showed significantly less FA and AD measures of WM integrity in the MPD group relative to controls in bilateral hippocampal cingulum bundle fibers (CgH). Additionally, in the MPD group, FA of the CgH was also negatively correlated with scores on the MPAI. These findings provide the first morphological evidence of altered brain structure with mobile phone overuse, and may help to better understand the neural mechanisms of MPD in relation to other behavioral and substance addiction disorders.

Love-related changes in the brain: a resting-state functional magnetic resonance imaging study.

Romantic love is a motivational state associated with a desire to enter or maintain a close relationship with a specific other person. Functional magnetic resonance imaging (fMRI) studies have found activation increases in brain regions involved in the processing of reward, motivation and emotion regulation, when romantic lovers view photographs of their partners. However, not much is known about whether romantic love affects the brain's functional architecture during rest. In the present study, resting state functional magnetic resonance imaging (rsfMRI) data was collected to compare the regional homogeneity (ReHo) and functional connectivity (FC) across an "in-love" group (LG, N = 34, currently intensely in love), an "ended-love" group (ELG, N = 34, ended romantic relationship recently), and a "single" group (SG, N = 32, never fallen in love). Results show that: (1) ReHo of the left dorsal anterior cingulate cortex (dACC) was significantly increased in the LG (in comparison to the ELG and the SG); (2) ReHo of the left dACC was positively correlated with length of time in love in the LG, and negatively correlated with the lovelorn duration since breakup in the ELG; (3) FC within the reward, motivation, and emotion regulation network (dACC, insula, caudate, amygdala, and nucleus accumbens) as well as FC in the social cognition network [temporo-parietal junction (TPJ), posterior cingulate cortex (PCC), medial prefrontal cortex (MPFC), inferior parietal, precuneus, and temporal lobe] was significantly increased in the LG (in comparison to the ELG and SG); (4) in most regions within both networks FC was positively correlated with the duration of love in the LG but negatively correlated with the lovelorn duration of time since breakup in the ELG. This study provides first empirical evidence of love-related alterations in brain functional architecture. Furthermore, the results shed light on the underlying neural mechanisms of romantic love, and demonstrate the possibility of applying a resting-state fMRI approach for investigating romantic love.

Gender differences in perception of romance in Chinese college students.

Women often complain that their partners are not romantic enough. This raises the question: how romance is recognized and evaluated in a love relationship? However, there has been essentially no empirical research bearing on this issue. The present set of studies examined possible gender differences in perceptions of romance and the associated neural mechanisms in Chinese college students. In Study 1, 303 participants (198 women, 105 men) were administrated a questionnaire consisting of 60 sentences and required to rate the romance level of each sentence. Results showed higher rating scores in males than females for low romance items, but not for high or medium romance items. In Study 2, 69 participants (37 women, 32 men) were recruited to judge the degree of romance in sentences presented on a computer screen one by one. Compared with females, males again showed higher scores and responded more slowly only to low romance items. In Study 3, 36 participants (18 women, 18 men) currently in love with someone were scanned with functional MRI while they did the romance judgment task from Study 2. Compared with females, greater brain activation was found for males in the frontal lobe, precentral gyrus, precuneus and parahippocampal gyrus for low romance items. The results provide the first piece of evidence for gender differences in romance perception, suggesting enhanced cognitive processing in males when evaluating the degree of romance in romantic scenes.