Dopamine’s Role in Nora D. Volkow, M.D. Director, National Institute on Drug Abuse NIDA NATIONAL INSTITUTE ON DRUG ABUSE NIAAA National Institute Alcohol Abuse and Alcoholism.
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Dopamine’s Role in Nora D. Volkow, M.D. Director, National Institute on Drug Abuse NIDA NATIONAL INSTITUTE ON DRUG ABUSE NIAAA National Institute Alcohol Abuse and Alcoholism frontal cortex AMPHETAMINE 0 VTA/SN % of Basal Release nucleus accumbens % of Basal Release Dopamine Neurotransmission 1100 1000 900 800 700 600 500 400 300 200 100 0 1 2 3 4 Time After Amphetamine 5 hr FOOD 200 150 100 50 0 Empty Box Feeding 0 60 120 180 Time (min) Di Chiara et al. DA DA TYROSINE TYROSINE DOPA DOPA DA DA DA DA DA raclopride R R High (0-10) DA and Drug Reinforcement DA DA DA DA R DA R R methylphenidate DA DA DA DA DA DA R raclopride “High” 10 8 6 4 2 0 -2-10 0 10 20 30 40 Change in Dopamine Bmax/kd (Placebo - MP) DA initiates and maintains responses to salient stimuli such as drugs • The mechanism(s) underlying the intense desire for the drug when addicted subjects are exposed to drug cues (places, people and paraphernalia linked with the drug), is still unknown. • Since DA is involved with reward and with prediction of reward, it could underlie craving Background DA Release NAc In rodents when a neutral stimuli is repeatedly paired with the drug (conditioned), it elicits DA increases. In training the cue was paired with cocaine Auditory cue In training the cue was not paired with cocaine Philipps et al Nature 422, 614-618 1. Subjects Eighteen cocaine abusers Inclusion criteria: – – – – DSM- IV criteria for cocaine dependence active use for at least the prior 6 months free-base or crack at least "four grams" a week Exclusion criteria: – past or present neuro and psychiatric diseases other than cocaine dependence – past or present endocrinological disease – head trauma with loss of consciousness – current medical illness 2. Subjects Gender Age Ethnicity Education Years used Route Dose used Last used Cigarette smokers 17 males, 1 female 43 6 years 15 AA, 3 Caucasians 13 2 years of education 15 7 years 18 smoked cocaine 2.8 1.6 grams a day 2 1.4 days (range 1 & 6 days) 15 current smokers Methods: Videos The neutral video featured non-repeating segments of nature scenes The cocaine-cue video featured non repeating scenes that simulated purchase, preparation, and smoking of cocaine Videos were shown 10 min prior to radiotracer injection for a total of 40 min Self-reports of craving during the neutral and the cocaine-cue video 4.00 3.50 3.00 Before 2.50 5.00 P < 0.01 4.50 4.00 3.50 3.00 2.50 2.00 Before 4.50 2.00 Cocaine-Cue Video Cocaine Craving 5.00 (1-7) Cocaine Craving Neutral Video Cocaine cues increased self reports of cocaine craving in cocaine abusers Source: Volkow, ND et al., Journal of Neuroscience, 26(24):6583-6588, 2006. Relationship between Cue-Induced Decreases in [11C]raclopride Binding and Cocaine Craving 2.5 (Pre - Post) Change in Craving Caudate P < 0.05 Putamen 2.0 2.0 1.5 1.5 1.0 1.0 0.50 0.50 0.0 0.0 -0.50 30 20 10 0 -10 -20 -30 -40 P < 0.002 2.5 -0.50 30 20 10 0 -10 -20 -30 -40 % Change Bmax/Kd Cue-induced increases in DA were associated with craving Source: Volkow, ND et al., Journal of Neuroscience, 26(24):6583-6588, 2006. Craving of Food Why is it that the sight of food can elicit the desire for it even when we are not hungry? Are the responses to cues similar to those that triggered the cocaine in cocaine abusers? Ten healthy food deprived controls (15-18 hours food deprivation) tested under neutral and food cue conditions Neutral: Subjects were asked to describe their family genealogy. Food Cues: The food-cue featured non repeating presentation of favorite foods that had been heated to enhance smell Stimuli were presented 10 min prior to radiotracer injection for a total of 40 min Brain Dopamine Response to Food Stimulation Neutral Food 1.5 10 0 3.5 ml/g p < 0.005 3 Desire for Food (Bmax/Kd) 4 8 6 4 2 0 -2 2.5 Placebo/Neutral MP/Food Source: Volkow, et al., Synapse 2002. 0 5 10 15 20 25 30 % Change Bmax/kd p < 0.01 [11C]Raclopride Binding in Food Deprived Controls During Neutral and Food Cues 1.5 (Bmax/Kd) 4 3.5 p < 0.005 3 Neutral 0 ml/g 2.5 Placebo/Neutral MP/Food Bmax/Kd decreased with exposure to food-cues presumably from DA increases Food Cue Source: Volkow, et al., Synapse 2002. Relationship Between DA Changes and SelfReports of Hunger and Desire for Food Induced by Food Cues 10 8 6 Hunger Desire for Food 10 8 6 4 2 0 -2 4 2 0 -2 0 5 10 15 20 25 30 0 5 10 15 20 25 30 % Change Bmax/kd p < 0.01 Both drug as well as food cues increased DA in dorsal striatum (brain region involved with initiation of action and with learning of habits), suggesting that drugs usurp physiological processes Cue-induced DA increases were associated with craving for drugs as well as for food, which highlights the automated (reflexes) nature of these responses DA activation of DS may underlie the “desire” (wanting) that result in the readiness to engage in the behaviors necessary to procure the desired object whether it’s a drug or food Funded by DOE and NIH F. Telang, R. MacGregor, P. Carter, D. Schlyer, C. Shea, J. Gatley, S. Dewey, C. Redvanly, P. King L. Caligiuri, G-J Wang, M. Franceschi, Y-S Ding, J. Logan, N. Volkow, J. Fowler, R. Ferrieri, C. Wong (not shown) D. Alexoff, C. Felder, N. Pappas, D. Franceschi, N. Netusil, V. Garza, R. Carciello, D. Warner, M. Gerasimov