Sex-dependent differences in the neural correlates of cocaine and
emotional cue-reactivity in regular cocaine users and non-drug using
controls: understanding the role of duration and severity of use
Abstract
Cocaine use disorder (CUD) is becoming more prevalent in females, but
research into sex-dependent neural mechanisms underlying cocaine use is
lacking. Accordingly, the main objective of the current study was to
investigate sex-dependent differences in the neural correlates of
cocaine and emotional cue reactivity within regular cocaine users (CUs)
and non-cocaine-using controls (non-CUs). A cocaine and emotional
cue-reactivity fMRI paradigm was completed by 31 male and 26 female CUs
and 28 male and 26 female non-CUs. A region of interest analysis was
performed to test for sex-specific differences in cocaine and emotional
cue-induce activation of the dorsal striatum (DS), ventral striatum
(VS), amygdala, and dorsal anterior cingulate cortex (dACC). Although
there were no significant sex-dependent differences between CUs and
non-CUs in neural cocaine and emotional cue reactivity, exploratory
analyses demonstrated that the association between cocaine cue-induced
activation of the DS and amygdala and cocaine use severity was
significantly moderated by sex: while this association was positive
female CUs, it was negative in male CUs. Similarly, the relationship
between emotional cue-induced activation of the dACC and VS and years of
regular cocaine use was also moderated by sex: while this association
was negative in female CUs, it was positive in male CUs. While
exploratory, the current findings highlight the importance of taking
into account sex differences when studying the underlying mechanism of
CUD, as this may pave the way for the identification of sex-specific
treatment targets.