%0 Journal Article %T Doubling down: increased risk-taking behavior following a loss by individuals with cocaine use disorder is associated with striatal and anterior cingulate dysfunction %J Biological psychiatry: cognitive neuroscience and neuroimaging %D 2017 %A Gowin, Joshua L. %A May, April C. %A Wittmann, Marc %A Tapert, Susan F. %A Paulus, Martin P. %V 2 %N 1 %P 94-103 %X BACKGROUND: Cocaine use disorders (CUDs) have been associated with increased risk-taking behavior. Neuroimaging studies have suggested that altered activity in reward and decision-making circuitry may underlie cocaine user's heightened risk-taking. It remains unclear if this behavior is driven by greater reward salience, lack of appreciation of danger, or another deficit in risk-related processing.

METHODS: Twenty-nine CUD participants and forty healthy comparison participants completed the Risky Gains Task during a functional magnetic resonance imaging scan. During the Risky Gains Task, participants choose between a safe option for a small, guaranteed monetary reward and risky options with larger rewards but also the chance to lose money. Frequency of risky choice overall and following a win versus a loss were compared. Neural activity during the decision and outcome phase were examined using linear mixed effects models.

RESULTS: Although the groups did not differ in overall risk-taking frequency, the CUD group chose a risky option more often following a loss. Neuroimaging analyses revealed that the comparison group showed increasing activity in the bilateral ventral striatum as they chose higher-value, risky options, but the CUD group failed to show this increase. During the outcome phase, the CUD group showed a greater decrease in bilateral striatal activity relative to the comparison group when losing the large amount, and this response was correlated with risk-taking frequency after a loss.

CONCLUSIONS: The brains of CUD individuals are hypersensitive to losses, leading to increased risk-taking behaviors, and this may help explain why these individuals take drugs despite aversive outcomes.

Language: en

%G en %I Elsevier Publishing %@ 2451-9030 %U http://dx.doi.org/10.1016/j.bpsc.2016.02.002