Social Context and Drug Cues Modulate Inhibitory Control in Cocaine Addiction: involvement of the STN evidenced through Functional Magnetic Resonance Imaging

Abstract Background Addictions often develop in a social context, although the influence of social factors did not receive much attention in the neuroscience of addiction. Recent animal studies suggest that peer presence can reduce cocaine intake, an influence potentially mediated, among others, by the subthalamic nucleus (STN). However, there is to date no such neurobiological study in humans. Methods This study investigated the impact of social context and drug cues on brain correlates of inhibitory control in individuals with and without cocaine use disorder (CUD) using functional Magnetic Resonance Imaging (fMRI). Seventeen CUD participants and 17 healthy controls (HC) performed a novel fMRI Stop-Signal task in the presence and absence of an observer while being exposed to cocaine-related and neutral pictures as cues. Results The results showed that CUD participants, while slower at stopping with neutral cues, recovered control level stopping abilities with cocaine cues, while HC did not show any difference. Neuroimaging revealed the involvement of frontal cortical regions and of the subthalamic nucleus (STN) in inhibitory control, which was modulated by both social context and drug cues in CUD participants but not in HC. Conclusions These findings highlight the impact of social context and drug cues on inhibitory control in CUD and suggest potential targets for intervention such as the STN, also emphasizing the importance of considering the social context in addiction research and treatment