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Chunk #16 — Responses to drug-related cues — Effect of abstinence, expectation and cognitive interventions

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Dysfunction of the prefrontal cortex in addiction: neuroimaging findings and clinical implications.
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A promising line of research explores behavioural modulation of cue reactivity. For example, a role for the mOFC in the suppression of craving was suggested by findings from a recent PET study in cocaine users. Craving increased after watching a video of cocainerelated cues, and craving levels correlated with glucose metabolism in the medial PFC55. Importantly, when participants were instructed — before watching the video — to inhibit craving, metabolism in the right mOFC decreased, and this was associated with activation of the right inferior frontal gyrus (Brodmann area 44), which is a crucial region in inhibitory control. In treatment-seeking cigarette smokers, the instruction to resist craving while viewing smoking-related videos was associated with DLPFC and ACC activation, although unexpectedly, this activation correlated positively with craving56. A recent study suggests that the direction of the change in activity and correlation with craving may be modulated by the behavioural strategy that is used to suppress craving. In this elegant study, cigarette smokers were instructed to consider the immediate versus long-term consequences of consuming the stimuli depicted in pictures (cigarette-related versus food-related