Neural activity related to anger in cocaine-dependent men: A possible linkto violence and relapse

This study examined the neural correlates of cue-induced anger in cocaine-d ependent men in an initial investigation of possible neurobiological explan ations for the putative association between cocaine addiction and violence. We used positron emission tomography (PET) to localize alterations in regi onal cerebral blood flow (rCBF) during mental imagery of a personal anger-a ssociated scene and of an emotionally neutral scene in ten cocaine-dependen t men. Compared to the emotionally neutral imagery control condition, anger was associated with marked decreases in rCBF in multiple areas of the fron tal cortex (particularly the right inferior frontal gyrus), left posterior insula, left fusiform gyrus, and midbrain. Conversely, this same inferior f rontal area was activated by anger imagery in nicotine-dependent men. Anger was also associated with increases in rCBF in the right fusiform gyrus, ri ght and left middle occipital gyri, left postcentral gyrus, left medial fro ntal gyrus, left cuneus, and in the left anterior cingulate gyrus. The stud y showed that cue-induced anger in cocaine-dependent men was associated wit h decreased activity in frontal cortical areas involved in response monitor ing and inhibition. The lack of this association in nicotine-dependent men suggests a possible deficit in anger regulation associated with cocaine dep endence and a possible link between cocaine dependence, violence, and relap se.