While the centrality of withdrawal in the diagnosis of addiction has been decreasing with each successive edition of the Diagnostic and Statistical Manual of Mental Disorders, psychometric and neurobiological evidence provides withdrawal a central role in the development and maintenance of addiction. The current study offers insight into these conflicting positions by using secondary analyses to assess how a history of DSM-assessed withdrawal influences the magnitude of bias in neural reactivity to drug- and/or food-related reward cues. To this end, we separated an existing sample of cocaine-dependent participants (Denomme et al., 2018) into those with (WD) and without (N-WD) a history of withdrawal, and compared food- and drug-cue reactivity between these groups, and to a non-dependent control group (ND). Analyses indicated that biases in neural reactivity towards drug- versus food-related cues only occurred among the WD participants (within: left dorsomedial prefrontal cortex, left anterior cingulate cortex, left orbitofrontal cortex, left caudate nucleus, and right ventrolateral prefrontal cortex). Thus, withdrawal status may be an important factor to consider when interpreting dependence-related biases in neural reactivity following reward-related cues. Interestingly, while N-WD participants did not show these broad biases in neural reactivity, the magnitude of their bias correlated positively with years of lifetime substance use history, particularly when psychopathic traits were low. It may be that for individuals who's addiction has not yet reached a compulsive state (see Wise and Koob, 2014), the magnitude of their drug > food bias could serve as a valuable biomarker of addiction severity.

中文翻译：

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戒断史调节可卡因依赖参与者的药物和食物提示反应性。

尽管戒断在成瘾诊断中的重要性随着《精神障碍诊断和统计手册》的每期后续版本而降低，但心理和神经生物学证据提供了戒断在成瘾发展和维持中的重要作用。本研究通过使用二级分析来评估DSM评估的戒断史如何影响与药物和/或食物相关的奖励线索的神经反应的偏倚程度，从而提供了对这些矛盾立场的洞见。为此，我们将现有的可卡因依赖参与者（Denomme et al。，2018）样本分为有（WD）和无（N-WD）戒断史的参与者，并比较了两者之间的食物和药物提示反应性这些组，以及非依赖性对照组（ND）。分析表明，仅在WD参与者中发生了对药物或食物相关线索的神经反应性偏见（在内部：左背前额叶皮层，左前扣带回皮层，左眶额叶皮层，左尾状核和右前外侧前额叶皮层）。因此，在解释与奖励有关的线索后，在解释神经反应性中与依赖性有关的偏见时，戒断状态可能是要考虑的重要因素。有趣的是，尽管N-WD参与者在神经反应性上没有表现出这些广泛的偏见，但他们的偏倚程度与终生使用药物的年限呈正相关，特别是当精神病性状低时。可能是对于成瘾者尚未达到强迫状态的个人（请参阅Wise和Koob，2014年），其药物的数量>