Cocaine dependence and attention switching within and between verbal and visuospatial working memory.

Many studies have shown the negative effects of cocaine on neuropsychological and cognitive performance in drug-dependent individuals, but little is known about the underlying neuroanatomy of these dysfunctions. The present study addressed attention switching between items held in working memory (WM) with a task in which subjects were required to store and update two items held in verbal or visuospatial WM. Attention-switching frequency varied between trials, thereby allowing us to isolate the switching component of task performance. Behavioural data revealed that cocaine addicts performed worse than healthy controls in all tasks. On the visuospatial task addicts performed at chance levels revealing particular impairment in visuospatial WM. On the verbal task, in which controls and users could be matched for performance, we identified attenuated responses in prefrontal and cingulate cortices and in striatal regions, while other areas such as dorsolateral prefrontal cortex did not differ between healthy controls and users. The results reveal that addiction may be accompanied by specific rather than ubiquitous hypoactivation in prefrontal and subcortical areas and suggest a compromised ability in users to control their attention to their thoughts as might be particularly relevant when required to switch away from drug-related thoughts, and thus the dysfunction in attention switching may contribute to the maintenance of addiction.