Neural correlates of hot and cold executive functions in polysubstance addiction: association between neuropsychological performance and resting brain metabolism as measured by positron emission tomography.

The study of substance-abuse-related neuropsychological deficits and brain alterations may provide a better understanding of the neuroadaptations associated with addiction. In this study we investigated the association between performance on neuropsychological tests of cold and hot executive functions and regional brain metabolism. Measured with positron emission tomography (PET), in a sample of 49 substance-dependent individuals (SDI). Neuropsychological performance in the SDI group was compared to that of a non-drug-using control group of 30 participants, and associated with two sets of PET-derived dependent measures: one based on regions of interest (examining mean uptake in selected regions), and a second based on voxel uptake measures (using Statistical Parametric Mapping voxel-based whole-brain analyses). Behavioral analyses showed that SDI had poorer performance than controls across executive function and emotion processing measures. Regression models showed that SDI's performance in "cold" executive tests (i.e., updating, inhibition and flexibility) was associated with regional metabolism in the dorsolateral prefrontal cortex (DLPFC), mid-superior frontal gyrus, superior and inferior temporal gyrus and inferior parietal cortex, whereas performance in "hot" executive functions (i.e., self-regulation, decision-making and emotion perception) was associated with DLPFC, mid-superior frontal gyrus, anterior and mid-posterior cingulate, and temporal and fusiform gyrus. These results are discussed in terms of their relevance for the understanding of cognitive dysfunction and neuroadaptations linked to addiction.