Our Research

At the Neuropsychoimaging of Addiction and Related Conditions (NARC) Research Program at Mount Sinai, our research team explores the human brain functions as they relate to drug addiction. Our research helps us learn how to improve the lives of people with addictions.  

Our current studies include:

Mindfulness-Oriented Recovery Enhancement for Treatment of Heroin Use Disorder

Relevant Publications:

Sex Differences in the Neural Correlates Underlying Cocaine and Heroin Addiction

Relevant Publications:

Transcranial Direct Current Stimulation (tDCS) for Treatment of Cocaine Use Disorder

Relevant Publications:

Imaging Atherosclerosis in Drug Addiction

Relevant Publications

Targeting Neural, Behavioral, and Pharmacological Mechanisms of Drug Memories with Methylphenidate

Salient memories of the drug use contribute to craving and relapse even after long periods of abstinence. Traditional cue-exposure therapies aimed at extinguishing these memories have not been effective at preventing relapse, warranting the development of alternative strategies. The goal of this project is to identify a pharmacologically enhanced learning and memory approach that aims to decrease craving and relapse in drug addiction. Here, we target the mechanisms underlying memory reconsolidation, a time-dependent process in which specific consolidated memories may become amenable to change (e.g., memory disruption). We will enhance this behavioral approach pharmacologically in individuals with cocaine use disorder (iCUD), using methylphenidate (MPH, a dopamine agonist) as a cognitive enhancer to promote learning-induced neural plasticity in iCUD. In a placebo-controlled design, we will psychophysiologically measure memory modification via functional magnetic resonance imaging and skin conductance responses following MPH, with a follow-up the following day, permitting the assessment of drug-cue memory disruption and effects on craving. Results from this project could ultimately be used to develop effective cue-exposure therapies to reduce cue-induced craving and relapse.

This work is funded by NIDA 1R21DA054281-01.
Clinical trial ID: NCT05978167

Relevant publications:

Neurofeedback During Naturalistic Stimuli to Reduce Craving in Heroin Addiction

Support groups are an important component of addiction treatment, where individuals at more stable stages of their recovery help others by sharing personal experiences. This phenomenon suggests that the brain states of individuals further along in their recovery process may be useful in guiding those who are at an earlier stage. In this project, we will test this idea and develop a personalized therapeutic tool based on real-time fMRI neurofeedback, whereby individuals with heroin use disorder (iHUD) early in treatment will learn to modulate their own brain state to more closely align with iHUD who are at later stages of treatment.  Specifically, iHUD exhibit heightened reactivity to naturalistic drug cues in brain networks underlying salience attribution, reward processing, executive function and others.  This fMRI brain hyperactivity pattern is reduced, concomitant with craving reductions, with about 3 months of inpatient treatment. In this neurofeedback project, iHUD who are beginning treatment will view naturalistic drug cues and receive feedback about how similar their brain activity is to the target recovery pattern, learning to modulate their own brain activity to reduce drug cue reactivity and craving.  This study will offer insights into the mechanisms of recovery in addiction, particularly as coordinated across individuals with shared experience and goals.  If successful, the neurofeedback-based training may lead to new brain-based and personalized tools for recovery in this devastating disorder.

This work is funded by NIDA R21DA058801-01.

Craving Incubation and Cognitive Reappraisal in Cocaine Addiction

Among the many addictions, cocaine addiction is particularly treatment-resistant, with estimated relapse rates greater than 45%. While most abstaining individuals with cocaine use disorders (iCUD) relapse within the first few weeks and months of abstinence, relapse continues to occur long after acute withdrawal has abated. Re-exposure to cues previously associated with drug use that evoke intense craving and associated brain reactivity that can be psychophysiologically measured (i.e., cue-induced craving) is a major contributing factor in relapse to drug use. Studies show cue-induced craving to increase with time into abstinence before decreasing, an incubation of craving that renders abstaining iCUD vulnerable to relapse. Using electroencephalography, we tracked attention to salient stimuli including drug-cues in initially abstaining iCUD, with longitudinal results replicating cross-sectional ones in demonstrating this dynamic vulnerability factor. In the current longitudinal project, performed at carefully selected abstinence durations, we will test whether this drug cue reactivity, and incubation of craving itself, can be suppressed with cognitive reappraisal of salient drug cues, a prefrontal cortex-mediated emotion regulation strategy. We will also explore whether the expected reductions in incubation of cue-reactivity track treatment response and predict clinical outcomes at 6 months follow-up. The ultimate goal is to improve clinical outcomes (e.g., reduce craving and prolong cocaine abstinence duration during the first 6 months of abstinence in iCUD).

This work is funded by NIDA R01DA041528-02 and R01DA058039-01A1.  

Relevant publication:

Diagnostic and prognostic biomarkers for subtypes of addictions-related circuit dysfunction

In collaboration with Conor Liston, MD, PhD, of Weil Cornell, we are using a recently developed and validated approach to discovering and diagnosing subtypes of SUD using functional magnetic resonance imaging (fMRI) measures of functional connectivity. In a secondary data analysis, we are leveraging multiple deeply characterized and large-scale neuroimaging datasets. Our central hypothesis is that individual differences in mechanisms underlying iRISA are mediated by distinct forms of dysfunctional connectivity in addiction-related circuits, which in turn interact and give rise to distinct neurophysiological addiction subtypes. Here we are using statistical clustering and machine-learning methods to delineate these subtypes and optimize classifiers (fMRI biomarkers) for diagnosing them in individual patients, focusing initially on cocaine addiction. Then, we validate these subtype-specific biomarkers by first replicating them in a new dataset and then evaluating their longitudinal stability and predictive utility. Finally, we will test whether subtype-specific circuit mechanisms generalize to mediate iRISA functions in other forms of addiction, and define their interactions with distinct mechanisms mediating anhedonia and anxious arousal in patients with comorbid depression and anxiety.

This work is funded by NIDA R01 DA047851-01A1.