Assessing Glutamate Homeostasis in Cocaine Addiction Using 7T 1H-MRS

Yale University, New Haven CT

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Abstract

Project Summary Relapse remains a critical unmet challenge in the treatment of cocaine addiction. While many will succeed in initiating abstinence, the vast majority of cocaine abusers will experience multiple relapses over the course of their illness, and many will fail to achieve an enduring drug-free existence. Thus, the current lack of medications for reducing relapse risk remains a major gap in the clinical management of cocaine dependence. A large body of basic research points to glutamate (GLU) as playing a central role in the neural adaptations to and reinstatement of repeated cocaine administration. In particular, preclinical work by Kalivas and colleagues has advanced a compelling model whereby dysregulated subcortical (i.e., nucleus accumbens or NAcc) GLU transmission accounts for the vulnerability to reinstated drug seeking in animals. The relevance of this GLU homeostasis hypothesis [14] for CD humans remains largely untested, however, due to the lack of clinical- translational tools capable of measuring GLU levels in the ventral striatum (VS) in humans. Innovations in high-field (7 Tesla), proton magnetic resonance spectroscopy (1H-MRS) by members of our research group now suggest the feasibility of obtaining direct measures of brain GLU in human VS. Thus, the current Exploratory/Developmental R21 application seeks to adapt and apply these advances to the development of a robust, practical, cost-effective, and objective biomarker of dysregulated GLU homeostasis in humans, one that can directly and efficiently inform the evaluation of candidate medications for CD patients. If achieved, the current study would set the stage for future prospective, controlled, biomarker-guided evaluations of candidate pharmacotherapies targeted at restoring GLU homeostasis on both a population, and even personalized medicine basis.