Childhood Adversity Neurocognitions in Substance Use Disorder

Early life adversity is strongly correlated with a number of negative life outcomes, including increased risk for development of a substance use disorders (SUDs) and other mental health disorders. Persons with childhood trauma, overall, have lower intellectual, memory, and executive functioning, as well as lower academic achievement. This is also found in persons with SUDs. It has been hypothesized that cognitive impairment and other early neurocognitive changes caused by early life adversity produce a specific vulnerability to later development of SUDs. Brain-derived neurotrophic factor (BDNF) is a neurochemical that is essential for neuronal development, neurogenesis, and cognitive function. BDNF levels have been found to be abnormal in patients with PTSD and mood disorders and has been hypothesized to be a mechanism by which the cognitive disruption symptoms of those disorders operate. BDNF levels have also been found to be altered in substance abuse animal models and patient populations and to affect levels of drug craving and withdrawal. Because of its role in neurogenesis and cognitive functioning, BDNF may be a mechanism by which early life adversity causes people to be more vulnerable to addiction. This study will investigate the possible BDNF--cognitive impairment--substance abuse pathway by measuring serum BDNF levels (proBDNF and mature BDNF) and cognitive performance in patients who are undergoing residential treatment for substance abuse. Measurements will be taken at entry into the program (post-detoxification), at 4 weeks, and at 8 weeks. Repeated measurement is important due to the spontaneous improvement that can occur during early abstinence. Changes in cognitive functioning and BDNF levels will be assessed. It is expected that level of early life adversity will moderate the level of improvement, with higher number of adverse events leading to lower levels of brain recovery.

It is anticipated that this pilot study will contribute to the understanding of the causal mechanisms by which childhood adversity leads to persistent negative life outcomes. Because BDNF levels are known to be malleable, primarily through diet, exercise, and cognitive stimulation, a number of possible avenues for treatment and prevention of adversity-related cognitive changes could be explored, including targeted cognitive rehabilitation, nutrition, and physical activity interventions, with the long-term goal of improving general health outcomes and reducing rates of substance abuse.