Psychopharmacology (2003) 170:205–212 DOI 10.1007/s00213-003-1542-7 ORIGINAL INVESTIGATION Ingmar H. A. Franken · Cornelis J. Stam · Vincent M. Hendriks · Wim van den Brink Neurophysiological evidence for abnormal cognitive processing of drug cues in heroin dependence Received: 14 February 2003 / Accepted: 22 May 2003 / Published online: 25 July 2003  Springer-Verlag 2003 Abstract Rationale: Recent studies provide evidence for specific aspects of cue processing in addictive disorders. Objective: The present study employs event related potentials (ERPs) to investigate heroin related visual information processing Methods: Neutral and heroin related pictures were presented to 19 male abstinent heroin dependent patients and 14 male healthy controls. Results: Patients exhibited larger slow positive wave (SPW) components of the ERP on heroin related pictures than on neutral pictures. Within healthy control subjects there was no difference on the SPW between neutral and heroin pictures. Within heroin dependent patients, mean SPW response to heroin pictures was correlated with post- experiment craving. Conclusion: This study provides neurophysiological evidence that information processing of drug-related information is abnormal in heroin depen- dent patients. The results provide further evidence for the cognitive and neurobiological accounts of substance dependence such as the incentive-sensitization theory. Keywords Craving · Emotion · Evoked potentials · Heroin dependence Introduction Recently, it has become clear that substance dependence is associated with a cognitive processing bias of drug related information. This bias reflects the dependent persons’ preoccupation with drugs, one of the striking features of addiction (APA 1994). Drug related stimuli become especially salient stimuli, stimuli that grab attention, that become especially attractive and wanted (Robinson and Berridge 2000). Several studies indicate that individuals with heroin, cocaine, nicotine, and/or alcohol dependence process drug related stimuli in an abnormal way (Franken et al. 2000a, 2000b; Waters and Feyerabend 2000; Pothos and Cox 2002). Using atten- tional tasks such as the Emotional Stroop task (Williams et al. 1996), these studies show that addicted individuals exhibit an excessive attentional focusing on drug-related cues: attentional bias. For example, heroin dependent patients process heroin related cues selectively, that is, more attentional resources are directed towards heroin cues compared to neutral cues (Franken et al. 2000b). Most studies, but not all (Stormark et al. 1997), show that attentional bias is directed toward drug-related cues (Franken 2003). Furthermore, it has been found that attentional bias for drugs and drug-related stimuli is related to the experience of drug craving (Franken et al. 2000a; Franken et al. 2000b) and may be regarded as a cognitive component of craving. Craving is another hallmark of addiction and is, at least partly, responsible for relapse in drug use after a period of abstinence (McKay 1999). In previous studies, attentional bias has been demon- strated using paradigms that employ behavioral measures (reaction time) as an index of these cognitive biases. However, event-related potentials (ERPs) of the electro- encephalogram (EEG) offer a more direct measure to study information processing and cognitive biases. Com- pared to behavioral measures, the advantage of ERP measurement is that it includes information about the location of cognitive responses in the brain, although this information is rather limited compared to other measures I. H. A. Franken ( ) ) Institute of Psychology, Erasmus University, Woudestein J5-43, PO Box 1738, 3000 DR Rotterdam, The Netherlands e-mail: franken@fsw.eur.nl Tel.: +31-10-4089563 Fax: +31-10-4089009 C. J. Stam Department of Clinical Neurophysiology, VU University Medical Centre, Amsterdam, The Netherlands I. H. A. Franken · V. M. Hendriks Parnassia Addiction Research Centre, Rotterdam, The Netherlands W. van den Brink Amsterdam Institute for Addiction Research and Department of Psychiatry, Academic Medical Center, Amsterdam, The Netherlands