Preliminary evidence of inhibitory and error-related neural alterations associated with early relapse in cocaine use disorder: A retrospective Go/No-Go ERP study

Introduction Cocaine Use Disorder (CUD) is associated with impairments in inhibitory control and error-monitoring, two neurocognitive mechanisms strongly linked to relapse. Characterizing how these processes differ at treatment entry between patients who later remain abstinent versus those who relapse may help clarify the neurophysiological factors associated with early recovery. Methods Thirty-one CUD patients undergoing a 15-day inpatient detoxification program were included and classified as abstainers (n = 16) or relapsers (n = 15) based on drug-use reports one month after discharge. Participants completed an EEG Go/No-Go task approximately 4 to 7 days after admission, once acute withdrawal symptoms had subsided. Inhibitory (N2d, P3d) and error-related (ERN, Pe) ERP components were extracted. Multivariate analyses controlled for psychotropic medication status. Results No behavioral differences were observed between groups. However, abstainers showed larger P3d and ERN amplitudes, reduced N2d and Pe amplitudes, and longer P3d latencies than relapsers. This profile suggests more efficient inhibitory processing and sharper early error monitoring in abstainers, while relapsers exhibited attenuated error detection and greater reliance on later evaluative processes. Conclusion The findings indicate that CUD patients differ markedly in their inhibitory and error-monitoring neural responses already at treatment entry. ERP measures may therefore constitute clinically relevant indicators of cognitive functioning in early detoxification and could support more individualized therapeutic strategies.