Goldstein RZ, Volkow ND. Dysfunction of the prefrontal cortex in addiction: neuroimaging findings and clinical implications. Nat Rev Neurosci 12: 652-669

Medical Department, Brookhaven National Laboratory, Upton, New York 11973, USA.
Nature Reviews Neuroscience (Impact Factor: 31.43). 11/2011; 12(11):652-69. DOI: 10.1038/nrn3119
Source: PubMed

ABSTRACT The loss of control over drug intake that occurs in addiction was initially believed to result from disruption of subcortical reward circuits. However, imaging studies in addictive behaviours have identified a key involvement of the prefrontal cortex (PFC) both through its regulation of limbic reward regions and its involvement in higher-order executive function (for example, self-control, salience attribution and awareness). This Review focuses on functional neuroimaging studies conducted in the past decade that have expanded our understanding of the involvement of the PFC in drug addiction. Disruption of the PFC in addiction underlies not only compulsive drug taking but also accounts for the disadvantageous behaviours that are associated with addiction and the erosion of free will.

27 Reads
  • Source
    • "Substantially weakened PFC function could, in turn, further disinhibit limbic-striatal responses especially under challenging situations, including stress and exposure to alcohol-related cues. In addition, given the crucial role of the PFC in inhibitory control and decisionmaking (Bechara 2005; Goldstein and Volkow 2011), altered PFC function could result in an inability to inhibit compulsive alcohol seeking and poor decisionmaking when confronted with the choice to return to drinking and continued alcohol use despite negative consequences, thereby aggravating the relapse cycle. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Chronic alcohol-related neuroadaptations in key neural circuits of emotional and cognitive control play a critical role in the development of, and recovery from, alcoholism. Converging evidence in the neurobiological literature indicates that neuroplastic changes in the prefrontal-striatal-limbic circuit, which governs emotion regulation and decisionmaking and controls physiological responses in the autonomic nervous system and hypothalamic-pituitary-adrenal axis system, contribute to chronic alcoholism and also are significant predictors of relapse and recovery. This paper reviews recent evidence on the neuroplasticity associated with alcoholism in humans, including acute and chronic effects, and how these neurobiological adaptations contribute to alcohol recovery, along with the discussion of relevant clinical implications and future research directions.
    Alcohol research : current reviews 09/2015; 37(1):143-152.
  • Source
    • "The prefrontal cortex is highly developed in humans and primates and critical to the executive functions of brain, including decision making (Euston et al., 2012), learning and memory (Rugg et al., 1996; Tomita et al., 1999), social behavior (Avale et al., 2011; Forbes and Grafman, 2010) and emotional regulation (Davidson and Irwin, 1999; Kennis et al., 2013). Prefrontal cortical dysfunction has been implicated in a number of neuropsychiatric disorders, including drug addiction (Goldstein and Volkow, 2011). "
    [Show abstract] [Hide abstract]
    ABSTRACT: The precise mechanisms by which cocaine and amphetamine-like psychostimulants exert their reinforcing effects are not yet fully defined. It is widely believed, however, that these drugs produce their effects by enhancing dopamine neurotransmission in the brain, especially in limbic areas such as the nucleus accumbens, by inducing dopamine transporter-mediated reverse transport and/or blocking dopamine reuptake though the dopamine transporter. Here, we present the evidence that aside from dopamine transporter, non-dopamine transporter-mediated mechanisms also participate in psychostimulant-induced dopamine release and contribute to the behavioral effects of these drugs, such as locomotor activation and reward. Accordingly, psychostimulants could increase norepinephrine release in the prefrontal cortex, the latter then alters the firing pattern of dopamine neurons resulting in changes in action potential-dependent dopamine release. These alterations would further affect the temporal pattern of dopamine release in the nucleus accumbens, thereby modifying information processing in that area. Hence, a synaptic input to a nucleus accumbens neuron may be enhanced or inhibited by dopamine depending on its temporal relationship to dopamine release. Specific temporal patterns of dopamine release may also be required for certain forms of synaptic plasticity in the nucleus accumbens. Together, these effects induced by psychostimulants, mediated through a non-dopamine transporter-mediated mechanism involving norepinephrine and the prefrontal cortex, may also contribute importantly to the reinforcing properties of these drugs. Copyright © 2015. Published by Elsevier B.V.
    European Journal of Pharmacology 07/2015; 764. DOI:10.1016/j.ejphar.2015.07.044 · 2.53 Impact Factor
  • Source
    • "It has further been suggested that reductions in inhibitory control may be greater when individuals with IGD are confronted with gaming-related cues (Brand et al., 2014; Liu et al., 2014). Impairments in both inhibitory control and decision-making processes have similarly been reported among individuals with substance addictions (Bechara, 2005; Goldstein and Volkow, 2011; Verdejo-Garcia et al., 2010). In addition, existing data suggest that impairments in inhibitory control processes may be related to impairments in decision-making among individuals with substance and behavioral addictions, including individuals with alcohol dependence (Noël et al., 2007), heavy drinking adolescents (Field et al., 2007), patients with opiate dependence (Brand et al., 2008), and pathological gamblers (Ochoa et al., 2013). "
    [Show abstract] [Hide abstract]
    ABSTRACT: A growing body of evidence indicates that both inhibition and decision-making deficits play essential roles in the development and maintenance of Internet gaming disorder (IGD). Clarifying whether impaired decision-making among individuals with IGD is related to poor inhibition will advance our understanding of IGD and contribute to intervention development. However, the relationship between these two functions remains unclear. In this study, we sought to systemically examine inhibitory processes, decision-making and the relationship between the two among individuals with IGD. Thirty-four individuals with IGD and 32 matched healthy controls (HCs) were recruited. In comparison to HCs, IGD subjects demonstrated inhibition deficits during performance of the gaming-related Go/No-Go task and impaired decision-making under risk. In addition, errors on No-Go trials during the gaming-related Go/No-Go task were positively associated with decision-making impairments under risk but not under ambiguity among IGD subjects. These results suggest individuals with IGD are impaired in some aspects of inhibition and decision-making functions, and that decision-making deficits under risk are linked to poor inhibition specifically related to gaming cues, which has implications for the development of novel intervention. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
    07/2015; 229(1-2):302-309. DOI:10.1016/j.psychres.2015.07.004
Show more

Preview (2 Sources)

27 Reads
Available from