Imaging addiction: D2 receptors and dopamine signaling in the striatum as biomarkers for impulsivity

Dependence to drugs of abuse is closely associated with impulsivity, or the propensity to choose a lower, but immediate, reward over a delayed, but more valuable outcome. Here, we review clinical and preclinical studies showing that striatal dopamine signaling and D2 receptor levels which have been shown to be decreased in addiction directly impact impulsivity, which is itself predictive of drug selfadministration. Based on these studies, we propose that the alterations in Dy receptor binding and dopamine release seen in imaging studies of addiction constitute neurobiological markers of impulsivity. Recent studies in animals also show that higher striatal dopamine signaling at the D2 receptor is associated with a greater willingness to expend effort to reach goals, and we propose that this same relationship applies to humans, particularly with respect to recovery from addiction. (C) 2013 Elsevier Ltd. All rights reserved.