期刊
NEUROPHARMACOLOGY
卷 56, 期 -, 页码 48-62出版社
PERGAMON-ELSEVIER SCIENCE LTD
DOI: 10.1016/j.neuropharm.2008.07.035
关键词
Decision-making; Addiction; Somatic states; Craving; Ventromedial prefrontal cortex; Amygdala; Insula; Dopamine; Serotonin
资金
- National Institute on Drug Abuse (NIDA) [DAI1779, DA12487, DA16708]
- MCYT [BS0200307169]
- Spanish Ministry of Education and Science [SEJ2006-08278/PSIC]
- NATIONAL INSTITUTE ON DRUG ABUSE [R21DA016708, R01DA011779, R01DA012487] Funding Source: NIH RePORTER
Similar to patients with ventromedial prefrontal cortex (VMPC) lesions, substance abusers show altered decision-making, characterized by a tendency to choose the immediate reward, at the expense of negative future consequences. The somatic marker model proposes that decision-making depends on neural substrates that regulate homeostasis, emotion and feeling. According to this model, there should be a link between alterations in processing emotions in substance abusers, and their impairments in decision-making. Growing evidence from neuroscientific studies indicate that core aspects of addiction may be explained in terms of abnormal emotional/homeostatic guidance of decision-making. Behavioral studies have revealed emotional processing and decision-making deficits in substance abusers. Neuroimaging studies have shown that altered decision-making in addiction is associated with abnormal functioning of a distributed neural network critical for the processing of emotional information, and the experience of craving, including the VMPC, the amygdala, the striatum, the anterior cingulate cortex, and the insular/somato-sensory cortices, as well as non-specific neurotransmitter systems that modulate activities of neural processes involved in decision-making. The aim of this paper is to review this growing evidence, and to examine the extent to which these studies Support a somatic marker theory of addiction. We conclude that there are at least two underlying types of dysfunction where emotional signals (somatic markers) turn in favor of immediate outcomes in addiction: (1) a hyperactivity in the amygdala or impulsive system, which exaggerates the rewarding impact of available incentives, and (2) hypoactivity in the prefrontal cortex or reflective system, which forecasts the long-term consequences of a given action. (c) 2008 Elsevier Ltd. All rights reserved.
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