Functional Domains of Substance Use and Trauma: A Systematic Review of Neuroimaging Studies

Abstract

In a framework for substance use concerning trauma, Hien and colleagues suggested three domains: reward salience, executive function, and negative emotionality. In this PRISMA-guided systematic review, we explored the neural correlates of these domains in individuals who use substances with or without trauma exposure. We included 45 studies utilizing tasks of interest in alcohol, tobacco, and cannabis use groups. Greater reward, lesser regulation of inhibitory processes, and mixed findings of negative emotionality processes in individuals who use substances versus controls were found. Specifically, greater orbitofrontal cortex, ventral tegmental area, striatum, amygdala, and hippocampal activation was found in response to reward-related tasks, and reduced activation was found in the inferior frontal gyrus and hippocampus in response to inhibition-related tasks. No studies in trauma-exposed individuals met our review criteria. Future studies examining the role of trauma-related factors are needed and should explore inhibition- and negative-emotionality domains in individuals who use substances to uncover alterations in these domains that place an individual at greater risk for developing SUD.