Impulsivity, Neural Deficits, and the Addictions

Adinoff, Bryon; Rilling, Laurie M.; Williams, Mark; Schreffler, Erica; Schepis, Ty S.; Rosvall, Traci; Rao, Uma

doi:10.1300/j069v26s01_04

Cited by 56 publications

(59 citation statements)

References 114 publications

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“…Decision making has been a research target in substance and alcohol misuse disorders (Bechara et al, 2001;Ersche et al, 2008;Rogers et al, 1999b;Rogers and Robbins, 2001), unipolar depression and bipolar disorder (Chandler et al, 2009;Murphy et al, 2001), suicidaility (Dombrovski et al, 2010;Jollant et al, 2005), and impulsive personality disorders (Bazanis et al, 2002;Kirkpatrick et al, 2007). Adjunctive work has explored the idea that impairments in decision making can serve as markers for likely relapse (Adinoff et al, 2007;Bechara et al, 2001) and facilitate the exploration of therapeutic interventions (Rahman et al, 2006;Robbins and Arnsten, 2009). …”

Section: Introductionmentioning

confidence: 99%

The Roles of Dopamine and Serotonin in Decision Making: Evidence from Pharmacological Experiments in Humans

Rogers

2010

Neuropsychopharmacol

192

130

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Neurophysiological experiments in primates, alongside neuropsychological and functional magnetic resonance investigations in humans, have significantly enhanced our understanding of the neural architecture of decision making. In this review, I consider the more limited database of experiments that have investigated how dopamine and serotonin activity influences the choices of human adults. These include those experiments that have involved the administration of drugs to healthy controls, experiments that have tested genotypic influences upon dopamine and serotonin function, and, finally, some of those experiments that have examined the effects of drugs on the decision making of clinical samples. Pharmacological experiments in humans are few in number and face considerable methodological challenges in terms of drug specificity, uncertainties about pre-vs post-synaptic modes of action, and interactions with baseline cognitive performance. However, the available data are broadly consistent with current computational models of dopamine function in decision making and highlight the dissociable roles of dopamine receptor systems in the learning about outcomes that underpins value-based decision making. Moreover, genotypic influences on (interacting) prefrontal and striatal dopamine activity are associated with changes in choice behavior that might be relevant to understanding exploratory behaviors and vulnerability to addictive disorders. Manipulations of serotonin in laboratory tests of decision making in human participants have provided less consistent results, but the information gathered to date indicates a role for serotonin in learning about bad decision outcomes, non-normative aspects of risk-seeking behavior, and social choices involving affiliation and notions of fairness. Finally, I suggest that the role played by serotonin in the regulation of cognitive biases, and representation of context in learning, point toward a role in the cortically mediated cognitive appraisal of reinforcers when selecting between actions, potentially accounting for its influence upon the processing salient aversive outcomes and social choice.

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Section: Introductionmentioning

confidence: 99%

The Roles of Dopamine and Serotonin in Decision Making: Evidence from Pharmacological Experiments in Humans

Rogers

2010

Neuropsychopharmacol

192

130

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“…Adinoff and colleagues 37 concluded that the different behavioural manifestations of impulsivity may correspond to different neurocognitive constructs with specific neuroanatomical correlates. Then, impulsivity should be described not only in terms of phenotypes (as measured by self-report tests) but also from an endophenotypic/neuropsychological point of view.…”

Section: Introductionmentioning

confidence: 99%

Effect of executive functioning, decision-making and self-reported impulsivity on the treatment outcome of pathologic gambling

Álvarez-Moya

Ochoa

Jiménez‐Murcia

et al. 2011

jpn

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Background: Impairments in self-regulatory behaviour reflect a deficit in executive functioning and decision-making, as well as higher levels of self-reported impulsivity, and may be involved in the development and maintenance of addictive disorders. We sought to explore the association between self-reported impulsivity and neurocognitive measures, and their association with treatment outcome in pathologic gambling. Methods: We assessed patients with pathologic gambling using executive functioning and decision -making tests and self-report measures of impulsivity. Patients underwent cognitive-behavioural therapy (CBT) for pathologic gambling. Results: We included 88 patients (8% women) in our study. High self-reported extravagance was associated with poor performance in the Iowa Gambling Task (IGT)-ABCD version. High impulsiveness, low disorderliness, high exploratory excitability (trend), poor backward block span and poor IGT-EFGH scores (trend) predicted dropout. We observed no self-reported or neurocognitive predictors of relapse or number of treatment sessions attended. Limitations: Most participants were slot-machine gamblers seeking treatment. No follow-up data and no control group were included in the study. The missing sample (i.e., individuals who were recruited and assessed in the pretreatment stage but who chose not to begin treatment) had higher extravagance scores than the final sample. Conclusion: Neurocognitive reward sensitivity was related to self-reported overspending behaviour. Self-regulatory impairments (especially rash impulsiveness and punishment sensitivity) and executive dysfunction predicted only dropout of CBT in participants with pathologic gambling. Different neurocognitive processes and personality traits might mediate treatment response to psychological therapy of pathologic gambling according to the specific target variable assessed. Research Paper Effect of executive functioning, decision-making IntroductionImpairments in self-regulatory behaviour seem to be involved in the development and maintenance of pathologic gambling and other addictive disorders.1,2 From a neuropsychological point of view, this impairment reflects a deficit in executive functioning and decision-making. 3,4 Executive functioning includes functions such as cognitive flexibility (set-shifting), which is associated with orbitofrontal functioning, and working memory, planning and abstract thinking, which are associated with dorsolateral prefrontal functioning. [5][6][7] However, decision-making seems to be mainly associated with activation of the ventromedial prefrontal cortex. 5,8 People with pathologic gambling have shown impaired performance in tasks measuring both concepts. Specifically, studies report deficits in cognitive inhibition, complex executive functions and attention. [9][10][11] This population also shows impairments in decision-making.12-14 Decision-making impairments are observed in impulsive individuals in general. Specifically, impulsive individuals show an insensitivity to variations in re...

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“…Striatal (Berlanga et al, 2003;Crespo et al, 2006;Mark et al, 1999) and hippocampal (Imperato et al, 1996;Smith et al, 2004a;Smith et al, 2004b) increases in ACh are associated with the acquisition of cocaine; in rodents, the run time (how fast an animal runs to obtain a contingent stimulus) is inversely correlated to nucleus accumbens (NAc) ACh release during cocaine acquisition (Crespo et al, 2006), NAc ACh neuronal activation is directly correlated with the amount of cocaine self-administered (Berlanga et al, 2003), and cholinergic input into the amygdala has a function in the cognitive processes involved in the learning and memory of drugassociated cues (Schroeder and Packard, 2004;See et al, 2003). Indirect evidence also suggests that the relevance of ACh to attentional (Robbins, 2002;Sarter et al, 2003) and decision-making (Chen et al, 2004;Ragozzino and Choi, 2004) processes may impact the observed deficits that many cocaine-addicted subjects show in these neurocognitive domains (Adinoff et al, 2007;Horner et al, 1996;Jovanovski et al, 2005). Substance-induced alterations in cholinergic systems, therefore, could reasonably be expected to alter both reward and cognitive systems relevant to the addictive process (Williams and Adinoff, 2008).…”

Section: Introductionmentioning

confidence: 99%

Altered Neural Cholinergic Receptor Systems in Cocaine-Addicted Subjects

Adinoff

Devous

Williams

et al. 2010

Neuropsychopharmacol

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Changes in the brain's cholinergic receptor systems underlie several neuropsychiatric disorders, including Alzheimer's disease, schizophrenia, and depression. An emerging preclinical literature also reveals that acetylcoholine may have an important function in addictive processes, including reward, learning, and memory. This study was designed to assess alterations in cholinergic receptor systems in limbic regions of abstinent cocaine-addicted subjects compared with healthy controls. On three separate days, 23 1-to 6-week abstinent, cocaine-(and mostly nicotine-) addicted subjects and 22 sex-, age-, and race-matched control subjects were administered the muscarinic and nicotinic cholinergic agonist physostigmine, the muscarinic antagonist scopolamine, and saline. Regional cerebral blood flow (rCBF) after each infusion was determined using single photon emission-computed tomography. Both cholinergic probes induced rCBF changes (po0.005) in relatively distinct, cholinergic-rich, limbic brain regions. After physostigmine, cocaine-addicted subjects showed altered rCBF, relative to controls, in limbic regions, including the left hippocampus, left amygdala, and right insula. Group differences in the right dorsolateral prefrontal cortex, posterior cingulate, and middle temporal gyrus were also evident. Scopolamine also revealed group differences in the left hippocampus and right insula as well as the posterior cingulate and middle temporal gyrus. Cocaine addicted and controls differ in their subcortical, limbic, and cortical response to cholinergic probes in areas relevant to craving, learning, and memory. Cholinergic systems may offer a pharmacologic target for cocaine addiction treatment.

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Impulsivity, Neural Deficits, and the Addictions

Cited by 56 publications

References 114 publications

The Roles of Dopamine and Serotonin in Decision Making: Evidence from Pharmacological Experiments in Humans

The Roles of Dopamine and Serotonin in Decision Making: Evidence from Pharmacological Experiments in Humans

Effect of executive functioning, decision-making and self-reported impulsivity on the treatment outcome of pathologic gambling

Altered Neural Cholinergic Receptor Systems in Cocaine-Addicted Subjects

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