The neurobiology of reward and cognitive control systems and their role in incentivizing health behavior

Impulsivity as a vulnerability factor for poor addiction treatment outcomes: A review of neurocognitive findings among individuals with substance use disorders

“…However, whereas previous review articles have focused on the relationship between neurocognitive impairment, cognitive rehabilitation and addiction treatment outcomes (Bates et al, 2013) and on the neurobiology of cognitive control/reward processes and their role in recovery (Garavan & Weierstall, 2012), none of these studies were systematic reviews nor focused specifically on the role of impulsivity.…”

“…Growing recognition of the centrality of neurocognitive impairments related to impulsivity in addiction should bring with it more attempts to examine the effects of these deficits on treatment outcomes, as this may result in an increased emphasis on top-down and bottom-up rehabilitation (Bates, Buckman, & Nguyen, 2013;Garavan & Weierstall, 2012). Indeed, different from the chronicity of memory loss in Alzheimer or motor dysfunction in Parkinson disease, aspects of impulsive action and impulsive choice are amenable to treatment and may -at least partially -recover by targeting top-down and bottom-up processes (Alfonso, Caracuel, Delgado-Pastor, & Verdejo-García, 2011;Bickel, Yi, Landes, Hill, & Baxter, 2011).…”

“…Indeed, different from the chronicity of memory loss in Alzheimer or motor dysfunction in Parkinson disease, aspects of impulsive action and impulsive choice are amenable to treatment and may -at least partially -recover by targeting top-down and bottom-up processes (Alfonso, Caracuel, Delgado-Pastor, & Verdejo-García, 2011;Bickel, Yi, Landes, Hill, & Baxter, 2011). In fact, heightened prefrontally-mediated cognitive control over subcortical bottom-up processes is increasingly being recognized as a key characteristic of successful abstinence (Garavan & Weierstall, 2012). Corroborating this notion, addiction treatment services with documented efficacy routinely employ therapeutic paradigms that (indirectly) target aspects of prefrontal cortical and/or bottom-up functioning.…”

Asociación diferencial entre el metabolismo regional de la corteza prefrontal y las estructuras límbicas y el tiempo de abstinencia en individuos dependientes de sustancias

“…Una hiperactivación o normalización del metabolismo cerebral en esta región que coincide con el papel de esta estructura en el control inhibitorio necesario para mantener la abstinencia (Connolly et al, 2012;Garavan y Weierstall, 2012;Volkow et al, 2010). En este sentido, la corteza frontal inferior ha sido consistentemente asociada con el control de la conducta (Aron, Fletcher, Bullmore, Sahakian y Robbins, 2003;Aron, Monsell, Sahakian y Robbins, 2004;Aron et al, 2007;Barrós-Loscertales et al, 2011;Garavan, Kaufman y Hester, 2008) y aunque la mayoría de los estudios de neuroimagen cerebral se han centrado en el papel de la corteza frontal inferior derecha, recientemente se ha demostrado que la parte izquierda también juega un papel fundamental en este proceso neuropsicológico (Connolly et al, 2012;Swick, Ashley y Turken, 2008).…”

“…La mayoría de los estudios que se han llevado a cabo en el campo de las adicciones se han centrado en la etiología del trastorno y en los cambios producidos a nivel cerebral como resultado del consumo de las diferentes drogas y sólo recientemente algunos investigadores han empezado a estudiar las áreas implicadas en el mantenimiento de la abstinencia o en la recuperación del paciente drogodependiente (Connolly, Foxe, Nierenberg, Shpaner y Garavan, 2012;Garavan y Weierstall, 2012).…”