School of Psychology and Psychiatry, Monash University, Clayton, Victoria 3800, Australia.
Neurosci Biobehav Rev. 2010 Nov;35(2):248-75. doi: 10.1016/j.neubiorev.2010.03.001. Epub 2010 Mar 17.
A principal feature of drug addiction is a reduced ability to regulate control over the desire to procure drugs regardless of the risks involved. Traditional models implicated the neural 'reward' system in providing a neurobiological model of addiction. Newer models however, have expanded on this circuitry to include two separate, but interconnecting systems, the limbic system in the incentive sensitization of drugs, and the prefrontal cortex (PFC) in regulating inhibitory control over drug use. Until the recent developments in neuroimaging and brain stimulation techniques, it has been extremely difficult to assess the involvement of the PFC in addiction. In the current review, we explore the involvement of the frontostriatal circuitry in regulating inhibitory control, and suggest how dysregulation of these circuits could be involved in an increased difficulty in ceasing drug use. Following this, we investigate the recent neuropsychological, neuroimaging and brain stimulation studies that explore the presence of these inhibitory deficits, and frontostriatal dysfunctions, across various different substance groups. Further insight into these deficits could contribute to the development of treatment strategies which target these cognitive impairments, and frontostriatal dysfunction, in reducing drug-seeking behaviors.
药物成瘾的一个主要特征是，无论涉及何种风险，个体调节获取药物的欲望的能力都会降低。传统模型表明，神经“奖励”系统为成瘾提供了一种神经生物学模型。然而，更新的模型在此电路的基础上进行了扩展，包括两个独立但相互连接的系统，即边缘系统在药物的激励敏化中的作用，以及前额叶皮层（PFC）在调节对药物使用的抑制性控制中的作用。直到神经影像学和脑刺激技术的最新发展，评估 PFC 在成瘾中的参与程度一直非常困难。在当前的综述中，我们探讨了额纹状体电路在调节抑制性控制中的作用，并提出了这些电路的失调如何参与增加停止药物使用的难度。在此之后，我们研究了最近的神经心理学、神经影像学和脑刺激研究，这些研究探索了不同物质群体中存在的这些抑制缺陷和额纹状体功能障碍。对这些缺陷的进一步了解可能有助于制定治疗策略，针对这些认知缺陷和额纹状体功能障碍，减少觅药行为。
