Luijten Maartje, Machielsen Marise W J, Veltman Dick J, Hester Robert, de Haan Lieuwe, Franken Ingmar H A
Institute of Psychology, Erasmus University Rotterdam, Rotterdam, the Netherlands.
Academic Medical Center, University of Amsterdam, Department of Psychiatry, Early Psychosis Department, Amsterdam, the Netherlands.
J Psychiatry Neurosci. 2014 May;39(3):149-69. doi: 10.1503/jpn.130052.
Several current theories emphasize the role of cognitive control in addiction. The present review evaluates neural deficits in the domains of inhibitory control and error processing in individuals with substance dependence and in those showing excessive addiction-like behaviours. The combined evaluation of event-related potential (ERP) and functional magnetic resonance imaging (fMRI) findings in the present review offers unique information on neural deficits in addicted individuals.
We selected 19 ERP and 22 fMRI studies using stop-signal, go/no-go or Flanker paradigms based on a search of PubMed and Embase.
The most consistent findings in addicted individuals relative to healthy controls were lower N2, error-related negativity and error positivity amplitudes as well as hypoactivation in the anterior cingulate cortex (ACC), inferior frontal gyrus and dorsolateral prefrontal cortex. These neural deficits, however, were not always associated with impaired task performance. With regard to behavioural addictions, some evidence has been found for similar neural deficits; however, studies are scarce and results are not yet conclusive. Differences among the major classes of substances of abuse were identified and involve stronger neural responses to errors in individuals with alcohol dependence versus weaker neural responses to errors in other substance-dependent populations.
Task design and analysis techniques vary across studies, thereby reducing comparability among studies and the potential of clinical use of these measures.
Current addiction theories were supported by identifying consistent abnormalities in prefrontal brain function in individuals with addiction. An integrative model is proposed, suggesting that neural deficits in the dorsal ACC may constitute a hallmark neurocognitive deficit under lying addictive behaviours, such as loss of control.
当前有几种理论强调认知控制在成瘾中的作用。本综述评估了物质依赖个体以及表现出过度成瘾样行为的个体在抑制控制和错误处理方面的神经缺陷。本综述对事件相关电位（ERP）和功能磁共振成像（fMRI）研究结果的综合评估提供了关于成瘾个体神经缺陷的独特信息。
我们通过检索PubMed和Embase，选择了19项使用停止信号、去/不去或侧翼范式的ERP研究以及22项fMRI研究。
与健康对照相比，成瘾个体最一致的发现是N2波、错误相关负波和错误正波的波幅较低，以及前扣带回皮质（ACC）、额下回和背外侧前额叶皮质的激活不足。然而，这些神经缺陷并不总是与任务表现受损相关。关于行为成瘾，已发现一些证据表明存在类似的神经缺陷；然而，研究较少且结果尚无定论。已确定了主要滥用物质类别之间的差异，包括酒精依赖个体对错误有更强的神经反应，而其他物质依赖人群对错误的神经反应较弱。
各研究的任务设计和分析技术各不相同，从而降低了研究之间的可比性以及这些测量方法在临床应用中的潜力。
当前的成瘾理论通过识别成瘾个体前额叶脑功能的一致异常得到了支持。提出了一个综合模型，表明背侧ACC的神经缺陷可能构成成瘾行为（如失控）背后的标志性神经认知缺陷。
