Gola Mateusz, Wordecha Małgorzata, Sescousse Guillaume, Lew-Starowicz Michał, Kossowski Bartosz, Wypych Marek, Makeig Scott, Potenza Marc N, Marchewka Artur
Swartz Center for Computational Neuroscience, Institute for Neural Computations, University of California San Diego, San Diego, CA, USA.
Clinical Neuroscience Laboratory, Institute of Psychology, Polish Academy of Sciences, Warsaw, Poland.
Neuropsychopharmacology. 2017 Sep;42(10):2021-2031. doi: 10.1038/npp.2017.78. Epub 2017 Apr 14.
Pornography consumption is highly prevalent, particularly among young adult males. For some individuals, problematic pornography use (PPU) is a reason for seeking treatment. Despite the pervasiveness of pornography, PPU appears under-investigated, including with respect to the underlying neural mechanisms. Using functional magnetic resonance imaging (fMRI), we examined ventral striatal responses to erotic and monetary stimuli, disentangling cue-related 'wanting' from reward-related 'liking' among 28 heterosexual males seeking treatment for PPU and 24 heterosexual males without PPU. Subjects engaged in an incentive delay task in the scanner, in which they received erotic or monetary rewards preceded by predictive cues. Blood-oxygen-level-dependent responses to erotic and monetary cues were analyzed and examined with respect to self-reported data on sexual activity collected over the 2 preceding months. Men with and without PPU differed in their striatal responses to cues predicting erotic pictures but not in their responses to erotic pictures. PPU subjects when compared with control subjects showed increased activation of ventral striatum specifically for cues predicting erotic pictures but not for cues predicting monetary gains. Relative sensitivity to cues predicting erotic pictures vs monetary gains was significantly related to the increased behavioral motivation to view erotic images (suggestive of higher 'wanting'), severity of PPU, amount of pornography use per week, and number of weekly masturbations. Our findings suggest that, similar to what is observed in substance and gambling addictions, the neural and behavioral mechanisms associated with the anticipatory processing of cues specifically predicting erotic rewards relate importantly to clinically relevant features of PPU. These findings suggest that PPU may represent a behavioral addiction and that interventions helpful in targeting behavioral and substance addictions warrant consideration for adaptation and use in helping men with PPU.
色情内容消费非常普遍，尤其是在年轻成年男性中。对一些人来说，问题性色情使用（PPU）是寻求治疗的一个原因。尽管色情内容无处不在，但PPU似乎研究不足，包括其潜在的神经机制方面。我们使用功能磁共振成像（fMRI），研究了28名因PPU寻求治疗的异性恋男性和24名无PPU的异性恋男性腹侧纹状体对色情和金钱刺激的反应，区分了与线索相关的“渴望”和与奖励相关的“喜好”。受试者在扫描仪中进行了一项激励延迟任务，在该任务中，他们在有预测线索的情况下接受色情或金钱奖励。分析了对色情和金钱线索的血氧水平依赖性反应，并结合前两个月收集的关于性活动的自我报告数据进行了研究。有PPU和无PPU的男性在纹状体对预测色情图片的线索的反应上存在差异，但对色情图片的反应没有差异。与对照组相比，PPU受试者的腹侧纹状体对预测色情图片的线索有增强的激活，但对预测金钱收益的线索没有增强的激活。对预测色情图片与金钱收益的线索的相对敏感性与观看色情图像的行为动机增加（暗示更高的“渴望”）、PPU的严重程度、每周使用色情内容的量以及每周手淫的次数显著相关。我们的研究结果表明，与物质成瘾和赌博成瘾中观察到的情况类似，与专门预测色情奖励的线索的预期处理相关的神经和行为机制与PPU的临床相关特征密切相关。这些发现表明，PPU可能代表一种行为成瘾，有助于针对行为和物质成瘾的干预措施值得考虑进行调整并用于帮助患有PPU的男性。
