LoFaro Francesca M, Gueguen Maëlle C M, Kapoor Ananya, Alvarez Emmanuel E, Bonagura Darla, Konova Anna B
Department of Psychiatry, University Behavioral Health Care, & the Brain Health Institute, Rutgers University, Piscataway, New Jersey 08854.
Laureate Institute for Brain Research, Tulsa, Oklahoma 74136.
J Neurosci. 2025 Oct 15;45(42):e0679252025. doi: 10.1523/JNEUROSCI.0679-25.2025.
Addiction, particularly opioid use disorder (OUD), is often characterized by heightened propensity for risk-taking. While tolerance for risk and uncertainty varies across individuals, the elevated risk-taking in people with OUD is assumed to stem from altered cognitive decision-making processes beyond differences due to idiosyncratic yet lawful tolerances. Specifically, the prevailing assumption is that people with addiction exhibit impairments in the internal representation and integration of information that should guide decisions and judgments about what is valuable. Using model-based functional magnetic resonance imaging, we examined how the choice behavior of treatment-engaged male and female participants with chronic OUD aligns with the neural encoding of their inferred subjective value (SV) of uncertain (risky and ambiguous) rewards and the evidence for impairment in this neural process. Using both univariate and multivariate analyses, we found that canonical value regions [ventromedial prefrontal cortex (vmPFC), striatum, and posterior cingulate cortex] track the SV of uncertain choice options in both participants with OUD and comparison controls, irrespective of their tolerance for uncertainty. This speaks against a fundamentally impaired subjective valuation process in OUD. However, value representations were less reliably decodable in people with OUD in some value regions (vmPFC) and throughout the brain, especially within the limbic and salience/ventral-attention networks. Thus, while people with OUD engage a neurocomputationally similar process during risky decision-making to controls, they may differ in the fidelity and distribution of SV signals across brain networks.
成瘾，尤其是阿片类物质使用障碍（OUD），通常表现为冒险倾向增强。虽然个体对风险和不确定性的耐受性各不相同，但患有OUD的人冒险行为增加被认为源于认知决策过程的改变，而非因特殊但合理的耐受性差异。具体而言，普遍的假设是，成瘾者在内部表征和信息整合方面存在缺陷，而这些信息本应指导对什么是有价值的事物进行决策和判断。我们使用基于模型的功能磁共振成像，研究了患有慢性OUD的接受治疗的男性和女性参与者的选择行为，如何与他们对不确定（有风险和模糊）奖励的推断主观价值（SV）的神经编码以及这一神经过程中存在缺陷的证据相一致。使用单变量和多变量分析，我们发现典型的价值区域[腹内侧前额叶皮层（vmPFC）、纹状体和后扣带回皮层]在患有OUD的参与者和对照者中都追踪不确定选择选项的SV，无论他们对不确定性的耐受性如何。这表明OUD患者的主观估值过程并没有根本性的损害。然而，在一些价值区域（vmPFC）以及整个大脑中，尤其是在边缘系统和显著性/腹侧注意网络中，患有OUD的人的价值表征解码可靠性较低。因此，虽然患有OUD的人在风险决策过程中与对照组在神经计算过程上相似，但他们在SV信号在脑网络中的保真度和分布上可能存在差异。
