Specific impairments within six large-scale brain networks during drug cue exposure, decision-making, inhibitory control, and social-emotional processing are associated with drug addiction behaviors, according to a systematic review of more than 100 published neuroimaging studies by experts at the Icahn School of Medicine at Mount Sinai and published Wednesday, June 6 in the journal Neuron.
While the involvement of these specific brain networks was task-specific, we generally observed that in a drug-related context (e.g., during exposure to drug cues) drug addicted individuals had increased engagement of the brain networks underlying decision making, inhibitory control, and social-emotional processing, but a blunted response during non-drug related tasks, as predicted by the iRISA model.”
Specifically, the Mount Sinai study team assessed brain function in drug addiction across a number of brain networks, including findings from whole-brain analyses of significant group differences. They organized the results across six large-scale brain networks that showed impairment of brain function in addiction, encompassing the “reward network,” which includes subcortical and cortical brain regions activated during the appraisal of subjective value; the striatal “habit network,” which underlies learning of automated behavior; the “salience network,” regions involved in (re)directing attentional resources toward salient stimuli; and the “executive network,” which supports the selection of possible behavioral responses (often also named the inhibitory control network).
Two additional networks, which were not discussed in prior reviews of the iRISA model, were found to be relevant to brain function in drug addiction: the “self-directed network,” which is activated during self-directed/referential cognitive processes, and the “memory network,” involved in flexible, multi-cue learning and memory.
“Our review is the first systematic approach to integrate what we know about the function of each of these networks into a comprehensive model underlying drug addiction symptomatology across the addiction cycle,” says Anna Zilverstand, PhD, Assistant Professor of Psychiatry at the Icahn School of Medicine at Mount Sinai and first author of the paper. “We demonstrated common deficits underlying drug addiction independent of the primary drug of choice, which are associated with measures of daily, real-life, drug use and which predict onset, escalation, and relapse into drug use. Our work could inform the development of treatments specifically targeted to alleviate these brain-behavioral deficits.”