A Systematic Review of Sex/Gender Differences in the Multi-dimensional Neurobiological Mechanisms in Addiction and Their Relevance to Impulsivity

Purpose of Review: Addiction may be characterized along three functional domains: Approach Behavior, Executive Function, and Negative Emotionality. Constructs underlying impulsivity thought to be relevant in addiction map on to these three functional domains. The purpose of the present review was to evaluate the extant research regarding sex/gender differences in the multi-dimensional domains of addiction using human neuroimaging and discuss their relevance to impulsivity. Recent Findings: Few papers over the past two decades have used human neuroimaging to test sex/gender differences in addiction. There is therefore a significant gap in the literature regarding sex/gender differences in the neurobiological mechanisms driving the multi-dimensionality of addiction and their implications to impulsivity. Summary: Of the 34 reviewed papers, the orbitofrontal cortex/ventromedial prefrontal cortex (OFC/vmPFC) was the most frequently reported brain region to evidence a sex/gender difference during fMRI tasks probing Approach Behavior and Negative Emotionality. This finding suggests potential sex/gender-specific patterns of subjective valuation in substance misuse, driven by OFC/vmPFC dysregulation.