The impaired response inhibition and salience attribution (iRISA) model proposes that impaired response inhibition and salience attribution underlie drug seeking and taking. To update this model, we systematically reviewed 105 task-related neuroimaging studies (n > 15/group) published since 2010. Results demonstrate specific impairments within six large-scale brain networks (reward, habit, salience, executive, memory, and self-directed networks) during drug cue exposure, decision making, inhibitory control, and social-emotional processing. Addicted individuals demonstrated increased recruitment of these networks during drug-related processing but a blunted response during non-drug-related processing, with the same networks also being implicated during resting state. Associations with real-life drug use, relapse, therapeutic interventions, and the relevance to initiation of drug use during adolescence support the clinical relevance of the results. Whereas the salience and executive networks showed impairments throughout the addiction cycle, the reward network was dysregulated at later stages of abuse. Effects were similar in alcohol, cannabis, and stimulant addiction. Zilverstand et al. find that behaviors in drug addiction are closely tied to brain impairments underlying drug cue reactivity, decision making, inhibitory control, and social-emotional processing. Neuroimaging biomarkers can also be used to predict initiation and progression of drug addiction.
Bibliographical noteFunding Information:
This work was supported by a fellowship from the Netherlands Organisation for Scientific Research ( Rubicon 446-14-015 to A.Z.) and by grants from the National Institute on Drug Abuse ( U01DA041174 and R01DA041528 to R.Z.G. and R01MH090134 to N.A.-K).
PubMed: MeSH publication types
- Journal Article
- Research Support, N.I.H., Extramural
- Research Support, Non-U.S. Gov't
- Systematic Review