J Psychiatry Neurosci 2014; 39(3): 149-169
Maartje Luijten, PhD; Marise W.J. Machielsen, MD; Dick J. Veltman, MD, PhD; Robert Hester, PhD; Lieuwe de Haan, MD, PhD; Ingmar H.A. Franken, PhD
Luijten (at the time of writing), Franken — Institute of Psychology, Erasmus University Rotterdam, Rotterdam, the Netherlands; Machielsen, de Haan — Academic Medical Center, University of Amsterdam, Department of Psychiatry, Early Psychosis Department, Amsterdam, the Netherlands; Veltman — Academic Medical Center, University of Amsterdam, Department of Psychiatry, Amsterdam Institute for Addiction Research, Amsterdam, the Netherlands; Hester — School of Psychological Sciences, University of Melbourne, Melbourne, Australia
Background: Several current theories emphasize the role of cognitive control in addiction. The present review evaluates neural deficits in the domains of inhibitory control and error processing in individuals with substance dependence and in those showing excessive addiction-like behaviours. The combined evaluation of event-related potential (ERP) and functional magnetic resonance imaging (fMRI) findings in the present review offers unique information on neural deficits in addicted individuals.
Methods: We selected 19 ERP and 22 fMRI studies using stop-signal, go/no-go or Flanker paradigms based on a search of PubMed and Embase.
Results: The most consistent findings in addicted individuals relative to healthy controls were lower N2, error-related negativity and error positivity amplitudes as well as hypoactivation in the anterior cingulate cortex (ACC), inferior frontal gyrus and dorsolateral prefrontal cortex. These neural deficits, however, were not always associated with impaired task performance. With regard to behavioural addictions, some evidence has been found for similar neural deficits; however, studies are scarce and results are not yet conclusive. Differences among the major classes of substances of abuse were identified and involve stronger neural responses to errors in individuals with alcohol dependence versus weaker neural responses to errors in other substance-dependent populations.
Limitations: Task design and analysis techniques vary across studies, thereby reducing comparability among studies and the potential of clinical use of these measures.
Conclusions: Current addiction theories were supported by identifying consistent abnormalities in prefrontal brain function in individuals with addiction. An integrative model is proposed, suggesting that neural deficits in the dorsal ACC may constitute a hallmark neurocognitive deficit under lying addictive behaviours, such as loss of control.
Submitted Mar. 25, 2013; Revised June 25, 2013; Accepted July 10, 2013.
Acknowledgements: This study was supported by a grant of the Netherlands Organization for Scientific Research (NWO; VIDI grant number 016.08.322). The funding organization had no role in preparation of the manuscript or decision for publication. The authors have no competing interests to declare.
Competing interests: None declared.
Contributors: All authors designed the study, acquired and analyzed the data and approved the final version to be published. M. Luijten and M.W.J. Machielsen wrote the article, which D.J. Veltman, R. Hester, L. de Haan and I.H.A. Franken reviewed.
Correspondence to: M. Luijten, Behavioural Science Institute, Radboud University Nijmegen, PO Box 9104, 6500 HE Nijmegen, the Netherlands; firstname.lastname@example.org