Neuroimaging Impaired Response Inhibition and Salience Attribution in Human Drug Addiction: A Systematic Review

Abstract

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.

Brain responses and approach bias to social alcohol cues and their association with drinking in a social setting in young adult males

“…This could reflect the fact that the social alcohol cue‐reactivity and the stimulus‐response compatibility tasks engage partly different (brain) mechanisms. More specifically, whereas cue‐reactivity (e.g., based on the incentive sensitization model of addiction (Robinson & Berridge, , , )) engages the salience and reward brain networks (Zilverstand, Huang, Alia‐Klein, & Goldstein, ), approach tendencies (e.g., seen as an automatic response in the dual‐process models of addiction (Wiers et al., ; Stacy & Wiers, )) require a response and therefore also involve the executive network (Zilverstand et al., ). This difference between the two measures might explain why they are not correlated in the present data and further suggest that cue‐reactivity and approach biases may be independent mechanisms associated with drinking behaviour.…”

Neurobiological Considerations for Tobacco Use Disorder

“…Findings supported predictions that brain regions and networks involved are more strongly engaged by drug-related processing and blunted by non-drug-related processing. Data further supported that brain regions implicated in habit (dorsal caudate and putamen) are associated with drug use initiation and relapse, consistent with their role in the transition from voluntary use to compulsive drug-taking behavior [25]. …”

“…The complexity of drug addiction at the whole-brain level was recently exemplified in a systematic review of neuroimaging studies of drugs of abuse including nicotine [25]. The review identified consistent impairments in brain function across a range of tasks including cue-exposure, decision making, inhibitory control, and social-emotional tasks, in six functional brain ‘networks’ including regions involved in reward and habit; the canonical salience network (SN), implicated in (re)orienting attention to salient stimuli; executive control network (ECN), implicated in selection of behavioral responses; and default mode network (DMN), implicated in self-referential processing; and regions involved in memory.…”

“…Further, using meta-analytic connectivity modeling and behavioral decoding, that study identified additional structural-functional relationships that may be relevant to smoking, such those related to pain perception [48]. Indeed, nicotine has multiple other cognitive effects, including on sensory processing, social-emotional processing, attention, and working memory [25], including cognitive-enhancing effects on attention and memory even in nonsmokers [49]. A potential mechanism was suggested by a meta-analysis of pharmacological neuroimaging studies, which consistently indicate that nAChR administration leads to decreased activity in the DMN and increased activity in the ECN, suggesting a shift from internal to external-directed attention that may underlie the cognitive-enhancing effects of nAChR agonists including nicotine and varenicline [50].…”

Addiction in focus: molecular mechanisms, model systems, circuit maps, risk prediction and the quest for effective interventions

“…As mentioned above, the study of individual differences, including sex differences, is also of paramount importance. In general, there is marked underrepresentation of females in neuroimaging studies (or in clinical trials) of drug addiction (Zilverstand et al, 2018). That said, the opposite trend also needs to be taken into account, since males are not well represented in the binge eating disorder literature (Naish et al, 2018).…”