The role of the opioid system in decision making and cognitive control: A review

Abstract

The opioid system regulates affective processing, including pain, pleasure, and reward. Restricting the role of this system to hedonic modulation may be an underestimation, however. Opioid receptors are distributed widely in the human brain, including the more Bcognitive^regions in the frontal and parietal lobes. Nonhuman animal research points to opioid modulation of cognitive and decision-making processes. We review emerging evidence on whether acute opioid drug modulation in healthy humans can influence cognitive function, such as how we choose between actions of different values and how we control our behavior in the face of distracting information. Specifically, we review studies employing opioid agonists or antagonists together with experimental paradigms of reward-based decision making, impulsivity, executive functioning, attention, inhibition, and effort. Although this field is still in its infancy, the emerging picture suggests that the mu-opioid system can influence higher-level cognitive function via modulation of valuation, motivation, and control circuits dense in mu-opioid receptors, including orbitofrontal cortex, basal ganglia, amygdalae, anterior cingulate cortex, and prefrontal cortex. The framework that we put forward proposes that opioids influence decision making and cognitive control by increasing the subjective value of reward and reducing aversive arousal. We highlight potential mechanisms that might underlie the effects of mu-opioid signaling on decision making and cognitive control and provide directions for future research.

Aerobic fitness is associated with cerebral mu-opioid receptor availability and activation in healthy humans

“…We observed greater opioid release in higher fit participants after aerobic exercise in ventral and dorsal striatum, left hippocampus, left thalamus, insular cortex, somatosensory cortex, temporal areas, and orbitofrontal cortex. MORs in these regions are closely involved in processing both nociceptive and hedonic signals [21,48] as well as modulating decision making and cognitive control [49]. We found that higher fit participants experienced greater improvements in mood following the aerobic exercise.…”

Brain Structure and Function of Chronic Low Back Pain Patients on Long-Term Opioid Analgesic Treatment: A Preliminary Study

“…heroin) exert their analgesic and addictive effects primarily through the µ-opioid receptor. 7 , 62 The binding of opioids in the limbic circuitry plays a critical role in analgesia, 32 learning and value-based decision making, 63 , 64 and hedonic processes. 65 , 66 For example, the infusion of naloxone, a µ-opioid receptor antagonist, into the basolateral amygdala decreases lever pressing for food in deprived rodents previously trained to associate lever pressing with delivery of a sucrose reward.…”

Can Damasio's Somatic Marker Hypothesis Explain More Than Its Originator Will Admit?

“…But reason, says Hume ( 1739 ), is the slave of the passions. Supporting Hume, latter-day empirical studies indicate that reasoning is an inherently emotional process [see van Steenbergen et al ( 2019 )].…”