Ventral Striatal Reactivity in Compulsive Sexual Behaviors

Abstract

Compulsive Sexual Behaviors (CSB) are a reason to seek treatment. Given this reality, the number of studies on CSB has increased substantially in the last decade and the World Health Organization (WHO) included CSB in its proposal for the upcoming ICD-11. Sixty percent of the neuroimaging studies on CSB published since 2014 aimed to examine similarities and differences between brain mechanisms underlying CSB, gambling disorder, and substance use disorders. One of the crucial brain circuits involved in addiction is the reward system involving the ventral striatum (including nucleus accumbens). There are two distinct theories describing ventral striatal activity in addictions: Incentive Salience Theory (IST) and Reward Deficiency Syndrome (RDS). IST describes increased ventral striatal activations during the anticipation of addiction-related reward, while RDS describes decreased ventral striatal reactivity both during the anticipation of the reward and during the reward processing. Here, we aim to investigate how the findings on ventral striatal reactivity in CSB support each of these two addiction frameworks. For this purpose, we conducted a systematic review of neuroimaging studies on CSB available in Pubmed, EBSCO, and Google Scholar between 2005 and 2018. We found nine relevant research papers. Only four of these studies directly investigated processing of erotic cues and/or rewards and reported findings related to ventral striatum activations. Three of these studies indicate increased ventral striatal reactivity for erotic stimuli, which is consistent with IST and does not support predictions based on RDS. Therefore, the current state of this data suggest that CSB is related to increased ventral striatal reactivity during the anticipation of erotic stimuli.

Hypothesizing in the Face of the Opioid Crisis Coupling Genetic Addiction Risk Severity (GARS) Testing with Electrotherapeutic Nonopioid Modalities Such as H-Wave Could Attenuate Both Pain and Hedonic Addictive Behaviors

“…While it is true that the major body of the RDS concept resides in many publications on the subject from our laboratory, there is an emerging increase in independent citations that embrace this novel construct. A brief sampling of this global cited work, while mostly favorable, can be assessed by reviewing specific references [ 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 84 , 85 , 86 , 87 , 88 , 89 , 90 , 91 , 92 , 93 , 94 , 95 , 96 , 97 , 98 ,…”

Women at Greater Sexual Risk for STIs/HIV Have a Lower Mesolimbic and Affective Bias Response to Sexual Stimuli

“…Significant nodes within the cue-reactive mask (e.g., dorsal striatum, insula) that differed between the Protected and Unprotected groups have been shown to be involved in the processing of visual sexual stimuli (Mitricheva et al, 2019). The caudate and putamen process both positive and negative stimuli (Lammel et al, 2014), driving reward-seeking behaviors and motivational states (Wise, 2004), such as pleasurable eating (e.g., Small et al, 2003), drug craving (e.g., Breiter et al, 1997;Wong et al, 2006;Volkow et al, 2006), sexual-related activities (see review, Gola and Draps, 2018), and the pursuit and loss of monetary value (e.g., Knutson et al, 2000). However, they have been found to differ in other processes, such as those associated with deliberative (caudate) and habit-based (putamen) behaviors (e.g., Yin and Knowlton, 2006;Graybiel, 2008;Regier et al, 2015).…”

Compulsive Sexual Behavior Disorder – the evolution of a new diagnosis introduced to the ICD-11, current evidence and ongoing research challenges

“…However, due to two issues, the World Health Organization's decision arouses controversial. Firstly, CSBD was placed in the category of "impulse-control disorders", and numerous neuroscientific studies conducted in the last 5 years have provided evidence that CSB is caused by the same mechanism that occurs in behavioral or substance addictions (43)(44)(45). Secondly, the CSBD diagnostic criteria do not include aspects proposed by Kafka (9) concerning "repetitively engaging in sexual fantasies, urges or behaviors in response to dysphoric mood states (A2.…”