A somatic marker theory of addiction

NEUROPHARMACOLOGY

卷:56

Review

Verdejo-Garcia, Antonio^2,3  Bechara, Antoine¹ 

[1] Univ So Calif, Brain & Creativ Inst, Los Angeles, CA 90089 USA

[2] Univ Granada, Dept Clin Psychol, E-18071 Granada, Spain

[3] Univ Granada, Inst Neurosci, E-18071 Granada, Spain

关键词: Decision-making;    Addiction;    Somatic states;    Craving;    Ventromedial prefrontal cortex;    Amygdala;    Insula;    Dopamine;    Serotonin;   

DOI  :  10.1016/j.neuropharm.2008.07.035

来源: Elsevier

【 摘 要 】

Similar to patients with ventromedial prefrontal cortex (VMPC) lesions, substance abusers show altered decision-making, characterized by a tendency to choose the immediate reward, at the expense of negative future consequences. The somatic marker model proposes that decision-making depends on neural substrates that regulate homeostasis, emotion and feeling. According to this model, there should be a link between alterations in processing emotions in substance abusers, and their impairments in decision-making. Growing evidence from neuroscientific studies indicate that core aspects of addiction may be explained in terms of abnormal emotional/homeostatic guidance of decision-making. Behavioral studies have revealed emotional processing and decision-making deficits in substance abusers. Neuroimaging studies have shown that altered decision-making in addiction is associated with abnormal functioning of a distributed neural network critical for the processing of emotional information, and the experience of craving, including the VMPC, the amygdala, the striatum, the anterior cingulate cortex, and the insular/somato-sensory cortices, as well as non-specific neurotransmitter systems that modulate activities of neural processes involved in decision-making. The aim of this paper is to review this growing evidence, and to examine the extent to which these studies Support a somatic marker theory of addiction. We conclude that there are at least two underlying types of dysfunction where emotional signals (somatic markers) turn in favor of immediate outcomes in addiction: (1) a hyperactivity in the amygdala or impulsive system, which exaggerates the rewarding impact of available incentives, and (2) hypoactivity in the prefrontal cortex or reflective system, which forecasts the long-term consequences of a given action. (c) 2008 Elsevier Ltd. All rights reserved.

【 授权许可】

Free