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Review
. 2013 Dec;37(10 Pt 2):2806-17.
doi: 10.1016/j.neubiorev.2013.10.002. Epub 2013 Oct 16.

Common and Distinct Neural Targets of Treatment: Changing Brain Function in Substance Addiction

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Review

Common and Distinct Neural Targets of Treatment: Changing Brain Function in Substance Addiction

Anna B Konova et al. Neurosci Biobehav Rev. .
Free PMC article

Abstract

Neuroimaging offers an opportunity to examine the neurobiological effects of therapeutic interventions for human drug addiction. Using activation likelihood estimation, the aim of the current meta-analysis was to quantitatively summarize functional neuroimaging studies of pharmacological and cognitive-based interventions for drug addiction, with an emphasis on their common and distinct neural targets. More exploratory analyses also contrasted subgroups of studies based on specific study and sample characteristics. The ventral striatum, a region implicated in reward, motivation, and craving, and the inferior frontal gyrus and orbitofrontal cortex, regions involved in inhibitory control and goal-directed behavior, were identified as common targets of pharmacological and cognitive-based interventions; these regions were observed when the analysis was limited to only studies that used established or efficacious interventions, and across imaging paradigms and types of addictions. Consistent with theoretical models, cognitive-based interventions were additionally more likely to activate the anterior cingulate cortex, middle frontal gyrus, and precuneus, implicated in self-referential processing, cognitive control, and attention. These results suggest that therapeutic interventions for addiction may target the brain structures that are altered across addictions and identify potential neurobiological mechanisms by which the tandem use of pharmacological and cognitive-based interventions may yield synergistic or complementary effects. These findings could inform the selection of novel functional targets in future treatment development for this difficult-to-treat disorder.

Keywords: Activation likelihood estimation (ALE) meta-analysis; Addiction; Cognitive-behavioral therapy; Craving regulation; Functional magnetic resonance imaging (fMRI); Functional neuroimaging; Pharmacological challenge; Pharmacotherapy; Positron emission tomography (PET); Therapeutic intervention.

Conflict of interest statement

Conflict of Interest: The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Any (all foci together) and individual effects of therapeutic interventions (effects by intervention strategy). Threshold: p<0.05 FDR-corrected and a minimum cluster size of 100 mm3. ACC, anterior cingulate cortex; IFG, inferior frontal gyrus; MB, midbrain; mFG, medial frontal gyrus; MFG, middle frontal gyrus; PHG, parahipppocampal gyrus; Prec, precuneus; SFG, superior frontal gyrus; VS, ventral striatum.
Figure 2
Figure 2
Common (A) and distinct (B) neural targets of pharmacological and cognitive-based therapeutic interventions. Threshold for conjunction: p<0.005 uncorrected and a minimum cluster size of 100 mm3. Threshold for difference contrast: p<0.05 FDR-corrected and a minimum cluster size of 100 mm3. ACC, anterior cingulate cortex; IFG, inferior frontal gyrus; MFG, middle frontal gyrus; OFC, orbitofrontal cortex; Prec, precuneus; VS, ventral striatum.

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