Neural circuitry and mechanisms of waiting impulsivity: relevance to addiction

Philos Trans R Soc Lond B Biol Sci. 2019 Feb 18;374(1766):20180145. doi: 10.1098/rstb.2018.0145.


Impatience-the failure to wait or tolerate delayed rewards (e.g. food, drug and monetary incentives)-is a common behavioural tendency in humans. However, when rigidly and rapidly expressed with limited regard for future, often negative consequences, impatient or impulsive actions underlie and confer susceptibility for such diverse brain disorders as drug addiction, attention-deficit hyperactivity disorder (ADHD) and major depressive disorder. Consequently, 'waiting' impulsivity has emerged as a candidate endophenotype to inform translational research on underlying neurobiological mechanisms and biomarker discovery for many of the so-called impulse-control disorders. Indeed, as reviewed in this article, this research enterprise has revealed a number of unexpected targets and mechanisms for intervention. However, in the context of drug addiction, impulsive decisions that maximize short-term gains (e.g. acute drug consumption) over longer-term punishment (e.g. unemployment, homelessness, personal harm) defines one aspect of impulsivity, which may or may not be related to rapid, unrestrained actions over shorter timescales. We discuss the relevance of this distinction in impulsivity subtypes for drug addiction with reference to translational research in humans and other animals. This article is part of the theme issue 'Risk taking and impulsive behaviour: fundamental discoveries, theoretical perspectives and clinical implications'.

Keywords: basal ganglia; dopamine; endophenotypes; nucleus accumbens; prefrontal cortex; substance use disorder.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Humans
  • Impulsive Behavior*
  • Punishment / psychology*
  • Reward*
  • Substance-Related Disorders*
  • Translational Research, Biomedical