Murat Yücel, PhD, MAPS & Dan I. Lubman, PhD, FRANZCP FAChAM, ORYGEN Research Centre, and Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne, Melbourne, Victoria, Australia.
Neurocognitive and neuroimaging evidence of behavioural dysregulation in human drug addiction: implications for diagnosis, treatment and prevention
Article first published online: 29 MAY 2009
2007 Australasian Professional Society on Alcohol and other Drugs
Drug and Alcohol Review
Volume 26, Issue 1, pages 33–39, January 2007
How to Cite
YÜCEL, M. and LUBMAN, D. I. (2007), Neurocognitive and neuroimaging evidence of behavioural dysregulation in human drug addiction: implications for diagnosis, treatment and prevention. Drug and Alcohol Review, 26: 33–39. doi: 10.1080/09595230601036978
- Issue published online: 29 MAY 2009
- Article first published online: 29 MAY 2009
- Received 19 May 2006; accepted for publication 20 July 2006.
- clinical management;
- compulsive behaviour;
- drug dependence;
- impulsive behaviour;
- treatment for drug addiction
Neuropsychological and neuroimaging studies have generated a wealth of data demonstrating structural and functional brain changes, as well as cognitive deficits in drug addicted populations. Despite this, it is often difficult to make generalisations or conclusive statements about the neuropsychological and neurobiological correlates of chronic drug use given variations in the nature or extent of deficits observed within or across different classes of drugs. In this review, we focus specifically on the evidence for impairments in prefrontally-mediated cognitive functions that underlie behavioural regulation, namely decision making and inhibitory control. We argue that impairments in these specific domains, which are often compounded by an earlier initiation of drug use, polydrug abuse, comorbid psychiatric conditions, previous head injury, and acute withdrawal effects can serve to increase the risk for making decisions that are impulsive, focussed on short-terms gains and lack inhibitory control. We further argue that these impairments of prefrontal functioning may underpin the compulsive and ‘loss-of-control’ pattern of drug-seeking and drug-taking that is characteristic of drug addiction. Finally, we consider the implications of these findings for diagnosis, treatment and prevention, suggesting that a comprehensive understanding of the nature and extent of these cognitive deficits should form a core part of the conceptualization and focus of effective treatment.