Substance use disorders and the orbitofrontal cortex: Systematic review of behavioural decision-making and neuroimaging studies

• Published in: British journal of psychiatry Vol. 187; no. 3; pp. 209 - 220
• Main Authors: Dom, G, Sabbe, B, Hulstijn, W, van den Brink, W
• Format: Journal Article
• Language: English
• Published: England RCP 01.09.2005; Cambridge University Press
• Subjects: Addictions; Addictive behaviors; Amphetamines; Behavior; Brain Mapping - methods; Brain research; Cocaine; Cortex; Craving; Cues; Decision Making; Detoxification; Drug addiction; Drug use; Female; Frontal Lobe - physiopathology; Functional relationships; Gambling; Heroin; Humans; Hyperactivity; Literature reviews; Magnetic Resonance Imaging; Male; Medical imaging; Neuroimaging; Positron-Emission Tomography; Psychiatry; Reactivity; Relapse; Smoking; Substance abusers; Substance use disorder; Substance-Related Disorders - physiopathology; Substance-Related Disorders - psychology; Tobacco; Belgium; United States > US; Iowa
• ISSN: 0007-1250; 1472-1465
• DOI: 10.1192/bjp.187.3.209

Orbitofrontal cortex dysfunctions have been frequently documented in people with substance use disorders. The exact role of this cortical region, however, remains unspecified. To assess the functionality of the orbitofrontal cortex in people with substance use disorders. Reports of studies using behavioural decision-making tasks and/or neuroimaging techniques to investigate orbitofrontal cortex functioning in cases of substance misuse were reviewed. Studies focusing exclusively on tobacco-smoking and gambling were excluded. Fifty-two research articles were evaluated. Most studies showed significant deficits in decision-making in people with substance use disorders. A consistent finding in the neuroimaging studies was hypoactivity of the orbitofrontal cortex after detoxification. The association between hyperactivity of this region and craving or cue reactivity was not consistent across studies. The orbitofrontal cortex has an important role in addictive behaviours. Further studies are needed to elucidate the underlying neuronal substrates of cue reactivity, craving and decision-making, and the implications for treatment and relapse prevention.