Functional Neuroanatomy of Addiction Flashcards

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1
Q

Define addiction, abuse, dependence, withdrawal, tolerance, and cross-tolerance.

A

Addiction: Chronic, progressive behavioral disorder whose central feature is compulsive drug use despite adverse consequences. Abuse: Maladaptive use over 12+ months that leads to impaired functioning. Dependence: Abuse + withdrawal, tolerance, or a pattern of compulsive use. Withdrawal: Physical or psychological symptoms after the reduction or cessation of use. Tolerance: Need for increased amounts to achieve the same positive effects. Cross-Tolerance: Development of tolerance to one substance because of using another.

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2
Q

Where does dopamine originate? Where does it project to? What are the significance roles of these circuits?

A

Dopamine cell bodies are in the Ventral Tegmental Area. Project to the Nucleus Accumbens (reward) and the Prefrontal Cortex (executive control).

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3
Q

What 4 areas of the prefrontal cortex are important? What do they do?

A

DLPFC: Statistical/Cross-Benefit Analysis (“Top down control center). VMPFC: Assigns emotional valence. OFC: Impulse prevention. ACC: Vigilance.

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4
Q

What is the basic effects of drugs in creating addictive behavior?

A

Increase the limbic reward pathway by enhancing DA release, enhancing DA effects in the NA, &/or producing effects similar to DA. Chronic use sustains this increased limbic function and decreases PFC function.

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5
Q

Describe the limbic circuit. What happens to this in addiction?

A

This circuit uses DA. VTA supplies DA to NA. Amygdala assigns emotional value and acts at the VTA and NA. All of these pathways are excessive in addictive behaviors.

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6
Q

Describe the cortical control circuit. What happens to this in addiction?

A

This circuit uses GLU. The OFC and DLPFC project to the NA & the VMPFC, which also projects to the NA. The OFC should suppress addictive behavior, the DLPFC should calculate risk/benefit ratio of addictive behavior, and the VMPFC should assign positive feelings to not doing addictive behavior. These are likely to be deficient in addictive patients: Less active (less GLU), atrophy.

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7
Q

What is a goal of psychotherapy?

A

Strengthen the cortical control centers (PFC) in order to “reign” in the limbic system.

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