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01-03-2018 | Review Article

The alcoholic brain: neural bases of impaired reward-based decision-making in alcohol use disorders

Authors: Caterina Galandra, Gianpaolo Basso, Stefano Cappa, Nicola Canessa

Published in: Neurological Sciences | Issue 3/2018

Abstract

Neuroeconomics is providing insights into the neural bases of decision-making in normal and pathological conditions. In the neuropsychiatric domain, this discipline investigates how abnormal functioning of neural systems associated with reward processing and cognitive control promotes different disorders, and whether such evidence may inform treatments. This endeavor is crucial when studying different types of addiction, which share a core promoting mechanism in the imbalance between impulsive subcortical neural signals associated with immediate pleasurable outcomes and inhibitory signals mediated by a prefrontal reflective system. The resulting impairment in behavioral control represents a hallmark of alcohol use disorders (AUDs), a chronic relapsing disorder characterized by excessive alcohol consumption despite devastating consequences. This review aims to summarize available magnetic resonance imaging (MRI) evidence on reward-related decision-making alterations in AUDs, and to envision possible future research directions. We review functional MRI (fMRI) studies using tasks involving monetary rewards, as well as MRI studies relating decision-making parameters to neurostructural gray- or white-matter metrics. The available data suggest that excessive alcohol exposure affects neural signaling within brain networks underlying adaptive behavioral learning via the implementation of prediction errors. Namely, weaker ventromedial prefrontal cortex activity and altered connectivity between ventral striatum and dorsolateral prefrontal cortex likely underpin a shift from goal-directed to habitual actions which, in turn, might underpin compulsive alcohol consumption and relapsing episodes despite adverse consequences. Overall, these data highlight abnormal fronto-striatal connectivity as a candidate neurobiological marker of impaired choice in AUDs. Further studies are needed, however, to unveil its implications in the multiple facets of decision-making.

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Title: The alcoholic brain: neural bases of impaired reward-based decision-making in alcohol use disorders
Authors: Caterina Galandra
Gianpaolo Basso
Stefano Cappa
Nicola Canessa
Publication date: 01-03-2018
Publisher: Springer Milan
Published in: Neurological Sciences / Issue 3/2018
Print ISSN: 1590-1874
Electronic ISSN: 1590-3478
DOI: https://doi.org/10.1007/s10072-017-3205-1

At a glance: The STEP trials

Springer Medicine

The alcoholic brain: neural bases of impaired reward-based decision-making in alcohol use disorders

Abstract

At a glance: The STEP trials

Springer Medicine

Abstract

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