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Review
. 2023 Dec;25(1):75-91.
doi: 10.1080/19585969.2023.2242359.

Neural mechanisms linked to treatment outcomes and recovery in substance-related and addictive disorders

Gemma Mestre-Bach  1 , Marc N Potenza  2   3   4   5   6   7
Affiliations
Review

Neural mechanisms linked to treatment outcomes and recovery in substance-related and addictive disorders

Gemma Mestre-Bach et al. Dialogues Clin Neurosci. 2023 Dec.

Abstract

The present review focuses on potential neural mechanisms underlying recovery from psychiatric conditions characterised by impaired impulse control, specifically substance use disorders, gambling disorder, and internet gaming disorder. Existing treatments (both pharmacological and psychological) for these addictions may impact brain processes, and these have been evaluated in neuroimaging studies. Medication challenge and short-term intervention administration will be considered with respect to treatment utility. Main models of addiction (e.g., dual process, reward deficiency syndrome) will be considered in the context of extant data. Additionally, advanced analytic approaches (e.g., machine-learning approaches) will be considered with respect to guiding treatment development efforts. Thus, this narrative review aims to provide directions for treatment development for addictive disorders.

Keywords: Neurobiology; addictive behaviours; gambling disorder; impulsivity; internet addiction; internet gaming disorder; recovery; substance-related disorders.

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Conflict of interest statement

None of the authors have any conflicts of interest. Dr. Potenza has consulted for Opiant Pharmaceuticals, Idorsia Pharmaceuticals, AXA, Game Day Data, and the Addiction Policy Forum; has been involved in a patent application with Yale University and Novartis; has received research support (to Yale) from Mohegan Sun Casino and the National Centre for Responsible Gaming; has participated in surveys, mailings or telephone consultations related to drug addiction, impulse-control disorders or other health topics; has consulted for and/or advised gambling and legal entities on issues related to impulse-control/addictive disorders; has provided clinical care in a problem gambling services program; has performed grant reviews for research-funding agencies; has edited journals and journal sections; has given academic lectures in grand rounds, CME events and other clinical or scientific venues; and has generated books or book chapters for publishers of mental health texts.

Figures

Figure 1.
Figure 1.
Hypothesised mechanisms of some key common neural features underlying addictions and how brain function may change with effective treatment or during recovery. SUDs: substance use disorders; GD: gambling disorder; IGD: internet gaming disorder.
See this image and copyright information in PMC

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