Addiction and PFC

PFC( Pre Frontal Cortex)

• Important in self-regulation and planning ahead. Examples would be
• controlling impulses and behaviour
• delaying instant gratification
• important for personality
• What is fab and motivation scale?
• FAB
• Frontal assessment battery
• designed to evaluate executive functioning
• used to assess cognitive abilities that are often impaired in individuals with frontal lobe damage or dysfunction, including those related to drug
abuse.
• Consists of :
• conceptualization (similarity)
•
mental flexibility (60 seconds, s words)
•
motor programming( lurias test)
•
sensitivity to interference (2-1, 1-2)
•
inhibitory control (1-1, 2-0)
•
environmental autonomy (do not take my hand)
•
Motivation
•
• SOCRATES
• Stages of Change Readiness and Treatment Eagerness Scale
• This looks at how motivated and ready an individual is to change their
behaviour on substances.
• Why are we doing this
• Addiction Causes Neurodegeneration:
• Dopamine Release:
• Pathway Fixation:
• Effects of Alcohol:
• Philosophical Implications:
 The biology of addiction
• the loss of control in addiction , through imaging studies showed a key involvement of the
prefrontal cortex (PFC) both through its regulation of limbic reward regions and its
involvement in higher-order executive function (for example, self-control, salience attribution
and awareness).(Goldstein & Volkow, 2011)
• White and grey matter :
• Gray Matter Reduction
• White Matter Integrity: can affect the connectivity between the PFC and other brain regions
involved in reward and motivation.
• It is plausible that the decision-making observed in addiction might be partly due to, or the
result of, aberrant communication caused by altered or damaged white matter between key
brain regions (Hampton, Alm, Venkatraman, Nugiel, & Olson, 2017; Zhang et al., 2011).
• Impaired Synaptic Plasticity:
• Glutamate, , is also dysregulated in addiction. which contributes to neuroinflammation and
impaired synaptic plasticity in the PFC.
• Dopamine and frontal cortex learning : about the two pathways, mesolimbic pathway projects
to nucleus accumbens and mesocortical pathway projects to the prefrontal cortex This pathway is
involved in the regulation of cognition, executive function, and emotional responses. It interacts
with the mesolimbic pathway to influence decision-making and goal-directed behavior. the
excessive dopamine release in the NAc during drug use creates a strong reward signal.
• This powerful reward signal can overshadow the regulatory signals from the mesocortical pathway,
which typically help in decision-making and controlling impulses.which heavily influences drug
seeking behaviour . Dysfunctions in this area can result in lack of motivation or apathy.
• Inflammation and Neurotoxicity
• Neuroinflammation: Microglia are the brain's resident immune cells. Chronic drug use activates
these cells, leading to a pro-inflammatory state.
• Activated microglia release cytokines, chemokines, and other inflammatory mediators,
contributing to neuroinflammation
• Oxidative Stress: Drugs of abuse can increase oxidative stress in the brain, production of reactive
oxygen species which are byproduct of oxidation reaction for metabolism of neurotransmitters and
reuptake enzymes also due to mitochondrial dysfunction due to overwork .
• Thus leading to neurodegeneration . which manifests as cognitive and emotional impairments
making it harder for individuals to resist drug cravings and make healthy decisions, perpetuating
the cycle of addiction.
Interventions