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      A Roadmap for Integrating Neuroscience Into Addiction Treatment: A Consensus of the Neuroscience Interest Group of the International Society of Addiction Medicine

      review-article
      1 , 2 , 3 , 4 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 3 , 4 , 11 , 12 , 13 , 14 , 15 , 3 , 16 , 17 , 18 , 18 , 19 , 19 , 20 , 21 , 22 , 23 , 24 , 8 , 24
      Frontiers in Psychiatry
      Frontiers Media S.A.
      neuroscience, addiction medicine, treatment, substance use disorder, fMRI, neuromodulation, neuropsychological assessment, cognitive rehabilitation

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          Abstract

          Although there is general consensus that altered brain structure and function underpins addictive disorders, clinicians working in addiction treatment rarely incorporate neuroscience-informed approaches into their practice. We recently launched the Neuroscience Interest Group within the International Society of Addiction Medicine (ISAM-NIG) to promote initiatives to bridge this gap. This article summarizes the ISAM-NIG key priorities and strategies to achieve implementation of addiction neuroscience knowledge and tools for the assessment and treatment of substance use disorders. We cover two assessment areas: cognitive assessment and neuroimaging, and two interventional areas: cognitive training/remediation and neuromodulation, where we identify key challenges and proposed solutions. We reason that incorporating cognitive assessment into clinical settings requires the identification of constructs that predict meaningful clinical outcomes. Other requirements are the development of measures that are easily-administered, reliable, and ecologically-valid. Translation of neuroimaging techniques requires the development of diagnostic and prognostic biomarkers and testing the cost-effectiveness of these biomarkers in individualized prediction algorithms for relapse prevention and treatment selection. Integration of cognitive assessments with neuroimaging can provide multilevel targets including neural, cognitive, and behavioral outcomes for neuroscience-informed interventions. Application of neuroscience-informed interventions including cognitive training/remediation and neuromodulation requires clear pathways to design treatments based on multilevel targets, additional evidence from randomized trials and subsequent clinical implementation, including evaluation of cost-effectiveness. We propose to address these challenges by promoting international collaboration between researchers and clinicians, developing harmonized protocols and data management systems, and prioritizing multi-site research that focuses on improving clinical outcomes.

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          Most cited references201

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          The MATRICS Consensus Cognitive Battery, part 1: test selection, reliability, and validity.

          The lack of an accepted standard for measuring cognitive change in schizophrenia has been a major obstacle to regulatory approval of cognition-enhancing treatments. A primary mandate of the National Institute of Mental Health's Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) initiative was to develop a consensus cognitive battery for clinical trials of cognition-enhancing treatments for schizophrenia through a broadly based scientific evaluation of measures. The MATRICS Neurocognition Committee evaluated more than 90 tests in seven cognitive domains to identify the 36 most promising measures. A separate expert panel evaluated the degree to which each test met specific selection criteria. Twenty tests were selected as a beta battery. The beta battery was administered to 176 individuals with schizophrenia and readministered to 167 of them 4 weeks later so that the 20 tests could be compared directly. The expert panel ratings are presented for the initially selected 36 tests. For the beta battery tests, data on test-retest reliability, practice effects, relationships to functional status, practicality, and tolerability are presented. Based on these data, 10 tests were selected to represent seven cognitive domains in the MATRICS Consensus Cognitive Battery. The structured consensus method was a feasible and fair mechanism for choosing candidate tests, and direct comparison of beta battery tests in a common sample allowed selection of a final consensus battery. The MATRICS Consensus Cognitive Battery is expected to be the standard tool for assessing cognitive change in clinical trials of cognition-enhancing drugs for schizophrenia. It may also aid evaluation of cognitive remediation strategies.
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            Common and distinct networks underlying reward valence and processing stages: a meta-analysis of functional neuroimaging studies.

            To better understand the reward circuitry in human brain, we conducted activation likelihood estimation (ALE) and parametric voxel-based meta-analyses (PVM) on 142 neuroimaging studies that examined brain activation in reward-related tasks in healthy adults. We observed several core brain areas that participated in reward-related decision making, including the nucleus accumbens (NAcc), caudate, putamen, thalamus, orbitofrontal cortex (OFC), bilateral anterior insula, anterior cingulate cortex (ACC) and posterior cingulate cortex (PCC), as well as cognitive control regions in the inferior parietal lobule and prefrontal cortex (PFC). The NAcc was commonly activated by both positive and negative rewards across various stages of reward processing (e.g., anticipation, outcome, and evaluation). In addition, the medial OFC and PCC preferentially responded to positive rewards, whereas the ACC, bilateral anterior insula, and lateral PFC selectively responded to negative rewards. Reward anticipation activated the ACC, bilateral anterior insula, and brain stem, whereas reward outcome more significantly activated the NAcc, medial OFC, and amygdala. Neurobiological theories of reward-related decision making should therefore take distributed and interrelated representations of reward valuation and valence assessment into account. Copyright © 2010 Elsevier Ltd. All rights reserved.
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              Impulsivity as a vulnerability marker for substance-use disorders: review of findings from high-risk research, problem gamblers and genetic association studies.

              There is a longstanding association between substance-use disorders (SUDs) and the psychological construct of impulsivity. In the first section of this review, personality and neurocognitive data pertaining to impulsivity will be summarised in regular users of four classes of substance: stimulants, opiates, alcohol and 3,4-methylenedioxymethamphetamine (MDMA). Impulsivity in these groups may arise via two alternative mechanisms, which are not mutually exclusive. By one account, impulsivity may occur as a consequence of chronic exposure to substances causing harmful effects on the brain. By the alternative account, impulsivity pre-dates SUDs and is associated with the vulnerability to addiction. We will review the evidence that impulsivity is associated with addiction vulnerability by considering three lines of evidence: (i) studies of groups at high-risk for development of SUDs; (ii) studies of pathological gamblers, where the harmful consequences of the addiction on brain structure are minimised, and (iii) genetic association studies linking impulsivity to genetic risk factors for addiction. Within each of these three lines of enquiry, there is accumulating evidence that impulsivity is a pre-existing vulnerability marker for SUDs.
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                Author and article information

                Contributors
                Journal
                Front Psychiatry
                Front Psychiatry
                Front. Psychiatry
                Frontiers in Psychiatry
                Frontiers Media S.A.
                1664-0640
                23 December 2019
                2019
                : 10
                : 877
                Affiliations
                [1] 1Turner Institute for Brain and Mental Health, Monash University , Melbourne, VIC, Australia
                [2] 2School of Psychology, Faculty of Health Sciences, Australian Catholic University , Canberra, ACT, Australia
                [3] 3Eastern Health Clinical School Turning Point, Eastern Health , Richmond, VIC, Australia
                [4] 4Eastern Health Clinical School, Monash University , Melbourne, VIC, Australia
                [5] 5School of Medicine, University of Tasmania , Hobart, TAS, Australia
                [6] 6School of Psychological Sciences, University of Melbourne , Melbourne, VIC, Australia
                [7] 7San Francisco Veterans Affairs Health Care System (SFVAHCS) , San Francisco, CA, United States
                [8] 8Department of Psychiatry, University of California , San Francisco, San Francisco, CA, United States
                [9] 9School of Medicine, University of St Andrews, Medical and Biological Science Building , North Haugh, St Andrews, United Kingdom
                [10] 10Department of Psychology, National University of Singapore , Singapore, Singapore
                [11] 11Department of Kinesiology and Health, Rutgers University , New Brunswick, NJ, United States
                [12] 12Department of Medicine, Faculty of Medicine, Imperial College , London, United Kingdom
                [13] 13Laboratoire de Psychologie Médicale et d’Addictologie, ULB Neuroscience Institute (UNI), CHU Brugmann-Université Libre de Bruxelles (U.L.B.) , Brussels, Belgium
                [14] 14Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill , Chapel Hill, NC, United States
                [15] 15Department of Psychiatry, Surrey and Borders Partnership NHS Foundation Trust , Leatherhead, United Kingdom
                [16] 16DVA Medical Center and Department of Radiology and Biomedical Imaging, University of California San Francisco, School of Medicine , San Francisco, CA, United States
                [17] 17School of Psychology, University of Queensland , Brisbane, QLD, Australia
                [18] 18Department of Cognitive Psychology, Institute for Cognitive Sciences Studies , Tehran, Iran
                [19] 19Iranian National Center for Addiction Studies, Tehran University of Medical Sciences , Tehran, Iran
                [20] 20School of Medicine, Shahid-Sadoughi University of Medical Sciences , Yazd, Iran
                [21] 21Department of Psychiatry, University of Minnesota , Minneapolis, MN, United States
                [22] 22Medical School, University of Dundee, Ninewells Hospital , Scotland, United Kingdom
                [23] 23Department of Psychiatry, Renaissance School of Medicine at Stony Brook University , Stony Brook, NY, United States
                [24] 24Laureate Institute for Brain Research, University of Tulsa , Tulsa, OK, United States
                Author notes

                Edited by: Peter Kirsch, Central Institute for Mental Health, Germany

                Reviewed by: Andy Wai Kan Yeung, The University of Hong Kong, Hong Kong; Kyriaki Nikolaou, University of Sussex, United Kingdom; Jasmin Vassileva, Virginia Commonwealth University, United States

                *Correspondence: Antonio Verdejo-Garcia, antonio.verdejo@ 123456monash.edu

                This article was submitted to Addictive Disorders, a section of the journal Frontiers in Psychiatry

                Article
                10.3389/fpsyt.2019.00877
                6935942
                31920740
                4beebcbb-4c41-444d-be37-95359c1c1dab
                Copyright © 2019 Verdejo-Garcia, Lorenzetti, Manning, Piercy, Bruno, Hester, Pennington, Tolomeo, Arunogiri, Bates, Bowden-Jones, Campanella, Daughters, Kouimtsidis, Lubman, Meyerhoff, Ralph, Rezapour, Tavakoli, Zare-Bidoky, Zilverstand, Steele, Moeller, Paulus, Baldacchino and Ekhtiari

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 15 June 2019
                : 06 November 2019
                Page count
                Figures: 4, Tables: 1, Equations: 0, References: 233, Pages: 23, Words: 12364
                Categories
                Psychiatry
                Review

                Clinical Psychology & Psychiatry
                neuroscience,addiction medicine,treatment,substance use disorder,fmri,neuromodulation,neuropsychological assessment,cognitive rehabilitation

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