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The Orbitofrontal Cortex$
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David Zald and Scott Rauch

Print publication date: 2006

Print ISBN-13: 9780198565741

Published to Oxford Scholarship Online: February 2010

DOI: 10.1093/acprof:oso/9780198565741.001.0001

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The orbitofrontal cortex in drug addiction

The orbitofrontal cortex in drug addiction

(p.481) Chapter 19 The orbitofrontal cortex in drug addiction
The Orbitofrontal Cortex

Rita Z. Goldstein

Nelly Alia-Klein

Lisa A. Cottone

Nora D. Volkow

Oxford University Press

This chapter reviews the role of the orbitofrontal cortex (OFC) in the clinical characteristics of drug addiction and their putative neuropsychological mechanisms. The OFC's role in reward processing, saliency attribution, and motivation is hypothesized to allow drugs of abuse to assume such intense value that the drug-addicted individual experiences intense wanting (or craving) of this valuable commodity at the cost of a generalized relative indifference for all other stimuli. It is suggested that the OFC maintains a representation of the drug as valuable. With this impairment in salience attribution, loss of inhibitory control ensues, causing the bingeing component of addiction. When the drug is no longer available, the individual experiences withdrawal, and OFC abnormalities may feedback into relapse to drug use, especially when the drug itself, or merely a cue, triggers the well-maintained association between the drug and its salient value.

Keywords:   drug, substance abuse, dependence, craving, salience, inhibition, motivation, dopamine

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