Attending to striatal ups and downs in addictions

Abstract

Reply by the current authors to the comments made by Marco Leyton & Paul Vezina (see record 2012-28726-013) on the original article (see record 2012-04221-001). Leyton and Vezina proposed that these divergent results may relate to cue specificity; in addicted populations addiction-related cues increase striatal activity, whereas in the absence of such cues, diminished striatal activity is observed. The authors suggested that the playing cards presented by van Holst et al. may be more familiar/salient to pathological gambling (PG) participants, whereas the predominance of text presented by Balodis et al. may account for the diminished striatal response. This explanation is complicated by several factors. First, the PG samples in both studies were heterogeneous in their gambling preferences. Second, the Monetary Incentive Delay Task used by Balodis et al. included money symbols on each trial and references to currency, wins, and losses, all of which might be considered addiction-related stimuli in PG. Functional roles of striatal subregions are dissociable and complex. Given the fundamental role of separate striatal subdivisions in different aspects of reward processing, careful attention should be given to anatomical distinctions. Dorsolateral and dorsomedial striatal regions are currently being further distinguished based on connectivity and function. To better understand anatomical and behavioral correlates of the striatum, we encourage a precise, nuanced approach in attending to striatal ups and downs.

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