Cognition and addiction


Antonio Verdejo-Garcia, Gloria Garcia-Fernandez, Geert Dom

Research output: Contribution to journalArticleResearchpeer-review

Abstract

In this targeted review, we summarize current knowledge on substance-use disorder (SUD)-related cognitive deficits, the link between these deficits and clinical outcomes, and the cognitive training, remediation, and pharmacological approaches that have the potential to rescue cognition. We conclude that: (i) people with SUDs have moderate deficits in memory, attention, executive functions, and decision-making (including reward expectancy, valuation, and learning); (ii) deficits in higher-order executive functions and decision-making are significant predictors of relapse; (iii) cognitive training programs targeting reward-related appetitive biases, cognitive remediation strategies targeting goal-based decision-making, and pharmacotherapies targeting memory, attention, and impulsivity have potential to rescue SUD-related cognitive deficits. We suggest avenues for future research, including developing brief, clinically oriented harmonized cognitive testing suites to improve individualized prediction of treatment outcomes; computational modeling that can achieve deep phenotyping of cognitive subtypes likely to respond to different interventions; and phenotype-targeted cognitive, pharmacological, and combined interventions. We conclude with a tentative model of neuroscience-informed precision medicine.
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Original languageEnglish
Pages (from-to)281-290
Number of pages10
JournalDialogues in Clinical Neuroscience
Volume21
Issue number3
DOIs
Publication statusPublished - 1 Sep 2019

Keywords

  • cognition
  • cognitive enhancer
  • cognitive remediation
  • cognitive training
  • decision-making
  • substance-use disorder
  • treatment outcome

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