Impaired Cognition Control and Inferior Frontal Cortex Modulation in Heroin Addiction

The inability to inhibit compulsive drug-driven behavior is a key hallmark of heroin addiction. This chapter provides behavioral and neural evidence of how cognitive control functions are affected in chronic and abstinent heroin-dependent individuals, as well as in patients actively enrolled in an opioid maintenance treatment. We first show that heroin addiction is accompanied by behavioral impairments across a wide range of cognitive control functions including deficits in attentional and inhibitory processes. The second part emphasizes that heroin-addicted subjects reveal structural and functional abnormalities in the right inferior frontal gyrus as measured with brain imaging techniques and indicates how they are related to cognitive performance, providing a putative relation between brain structure, function, and behavior. The reported findings suggest that heroin addiction is more related to a general rather than to a specific cognitive impairment. Longitudinal study designs are needed to understand how these behavioral and neural correlates of cognitive control deficits develop over both the course of addiction and different therapeutic scenarios.