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This study reveals that substance-use disorders and behavioral addictions show distinct brain structure changes, with some overlap in the caudate nucleus. Pooled analysis identified interactive brain regions crucial for reward processing in addiction.

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Area of Science:

  • Neuroscience
  • Psychiatry
  • Radiology

Background:

  • Addictions are classified as substance-use disorders (SUD) or behavioral addictions (BA).
  • SUDs are established diagnoses, while BAs are recently recognized with evolving classifications.
  • No comprehensive meta-analysis has examined brain structure in both SUD and BA.

Purpose of the Study:

  • To identify gray matter (GM) alterations in SUD and BA, both independently and jointly.
  • To perform coordinate-based meta-analyses (CBMA) on existing VBM studies.
  • To explore transdiagnostic patterns of neuroanatomical changes in addiction.

Main Methods:

  • Conducted eight transdiagnostic alteration likelihood estimation (ALE) CBMAs on 108 VBM studies (83 SUD, 25 BA).
  • Performed three primary ALEs for SUD, BA, and pooled addictions (SUD + BA).
  • Executed five ALE-to-ALE comparison analyses, including interaction, overlap, conjunction, and contrast.

Main Results:

  • Independent ALEs showed distinct GM alteration patterns for SUD and BA, with overlap only in the caudate nucleus.
  • Pooled ALE identified 24 new alteration foci not found in independent analyses, termed 'interactive' as they were contributed to by both SUD and BA.
  • Functional decoding consistently linked brain regions with structural alterations to reward and reward-related cognitive operations across all ALEs.

Conclusions:

  • SUD and BA exhibit largely distinct neuroanatomical patterns, but share overlapping regions.
  • Interactive brain regions, identified through pooled analysis, are critical for understanding addiction transdiagnostically.
  • Structural alterations in addiction disorders are functionally associated with reward processing pathways.