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July 27, 2022

Neuropsychoimaging Measures as Alternatives to Drug Use Outcomes in Clinical Trials for Addiction

Author Affiliations
  • 1Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York
  • 2Department of Neuroscience, Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, New York
JAMA Psychiatry. 2022;79(9):843-844. doi:10.1001/jamapsychiatry.2022.1970

Cognitive impairments in people with substance use disorders have been reliably documented, generalizable across multiple domains and substance types.1 Specific neuropsychological domains of dysfunction have been identified, encompassing decision-making, inhibitory control, and salience attribution/value assignment (spanning also emotional and motivational dimensions such as cue reactivity and negative affect processing). Indeed, targeting improvements in these and related functions, interventions such as cognitive reappraisal and inhibition of craving, motivational and emotional regulation, mindfulness, and neurofeedback are effective in normalizing underlying neural function and reducing drug use in people with substance use disorders. There is now widespread recognition of the importance of neuropsychological function and dysfunction in addiction and the link between cognitive resources and treatment and longitudinal outcomes (eg, cognitive dysfunction negatively affects treatment retention/adherence and quality of life, showing associations with craving and relapse).2 However, the use of these neuropsychological and neuroimaging measures (that is, neuropsychoimaging) as main outcomes in clinical trials is not yet widely adopted. In this Viewpoint, I spotlight the importance of using neuropsychoimaging functions as main outcome measures in clinical trials for addiction.

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