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Prog Brain Res. 2016;224:345-69. doi: 10.1016/bs.pbr.2015.07.022. Epub 2015 Nov 26.

Perspectives on neurocognitive rehabilitation as an adjunct treatment for addictive disorders: From cognitive improvement to relapse prevention.

Author information

1
Research Center for Molecular and Cellular Imaging, Tehran University of Medical Sciences, Tehran, Iran; Translational Neuroscience Program, Institute for Cognitive Science Studies, Tehran, Iran.
2
Department of Psychiatry, School of Medicine, Yale University, New Haven, CT, USA.
3
Department of Psychiatry, School of Medicine, Yale University, New Haven, CT, USA; VA Connecticut Healthcare System, West Haven, CT, USA.
4
Translational Neuroscience Program, Institute for Cognitive Science Studies, Tehran, Iran; Research Center for Molecular and Cellular Imaging, Tehran University of Medical Sciences, Tehran, Iran. Electronic address: H_Ekhtiari@razi.tums.ac.ir.

Abstract

Addiction, as a brain disorder, can be defined with two distinct but interacting components: drug dependency and neurocognitive deficits. Most of the therapeutic interventions in addiction medicine, including pharmacological or psychosocial therapies, that are in clinical use have been mainly focused on directly addressing addictive behaviors, especially drug use and urges to use drugs. In the field of addiction treatment, it is often presumed that drug users' neurocognitive deficits will reverse following abstinence. However, in many cases, neurocognitive deficits are not fully ameliorated following sustained abstinence, and neurocognitive function may further deteriorate in early abstinence. It can be argued that many cognitive functions, such as sustained attention and executive control, are essential for full recovery and long-term abstinence from addiction. Recent advances in cognitive neuroscience have provided scientific foundations for neurocognitive rehabilitation as a means of facilitating recovery from drug addiction. Neurocognitive rehabilitation for drug addicted individuals could be implemented as part of addiction treatment, with highly flexible delivery methods including traditional "paper and pencil" testing, or computer-based technology via laptops, web-based, or smartphones in inpatient and outpatient settings. Despite this promise, there has been limited research into the potential efficacy of neurocognitive rehabilitation as a treatment for drug addiction. Further, many questions including the optimum treatment length, session duration, and necessary treatment adherence for treatment efficacy remain to be addressed. In this chapter, we first introduce cognitive rehabilitation as one of the potential areas to bridge the gap between cognitive neuroscience and addiction medicine, followed by an overview of current challenges and future directions.

KEYWORDS:

Addiction; Neurocognitive rehabilitation; Neuroplasticity

PMID:
26822366
DOI:
10.1016/bs.pbr.2015.07.022
[Indexed for MEDLINE]

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