Drug addiction is a chronically relapsing disorder characterized by compulsion to seek and take drug(s) regardless of the adverse consequences that may ensue (
American Psychiatric Association, 1994). Addicts typically exhibit decreased motivation for natural rewards (e.g., food, water, sex) that normally drive behavior. The abrupt cessation of drug use leads to the emergence of both affective (e.g., dysphoria, anxiety, anhedonia, somatic) and somatic withdrawal signs (
Gawin, 1991;
Koob and LeMoal, 1997; review: Koob, 2005). The contribution of VTA DA neurons projecting to the NAc to the rewarding effects of psychostimulants and other stimuli is well documented (
Ranaldi et al., 1999;
Wise, 1998). Similarly, several lines of evidence suggest an important role of this DA system in the transition from casual drug use to abuse (review:
Wise, 2004). However, the application of a systems approach to the study of addiction has provided new insights as to the role of brain regions comprising the limbic cortical-striatopallidal circuit in mediating the dysregulation of behavior that characterizes addiction (review:
Everitt and Wolf, 2002).
DA afferents arising from the VTA are key elements of the limbic cortical-striatopallidal circuit, a neural circuit that has been implicated in the control of mood, incentive motivation and habit (stimulus-response) learning (
Schultz 2002;
Graybiel, 2005). Brain regions comprising this circuit include the prefrontal cortex (medial, orbital and cingulate), VTA, substantia nigra, dorsal striatum and NAc (core and shell) as well as the hippocampus, amygdala and ventral pallidum (
Everitt and Robbins, 2005,
Heimer and Van Hoesen, 2006). Projections to the VTA arise from both the NAc and ventral pallidum and exhibit a mediolateral topography (
Groenewegen et al., 1993;
Zahm and Heimer, 1993). Projections from the NAc shell are restricted to the VTA whereas those from the core occupy the lateral part of the VTA and also extend through much of the substantia nigra pars compacta. VTA DA neurons project to the NAc and medial prefrontal cortex whereas DA neurons arising in the substantia nigra innervate the dorsal striatum (
Graybiel 1990). Cross-talk between these regions is mediated in part, by glutamatergic neurons originating in the prefrontal cortex that project to the VTA, NAc and substantia nigra as well as by axons and axon collaterals of medium spiny neurons in the striatum and NAc (
Kalivas et al. 2005).
Reciprocal connections between specific parts of the shell and core of the NAC have been documented (
Haber et al., 2000; van Dongen et al., 2005). Anatomical studies suggest that output from the NAc shell can influence the function of ascending DA projections to the core which in turn modulate the activity of dorsal striatal neurons via projections to the substantia nigra. Within the striatum, excitatory inputs from cortical glutamatergic neurons and modulatory inputs from GABAergic and midbrain DA neurons converge onto dendritic spines of medium spiny neurons (
Yung and Bolam, 2000) which express GABA, DYN and other neuropeptides. Medium spiny neurons in both the striatum and NAc can be classified into two types. Both release GABA. However, one class contains DYN and predominately expresses the D1 DA receptor whereas the other contains enkephalin and the D2 class of DA receptors (
Gerfen et al., 1990;
Graybiel, 1990). DYN containing neurons project directly project to the substantia nigra and VTA to synapse on DA cells whereas the enkephalin pathway to DA cells is indirect.
DA neurotransmission in the NAc is essential for the processing of behaviorally relevant stimuli and the attribution of motivational valence to reward related events (
Robinson and Berridge, 1993; Schultz, 1998;
Schultz, 2002). Psychostimulants and other drugs of abuse increase extracellular DA levels in the NAc (
DiChiara and Imperato, 1988). Both pharmacological and neurochemical studies have shown that this action underlies the rewarding effects of these agents and the initiation of drug abuse (
Di Chiara et al., 2004;
Wise, 1998;
Wise, 2004). Cocaine produces this effect at the level of the DA nerve terminal by binding to and inhibiting the dopamine transporter (DAT), a transmembrane protein that re-uptakes DA released into the extracellular space (
Ritz et al., 1987). In contrast, ethanol and opiates such as morphine stimulate the firing of mesoaccumbal DA neurons in the VTA (
Brodie et al., 1999; Matthews and German, 1984).
Repeated cocaine use alters mesoaccumbal DA neurotransmission. However, the magnitude and type of effect observed can vary depending upon the dose and frequency of drug administration, duration of abstinence and sub-region examined. Several laboratories have shown that basal DA uptake is increased in the NAc core during the early phase of abstinence from repeated cocaine (
Ng et al., 1991;
Mateo et al., 2005;
Thompson et al., 2000). By contrast, the ability of an acute injection of cocaine to inhibit DA uptake in either the shell or core, and hence, increase NAc DA levels is typically decreased at this time point (
Kalivas and Duffy, 1993; Segal and Kuczenski, 1992). Decreased basal and drug-evoked DA neurotransmission is also observed in laboratory animals during the early phase of abstinence from alcohol and opiates (
Diana et al., 1993,
1996;
Spanagel et al., 1994;
Weiss et al., 1996;
Zapata et al., 2006). Decreased basal DA neurotransmission is thought to contribute to the “crash” that characterizes cocaine withdrawal, the anhedonic effects associated with opiate withdrawal, and to the affective component of alcohol withdrawal. With sustained abstinence, basal DA dynamics normalize and the ability of acute exposure to several drugs of abuse to increase NAc DA levels is enhanced (
Kalivas and Duffy, 1993;
Heidbreder et al., 1996). The time course of this enhancement parallels the progressive increase in the locomotor activating effects of cocaine that occurs as abstinence progresses (
Kalivas and Duffy, 1993;
Heidbreder et al., 1996) indicating an important role of the mesoaccumbal DA projection in mediating the long-term expression of sensitization to the psychomotor stimulant effects of cocaine. Although self-administration studies (
Morgan et al., 2006) have shown that sensitization develops to the rewarding effects of cocaine, whether this effect is also associated with similar alterations in presynaptic DA transmission has not been examined.
Modulation of DA release in the prefrontal cortex as well as the NAc appears to be a critical mechanism by which cocaine and other drugs of abuse gain control over behavioral output (
Kalivas and Volkow, 2005). In addition, emerging evidence indicates that the prefrontal cortex (PFC), a region critical for working memory, is a final common pathway by which exposure to stress, cues previously associated with the drug, or drug itself can trigger relapse (
Breiter et al., 1997;
Capriles et al., 2003;
McFarland et al., 2004;
Rebec and Sun, 2005). Studies of the medial PFC have shown that the repeated administration of cocaine is associated with alterations in basal and cocaine-evoked DA dynamics (
Chefer et al., 2000; Meiergard et al., 1997;
Williams and Steketee, 2005). During the early phase of cocaine abstinence, basal DA uptake is increased and depolarization-evoked DA release is reduced. Furthermore, the ability of an acute cocaine challenge to increase DA overflow is reduced. Decreases in extracellular DA levels and D2 receptor function in the prefrontal cortex are postulated to lead to the compulsive drug-seeking and reduced drive for natural rewards that characterizes addiction (
Kalivas et al., 2005).
The ventral pallidum regulates motivated behaviors (
Mogenson and Yang, 1991) and it appears to be involved in cocaine-mediated effects. For example, intra-ventral pallidal injections of cocaine are sufficient to induce place conditioning (
Gong et al., 1996). Furthermore, dopamine deafferentation of the pallidum attenuates the conditioned rewarding effect of systemically administered cocaine (
Gong et al., 1997). Neurochemical data indicating the possible involvement of the mesopallidal projection in mediating cocaine as well as ethanol self-administration has also been demonstrated (Melandez et al., 2004;
Smith et al., 2003).
Data indicating an involvement of dorsal striatal DA neurons in the pathogenesis of compulsive drug seeking, once, established, has more recently been obtained. Studies in which second order schedules of reinforcement have been used to distinguish drug-taking from drug-seeking indicate that DA input to this region is critical for cue-evoked drug-seeking in animals with an extended history of cocaine self-administration (
Ito et al; 2002;
Vanderschuren et al., 2005). These findings are particularly noteworthy in view of the distinct roles of the dorsomedial and dorsolateral striatum in mediating goal-directed and habit (stimulus-response) learning, respectively (
Packard and Knowlton, 2002;
Yin et al., 2005). Furthermore, as discussed below, cocaine-induced alterations in PDYN expression are most marked in these striatal sectors. When viewed in the context of the circuitry of the prefrontal cortico-striatal loop, these findings and others suggest that with repeated drug use, there is a transition from prefrontal cortical to striatal control over responding and from ventral to dorsal striatal subregions. As a consequence, drug use which was initially goal-directed becomes habitual and the motivational valence of other stimuli is reduced (
Robbins and Everitt, 1999).
Glutamatergic systems are another important neuronal substrate of behaviors induced by drugs of abuse. During the early phase of abstinence, both stress- and drug-induced reinstatement of cocaine seeking are associated with an elevation of extracellular glutamate levels in the NAc core (
McFarland et al., 2004). Inactivation of the dorsal PFC blocks stress-induced glutamate release within the Acb core and inhibits stress-induced reinstatement of drug-seeking. These findings, and those regarding pharmacological inactivation of the central extended amygdala, have led to the hypothesis that stress (e.g., footshock) activates limbic circuitry, which in turn activates a VTA dopamine projection to the PFC. Activation of a glutamatergic projection from the PFC to the NAc also appears necessary for cocaine-primed reinstatement of drug-seeking behavior (
McFarland et al., 2003). Other studies have shown that blockade of glutamate transmission to the NAc core prevents drug-seeking behavior in response to cocaine associated cues (
Di Ciano and Everitt, 2001;
2004). Like DA, glutamate levels in the NAc core are reduced during the early phase of cocaine abstinence (
Baker et al., 2003;
McFarland et al., 2003). It has been hypothesized that this reduction, and the resultant decrease in the activity of metabotropic glutamate autoreceptors, underlies the increase in extracellular glutamate levels that is associated with the reinstatement of compulsive drug-seeking (
Kalivas et al., 2005). According to current theories, this increase may not only lead to a strengthening of drug-seeking behavior, making it more compulsive, but also decrease responding for non-drug stimuli.
Studies using a second order schedule of reinforcement in animals with an extensive history of cocaine-seeking and taking suggest that glutamate as well as DA transmission in the dorsal striatum is essential for drug seeking behavior elicited by cocaine-associated stimuli (
Vanderschuren et al., 2005). Thus, intra-striatal infusion of a DA receptor antagonist or a selective AMPA/kainate receptor antagonist decreased cue-controlled cocaine seeking. These findings highlight the importance of aberrant DA and glutamate neurotransmission in the addiction process. As discussed below, KOPr are present on DA and glutamate neurons in prefrontal cortico-striatal loop. Furthermore, ultrastructural studies have revealed multiple sites for presynaptic modulation of DA and glutamate by DYN/KOPr systems.