BRAIN REWARDING CIRCUITS IN MECHANISMS OF PLEASURE AND ADDICTION: IMPLICATIONS FOR PSYCHOSURGERY

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Background. Several psychiatric disorders like Obsessive-compulsive disorder, Eatting behavior disorders and refractory Drug Addiction, share some neural mechanisms that are based on the brain circuitry that regulate reward and pleasure, the so-called Brain Rewarding Circuits. These circuits were first studied in experience animal during the fifties in the XX century, but only later they have been extensively investigated in the human brain: the structures, the pathways, the neurotransmitters, the way they interact and the clinical manifestations for which they are responsible. There are many involved structures and paths, namely the Ventral Tegmental Area, the Nucleus Accumbens, the Amygdala and the Stria Terminalis, the Hypothalamus, the Prefrontal Cortex, the Medial Forebrain Bundle; these are the main ones among several others interesting the limbic system and more. Conclusions. The author presents an updated review of these aspects and their major clinical implications respecting the above mentioned disorders, including his own experience on Deep Brain Stimulation (DBS) to treat Refractory Drug Addiction.