The orbitofrontal cortex has emerged as a potential neural substrate for an impaired ability to evaluate expected outcomes leading to poor decision making among SDI (8,2,4).Through its connections with the limbic system, OFC integrates associative information to produce a representation of expected outcomes. Chronic drug use results in adaptations in neural morphology and cell signaling that are thought to disrupt cognitive processes such as decision-making (8). Rats treated with cocaine show deficits in OFC-dependent functions such as reversal learning (4). In chronic cocaine users, metabolic abnormalities are relatively specific to frontal lobes (7). As noted above, some changes are transient, but others may persist long after drug exposure (2,25,26)
