Nucleus accumbens reward — MRCPsych Paper A MCQ

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ModerateNeuroanatomyNucleus accumbens rewardMRCPsych Paper A

A 28-year-old man with cocaine dependence experiences intense craving and approach motivation whenever he enters places associated with his previous cocaine use. These conditioned cues have acquired incentive salience within the mesolimbic reward system. Which structure is the ventral striatal target most directly involved in translating this cue-related salience into drug-seeking behaviour?

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Correct answer: E — Nucleus accumbens

The correct answer is E, nucleus accumbens. It is part of the ventral striatum and a major target of mesolimbic dopaminergic projections. It integrates cortical and limbic inputs and helps conditioned drug cues acquire incentive salience, promoting craving and drug-seeking. The ventral tegmental area is the principal origin of mesolimbic dopamine neurons rather than their ventral striatal target. The amygdala contributes emotional and conditioned associations, while the hippocampus provides contextual memory for places associated with drug use. The dorsolateral prefrontal cortex contributes executive control and cue responses but is not the key ventral striatal reward structure described.

Reference: Scofield MD et al. The Nucleus Accumbens: Mechanisms of Addiction across Drug Classes Reflect the Importance of Glutamate Homeostasis. Pharmacological Reviews. 2016;68(3):816-871. https://pubmed.ncbi.nlm.nih.gov/27363441/