Striatal Neural Processing of Sexual Cues in Problematic Pornography Use: A Systematic Review

Abstract Purpose of Review This preregistered systematic review examines the role of the striatum in sexual cue processing, with a focus on its involvement in problematic pornography use (PPU) and associations with psycho-behavioral markers of pornography use. Distinctions are made between cue processing in ventral and dorsal striatal subregions as well as between proximal and distal cue types. Recent Findings Both ventral and dorsal striatal regions are involved in processing proximal and distal sexual cues in clinical and non-clinical populations. Some studies find higher ventral and dorsal striatal activity in participants with PPU compared to non-problematic users when processing proximal and distal sexual cues, whereas other studies report no striatal activity differences. Moreover, altered cue-induced corticostriatal connectivity has been observed in PPU groups. Striatal reactivity and connectivity are further associated with motivational salience, subjective valence of cues and pornography viewing behavior. Summary Striatal dysregulation may contribute to mechanisms fostering PPU, but the evidence is still limited. The involvement of striatal subregions in specific processes underlying PPU development should be examined in future research.