Rationale and objectives: Repeated exposure to many drugs of abuse results in a progressive and enduring enhancement in the motor stimulant effect
elicited by a subsequent drug challenge. This phenomenon, termed behavioral sensitization, is thought to underlie certain
aspects of drug addiction. Behavioral sensitization is the consequence of drug-induced neuroadaptive changes in a circuit
involving dopaminergic and glutamatergic interconnections between the ventral tegmental area, nucleus accumbens, prefrontal
cortex and amygdala.
Methods: The literature was critically reviewed in an effort to discern the relative roles of glutamate and dopamine transmission
in the induction and expression of sensitization to amphetamine, cocaine and µ-opioids. In addition, the literature was reviewed
to evaluate distinctions between these drugs in the involvement of the relevant brain nuclei listed above.
Results: The common substrates between sensitizing drugs are glutamate transmission, especially at the NMDA receptor, and an action
in the ventral tegmental area. In contrast, a role for dopamine is only clearly seen in amphetamine sensitization and critical
involvement of nuclei outside the ventral tegmental area is found for cocaine and morphine. While enhanced dopamine transmission
is associated with sensitization by all three drugs, a role for glutamate is clearly identified only with cocaine sensitization.
Accordingly, glutamatergic cortical and allocortical brain regions such as the prefrontal cortex appear more critical for
cocaine sensitization.
Conclusions: The distinctions between drugs in the induction and expression of sensitization indicate that behavioral sensitization can
arise from multiple neuroadaptations in multiple brain nuclei. This is not only the result of distinct molecular targets for
the drugs, but may also include a differential involvement of learned associations. It is postulated that the relatively more
robust pharmacological capacity of amphetamine to release dopamine may induce a form of sensitization that is more dependent
on adaptations in mesoaccumbens dopamine transmission compared with cocaine and morphine sensitization.
Keywords Behavioral sensitization - Locomotor activity - Dopamine - Glutamate - Ventral tegmental area - Nucleus accumbens - Prefrontal cortex - Drug addiction
Received: 11 January 2000 / Accepted: 2 May 2000