Mental Health
Striatal Neural Processing of Sexual Cues in Problematic Pornography Use: A Systematic Review.
Open Access: No.
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.
Relevance
“The reviewed evidence suggests that individuals with PPU [problematic pornography use] or CSBD [compulsive sexual behavior disorder] may show heightened ventral and dorsal (caudate nucleus and putamen) striatal responses to proximal and distal sexual cues.”
The findings “are consistent with the notion that heightened cue reactivity of the ventral striatum to proximal and distal cues in individuals with PPU may be related to increased reward or relief attribution (‘feels better’ pathway) promoting problematic use.” The findings, too, “could indicate alterations in sexual reward thresholds and mechanisms of habituation to sexual content, similar to habituation effects in other addictions.”
“The present systematic review highlights the central involvement of ventral and dorsal striatal processing of proximal and distal sexual stimuli across non-clinical and clinical populations related to PPU. There is some indication that individuals with PPU may show enhanced ventral and dorsal striatal cue processing…Across both proximal and distal cue processing, ventral striatum and caudate activity was positively associated with indicators of valence and motivational salience and putamen activity related to pornography viewing behavior. The results support the idea that striatal activity is closely tied to the reinforcing emotional, motivational and behavioral processes involved in PPU. Moreover, symptom severity may be related to corticostriatal connectivity and the strength of the relationship between striatal responses and reinforcing emotional and motivational factors. ”
Citation
Lichte, A., Kyuchukova, D., Stark, R., Brand, M., & Antons, S. (2025). Striatal Neural Processing of Sexual Cues in Problematic Pornography Use: A Systematic Review. Current Addictions Reports, 12, Article 91. https://doi.org/10.1007/s40429-025-00702-2
