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Farré-Colomés À, Tan H, Gerhardt S, Gerchen MF, Kirsch M, Hoffmann S, Kirsch P, Kiefer F, Vollstädt-Klein S. Cue-exposure treatment influences resting-state functional connectivity-a randomized controlled fMRI study in alcohol use disorder. Psychopharmacology (Berl) 2024; 241:513-524. [PMID: 38261011 PMCID: PMC10884177 DOI: 10.1007/s00213-024-06531-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 01/08/2024] [Indexed: 01/24/2024]
Abstract
RATIONALE Cue-exposure therapy (CET) consists of exposing patients to the cause of their affliction in a controlled environment and after psychological preparation. Ever since it was conceived, it has been suggested as a treatment for different types of behavioural impairments, from anxiety disorders to substance abuse. In the field of addictive behaviour, many different findings have been shown regarding the effectiveness of this therapy. OBJECTIVES This study aims to examine the underlying neurobiological mechanisms of the effects of CET in patients with alcohol use disorder using resting-state functional magnetic resonance imaging (rs-fMRI). METHODS In a randomized, controlled study, we examined patients after inpatient detoxification as well as healthy controls. Patients underwent nine sessions of CET spaced over 3 weeks. Rs-fMRI was conducted before treatment and 3 weeks after treatment onset in patients, healthy controls received only one rs-fMRI measurement. The final participant sample with complete data included 35 patients in the CET group, 17 patients in the treatment-as-usual group, and 43 HCs. RESULTS Our results show differences in the Salience Network when comparing the CET group to the treatment-as-usual group (TAU). Functional connectivity between the anterior cingulate Cortex (ACC) and the insula was increased after CET, whereas it was decreased from ACC to the putamen and globus pallidus. Further, increased connectivity with the precuneus was found in the dorsal attention network after cue exposure treatment. CONCLUSIONS These findings suggest that cue exposure therapy changes the resting-state brain connectivity with additional effects to the standard psychotherapy treatment. Hence, our study results suggest why including CET in standard therapies might improve the preparation of patients in front of daily situations.
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Affiliation(s)
- Àlvar Farré-Colomés
- Department of Addictive Behaviour and Addiction Medicine, Central Institute of Mental Health, Medical Faculty of Mannheim, Heidelberg University, 68159, Mannheim, Germany
| | - Haoye Tan
- Department of Addictive Behaviour and Addiction Medicine, Central Institute of Mental Health, Medical Faculty of Mannheim, Heidelberg University, 68159, Mannheim, Germany
| | - Sarah Gerhardt
- Department of Addictive Behaviour and Addiction Medicine, Central Institute of Mental Health, Medical Faculty of Mannheim, Heidelberg University, 68159, Mannheim, Germany
| | - Martin Fungisai Gerchen
- Department of Clinical Psychology, Central Institute of Mental Health, Medical Faculty of Mannheim, Heidelberg University, 68159, Mannheim, Germany
- Bernstein Center for Computational Neuroscience Heidelberg/Mannheim, 68159, Mannheim, Germany
- Department of Psychology, Heidelberg University, 69117, Heidelberg, Germany
| | - Martina Kirsch
- Department of Addictive Behaviour and Addiction Medicine, Central Institute of Mental Health, Medical Faculty of Mannheim, Heidelberg University, 68159, Mannheim, Germany
| | - Sabine Hoffmann
- Department of Addictive Behaviour and Addiction Medicine, Central Institute of Mental Health, Medical Faculty of Mannheim, Heidelberg University, 68159, Mannheim, Germany
| | - Peter Kirsch
- Department of Clinical Psychology, Central Institute of Mental Health, Medical Faculty of Mannheim, Heidelberg University, 68159, Mannheim, Germany
- Bernstein Center for Computational Neuroscience Heidelberg/Mannheim, 68159, Mannheim, Germany
- Department of Psychology, Heidelberg University, 69117, Heidelberg, Germany
| | - Falk Kiefer
- Department of Addictive Behaviour and Addiction Medicine, Central Institute of Mental Health, Medical Faculty of Mannheim, Heidelberg University, 68159, Mannheim, Germany
- Mannheim Center for Translational Neurosciences (MCTN), Medical Faculty of Mannheim, Heidelberg University, 68159, Mannheim, Germany
- Feuerlein Center on Translational Addiction Medicine, Heidelberg University, 69117, Heidelberg, Germany
| | - Sabine Vollstädt-Klein
- Department of Addictive Behaviour and Addiction Medicine, Central Institute of Mental Health, Medical Faculty of Mannheim, Heidelberg University, 68159, Mannheim, Germany.
- Mannheim Center for Translational Neurosciences (MCTN), Medical Faculty of Mannheim, Heidelberg University, 68159, Mannheim, Germany.
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Larsen JK, Hollands GJ, Garland EL, Evers AWM, Wiers RW. Be more mindful: Targeting addictive responses by integrating mindfulness with cognitive bias modification or cue exposure interventions. Neurosci Biobehav Rev 2023; 153:105408. [PMID: 37758008 DOI: 10.1016/j.neubiorev.2023.105408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 09/01/2023] [Accepted: 09/22/2023] [Indexed: 09/29/2023]
Abstract
This review provides an overview of the most prominent neurocognitive effects of cognitive bias modification (CBM), cue-exposure therapy and mindfulness interventions for targeting addictive responses. It highlights the key insights that have stemmed from cognitive neuroscience and brain imaging research and combines these with insights from behavioural science in building a conceptual model integrating mindfulness with response-focused CBM or cue-exposure interventions. This furthers our understanding of whether and how mindfulness strategies may i) facilitate or add to the induced response-focused effects decreasing cue-induced craving, and ii) further weaken the link between craving and addictive responses. Specifically, awareness/monitoring may facilitate, and decentering may add to, response-focused effects. Combined awareness acceptance strategies may also diminish the craving-addiction link. The conceptual model presented in this review provides a specific theoretical framework to deepen our understanding of how mindfulness strategies and CBM or cue-exposure interventions can be combined to greatest effect. This is important in both suggesting a roadmap for future research, and for the further development of clinical interventions.
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Affiliation(s)
- Junilla K Larsen
- Behavioural Science Institute, Radboud University, PO Box 9104, 6500 HE Nijmegen, the Netherlands.
| | - Gareth J Hollands
- EPPI Centre, UCL Social Research Institute, University College London, UK
| | - Eric L Garland
- Center on Mindfulness and Integrative Health Intervention Development, College of Social Work, University of Utah, Salt Lake City, USA
| | - Andrea W M Evers
- Health, Medical and Neuropsychology Unit, Leiden University, NL, and Medical Delta, Leiden University, TU Delft and Erasmus University, UK
| | - Reinout W Wiers
- Addiction Development and Psychopathology (ADAPT)-lab, Department of Psychology, University of Amsterdam and Centre for Urban Mental Health, University of Amsterdam, the Netherlands
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Zeng J, Yu S, Cao H, Su Y, Dong Z, Yang X. Neurobiological correlates of cue-reactivity in alcohol-use disorders: A voxel-wise meta-analysis of fMRI studies. Neurosci Biobehav Rev 2021; 128:294-310. [PMID: 34171325 DOI: 10.1016/j.neubiorev.2021.06.031] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 05/31/2021] [Accepted: 06/19/2021] [Indexed: 02/08/2023]
Abstract
Altered brain responses to alcohol-associated stimuli are a neural hallmark of alcohol-use disorder (AUD) and a promising target for pharmacotherapy. However, findings in cue-reactivity based functional MRI (fMRI) studies are inconclusive. To investigate the neural substrates of cue-reactivity and their relevance to treatment outcomes, alcohol craving and relapse in AUD patients, we performed five meta-analyses using signed differential mapping software. Our meta-analysis revealed that alcohol cues evoke greater cue-reactivity than neutral cues in the mesocorticolimbic circuit and lower reactivity in the parietal and temporal regions in AUD patients. Compared to controls, AUD individuals displayed hyperactivations in the medial prefrontal cortex and anterior/middle part of the cingulate cortex. After receiving AUD treatment, AUD patients exhibited greater activations in the precentral gyrus but reduced activations in the bilateral caudate nucleus, insula, right DLPFC, and left superior frontal gyrus. No significant results were found in cue-reactivity correlates of alcohol craving and relapse. Our results implicate cue-induced abnormalities in corticostriatal-limbic circuits may underline the pathophysiology of AUD, and have translational value for treatment development.
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Affiliation(s)
- Jianguang Zeng
- School of Economics and Business Administration, Chongqing University, Chongqing, 400044, China
| | - Shuxian Yu
- School of Economics and Business Administration, Chongqing University, Chongqing, 400044, China
| | - Hengyi Cao
- Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Hempstead, NY, USA; Division of Psychiatry Research, Zucker Hillside Hospital, Glen Oaks, NY, USA
| | - Yueyue Su
- School of Public Policy and Administration, Chongqing University, Chongqing, 400044, China
| | - Zaiquan Dong
- Department of Psychiatry, State Key Lab of Biotherapy, West China Hospital of Sichuan University, Chengdu, 610041, China
| | - Xun Yang
- School of Public Policy and Administration, Chongqing University, Chongqing, 400044, China.
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4
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Gleich T, Spitta G, Butler O, Zacharias K, Aydin S, Sebold M, Garbusow M, Rapp M, Schubert F, Buchert R, Heinz A, Gallinat J. Dopamine D2/3 receptor availability in alcohol use disorder and individuals at high risk: Towards a dimensional approach. Addict Biol 2021; 26:e12915. [PMID: 32500613 DOI: 10.1111/adb.12915] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Revised: 04/09/2020] [Accepted: 04/17/2020] [Indexed: 12/14/2022]
Abstract
Alcohol use disorder (AUD) is the most common substance use disorder worldwide. Although dopamine-related findings were often observed in AUD, associated neurobiological mechanisms are still poorly understood. Therefore, in the present study, we investigate D2/3 receptor availability in healthy participants, participants at high risk (HR) to develop addiction (not diagnosed with AUD), and AUD patients in a detoxified stage, applying 18 F-fallypride positron emission tomography (18 F-PET). Specifically, D2/3 receptor availability was investigated in (1) 19 low-risk (LR) controls, (2) 19 HR participants, and (3) 20 AUD patients after alcohol detoxification. Quality and severity of addiction were assessed with clinical questionnaires and (neuro)psychological tests. PET data were corrected for age of participants and smoking status. In the dorsal striatum, we observed significant reductions of D2/3 receptor availability in AUD patients compared with LR participants. Further, receptor availability in HR participants was observed to be intermediate between LR and AUD groups (linearly decreasing). Still, in direct comparison, no group difference was observed between LR and HR groups or between HR and AUD groups. Further, the score of the Alcohol Dependence Scale (ADS) was inversely correlated with D2/3 receptor availability in the combined sample. Thus, in line with a dimensional approach, striatal D2/3 receptor availability showed a linear decrease from LR participants to HR participants to AUD patients, which was paralleled by clinical measures. Our study shows that a core neurobiological feature in AUD seems to be detectable in an early, subclinical state, allowing more individualized alcohol prevention programs in the future.
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Affiliation(s)
- Tobias Gleich
- Department of Psychiatry and Psychotherapy, Charité Campus Mitte (CCM) Charité – Universitätsmedizin Berlin Berlin Germany
| | - Gianna Spitta
- Department of Psychiatry and Psychotherapy, Charité Campus Mitte (CCM) Charité – Universitätsmedizin Berlin Berlin Germany
| | - Oisin Butler
- Max Planck Institute for Human Development Center for Lifespan Psychology Berlin Germany
| | - Kristin Zacharias
- Department of Psychiatry and Psychotherapy, Charité Campus Mitte (CCM) Charité – Universitätsmedizin Berlin Berlin Germany
| | - Semiha Aydin
- Physikalisch‐Technische Bundesanstalt (PTB) Berlin Germany
| | - Miriam Sebold
- Department of Psychiatry and Psychotherapy, Charité Campus Mitte (CCM) Charité – Universitätsmedizin Berlin Berlin Germany
- Department for Social and Preventive Medicine University of Potsdam Potsdam Germany
| | - Maria Garbusow
- Department of Psychiatry and Psychotherapy, Charité Campus Mitte (CCM) Charité – Universitätsmedizin Berlin Berlin Germany
| | - Michael Rapp
- Max Planck Institute for Human Development Center for Lifespan Psychology Berlin Germany
| | | | - Ralph Buchert
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine University Medical Center Hamburg‐Eppendorf Hamburg Germany
| | - Andreas Heinz
- Department of Psychiatry and Psychotherapy, Charité Campus Mitte (CCM) Charité – Universitätsmedizin Berlin Berlin Germany
| | - Juergen Gallinat
- Department of Psychiatry and Psychotherapy University Medical Center Hamburg‐Eppendorf (UKE) Hamburg Germany
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5
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Agarwal K, Manza P, Leggio L, Livinski AA, Volkow ND, Joseph PV. Sensory cue reactivity: Sensitization in alcohol use disorder and obesity. Neurosci Biobehav Rev 2021; 124:326-357. [PMID: 33587959 DOI: 10.1016/j.neubiorev.2021.02.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 02/03/2021] [Accepted: 02/07/2021] [Indexed: 12/21/2022]
Abstract
Neuroimaging techniques to measure the function of the human brain such as electroencephalography (EEG), positron emission tomography (PET), and functional magnetic resonance imaging (fMRI), are powerful tools for understanding the underlying neural circuitry associated with alcohol use disorder (AUD) and obesity. The sensory (visual, taste and smell) paradigms used in neuroimaging studies represent an ideal platform to investigate the connection between the different neural circuits subserving the reward/executive control systems in these disorders, which may offer a translational mechanism for novel intervention predictions. Thus, the current review provides an integrated summary of the recent neuroimaging studies that have applied cue-reactivity paradigms and neuromodulation strategies to explore underlying alterations in neural circuitry as well in treatment strategies in AUD and obesity. Finally, we discuss literature on mechanisms associated with increased alcohol sensitivity post-bariatric surgery (BS) which offers guidance for future research to use sensory percepts in elucidating the relation of reward signaling in AUD development post-BS.
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Affiliation(s)
- Khushbu Agarwal
- National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, USA; National Institute of Nursing Research, Bethesda, MD, USA
| | - Peter Manza
- National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, USA
| | - Lorenzo Leggio
- National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, USA; National Institute on Drug Abuse, Bethesda and Baltimore, MD, USA
| | | | - Nora D Volkow
- National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, USA; National Institute on Drug Abuse, Bethesda and Baltimore, MD, USA
| | - Paule Valery Joseph
- National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, USA; National Institute of Nursing Research, Bethesda, MD, USA.
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6
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Gerchen MF, Weiss F, Kirsch M, Rentsch A, Halli P, Kiefer F, Kirsch P. Dynamic frontostriatal functional peak connectivity (in alcohol use disorder). Hum Brain Mapp 2020; 42:36-46. [PMID: 32885886 PMCID: PMC7721230 DOI: 10.1002/hbm.25201] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 07/31/2020] [Accepted: 08/23/2020] [Indexed: 01/25/2023] Open
Abstract
Alcohol use disorder (AUD) is associated with changes in frontostriatal connectivity, but functional magnetic resonance imaging (fMRI) functional connectivity (FC) approaches are usually not adapted to these circuits. We developed a circuit‐specific fMRI analysis approach to detect dynamic changes in frontostriatal FC inspired by medial‐ventral‐rostral to lateral‐dorsal‐caudal frontostriatal gradients originally identified in nonhuman primate tract‐tracing data. In our PeaCoG (“peak connectivity on a gradient”) approach we use information about the location of strongest FC on empirical frontostriatal connectivity gradients. We have recently described a basic PeaCoG version with conventional FC, and now developed a dynamic PeaCoG approach with sliding‐window FC. In resting state data of n = 66 AUD participants and n = 40 healthy controls we continue here the analyses that we began with the basic version. Our former result of an AUD‐associated ventral shift in right orbitofrontal cortex PeaCoG is consistently detected in the dynamic approach. Temporospatial variability of dynamic PeaCoG in the left dorsolateral prefrontal cortex is reduced in AUD and associated with self‐efficacy to abstain and days of abstinence. Our method has the potential to provide insight into the dynamics of frontostriatal circuits, which has so far been relatively unexplored, and into their role in mental disorders and normal cognition.
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Affiliation(s)
- Martin Fungisai Gerchen
- Department of Clinical Psychology, Central Institute of Mental Health, Heidelberg University/Medical Faculty Mannheim, Mannheim, Germany.,Department of Psychology, Heidelberg University, Heidelberg, Germany.,Bernstein Center for Computational Neuroscience Heidelberg/Mannheim, Mannheim, Germany
| | - Franziska Weiss
- Department of Clinical Psychology, Central Institute of Mental Health, Heidelberg University/Medical Faculty Mannheim, Mannheim, Germany
| | - Martina Kirsch
- Department of Addiction Behavior and Addiction Medicine, Central Institute of Mental Health, Heidelberg University/Medical Faculty Mannheim, Mannheim, Germany
| | - Alena Rentsch
- Department of Clinical Psychology, Central Institute of Mental Health, Heidelberg University/Medical Faculty Mannheim, Mannheim, Germany
| | - Patrick Halli
- Department of Clinical Psychology, Central Institute of Mental Health, Heidelberg University/Medical Faculty Mannheim, Mannheim, Germany
| | - Falk Kiefer
- Department of Addiction Behavior and Addiction Medicine, Central Institute of Mental Health, Heidelberg University/Medical Faculty Mannheim, Mannheim, Germany
| | - Peter Kirsch
- Department of Clinical Psychology, Central Institute of Mental Health, Heidelberg University/Medical Faculty Mannheim, Mannheim, Germany.,Department of Psychology, Heidelberg University, Heidelberg, Germany.,Bernstein Center for Computational Neuroscience Heidelberg/Mannheim, Mannheim, Germany
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7
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Horn SR, Fisher PA, Pfeifer JH, Allen NB, Berkman ET. Levers and barriers to success in the use of translational neuroscience for the prevention and treatment of mental health and promotion of well-being across the lifespan. JOURNAL OF ABNORMAL PSYCHOLOGY 2020; 129:38-48. [PMID: 31868386 DOI: 10.1037/abn0000465] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Neuroscientific tools and approaches such as neuroimaging, measures of neuroendocrine and psychoneuroimmune activity, and peripheral physiology are increasingly used in clinical science and health psychology research. We define translational neuroscience (TN) as a systematic, theory-driven approach that aims to develop and leverage basic and clinical neuroscientific knowledge to aid the development and optimization of clinical and public health interventions. There is considerable potential across basic and clinical science fields for this approach to provide insights into mental and physical health pathology that had previously been inaccessible. For example, TN might hold the potential to enhance diagnostic specificity, better recognize increased vulnerability in at-risk populations, and augment intervention efficacy. Despite this potential, there has been limited consideration of the advantages and limitations of such an approach. In this article, we articulate extant challenges in defining TN and propose a unifying conceptualization. We illustrate how TN can inform the application of neuroscientific tools to realistically guide clinical research and inform intervention design. We outline specific leverage points of the TN approach and barriers to progress. Ten principles of TN are presented to guide and shape the emerging field. We close by articulating ongoing issues facing TN research. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Filippi I, Hoertel N, Artiges E, Airagnes G, Guérin-Langlois C, Seigneurie AS, Frère P, Dubol M, Guillon F, Lemaître H, Rahim M, Martinot JL, Limosin F. Family history of alcohol use disorder is associated with brain
structural and functional changes in healthy first-degree relatives. Eur Psychiatry 2020; 62:107-115. [DOI: 10.1016/j.eurpsy.2019.08.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Revised: 08/05/2019] [Accepted: 08/26/2019] [Indexed: 12/21/2022] Open
Abstract
Abstract
Background:
Neuroimaging studies of vulnerability to Alcohol Use Disorder (AUD)
have identified structural and functional variations which might reflect
inheritable features in alcohol-naïve relatives of AUD individuals (FH+)
compared to controls having no such family history (FH-). However, prior
research did not simultaneously account for childhood maltreatment, any
clinically significant disorder and maternal AUD. Therefore, we mainly
aimed to investigate the brain structure and reward-related neural
activations (fMRI), using whole-brain analysis in FH+ young adults with
no prevalent confounders.
Methods:
46 FH+ and 45 FH- male and female participants had no severe
childhood maltreatment exposure, neither any psychiatric disorder or
AUD, nor a prenatal exposure to maternal AUD. We used a 3 T MRI coupled
with a whole brain voxel-based method to compare between groups the grey
matter volumes and activations in response to big
versus small wins during a Monetary
Incentive Delay task. The Childhood Trauma Questionnaire score was used
as confounding variable in the analyses to account for the remaining
variance between groups.
Results:
Compared to FH- controls, FH+ participants had smaller grey matter
volumes in the frontal and cingulate regions as well as in the bilateral
nucleus accumbens and right insula. The FH+ participants’ fMRI datasets
denoted a blunted activation in the middle cingulum with respect to FH-
controls’ during the processing of reward magnitude, and a greater
activation in the anterior cingulum in response to anticipation of a
small win.
Conclusions:
Family history of alcohol use disorder is linked to structural and
functional variations including brain regions involved in reward
processes.
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Gerchen MF, Rentsch A, Kirsch M, Kiefer F, Kirsch P. Shifts in the functional topography of frontal cortex-striatum connectivity in alcohol use disorder. Addict Biol 2019; 24:1245-1253. [PMID: 30468293 DOI: 10.1111/adb.12692] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Revised: 10/09/2018] [Accepted: 10/09/2018] [Indexed: 11/27/2022]
Abstract
Frontostriatal circuits are centrally involved in the selection of behavioral programs and play a prominent role in alcohol use disorder (AUD) as well as other mental disorders. However, how frontal regions change their striatal connectivity to implement adaptive cognitive control is still not fully understood. Here, we developed an approach for functional magnetic resonance imaging (fMRI) connectivity analysis in which we change the focus from connectivity to individual voxels towards spatial information about the location of strongest functional connectivity. In resting state data of n = 66 participants with AUD and n = 40 healthy controls (HC) we used the approach to estimate frontostriatal connectivity gradients consistent with nonhuman primate tract-tracing studies, characterized for each frontal voxel the striatal peak connectivity location on this gradient (PeaCoG), and tested for group differences and associations with clinical variables. We identified a cluster in the right orbitofrontal cortex (rOFC) with a peak connectivity shift towards ventral striatal regions in AUD. Reduced variability of rOFC striatal peak connectivity in the AUD group suggests a "clamping" to the ventral striatum as the underlying effect. Within the AUD group striatal peak connectivity in the superior frontal gyrus was associated with self-efficacy to abstain from alcohol, in the medial frontal and dorsolateral prefrontal cortex with alcohol dependency, and in the right inferior frontal gyrus with the urge to consume alcohol. Our results demonstrate that the functional topography of frontostriatal circuits exhibits interindividual variability, which provides insight into frontostriatal network adaptations in AUD and potentially other mental disorders.
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Affiliation(s)
- Martin Fungisai Gerchen
- Department of Clinical PsychologyCentral Institute of Mental Health, University of Heidelberg/Medical Faculty Mannheim Mannheim Germany
- Bernstein Center for Computational Neuroscience Heidelberg/Mannheim Mannheim Germany
| | - Alena Rentsch
- Department of Clinical PsychologyCentral Institute of Mental Health, University of Heidelberg/Medical Faculty Mannheim Mannheim Germany
| | - Martina Kirsch
- Department of Addiction Behavior and Addiction Medicine, Central Institute of Mental HealthUniversity of Heidelberg/Medical Faculty Mannheim Mannheim Germany
| | - Falk Kiefer
- Department of Addiction Behavior and Addiction Medicine, Central Institute of Mental HealthUniversity of Heidelberg/Medical Faculty Mannheim Mannheim Germany
| | - Peter Kirsch
- Department of Clinical PsychologyCentral Institute of Mental Health, University of Heidelberg/Medical Faculty Mannheim Mannheim Germany
- Bernstein Center for Computational Neuroscience Heidelberg/Mannheim Mannheim Germany
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The impact of successful learning of self-regulation on reward processing in children with ADHD using fMRI. ATTENTION DEFICIT AND HYPERACTIVITY DISORDERS 2019; 11:31-45. [PMID: 30225805 DOI: 10.1007/s12402-018-0269-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Accepted: 09/10/2018] [Indexed: 12/24/2022]
Abstract
Neurofeedback (NF) is a non-pharmacological treatment for attention-deficit/hyperactivity disorder (ADHD) that is targeting self-regulation, is efficacious when standard protocols are used and induces partly specific neurophysiological changes in the inhibitory network. However, its effects on reward processing, which is also considered an important aspect of ADHD and has been linked to neurophysiological deficits, remain unknown. Children with ADHD (N = 15, mean age 11.8, SD 1.52) were randomly assigned to either slow cortical potential NF (n = 8) or EMG biofeedback control training (n = 7) and received 20 sessions of training under comparable conditions. Learning was defined as the slope of successful training runs across all transfer sessions. Whole brain analysis, region-of-interest analysis of anticipatory ventral striatal (VS) activation, and analysis of behavioral data were performed. Clinically, the NF group improved more than the EMG group. Whole brain analysis indicated increased activation in the left superior frontal gyrus in the control group only, and in medial prefrontal cortex and dorsolateral prefrontal gyrus (DLPFC) after treatment across all groups. Only successful learners of self-regulation (n = 8) showed increased left inferior frontal gyrus and DLPFC activation after treatment. Left VS activation was increased after treatment and showed a significant time*medication-status interaction. Specific treatment effects were found in left frontal regions for the control treatment and successful learners. Also, unmedicated participants, irrespective of treatment type or successful learning, showed treatment-induced improvement in reward processing. The results suggest no prominent specific effect of NF on reward processing. However, cautious interpretation is warranted due to the small sample.
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12
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Gerchen MF, Kirsch M, Bahs N, Halli P, Gerhardt S, Schäfer A, Sommer WH, Kiefer F, Kirsch P. The SyBil-AA real-time fMRI neurofeedback study: protocol of a single-blind randomized controlled trial in alcohol use disorder. BMC Psychiatry 2018; 18:12. [PMID: 29343230 PMCID: PMC5773029 DOI: 10.1186/s12888-018-1604-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Accepted: 01/11/2018] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Alcohol Use Disorder is a highly prevalent mental disorder which puts a severe burden on individuals, families, and society. The treatment of Alcohol Use Disorder is challenging and novel and innovative treatment approaches are needed to expand treatment options. A promising neuroscience-based intervention method that allows targeting cortical as well as subcortical brain processes is real-time functional magnetic resonance imaging neurofeedback. However, the efficacy of this technique as an add-on treatment of Alcohol Use Disorder in a clinical setting is hitherto unclear and will be assessed in the Systems Biology of Alcohol Addiction (SyBil-AA) neurofeedback study. METHODS N = 100 patients with Alcohol Use Disorder will be randomized to 5 parallel groups in a single-blind fashion and receive real-time functional magnetic resonance imaging neurofeedback while they are presented pictures of alcoholic beverages. The groups will either downregulate the ventral striatum, upregulate the right inferior frontal gyrus, negatively modulate the connectivity between these regions, upregulate, or downregulate the auditory cortex as a control region. After receiving 3 sessions of neurofeedback training within a maximum of 2 weeks, participants will be followed up monthly for a period of 3 months and relapse rates will be assessed as the primary outcome measure. DISCUSSION The results of this study will provide insights into the efficacy of real-time functional magnetic resonance imaging neurofeedback training in the treatment of Alcohol Use Disorder as well as in the involved brain systems. This might help to identify predictors of successful neurofeedback treatment which could potentially be useful in developing personalized treatment approaches. TRIAL REGISTRATION The study was retrospectively registered in the German Clinical Trials Register (trial identifier: DRKS00010253 ; WHO Universal Trial Number (UTN): U1111-1181-4218) on May 10th, 2016.
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Affiliation(s)
- Martin Fungisai Gerchen
- Department of Clinical Psychology, Central Institute of Mental Health (ZI), University of Heidelberg/Medical Faculty Mannheim, J5, 68159, Mannheim, Germany. .,Bernstein Center for Computational Neuroscience Heidelberg/Mannheim, Mannheim, Germany.
| | - Martina Kirsch
- 0000 0001 2190 4373grid.7700.0Department of Addiction Behavior and Addiction Medicine, Central Institute of Mental Health, University of Heidelberg/Medical Faculty Mannheim, Mannheim, Germany
| | - Nathalie Bahs
- 0000 0001 2190 4373grid.7700.0Department of Addiction Behavior and Addiction Medicine, Central Institute of Mental Health, University of Heidelberg/Medical Faculty Mannheim, Mannheim, Germany
| | - Patrick Halli
- 0000 0004 0477 2235grid.413757.3Department of Clinical Psychology, Central Institute of Mental Health (ZI), University of Heidelberg/Medical Faculty Mannheim, J5, 68159 Mannheim, Germany
| | - Sarah Gerhardt
- 0000 0001 2190 4373grid.7700.0Department of Addiction Behavior and Addiction Medicine, Central Institute of Mental Health, University of Heidelberg/Medical Faculty Mannheim, Mannheim, Germany
| | - Axel Schäfer
- 0000 0001 2190 4373grid.7700.0Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, University of Heidelberg/Medical Faculty Mannheim, Mannheim, Germany
| | - Wolfgang H. Sommer
- 0000 0001 2190 4373grid.7700.0Department of Addiction Behavior and Addiction Medicine, Central Institute of Mental Health, University of Heidelberg/Medical Faculty Mannheim, Mannheim, Germany ,0000 0001 2190 4373grid.7700.0Department of Psychopharmacology, Central Institute of Mental Health, University of Heidelberg/Medical Faculty Mannheim, Mannheim, Germany
| | - Falk Kiefer
- 0000 0001 2190 4373grid.7700.0Department of Addiction Behavior and Addiction Medicine, Central Institute of Mental Health, University of Heidelberg/Medical Faculty Mannheim, Mannheim, Germany
| | - Peter Kirsch
- 0000 0004 0477 2235grid.413757.3Department of Clinical Psychology, Central Institute of Mental Health (ZI), University of Heidelberg/Medical Faculty Mannheim, J5, 68159 Mannheim, Germany ,grid.455092.fBernstein Center for Computational Neuroscience Heidelberg/Mannheim, Mannheim, Germany
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