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Ghosh Dastidar S, Pegwal N, Balhara YPS, Tayade P, Sharma R, Kaur S. Aberrance in default mode and executive network activity underlie working memory deficits in addictive disorders: A preliminary, exploratory case-control study. Psychiatry Res Neuroimaging 2024; 343:111865. [PMID: 39102758 DOI: 10.1016/j.pscychresns.2024.111865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 05/31/2024] [Accepted: 07/31/2024] [Indexed: 08/07/2024]
Abstract
BACKGROUND Addiction can alter neural processes during rest and cognitive performance. Subjects with addictive disorders exhibit preoccupation and anticipation for the psychoactive substance when idle and cognitive deficits, during tasks. METHODS 128 channel EEG was recorded in sixty subjects (30, with alcohol, opioid and internet addiction; 30 controls) during rest and while performing working memory task to ascertain underlying differences in cortical activity between the groups while at rest and during performance of the task. Artifactually clean data was then subjected to source analysis using sLORETA software in both the groups. RESULTS EEG cortical source analysis in subjects with addictive disorders showed significant activation of areas of Default Mode Network (DMN) and reduced activation in dorsolateral prefrontal cortices (DLPFC), an area known to be involved in executive function, during performance of task. However, control subjects demonstrated significantly reduced activation in areas of DMN; and increased activation of DLPFC during task performance. CONCLUSION Inability to suppress DMN inhibits reallocation of neural resources to areas of executive functioning leading to working memory deficits in subjects with addictive disorder.
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Affiliation(s)
- Shaon Ghosh Dastidar
- Stress and Cognitive Electroimaging Laboratory, Department of Physiology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi-110029, India
| | - Nishi Pegwal
- Stress and Cognitive Electroimaging Laboratory, Department of Physiology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi-110029, India
| | - Yatan Pal Singh Balhara
- NDDTC and Department of Psychiatry, All India Institute of Medical Sciences, Ansari Nagar, New Delhi-110029, India
| | - Prashant Tayade
- Stress and Cognitive Electroimaging Laboratory, Department of Physiology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi-110029, India
| | - Ratna Sharma
- Stress and Cognitive Electroimaging Laboratory, Department of Physiology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi-110029, India
| | - Simran Kaur
- Stress and Cognitive Electroimaging Laboratory, Department of Physiology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi-110029, India.
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Muehlhan M, Spindler C, Nowaczynski S, Buchner C, Fascher M, Trautmann S. Where alcohol use disorder meets interoception: A meta-analytic view on structural and functional neuroimaging data. J Neurochem 2024; 168:2515-2531. [PMID: 38528368 DOI: 10.1111/jnc.16104] [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: 01/31/2024] [Revised: 03/07/2024] [Accepted: 03/08/2024] [Indexed: 03/27/2024]
Abstract
Alcohol use disorder (AUD) has been associated with changes in the processing of internal body signals, known as interoception. Changes in brain structure, particularly in the insula, are thought to underlie impaired interoception. As studies specifically investigating this association are largely lacking, this analysis takes an approach that compares meta-analytic results on interoception with recently published meta-analytic results on gray matter reduction in AUD. A systematic literature search identified 25 eligible interoception studies. Activation likelihood estimation (ALE) was used to test for spatial convergence of study results. Overlap between interoception and AUD clusters was tested using conjunction analysis. Meta-analytic connectivity modeling (MACM) and resting-state functional connectivity were used to identify the functional network of interoception and to test where this network overlapped with AUD meta-analytic clusters. The results were characterized using behavioral domain analysis. The interoception ALE identified a cluster in the left middle insula. There was no overlap with clusters of reduced gray matter in AUD. MACM analysis of the interoception cluster revealed a large network located in the insulae, thalami, basal nuclei, cingulate and medial frontal cortices, and pre- and postcentral gyri. Resting state analysis confirmed this result, showing the strongest connections to nodes of the salience- and somatomotor network. Five of the eight clusters that showed a structural reduction in AUD were located within these networks. The behavioral profiles of these clusters were suggestive of higher-level processes such as salience control, somatomotor functions, and skin sensations. The results suggest an altered salience mapping of interoceptive signals in AUD, consistent with current models. Connections to the somatomotor network may be related to action control and integration of skin sensations. Mindfulness-based interventions, pleasurable touch, and (deep) transcranial magnetic stimulation may be targeted interventions that reduce interoceptive deficits in AUD and thus contribute to drug use reduction and relapse prevention.
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Affiliation(s)
- Markus Muehlhan
- Department of Psychology, Faculty of Human Sciences, MSH Medical School Hamburg, Hamburg, Germany
- ICAN Institute of Cognitive and Affective Neuroscience, MSH Medical School Hamburg, Hamburg, Germany
| | - Carolin Spindler
- Department of Psychology, Faculty of Human Sciences, MSH Medical School Hamburg, Hamburg, Germany
| | - Sandra Nowaczynski
- Department of Psychology, Faculty of Human Sciences, MSH Medical School Hamburg, Hamburg, Germany
- ICAN Institute of Cognitive and Affective Neuroscience, MSH Medical School Hamburg, Hamburg, Germany
- Department of Addiction Medicine, Carl-Friedrich-Flemming-Clinic, Helios Medical Center Schwerin, Schwerin, Germany
| | - Claudius Buchner
- Department of Psychology, Faculty of Human Sciences, MSH Medical School Hamburg, Hamburg, Germany
| | - Maximilian Fascher
- Department of Psychology, Faculty of Human Sciences, MSH Medical School Hamburg, Hamburg, Germany
- ICAN Institute of Cognitive and Affective Neuroscience, MSH Medical School Hamburg, Hamburg, Germany
| | - Sebastian Trautmann
- Department of Psychology, Faculty of Human Sciences, MSH Medical School Hamburg, Hamburg, Germany
- ICPP Institute of Clinical Psychology and Psychotherapy, MSH Medical School Hamburg, Hamburg, Germany
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Taxier LR, Flanigan ME, Haun HL, Kash TL. Retrieval of an ethanol-conditioned taste aversion promotes GABAergic plasticity in the insular cortex. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.03.20.585950. [PMID: 38562680 PMCID: PMC10983921 DOI: 10.1101/2024.03.20.585950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
Blunted sensitivity to ethanol's aversive effects can increase motivation to consume ethanol; yet, the neurobiological circuits responsible for encoding these aversive properties are not fully understood. Plasticity in cells projecting from the insular cortex (IC) to the basolateral amygdala (BLA) is critical for taste aversion learning and retrieval, suggesting this circuit's potential involvement in modulating the aversive properties of ethanol. Here, we tested the hypothesis that GABAergic activity onto IC-BLA projections would be facilitated following the retrieval of an ethanol-conditioned taste aversion (CTA). Consistent with this hypothesis, frequency of mIPSCs was increased following retrieval of an ethanol-CTA across cell layers in IC-BLA projection neurons. This increase in GABAergic plasticity occurred in both a circuit-specific and learning-dependent manner. Additionally, local inhibitory inputs onto layer 2/3 IC-BLA projection neurons were greater in number and strength following ethanol-CTA. Finally, DREADD-mediated inhibition of IC parvalbumin-expressing cells blunted the retrieval of ethanol-CTA in male, but not female, mice. Collectively, this work implicates a circuit-specific and learning-dependent increase in GABAergic tone following retrieval of an ethanol-CTA, thereby advancing our understanding of how the aversive effects of ethanol are encoded in the brain.
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Affiliation(s)
- Lisa R Taxier
- Bowles Center for Alcohol Studies, University of North Carolina School of Medicine, Chapel Hill, NC, USA, 27599
| | - Meghan E Flanigan
- Bowles Center for Alcohol Studies, University of North Carolina School of Medicine, Chapel Hill, NC, USA, 27599
| | - Harold L Haun
- Bowles Center for Alcohol Studies, University of North Carolina School of Medicine, Chapel Hill, NC, USA, 27599
| | - Thomas L Kash
- Bowles Center for Alcohol Studies, University of North Carolina School of Medicine, Chapel Hill, NC, USA; Department of Pharmacology, University of North Carolina School of Medicine, Chapel Hill, NC, USA, 27599
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4
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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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Agarwal K, Joseph PV, Zhang R, Schwandt ML, Ramchandani VA, Diazgranados N, Goldman D, Momenan R. Early life stress and body-mass-index modulate brain connectivity in alcohol use disorder. Transl Psychiatry 2024; 14:43. [PMID: 38245501 PMCID: PMC10799859 DOI: 10.1038/s41398-024-02756-8] [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: 11/13/2023] [Revised: 01/03/2024] [Accepted: 01/08/2024] [Indexed: 01/22/2024] Open
Abstract
Early life stress (ELS) significantly increases susceptibility to alcohol use disorder (AUD) by affecting the interplay between the executive and the salience networks (SNs). The link between AUD and higher body-mass index (BMI) is known, but we lack understanding of how BMI impacts the relationship between ELS and brain connectivity in individuals with AUD. To bridge this gap, we investigated the main and interaction effects of ELS and BMI on brain connectivity in individuals with AUD compared to non-AUD participants (n = 77 sex-matched individuals per group). All participants underwent resting-state functional magnetic resonance imaging, revealing intriguing positive functional connectivity between SN seeds and brain regions involved in somatosensory processing, motor coordination and executive control. Examining the relationship of brain connectivity with ELS and BMI, we observed positive associations with the correlations of SN seeds, right anterior insula (RAIns) and supramarginal gyrus (SMG) with clusters in motor [occipital cortex, supplementary motor cortex]; anterior cingulate cortex (ACC) with clusters in frontal, or executive, control regions (middle frontal gyrus; MFG, precentral gyrus) that reportedly are involved in processing of emotionally salient stimuli (all |β | > 0.001, |p | < 0.05). Interestingly, a negative association of the interaction effect of ELS events and BMI measures with the functional connectivity of SN seeds ACC with decision-making (MFG, precentral gyrus), RAIns and RSMG with visuo-motor control regions (occipital cortex and supplementary motor cortex) (all |β | = -0.001, |p | < 0.05). These findings emphasize the moderating effect of BMI on ELS-associated SN seed brain connectivity in AUD. Understanding the neural mechanisms linking BMI, ELS and AUD can guide targeted interventions for this population.
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Affiliation(s)
- Khushbu Agarwal
- Section of Sensory Science and Metabolism, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, 20892, USA
- National Institute of Nursing Research, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, 20892, USA
| | - Paule V Joseph
- Section of Sensory Science and Metabolism, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, 20892, USA
- National Institute of Nursing Research, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, 20892, USA
| | - Rui Zhang
- Laboratory of Neuroimaging, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, 20892, USA
| | - Melanie L Schwandt
- Office of the Clinical Director, National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, 20892, USA
| | - Vijay A Ramchandani
- Human Psychopharmacology Laboratory, National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, 20892, USA
| | - Nancy Diazgranados
- Office of the Clinical Director, National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, 20892, USA
| | - David Goldman
- Office of the Clinical Director, National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, 20892, USA
- Laboratory of Neurogenetics, National Institute on Alcohol Abuse and Alcoholism, Rockville, MD, 20892, USA
| | - Reza Momenan
- Clinical NeuroImaging Research Core, National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, 20892, USA.
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North KC, Shaw AA, Moreira L, Bukiya AN, Dopico AM. Alcohol and pregnenolone interaction on cerebral arteries through targeting of vascular smooth muscle Ca2+- and voltage-gated K + channels of big conductance. ADVANCES IN DRUG AND ALCOHOL RESEARCH 2023; 3:11735. [PMID: 37846408 PMCID: PMC10578043 DOI: 10.3389/adar.2023.11735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/18/2023]
Abstract
Despite the significant number of people who may be taking pregnenolone supplements while drinking alcohol (ethanol), the widely documented cerebrovascular actions of pregnenolone and ethanol, and the critical dependence of cerebrovascular function on cerebral artery diameter, there are no studies addressing the effect of pregnenolone + ethanol in combination on cerebral artery diameter. We investigated this by evaluating the effect of this combination on middle cerebral artery diameter in male and female C57BL/6J mice, both in vivo and in vitro. The use of de-endothelialized, in vitro pressurized middle cerebral artery segments allowed us to conduct a concentration-response study of constriction induced by pregnenolone ± ethanol, in which drug action could be evaluated independently of circulating and endothelial factors. In both male and female animals, pregnenolone at lower concentrations (≤1 μM) was found to synergize with 50 mM ethanol to cause vasoconstriction. In both sexes, this synergism was lost as one or both vasoconstrictors approached their maximally effective concentrations (75 mM and 10 μM for ethanol and pregnenolone, respectively), whether this was evaluated in vitro or in vivo using a cranial window. Vasoconstriction by pregnenolone + ethanol was abolished by 1 μM paxilline, indicating BK channel involvement. Moreover, cell-free recordings of BK channel activity in cerebral artery myocyte membranes showed that 10 μM pregnenolone and pregnenolone +50 mM ethanol reduced channel activity to an identical extent, suggesting that these drugs inhibit cerebrovascular BK channels via a common mechanism or mechanisms. Indeed, pregnenolone was found to disrupt allosteric coupling to C a 2 + -driven gating, as previously reported for ethanol.
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Affiliation(s)
- Kelsey C. North
- Department Pharmacology, Addiction Science and Toxicology, College of Medicine, The University of Tennessee Health Science Center, Memphis, TN, United States
| | - Andrew A. Shaw
- Department Pharmacology, Addiction Science and Toxicology, College of Medicine, The University of Tennessee Health Science Center, Memphis, TN, United States
| | - Luiz Moreira
- Department Pharmacology, Addiction Science and Toxicology, College of Medicine, The University of Tennessee Health Science Center, Memphis, TN, United States
| | - Anna N. Bukiya
- Department Pharmacology, Addiction Science and Toxicology, College of Medicine, The University of Tennessee Health Science Center, Memphis, TN, United States
| | - Alex M. Dopico
- Department Pharmacology, Addiction Science and Toxicology, College of Medicine, The University of Tennessee Health Science Center, Memphis, TN, United States
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7
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Agarwal K, Joseph P, Zhang R, Schwandt M, Ramchandani V, Diazgranados N, Goldman D, Momenan R. Early Life Stress and Body-Mass Index Modulate Brain Connectivity in Alcohol Use Disorder. RESEARCH SQUARE 2023:rs.3.rs-3150110. [PMID: 37502837 PMCID: PMC10371145 DOI: 10.21203/rs.3.rs-3150110/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/29/2023]
Abstract
Early life stress (ELS) significantly increases susceptibility to alcohol use disorder (AUD) by affecting the interplay between executive and salience networks (SN). The link between AUD and higher body-mass index (BMI) is known, but we lack understanding of how BMI impacts the relationship between ELS and brain connectivity in individuals with AUD. To bridge this gap, we investigated the effects of ELS on brain connectivity in AUD participants, taking into account differences in BMI. The cohort included 401 individuals with AUD, with approximately 60% having a BMI ≥ 25. Within the overall cohort, 123 participants underwent resting-state functional magnetic resonance imaging, revealing intriguing anticorrelations between SN seeds and brain regions involved in somatosensory processing, motor coordination, and executive control as an effect of ELS. Examining the relationship between ELS-driven brain connectivity and BMI, we observed negative correlations in connectivity among low BMI (≤ 24.9) vs. high BMI (≥ 25) individuals. For example, the left supramarginal gyrus (SMG) seed exhibited decreased connectivity with emotion regulation and decision-making regions, including the right occipital cortex, posterior cingulate cortex, and precuneus clusters (all |β| < -0.03, |p| < 0.05). Additionally, the right SMG seed showed reduced connectivity with impulse control and executive function regions, such as the left postcentral/middle frontal gyrus cluster (β = 0.04, p = 0.02). These findings highlight the role of ELS-induced alterations in SN seed connectivity, influenced by BMI, in the neurobiology of AUD. Understanding the neural mechanisms linking obesity, AUD, and ELS can guide targeted interventions for this population.
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Affiliation(s)
| | | | - Rui Zhang
- National Institute on Alcohol Abuse and Alcoholism
| | - Melanie Schwandt
- National Institute on Alcohol Abuse and Alcoholism / National Institutes of Health
| | | | | | | | - Reza Momenan
- National Institute On Alcohol Abuse and Alcoholism
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8
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Cushnie AK, Tang W, Heilbronner SR. Connecting Circuits with Networks in Addiction Neuroscience: A Salience Network Perspective. Int J Mol Sci 2023; 24:9083. [PMID: 37240428 PMCID: PMC10219092 DOI: 10.3390/ijms24109083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 04/18/2023] [Accepted: 05/08/2023] [Indexed: 05/28/2023] Open
Abstract
Human neuroimaging has demonstrated the existence of large-scale functional networks in the cerebral cortex consisting of topographically distant brain regions with functionally correlated activity. The salience network (SN), which is involved in detecting salient stimuli and mediating inter-network communication, is a crucial functional network that is disrupted in addiction. Individuals with addiction display dysfunctional structural and functional connectivity of the SN. Furthermore, while there is a growing body of evidence regarding the SN, addiction, and the relationship between the two, there are still many unknowns, and there are fundamental limitations to human neuroimaging studies. At the same time, advances in molecular and systems neuroscience techniques allow researchers to manipulate neural circuits in nonhuman animals with increasing precision. Here, we describe attempts to translate human functional networks to nonhuman animals to uncover circuit-level mechanisms. To do this, we review the structural and functional connections of the salience network and its homology across species. We then describe the existing literature in which circuit-specific perturbation of the SN sheds light on how functional cortical networks operate, both within and outside the context of addiction. Finally, we highlight key outstanding opportunities for mechanistic studies of the SN.
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Affiliation(s)
- Adriana K. Cushnie
- Department of Neuroscience, University of Minnesota Twin Cities, 2-164 Jackson Hall, 321 Church St. SE, Minneapolis, MN 55455, USA;
| | - Wei Tang
- Department of Computer Science, Indiana University Bloomington, Bloomington, IN 47408, USA
| | - Sarah R. Heilbronner
- Department of Neuroscience, University of Minnesota Twin Cities, 2-164 Jackson Hall, 321 Church St. SE, Minneapolis, MN 55455, USA;
- Department of Neurosurgery, Baylor College of Medicine, Houston, TX 77030, USA
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9
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Lee MR, Rio D, Kwako L, George DT, Heilig M, Momenan R. Corticotropin-Releasing Factor receptor 1 (CRF1) antagonism in patients with alcohol use disorder and high anxiety levels: effect on neural response during Trier Social Stress Test video feedback. Neuropsychopharmacology 2023; 48:816-820. [PMID: 36564531 PMCID: PMC10066297 DOI: 10.1038/s41386-022-01521-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 11/29/2022] [Accepted: 12/02/2022] [Indexed: 12/25/2022]
Abstract
In preclinical models of alcohol use disorder, the corticotropin-releasing factor (CRF) receptor is upregulated, particularly in the extended amygdala. This upregulation is thought to play a role in stress-induced relapse to drinking by a mechanism that is independent of the hypothalamic-pituitary-adrenal axis. As part of a double-blind, placebo-controlled clinical study with pexacerfont, a selective, orally available, and brain-penetrant CRF1 receptor antagonist which has anti-anxiety effects in preclinical studies, we examined the effect of pexacerfont on the neural response to a social stress task adapted to fMRI. Subjects were 39 individuals (4 women) with high trait anxiety and moderate to severe alcohol use disorder randomized to receive pexacerfont or placebo. The task involved feedback of videoclips of an individual performing the Trier Social Stress Test. Pexacerfont had no effect on the neural response to self-observation under stress. The neural response to viewing oneself under stress vs an unknown other under stress activated prefrontal brain regions including insula, inferior frontal gyrus as well as medial, superior frontal gyri. These regions of activation overlap with those found in studies using similar paradigms. Potential applications of this task to probe neurocircuitry that is disrupted in addiction is discussed.
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Affiliation(s)
- Mary R Lee
- Veterans Affairs Medical Center, Washington, DC, USA.
| | - Daniel Rio
- Clinical Neuroimaging Research Core, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD, USA
| | - Laura Kwako
- Division of Treatment and Recovery, Health Services, and Recovery Branch (THSRB), National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD, USA
| | - David T George
- Office of the Clinical Director, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD, USA
| | - Markus Heilig
- Center for Social and Affective Neuroscience, Department of Biomedical and Clinical Sciences, Linköping University Hospital, Linköping, Sweden
| | - Reza Momenan
- Clinical Neuroimaging Research Core, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD, USA
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10
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Mysiewicz S, North KC, Moreira L, Odum SJ, Bukiya AN, Dopico AM. Interspecies and regional variability of alcohol action on large cerebral arteries: regulation by KCNMB1 proteins. Am J Physiol Regul Integr Comp Physiol 2023; 324:R480-R496. [PMID: 36717168 PMCID: PMC10027090 DOI: 10.1152/ajpregu.00103.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 01/23/2023] [Accepted: 01/23/2023] [Indexed: 02/01/2023]
Abstract
Alcohol intake leading to blood ethanol concentrations (BEC) ≥ legal intoxication modifies brain blood flow with increases in some regions and decreases in others. Brain regions receive blood from the Willis' circle branches: anterior, middle (MCA) and posterior cerebral (PCA), and basilar (BA) arteries. Rats and mice have been used to identify the targets mediating ethanol-induced effects on cerebral arteries, with conclusions being freely interchanged, albeit data were obtained in different species/arterial branches. We tested whether ethanol action on cerebral arteries differed between male rat and mouse and/or across different brain regions and identified the targets of alcohol action. In both species and all Willis' circle branches, ethanol evoked reversible and concentration-dependent constriction (EC50s ≈ 37-86 mM; below lethal BEC in alcohol-naïve humans). Although showing similar constriction to depolarization, both species displayed differential responses to ethanol: in mice, MCA constriction was highly sensitive to the presence/absence of the endothelium, whereas in rat PCA was significantly more sensitive to ethanol than its mouse counterpart. In the rat, but not the mouse, BA was more ethanol sensitive than other branches. Both interspecies and regional variability were ameliorated by endothelium. Selective large conductance (BK) channel block in de-endothelialized vessels demonstrated that these channels were the effectors of alcohol-induced cerebral artery constriction across regions and species. Variabilities in alcohol actions did not fully matched KCNMB1 expression across vessels. However, immunofluorescence data from KCNMB1-/- mouse arteries electroporated with KCNMB1-coding cDNA demonstrate that KCNMB1 proteins, which regulate smooth muscle (SM) BK channel function and vasodilation, regulate interspecies and regional variability of brain artery responses to alcohol.
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Affiliation(s)
- Steven Mysiewicz
- Department of Pharmacology, Addiction Science, and Toxicology, College of Medicine, The University of Tennessee Health Science Center, Memphis, Tennessee, United States
| | - Kelsey C North
- Department of Pharmacology, Addiction Science, and Toxicology, College of Medicine, The University of Tennessee Health Science Center, Memphis, Tennessee, United States
| | - Luiz Moreira
- Department of Pharmacology, Addiction Science, and Toxicology, College of Medicine, The University of Tennessee Health Science Center, Memphis, Tennessee, United States
| | - Schyler J Odum
- Department of Pharmacology, Addiction Science, and Toxicology, College of Medicine, The University of Tennessee Health Science Center, Memphis, Tennessee, United States
| | - Anna N Bukiya
- Department of Pharmacology, Addiction Science, and Toxicology, College of Medicine, The University of Tennessee Health Science Center, Memphis, Tennessee, United States
| | - Alex M Dopico
- Department of Pharmacology, Addiction Science, and Toxicology, College of Medicine, The University of Tennessee Health Science Center, Memphis, Tennessee, United States
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11
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Newman AH, Xi ZX, Heidbreder C. Current Perspectives on Selective Dopamine D 3 Receptor Antagonists/Partial Agonists as Pharmacotherapeutics for Opioid and Psychostimulant Use Disorders. Curr Top Behav Neurosci 2023; 60:157-201. [PMID: 35543868 PMCID: PMC9652482 DOI: 10.1007/7854_2022_347] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Over three decades of evidence indicate that dopamine (DA) D3 receptors (D3R) are involved in the control of drug-seeking behavior and may play an important role in the pathophysiology of substance use disorders (SUD). The expectation that a selective D3R antagonist/partial agonist would be efficacious for the treatment of SUD is based on the following key observations. First, D3R are distributed in strategic areas belonging to the mesolimbic DA system such as the ventral striatum, midbrain, and ventral pallidum, which have been associated with behaviors controlled by the presentation of drug-associated cues. Second, repeated exposure to drugs of abuse produces neuroadaptations in the D3R system. Third, the synthesis and characterization of highly potent and selective D3R antagonists/partial agonists have further strengthened the role of the D3R in SUD. Based on extensive preclinical and preliminary clinical evidence, the D3R shows promise as a target for the development of pharmacotherapies for SUD as reflected by their potential to (1) regulate the motivation to self-administer drugs and (2) disrupt the responsiveness to drug-associated stimuli that play a key role in reinstatement of drug-seeking behavior triggered by re-exposure to the drug itself, drug-associated environmental cues, or stress. The availability of PET ligands to assess clinically relevant receptor occupancy by selective D3R antagonists/partial agonists, the definition of reliable dosing, and the prospect of using human laboratory models may further guide the design of clinical proof of concept studies. Pivotal clinical trials for more rapid progression of this target toward regulatory approval are urgently required. Finally, the discovery that highly selective D3R antagonists, such as R-VK4-116 and R-VK4-40, do not adversely affect peripheral biometrics or cardiovascular effects alone or in the presence of oxycodone or cocaine suggests that this class of drugs has great potential in safely treating psychostimulant and/or opioid use disorders.
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Affiliation(s)
- Amy Hauck Newman
- Medicinal Chemistry Section, Molecular Targets and Medications Discovery Branch, National Institute on Drug Abuse-Intramural Research Program, Baltimore, MD, USA.
| | - Zheng-Xiong Xi
- Medicinal Chemistry Section, Molecular Targets and Medications Discovery Branch, National Institute on Drug Abuse-Intramural Research Program, Baltimore, MD, USA
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12
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Canessa N, Basso G, Manera M, Poggi P, Gianelli C. Functional Coherence in Intrinsic Frontal Executive Networks Predicts Cognitive Impairments in Alcohol Use Disorder. Brain Sci 2022; 13:45. [PMID: 36672027 PMCID: PMC9856140 DOI: 10.3390/brainsci13010045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 12/03/2022] [Accepted: 12/22/2022] [Indexed: 12/28/2022] Open
Abstract
Growing evidence highlights the potential of innovative rehabilitative interventions such as cognitive remediation and neuromodulation, aimed at reducing relapses in Alcohol Use Disorder (AUD). Enhancing their effectiveness requires a thorough description of the neural correlates of cognitive alterations in AUD. Past related attempts, however, were limited by the focus on selected neuro-cognitive variables. We aimed to fill this gap by combining, in 22 AUD patients and 18 controls, an extensive neuro-cognitive evaluation and metrics of intrinsic connectivity as highlighted by resting-state brain activity. We addressed an inherent property of intrinsic activity such as intra-network coherence, the temporal correlation of the slow synchronous fluctuations within resting-state networks, representing an early biomarker of alterations in the functional brain architecture underlying cognitive functioning. AUD patients displayed executive impairments involving working-memory, attention and visuomotor speed, reflecting abnormal coherence of activity and grey matter atrophy within default mode, in addition to the attentional and the executive networks. The stronger relationship between fronto-lateral coherent activity and executive performance in patients than controls highlighted possible compensatory mechanisms counterbalancing the decreased functionality of networks driving the switch from automatic to controlled behavior. These results provide novel insights into AUD patients' cognitive impairments, their neural bases, and possible targets of rehabilitative interventions.
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Affiliation(s)
- Nicola Canessa
- IUSS Cognitive Neuroscience (ICON) Center, Scuola Universitaria Superiore IUSS, 27100 Pavia, Italy
- Istituti Clinici Scientifici Maugeri IRCCS, Cognitive Neuroscience Laboratory of Pavia Institute, 27100 Pavia, Italy
| | - Gianpaolo Basso
- School of Medicine and Surgery, University of Milano-Bicocca, 20126 Milan, Italy
| | - Marina Manera
- Istituti Clinici Scientifici Maugeri IRCCS, Clinical Psychology Unit of Pavia Institute, 27100 Pavia, Italy
| | - Paolo Poggi
- Istituti Clinici Scientifici Maugeri IRCCS, Radiology Unit of Pavia Institute, 27100 Pavia, Italy
| | - Claudia Gianelli
- IUSS Cognitive Neuroscience (ICON) Center, Scuola Universitaria Superiore IUSS, 27100 Pavia, Italy
- Department of Clinical and Experimental Medicine, University of Messina, 98122 Messina, Italy
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13
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Honnorat N, Fama R, Müller-Oehring EM, Zahr NM, Pfefferbaum A, Sullivan EV, Pohl KM. Alcohol Use Disorder and Its Comorbidity With HIV Infection Disrupts Anterior Cingulate Cortex Functional Connectivity. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2022; 7:1127-1136. [PMID: 33558196 PMCID: PMC8160024 DOI: 10.1016/j.bpsc.2020.11.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 11/16/2020] [Accepted: 11/17/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND Individuals with alcohol use disorder (AUD) have a heightened risk of contracting HIV infection. The effects of these two diseases and their comorbidity on brain structure have been well described, but their effects on brain function have never been investigated at the scale of whole-brain connectomes. METHODS In contrast with prior studies that restricted analyses to specific brain networks or examined relatively small groups of participants, our analyses are based on whole-brain functional connectomes of 292 participants. RESULTS Relative to participants without AUD, the functional connectivity between the anterior cingulate cortex and orbitofrontal cortex was lower for participants with AUD. Compared with participants without AUD+HIV comorbidity, the functional connectivity between the anterior cingulate cortex and hippocampus was lower for the AUD+HIV participants. Compromised connectivity between these pairs was significantly correlated with greater total lifetime alcohol consumption; the effects of total lifetime alcohol consumption on executive functioning were significantly mediated by the functional connectivity between the pairs. CONCLUSIONS Taken together, our results suggest that the functional connectivity of the anterior cingulate cortex is disrupted in individuals with AUD alone and AUD with HIV infection comorbidity. Moreover, the affected connections are associated with deficits in executive functioning, including heightened impulsiveness.
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Affiliation(s)
- Nicolas Honnorat
- Center for Health Sciences, SRI International, Menlo Park, California
| | - Rosemary Fama
- Center for Health Sciences, SRI International, Menlo Park, California; Department of Psychiatry and Behavioral Sciences, School of Medicine, Stanford University, Stanford, California
| | - Eva M Müller-Oehring
- Center for Health Sciences, SRI International, Menlo Park, California; Department of Psychiatry and Behavioral Sciences, School of Medicine, Stanford University, Stanford, California
| | - Natalie M Zahr
- Center for Health Sciences, SRI International, Menlo Park, California; Department of Psychiatry and Behavioral Sciences, School of Medicine, Stanford University, Stanford, California
| | - Adolf Pfefferbaum
- Center for Health Sciences, SRI International, Menlo Park, California; Department of Psychiatry and Behavioral Sciences, School of Medicine, Stanford University, Stanford, California
| | - Edith V Sullivan
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Stanford University, Stanford, California
| | - Kilian M Pohl
- Center for Health Sciences, SRI International, Menlo Park, California; Department of Psychiatry and Behavioral Sciences, School of Medicine, Stanford University, Stanford, California.
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14
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Halcomb M, Dzemidzic M, Shen YI, Lin Z, Butcher TJ, Yoder KK, Oberlin B. Delay discounting and alcohol consumption correlate with dorsal anterior insula activation during choice in nontreatment-seeking heavy drinkers. Alcohol Clin Exp Res 2022; 46:1397-1407. [PMID: 35707988 PMCID: PMC9427725 DOI: 10.1111/acer.14888] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 06/08/2022] [Accepted: 06/09/2022] [Indexed: 01/31/2023]
Abstract
BACKGROUND The anterior insular cortex (AIC), a prominent salience network node, integrates interoceptive information and emotional states into decision making. While AIC activation during delay discounting (DD) in alcohol use disorder (AUD) has been previously reported, the associations between AIC activation, impulsive choice, alcohol consumption, and connectivity remain unknown. We therefore tested AIC brain responses during DD in heavy drinkers and their association with DD performance, alcohol drinking, and task-based connectivity. METHODS Twenty-nine heavy drinkers (12 females; mean (SD) age=31.5 ± 6.1 years; mean (SD)=40.8 ± 23.4 drinks/week) completed a DD task during functional MRI. Regions activated during DD decision making were tested for correlation with DD behavior and alcohol drinking. Psychophysiological interaction (PPI) models assessed the task-dependent functional connectivity (FC) of activation during choice. RESULTS Delay discounting choice activated bilateral anterior insular cortex, anterior cingulate cortex, and left precentral gyrus. Right dorsal (d) AIC activation during choice negatively correlated withdiscounting of delayed rewards and alcohol consumption. PPI analysis revealed FC of the right dAIC to both the anterior and posterior cingulate cortices-key nodes in the midline default mode network. CONCLUSIONS Greater dAIC involvement in intertemporal choice may confer more adaptive behavior (lower impulsivity and alcohol consumption). Moreover, salience network processes governing discounting may require midline default mode (precuneus/posterior cingulate cortex) recruitment. These findings supporta key adaptive role for right dAIC in decision making involving future rewards and risky drinking.
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Affiliation(s)
- Meredith Halcomb
- Department of Radiology and Imaging SciencesIndiana University School of MedicineIndianapolisIndianaUSA
| | - Mario Dzemidzic
- Department of Radiology and Imaging SciencesIndiana University School of MedicineIndianapolisIndianaUSA
- Department of NeurologyIndiana University School of MedicineIndianapolisIndianaUSA
| | - Yitong I. Shen
- Addiction Neuroscience Graduate ProgramIndiana University – Purdue University IndianapolisIndianapolisIndianaUSA
- Department of PsychiatryIndiana University School of MedicineIndianapolisIndianaUSA
| | - Zikai Lin
- Department of PsychiatryIndiana University School of MedicineIndianapolisIndianaUSA
| | - Tarah J. Butcher
- Addiction Neuroscience Graduate ProgramIndiana University – Purdue University IndianapolisIndianapolisIndianaUSA
| | - Karmen K. Yoder
- Department of Radiology and Imaging SciencesIndiana University School of MedicineIndianapolisIndianaUSA
| | - Brandon Oberlin
- Department of NeurologyIndiana University School of MedicineIndianapolisIndianaUSA
- Addiction Neuroscience Graduate ProgramIndiana University – Purdue University IndianapolisIndianapolisIndianaUSA
- Department of PsychiatryIndiana University School of MedicineIndianapolisIndianaUSA
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15
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Padula CB, Tenekedjieva LT, McCalley DM, Al-Dasouqi H, Hanlon CA, Williams LM, Kozel FA, Knutson B, Durazzo TC, Yesavage JA, Madore MR. Targeting the Salience Network: A Mini-Review on a Novel Neuromodulation Approach for Treating Alcohol Use Disorder. Front Psychiatry 2022; 13:893833. [PMID: 35656355 PMCID: PMC9152026 DOI: 10.3389/fpsyt.2022.893833] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 04/11/2022] [Indexed: 11/24/2022] Open
Abstract
Alcohol use disorder (AUD) continues to be challenging to treat despite the best available interventions, with two-thirds of individuals going on to relapse by 1 year after treatment. Recent advances in the brain-based conceptual framework of addiction have allowed the field to pivot into a neuromodulation approach to intervention for these devastative disorders. Small trials of repetitive transcranial magnetic stimulation (rTMS) have used protocols developed for other psychiatric conditions and applied them to those with addiction with modest efficacy. Recent evidence suggests that a TMS approach focused on modulating the salience network (SN), a circuit at the crossroads of large-scale networks associated with AUD, may be a fruitful therapeutic strategy. The anterior insula or dorsal anterior cingulate cortex may be particularly effective stimulation sites given emerging evidence of their roles in processes associated with relapse.
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Affiliation(s)
- Claudia B Padula
- Mental Illness Research Education and Clinical Center, VA Palo Alto Health Care System, Palo Alto, CA, United States.,Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, United States
| | - Lea-Tereza Tenekedjieva
- Mental Illness Research Education and Clinical Center, VA Palo Alto Health Care System, Palo Alto, CA, United States.,Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, United States
| | - Daniel M McCalley
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, United States.,Department of Neurosciences, Medical University of South Carolina, Charleston, SC, United States
| | - Hanaa Al-Dasouqi
- Mental Illness Research Education and Clinical Center, VA Palo Alto Health Care System, Palo Alto, CA, United States
| | - Colleen A Hanlon
- Department of Cancer Biology, Wake Forest School of Medicine, Winston-Salem, NC, United States
| | - Leanne M Williams
- Mental Illness Research Education and Clinical Center, VA Palo Alto Health Care System, Palo Alto, CA, United States.,Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, United States
| | - F Andrew Kozel
- Department of Behavioral Sciences and Social Medicine, Florida State University College of Medicine, Florida State University, Tallahassee, FL, United States
| | - Brian Knutson
- Department of Psychology, Stanford University, Stanford, CA, United States
| | - Timothy C Durazzo
- Mental Illness Research Education and Clinical Center, VA Palo Alto Health Care System, Palo Alto, CA, United States.,Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, United States
| | - Jerome A Yesavage
- Mental Illness Research Education and Clinical Center, VA Palo Alto Health Care System, Palo Alto, CA, United States.,Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, United States
| | - Michelle R Madore
- Mental Illness Research Education and Clinical Center, VA Palo Alto Health Care System, Palo Alto, CA, United States.,Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, United States
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16
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Wiśniewski P, Maurage P, Jakubczyk A, Trucco EM, Suszek H, Kopera M. Alcohol use and interoception - A narrative review. Prog Neuropsychopharmacol Biol Psychiatry 2021; 111:110397. [PMID: 34224795 PMCID: PMC8380667 DOI: 10.1016/j.pnpbp.2021.110397] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Revised: 05/31/2021] [Accepted: 06/29/2021] [Indexed: 01/29/2023]
Abstract
Interoception, defined as the ability to perceive and interpret body signals, may play an important role in alcohol use disorder (AUD). Earlier studies suggested an association between interoception impairment and known risk factors for AUD (e.g., alexithymia, emotion dysregulation, impulsivity, pain). Neurobiological studies show that the neurotoxicity of alcohol affects various elements of the interoceptive system (especially the insula) at structural and functional levels, with differential short/long term impacts. Conversely, primary interoceptive impairments may promote alcohol consumption and foster the evolution towards addiction. Despite convincing evidence demonstrating that interoception impairment may be an important contributor to the development and course of AUD, only a few studies directly evaluated interoceptive abilities in AUD. The research shows that interoceptive accuracy, the objective component of interoception, is lower in AUD individuals, and is correlated with craving and emotion dysregulation. Interoceptive sensibility is in turn higher in AUD individuals compared to healthy controls. Moreover, there is evidence that therapy focused on improving the ability to sense signals from the body in addiction treatment is effective. However, important methodological limitations in interoceptive measures persist, and it is therefore necessary to further investigate the associations between interoception and AUD.
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Affiliation(s)
- Paweł Wiśniewski
- Department of Psychiatry, Medical University of Warsaw, Warsaw, Poland.
| | - Pierre Maurage
- Louvain Experimental Psychopathology research group (LEP), Psychological Sciences Research Institute, UCLouvain, Louvain-la-Neuve, Belgium
| | - Andrzej Jakubczyk
- Department of Psychiatry, Medical University of Warsaw, Warsaw, Poland
| | - Elisa M Trucco
- Department of Psychology, Center for Children and Families, Florida International University, Miami, FL, USA; Department of Psychiatry, Addiction Center, University of Michigan, Ann Arbor, MI, USA
| | - Hubert Suszek
- Department of Psychology, University of Warsaw, Warsaw, Poland
| | - Maciej Kopera
- Department of Psychiatry, Medical University of Warsaw, Warsaw, Poland
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17
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Interoception and alcohol: Mechanisms, networks, and implications. Neuropharmacology 2021; 200:108807. [PMID: 34562442 DOI: 10.1016/j.neuropharm.2021.108807] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 09/20/2021] [Accepted: 09/21/2021] [Indexed: 01/25/2023]
Abstract
Interoception refers to the perception of the internal state of the body and is increasingly being recognized as an important factor in mental health disorders. Drugs of abuse produce powerful interoceptive states that are upstream of behaviors that drive and influence drug intake, and addiction pathology is impacted by interoceptive processes. The goal of the present review is to discuss interoceptive processes related to alcohol. We will cover physiological responses to alcohol, how interoceptive states can impact drinking, and the recruitment of brain networks as informed by clinical research. We also review the molecular and brain circuitry mechanisms of alcohol interoceptive effects as informed by preclinical studies. Finally, we will discuss emerging treatments with consideration of interoception processes. As our understanding of the role of interoception in drug and alcohol use grows, we suggest that the convergence of information provided by clinical and preclinical studies will be increasingly important. Given the complexity of interoceptive processing and the multitude of brain regions involved, an overarching network-based framework can provide context for how focused manipulations modulate interoceptive processing as a whole. In turn, preclinical studies can systematically determine the roles of individual nodes and their molecular underpinnings in a given network, potentially suggesting new therapeutic targets and directions. As interoceptive processing drives and influences motivation, emotion, and subsequent behavior, consideration of interoception is important for our understanding of processes that drive ongoing drinking and relapse.
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18
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Butcher TJ, Chumin EJ, West JD, Dzemidzic M, Yoder KK. Cerebral Blood Flow in the Salience Network of Individuals with Alcohol Use Disorder. Alcohol Alcohol 2021; 57:445-451. [PMID: 34541599 DOI: 10.1093/alcalc/agab062] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 07/27/2021] [Accepted: 08/12/2021] [Indexed: 02/06/2023] Open
Abstract
AIMS Magnetic resonance imaging (MRI) studies have identified structural and functional differences in salience network nodes of individuals with alcohol use disorders (AUDs) after chronic exposure to alcohol. However, no studies have investigated cerebral blood flow (CBF) in nontreatment-seeking (NTS) individuals with AUD. METHODS In this work, we sought to quantify putative CBF deficits in NTS individuals relative to social drinking (SD) controls and determine if CBF in the salience network is associated with AUD severity. Fifteen NTS (36.5 ± 11.2 years old, 30.0 ± 22.7 drinks/week) and 22 SD (35.6 ± 11.9 years old, 9.1 ± 5.7 drinks/week) underwent pseudocontinuous arterial spin labeling MRI. RESULTS Compared with social drinkers, NTS individuals had significantly lower CBF in the right and left dorsal anterior insula, and the left ventral anterior and posterior insula. The Alcohol Use Disorder Identification Test (AUDIT) score showed a significant negative relationship with CBF in the bilateral caudal anterior cingulate cortex. In addition, a significant negative correlation was present between number of standard drinks consumed per week and the left frontal opercular CBF. CONCLUSION These results provide evidence that insular CBF is negatively associated with heavy drinking, and that severity of alcohol use is related to CBF deficits in key nodes of the salience network. Longitudinal data are needed to understand if disruptions of CBF in the insula and the salience network are a predisposition for or a consequence of chronic AUD.
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Affiliation(s)
- Tarah J Butcher
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, 355 W. 16th St., Indianapolis, IN 46202, USA.,Department of Radiology and Imaging Sciences, Indiana University Center for Neuroimaging, Indiana University School of Medicine, 355 W. 16th St., Indianapolis, IN 46202, USA.,Department of Psychiatry, Indiana University School of Medicine, 355 W. 16th St., Indianapolis, IN 46202, USA.,Department of Psychology, Indiana University Purdue University Indianapolis, 402 N. Blackford St, Indianapolis, IN 46202, USA
| | - Evgeny J Chumin
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, 355 W. 16th St., Indianapolis, IN 46202, USA.,Department of Radiology and Imaging Sciences, Indiana University Center for Neuroimaging, Indiana University School of Medicine, 355 W. 16th St., Indianapolis, IN 46202, USA.,Stark Neurosciences Research Institute, Indiana University School of Medicine, 320 W. 15th St., Indianapolis, IN 46202, USA.,Department of Psychological and Brain Sciences, Indiana University, 1101 E 10th St, Bloomington, IN 47405, USA.,Indiana University Network Science Institute, Indiana University, 1001 IN-45, Bloomington, IN 47408, USA
| | - John D West
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, 355 W. 16th St., Indianapolis, IN 46202, USA.,Department of Radiology and Imaging Sciences, Indiana University Center for Neuroimaging, Indiana University School of Medicine, 355 W. 16th St., Indianapolis, IN 46202, USA.,Stark Neurosciences Research Institute, Indiana University School of Medicine, 320 W. 15th St., Indianapolis, IN 46202, USA
| | - Mario Dzemidzic
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, 355 W. 16th St., Indianapolis, IN 46202, USA.,Department of Radiology and Imaging Sciences, Indiana University Center for Neuroimaging, Indiana University School of Medicine, 355 W. 16th St., Indianapolis, IN 46202, USA.,Department of Neurology, Indiana University School of Medicine, 355. W. 16th St., Indianapolis, IN 46202, USA
| | - Karmen K Yoder
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, 355 W. 16th St., Indianapolis, IN 46202, USA.,Department of Radiology and Imaging Sciences, Indiana University Center for Neuroimaging, Indiana University School of Medicine, 355 W. 16th St., Indianapolis, IN 46202, USA.,Stark Neurosciences Research Institute, Indiana University School of Medicine, 320 W. 15th St., Indianapolis, IN 46202, USA.,Department of Psychology, Indiana University Purdue University Indianapolis, 402 N. Blackford St, Indianapolis, IN 46202, USA
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19
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Gautier M, Pabst A, Maurage P. Social decision making in severe alcohol use disorder: Scoping review and experimental perspectives. Alcohol Clin Exp Res 2021; 45:1548-1559. [PMID: 34342010 DOI: 10.1111/acer.14664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 05/21/2021] [Accepted: 06/16/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Patients with severe alcohol use disorder (SAUD) demonstrate multifaceted impairments in social cognition abilities, including emotional decoding or Theory of Mind. Such impairments are associated with real-life interpersonal difficulties, which in turn could contribute to the persistence of SAUD. However, little is known regarding how patients with SAUD make decisions in a social context and this literature has not been comprehensively reviewed. OBJECTIVES The main aim of this paper was to conduct the first review specifically focusing on social decision-making abilities in SAUD. Following PRISMA guidelines for scoping reviews, we describe existing knowledge regarding the difficulties experienced by patients with SAUD during social interactions. Our second objective was to propose perspectives for future research, based on the shortcomings identified in the available literature. DESIGN We searched three online databases (PubMed, PsycINFO, and Scopus) and identified 14 papers using behavioral tasks to assess social decision making in patients with SAUD. RESULTS Included studies assessed social decision making through three paradigms: (1) economic games (four papers), (2) moral dilemmas (four papers), and (3) interpersonal problem-solving (six papers). Results indicated that patients with SAUD behave differently from controls in all three paradigms. CONCLUSIONS Previous studies suggested large-scale social decision-making impairments or biases in SAUD. However, in light of the limited number of studies available and of the restricted set of processes measured, we call for the extension of this field through more ecologically relevant and model-based paradigms in order to elucidate the underlying mechanisms of these effects.
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Affiliation(s)
- Mado Gautier
- Louvain Experimental Psychopathology Research Group (LEP), Psychological Science Research Institute, UCLouvain, Louvain-la-Neuve, Belgium
| | - Arthur Pabst
- Louvain Experimental Psychopathology Research Group (LEP), Psychological Science Research Institute, UCLouvain, Louvain-la-Neuve, Belgium
| | - Pierre Maurage
- Louvain Experimental Psychopathology Research Group (LEP), Psychological Science Research Institute, UCLouvain, Louvain-la-Neuve, Belgium
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20
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Rowland JA, Stapleton-Kotloski JR, Alberto GE, Davenport AT, Epperly PM, Godwin DW, Daunais JB. Rich Club Characteristics of Alcohol-Naïve Functional Brain Networks Predict Future Drinking Phenotypes in Rhesus Macaques. Front Behav Neurosci 2021; 15:673151. [PMID: 34149371 PMCID: PMC8206638 DOI: 10.3389/fnbeh.2021.673151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 04/28/2021] [Indexed: 11/30/2022] Open
Abstract
Purpose: A fundamental question for Alcohol use disorder (AUD) is how and when naïve brain networks are reorganized in response to alcohol consumption. The current study aimed to determine the progression of alcohol’s effect on functional brain networks during transition from the naïve state to chronic consumption. Procedures: Resting-state brain networks of six female rhesus macaque (Macaca mulatta) monkeys were acquired using magnetoencephalography (MEG) prior to alcohol exposure and after free-access to alcohol using a well-established model of chronic heavy alcohol consumption. Functional brain network metrics were derived at each time point. Results: The average connection frequency (p < 0.024) and membership of the Rich Club (p < 0.022) changed significantly over time. Metrics describing network topology remained relatively stable from baseline to free-access drinking. The minimum degree of the Rich Club prior to alcohol exposure was significantly predictive of future free-access drinking (r = −0.88, p < 0.001). Conclusions: Results suggest naïve brain network characteristics may be used to predict future alcohol consumption, and that alcohol consumption alters functional brain networks, shifting hubs and Rich Club membership away from previous regions in a non-systematic manner. Further work to refine these relationships may lead to the identification of a high-risk drinking phenotype.
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Affiliation(s)
- Jared A Rowland
- Research and Academic Affairs Service Line, Mid-Atlantic Mental Illness Research Education and Clinical Center, Salisbury VA Medical Center, Salisbury, NC, United States.,Department of Neurobiology and Anatomy, Wake Forest School of Medicine, Winston-Salem, NC, United States.,Department of Psychiatry and Behavioral Medicine, Wake Forest School of Medicine, Winston-Salem, NC, United States
| | - Jennifer R Stapleton-Kotloski
- Research and Academic Affairs Service Line, Mid-Atlantic Mental Illness Research Education and Clinical Center, Salisbury VA Medical Center, Salisbury, NC, United States.,Department of Neurology, Wake Forest School of Medicine, Winston-Salem, NC, United States
| | - Greg E Alberto
- Department of Neurobiology and Anatomy, Wake Forest School of Medicine, Winston-Salem, NC, United States
| | - April T Davenport
- Department of Physiology and Pharmacology, Wake Forest School of Medicine, Winston-Salem, NC, United States
| | - Phillip M Epperly
- Department of Physiology and Pharmacology, Wake Forest School of Medicine, Winston-Salem, NC, United States
| | - Dwayne W Godwin
- Department of Neurobiology and Anatomy, Wake Forest School of Medicine, Winston-Salem, NC, United States.,Department of Neurology, Wake Forest School of Medicine, Winston-Salem, NC, United States.,Department of Physiology and Pharmacology, Wake Forest School of Medicine, Winston-Salem, NC, United States
| | - James B Daunais
- Department of Physiology and Pharmacology, Wake Forest School of Medicine, Winston-Salem, NC, United States
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21
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Joo YH, Kim JH, Kim HK, Son YD, Cumming P, Kim JH. Functional Analysis of Brain Imaging Suggests Changes in the Availability of mGluR5 and Altered Connectivity in the Cerebral Cortex of Long-Term Abstaining Males with Alcohol Dependence: A Preliminary Study. Life (Basel) 2021; 11:life11060506. [PMID: 34070900 PMCID: PMC8228527 DOI: 10.3390/life11060506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 05/23/2021] [Accepted: 05/27/2021] [Indexed: 11/16/2022] Open
Abstract
Direct in vivo evidence of altered metabotropic glutamate receptor-5 (mGluR5) availability in alcohol-related disorders is lacking. We performed [11C]ABP688 positron emission tomography (PET) and resting-state functional magnetic resonance imaging (rs-fMRI) in prolonged abstinent subjects with alcohol dependence to examine alterations of mGluR5 availability, and to investigate their functional significance relating to neural systems-level changes. Twelve prolonged abstinent male subjects with alcohol dependence (median abstinence duration: six months) and ten healthy male controls underwent [11C]ABP688 PET imaging and 3-Tesla MRI. For mGluR5 availability, binding potential (BPND) was calculated using the simplified reference tissue model with cerebellar gray matter as the reference region. The initial region-of-interest (ROI)-based analysis yielded no significant group differences in mGluR5 availability. The voxel-based analysis revealed significantly lower [11C]ABP688 BPND in the middle temporal and inferior parietal cortices, and higher BPND in the superior temporal cortex in the alcohol dependence group compared with controls. Functional connectivity analysis of the rs-fMRI data employed seed regions identified from the quantitative [11C]ABP688 PET analysis, which revealed significantly altered functional connectivity from the inferior parietal cortex seed to the occipital pole and dorsal visual cortex in the alcohol dependence group compared with the control group. To our knowledge, this is the first report on the combined analysis of mGluR5 PET imaging and rs-fMRI in subjects with alcohol dependence. These preliminary results suggest the possibility of region-specific alterations of mGluR5 availability in vivo and related functional connectivity perturbations in prolonged abstinent subjects.
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Affiliation(s)
- Yo-Han Joo
- Neuroscience Research Institute, Gachon University, Incheon 21565, Korea; (Y.-H.J.); (J.-H.K.); (H.-K.K.)
| | - Jeong-Hee Kim
- Neuroscience Research Institute, Gachon University, Incheon 21565, Korea; (Y.-H.J.); (J.-H.K.); (H.-K.K.)
- Department of Biomedical Engineering, College of Health Science, Gachon University, Incheon 21936, Korea
| | - Hang-Keun Kim
- Neuroscience Research Institute, Gachon University, Incheon 21565, Korea; (Y.-H.J.); (J.-H.K.); (H.-K.K.)
- Department of Biomedical Engineering, College of Health Science, Gachon University, Incheon 21936, Korea
- Gachon Advanced Institute for Health Science and Technology, Graduate School, Gachon University, Incheon 21565, Korea
| | - Young-Don Son
- Neuroscience Research Institute, Gachon University, Incheon 21565, Korea; (Y.-H.J.); (J.-H.K.); (H.-K.K.)
- Department of Biomedical Engineering, College of Health Science, Gachon University, Incheon 21936, Korea
- Gachon Advanced Institute for Health Science and Technology, Graduate School, Gachon University, Incheon 21565, Korea
- Correspondence: (Y.-D.S.); or (J.-H.K.); Tel.: +82-32-820-4416 (Y.-D.S.); +82-32-460-2696 (J.-H.K.)
| | - Paul Cumming
- Department of Nuclear Medicine, Inselspital, University of Bern, CH-3010 Bern, Switzerland;
- School of Psychology and Counselling, Queensland University of Technology, Brisbane, QLD 4059, Australia
| | - Jong-Hoon Kim
- Neuroscience Research Institute, Gachon University, Incheon 21565, Korea; (Y.-H.J.); (J.-H.K.); (H.-K.K.)
- Gachon Advanced Institute for Health Science and Technology, Graduate School, Gachon University, Incheon 21565, Korea
- Gil Medical Center, Department of Psychiatry, Gachon University College of Medicine, Gachon University, Incheon 21565, Korea
- Correspondence: (Y.-D.S.); or (J.-H.K.); Tel.: +82-32-820-4416 (Y.-D.S.); +82-32-460-2696 (J.-H.K.)
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22
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Binge drinking is associated with altered resting state functional connectivity of reward-salience and top down control networks. Brain Imaging Behav 2021; 14:1731-1746. [PMID: 31073695 DOI: 10.1007/s11682-019-00107-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Binge drinking is characterized by bouts of high-intensity alcohol intake and is associated with an array of health-related harms. Even though the transition from occasional impulsive to addictive alcohol use is not well understood, neurobiological models of addiction suggest that repeated cycles of intoxication and withdrawal contribute to the development of addiction in part through dysregulation of neurofunctional networks. Research on the neural sequelae associated with binge drinking is scant but resting state functional connectivity (RSFC) studies of alcohol use disorders (AUD) indicate that the development and maintenance of long-term excessive drinking may be mediated by network-level disruptions. The present study examined RSFC in young adult binge (BD) and light (LD) drinkers with seeds representing the networks subserving reward (the nucleus accumbens and caudate nucleus), salience (anterior cingulate cortex, ACC), and executive control (inferior frontal cortex, IFC). BDs exhibited enhanced connectivity between the striatal reward areas and the orbitofrontal cortex and the ACC, which is consistent with AUD studies and may be indicative of alcohol-motivated appetitive behaviors. Conversely, BDs demonstrated lower connectivity between the IFC and hippocampus which was associated with higher craving. This may indicate impaired ability to suppress unwanted thoughts and a failure to employ memory of the harmful consequences of heavy drinking in prospective plans and intentions. The observed greater connectivity of the reward/salience network and the lower prefrontal-hippocampal connectivity were associated with hazardous drinking levels indicating that dysregulation of neurofunctional networks may underlie binge drinking patterns.
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23
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Sullivan EV, Zhao Q, Pohl KM, Zahr NM, Pfefferbaum A. Attenuated cerebral blood flow in frontolimbic and insular cortices in Alcohol Use Disorder: Relation to working memory. J Psychiatr Res 2021; 136:140-148. [PMID: 33592385 PMCID: PMC8009820 DOI: 10.1016/j.jpsychires.2021.01.053] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Revised: 01/12/2021] [Accepted: 01/29/2021] [Indexed: 12/25/2022]
Abstract
Chronic, excessive alcohol consumption is associated with cerebrovascular hypoperfusion, which has the potential to interfere with cognitive processes. Magnetic resonance pulsed continuous arterial spin labeling (PCASL) provides a noninvasive approach for measuring regional cerebral blood flow (CBF) and was used to study 24 men and women with Alcohol Use Disorder (AUD) and 20 age- and sex-matched controls. Two analysis approaches tested group differences: a data-driven, regionally-free method to test for group differences on a voxel-by-voxel basis and a region of interest (ROI) approach, which focused quantification on atlas-determined brain structures. Whole-brain, voxel-wise quantification identified low AUD-related cerebral perfusion in large volumes of medial frontal and cingulate cortices. The ROI analysis also identified lower CBF in the AUD group relative to the control group in medial frontal, anterior/middle cingulate, insular, and hippocampal/amygdala ROIs. Further, years of AUD diagnosis negatively correlated with temporal cortical CBF, and scores on an alcohol withdrawal scale negatively correlated with posterior cingulate and occipital gray matter CBF. Regional volume deficits did not account for AUD CBF deficits. Functional relevance of attenuated regional CBF in the AUD group emerged with positive correlations between episodic working memory test scores and anterior/middle cingulum, insula, and thalamus CBF. The frontolimbic and insular cortical neuroconstellation with dampened perfusion suggests a mechanism of dysfunction associated with these brain regions in AUD.
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Affiliation(s)
- Edith V. Sullivan
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA;,Correspondence Edith V. Sullivan, Ph.D., Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine (MC5723), 401 Quarry Road, Stanford, CA 94305-5723, phone: (650) 859-2880, FAX: (650) 859-2743,
| | - Qingyu Zhao
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA
| | - Kilian M. Pohl
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA;,Center for Health Sciences, SRI International, Menlo Park, CA
| | - Natalie M. Zahr
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA;,Center for Health Sciences, SRI International, Menlo Park, CA
| | - Adolf Pfefferbaum
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA;,Center for Health Sciences, SRI International, Menlo Park, CA
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24
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Campbell EJ, Lawrence AJ. It's more than just interoception: The insular cortex involvement in alcohol use disorder. J Neurochem 2021; 157:1644-1651. [PMID: 33486788 DOI: 10.1111/jnc.15310] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 01/13/2021] [Accepted: 01/14/2021] [Indexed: 12/24/2022]
Abstract
Understanding brain structures and circuits impacted by alcohol use disorder is critical for improving our future prevention techniques and treatment options. A brain region that has recently gained traction for its involvement in substance use disorder is the insular cortex. This brain region is multi-functional and spatially complex, resulting in a relative lack of understanding of the involvement of the insular cortex in alcohol use disorder. Here we discuss the role of the insular cortex in alcohol use disorder, particularly during periods of abstinence and in response to alcohol and alcohol-related cues and contexts. We also discuss a broader role of the insular in alcohol-associated risky decision making and impulse control. Finally, we canvas potential challenges associated with targeting the insular cortex to treat individuals with alcohol use disorder.
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Affiliation(s)
- Erin J Campbell
- The Florey Institute of Neuroscience and Mental Health, Parkville, Vic, Australia.,Florey Department of Neuroscience and Mental Health, The University of Melbourne, Melbourne, Vic, Australia
| | - Andrew J Lawrence
- The Florey Institute of Neuroscience and Mental Health, Parkville, Vic, Australia.,Florey Department of Neuroscience and Mental Health, The University of Melbourne, Melbourne, Vic, Australia
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25
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Sion A, Bruña Fernández R, Martínez Maldonado A, Domínguez Centeno I, Torrado‐Carvajal A, Rubio G, Pereda E, Jurado‐Barba R. Resting‐state connectivity and network parameter analysis in alcohol‐dependent males. A simultaneous EEG‐MEG study. J Neurosci Res 2020; 98:1857-1876. [DOI: 10.1002/jnr.24673] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2020] [Revised: 05/15/2020] [Accepted: 05/25/2020] [Indexed: 02/04/2023]
Affiliation(s)
- Ana Sion
- 12 de Octubre Biomedical Research Institute Madrid Spain
| | - Ricardo Bruña Fernández
- Laboratory of Cognitive and Computational Neuroscience Center for Biomedical Technology (CTB) Madrid Spain
- Department of Experimental Psychology Universidad Complutense de Madrid Madrid Spain
- Networking Research Center on Bioengineering Biomaterials and Nanomedicine (CIBER‐BBN) Madrid Spain
| | | | - Isabel Domínguez Centeno
- 12 de Octubre Biomedical Research Institute Madrid Spain
- Psychology Department, Health Science Faculty Camilo José Cela University Madrid Spain
| | - Angel Torrado‐Carvajal
- Athinoula A. Martinos Center for Biomedical Imaging Department of Radiology Massachusetts General Hospital and Harvard Medical School Boston MA USA
- Medical Image Analysis and Biometry Laboratory Universidad Rey Juan Carlos Madrid Spain
| | - Gabriel Rubio
- 12 de Octubre Biomedical Research Institute Madrid Spain
- 12 de Octubre Hospital Madrid Spain
- Medicine Faculty Complutense de Madrid University Madrid Spain
- Addictive Disorders Network (Red de Trastornos adictivos, RETIS) Carlos III Institute Madrid Spain
| | - Ernesto Pereda
- Laboratory of Cognitive and Computational Neuroscience Center for Biomedical Technology (CTB) Madrid Spain
- Department of Industrial Engineering & IUNE Universidad de la Laguna San Cristóbal de La Laguna Spain
| | - Rosa Jurado‐Barba
- 12 de Octubre Biomedical Research Institute Madrid Spain
- Psychology Department, Health Science Faculty Camilo José Cela University Madrid Spain
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26
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Scuppa G, Tambalo S, Pfarr S, Sommer WH, Bifone A. Aberrant insular cortex connectivity in abstinent alcohol-dependent rats is reversed by dopamine D3 receptor blockade. Addict Biol 2020; 25:e12744. [PMID: 30907042 PMCID: PMC7187338 DOI: 10.1111/adb.12744] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Revised: 01/12/2019] [Accepted: 02/12/2019] [Indexed: 12/23/2022]
Abstract
A few studies have reported aberrant functional connectivity in alcoholic patients, but the specific neural circuits involved remain unknown. Moreover, it is unclear whether these alterations can be reversed upon treatment. Here, we used functional MRI to study resting state connectivity in rats following chronic intermittent exposure to ethanol. Further, we evaluated the effects of SB-277011-a, a selective dopamine D3 receptor antagonist, known to decrease ethanol consumption. Alcohol-dependent and control rats (N = 13/14 per group), 3 weeks into abstinence, were administered SB-277011-a or vehicle before fMRI sessions. Resting state connectivity networks were extracted by independent component analysis. A dual-regression analysis was performed using independent component maps as spatial regressors, and the effects of alcohol history and treatment on connectivity were assessed. A history of alcohol dependence caused widespread reduction of the internal coherence of components. Weaker correlation was also found between the insula cortex (IC) and cingulate cortices, key constituents of the salience network. Similarly, reduced connectivity was observed between a component comprising the anterior insular cortex, together with the caudate putamen (CPu-AntIns), and the posterior part of the IC. On the other hand, postdependent rats showed strengthened connectivity between salience and reward networks. In particular, higher connectivity was observed between insula and nucleus accumbens, between the ventral tegmental area and the cingulate cortex and between the VTA and CPu-AntIns. Interestingly, aberrant connectivity in postdependent rats was partially restored by acute administration of SB-277011-a, which, conversely, had no significant effects in naïve rats.
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Affiliation(s)
- Giulia Scuppa
- Center for Neuroscience and Cognitive SystemsIstituto Italiano di TecnologiaRoveretoItaly
| | - Stefano Tambalo
- Center for Neuroscience and Cognitive SystemsIstituto Italiano di TecnologiaRoveretoItaly
| | - Simone Pfarr
- Institute of Psychopharmacology, Central Institute of Mental HealthUniversity of HeidelbergMannheimGermany
| | - Wolfgang H. Sommer
- Institute of Psychopharmacology, Central Institute of Mental HealthUniversity of HeidelbergMannheimGermany
- Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental HealthUniversity of HeidelbergMannheimGermany
| | - Angelo Bifone
- Center for Neuroscience and Cognitive SystemsIstituto Italiano di TecnologiaRoveretoItaly
- Department of Molecular Biotechnology and Health SciencesUniversity of TorinoTorinoItaly
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27
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Jurado-Barba R, Sion A, Martínez-Maldonado A, Domínguez-Centeno I, Prieto-Montalvo J, Navarrete F, García-Gutierrez MS, Manzanares J, Rubio G. Neuropsychophysiological Measures of Alcohol Dependence: Can We Use EEG in the Clinical Assessment? Front Psychiatry 2020; 11:676. [PMID: 32765317 PMCID: PMC7379886 DOI: 10.3389/fpsyt.2020.00676] [Citation(s) in RCA: 6] [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: 12/27/2019] [Accepted: 06/29/2020] [Indexed: 01/03/2023] Open
Abstract
Addiction management is complex, and it requires a bio-psycho-social perspective, that ought to consider the multiple etiological and developmental factors. Because of this, a large amount of resources has been allocated to assess the vulnerability to dependence, i.e., to identify the processes underlying the transition from substance use to dependence, as well as its course, in order to determine the key points in its prevention, treatment, and recovery. Consequently, knowledge \from neuroscience must be taken into account, which is why different initiatives have emerged with this objective, such as the "Research Domain Criteria" (RDoC), and the "Addiction Neuroclinical Assessment" (ANA). Particularly, neuropsychophysiological measures could be used as markers of cognitive and behavioral attributes or traits in alcohol dependence, and even trace clinical change. In this way, the aim of this narrative review is to provide an overview following ANA clinical framework, to the most robust findings in neuropsychophysiological changes in alcohol dependence, that underlie the main cognitive domains implicated in addiction: incentive salience, negative emotionality, and executive functioning. The most consistent results have been found in event-related potential (ERP) analysis, especially in the P3 component, that could show a wide clinical utility, mainly for the executive functions. The review also shows the usefulness of other components, implicated in affective and substance-related processing (P1, N1, or the late positive potential LPP), as well as event-related oscillations, such as theta power, with a possible use as vulnerability or clinical marker in alcohol dependence. Finally, new tools emerging from psychophysiology research, based on functional connectivity or brain graph analysis could help toward a better understanding of altered circuits in alcohol dependence, as well as communication efficiency and effort during mental operations. This review concludes with an examination of these tools as possible markers in the clinical field and discusses methodological differences, the need for more replicability studies and incipient lines of work. It also uses consistent findings in psychophysiology to draw possible treatment targets and cognitive profiles in alcohol dependence.
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Affiliation(s)
- Rosa Jurado-Barba
- Biomedical Research Institute, Hospital 12 de Octubre, Madrid, Spain.,Department of Psychology, Education and Health Science Faculty, Camilo José Cela University, Madrid, Spain
| | - Ana Sion
- Biomedical Research Institute, Hospital 12 de Octubre, Madrid, Spain.,Addictive Disorders Network, Carlos III Institute, Madrid, Spain
| | | | - Isabel Domínguez-Centeno
- Department of Psychology, Education and Health Science Faculty, Camilo José Cela University, Madrid, Spain
| | | | - Francisco Navarrete
- Addictive Disorders Network, Carlos III Institute, Madrid, Spain.,Neuroscience Institute, Miguel Hernández University-CSIC, Alicante, Spain
| | - María Salud García-Gutierrez
- Addictive Disorders Network, Carlos III Institute, Madrid, Spain.,Neuroscience Institute, Miguel Hernández University-CSIC, Alicante, Spain
| | - Jorge Manzanares
- Addictive Disorders Network, Carlos III Institute, Madrid, Spain.,Neuroscience Institute, Miguel Hernández University-CSIC, Alicante, Spain
| | - Gabriel Rubio
- Biomedical Research Institute, Hospital 12 de Octubre, Madrid, Spain.,Addictive Disorders Network, Carlos III Institute, Madrid, Spain.,Medicine Faculty, Complutense de Madrid University, Madrid, Spain
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28
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Crespi C, Galandra C, Canessa N, Manera M, Poggi P, Basso G. Microstructural damage of white-matter tracts connecting large-scale networks is related to impaired executive profile in alcohol use disorder. Neuroimage Clin 2019; 25:102141. [PMID: 31927501 PMCID: PMC6953958 DOI: 10.1016/j.nicl.2019.102141] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Revised: 12/18/2019] [Accepted: 12/21/2019] [Indexed: 12/16/2022]
Abstract
Alcohol Use Disorders (AUD) is associated with negative consequences on global functioning, likely reflecting chronic changes in brain morphology and connectivity. Previous attempts to characterize cognitive impairment in AUD addressed patients' performance in single domains, without considering their cognitive profile as a whole. While altered cognitive performance likely reflects abnormal white-matter microstructural properties, to date no study has directly addressed the relationship between a proxy of patients' cognitive profile and microstructural damage. To fill this gap we aimed to characterize the microstructural damage pattern, and its relationship with cognitive profile, in treatment-seeking AUD patients. Twenty-two AUD patients and 18 healthy controls underwent a multimodal MRI protocol including diffusion tensor imaging (DTI), alongside a comprehensive neurocognitive assessment. We used a principal component analysis (PCA) to identify superordinate components maximally explaining variability in cognitive performance, and whole-brain voxelwise analyses to unveil the neural correlates of AUD patients' cognitive impairment in terms of different white-matter microstructural features, i.e. fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD) and radial diffusivity (RD). PCA revealed a basic executive component, significantly impaired in AUD patients, associated with tasks tapping visuo-motor processing speed, attention and working-memory. Within a widespread pattern of white-matter damage in patients, we found diverse types of relationship linking WM microstructure and executive performance: (i) in the whole sample, we observed a linear relationship involving MD/RD metrics within both 'superficial' white-matter systems mediating connectivity within large-scale brain networks, and deeper systems modulating their reciprocal connections; (ii) in AUD patients vs. controls, a performance-by-group interaction highlighted a MD/AD pattern involving two frontal white-matter systems, including the genu of corpus callosum and cingulum bundle, mediating structural connectivity among central executive, salience and default mode networks. Alterations of prefrontal white-matter pathways are suggestive of abnormal structural connectivity in AUD, whereby a defective interplay among large-scale networks underpins patients' executive dysfunction. These findings highlight different directions for future basic and translational research aiming to tailor novel rehabilitation strategies and assess their functional outcomes.
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Affiliation(s)
- Chiara Crespi
- Scuola Universitaria Superiore IUSS Pavia, Piazza della Vittoria 15 27100, Pavia, Italy; Cognitive Neuroscience Laboratory, IRCCS ICS Maugeri, 27100, Pavia, Italy.
| | - Caterina Galandra
- Cognitive Neuroscience Laboratory, IRCCS ICS Maugeri, 27100, Pavia, Italy
| | - Nicola Canessa
- Scuola Universitaria Superiore IUSS Pavia, Piazza della Vittoria 15 27100, Pavia, Italy; Cognitive Neuroscience Laboratory, IRCCS ICS Maugeri, 27100, Pavia, Italy
| | - Marina Manera
- Psychology Unit, IRCCS ICS Maugeri, 27100, Pavia, Italy
| | - Paolo Poggi
- Radiology Unit, IRCCS ICS Maugeri, 27100, Pavia, Italy
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29
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Crespi C, Galandra C, Manera M, Basso G, Poggi P, Canessa N. Executive Impairment in Alcohol Use Disorder Reflects Structural Changes in Large-Scale Brain Networks: A Joint Independent Component Analysis on Gray-Matter and White-Matter Features. Front Psychol 2019; 10:2479. [PMID: 32038340 PMCID: PMC6988803 DOI: 10.3389/fpsyg.2019.02479] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Accepted: 10/21/2019] [Indexed: 12/28/2022] Open
Abstract
Alcohol Use Disorder (AUD) entails chronic effects on brain structure. Neurodegeneration due to alcohol toxicity is a neural signature of executive impairment typically observed in AUD, previously related to both gray-matter volume/density and white-matter abnormalities. Recent studies highlighted the role of meso-cortico-limbic structures supporting the salience and executive networks, in which the extent of neurostructural damage is significantly related to patients’ executive performance. Here we aim to integrate multimodal information on gray-matter and white-matter features with a multivariate data-driven approach (joint Independent Component Analysis, jICA), and to assess the relationship between the extent of damage in the resulting neurostructural superordinate components and executive profile in AUD. Twenty-two AUD patients and 18 matched healthy controls (HC) underwent a Magnetic Resonance Imaging (MRI) protocol, alongside clinical and neuropsychological examinations. We ran jICA on five neurostructural features, including gray-matter density and different diffusion tensor imaging metrics. We extracted 12 Independent Components (ICs) and compared the resulting mixing coefficients in patients vs. HC. Finally, we correlated significant ICs with executive and clinical variables. One out of 12 ICs (IC11) discriminated patients from healthy controls and correlated positively both with executive performance in all subjects, and with lifetime duration of alcohol abuse in patients. In line with previous related evidence, this component involved widespread gray-matter and white-matter patterns including key nodes and fiber tracts of salience, default-mode and central executive networks. These findings highlighted the role of multivariate data integration as a valuable approach revealing superordinate hallmarks of neural changes related to cognition in neurological and psychiatric populations.
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Affiliation(s)
- Chiara Crespi
- NEtS Center, Scuola Universitaria Superiore Istituto Universitario di Studi Superiori Pavia, Pavia, Italy.,Cognitive Neuroscience Laboratory, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy
| | - Caterina Galandra
- Cognitive Neuroscience Laboratory, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy
| | - Marina Manera
- Psychology Unit, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy
| | | | - Paolo Poggi
- Radiology Unit, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy
| | - Nicola Canessa
- NEtS Center, Scuola Universitaria Superiore Istituto Universitario di Studi Superiori Pavia, Pavia, Italy.,Cognitive Neuroscience Laboratory, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy
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30
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Abstract
OBJECTIVE To review deficits in emotional processing and social cognition potentially contributing to the dysfunctional emotion regulation and difficulties with interpersonal relationships observed in individuals with alcohol use disorder (AUD) and to provide directions for future research. METHOD First is presented a review of emotional and social-cognitive impairments in recently detoxified AUD individuals that include alexithymia, difficulties in decoding others' emotions, and reduced theory of mind and empathy skills. Social cognition disorders in AUD pose different issues discussed, such as whether (1) these deficits are consequences of excessive alcohol consumption or premorbid risk factors for addiction, (2) emotional and social impairments impede positive treatment outcome, (3) recovery of social abilities is possible with sustained abstinence, and (4) AUD patients are unaware of their emotional and social dysfunctions. Finally, current knowledge on structural and functional brain correlates of these deficits in AUD are reviewed. RESULTS Emotional and social-cognitive functions affected in AUD can potentially compromise efforts to initiate and maintain abstinence by hampering efficacy of clinical treatment. Such dysfunction can obstruct efforts to enable or reinstate higher-order abilities such as emotional self-regulation, motivation to change, success in interpersonal/social interactions, and emotional insight and awareness of social dysfunctions (i.e., accurate metacognition). CONCLUSIONS The present review highlights the need to account for emotional processing and social cognition in the evaluation and rehabilitation of alcohol-related neurocognitive disorders and to consider psychotherapeutic treatment involving remediation of emotional and social skills as implemented in psychiatric and neurological disorders. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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31
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Sullivan EV, Pfefferbaum A. Brain-behavior relations and effects of aging and common comorbidities in alcohol use disorder: A review. Neuropsychology 2019; 33:760-780. [PMID: 31448945 PMCID: PMC7461729 DOI: 10.1037/neu0000557] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVE Alcohol use disorder (AUD) is a complex, dynamic condition that waxes and wanes with unhealthy drinking episodes and varies in drinking patterns and effects on brain structure and function with age. Its excessive use renders chronically heavy drinkers vulnerable to direct alcohol toxicity and a variety of comorbidities attributable to nonalcohol drug misuse, viral infections, and accelerated or premature aging. AUD affects widespread brain systems, commonly, frontolimbic, frontostriatal, and frontocerebellar networks. METHOD AND RESULTS Multimodal assessment using selective neuropsychological testing and whole-brain neuroimaging provides evidence for AUD-related specific brain structure-function relations established with double dissociations. Longitudinal study using noninvasive imaging provides evidence for brain structural and functional improvement with sustained sobriety and further decline with relapse. Functional imaging suggests the possibility that some alcoholics in recovery can compensate for impairment by invoking brain systems typically not used for a target task but that can enable normal-level performance. CONCLUSIONS Evidence for AUD-aging interactions, indicative of accelerated aging, together with increasing alcohol consumption in middle-age and older adults, put aging drinkers at special risk for developing cognitive decline and possibly dementia. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Affiliation(s)
- Edith V. Sullivan
- Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, CA
| | - Adolf Pfefferbaum
- Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, CA
- Center for Health Sciences, SRI International, Menlo Park, CA
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32
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Ibrahim C, Rubin-Kahana DS, Pushparaj A, Musiol M, Blumberger DM, Daskalakis ZJ, Zangen A, Le Foll B. The Insula: A Brain Stimulation Target for the Treatment of Addiction. Front Pharmacol 2019; 10:720. [PMID: 31312138 PMCID: PMC6614510 DOI: 10.3389/fphar.2019.00720] [Citation(s) in RCA: 68] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Accepted: 06/05/2019] [Indexed: 12/15/2022] Open
Abstract
Substance use disorders (SUDs) are a growing public health concern with only a limited number of approved treatments. However, even approved treatments are subject to limited efficacy with high long-term relapse rates. Current treatment approaches are typically a combination of pharmacotherapies and behavioral counselling. Growing evidence and technological advances suggest the potential of brain stimulation techniques for the treatment of SUDs. There are three main brain stimulation techniques that are outlined in this review: transcranial magnetic stimulation (TMS), transcranial direct current stimulation (tDCS), and deep brain stimulation (DBS). The insula, a region of the cerebral cortex, is known to be involved in critical aspects underlying SUDs, such as interoception, decision making, anxiety, pain perception, cognition, mood, threat recognition, and conscious urges. This review focuses on both the preclinical and clinical evidence demonstrating the role of the insula in addiction, thereby demonstrating its promise as a target for brain stimulation. Future research should evaluate the optimal parameters for brain stimulation of the insula, through the use of relevant biomarkers and clinical outcomes for SUDs.
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Affiliation(s)
- Christine Ibrahim
- Translational Addiction Research Laboratory, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Pharmacology, University of Toronto, Toronto, ON, Canada
| | - Dafna S. Rubin-Kahana
- Translational Addiction Research Laboratory, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Abhiram Pushparaj
- Qunuba Sciences, Toronto, ON, Canada
- Ironstone Product Development, Toronto, ON, Canada
| | | | - Daniel M. Blumberger
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Temerty Centre for Therapeutic Brain Intervention, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Zafiris J. Daskalakis
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Temerty Centre for Therapeutic Brain Intervention, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Abraham Zangen
- Department of Life Sciences and the Zlotowski Center for Neuroscience, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Bernard Le Foll
- Translational Addiction Research Laboratory, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Pharmacology, University of Toronto, Toronto, ON, Canada
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Addictions Division, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Institute of Medical Sciences, University of Toronto, Toronto, ON, Canada
- Alcohol Research and Treatment Clinic, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
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Burchi E, Makris N, Lee MR, Pallanti S, Hollander E. Compulsivity in Alcohol Use Disorder and Obsessive Compulsive Disorder: Implications for Neuromodulation. Front Behav Neurosci 2019; 13:70. [PMID: 31139059 PMCID: PMC6470293 DOI: 10.3389/fnbeh.2019.00070] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Accepted: 03/22/2019] [Indexed: 01/22/2023] Open
Abstract
Alcohol use Disorder (AUD) is one of the leading causes of morbidity and mortality worldwide. The progression of the disorder is associated with the development of compulsive alcohol use, which in turn contributes to the high relapse rate and poor longer term functioning reported in most patients, even with treatment. While the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) defines AUD by a cluster of symptoms, parsing its heterogeneous phenotype by domains of behavior such as compulsivity may be a critical step to improve outcomes of this condition. Still, neurobiological underpinnings of compulsivity need to be fully elucidated in AUD in order to better design targeted treatment strategies. In this manuscript, we review and discuss findings supporting common mechanisms between AUD and OCD, dissecting the construct of compulsivity and focusing specifically on characteristic disruptions in habit learning and cognitive control in the two disorders. Finally, neuromodulatory interventions are proposed as a probe to test compulsivity as key pathophysiologic feature of AUD, and as a potential therapy for the subgroup of individuals with compulsive alcohol use, i.e., the more resistant stage of the disorder. This transdiagnostic approach may help to destigmatize the disorder, and suggest potential treatment targets across different conditions.
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Affiliation(s)
- Elisabetta Burchi
- Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY, United States.,Department of Health Sciences, University of Florence, Florence, Italy
| | - Nikolaos Makris
- Center for Morphometric Analysis, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States.,Psychiatry Neuroimaging Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
| | - Mary R Lee
- Section on Clinical Psychoneuroendocrinology and Neuropsychopharmacology, National Institute on Alcohol Abuse and Alcoholism and National Institute on Drug Abuse, Bethesda, MD, United States
| | - Stefano Pallanti
- Department of Psychiatry and Behavioral Sciences, Stanford University Medical Center, Stanford, CA, United States
| | - Eric Hollander
- Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY, United States
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Galandra C, Basso G, Manera M, Crespi C, Giorgi I, Vittadini G, Poggi P, Canessa N. Abnormal fronto-striatal intrinsic connectivity reflects executive dysfunction in alcohol use disorders. Cortex 2019; 115:27-42. [PMID: 30738999 DOI: 10.1016/j.cortex.2019.01.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Revised: 11/19/2018] [Accepted: 01/10/2019] [Indexed: 12/12/2022]
Abstract
The neural bases of cognitive impairment(s) in alcohol use disorders (AUDs) have been explained either with the specific involvement of frontal regions mostly affected by alcohol neurotoxic effects, or with a global brain damage underlying different neuro-cognitive alterations. Novel insights into this issue might come from the analysis of resting-state brain activity, representing a baseline level of intrinsic connectivity within and between the networks underlying cognitive performance. We thus addressed the neural bases of cognitive impairment(s) in 22 AUD patients, compared with 18 healthy controls, by coupling resting-state fMRI with an in-depth neuropsychological assessment of the main cognitive domains. We assessed a relationship between AUD patients' cognitive impairment and two complementary facets of intrinsic brain functioning, i.e., intensity of activation and functional network connectivity, related to the strength of connectivity within and between resting-state networks, respectively. Alcoholic patients' decreased cognitive performance involved specifically an executive domain associated with attentional and working-memory tasks. This impairment reflected an abnormal relationship, in patients versus controls, between cognitive performance and the intensity of intrinsic activity in the dorsolateral prefrontal and striatal nodes of the executive control network. Functional connectivity between the same structures was positively correlated with executive performance in the whole sample, but significantly reduced in patients. The present data suggest that AUD patients' executive impairment reflects dysfunctional connectivity between the cortical and subcortical nodes of the networks underlying cognitive control on goal-directed behavior. This evidence provides a baseline for future studies addressing the abnormal neural architecture underlying cognitive impairment in AUDs and the outcome of rehabilitative treatment.
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Affiliation(s)
- Caterina Galandra
- Scuola universitaria superiore IUSS, Pavia, Italy; Cognitive Neuroscience Laboratory, ICS Maugeri, Pavia, Italy; LabNIT, ICS Maugeri, Pavia, Italy
| | - Gianpaolo Basso
- LabNIT, ICS Maugeri, Pavia, Italy; University of Milano-Bicocca, Milan, Italy
| | | | - Chiara Crespi
- Scuola universitaria superiore IUSS, Pavia, Italy; LabNIT, ICS Maugeri, Pavia, Italy
| | - Ines Giorgi
- Clinical Psychology Unit, ICS Maugeri, Pavia, Italy
| | | | | | - Nicola Canessa
- Scuola universitaria superiore IUSS, Pavia, Italy; Cognitive Neuroscience Laboratory, ICS Maugeri, Pavia, Italy.
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Neural correlates of visual attention in alcohol use disorder. Drug Alcohol Depend 2019; 194:430-437. [PMID: 30502544 DOI: 10.1016/j.drugalcdep.2018.10.032] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Revised: 10/30/2018] [Accepted: 10/31/2018] [Indexed: 10/27/2022]
Abstract
Numerous studies have documented cognitive impairments in multiple domains in patients with an alcohol use disorder (AUD), including perceptuomotor, executive, and visuospatial functions. Although the neural underpinnings of cognitive deficits in AUD have been studied extensively, the neural basis of attention deficits in AUD remains relatively unexplored. Here, we investigated neural responses to a visual attention task (VAT) in 19 recently abstinent patients with AUD and 23 healthy control participants (HC) using functional MRI (fMRI). AUD had a mean number of 62 ± 34SD drinks per week and 29 ± 13 years' history of alcohol use. Results show that there were no behavioral differences (accuracy or reaction time) between groups during the VAT. For both groups, the VAT activated brain areas associated with visual attention load (i.e., parietal and prefrontal cortices) and visual processing (i.e., occipital cortex), which is in line with previous reports on the same task in healthy volunteers. Despite similar behavioral performances, AUD participants showed decreased VAT activation in regions of the dorsal and ventral attention networks, including parietal and prefrontal cortices, and in the insula as compared to controls. These findings corroborate differences in attention networks in AUD compared to HC that might underlie attention deficits in AUD, whereas impairments in the insula could reflect a disruption of interoception processing as found in other addictions.
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36
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Salience network structural integrity predicts executive impairment in alcohol use disorders. Sci Rep 2018; 8:14481. [PMID: 30262893 PMCID: PMC6160480 DOI: 10.1038/s41598-018-32828-x] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Accepted: 09/17/2018] [Indexed: 01/12/2023] Open
Abstract
The neural bases of cognitive impairment(s) in alcohol use disorders (AUDs) might reflect either a global brain damage underlying different neuro-cognitive alterations, or the involvement of specific regions mostly affected by alcohol neuro-toxic effects. While voxel-based-morphometry (VBM) studies have shown a distributed atrophic pattern in fronto-limbic and cerebellar structures, the lack of comprehensive neuro-cognitive assessments prevents previous studies from drawing robust inferences on the specificity of the association between neuro-structural and cognitive impairments in AUDs. To fill this gap, we addressed the neuro-structural bases of cognitive impairment in AUDs, by coupling VBM with an in-depth neuropsychological assessment. VBM results highlighted a diffuse pattern of grey matter reduction in patients, involving the key-nodes of the meso-cortico-limbic (striatum, hippocampus, medial prefrontal cortex), salience (insular and dorsal anterior cingulate cortex) and executive (inferior frontal cortex) networks. Grey matter density in the insular and anterior cingulate sectors of the salience network, significantly decreased in patients, explained almost half of variability in their defective attentional and working-memory performance. The multiple cognitive and neurological impairments observed in AUDs might thus reflect a specific executive deficit associated with the selective damage of a salience-based neural mechanism enhancing access to cognitive resources required for controlled cognition and behaviour.
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Cortes CR, Grodin EN, Mann CL, Mathur K, Kerich M, Zhu X, Schwandt M, Diazgranados N, George DT, Momenan R, Heilig M. Insula Sensitivity to Unfairness in Alcohol Use Disorder. Alcohol Alcohol 2018; 53:201-208. [PMID: 29309499 DOI: 10.1093/alcalc/agx115] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Accepted: 12/28/2017] [Indexed: 02/04/2023] Open
Abstract
Aims Social decision making has recently been evaluated in alcohol use disorder (AUD) using the ultimatum game (UG) task, suggesting a possible deficit in aversive emotion regulation elicited by the unfairness during this task. Despite the relevance to relapse of this possible faulty regulation, the brain correlates of the UG in AUD are unknown. Methods In total, 23 AUD and 27 healthy controls (HC) played three consecutive fMRI runs of the UG, while behavioral and brain responses were recorded. Results Overall, acceptance rate of unfair offers did not differ between groups, but there was a difference in the rate of behavioral change across runs. We found significant anterior insula (aINS) activation in both groups for both fair and unfair conditions, but only HC showed a trend towards increased activation during unfair vs. fair offers. There were not overall whole-brain between-group significant differences. We found a trend of signal attenuation, instead of an increase, in the aINS for AUD when compared to HC during the third run, which is consistent with our recent findings of selective insula atrophy in AUD. Conclusion We found differential group temporal dynamics of behavioral response in the UG. The HC group had a low acceptance rate for unfair offers in the first two runs that increased markedly for the third run; whereas the AUD group was consistent in their rejection of unfair offers across the three runs. We found a strong significant decrease in neural response across runs for both groups. Short summary This fMRI study of UG in alcohol use disorder found behavioral group differences in acceptance rate across runs, which together with significant BOLD-signal decrease across runs in UG-related regions in both groups, highlights the impairment of strategy in AUD and the effect of repetitive exposure to unfairness in this task.
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Affiliation(s)
- Carlos R Cortes
- Clinical Neuroimaging Research Core, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, 10 Center Drive (10 CRC/1-5330), Bethesda, MD 20892-1108, USA
| | - Erica N Grodin
- Clinical Neuroimaging Research Core, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, 10 Center Drive (10 CRC/1-5330), Bethesda, MD 20892-1108, USA
| | - Claire L Mann
- Clinical Neuroimaging Research Core, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, 10 Center Drive (10 CRC/1-5330), Bethesda, MD 20892-1108, USA
| | - Karan Mathur
- Clinical Neuroimaging Research Core, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, 10 Center Drive (10 CRC/1-5330), Bethesda, MD 20892-1108, USA
| | - Michael Kerich
- Clinical Neuroimaging Research Core, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, 10 Center Drive (10 CRC/1-5330), Bethesda, MD 20892-1108, USA
| | - Xi Zhu
- Clinical Neuroimaging Research Core, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, 10 Center Drive (10 CRC/1-5330), Bethesda, MD 20892-1108, USA
| | - Melanie Schwandt
- Office of the Clinical Director, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, 10 Center Drive (10 CRC/1-5330), Bethesda, MD 20892-1108, USA
| | - Nancy Diazgranados
- Office of the Clinical Director, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, 10 Center Drive (10 CRC/1-5330), Bethesda, MD 20892-1108, USA
| | - David T George
- Office of the Clinical Director, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, 10 Center Drive (10 CRC/1-5330), Bethesda, MD 20892-1108, USA
| | - Reza Momenan
- Clinical Neuroimaging Research Core, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, 10 Center Drive (10 CRC/1-5330), Bethesda, MD 20892-1108, USA
| | - Markus Heilig
- Department of Clinical and Experimental Medicine, Center for Social and Affective Neuroscience, Linköping University, Linköping, Sweden
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Topiwala H, Terrera GM, Stirland L, Saunderson K, Russ TC, Dozier MF, Ritchie CW. Lifestyle and neurodegeneration in midlife as expressed on functional magnetic resonance imaging: A systematic review. ALZHEIMERS & DEMENTIA-TRANSLATIONAL RESEARCH & CLINICAL INTERVENTIONS 2018; 4:182-194. [PMID: 29955662 PMCID: PMC6021545 DOI: 10.1016/j.trci.2018.04.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Introduction Lifestyle factors may influence brain health in midlife. Functional magnetic resonance imaging is a widely used tool to investigate early changes in brain health, including neurodegeneration. In this systematic review, we evaluate the relationship between lifestyle factors and neurodegeneration in midlife, as expressed using functional magnetic resonance imaging. Methods We searched MEDLINE, EMBASE, and PsycINFO combining subject headings and free text terms adapted for each database. Articles were screened, and their quality was assessed independently by two reviewers before final inclusion in the review. Results We screened 4116 studies and included 29 in the review. Seven lifestyle factors, such as alcohol, cognitive training, excessive internet use, fasting, physical training, smoking, and substance misuse, were identified in this review. Discussion Cognitive and physical trainings appear to be associated with a neuroprotective effect, whereas alcohol misuse, smoking, and substance misuse appear to be associated with neurodegeneration. Further research is required into the effects of excessive internet use and fasting.
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Affiliation(s)
- Hinesh Topiwala
- Centre for Dementia Prevention, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Graciela Muniz Terrera
- Centre for Dementia Prevention, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Lucy Stirland
- Centre for Dementia Prevention, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Kathryn Saunderson
- Centre for Dementia Prevention, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Tom C Russ
- Centre for Dementia Prevention, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK.,Alzheimer Scotland Dementia Research Centre, University of Edinburgh, Edinburgh, UK
| | | | - Craig W Ritchie
- Centre for Dementia Prevention, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
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Hong JY, Müller-Oehring EM, Pfefferbaum A, Sullivan EV, Kwon D, Schulte T. Aberrant blood-oxygen-level-dependent signal oscillations across frequency bands characterize the alcoholic brain. Addict Biol 2018; 23:824-835. [PMID: 28699704 DOI: 10.1111/adb.12532] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Revised: 04/20/2017] [Accepted: 05/29/2017] [Indexed: 11/26/2022]
Abstract
Chronic alcoholism is associated with widespread regional differences from controls in brain activity and connectivity dynamics measured by blood-oxygen-level-dependent (BOLD) signals. Identification of alcoholism-related neurofunctional power dynamics using functional magnetic resonance imaging (fMRI) that relate to cognition and behavior may serve as biomarkers of alcoholism. Previously, resting-state fMRI studies examined BOLD signals at a single low-frequency (LF) bandwidth. BOLD signals, however, oscillate systematically at different frequencies and are organized in a resting brain where LF oscillation facilitates long-distance communication between regions across cortical regions, whereas high-frequency (HF) oscillation occurs in closely localized, subcortical areas. Using a frequency power quantification approach, we investigated whether the organization of BOLD signal oscillations across all measured frequency bandwidths is altered in alcoholism and relates to cognitive performance. Frequency-dependent oscillation power differences between 56 sober alcoholics and 56 healthy controls occurred for all frequency bands. Alcoholics exhibited greater frequency oscillation power in the orbitofrontal cortex and less power in the posterior insula within the HF bandwidth than controls. Aberrant orbitofrontal HF power was associated with poorer memory performance and slower psychomotor speed in alcoholics. Middle-frequency and LF power proved sensitive in detecting altered frequency oscillation dynamics in parietal and postcentral cortical regions of alcoholics. This study is novel in identifying alcohol-related differences in BOLD oscillation power of the full fMRI frequency bandwidth. Specifically, HF power aberrations were associated with poorer cognitive functioning in alcoholism and may serve as a biomarker for identifying neural targets for repair.
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Affiliation(s)
- Jui-Yang Hong
- Neuroscience Program, Center for Health Sciences; SRI International; Menlo Park CA USA
| | - Eva M. Müller-Oehring
- Neuroscience Program, Center for Health Sciences; SRI International; Menlo Park CA USA
- Department of Psychiatry & Behavioral Sciences; Stanford University; Stanford CA USA
| | - Adolf Pfefferbaum
- Neuroscience Program, Center for Health Sciences; SRI International; Menlo Park CA USA
- Department of Psychiatry & Behavioral Sciences; Stanford University; Stanford CA USA
| | - Edith V. Sullivan
- Department of Psychiatry & Behavioral Sciences; Stanford University; Stanford CA USA
| | - Dongjin Kwon
- Neuroscience Program, Center for Health Sciences; SRI International; Menlo Park CA USA
| | - Tilman Schulte
- Neuroscience Program, Center for Health Sciences; SRI International; Menlo Park CA USA
- Pacific Graduate School of Psychology; Palo Alto CA USA
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40
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Murray DE, Durazzo TC, Schmidt TP, Murray TA, Abé C, Guydish J, Meyerhoff DJ. Regional cerebral blood flow in opiate dependence relates to substance use and neuropsychological performance. Addict Biol 2018. [PMID: 28627790 DOI: 10.1111/adb.12523] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Neuroimaging of opiate-dependent individuals indicates both altered brain structure and function. Magnetic resonance-based arterial spin labeling has been used to measure noninvasively cerebral blood flow (i.e. perfusion) in alcohol, tobacco and stimulant dependence; only one arterial spin labeling paper in opiate-dependent individuals demonstrated frontal and parietal perfusion deficits. Additional research on regional brain perfusion in opiate dependence and its relationship to cognition and self-regulation (impulsivity, risk taking and decision making) may inform treatment approaches for opiate-dependent individuals. Continuous arterial spin labeling magnetic resonance imaging at 4 T and neuropsychological measures assessed absolute brain perfusion levels, cognition and self-regulation in 18 cigarette smoking opiate-dependent individuals (sODI) stable on buprenorphine maintenance therapy. The sODI were compared with 20 abstinent smoking alcohol-dependent individuals (a substance-dependent control group), 35 smoking controls and 29 nonsmoking controls. sODI had lower perfusion in several cortical and subcortical regions including regions within the brain reward/executive oversight system compared with smoking alcohol-dependent individuals and nonsmoking controls. Perfusion was increased in anterior cingulate cortex and globus pallidus of sODI. Compared with all other groups, sODI had greater age-related declines in perfusion in most brain reward/executive oversight system and some other regions. In sODI, lower regional perfusion related to greater substance use, higher impulsivity and weaker visuospatial skills. Overall, sODI showed cortical and subcortical hypoperfusion and hyperperfusion. Relating to neuropsychological performance and substance use quantities, the frontal perfusion alterations are clinically relevant and constitute potential targets for pharmacological and cognitive-based therapeutic interventions to improve treatment outcome in opiate dependence.
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Affiliation(s)
- Donna E. Murray
- Center for Imaging of Neurodegenerative Diseases (CIND); San Francisco VA Medical Center; San Francisco CA USA
- Department of Radiology and Biomedical Imaging; University of California San Francisco; San Francisco CA USA
| | - Timothy C. Durazzo
- Department of Psychiatry and Behavioral Sciences; Stanford University School of Medicine; Stanford CA USA
- VA Palo Alto Health Care System; Mental Illness Research and Education Clinical Centers, Sierra-Pacific War Related Illness and Injury Study Center; Palo Alto CA USA
| | - Thomas P. Schmidt
- Center for Imaging of Neurodegenerative Diseases (CIND); San Francisco VA Medical Center; San Francisco CA USA
- Department of Radiology and Biomedical Imaging; University of California San Francisco; San Francisco CA USA
| | - Troy A. Murray
- Center for Imaging of Neurodegenerative Diseases (CIND); San Francisco VA Medical Center; San Francisco CA USA
| | - Christoph Abé
- Department of Clinical Neuroscience, Osher Center; Karolinska Institute; Stockholm Sweden
| | - Joseph Guydish
- Philip R. Lee Institute for Health Policy Studies; University of California San Francisco; San Francisco CA USA
| | - Dieter J. Meyerhoff
- Center for Imaging of Neurodegenerative Diseases (CIND); San Francisco VA Medical Center; San Francisco CA USA
- Department of Radiology and Biomedical Imaging; University of California San Francisco; San Francisco CA USA
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Chen YL, Yang CY, Chen SJ, Chen YC, Su CY. Everyday memory problems in alcohol abuse and dependence: Frequency, patterns and patient-proxy agreement. Psychiatry Res 2018; 261:488-497. [PMID: 29360054 DOI: 10.1016/j.psychres.2018.01.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Revised: 11/01/2017] [Accepted: 01/08/2018] [Indexed: 11/16/2022]
Abstract
Using self-report to assess everyday memory in alcoholics presents challenges given the presence of both memory and metamemory deficits. Accordingly, evaluation of the reliability and validity of proxy ratings as well as the frequency of these memory lapses are of clinical importance. In the present study, 180 patient-proxy dyads completed the Prospective and Retrospective Memory Questionnaire (PRMQ). 31.7% of proxy-rated versus 2.8% of patient-rated prospective memory scores fell in the impaired to below average range. 15% of proxy-rated retrospective memory scores were below average, whereas none of the patients reported problems in this regard. Longer delays between intention formation and action yielded better prospective memory performance, while the opposite was true for retrospective memory. Agreement between patients and proxies was generally poor to fair across severity levels and the magnitude of observed differences was large (standardized response mean > 0.8). For all PRMQ items, exact agreement occurred in 45.3% of the cases. Larger patient-proxy discrepancy was associated with older age, less education and greater disease severity. Proxy ratings were internally consistent, significantly correlated with objective memory performance, and were sensitive to differences in overall PRMQ performance between severity groups. Caution should be used in the interpretations of patients' reports.
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Affiliation(s)
- Yen-Liang Chen
- Department of Psychiatry, Taitung MacKay Memorial Hospital, Taitung, Taiwan
| | - Chung-Yuan Yang
- Department of Psychiatry, Taitung MacKay Memorial Hospital, Taitung, Taiwan
| | - Shaw-Ji Chen
- Department of Psychiatry, Taitung MacKay Memorial Hospital, Taitung, Taiwan
| | - Yen-Cheng Chen
- Department of Applied Science of Living, Chinese Cultural University, Taiwan
| | - Chwen-Yng Su
- Department of Occupational Therapy, College of Health Sciences, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
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Schulte T, Jung YC, Sullivan EV, Pfefferbaum A, Serventi M, Müller-Oehring EM. The neural correlates of priming emotion and reward systems for conflict processing in alcoholics. Brain Imaging Behav 2017; 11:1751-1768. [PMID: 27815773 PMCID: PMC5418124 DOI: 10.1007/s11682-016-9651-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Emotional dysregulation in alcoholism (ALC) may result from disturbed inhibitory mechanisms. We therefore tested emotion and alcohol cue reactivity and inhibitory processes using negative priming. To test the neural correlates of cue reactivity and negative priming, 26 ALC and 26 age-matched controls underwent functional MRI performing a Stroop color match-to-sample task. In cue reactivity trials, task-irrelevant emotion and alcohol-related pictures were interspersed between color samples and color words. In negative priming trials, pictures primed the semantic content of an alcohol or emotion Stroop word. Behaviorally, both groups showed response facilitation to picture cue trials and response inhibition to primed trials. For cue reactivity to emotion and alcohol pictures, ALC showed midbrain-limbic activation. By contrast, controls activated frontoparietal executive control regions. Greater midbrain-hippocampal activation in ALC correlated with higher amounts of lifetime alcohol consumption and higher anxiety. With negative priming, ALC exhibited frontal cortical but not midbrain-hippocampal activation, similar to the pattern observed in controls. Higher frontal activation to alcohol-priming correlated with less craving and to emotion-priming with fewer depressive symptoms. The findings suggest that neurofunctional systems in ALC can be primed to deal with upcoming emotion- and alcohol-related conflict and can overcome the prepotent midbrain-limbic cue reactivity response.
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Affiliation(s)
- T Schulte
- Neuroscience Program, Biosciences Division, SRI International, Menlo Park, CA, 94025-3493, USA.
- Pacific Graduate School of Psychology, Palo Alto University, Palo Alto, CA, USA.
| | - Y-C Jung
- Deptartment of Psychiatry & Beh. Sci, Stanford University, Stanford, CA, USA
- Department of Psychiatry, Yonsei University College of Medicine, Seoul, South Korea
| | - E V Sullivan
- Deptartment of Psychiatry & Beh. Sci, Stanford University, Stanford, CA, USA
| | - A Pfefferbaum
- Neuroscience Program, Biosciences Division, SRI International, Menlo Park, CA, 94025-3493, USA
- Deptartment of Psychiatry & Beh. Sci, Stanford University, Stanford, CA, USA
| | - M Serventi
- Neuroscience Program, Biosciences Division, SRI International, Menlo Park, CA, 94025-3493, USA
- Deptartment of Psychiatry & Beh. Sci, Stanford University, Stanford, CA, USA
| | - E M Müller-Oehring
- Neuroscience Program, Biosciences Division, SRI International, Menlo Park, CA, 94025-3493, USA
- Deptartment of Psychiatry & Beh. Sci, Stanford University, Stanford, CA, USA
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Abstract
Alcohol use disorder (AUD) has been a major cause of family, social, and personal strife for centuries, with current prevalence estimates of 14% for 12-month and 29% lifetime AUD. Neuropsychological testing of selective cognitive, sensory, and motor functions complemented with in vivo brain imaging has enabled tracking the consequences of AUD, which follows a dynamic course of development, maintenance, and recovery or relapse. Controlled studies of alcoholism reviewed herein provide evidence for disruption of selective functions involving executive, visuospatial, mnemonic, emotional, and attentional processes, response inhibition, prosody, and postural stability and brain systems supporting these functions. On a hopeful front, longitudinal study provides convincing evidence for improvement in brain structure and function following sustained sobriety. These discoveries have a strong legacy in the International Neuropsychological Society (INS), starting from its early days when assumptions regarding which brain regions were disrupted relied solely on patterns of functional sparing and impairment deduced from testing. This review is based on the symposium presentation delivered at the 2017 annual North American meeting of the INS in celebration of the 50th anniversary since its institution in 1967. In the spirit of the meeting's theme, "Binding the Past and Present," the lecture and this review recognized the past by focusing on early, rigorous neuropsychological studies of alcoholism and their influence on research currently conducted using imaging methods enabling hypothesis testing of brain substrates of observed functional deficits. (JINS, 2017, 23, 843-859).
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Thijssen S, Rashid B, Gopal S, Nyalakanti P, Calhoun VD, Kiehl KA. Regular cannabis and alcohol use is associated with resting-state time course power spectra in incarcerated adolescents. Drug Alcohol Depend 2017; 178:492-500. [PMID: 28715777 PMCID: PMC5561725 DOI: 10.1016/j.drugalcdep.2017.05.045] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2016] [Revised: 05/31/2017] [Accepted: 05/31/2017] [Indexed: 12/24/2022]
Abstract
Cannabis and alcohol are believed to have widespread effects on the brain. Although adolescents are at increased risk for substance use, the adolescent brain may also be particularly vulnerable to the effects of drug exposure due to its rapid maturation. Here, we examined the association between cannabis and alcohol use duration and resting-state functional connectivity in a large sample of male juvenile delinquents. The present sample was drawn from the Southwest Advanced Neuroimaging Cohort, Youth sample, and from a youth detention facility in Wisconsin. All participants were scanned at the maximum-security facilities using The Mind Research Network's 1.5T Avanto SQ Mobile MRI scanner. Information on cannabis and alcohol regular use duration was collected using self-report. Resting-state networks were computed using group independent component analysis in 201 participants. Associations with cannabis and alcohol use were assessed using Mancova analyses controlling for age, IQ, smoking and psychopathy scores in the complete case sample of 180 male juvenile delinquents. No associations between alcohol or cannabis use and network spatial maps were found. Longer cannabis use was associated with decreased low frequency power of the default mode network, the executive control networks (ECNs), and several sensory networks, and with decreased functional network connectivity. Duration of alcohol use was associated with decreased low frequency power of the right frontoparietal network, salience network, dorsal attention network, and several sensory networks. Our findings suggest that adolescent cannabis and alcohol use are associated with widespread differences in resting-state time course power spectra, which may persist even after abstinence.
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Affiliation(s)
- Sandra Thijssen
- School of Pedagogical and Educational Sciences, Erasmus University of Rotterdam, The Netherlands; Center for Child and Family Studies, Leiden University, The Netherlands
| | - Barnaly Rashid
- The Mind Research Network, Albuquerque, NM, USA; Department of Electrical and Computer Engineering, University of New Mexico, Albuquerque, NM, USA
| | - Shruti Gopal
- The Mind Research Network, Albuquerque, NM, USA; Chester F. Carlson Center for Imaging Science, Rochester Institute of Technology, Rochester, NY, USA
| | | | - Vince D Calhoun
- The Mind Research Network, Albuquerque, NM, USA; Department of Electrical and Computer Engineering, University of New Mexico, Albuquerque, NM, USA; Chester F. Carlson Center for Imaging Science, Rochester Institute of Technology, Rochester, NY, USA
| | - Kent A Kiehl
- The Mind Research Network, Albuquerque, NM, USA; Department of Neurosciences, School of Medicine, University of New Mexico, Albuquerque, NM, USA; Departments of Psychology, Neuroscience, and Law, University Of New Mexico, Albuquerque, NM, United States.
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Le Berre AP, Müller-Oehring EM, Schulte T, Serventi MR, Pfefferbaum A, Sullivan EV. Deviant functional activation and connectivity of the right insula are associated with lack of awareness of episodic memory impairment in nonamnesic alcoholism. Cortex 2017; 95:15-28. [PMID: 28806707 DOI: 10.1016/j.cortex.2017.07.016] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Revised: 04/10/2017] [Accepted: 07/16/2017] [Indexed: 01/02/2023]
Abstract
A disorder of metamemory, expressed as unawareness of mnemonic ability, is typically associated with the profound amnesia of Korsakoff's Syndrome (KS). A similar but less severe type of limited awareness can also occur in non-KS alcoholism and is observed as an impairment in generating Feeling-of-Knowing (FOK) predictions about future recognition performance. We previously found that FOK accuracy was selectively related to volumes of the insula in alcoholics involved in the present study. Unknown, however, are the neural substrates of unawareness of memory impairment in alcoholism. A task-activated fMRI paradigm served to identify neural nodes and networks implicated in inaccurate self-estimation of mnemonic ability in sober alcoholics while they made prospective FOK judgments in an episodic memory paradigm. Lower activation in the right insula correlated with greater overestimations of future memory abilities in alcoholics. Weaker connectivity of the right insula with the left dorsal anterior cingulate cortex, a node of the salience network, and stronger connectivity of the right insula with the right ventromedial prefrontal cortex (vmPFC), a node of the default mode network (DMN), co-occurred in alcoholics relative to the controls. Specifically, alcoholics, who failed to desynchronize insula-vmPFC activity, had greater overestimation of their memory predictions and poorer recognition performance. This study provides novel support that deviant functional activation and connectivity involving the right insula, a hub of the salience network, appears to participate in disrupting metamemory functioning in alcoholics. Compromised FOK performance might result from disturbance of the switching mechanism between brain networks serving self-referential processes (i.e., DMN network) and networks serving externally-driven activities like memory monitoring (i.e., fronto-parietal network). Thus, compromise in insular network coupling could be a neural mechanism underlying anosognosia for subtle mnemonic impairment in nonamnesic alcoholism.
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Affiliation(s)
- Anne-Pascale Le Berre
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, 94305, USA
| | - Eva M Müller-Oehring
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, 94305, USA; Neuroscience Program, SRI International, Menlo Park, CA, 94025, USA
| | - Tilman Schulte
- Neuroscience Program, SRI International, Menlo Park, CA, 94025, USA
| | - Matthew R Serventi
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, 94305, USA; Neuroscience Program, SRI International, Menlo Park, CA, 94025, USA
| | - Adolf Pfefferbaum
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, 94305, USA; Neuroscience Program, SRI International, Menlo Park, CA, 94025, USA
| | - Edith V Sullivan
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, 94305, USA.
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Anosognosia for Memory Impairment in Addiction: Insights from Neuroimaging and Neuropsychological Assessment of Metamemory. Neuropsychol Rev 2016; 26:420-431. [PMID: 27447979 DOI: 10.1007/s11065-016-9323-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2015] [Accepted: 06/22/2016] [Indexed: 01/27/2023]
Abstract
In addiction, notably Alcohol Use Disorder (AUD), patients often have a tendency to fail to acknowledge the reality of the disease and to minimize the physical, psychological, and social difficulties attendant to chronic alcohol consumption. This lack of awareness can reduce the chances of initiating and maintaining sobriety. Presented here is a model focusing on compromised awareness in individuals with AUD of mild to moderate cognitive deficits, in particular, for episodic memory impairment-the ability to learn new information, such as recent personal experiences. Early in abstinence, alcoholics can be unaware of their memory deficits and overestimate their mnemonic capacities, which can be investigated with metamemory paradigms. Relevant neuropsychological and neuroimaging results considered suggest that the alcoholics' impairment of awareness of their attenuated memory function can be a clinical manifestation explained mechanistically by neurobiological factors, including compromise of brain systems that result in a mild form of mnemonic anosognosia. Specifically, unawareness of memory impairment in AUD may result from a lack of personal knowledge updating attributable to damage in brain regions or connections supporting conscious recollection in episodic memory. Likely candidates are posterior parietal and medial frontal regions known to be integral part of the Default Mode Network (DMN) and the insula leading to an impaired switching mechanism between the DMN and the Central-Executive Control (i.e., Lateral Prefronto-Parietal) Network. The cognitive concepts and neural substrates noted for addictive disorders may also be relevant for problems in self-identification of functional impairment resulting from injury following war-related blast, sport-related concussion, and insidiously occurring dementia.
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Gu X, Lohrenz T, Salas R, Baldwin PR, Soltani A, Kirk U, Cinciripini PM, Montague PR. Belief about Nicotine Modulates Subjective Craving and Insula Activity in Deprived Smokers. Front Psychiatry 2016; 7:126. [PMID: 27468271 PMCID: PMC4942468 DOI: 10.3389/fpsyt.2016.00126] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Accepted: 06/29/2016] [Indexed: 12/20/2022] Open
Abstract
Little is known about the specific neural mechanisms through which cognitive factors influence craving and associated brain responses, despite the initial success of cognitive therapies in treating drug addiction. In this study, we investigated how cognitive factors such as beliefs influence subjective craving and neural activities in nicotine-addicted individuals using model-based functional magnetic resonance imaging (fMRI) and neuropharmacology. Deprived smokers (N = 24) participated in a two-by-two balanced placebo design, which crossed beliefs about nicotine (told "nicotine" vs. told "no nicotine") with the nicotine content in a cigarette (nicotine vs. placebo) which participants smoked immediately before performing a fMRI task involving reward learning. Subjects' reported craving was measured both before smoking and after the fMRI session. We found that first, in the presence of nicotine, smokers demonstrated significantly reduced craving after smoking when told "nicotine in cigarette" but showed no change in craving when told "no nicotine." Second, neural activity in the insular cortex related to craving was only significant when smokers were told "nicotine" but not when told "no nicotine." Both effects were absent in the placebo condition. Third, insula activation related to computational learning signals was modulated by belief about nicotine regardless of nicotine's presence. These results suggest that belief about nicotine has a strong impact on subjective craving and insula responses related to both craving and learning in deprived smokers, providing insights into the complex nature of belief-drug interactions.
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Affiliation(s)
- Xiaosi Gu
- Wellcome Trust Centre for Neuroimaging, University College London, London, UK
- School of Behavioral and Brain Sciences, The University of Texas at Dallas, Dallas, TX, USA
| | - Terry Lohrenz
- Human Neuroimaging Laboratory, Virginia Tech Carilion Research Institute, Roanoke, VA, USA
| | - Ramiro Salas
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Philip R. Baldwin
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Alireza Soltani
- Department of Psychological and Brain Sciences, Dartmouth College, Hanover, NH, USA
| | - Ulrich Kirk
- Institute of Psychology, University of Southern Denmark, Odense, Denmark
| | - Paul M. Cinciripini
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - P. Read Montague
- Wellcome Trust Centre for Neuroimaging, University College London, London, UK
- Human Neuroimaging Laboratory, Virginia Tech Carilion Research Institute, Roanoke, VA, USA
- Department of Physics, Virginia Polytechnic Institute, State University, Blacksburg, VA, USA
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Abstract
Research on the neural substrates of drug reward, withdrawal and relapse has yet to be translated into significant advances in the treatment of addiction. One potential reason is that this research has not captured a common feature of human addiction: progressive social exclusion and marginalization. We propose that research aimed at understanding the neural mechanisms that link these processes to drug seeking and drug taking would help to make addiction neuroscience research more clinically relevant.
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Zhu X, Sundby K, Bjork JM, Momenan R. Alcohol Dependence and Altered Engagement of Brain Networks in Risky Decisions. Front Hum Neurosci 2016; 10:142. [PMID: 27064561 PMCID: PMC4814760 DOI: 10.3389/fnhum.2016.00142] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2015] [Accepted: 03/18/2016] [Indexed: 12/04/2022] Open
Abstract
Alcohol dependence is associated with heightened risk tolerance and altered decision-making. This raises the question as to whether alcohol dependent patients (ADP) are incapable of proper risk assessment. We investigated how healthy controls (HC) and ADP engage neural networks to cope with the increased cognitive demands of risky decisions. We collected fMRI data while 34 HC and 16 ADP played a game that included “safe” and “risky” trials. In safe trials, participants accrued money at no risk of a penalty. In risky trials, reward and risk simultaneously increased as participants were instructed to decide when to stop a reward accrual period. If the participant failed to stop before an undisclosed time, the trial would “bust” and participants would not earn the money from that trial. Independent Component Analysis was used to identify networks engaged during the anticipation and the decision execution of risky compared with safe trials. Like HC, ADP demonstrated distinct network engagement for safe and risky trials at anticipation. However, at decision execution, ADP exhibited severely reduced discrimination in network engagement between safe and risky trials. Although ADP behaviorally responded to risk they failed to appropriately modify network engagement as the decision continued, leading ADP to assume similar network engagement regardless of risk prospects. This may reflect disorganized network switching and a facile response strategy uniformly adopted by ADP across risk conditions. We propose that aberrant salience network (SN) engagement in ADP might contribute to ineffective network switching and that the role of the SN in risky decisions warrants further investigation.
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Affiliation(s)
- Xi Zhu
- Clinical NeuroImaging Research Core, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda MD, USA
| | - Kelsey Sundby
- Clinical NeuroImaging Research Core, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda MD, USA
| | - James M Bjork
- Department of Psychiatry, Virginia Commonwealth University, Richmond VA, USA
| | - Reza Momenan
- Clinical NeuroImaging Research Core, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda MD, USA
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Moeller SJ, London ED, Northoff G. Neuroimaging markers of glutamatergic and GABAergic systems in drug addiction: Relationships to resting-state functional connectivity. Neurosci Biobehav Rev 2016; 61:35-52. [PMID: 26657968 PMCID: PMC4731270 DOI: 10.1016/j.neubiorev.2015.11.010] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Revised: 11/05/2015] [Accepted: 11/21/2015] [Indexed: 12/29/2022]
Abstract
Drug addiction is characterized by widespread abnormalities in brain function and neurochemistry, including drug-associated effects on concentrations of the excitatory and inhibitory neurotransmitters glutamate and gamma-aminobutyric acid (GABA), respectively. In healthy individuals, these neurotransmitters drive the resting state, a default condition of brain function also disrupted in addiction. Here, our primary goal was to review in vivo magnetic resonance spectroscopy and positron emission tomography studies that examined markers of glutamate and GABA abnormalities in human drug addiction. Addicted individuals tended to show decreases in these markers compared with healthy controls, but findings also varied by individual characteristics (e.g., abstinence length). Interestingly, select corticolimbic brain regions showing glutamatergic and/or GABAergic abnormalities have been similarly implicated in resting-state functional connectivity deficits in drug addiction. Thus, our secondary goals were to provide a brief review of this resting-state literature, and an initial rationale for the hypothesis that abnormalities in glutamatergic and/or GABAergic neurotransmission may underlie resting-state functional deficits in drug addiction. In doing so, we suggest future research directions and possible treatment implications.
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Affiliation(s)
- Scott J Moeller
- Departments of Psychiatry and Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA.
| | - Edythe D London
- Departments of Psychiatry and Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Departments of Psychiatry and Biobehavioral Sciences, and Molecular and Medical Pharmacology, University of California Los Angeles, Los Angeles, CA, USA
| | - Georg Northoff
- Brain Imaging and Neuroethics Research Unit, Institute of Mental Health Research, Ottawa, Canada.
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