Association between impulsivity and neural activation to alcohol cues in heavy drinkers

Impact of text-only versus large text-and-picture alcohol warning formats: A functional magnetic resonance imaging study in French young male drinkers

BACKGROUND

Although the World Health Organization recommends visible and clear warning labels about the risks of alcohol consumption on containers and advertising, many of the currently used labels are too small to be visible. This study investigated the brain activity (using fMRI) and alcohol consumption intentions of French young men exposed to two warning formats displayed on alcoholic beverage advertisements: a small Text-only Alcohol Warning (TAW) currently used in many countries, and a larger text-and-picture alcohol warning (PAW).

METHODS

Seventy-four eligible 18-25-year-old male drinkers completed a face-to-face individual visit with a physician expert in addiction medicine. This was followed by the fMRI session during which they viewed 288 stimuli [96 alcohol advertisements with TAWs, the same 96 advertisements with PAWs, and 96 water advertisements (controls)] for 3 s each. If the advertisement made participants want ("yes")/do not want ("no") to consume the product, they pressed the corresponding button (self-report responses). The number of "yes" responses was compared between advertisement types with a paired sample t-test. Whole-brain and region-of-interest (ROI) analyses of the fMRI data were performed.

RESULTS

Whole-brain BOLD fMRI highlighted contrasting effects of PAWs and TAWs. Compared with TAWs, PAWs elicited more activation in the precuneus, angular gyrus, occipital, frontal and temporal areas, and less activation in the nucleus accumbens, ventral tegmental areas, and putamen areas (regions of the reward circuit). The ROI analysis confirmed less activation in the reward circuit (left and right ventral tegmental areas, left and right nucleus accumbens) when viewing PAWs than TAWs. Analysis of the self-report responses indicated that the desire to consume the advertised alcohol product was lower when PAWs were viewed (compared with TAWs) (T = 8.18, p < 10-11).

CONCLUSIONS

This is the first fMRI study to assess the effect of different alcohol warning formats. Our findings show that compared with TAWs, stronger PAWs in advertisements elicited less activity in key regions of the reward system. This suggests that the effects may influence the desire to consume alcohol products (self-report response analysis). These results could help policymakers who are interested in developing more effective labeling measures that target young people.

Dual-systems models of the genetic architecture of impulsive personality traits: neurogenetic evidence of distinct but related factors

BACKGROUND

Dual-systems models, positing an interaction between two distinct and competing systems (i.e. top-down self-control, and bottom-up reward- or emotion-based drive), provide a parsimonious framework for investigating the interplay between cortical and subcortical brain regions relevant to impulsive personality traits (IPTs) and their associations with psychopathology. Despite recent developments in multivariate analysis of genome-wide association studies (GWAS), molecular genetic investigations of these models have not been conducted.

METHODS

Using IPT GWAS, we conducted confirmatory genomic structural equation models (GenomicSEM) to empirically evaluate dual-systems models of the genetic architecture of IPTs. Genetic correlations between dual-systems factors and relevant cortical and subcortical neuroimaging phenotypes (regional/structural volume, cortical surface area, cortical thickness) were estimated and compared.

RESULTS

GenomicSEM dual-systems models underscored important sources of shared and unique genetic variance between top-down and bottom-up constructs. Specifically, a dual-systems genomic model consisting of sensation seeking and lack of self-control factors demonstrated distinct but related sources of genetic influences (rg = 0.60). Genetic correlation analyses provided evidence of differential associations between dual-systems factors and cortical neuroimaging phenotypes (e.g. lack of self-control negatively associated with cortical thickness, sensation seeking positively associated with cortical surface area). No significant associations were observed with subcortical phenotypes.

CONCLUSIONS

Dual-systems models of the genetic architecture of IPTs tested were consistent with study hypotheses, but associations with relevant neuroimaging phenotypes were mixed (e.g. no associations with subcortical volumes). Findings demonstrate the utility of dual-systems models for studying IPT genetic influences, but also highlight potential limitations as a framework for interpreting IPTs as endophenotypes for psychopathology.

Stressful Life Events, Sleep Quality and Non-Suicidal Self-Injury in Chinese Adolescents: The Moderating Effect of Sensation Seeking

Despite the growing evidence that stressful life events are associated with adolescent non-suicidal self-injury (NSSI), few studies have investigated the mediating and moderating mechanisms underlying this link. The current study examined whether sleep quality mediated the link between stressful life events and NSSI and whether this mediating process was moderated by adolescent sensation seeking. The participants were 1006 Chinese adolescents (48.21% boys; mean age = 13.16 years, SD = 0.67). They completed the Life Events Checklist, Pittsburgh Sleep Quality Index, UPPS-P Impulsive Behavior Scale, and NSSI Questionnaire. The PROCESS macro for SPSS was used to examine the hypothesized moderated mediation model. The results showed that sleep quality significantly mediated the positive association between stressful life events and adolescent NSSI. Moreover, this mediating pathway was moderated by sensation seeking. Specifically, the risk impact of stressful life events on NSSI through sleep quality was significant only among adolescents with high-level sensation seeking but not among those with low-level sensation seeking. These findings provide intervention insights to reduce the risk of adolescent NSSI.

Brain response in heavy drinkers during cross-commodity alcohol and money discounting with potentially real rewards: A preliminary study

Background

Alcohol use disorder (AUD) is associated with exaggerated preference for immediate rewards, a candidate endophenotype for use disorders. Addiction symptomology is often well-described by the preference for immediate intoxication over other delayed prosocial rewards. We measured brain activation in AUD-implicated regions during a cross-commodity delay discounting (CCD) task with choices for immediate alcohol and delayed money.

Methods

Heavy drinkers (n=24) experienced a brief intravenous alcohol infusion prime, regained sobriety, then chose between 'One Shot' and delayed money in an adjusting delay CCD task (sober and intoxicated); also during fMRI (sober). Participants also performed a behavioral sensation seeking task and completed self-report inventories of other risk factors. We assessed brain activation to choices representing immediate intoxication versus delayed money rewards in a priori regions of interest defined within the framework of Addictions NeuroImaging Assessment.

Results

Activation to CCD choice versus control trials activated paralimbic and ventral frontal cortical regions, including orbital and medial prefrontal cortex, posterior cingulate/retrosplenial cortex, angular and superior frontal gyri. We detected no differences between immediate or delayed choices. Left medial orbitofrontal cortex activation correlated with alcohol-induced wanting for alcohol; females showed greater activation than males. Behavioral sensation seeking correlated with right nucleus accumbens task engagement.

Conclusions

Alcohol decision-making elicited activation in regions governing reward, introspection, and executive decision-making in heavy drinkers, demonstrating the utility of laboratory tasks designed to better model real-world choice. Our findings suggest that the brain processes subserving immediate and delayed choices are mostly overlapping, even with varied commodities.

Appetitive and aversive cue reactivities differentiate neural subtypes of alcohol drinkers

Craving reflects the subjective urge to use drugs and can be triggered by both positive and negative emotional states. No studies have systematically investigated the relative roles of these mechanisms in the pathophysiology of substance misuse. Here, we performed meta-analyses of drug cue-elicited reactivity and win and loss processing in the monetary incentive delay task to identify distinct neural correlates of appetitive and aversive responses to drug cues. We then characterized the appetitive and aversive cue responses in seventy-six alcohol drinkers performing a cue craving task during fMRI. Imaging data were processed according to published routines. The appetitive circuit involved medial cortical regions and the ventral striatum, and the aversive circuit involved the insula, caudate and mid-cingulate cortex. We observed a significant correlation of cue-elicited activity (β estimates) of the appetitive and aversive circuit. However, individuals varied in appetitive and aversive cue responses. From the regression of appetitive (y) vs. aversive (x) β, we identified participants in the top 1/3 each of those with positive and negative residuals as "approach" (n = 15) and "avoidance" (n = 11) and the others as the "mixed" (n = 50) subtype. In clinical characteristics, the avoidance subtype showed higher sensitivity to punishment and, in contrast, the approach subtype showed higher levels of sensation seeking and alcohol expectancy for social and physical pressure. The findings highlighted distinct neural underpinnings of appetitive and aversive components of cue-elicited reactivity and provided evidence for potential subtypes of alcohol drinkers.

Dual-systems models of the genetic architecture of impulsive personality traits: Neurogenetic evidence of distinct but related factors

Background

Dual-systems models provide a parsimonious framework for understanding the interplay between cortical and subcortical brain regions relevant to impulsive personality traits (IPTs) and their associations with psychiatric disorders. Despite recent developments in multivariate analysis of genome-wide association studies (GWAS), molecular genetic investigations of these models have not been conducted.

Methods

Using extant IPT GWAS, we conducted confirmatory genomic structural equation models (GenomicSEM) to empirically evaluate dual-systems models of the genetic architecture of IPTs. Genetic correlations between results of multivariate GWAS of dual-systems factors and GWAS of relevant cortical and subcortical neuroimaging phenotypes (regional/structural volume, cortical surface area, cortical thickness) were calculated and compared.

Results

Evaluation of GenomicSEM model fit indices for dual-systems models suggested that these models highlight important sources of shared and unique genetic variance between top-down and bottom-up constructs. Specifically, a dual-systems genomic model consisting of sensation seeking and lack of self-control factors demonstrated distinct but related sources of genetic influences ( r g =.60). Genetic correlation analyses provided evidence of differential associations between dual-systems factors and cortical neuroimaging phenotypes (e.g., lack of self-control negatively associated with cortical thickness, sensation seeking positively associated with cortical surface area). However, no significant associations were observed for subcortical phenotypes inconsistent with hypothesized functional localization of dual-systems constructs.

Conclusions

Dual-systems models of the genetic architecture of IPTs tested here demonstrate evidence of shared and unique genetic influences and associations with relevant neuroimaging phenotypes. These findings emphasize potential advantages in utilizing dual-systems models to study genetic influences for IPTs and transdiagnostic associations with psychiatric disorders.

Reward sensitivity and hazardous alcohol consumption in women: The parallel mediation effect of self-control and impulsivity traits

Introduction: Little research has been carried out on the associations between several individual factors and hazardous alcohol use in women. The aim of this study was first, to study the relationship between reward sensitivity (RS) and alcohol use in both women with and without hazardous drinking separately. Second, to explore the potential mediating roles of the impulsivity and self-control traits in this relationship. Method: The study was analytical and cross-sectional and included 645 female participants (mean age = 19.14; standard deviation (SD)=1.60). All women were divided into two groups (286, 44.3%, with hazardous drinking, HDW; and 359, 55.7%, with light drinking, LDW). Correlation analyses were carried out to explore the associations between the variables, and parallel mediation analyses were performed to investigate the potential mediating roles of impulsivity and self-control in the RS-alcohol use associations in each group separately. Results: A significant association was observed between RS and alcohol use in HDW, contrary to that observed in their counterparts. In addition, both higher impulsivity and less self-control mediated the association between RS and alcohol use only in HDW. Conclusions: Impulsivity and self-control differently affect alcohol use under the condition of high reward sensitivity, only in HDW, suggesting alterations of the dual top-down and bottom-up mechanisms and a possible imbalance between the competing reflexive and impulsive brain systems. More research is needed regarding the individual factors that affect women's drinking to develop sensitive measures for the assessment of alcohol use and more efficient interventions for women.

Impulsive trait mediates the relationship between white matter integrity of prefrontal-striatal circuits and the severity of dependence in alcoholism

BACKGROUND

Alcohol dependence (AD) remains one of the major public health concerns. Impulsivity plays a central role in the transfer from recreational alcohol use to dependence and relapse. White matter dysfunction has been implicated in alcohol addiction behaviors and impulsivity. However, little is known about the role of systematic striatal structural connections underlying the mechanism of impulsive traits in AD.

METHODS

In our study, we used seed-based classification by probabilistic tractography with five target masks of striatal circuits to explore the differences in white matter integrity (fractional anisotropy, FA) in AD male patients (N = 51) and healthy controls (N = 27). We mainly explored the correlation between FA of the striatal circuits and impulsive traits (Barratt Impulsiveness Scale, BIS-11), and the mediation role of impulsivity in white matter integrity and the severity of alcohol dependence.

RESULTS

Compared with healthy controls, AD showed much lower FA in the left and right striatum-supplementary motor area (SMA) and left striatum-amygdala. We also found the decreased FA of right striatum-vlPFC was correlated with higher impulsivity. Besides, the relationship between reduced FA of right striatum-vlPFC and severity of dependence could be mediated by impulsivity.

CONCLUSION

In our study, we found disrupted white matter integrity in systematic striatal circuits in AD and the decreased FA of right striatum-vlPFC was correlated with higher impulsivity in AD. Our main findings provide evidence for reduced white matter integrity of systematic striatal circuits and the underlying mechanisms of impulsivity in male AD individuals.

Effect of Caregivers' Parenting Styles on the Emotional and Behavioral Problems of Left-Behind Children: The Parallel Mediating Role of Self-Control

Childhood is an important period of individual psychological development, and parents' company and parenting styles are highly significant to children's personality cultivation and mental health. With the advancement of China's modernization and urbanization, left-behind children without their parents' company have become a growing concern. Compared with children raised by their parents, left-behind children are more likely to show social maladaptation and mental health problems. This study explored the mediating effects of left-behind children's dual mode of self-control between caregivers' parenting styles and emotional and behavioral problems (EBPs). In this study, 469 left-behind children in senior classes of primary schools were investigated by adopting the caregivers' parenting styles questionnaire of left-behind children, the dual-mode of self-control scale and the strengths and difficulties questionnaire. This study found that (1) the protective and risk factors for caregivers' parenting styles not only directly affected EBP, but also affected it through the mediating effect of the dual-mode of self-control, and (2) the mediating effect of the impulsive system was significantly greater than that of the control system. This study confirmed that caregivers' parenting styles had an important impact on left-behind children's psychological growth: positive parenting styles not only directly reduced the risk of EBP, but also indirectly improved left-behind children's mental health by promoting their level of self-control; negative parenting styles directly increased the risk of EBP and indirectly affected left-behind children's mental problems by enhancing their level of impulsiveness. These findings provide an important basis for reducing the risk of mental health problems and cultivating good personality qualities of left-behind children.

Cerebral microstructural abnormalities in impulsivity: a magnetic resonance study

Studies that investigated neurobiological parameters subtended to impulsivity trait found their relationship with structural and functional brain alterations. No studies investigated the white matter microstructural attributes of impulsivity in a large sample of healthy subjects. In the present study 1007 subjects from Human Connectome Project public dataset were divided in two groups, impulsive and not impulsive, basing on Delay Discounting task score. For both groups brain morphometric and microstructural characteristics were investigated. A t-test (correct for multiple comparisons) was performed for each brain parcel and impulsivity measure. Magnetic resonance diffusion images were pre-processed and selected to perform a voxelwise analysis on the fractional anisotropy (FA) maps between impulsive and not impulsive groups. Group analysis showed significant differences in morphometric brain data mainly for temporal and frontal lobes. The impulsive group presented higher FA values in four regions: bilateral medial lemniscus and midbrain reticular formation, right superior longitudinal fasciculus, left forceps major, right corticospinal tract. Not impulsive group showed higher FA values in two significant regions: right and left anterior thalamus radiation. Concluding, macroscopic and microstructural brain alterations were assessed, identifying new neuroanatomical substrates for multidimensional impulsivity construct in a large sample of healthy subjects.

Neural correlates of alcohol use disorder severity among nontreatment-seeking heavy drinkers: An examination of the incentive salience and negative emotionality domains of the alcohol and addiction research domain criteria

BACKGROUND

The Alcohol and Addiction Research Domain Criteria (AARDoC) propose that alcohol use disorder is associated with neural dysfunction in three primary domains: incentive salience, negative emotionality, and executive function. Prior studies in heavy drinking samples have examined brain activation changes associated with alcohol and negative affect cues, representing the incentive salience and negative emotionality domains, respectively. Yet studies examining such cue-induced changes in functional connectivity (FC) are relatively sparse.

METHODS

Nontreatment-seeking heavy drinking adults (N = 149, 56.0% male, 48.6% non-white, mean age 34.8 years (SD = 10.0)) underwent functional magnetic resonance imaging during presentation of alcohol, negative, and neutral pictures. We focused on FC changes involving the nucleus accumbens and amygdala in addition to activation and FC correlations with self-reported AUD severity.

RESULTS

For alcohol cues versus neutral cues, we observed accumbens FC changes in the cerebellum and prefrontal cortex (PFC), and amygdala FC changes with occipital, parietal, and hippocampal regions. AUD severity correlated positively with activation in the cerebellum (p < 0.05), accumbens FC in the cingulate gyri, somatosensory gyri, and cerebellum (p < 0.05), and with amygdala FC in the PFC and inferior parietal lobule (p < 0.05) for alcohol cues versus neutral cues. For negative cues versus neutral cues, we observed accumbens FC changes in the lateral temporal, occipital, and parietal regions, and amygdala FC changes in the fusiform and lingual gyri (p < 0.05).

CONCLUSIONS

The present findings provide empirical support for the AARDoC domains of incentive salience and negative emotionality and indicate that AUD severity is associated with salience and response control for reward cues. When covarying for differences in nonalcohol substance use and mood disorder diagnoses, AUD severity was also associated with emotional reactivity for negative cues.

Impulsivity in heroin-dependent individuals: structural and functional abnormalities within frontostriatal circuits

High levels of impulsivity are a risk factor for the initiation of heroin use and a core behavioral characteristic of heroin dependence. Impulsivity also contributes to the maintenance of drug use and hinders effective therapy. Here we sought to identify neuroimaging markers of impulsivity in heroin-dependent individuals (HDI), with a focus on the nucleus accumbens (NAc), a key region implicated in impulsivity and drug addiction generally. Volume and resting-state functional connectivity (RSFC) differences of the bilateral NAc were investigated between 21 HDI and 21 age-, gender-, nicotine-, alcohol-matched healthy controls (HC). The neuroimaging results were then correlated with the Barratt Impulsivity Scales (BIS-11). Higher motor impulsivity (t = 2.347, p = 0.0253) and larger right NAc volume (F (1,38) = 4.719, p = 0.036) was observed in HDI. The right NAc volume was positively correlated with BIS total (r = 0.6196, p = 0.0239) /motor (r = 0.5921, p = 0.0330) scores in HC and BIS motor (r = 0.5145, p = 0.0170) score in HDI. A negative correlation was found between RSFC of the right NAc-bilateral superior frontal gyrus (SFG) and motor impulsivity in HDI (left: r=-0.6537, p = 0.0013; right: r=-0.6167, p = 0.0029) and HC (left: r=-0.6490,p = 0.0164; right: r=-0.6993, p = 0.0078). We aimed to reveal novel multimodality neuroimaging biomarkers of the higher impulsivity in HDI by focusing on the NAc and corresponding functional circuits. Higher motor impulsivity was observed in HDI. Furthermore, the volume of the right NAc and the RSFC strength of right NAc-SFG could be neuroimaging biomarkers for the severity of impulsivity in HDI. These potential biomarkers could be a target for novel treatments in HDI.

Addictions NeuroImaging Assessment (ANIA): Towards an integrative framework for alcohol use disorder

Alcohol misuse and addiction are major international public health issues. Addiction can be characterized as a disorder of aberrant neurocircuitry interacting with environmental, genetic and social factors. Neuroimaging in alcohol misuse can thus provide a critical window into underlying neural mechanisms, highlighting possible treatment targets and acting as clinical biomarkers for predicting risk and treatment outcomes. This neuroimaging review on alcohol misuse in humans follows the Addictions Neuroclinical Assessment (ANA) that proposes incorporating three functional neuroscience domains integral to the neurocircuitry of addiction: incentive salience and habits, negative emotional states, and executive function within the context of the addiction cycle. Here we review and integrate multiple imaging modalities focusing on underlying cognitive processes such as reward anticipation, negative emotionality, cue reactivity, impulsivity, compulsivity and executive function. We highlight limitations in the literature and propose a model forward in the use of neuroimaging as a tool to understanding underlying mechanisms and potential clinical applicability for phenotyping of heterogeneity and predicting risk and treatment outcomes.

Alcohol Use Disorder Interventions Targeting Brain Sites for Both Conditioned Reward and Delayed Gratification

Alcohol use disorder is a destructive compulsion characterized by chronic relapse and poor recovery outcomes. Heightened reactivity to alcohol-associated stimuli and compromised executive function are hallmarks of alcohol use disorder. Interventions targeting these two interacting domains are thought to ameliorate these altered states, but the mutual brain sites of action are yet unknown. Although interventions on alcohol cue reactivity affect reward area responses, how treatments alter brain responses when subjects exert executive effort to delay gratification is not as well-characterized. Focusing on interventions that could be developed into effective clinical treatments, we review and identify brain sites of action for these two categories of potential therapies. Using activation likelihood estimation (ALE) meta-analysis, we find that interventions on alcohol cue reactivity localize to ventral prefrontal cortex, dorsal anterior cingulate, and temporal, striatal, and thalamic regions. Interventions for increasing delayed reward preference elicit changes mostly in midline default mode network regions, including posterior cingulate, precuneus, and ventromedial prefrontal cortex-in addition to temporal and parietal regions. Anatomical co-localization of effects appears in the ventromedial prefrontal cortex, whereas effects specific to delay-of-gratification appear in the posterior cingulate and precuneus. Thus, the current available literature suggests that interventions in the domains of cue reactivity and delay discounting alter brain activity along midline default mode regions, specifically in the ventromedial prefrontal cortex for both domains, and the posterior cingulate/precuneus for delay-of-gratification. We believe that these findings could facilitate targeting and development of new interventions, and ultimately treatments of this challenging disorder.