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Zeng Y, Lin J, Li Z, Xiao Z, Wang C, Ge X, Wang C, Huang G, Liu M. Adaptive node feature extraction in graph-based neural networks for brain diseases diagnosis using self-supervised learning. Neuroimage 2024; 297:120750. [PMID: 39059681 DOI: 10.1016/j.neuroimage.2024.120750] [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: 05/19/2024] [Revised: 07/06/2024] [Accepted: 07/22/2024] [Indexed: 07/28/2024] Open
Abstract
Electroencephalography (EEG) has demonstrated significant value in diagnosing brain diseases. In particular, brain networks have gained prominence as they offer additional valuable insights by establishing connections between EEG signal channels. While brain connections are typically delineated by channel signal similarity, there lacks a consistent and reliable strategy for ascertaining node characteristics. Conventional node features such as temporal and frequency domain properties of EEG signals prove inadequate for capturing the extensive EEG information. In our investigation, we introduce a novel adaptive method for extracting node features from EEG signals utilizing a distinctive task-induced self-supervised learning technique. By amalgamating these extracted node features with fundamental edge features constructed using Pearson correlation coefficients, we showed that the proposed approach can function as a plug-in module that can be integrated to many common GNN networks (e.g., GCN, GraphSAGE, GAT) as a replacement of node feature selections module. Comprehensive experiments are then conducted to demonstrate the consistently superior performance and high generality of the proposed method over other feature selection methods in various of brain disorder prediction tasks, such as depression, schizophrenia, and Parkinson's disease. Furthermore, compared to other node features, our approach unveils profound spatial patterns through graph pooling and structural learning, shedding light on pivotal brain regions influencing various brain disorder prediction based on derived features.
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Affiliation(s)
- Youbing Zeng
- School of Biomedical Engineering, Sun Yat-sen University, 518107, Guangdong, China.
| | - Jiaying Lin
- School of Biomedical Engineering, Sun Yat-sen University, 518107, Guangdong, China.
| | - Zhuoshuo Li
- School of Biomedical Engineering, Sun Yat-sen University, 518107, Guangdong, China.
| | - Zehui Xiao
- School of Biomedical Engineering, Sun Yat-sen University, 518107, Guangdong, China.
| | - Chen Wang
- School of Biomedical Engineering, Sun Yat-sen University, 518107, Guangdong, China.
| | - Xinting Ge
- Department of Information Science and Engineering, Shandong Normal University, Shandong, China.
| | - Cheng Wang
- Shenzhen RxHEAL Medical Technology Co., Ltd., Guangdong, China.
| | - Gui Huang
- School of Biomedical Engineering, Sun Yat-sen University, 518107, Guangdong, China.
| | - Mengting Liu
- School of Biomedical Engineering, Sun Yat-sen University, 518107, Guangdong, China.
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2
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Bruns Vi N, Tressler EH, Vendruscolo LF, Leggio L, Farokhnia M. IUPHAR review - Glucagon-like peptide-1 (GLP-1) and substance use disorders: An emerging pharmacotherapeutic target. Pharmacol Res 2024; 207:107312. [PMID: 39032839 DOI: 10.1016/j.phrs.2024.107312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2024] [Revised: 07/10/2024] [Accepted: 07/15/2024] [Indexed: 07/23/2024]
Abstract
Addiction is a chronic relapsing disease with high morbidity and mortality. Treatments for addiction include pharmacological and psychosocial interventions; however, currently available medications are limited in number and efficacy. The glucagon-like-peptide-1 (GLP-1) system is emerging as a potential novel pharmacotherapeutic target for alcohol and other substance use disorders (ASUDs). In this review, we summarize and discuss the wealth of available evidence from testing GLP-1 receptor (GLP-1R) agonist medications in preclinical models and humans with ASUDs, possible mechanisms underlying the impact of GLP-1R agonists on alcohol/substance use, gaps in knowledge, and future directions. Most of the research with GLP-1R agonists has been conducted in relation to alcohol use; psychostimulants, opioids, and nicotine have also been investigated. Preclinical evidence suggests that GLP-1R agonists reduce alcohol/substance use and other related outcomes. The main proposed mechanisms are related to reward processing, stress, and cognitive function, as well as broader mechanisms related to satiety, changes in gastric motility, and glucose homeostasis. More in-depth mechanistic studies are warranted. Clinical studies have been limited and their findings have been less conclusive; however, most support the safety and potential efficacy of GLP-1R agonists in ASUD treatment. Identifying preferred compounds, as well as possible subgroups who are most responsive to GLP-1R agonists are some of the key research questions to translate the promising preclinical data into clinical settings. Several clinical trials are underway to test GLP-1R agonists in people with ASUDs.
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Affiliation(s)
- Nicolaus Bruns Vi
- Clinical Psychoneuroendocrinology and Neuropsychopharmacology Section, Translational Addiction Medicine Branch, National Institute on Drug Abuse Intramural Research Program and National Institute on Alcohol Abuse and Alcoholism Division of Intramural Clinical and Biological Research, National Institutes of Health, Baltimore, MD, USA; Neurobiology of Addiction Section, Integrative Neuroscience Research Branch, National Institute on Drug Abuse Intramural Research Program, National Institutes of Health, Baltimore, MD, USA; Stress & Addiction Neuroscience Unit, Integrative Neuroscience Research Branch, National Institute on Drug Abuse Intramural Research Program and National Institute on Alcohol Abuse and Alcoholism Division of Intramural Clinical and Biological Research, National Institutes of Health, Baltimore, MD, USA
| | - Elizabeth H Tressler
- Clinical Psychoneuroendocrinology and Neuropsychopharmacology Section, Translational Addiction Medicine Branch, National Institute on Drug Abuse Intramural Research Program and National Institute on Alcohol Abuse and Alcoholism Division of Intramural Clinical and Biological Research, National Institutes of Health, Baltimore, MD, USA; Neurobiology of Addiction Section, Integrative Neuroscience Research Branch, National Institute on Drug Abuse Intramural Research Program, National Institutes of Health, Baltimore, MD, USA; Stress & Addiction Neuroscience Unit, Integrative Neuroscience Research Branch, National Institute on Drug Abuse Intramural Research Program and National Institute on Alcohol Abuse and Alcoholism Division of Intramural Clinical and Biological Research, National Institutes of Health, Baltimore, MD, USA
| | - Leandro F Vendruscolo
- Stress & Addiction Neuroscience Unit, Integrative Neuroscience Research Branch, National Institute on Drug Abuse Intramural Research Program and National Institute on Alcohol Abuse and Alcoholism Division of Intramural Clinical and Biological Research, National Institutes of Health, Baltimore, MD, USA
| | - Lorenzo Leggio
- Clinical Psychoneuroendocrinology and Neuropsychopharmacology Section, Translational Addiction Medicine Branch, National Institute on Drug Abuse Intramural Research Program and National Institute on Alcohol Abuse and Alcoholism Division of Intramural Clinical and Biological Research, National Institutes of Health, Baltimore, MD, USA.
| | - Mehdi Farokhnia
- Clinical Psychoneuroendocrinology and Neuropsychopharmacology Section, Translational Addiction Medicine Branch, National Institute on Drug Abuse Intramural Research Program and National Institute on Alcohol Abuse and Alcoholism Division of Intramural Clinical and Biological Research, National Institutes of Health, Baltimore, MD, USA.
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3
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Acuff SF, Strickland JC, Smith K, Field M. Heterogeneity in choice models of addiction: the role of context. Psychopharmacology (Berl) 2024:10.1007/s00213-024-06646-1. [PMID: 38990313 DOI: 10.1007/s00213-024-06646-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Accepted: 07/01/2024] [Indexed: 07/12/2024]
Abstract
RATIONALE Theories of addiction guide scientific progress, funding priorities, and policy development and ultimately shape how people experiencing or recovering from addiction are perceived and treated. Choice theories of addiction are heterogenous, and different models have divergent implications. This breeds confusion among laypeople, scientists, practitioners, and policymakers and reduces the utility of robust findings that have the potential to reduce the global burden of addiction-associated harms. OBJECTIVE Here we differentiate classes of choice models and articulate a novel framing for a class of addiction models, called contextual models, which share as a first principle the influence of the environment and other contextual factors on behavior within discrete choice contexts. RESULTS These models do not assume that all choice behaviors are voluntary, but instead that both proximal and distal characteristics of the choice environment-and particularly the benefits and costs of both drug use and non-drug alternatives-can influence behavior in ways that are outside of the awareness of the individual. From this perspective, addiction is neither the individual's moral failing nor an internal uncontrollable urge but rather is the result of environmental contingencies that reinforce the behavior. CONCLUSIONS Contextual models have implications for guiding research, practice, and policy, including identification of novel target mechanisms while also improving existing interventions.
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Affiliation(s)
- Samuel F Acuff
- Recovery Research Institute, Center for Addiction Medicine, Massachusetts General Hospital and Harvard Medical School, 151 Merrimac Street, Boston, MA, 02114, USA.
| | - Justin C Strickland
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 5510 Nathan Shock Drive, Baltimore, MD, 21224, USA
| | - Kirsten Smith
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 5510 Nathan Shock Drive, Baltimore, MD, 21224, USA
| | - Matt Field
- Department of Psychology, University of Sheffield, Sheffield, S1 2LT, UK
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4
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Paul P, Campbell G, Zekeridou A, Mauermann M, Naddaf E. Diagnosing Peripheral Neuropathy in Patients With Alcohol Use Disorder. Mayo Clin Proc 2024; 99:S0025-6196(24)00132-0. [PMID: 39093265 DOI: 10.1016/j.mayocp.2024.02.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 12/04/2023] [Accepted: 02/15/2024] [Indexed: 08/04/2024]
Abstract
With the lack of distinctive features or diagnostic biomarkers, peripheral neuropathy in patients with excessive alcohol consumption is often misdiagnosed as alcohol-related neuropathy, influenced by underlying implicit and explicit bias against patients with an alcohol use disorder (AUD). Alcohol-related nerve toxicity has been attributed to various underlying mechanisms including altered trophic factor signaling, disrupted protein synthesis, free radical injury from oxidative stress, and nutritional deficiencies. Alcohol-related neuropathy has been most described as mild but painful, predominantly affecting small sensory fibers, without major functional limitations. This phenotype may be indistinguishable from a chronic idiopathic axonal neuropathy; hence, a causal relationship with AUD cannot be established with certainty. Searching for alternative causes is warranted, especially in patients with a more severe or rapidly progressive peripheral neuropathy. At the same time, there is underlying implicit and explicit bias in the medical field against patients with AUDs. Patients often experience devaluation and stigma, which can affect their adherence to medical advice and may lead to social reclusion. Addressing biases in health care workers is crucial to ensure that individuals receive proper care and are not subjected to stigmatization. In this article, we present a comprehensive narrative review of the literature on the clinical presentation and underlying pathomechanisms of alcohol-related peripheral neuropathy, raising awareness of the bias in the medical field against patients with AUD.
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Affiliation(s)
- Pritikanta Paul
- Department of Neurology and Rehabilitation, University of Illinois at Chicago, Chicago, IL
| | | | - Anastasia Zekeridou
- Department of Neurology, Mayo Clinic, Rochester, MN; Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN
| | | | - Elie Naddaf
- Department of Neurology, Mayo Clinic, Rochester, MN.
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Haque LY, Leggio L. Integrated and collaborative care across the spectrum of alcohol-associated liver disease and alcohol use disorder. Hepatology 2024:01515467-990000000-00939. [PMID: 38935926 DOI: 10.1097/hep.0000000000000996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2024] [Accepted: 06/08/2024] [Indexed: 06/29/2024]
Abstract
The public health impact of alcohol-associated liver disease (ALD), a serious consequence of problematic alcohol use, and alcohol use disorder (AUD) is growing, with ALD becoming a major cause of alcohol-associated death overall and the leading indication for liver transplantation in the United States. Comprehensive care for ALD often requires treatment of AUD. Although there is a growing body of evidence showing that AUD treatment is associated with reductions in liver-related morbidity and mortality, only a minority of patients with ALD and AUD receive this care. Integrated and collaborative models that streamline both ALD and AUD care for patients with ALD and AUD are promising approaches to bridge this treatment gap and rely on multidisciplinary and interprofessional teams and partnerships. Here, we review the role of AUD care in ALD treatment, the effects of AUD treatment on liver-related outcomes, the impact of comorbid conditions such as other substance use disorders, obesity, and metabolic syndrome, and the current landscape of integrated and collaborative care for ALD and AUD in various treatment settings. We further review knowledge gaps and unmet needs that remain, including the role of precision medicine, the application of harm reduction approaches, the impact of health disparities, and the need for additional AUD treatment options, as well as further efforts to support implementation and dissemination.
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Affiliation(s)
- Lamia Y Haque
- Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, USA
- Yale Program in Addiction Medicine, Yale School of Medicine, New Haven, Connecticut, USA
| | - Lorenzo Leggio
- Clinical Psychoneuroendocrinology and Neuropsychopharmacology Section, Translational Addiction Medicine Branch, National Institute on Drug Abuse and National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Baltimore and Bethesda, Maryland, USA
- Department of Behavioral and Social Sciences, Center for Alcohol and Addiction Studies, School of Public Health, Brown University, Providence, Rhode Island, USA
- Division of Addiction Medicine, Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
- Department of Neuroscience, Georgetown University Medical Center, Washington, District of Columbia, USA
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6
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Gizdic A, Antičević V, Brajević-Gizdić I. The role of attachment and personality traits in choosing opiate addiction replacement therapy. Sci Rep 2024; 14:14623. [PMID: 38918504 PMCID: PMC11199502 DOI: 10.1038/s41598-024-65695-w] [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: 01/23/2024] [Accepted: 06/24/2024] [Indexed: 06/27/2024] Open
Abstract
Contemporary medical approaches for opioid addiction often include medication-assisted therapy, utilizing methadone and buprenorphine. However, factors influencing patient preferences for starting buprenorphine or methadone therapy are poorly understood. This study aims to explore whether variances in personality traits and attachment styles are related to treatment preferences among individuals undergoing buprenorphine and methadone maintenance therapies. 300 participants completed the Big Five Questionnaire for personality traits and sub-dimensions and the Experiences in Close Relationship Scale for assessing attachment styles. The results indicated that patients with higher levels of Dynamism, Conscientiousness, and Perseverance personality traits were more likely to choose buprenorphine over methadone for achieving and maintaining abstinence. Although attachment styles showed a greater ability to differentiate between groups compared to personality traits, the differences were not significant. However, Conscientiousness stood out for its high discriminant validity, suggesting that scores in this personality dimension could significantly distinguish between groups, with individuals in the buprenorphine group showing higher levels of Conscientiousness compared to the methadone group. The study suggests a partial association between individuals' preference for abstinence therapy and their personality traits. These findings could be considered useful indicators when choosing maintenance therapy to help opiate-addicted patients achieve and maintain abstinence.
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Affiliation(s)
- Alena Gizdic
- University Department of Health Studies, University of Split, Split, Croatia.
- Department of Psychology, Vanderbilt University, Nashville, TN, USA.
| | - Vesna Antičević
- University Department of Health Studies, University of Split, Split, Croatia
| | - Igna Brajević-Gizdić
- Teaching Institute of Public Health, County of Split Dalmatia, Service of Mental Health, Split, Croatia
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7
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Heilig M, Witkiewitz K, Ray LA, Leggio L. Novel medications for problematic alcohol use. J Clin Invest 2024; 134:e172889. [PMID: 38828724 PMCID: PMC11142745 DOI: 10.1172/jci172889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2024] Open
Abstract
Alcohol-related harm, a major cause of disease burden globally, affects people along a spectrum of use. When a harmful pattern of drinking is present in the absence of significant behavioral pathology, low-intensity brief interventions that provide information about health consequences of continued use provide large health benefits. At the other end of the spectrum, profound behavioral pathology, including continued use despite knowledge of potentially fatal consequences, warrants a medical diagnosis, and treatment is strongly indicated. Available behavioral and pharmacological treatments are supported by scientific evidence but are vastly underutilized. Discovery of additional medications, with a favorable balance of efficacy versus safety and tolerability can improve clinical uptake of treatment, allow personalized treatment, and improve outcomes. Here, we delineate the clinical conditions when pharmacotherapy should be considered in relation to the main diagnostic systems in use and discuss clinical endpoints that represent meaningful clinical benefits. We then review specific developments in three categories of targets that show promise for expanding the treatment toolkit. GPCRs remain the largest category of successful drug targets across contemporary medicine, and several GPCR targets are currently pursued for alcohol-related indications. Endocrine systems are another established category, and several promising targets have emerged for alcohol indications. Finally, immune modulators have revolutionized treatment of multiple medical conditions, and they may also hold potential to produce benefits in patients with alcohol problems.
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Affiliation(s)
- Markus Heilig
- Center for Social and Affective Neuroscience, Linköping University, and Department of Psychiatry, Linköping University Hospital, Linköping, Sweden
| | - Katie Witkiewitz
- Department of Psychology and Center on Alcohol, Substance Use and Addictions, University of New Mexico, Albuquerque, New Mexico, USA
| | - Lara A. Ray
- Department of Psychology, UCLA, Los Angeles, California, USA
| | - Lorenzo Leggio
- Clinical Psychoneuroendocrinology and Neuropsychopharmacology Section, Translational Addiction Medicine Branch, National Institute on Drug Abuse Intramural Research Program and National Institute on Alcohol Abuse and Alcoholism Division of Intramural Clinical and Biological Research, NIH, Baltimore and Bethesda, Maryland, USA
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Lingerfelt C, Hutson S, Thomas S, Morgan KH. An Interpretive Description of Drug Withdrawal Among Pregnant Women in Jail. Nurs Womens Health 2024; 28:187-198. [PMID: 38522481 DOI: 10.1016/j.nwh.2023.12.002] [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: 08/10/2023] [Revised: 12/07/2023] [Accepted: 02/22/2024] [Indexed: 03/26/2024]
Abstract
OBJECTIVE To explore the experience of drug withdrawal among pregnant women in jail. DESIGN A qualitative interpretive descriptive approach. SETTING/PROBLEM The care of incarcerated pregnant women constitutes a complex and significant public health problem. Many have substance use disorder (SUD) and cycle in and out of jails in their community, resulting in repeated experiences of drug withdrawal. Most jails do not provide medication-assisted therapy for management of withdrawal, a situation that violates standards of care set by leading health organizations. The experience of drug withdrawal among pregnant women in jail has not been qualitatively explored in the literature. PARTICIPANTS Five women completed interviews for the study. INTERVENTION In-depth, qualitative interviews. RESULTS Five themes with subthemes emerged from the interviews: Framing the Story Through Life History: I Need You to Know Where I Come From, Patterns of Thinking About Substance Use, The Manifestations of Withdrawal: Body and Mind, Perceived Punishment for Drug Use During Pregnancy, and Mixed Perceptions of Withdrawal Treatment. CONCLUSION Participants told a story beyond that of the physical withdrawal symptoms, revealing new insights into their maternal distress and the need for compassionate, nonstigmatized care to address physical and mental symptoms, as well as advocacy for the provision of an evidence-based standard of care. Nurses who care for pregnant women with SUD in the jail setting could benefit from collaborative relationships with other health care professionals in the community to reduce disparate health outcomes for this vulnerable population.
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9
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Moore GJ, Ridway H, Gadanec LK, Apostolopoulos V, Zulli A, Swiderski J, Kelaidonis K, Vidali VP, Matsoukas MT, Chasapis CT, Matsoukas JM. Structural Features Influencing the Bioactive Conformation of Angiotensin II and Angiotensin A: Relationship between Receptor Desensitization, Addiction, and the Blood-Brain Barrier. Int J Mol Sci 2024; 25:5779. [PMID: 38891966 PMCID: PMC11171751 DOI: 10.3390/ijms25115779] [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: 03/27/2024] [Revised: 05/04/2024] [Accepted: 05/08/2024] [Indexed: 06/21/2024] Open
Abstract
The N-terminal portion of the octapeptide angiotensin II (DRVYIHPF; AngII), a vasopressor peptide that favorably binds to, and activates, AngII type 1 receptor (AT1R), has an important role in maintaining bioactive conformation. It involves all three charged groups, namely (i) the N-terminal amino group cation, (ii) the Asp sidechain anion and (iii) the Arg guanidino cation. Neutralization of any one of these three charged groups results in a substantial reduction (<5%) in bioactivity, implicating a specialized function for this cluster. In contrast, angiotensin A (ARVYIHPF; AngA) has reduced bioactivity at AT1R; however, replacement of Asp in AngII with sarcosine (N-methyl-glycine) not only restores bioactivity but increases the activity of agonist, antagonist, and inverse agonist analogues. A bend produced at the N-terminus by the introduction of the secondary amino acid sarcosine is thought to realign the functional groups that chaperone the C-terminal portion of AngII, allowing transfer of the negative charge originating at the C-terminus to be transferred to the Tyr hydroxyl-forming tyrosinate anion, which is required to activate the receptor and desensitizes the receptor (tachyphylaxis). Peptide (sarilesin) and nonpeptide (sartans) moieties, which are long-acting inverse agonists, appear to desensitize the receptor by a mechanism analogous to tachyphylaxis. Sartans/bisartans were found to bind to alpha adrenergic receptors resulting in structure-dependent desensitization or resensitization. These considerations have provided information on the mechanisms of receptor desensitization/tolerance and insights into possible avenues for treating addiction. In this regard sartans, which appear to cross the blood-brain barrier more readily than bisartans, are the preferred drug candidates.
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Affiliation(s)
- Graham J. Moore
- Pepmetics Inc., 772 Murphy Place, Victoria, BC V8Y 3H4, Canada;
- Department of Physiology and Pharmacology, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Harry Ridway
- Institute for Sustainable Industries and Liveable Cities, Victoria University, Melbourne, VIC 8001, Australia;
| | - Laura Kate Gadanec
- Institute for Health and Sport, Immunology and Translational Research, Victoria University, Melbourne, VIC 3030, Australia; (L.K.G.); (V.A.); (A.Z.); (J.S.)
| | - Vasso Apostolopoulos
- Institute for Health and Sport, Immunology and Translational Research, Victoria University, Melbourne, VIC 3030, Australia; (L.K.G.); (V.A.); (A.Z.); (J.S.)
- Immunology Program, Australian Institute for Musculoskeletal Science (AIMSS), Melbourne, VIC 3021, Australia
| | - Anthony Zulli
- Institute for Health and Sport, Immunology and Translational Research, Victoria University, Melbourne, VIC 3030, Australia; (L.K.G.); (V.A.); (A.Z.); (J.S.)
| | - Jordan Swiderski
- Institute for Health and Sport, Immunology and Translational Research, Victoria University, Melbourne, VIC 3030, Australia; (L.K.G.); (V.A.); (A.Z.); (J.S.)
| | | | - Veroniki P. Vidali
- Institute of Nanoscience and Nanotechnology, National Centre for Scientific Research “Demokritos”, 15341 Athens, Greece;
| | | | - Christos T. Chasapis
- Institute of Chemical Biology, National Hellenic Research Foundation, 11635 Athens, Greece;
| | - John M. Matsoukas
- Department of Physiology and Pharmacology, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada
- Institute for Health and Sport, Immunology and Translational Research, Victoria University, Melbourne, VIC 3030, Australia; (L.K.G.); (V.A.); (A.Z.); (J.S.)
- NewDrug/NeoFar PC, Patras Science Park, 26504 Patras, Greece;
- Department of Chemistry, University of Patras, 26504 Patras, Greece
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10
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Cabey W, Duffield O, Hart B, Stern S, Tuohy B. Revive and Respect: Using Structural Competency and Humility to Reframe Discussions of Decision-Making Capacity. THE AMERICAN JOURNAL OF BIOETHICS : AJOB 2024; 24:27-30. [PMID: 38635436 DOI: 10.1080/15265161.2024.2327306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/20/2024]
Affiliation(s)
- Whitney Cabey
- Center for Urban Bioethics, Lewis Katz School of Medicine at Temple University
| | - Olivia Duffield
- Center for Urban Bioethics, Lewis Katz School of Medicine at Temple University
| | - Brendan Hart
- Center for Urban Bioethics, Lewis Katz School of Medicine at Temple University
| | - Sam Stern
- Center for Urban Bioethics, Lewis Katz School of Medicine at Temple University
| | - Brian Tuohy
- Center for Urban Bioethics, Lewis Katz School of Medicine at Temple University
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11
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Ahmed SH. The importance of choice and agency in animal models of addiction. J Neural Transm (Vienna) 2024; 131:487-489. [PMID: 37906290 DOI: 10.1007/s00702-023-02712-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 10/15/2023] [Indexed: 11/02/2023]
Abstract
The aim of this short commentary is twofold. First, it uncovers and outlines in broad strokes a historical, albeit oft-overlooked, trend toward a growing place for choice and agency in the design of animal models of addiction. Next, it tries to draw from this historical trend some perspectives and implications for future research.
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Affiliation(s)
- Serge H Ahmed
- Univ. Bordeaux, CNRS, INCIA, UMR 5287, 33000, Bordeaux, France.
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12
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Harp NR, Wager TD, Kober H. Neuromarkers in addiction: definitions, development strategies, and recent advances. J Neural Transm (Vienna) 2024; 131:509-523. [PMID: 38630190 DOI: 10.1007/s00702-024-02766-2] [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: 11/21/2023] [Accepted: 03/12/2024] [Indexed: 04/28/2024]
Abstract
Substance use disorders (SUDs) are the most costly and prevalent psychiatric conditions. Recent calls emphasize a need for biomarkers-measurable, stable indicators of normal and abnormal processes and response to treatment or environmental agents-and, in particular, brain-based neuromarkers that will advance understanding of the neurobiological basis of SUDs and clinical practice. To develop neuromarkers, researchers must be grounded in evidence that a putative marker (i) is sensitive and specific to the psychological phenomenon of interest, (ii) constitutes a predictive model, and (iii) generalizes to novel observations (e.g., through internal cross-validation and external application to novel data). These neuromarkers may be used to index risk of developing SUDs (susceptibility), classify individuals with SUDs (diagnostic), assess risk for progression to more severe pathology (prognostic) or index current severity of pathology (monitoring), detect response to treatment (response), and predict individualized treatment outcomes (predictive). Here, we outline guidelines for developing and assessing neuromarkers, we then review recent advances toward neuromarkers in addiction neuroscience centering our discussion around neuromarkers of craving-a core feature of SUDs. In doing so, we specifically focus on the Neurobiological Craving Signature (NCS), which show great promise for meeting the demand of neuromarkers.
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Affiliation(s)
- Nicholas R Harp
- Department of Psychiatry, Yale University, New Haven, CT, USA
| | - Tor D Wager
- Department of Psychological & Brain Sciences, Dartmouth College, Hanover, NH, USA
| | - Hedy Kober
- Department of Psychiatry, Yale University, New Haven, CT, USA.
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13
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Jones A, Sharples D, Burton S, Montgomery C, Rose AK. The Associations among Perceived Courtesy Stigma, Health and Social Behaviours in Family Members and Friends of People Who Use Substances: An Ecological Momentary Assessment Study. Subst Use Misuse 2024; 59:1440-1445. [PMID: 38629645 DOI: 10.1080/10826084.2024.2340971] [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] [Indexed: 06/05/2024]
Abstract
Background: The stigma and discrimination experienced by individuals with an alcohol/substance use disorder often extends to the family members and friends who provide care, which is known as courtesy stigma. This courtesy stigma can lead to isolation, poor mental health and might impact the quality-of-care these individuals provide. The aim of this study was to examine the frequency of experienced courtesy stigma/discrimination in individuals in a family support service for a loved one's substance use, and to examine any cross-sectional associations with changes in mood, health- and social-related outcomes. Methods: Thirty-six individuals (25 female) with a mean age of 51.91 years took part in an ecological momentary assessment study in which the experience of courtesy stigma/discrimination and measures of mood, health (e.g. alcohol use, nicotine use, healthy eating, sleep, physical activity) and social connections were taken 3 times per day for fourteen days. Results: Across 1029 competed assessments (compliance ∼68%), there were 122 (∼11%) reports of courtesy stigma/discrimination. The most common sources of stigma/discrimination were from family members (∼43% of occurrences) and friends (∼31% of occurrences). Experiencing this stigma/discrimination was associated with increases in alcohol and nicotine use, as well as reductions in healthy eating, physical activity, sleep, social connections, and mood. Conclusions: The experience of courtesy stigma/discrimination was common in a sample of individual's who support a loved one with alcohol or substance use disorder. These experiences are associated with changes in health and social behaviors and may lead to a poorer quality of care.
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Affiliation(s)
- Andrew Jones
- School of Psychology, Liverpool John Moores University, Liverpool, UK
| | - Diane Sharples
- School of Psychology, Liverpool John Moores University, Liverpool, UK
| | - Sam Burton
- School of Psychology, Liverpool John Moores University, Liverpool, UK
| | | | - Abigail K Rose
- School of Psychology, Liverpool John Moores University, Liverpool, UK
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14
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da Silva MCM, de Souza Ferreira LP, Giustina AD. Could immunotherapy be a hope for addiction treatment? Clinics (Sao Paulo) 2024; 79:100347. [PMID: 38583393 PMCID: PMC11002847 DOI: 10.1016/j.clinsp.2024.100347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 01/26/2024] [Accepted: 03/10/2024] [Indexed: 04/09/2024] Open
Affiliation(s)
| | - Luiz Philipe de Souza Ferreira
- Department of Morphology and Genetics, Structural and Functional Biology Graduate Program, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | - Amanda Della Giustina
- Sprott Centre for Stem Cell Research, Ottawa Hospital Research Institute, Ottawa, ON, Canada
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15
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Ochterbeck D, Frense J, Forberger S. A survey of international addiction researchers' views on implications of brain-based explanations of addiction and the responsibility of affected persons. NORDIC STUDIES ON ALCOHOL AND DRUGS 2024; 41:39-56. [PMID: 38356788 PMCID: PMC10863558 DOI: 10.1177/14550725231188802] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 07/04/2023] [Indexed: 02/16/2024] Open
Abstract
Aim: To complement existing stakeholder surveys by exploring addiction researchers' views on the implications of brain-based explanations of addiction and the responsibilities of addicted persons. Methods: A total of 190 researchers from 29 countries (13.2%) participated in a LimeSurvey. Their perspectives on implications of brain-based explanations of addiction were explored qualitatively using open-ended questions. In addition, respondents could indicate their views on the responsibility of addicted individuals for their condition and actions using a Likert scale and a free-text field ("mixed methods light"). Qualitative analyses inductively identified the most frequent themes and deductively assessed the overall impact (positive, negative or both/ambivalent). Quantitative analyses included frequencies and proportions. Results: The major themes mentioned were medicalisation and the neglect of other factors, better treatment options and access, (reduced) stigma and (impaired) agency of affected persons. The overall evaluation yielded 46% positive, 33% negative and 16% ambivalent views. Approximately 60% of the participants considered addicted persons to be responsible for their condition and 80% for their actions. Conclusions: According to researchers, a brain-based approach to addictions has positive and negative implications. In particular, the neglect of factors other than biomedical seems to be of concern. Thus, a re-consideration of research priorities as well as affected individuals' agency and role in treatment and care seems warranted.
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Affiliation(s)
- Doris Ochterbeck
- Leibniz Institute for Prevention Research and Epidemiology – BIPS, Bremen, Germany
| | - Jennifer Frense
- Leibniz Institute for Prevention Research and Epidemiology – BIPS, Bremen, Germany
| | - Sarah Forberger
- Leibniz Institute for Prevention Research and Epidemiology – BIPS, Bremen, Germany
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16
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Singal AK, Leggio L, DiMartini A. Alcohol use disorder in alcohol-associated liver disease: Two sides of the same coin. Liver Transpl 2024; 30:200-212. [PMID: 37934047 DOI: 10.1097/lvt.0000000000000296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 10/16/2023] [Indexed: 11/08/2023]
Abstract
Alcohol-associated liver disease (ALD) has emerged as the leading indication for liver transplantation (LT) worldwide, with 40% of LTs in the United States performed for ALD in 2019. The ALD-related health care burden accelerated during the COVID-19 pandemic, especially in young individuals. Alcohol use disorder (AUD), which focuses on the negative effects of alcohol on psychosocial, physical, and mental health, is present in the majority of patients with ALD, with moderate to severe AUD in 75%-80%. During the last decade, early liver transplantation (eLT) has emerged as a lifesaving treatment for selected patients with alcohol-associated hepatitis; these patients may have a higher risk of using alcohol after LT. The risk of alcohol use recurrence may be reduced during the pretransplant or post-transplant period with AUD treatment using behavioral and/or pharmacological therapies and with regular monitoring for alcohol use (self-reported and complemented with biomarkers like phosphatidylethanol). However, AUD treatment in patients with ALD is challenging due to patient, clinician, and system barriers. An integrated model to provide AUD and ALD care by hepatologists and addiction experts in a colocated clinic starting from LT evaluation and selection to monitoring listed candidates and then to following up on recipients of LT should be promoted. However, the integration of addiction and hepatology teams in an LT program in the real world is often present only during evaluation and candidate selection for LT. Data are emerging to show that a multidisciplinary integrated AUD treatment within an LT program reduces recurrent alcohol use after LT. If we want to continue using early liver transplantation for patients with severe alcohol-associated hepatitis, LT programs should focus on building integrated multidisciplinary care teams for the integrated treatment of both AUD and ALD.
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Affiliation(s)
- Ashwani K Singal
- Department of Medicine, University of South Dakota, Vermillion, South Dakota, USA
- Department of Gastroenterology and Hepatology, Avera McKennan University Hospital, Sioux Falls, South Dakota, USA
- Department of Transplant Hepatology, Avera Transplant Institute, Sioux Falls, South Dakota, USA
- Department of Medicine, VA Medical Center, Sioux Falls, South Dakota, USA
| | - Lorenzo Leggio
- Department of Neuropsychopharmacology Clinical Psychoneuroendocrinology and Neuropsychopharmacology Section, Translational Addiction Medicine Branch, Division of Intramural Clinical and Biological Research, National Institute on Drug Abuse Intramural Research Program and National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, Maryland, USA
- Department of Behavioral and Social Sciences, Center for Alcohol and Addiction Studies, Brown University, Providence, Rhode Island, USA
- Department of Medicine, Division of Addiction Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
- Department of Neuroscience, Georgetown University Medical Center, Washington, District of Columbia, USA
| | - Andrea DiMartini
- Departments of Psychiatry and Transplant Surgery, and the Clinical and Translational Science Institute, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
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17
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Cole S, Olive MF, Wirkus S. The dynamics of heroin and illicit opioid use disorder, casual use, treatment, and recovery: A mathematical modeling analysis. MATHEMATICAL BIOSCIENCES AND ENGINEERING : MBE 2024; 21:3165-3206. [PMID: 38454724 DOI: 10.3934/mbe.2024141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/09/2024]
Abstract
A leading crisis in the United States is the opioid use disorder (OUD) epidemic. Opioid overdose deaths have been increasing, with over 100,000 deaths due to overdose from April 2020 to April 2021. This paper presents a mathematical model to address illicit OUD (IOUD), initiation, casual use, treatment, relapse, recovery, and opioid overdose deaths within an epidemiological framework. Within this model, individuals remain in the recovery class unless they relapse back to use and due to the limited availability of specialty treatment facilities for individuals with OUD, a saturation treatment function was incorporated. Additionally, a casual user class and its corresponding specialty treatment class were incorporated. We use both heroin and all-illicit opioids datasets to find parameter estimates for our models. Bistability of equilibrium solutions was found for realistic parameter values for the heroin-only dataset. This result implies that it would be beneficial to increase the availability of treatment. An alarming effect was discovered about the high overdose death rate: by 2046, the disorder-free equilibrium would be the only stable equilibrium. This consequence is concerning because it means the epidemic would end due to high overdose death rates. The IOUD model with a casual user class, its sensitivity results, and the comparison of parameters for both datasets, showed the importance of not overlooking the influence that casual users have in driving the all-illicit opioid epidemic. Casual users stay in the casual user class longer and are not going to treatment as quickly as the users of the heroin epidemic. Another result was that the users of the all-illicit opioids were going to the recovered class by means other than specialty treatment. However, the change in the relapse rate has more of an influence for those individuals than in the heroin-only epidemic. The results above from analyzing this model may inform health and policy officials, leading to more effective treatment options and prevention efforts.
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Affiliation(s)
- Sandra Cole
- Arizona State University, School of Mathematical and Natural Sciences, Glendale, AZ, USA
| | - M Foster Olive
- Arizona State University, Department of Psychology, Tempe, AZ, USA
| | - Stephen Wirkus
- Arizona State University, School of Mathematical and Natural Sciences, Glendale, AZ, USA
- The University of Texas at San Antonio, Department of Mathematics, San Antonio, TX, USA
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18
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Page S, Fedorowicz S, McCormack F, Whitehead S. Women, Addictions, Mental Health, Dishonesty, and Crime Stigma: Solutions to Reduce the Social Harms of Stigma. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:63. [PMID: 38248528 PMCID: PMC10815751 DOI: 10.3390/ijerph21010063] [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: 11/29/2023] [Revised: 12/21/2023] [Accepted: 12/30/2023] [Indexed: 01/23/2024]
Abstract
British drug policies could underserve women with treatment needs, and this paper provides evidence that communication through the words and actions of professionals across drug and alcohol services, health and mental health, social work and the criminal justice sector can leave women feeling stigmatised and failed. Women live with the stigma of 'the lying addict'; however, documents and courtroom statements provided by professionals can misrepresent women's experiences, which exacerbates social harm. Data are drawn from feminist participatory action research, where female lived experience experts worked alongside academics to implement a qualitative study using interviews and focus groups with women using treatment services (n = 28) and an online world café with professionals working with these women (n = 9) and further professionals providing support at lived experience data collection events (n = 5). This data set is cross-referenced with one-to-one and small-group interviews with professionals in the field (n = 17) conducted by a third-sector partner. Findings establish that stigma negatively impacts the identification of treatment needs and access to timely and appropriate service delivery. Social harms to women with addictions could be significantly reduced with timely, authentic, honest, gender-informed and trauma-informed practices for girls and women using drugs and alcohol to self-medicate from traumatic experiences.
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Affiliation(s)
- Sarah Page
- Centre for Crime, Justice and Security, Staffordshire University, LW126 Ashley 2 Building, College Rd., Stoke-on-Trent ST4 2DE, UK
| | - Sophia Fedorowicz
- Expert Citizens CIC, Federation House Station Road, Stoke on Trent ST4 2SA, UK;
| | - Fiona McCormack
- Centre for Health and Development, Staffordshire University, LW126 Ashley 2 Building, College Rd., Stoke-on-Trent ST4 2DE, UK;
| | - Stephen Whitehead
- Independent Researcher, Centre for Justice Innovation, 102, Edinburgh House, 170 Kennington Ln, London SE11 5DP, UK;
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19
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Zhang S, Yang W, Li M, Wen X, Shao Z, Li J, Liu J, Zhang J, Yu D, Liu J, Yuan K. Reconfigurations of Dynamic Functional Network Connectivity in Large-scale Brain Network after Prolonged Abstinence in Heroin Users. Curr Neuropharmacol 2024; 22:1144-1153. [PMID: 36453493 PMCID: PMC10964104 DOI: 10.2174/1570159x21666221129105408] [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: 06/20/2022] [Revised: 11/01/2022] [Accepted: 11/02/2022] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Brain recovery phenomenon after long-term abstinence had been reported in substance use disorders. Yet, few longitudinal studies have been conducted to observe the abnormal dynamic functional connectivity (dFNC) of large-scale brain networks and recovery after prolonged abstinence in heroin users. OBJECTIVE The current study will explore the brain network dynamic connection reconfigurations after prolonged abstinence in heroin users (HUs). METHODS The 10-month longitudinal design was carried out for 40 HUs. The 40 healthy controls (HCs) were also enrolled. Group independent component analysis (GICA) and dFNC analysis were employed to detect the different dFNC patterns of addiction-related ICNs between HUs and HCs. The temporal properties and the graph-theoretical properties were calculated. Whether the abnormalities would be reconfigured in HUs after prolonged abstinence was then investigated. RESULTS Based on eight functional networks extracted from GICA, four states were identified by the dFNC analysis. Lower mean dwell time and fraction rate in state4 were found for HUs, which were increased toward HCs after prolonged abstinence. In this state, HUs at baseline showed higher dFNC of RECN-aSN, aSN- aSN and dDMN-pSN, which decreased after protracted abstinence. A similar recovery phenomenon was found for the global efficiency and path length in abstinence HUs. Mean while, the abnormal dFNC strength was correlated with craving both at baseline and after abstinence. CONCLUSION Our longitudinal study observed the large-scale brain network reconfiguration from the dynamic perspective in HUs after prolonged abstinence and improved the understanding of the neurobiology of prolonged abstinence in HUs.
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Affiliation(s)
- Shan Zhang
- Center for Brain Imaging, School of Life Science and Technology, Xidian University, Xi'an, Shaanxi, 710126, China
- Engineering Research Center of Molecular and Neuro Imaging Ministry of Education, Xi'an, Shaanxi, 710071, China
| | - Wenhan Yang
- Department of Radiology, Second Xiangya Hospital, Central South University, Changsha, 410011, China
| | - Minpeng Li
- Center for Brain Imaging, School of Life Science and Technology, Xidian University, Xi'an, Shaanxi, 710126, China
- Engineering Research Center of Molecular and Neuro Imaging Ministry of Education, Xi'an, Shaanxi, 710071, China
| | - Xinwen Wen
- Center for Brain Imaging, School of Life Science and Technology, Xidian University, Xi'an, Shaanxi, 710126, China
- Engineering Research Center of Molecular and Neuro Imaging Ministry of Education, Xi'an, Shaanxi, 710071, China
| | - Ziqiang Shao
- Center for Brain Imaging, School of Life Science and Technology, Xidian University, Xi'an, Shaanxi, 710126, China
- Engineering Research Center of Molecular and Neuro Imaging Ministry of Education, Xi'an, Shaanxi, 710071, China
| | - Jun Li
- Center for Brain Imaging, School of Life Science and Technology, Xidian University, Xi'an, Shaanxi, 710126, China
- Engineering Research Center of Molecular and Neuro Imaging Ministry of Education, Xi'an, Shaanxi, 710071, China
| | - Jixin Liu
- Center for Brain Imaging, School of Life Science and Technology, Xidian University, Xi'an, Shaanxi, 710126, China
- Engineering Research Center of Molecular and Neuro Imaging Ministry of Education, Xi'an, Shaanxi, 710071, China
| | - Jun Zhang
- Hunan Judicial Police Academy, Changsha, 410000, China
| | - Dahua Yu
- Information Processing Laboratory, School of Information Engineering, Inner Mongolia University of Science and Technology, Baotou, Inner Mongolia, 014010, China
| | - Jun Liu
- Department of Radiology, Second Xiangya Hospital, Central South University, Changsha, 410011, China
| | - Kai Yuan
- Center for Brain Imaging, School of Life Science and Technology, Xidian University, Xi'an, Shaanxi, 710126, China
- Engineering Research Center of Molecular and Neuro Imaging Ministry of Education, Xi'an, Shaanxi, 710071, China
- Information Processing Laboratory, School of Information Engineering, Inner Mongolia University of Science and Technology, Baotou, Inner Mongolia, 014010, China
- International Joint Research Center for Advanced Medical Imaging and Intelligent Diagnosis and Treatment & Xi'an Key Laboratory of Intelligent Sensing and Regulation of Trans-Scale Life Information, School of Life Science and Technology, Xidian University, Xi'an, Shaanxi, 710126, China
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20
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Tyler RE, Leggio L. Biological basis of addiction and alcohol use disorder. Clin Liver Dis (Hoboken) 2024; 23:e0177. [PMID: 38831763 PMCID: PMC11146604 DOI: 10.1097/cld.0000000000000177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Accepted: 04/01/2024] [Indexed: 06/05/2024] Open
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21
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Icick R, Shadrin A, Holen B, Karadag N, Parker N, O'Connell K, Frei O, Bahrami S, Høegh M, Lagerberg T, Cheng W, Seibert T, Djurovic S, Dale A, Zhou H, Edenberg H, Gelernter J, Smeland O, Hindley G, Andreassen O. Identification of Novel Loci and Cross-Disorder Pleiotropy Through Multi-Ancestry Genome-Wide Analysis of Alcohol Use Disorder in Over One Million Individuals. RESEARCH SQUARE 2023:rs.3.rs-3755915. [PMID: 38196616 PMCID: PMC10775504 DOI: 10.21203/rs.3.rs-3755915/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/11/2024]
Abstract
Alcohol use disorder (AUD) is highly heritable and burdensome worldwide. Genome-wide association studies (GWASs) can provide new evidence regarding the aetiology of AUD. We report a multi-ancestry GWASs across diverse ancestries focusing on a narrow AUD phenotype, using novel statistical tools in a total sample of 1,041,450 individuals [102,079 cases; European, 75,583; African, 20,689 (mostly African-American); Hispanic American, 3,449; East Asian, 2,254; South Asian, 104; descent]. Cross-ancestry functional analyses were performed with European and African samples. Thirty-seven genome-wide significant loci were identified, of which seven were novel for AUD and six for other alcohol phenotypes. Loci were mapped to genes enriched for brain regions relevant for AUD (striatum, hypothalamus, and prefrontal cortex) and potential drug targets (GABAergic, dopaminergic and serotonergic neurons). African-specific analysis yielded a unique pattern of immune-related gene sets. Polygenic overlap and positive genetic correlations showed extensive shared genetic architecture between AUD and both mental and general medical phenotypes, suggesting they are not only complications of alcohol use but also share genetic liability with AUD. Leveraging a cross-ancestry approach allowed identification of novel genetic loci for AUD and underscores the value of multi-ancestry genetic studies. These findings advance our understanding of AUD risk and clinically-relevant comorbidities.
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Affiliation(s)
| | | | - Børge Holen
- NORMENT Centre, Institute of Clinical Medicine, University of Oslo and Division of Mental Health and Addiction, Oslo University Hospital, 0407 Oslo
| | - Naz Karadag
- NORMENT Centre, Institute of Clinical Medicine, University of Oslo and Division of Mental Health and Addiction, Oslo University Hospital, 0407 Oslo
| | - Nadine Parker
- NORMENT Centre, Institute of Clinical Medicine, University of Oslo and Division of Mental Health and Addiction, Oslo University Hospital, 0407 Oslo
| | - Kevin O'Connell
- NORMENT Centre, Institute of Clinical Medicine, University of Oslo and Division of Mental Health and Addiction, Oslo University Hospital, 0407 Oslo
| | | | - Shahram Bahrami
- NORMENT Centre, Institute of Clinical Medicine, University of Oslo and Division of Mental Health and Addiction, Oslo University Hospital, 0407 Oslo
| | - Margrethe Høegh
- NORMENT Centre, Institute of Clinical Medicine, University of Oslo and Division of Mental Health and Addiction, Oslo University Hospital, 0407 Oslo
| | - Trine Lagerberg
- NORMENT Centre, Institute of Clinical Medicine, University of Oslo and Division of Mental Health and Addiction, Oslo University Hospital, 0407 Oslo
| | - Weiqiu Cheng
- NORMENT Centre, Institute of Clinical Medicine, University of Oslo and Division of Mental Health and Addiction, Oslo University Hospital, 0407 Oslo
| | - Tyler Seibert
- Department of Radiation Medicine and Applied Sciences, Department of Radiology, Department of Bioengineering, University of California, San Diego, La Jolla, CA 92093
| | - Srdjan Djurovic
- Department of Medical Genetics, Oslo University Hospital, Oslo; NORMENT Centre, Department of Clinical Science, University of Bergen, Bergen
| | - Anders Dale
- Department of Neurosciences, University of California San Diego
| | | | | | | | - Olav Smeland
- NORMENT Centre for Mental Disorders Research, University of Oslo and Oslo University Hospital
| | - Guy Hindley
- NORMENT Centre, Institute of Clinical Medicine, University of Oslo and Division of Mental Health and Addiction, Oslo University Hospital, 0407 Oslo
| | - Ole Andreassen
- Oslo University Hospital & Institute of Clinical Medicine, University of Oslo
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22
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Chen H, Kuitunen-Paul S, Weinstein AM, Petzold J. Editorial: Addiction and the brain: current knowledge, methods, and perspectives. Front Psychiatry 2023; 14:1343524. [PMID: 38173709 PMCID: PMC10761471 DOI: 10.3389/fpsyt.2023.1343524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 12/05/2023] [Indexed: 01/05/2024] Open
Affiliation(s)
- Hao Chen
- Department of Psychiatry and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Sören Kuitunen-Paul
- Department of Clinical Psychology and Psychotherapy, Technische Universität Chemnitz, Chemnitz, Germany
- Department of Child and Adolescent Psychiatry, Technische Universität Dresden, Dresden, Germany
| | | | - Johannes Petzold
- Department of Psychiatry and Psychotherapy, Technische Universität Dresden, Dresden, Germany
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23
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Maron JL. Addicted to Addictions: Why Recovering from One Deleterious Habit May Lead to the Next. Clin Ther 2023; 45:1161. [PMID: 38092469 DOI: 10.1016/j.clinthera.2023.11.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 11/13/2023] [Indexed: 12/18/2023]
Affiliation(s)
- Jill L Maron
- Division of Pediatrics, Women & Infants Hospital of Rhode Island, Providence, Rhode Island.
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24
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Auguste E, Bowdring M, Kasparek SW, McPhee J, Tabachnick AR, Tung I, Galán CA. Psychology's Contributions to Anti-Blackness in the United States Within Psychological Research, Criminal Justice, and Mental Health. PERSPECTIVES ON PSYCHOLOGICAL SCIENCE 2023; 18:1282-1305. [PMID: 36753574 PMCID: PMC10715736 DOI: 10.1177/17456916221141374] [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] [Indexed: 02/10/2023]
Abstract
The mass incarceration of Black people in the United States is gaining attention as a public-health crisis with extreme mental-health implications. Although it is well documented that historical efforts to oppress and control Black people in the United States helped shape definitions of mental illness and crime, many psychologists are unaware of the ways the field has contributed to the conception and perpetuation of anti-Blackness and, consequently, the mass incarceration of Black people. In this article, we draw from existing theory and empirical evidence to demonstrate historical and contemporary examples of psychology's oppression of Black people through research and clinical practices and consider how this history directly contradicts the American Psychological Association's ethics code. First, we outline how anti-Blackness informed the history of psychological diagnoses and research. Next, we discuss how contemporary systems of forensic practice and police involvement in mental-health-crisis response maintain historical harm. Specific recommendations highlight strategies for interrupting the criminalization of Blackness and offer example steps psychologists can take to redefine psychology's relationship with justice. We conclude by calling on psychologists to recognize their unique power and responsibility to interrupt the criminalization and pathologizing of Blackness as researchers and mental-health providers.
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Affiliation(s)
| | - Molly Bowdring
- Department of Psychiatry and Behavioral Sciences, Stanford University
| | | | - Jeanne McPhee
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco
| | | | - Irene Tung
- Department of Psychology, California State University Dominguez Hills
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25
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Falconnier C, Caparros-Roissard A, Decraene C, Lutz PE. Functional genomic mechanisms of opioid action and opioid use disorder: a systematic review of animal models and human studies. Mol Psychiatry 2023; 28:4568-4584. [PMID: 37723284 PMCID: PMC10914629 DOI: 10.1038/s41380-023-02238-1] [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: 12/20/2022] [Revised: 08/17/2023] [Accepted: 08/24/2023] [Indexed: 09/20/2023]
Abstract
In the past two decades, over-prescription of opioids for pain management has driven a steep increase in opioid use disorder (OUD) and death by overdose, exerting a dramatic toll on western countries. OUD is a chronic relapsing disease associated with a lifetime struggle to control drug consumption, suggesting that opioids trigger long-lasting brain adaptations, notably through functional genomic and epigenomic mechanisms. Current understanding of these processes, however, remain scarce, and have not been previously reviewed systematically. To do so, the goal of the present work was to synthesize current knowledge on genome-wide transcriptomic and epigenetic mechanisms of opioid action, in primate and rodent species. Using a prospectively registered methodology, comprehensive literature searches were completed in PubMed, Embase, and Web of Science. Of the 2709 articles identified, 73 met our inclusion criteria and were considered for qualitative analysis. Focusing on the 5 most studied nervous system structures (nucleus accumbens, frontal cortex, whole striatum, dorsal striatum, spinal cord; 44 articles), we also conducted a quantitative analysis of differentially expressed genes, in an effort to identify a putative core transcriptional signature of opioids. Only one gene, Cdkn1a, was consistently identified in eleven studies, and globally, our results unveil surprisingly low consistency across published work, even when considering most recent single-cell approaches. Analysis of sources of variability detected significant contributions from species, brain structure, duration of opioid exposure, strain, time-point of analysis, and batch effects, but not type of opioid. To go beyond those limitations, we leveraged threshold-free methods to illustrate how genome-wide comparisons may generate new findings and hypotheses. Finally, we discuss current methodological development in the field, and their implication for future research and, ultimately, better care.
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Affiliation(s)
- Camille Falconnier
- Centre National de la Recherche Scientifique, Université de Strasbourg, Institut des Neurosciences Cellulaires et Intégratives UPR 3212, 67000, Strasbourg, France
| | - Alba Caparros-Roissard
- Centre National de la Recherche Scientifique, Université de Strasbourg, Institut des Neurosciences Cellulaires et Intégratives UPR 3212, 67000, Strasbourg, France
| | - Charles Decraene
- Centre National de la Recherche Scientifique, Université de Strasbourg, Institut des Neurosciences Cellulaires et Intégratives UPR 3212, 67000, Strasbourg, France
- Centre National de la Recherche Scientifique, Université de Strasbourg, Laboratoire de Neurosciences Cognitives et Adaptatives UMR 7364, 67000, Strasbourg, France
| | - Pierre-Eric Lutz
- Centre National de la Recherche Scientifique, Université de Strasbourg, Institut des Neurosciences Cellulaires et Intégratives UPR 3212, 67000, Strasbourg, France.
- Douglas Mental Health University Institute, Montreal, QC, Canada.
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Richardson RS, Sulima A, Rice KC, Kucharczk JA, Janda KD, Nisbett KE, Koob GF, Vendruscolo LF, Leggio L. Pharmacological GHSR (ghrelin receptor) blockade reduces alcohol binge-like drinking in male and female mice. Neuropharmacology 2023; 238:109643. [PMID: 37369277 PMCID: PMC10513123 DOI: 10.1016/j.neuropharm.2023.109643] [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: 05/05/2023] [Revised: 06/20/2023] [Accepted: 06/22/2023] [Indexed: 06/29/2023]
Abstract
Ghrelin is a peptide that is produced by endocrine cells that are primarily localized in the stomach. Ghrelin receptors (GHSR) are expressed in the brain and periphery. Preclinical and clinical studies support a role for ghrelin in alcohol drinking and seeking. The GHSR has been suggested to be a potential pharmacotherapeutic target for alcohol use disorder (AUD). However, the role of the ghrelin system and its potential modulation by biological sex on binge-like drinking has not been comprehensively investigated. The present study tested six GHSR antagonists in an alcohol binge-like drinking procedure in male and female mice. Systemic administration of the GHSR antagonists JMV2959, PF-5190457, PF-6870961, and HM-04 reduced alcohol intake in both male and female mice. YIL-781 decreased intake in males, and LEAP2 (likely peripherally restricted) did not reduce intake in mice of either sex. We also administered LEAP2 and JMV2959 intracerebroventricularly to investigate whether the effects of GHSR blockade on alcohol intake are mediated by central receptors. The central administration of LEAP2 and JMV2959 decreased alcohol intake, particularly in high-drinking animals. Finally, in a preliminary experiment, an anti-ghrelin vaccine was examined for its potential effect on binge-like drinking and had no effect. In all experiments, there was a lack of meaningful sex differences. These findings suggest that central GHSR mediates binge-like alcohol intake. These data reveal novel pharmacological compounds with translational potential in the treatment of AUD and provide further evidence of the GHSR as a potential treatment target for AUD.
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Affiliation(s)
- Rani S Richardson
- Clinical Psychoneuroendocrinology and Neuropsychopharmacology Section, Translational Addiction Medicine Branch, National Institute on Drug Abuse Intramural Research Program and National Institute on Alcohol Abuse and Alcoholism Division of Intramural Clinical and Biological Research, National Institutes of Health, Baltimore, MD, USA; Neurobiology of Addiction Section, National Institute on Drug Abuse Intramural Research Program, National Institutes of Health, Baltimore, MD, USA; Stress & Addiction Neuroscience Unit, National Institute on Drug Abuse Intramural Research Program and National Institute on Alcohol Abuse and Alcoholism Division of Intramural Clinical and Biological Research, National Institutes of Health, Baltimore, MD, USA; University of North Carolina School of Medicine MD/PhD Program, University of North Carolina, Chapel Hill, NC, USA; Department of Cell Biology and Physiology, University of North Carolina, Chapel Hill, NC, USA
| | - Agnieszka Sulima
- Molecular Targets and Medications Discovery Branch, National Institute on Drug Abuse Intramural Research Program, National Institutes of Health, Baltimore, MD, USA
| | - Kenner C Rice
- Molecular Targets and Medications Discovery Branch, National Institute on Drug Abuse Intramural Research Program, National Institutes of Health, Baltimore, MD, USA
| | - Jed A Kucharczk
- Molecular Targets and Medications Discovery Branch, National Institute on Drug Abuse Intramural Research Program, National Institutes of Health, Baltimore, MD, USA
| | - Kim D Janda
- Department of Chemistry, Department of Immunology and Microbial Science, The Skaggs Institute for Chemical Biology, WIRM Institute for Research and Medicine, The Scripps Research Institute, La Jolla, CA, USA
| | - Khalin E Nisbett
- Neurobiology of Addiction Section, National Institute on Drug Abuse Intramural Research Program, National Institutes of Health, Baltimore, MD, USA; Stress & Addiction Neuroscience Unit, National Institute on Drug Abuse Intramural Research Program and National Institute on Alcohol Abuse and Alcoholism Division of Intramural Clinical and Biological Research, National Institutes of Health, Baltimore, MD, USA; Graduate Program in Neuroscience, Graduate College, University of Illinois Chicago, Chicago, IL, USA
| | - George F Koob
- Neurobiology of Addiction Section, National Institute on Drug Abuse Intramural Research Program, National Institutes of Health, Baltimore, MD, USA
| | - Leandro F Vendruscolo
- Stress & Addiction Neuroscience Unit, National Institute on Drug Abuse Intramural Research Program and National Institute on Alcohol Abuse and Alcoholism Division of Intramural Clinical and Biological Research, National Institutes of Health, Baltimore, MD, USA.
| | - Lorenzo Leggio
- Clinical Psychoneuroendocrinology and Neuropsychopharmacology Section, Translational Addiction Medicine Branch, National Institute on Drug Abuse Intramural Research Program and National Institute on Alcohol Abuse and Alcoholism Division of Intramural Clinical and Biological Research, National Institutes of Health, Baltimore, MD, USA; Department of Behavioral and Social Sciences, Center for Alcohol and Addiction Studies, Brown University, Providence, RI, USA; Division of Addiction Medicine, Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, MD, USA; Department of Neuroscience, Georgetown University Medical Center, Washington, DC, USA.
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27
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Diaz LA, Winder GS, Leggio L, Bajaj JS, Bataller R, Arab JP. New insights into the molecular basis of alcohol abstinence and relapse in alcohol-associated liver disease. Hepatology 2023:01515467-990000000-00605. [PMID: 37862466 DOI: 10.1097/hep.0000000000000645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 10/11/2023] [Indexed: 10/22/2023]
Abstract
Alcohol use disorder remains a significant public health concern, affecting around 5% of adults worldwide. Novel pathways of damage have been described during the last years, providing insight into the mechanism of injury due to alcohol misuse beyond the direct effect of ethanol byproducts on the liver parenchyma and neurobehavioral mechanisms. Thus, the gut-liver-brain axis and immune system involvement could be therapeutic targets for alcohol use disorder. In particular, changes in gut microbiota composition and function, and bile acid homeostasis, have been shown with alcohol consumption and cessation. Alcohol can also directly disrupt intestinal and blood-brain barriers. Activation of the immune system can be triggered by intestinal barrier dysfunction and translocation of bacteria, pathogen-associated molecular patterns (such as lipopolysaccharide), cytokines, and damage-associated molecular patterns. These factors, in turn, promote liver and brain inflammation and the progression of liver fibrosis. Other involved mechanisms include oxidative stress, apoptosis, autophagy, and the release of extracellular vesicles and miRNA from hepatocytes. Potential therapeutic targets include gut microbiota (probiotics and fecal microbiota transplantation), neuroinflammatory pathways, as well as neuroendocrine pathways, for example, the ghrelin system (ghrelin receptor blockade), incretin mimetics (glucagon-like peptide-1 analogs), and the mineralocorticoid receptor system (spironolactone). In addition, support with psychological and behavioral treatments is essential to address the multiple dimensions of alcohol use disorder. In the future, a personalized approach considering these novel targets can contribute to significantly decreasing the alcohol-associated burden of disease.
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Affiliation(s)
- Luis Antonio Diaz
- Departamento de Gastroenterología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | | | - Lorenzo Leggio
- Clinical Psychoneuroendocrinology and Neuropsychopharmacology Section, Translational Addiction Medicine Branch, National Institutes of Health, NIDA and NIAAA, Baltimore, Maryland, USA
| | - Jasmohan S Bajaj
- Division of Gastroenterology, Hepatology, and Nutrition, Virginia Commonwealth University and Central Virginia Veterans Health Care System, Richmond, Virginia, USA
| | - Ramon Bataller
- Liver Unit, Hospital Clinic, Institut d'Investigacions August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Juan Pablo Arab
- Departamento de Gastroenterología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
- Department of Medicine, Division of Gastroenterology, Schulich School of Medicine, Western University, London, Ontario, Canada
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Madole JW, Harden KP. Causal complexity in human research: On the shared challenges of behavior genetics, medical genetics, and environmentally oriented social science. Behav Brain Sci 2023; 46:e206. [PMID: 37694936 DOI: 10.1017/s0140525x23000833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/12/2023]
Abstract
We received 23 spirited commentaries on our target article from across the disciplines of philosophy, economics, evolutionary genetics, molecular biology, criminology, epidemiology, and law. We organize our reply around three overarching questions: (1) What is a cause? (2) How are randomized controlled trials (RCTs) and within-family genome-wide association studies (GWASs) alike and unalike? (3) Is behavior genetics a qualitatively different enterprise? Throughout our discussion of these questions, we advocate for the idea that behavior genetics shares many of the same pitfalls and promises as environmentally oriented research, medical genetics, and other arenas of the social and behavioral sciences.
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Affiliation(s)
- James W Madole
- Department of Psychology, University of Texas at Austin, Austin, TX, USA
- VA Puget Sound Health Care System, Seattle, WA, USA
| | - K Paige Harden
- Department of Psychology, University of Texas at Austin, Austin, TX, USA
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29
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Poikolainen K. A new paradigm for addictions. Alcohol Alcohol 2023; 58:512-514. [PMID: 37092272 PMCID: PMC10493516 DOI: 10.1093/alcalc/agad027] [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: 12/19/2022] [Revised: 02/20/2023] [Accepted: 04/04/2023] [Indexed: 04/25/2023] Open
Abstract
AIM To suggest a new paradigm for addictions. METHODS Consideration of relevant research findings and thought experiments. RESULTS Common mental motors leading to addictions are pleasure-seeking and hyperbolic discounting. The important point of the latter is that given two choices of future rewards, commonly one initially prefers the larger one available after a longer waiting time but despite this the smaller and sooner reward will be chosen when it becomes available. These are general biological properties, found at least in human beings, the rat, and the pigeon. If this continues it may create an unconscious habit, difficult to change. Several other risk factors for addictions are known, notably both externalizing and internalizing mental problems. Predisposing factors are likely to interact. CONCLUSIONS The above suggests a new paradigm for addictions. Pleasure provides temptations, hyperbolic discounting weakens the will. Habits emerge. Addictions seem to be a group of problems of its own kind, not diseases, because diseases do not bring about pleasure, and are not sought for pleasure.
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Latimore AD, Salisbury-Afshar E, Duff N, Freiling E, Kellett B, Sullenger RD, Salman A. Primary, Secondary, and Tertiary Prevention of Substance Use Disorders through Socioecological Strategies. NAM Perspect 2023; 2023:202309b. [PMID: 38784638 PMCID: PMC11114594 DOI: 10.31478/202309b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2024]
Affiliation(s)
| | | | | | | | | | | | - Aisha Salman
- National Academy of Medicine; and the Prevention, Treatment, and Recovery Services Working Group of the National Academy of Medicine's Action Collaborative on Countering the U.S. Opioid Epidemic
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31
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Greener MR, Storr SJ. Conflicting theories on addiction aetiology and the strengths and limitations of substance use disorder disease modelling. Front Mol Neurosci 2023; 16:1166852. [PMID: 37745284 PMCID: PMC10511750 DOI: 10.3389/fnmol.2023.1166852] [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: 02/15/2023] [Accepted: 08/21/2023] [Indexed: 09/26/2023] Open
Abstract
A lack of cross-disciplinary unanimity prevails within addiction research. Theories conceptualizing addiction through the three-stage brain disease model contest other theories that substance use disorder is of behavioural or genetic origin. The reverberations of this lack of consensus are noticeable throughout addiction research and within the foundations of disease modelling. The availability of methods to investigate substance use disorder are inconsistent and sometimes unrepresentative. This review discusses theories of addiction aetiology, available models for addiction research and the strengths and limitations of current practical experimental methods of study.
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Affiliation(s)
- Megan R. Greener
- Biodiscovery Institute, University of Nottingham, Nottingham, United Kingdom
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32
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Massah O, Arab AM, Farhoudian A, Noroozi M, Hashemirad F. The Correlation between Neck Pain and Disability, Forward Head Posture, and Hyperkyphosis with Opium Smoking: A Cross-Sectional Study from Iran. Brain Sci 2023; 13:1281. [PMID: 37759882 PMCID: PMC10526810 DOI: 10.3390/brainsci13091281] [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: 07/17/2023] [Revised: 08/28/2023] [Accepted: 09/01/2023] [Indexed: 09/29/2023] Open
Abstract
Opium smoking has been a common practice in Iran for many years, with people often smoking for long hours. During the COVID-19 pandemic, there was an increase in opium smoking due to false beliefs about its protective effects against COVID-19 infection. In this study, we aimed to examine the association between the non-ergonomic positions associated with traditional opium smoking in Iran and the development of neck pain and disability, forward head posture (FHP), and hyperkyphosis (HK). In this cross-sectional, correlational study, a total of 120 individuals who smoked opium were selected based on the inclusion criteria. They were interviewed about their addiction profile using the Lite version of the Addiction Severity Index and the Leeds Dependence Questionnaire. The presence of neck pain and disability was also evaluated using the Visual Analog Scale and the Neck Disability Index. The participants were examined for FHP via side-view photography and for HK using a flexible ruler. Data were analyzed using correlation coefficient tests and stepwise linear regression analysis. Based on the results, homelessness, the lifetime duration of opium smoking (in months), the duration of daily opium smoking (in minutes), and the severity of drug dependence had significant relationships with the severity of neck pain, neck disability, FHP, and HK. Homelessness was the strongest predictor of neck pain and disability (R2 = 0.367, p < 0.001), FHP (R2 = 0.457, p < 0.001), and HK (R2 = 0.476, p < 0.001), followed by the lifetime duration of opium smoking and the duration of daily opium smoking, respectively, in which R2 increased to 0.505 (p = 0.011), 0.546 (p = 0.022), and 0.570 (p = 0.004) with the addition of two other variables. Overall, an increase in the duration of sitting in non-ergonomic positions could lead to neck pain and disability, FHP, and HK due to the non-neutral posture of opium smokers.
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Affiliation(s)
- Omid Massah
- Substance Abuse and Dependence Researcher Center, University of Social Welfare and Rehabilitation Sciences, Tehran 1985713834, Iran;
| | - Amir Masoud Arab
- Department of Physiotherapy, University of Social Welfare and Rehabilitation Sciences, Tehran 1985713834, Iran; (A.M.A.); (F.H.)
| | - Ali Farhoudian
- Department of Psychiatry, Tehran University of Medical Sciences, Tehran 1461884513, Iran;
| | - Mehdi Noroozi
- Substance Abuse and Dependence Researcher Center, University of Social Welfare and Rehabilitation Sciences, Tehran 1985713834, Iran;
- Department of Psychiatry, University of Social Welfare and Rehabilitation Sciences, Tehran 1985713834, Iran
- Psychosis Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran 1985713834, Iran
| | - Fahimeh Hashemirad
- Department of Physiotherapy, University of Social Welfare and Rehabilitation Sciences, Tehran 1985713834, Iran; (A.M.A.); (F.H.)
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33
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Murnane KS, Edinoff AN, Cornett EM, Kaye AD. Updated Perspectives on the Neurobiology of Substance Use Disorders Using Neuroimaging. Subst Abuse Rehabil 2023; 14:99-111. [PMID: 37583934 PMCID: PMC10424678 DOI: 10.2147/sar.s362861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 06/27/2023] [Indexed: 08/17/2023] Open
Abstract
Substance use problems impair social functioning, academic achievement, and employability. Psychological, biological, social, and environmental factors can contribute to substance use disorders. In recent years, neuroimaging breakthroughs have helped elucidate the mechanisms of substance misuse and its effects on the brain. Functional magnetic resonance imaging (MRI), positron emission tomography (PET), single-photon emission computed tomography (SPECT), and magnetic resonance spectroscopy (MRS) are all examples. Neuroimaging studies suggest substance misuse affects executive function, reward, memory, and stress systems. Recent neuroimaging research attempts have provided clinicians with improved tools to diagnose patients who misuse substances, comprehend the complicated neuroanatomy and neurobiology involved, and devise individually tailored and monitorable treatment regimens for individuals with substance use disorders. This review describes the most recent developments in drug misuse neuroimaging, including the neurobiology of substance use disorders, neuroimaging, and substance use disorders, established neuroimaging techniques, recent developments with established neuroimaging techniques and substance use disorders, and emerging clinical neuroimaging technology.
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Affiliation(s)
- Kevin S Murnane
- Department of Pharmacology, Toxicology and Neuroscience, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA, USA
| | - Amber N Edinoff
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Elyse M Cornett
- Department of Anesthesiology, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA, USA
| | - Alan D Kaye
- Department of Anesthesiology, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA, USA
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Khom S, Borgonetti V, Vozella V, Kirson D, Rodriguez L, Gandhi P, Bianchi PC, Snyder A, Vlkolinsky R, Bajo M, Oleata CS, Ciccocioppo R, Roberto M. Glucocorticoid receptors regulate central amygdala GABAergic synapses in Marchigian-Sardinian alcohol-preferring rats. Neurobiol Stress 2023; 25:100547. [PMID: 37547774 PMCID: PMC10401345 DOI: 10.1016/j.ynstr.2023.100547] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 04/27/2023] [Accepted: 05/29/2023] [Indexed: 08/08/2023] Open
Abstract
Impairments in the function of the hypothalamic-pituitary-adrenal (HPA) axis and enhanced glucocorticoid receptor (GR) activity in the central amygdala (CeA) are critical mechanisms in the pathogenesis of alcohol use disorder (AUD). The GR antagonist mifepristone attenuates craving in AUD patients, alcohol consumption in AUD models, and decreases CeA γ-aminobutyric acid (GABA) transmission in alcohol-dependent rats. Previous studies suggest elevated GR activity in the CeA of male alcohol-preferring Marchigian-Sardinian (msP) rats, but its contribution to heightened CeA GABA transmission driving their characteristic post-dependent phenotype is largely unknown. We determined Nr3c1 (the gene encoding GR) gene transcription in the CeA in male and female msP and Wistar rats using in situ hybridization and studied acute effects of mifepristone (10 μM) and its interaction with ethanol (44 mM) on pharmacologically isolated spontaneous inhibitory postsynaptic currents (sIPSCs) and electrically evoked inhibitory postsynaptic potentials (eIPSPs) in the CeA using ex vivo slice electrophysiology. Female rats of both genotypes expressed more CeA GRs than males, suggesting a sexually dimorphic GR regulation of CeA activity. Mifepristone reduced sIPSC frequencies (GABA release) and eIPSP amplitudes in msP rats of both sexes, but not in their Wistar counterparts; however, it did not prevent acute ethanol-induced increase in CeA GABA transmission in male rats. In msP rats, GR regulates CeA GABAergic signaling under basal conditions, indicative of intrinsically active GR. Thus, enhanced GR function in the CeA represents a key mechanism contributing to maladaptive behaviors associated with AUD.
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Affiliation(s)
- Sophia Khom
- Department of Molecular Medicine, The Scripps Research Institute, 10550 N. Torrey Pines Road, La Jolla, CA 92037, USA
- Department of Pharmaceutical Sciences, University of Vienna, Josef-Holaubek-Platz 2, Vienna, A 1090, Austria
| | - Vittoria Borgonetti
- Department of Molecular Medicine, The Scripps Research Institute, 10550 N. Torrey Pines Road, La Jolla, CA 92037, USA
| | - Valentina Vozella
- Department of Molecular Medicine, The Scripps Research Institute, 10550 N. Torrey Pines Road, La Jolla, CA 92037, USA
| | - Dean Kirson
- Department of Molecular Medicine, The Scripps Research Institute, 10550 N. Torrey Pines Road, La Jolla, CA 92037, USA
- Department of Pharmacology, Addiction Science, and Toxicology, The University of Tennessee Health Science Center, Memphis, TN 38163, USA
| | - Larry Rodriguez
- Department of Molecular Medicine, The Scripps Research Institute, 10550 N. Torrey Pines Road, La Jolla, CA 92037, USA
| | - Pauravi Gandhi
- Department of Molecular Medicine, The Scripps Research Institute, 10550 N. Torrey Pines Road, La Jolla, CA 92037, USA
| | - Paula Cristina Bianchi
- Department of Molecular Medicine, The Scripps Research Institute, 10550 N. Torrey Pines Road, La Jolla, CA 92037, USA
- Department of Pharmacology, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP 04024-002, Brazil
| | - Angela Snyder
- Department of Molecular Medicine, The Scripps Research Institute, 10550 N. Torrey Pines Road, La Jolla, CA 92037, USA
| | - Roman Vlkolinsky
- Department of Molecular Medicine, The Scripps Research Institute, 10550 N. Torrey Pines Road, La Jolla, CA 92037, USA
| | - Michal Bajo
- Department of Molecular Medicine, The Scripps Research Institute, 10550 N. Torrey Pines Road, La Jolla, CA 92037, USA
| | - Christopher S. Oleata
- Department of Molecular Medicine, The Scripps Research Institute, 10550 N. Torrey Pines Road, La Jolla, CA 92037, USA
| | | | - Marisa Roberto
- Department of Molecular Medicine, The Scripps Research Institute, 10550 N. Torrey Pines Road, La Jolla, CA 92037, USA
- Department of Neuroscience, The Scripps Research Institute, 10550 N. Torrey Pines Road, La Jolla, CA 92037, USA
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Rodríguez FD, Sánchez ML, Coveñas R. Neurotensin and Alcohol Use Disorders: Towards a Pharmacological Treatment. Int J Mol Sci 2023; 24:ijms24108656. [PMID: 37240004 DOI: 10.3390/ijms24108656] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 05/06/2023] [Accepted: 05/10/2023] [Indexed: 05/28/2023] Open
Abstract
Harmful alcohol use is responsible for a group of disorders collectively named alcohol use disorders (AUDs), according to the DSM-5 classification. The damage induced by alcohol depends on the amount, time, and consumption patterns (continuous and heavy episodic drinking). It affects individual global well-being and social and familial environments with variable impact. Alcohol addiction manifests with different degrees of organ and mental health detriment for the individual, exhibiting two main traits: compulsive drinking and negative emotional states occurring at withdrawal, frequently causing relapse episodes. Numerous individual and living conditions, including the concomitant use of other psychoactive substances, lie in the complexity of AUD. Ethanol and its metabolites directly impact the tissues and may cause local damage or alter the homeostasis of brain neurotransmission, immunity scaffolding, or cell repair biochemical pathways. Brain modulator and neurotransmitter-assembled neurocircuitries govern reward, reinforcement, social interaction, and consumption of alcohol behaviors in an intertwined manner. Experimental evidence supports the participation of neurotensin (NT) in preclinical models of alcohol addiction. For example, NT neurons in the central nucleus of the amygdala projecting to the parabrachial nucleus strengthen alcohol consumption and preference. In addition, the levels of NT in the frontal cortex were found to be lower in rats bred to prefer alcohol to water in a free alcohol-water choice compared to wild-type animals. NT receptors 1 and 2 seem to be involved in alcohol consumption and alcohol effects in several models of knockout mice. This review aims to present an updated picture of the role of NT systems in alcohol addiction and the possible use of nonpeptide ligands modulating the activity of the NT system, applied to experimental animal models of harmful drinking behavior mimicking alcohol addiction leading to health ruin in humans.
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Affiliation(s)
- Francisco D Rodríguez
- Department of Biochemistry and Molecular Biology, Faculty of Chemical Sciences, University of Salamanca, 37008 Salamanca, Spain
- Group GIR-USAL: BMD (Bases Moleculares del Desarrollo), University of Salamanca, 37008 Salamanca, Spain
| | - Manuel Lisardo Sánchez
- Laboratory of Neuroanatomy of the Peptidergic Systems, Institute of Neurosciences of Castilla and León (INCYL), University of Salamanca, C/Pintor Fernando Gallego 1, 37007 Salamanca, Spain
| | - Rafael Coveñas
- Group GIR-USAL: BMD (Bases Moleculares del Desarrollo), University of Salamanca, 37008 Salamanca, Spain
- Laboratory of Neuroanatomy of the Peptidergic Systems, Institute of Neurosciences of Castilla and León (INCYL), University of Salamanca, C/Pintor Fernando Gallego 1, 37007 Salamanca, Spain
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36
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Heilig M. Stress-related neuropeptide systems as targets for treatment of alcohol addiction: A clinical perspective. J Intern Med 2023; 293:559-573. [PMID: 37052145 DOI: 10.1111/joim.13636] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/14/2023]
Abstract
Alcohol use is a major cause of disability and death globally. These negative consequences disproportionately affect people who develop alcohol addiction, a chronic relapsing condition characterized by increased motivation to use alcohol, choice of alcohol over healthy, natural rewards, and continued use despite negative consequences. Available pharmacotherapies for alcohol addiction are few, have effect sizes in need of improvement, and remain infrequently prescribed. Research aimed at developing novel therapeutics has in large part focused on attenuating pleasurable or "rewarding" properties of alcohol, but this targets processes that primarily play a role as initiation factors. As clinical alcohol addiction develops, long-term changes in brain function result in a shift of affective homeostasis, and rewarding alcohol effects become progressively reduced. Instead, increased stress sensitivity and negative affective states emerge in the absence of alcohol and create powerful incentives for relapse and continued use through negative reinforcement, or "relief." Based on research in animal models, several neuropeptide systems have been proposed to play an important role in this shift, suggesting that these systems could be targeted by novel medications. Two mechanisms in this category, antagonism at corticotropin-releasing factor type 1, and neurokinin 1/substance P receptors, have been subject to initial evaluation in humans. A third, kappa-opioid receptor antagonism, has been evaluated in nicotine addiction and could soon be tested for alcohol. This paper discusses findings with these mechanisms to date, and their prospects as future targets for novel medications.
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Affiliation(s)
- Markus Heilig
- Center for Social and Affective Neuroscience, BKV, Linköping University and Department of Psychiatry, Linköping University Hospital, Linköping, Sweden
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37
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Pytell JD, Chander G, Thakrar AP, Ogunwole SM, McGinty EE. Does a Survivorship Model of Opioid Use Disorder Improve Public Stigma or Policy Support? A General Population Randomized Experiment. J Gen Intern Med 2023; 38:1638-1646. [PMID: 36394698 PMCID: PMC10212853 DOI: 10.1007/s11606-022-07865-y] [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: 06/14/2022] [Accepted: 10/21/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND The chronic disease model of opioid use disorder (OUD) is promoted by many public health authorities, yet high levels of stigma persist along with low support for policies that would benefit people with OUD. OBJECTIVE Determine if a survivorship model of OUD, which does not imply a chronic, relapsing disease state, compared to a chronic disease model improves public stigma and support for opioid-related policies. Explore if race or gender moderates any effect. DESIGN Online, vignette-based randomized study. PARTICIPANTS US adults recruited through a market research firm. INTERVENTION Participants viewed one of 8 vignettes depicting a person with OUD in sustained remission. Vignettes varied in terms of the OUD model (survivorship, chronic disease) and vignette individual's race (Black, White) and gender (man, woman). MAIN MEASURES (1) Public stigma measured by desire for social distance, perceptions of dangerousness, and overall feelings toward the vignette individual. (2) Support for 7 opioid-related policies. Overall feelings were measured on a feelings thermometer (0/cold-100/warm). Stigma and policy support responses were measured on Likert scales dichotomized to indicate a positive (4, 5) or negative/indifferent (1-3) response. KEY RESULTS Of 1440 potential participants, 1172 (81%) were included in the analysis. Exposure to the survivorship model resulted in warmer feelings (mean 72, SD 23) compared to the chronic disease (mean 67, SD 23; difference 4, 95%CI 1-6). There was no effect modification from the vignette individual's race or gender. There was no significant difference between OUD models on other measures of public stigma or support for policies. CONCLUSIONS The survivorship model of OUD improved overall feelings compared to the chronic disease model, but we did not detect an effect of this model on other domains of public stigma or support for policies. Further refinement and testing of this novel, survivorship model of OUD could improve public opinions.
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Affiliation(s)
- Jarratt D Pytell
- Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA.
- Department of Medicine, University of Colorado School of Medicine, Mail Stop B180, 12631 E. 17th Ave, Aurora, CO, 80045, USA.
| | - Geetanjali Chander
- Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA
- Department of Medicine, University of Washington School of Medicine, Seattle, WA, USA
| | - Ashish P Thakrar
- National Clinician Scholars Program at the Corporal Michael J. Crescenz VA Medical Center, University of Pennsylvania, Philadelphia, PA, USA
| | - S Michelle Ogunwole
- Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Emma E McGinty
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Matson TE, Hallgren KA, Lapham GT, Oliver M, Wang X, Williams EC, Bradley KA. Psychometric Performance of a Substance Use Symptom Checklist to Help Clinicians Assess Substance Use Disorder in Primary Care. JAMA Netw Open 2023; 6:e2316283. [PMID: 37234003 PMCID: PMC10220521 DOI: 10.1001/jamanetworkopen.2023.16283] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 04/18/2023] [Indexed: 05/27/2023] Open
Abstract
Importance Substance use disorders (SUDs) are underrecognized in primary care, where structured clinical interviews are often infeasible. A brief, standardized substance use symptom checklist could help clinicians assess SUD. Objective To evaluate the psychometric properties of the Substance Use Symptom Checklist (hereafter symptom checklist) used in primary care among patients reporting daily cannabis use and/or other drug use as part of population-based screening and assessment. Design, Setting, and Participants This cross-sectional study was conducted among adult primary care patients who completed the symptom checklist during routine care between March 1, 2015, and March 1, 2020, at an integrated health care system. Data analysis was conducted from June 1, 2021, to May 1, 2022. Main Outcomes and Measures The symptom checklist included 11 items corresponding to SUD criteria in the Diagnostic and Statistical Manual for Mental Disorders (Fifth Edition) (DSM-5). Item response theory (IRT) analyses tested whether the symptom checklist was unidimensional and reflected a continuum of SUD severity and evaluated item characteristics (discrimination and severity). Differential item functioning analyses examined whether the symptom checklist performed similarly across age, sex, race, and ethnicity. Analyses were stratified by cannabis and/or other drug use. Results A total of 23 304 screens were included (mean [SD] age, 38.2 [5.6] years; 12 554 [53.9%] male patients; 17 439 [78.8%] White patients; 20 393 [87.5%] non-Hispanic patients). Overall, 16 140 patients reported daily cannabis use only, 4791 patients reported other drug use only, and 2373 patients reported both daily cannabis and other drug use. Among patients with daily cannabis use only, other drug use only, or both daily cannabis and other drug use, 4242 (26.3%), 1446 (30.2%), and 1229 (51.8%), respectively, endorsed 2 or more items on the symptom checklist, consistent with DSM-5 SUD. For all cannabis and drug subsamples, IRT models supported the unidimensionality of the symptom checklist, and all items discriminated between higher and lower levels of SUD severity. Differential item functioning was observed for some items across sociodemographic subgroups but did not result in meaningful change (<1 point difference) in the overall score (0-11). Conclusions and Relevance In this cross-sectional study, a symptom checklist, administered to primary care patients who reported daily cannabis and/or other drug use during routine screening, discriminated SUD severity as expected and performed well across subgroups. Findings support the clinical utility of the symptom checklist for standardized and more complete SUD symptom assessment to help clinicians make diagnostic and treatment decisions in primary care.
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Affiliation(s)
- Theresa E. Matson
- Kaiser Permanente Washington Health Research Institute, Seattle
- Department of Health Systems and Population Health, University of Washington School of Public Health, Seattle
- Health Services Research & Development Center for Innovation for Veteran-Centered and Value-Driven Care, Veterans Affairs Puget Sound Health Care System, Seattle, Washington
| | - Kevin A. Hallgren
- Kaiser Permanente Washington Health Research Institute, Seattle
- Department of Health Systems and Population Health, University of Washington School of Public Health, Seattle
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle
| | - Gwen T. Lapham
- Kaiser Permanente Washington Health Research Institute, Seattle
- Department of Health Systems and Population Health, University of Washington School of Public Health, Seattle
| | - Malia Oliver
- Kaiser Permanente Washington Health Research Institute, Seattle
| | - Xiaoming Wang
- Center for the Clinical Trials Network, National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland
| | - Emily C. Williams
- Kaiser Permanente Washington Health Research Institute, Seattle
- Department of Health Systems and Population Health, University of Washington School of Public Health, Seattle
- Health Services Research & Development Center for Innovation for Veteran-Centered and Value-Driven Care, Veterans Affairs Puget Sound Health Care System, Seattle, Washington
| | - Katharine A. Bradley
- Kaiser Permanente Washington Health Research Institute, Seattle
- Department of Health Systems and Population Health, University of Washington School of Public Health, Seattle
- Department of Medicine, University of Washington School of Medicine, Seattle
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Morris J, Boness CL, Witkiewitz K. Should we promote alcohol problems as a continuum? Implications for policy and practice. DRUGS (ABINGDON, ENGLAND) 2023; 31:271-281. [PMID: 38682086 PMCID: PMC11052541 DOI: 10.1080/09687637.2023.2187681] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 03/01/2023] [Indexed: 04/03/2023]
Abstract
The highly heterogeneous nature of alcohol use and problems has presented significant challenges to those attempting to understand, treat or prevent what is commonly termed alcohol use disorder (AUD). However, any attempts to capture this complex phenomenon, including the various current criterion of AUD, come with a number of limitations. One particular limitation has been how alcohol problems are represented or understood in ways which do not capture the broad spectrum of alcohol use and harms and the many potential routes to prevention, treatment, and recovery. One possible response to this has been proposed as more explicitly framing or conceptualizing a continuum model of alcohol use and harms. In this commentary, we attempt to identify the key implications of a continuum model for policy and practice, examining the historical and current context of alcohol problem classifications and models. We argue a continuum model of alcohol use and problems holds a number of advantages for advancing public health goals, but also some potential limitations, both of which require further examination.
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Affiliation(s)
- J Morris
- Centre for Addictive Behaviours Research, School of Applied Sciences, London South Bank University, United Kingdom
| | - C L Boness
- Center on Alcohol, Substance use, And Addictions, University of New Mexico, Albuquerque, New Mexico
| | - K Witkiewitz
- Center on Alcohol, Substance use, And Addictions, University of New Mexico, Albuquerque, New Mexico
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40
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Domanegg K, Sommer WH, Meinhardt MW. Psychedelic Targeting of Metabotropic Glutamate Receptor 2 and Its Implications for the Treatment of Alcoholism. Cells 2023; 12:963. [PMID: 36980303 PMCID: PMC10047550 DOI: 10.3390/cells12060963] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 03/16/2023] [Accepted: 03/20/2023] [Indexed: 03/30/2023] Open
Abstract
Alcohol abuse is a leading risk factor for the public health burden worldwide. Approved pharmacotherapies have demonstrated limited effectiveness over the last few decades in treating alcohol use disorders (AUD). New therapeutic approaches are therefore urgently needed. Historical and recent clinical trials using psychedelics in conjunction with psychotherapy demonstrated encouraging results in reducing heavy drinking in AUD patients, with psilocybin being the most promising candidate. While psychedelics are known to induce changes in gene expression and neuroplasticity, we still lack crucial information about how this specifically counteracts the alterations that occur in neuronal circuits throughout the course of addiction. This review synthesizes well-established knowledge from addiction research about pathophysiological mechanisms related to the metabotropic glutamate receptor 2 (mGlu2), with findings and theories on how mGlu2 connects to the major signaling pathways induced by psychedelics via serotonin 2A receptors (2AR). We provide literature evidence that mGlu2 and 2AR are able to regulate each other's downstream signaling pathways, either through monovalent crosstalk or through the formation of a 2AR-mGlu2 heteromer, and highlight epigenetic mechanisms by which 2ARs can modulate mGlu2 expression. Lastly, we discuss how these pathways might be targeted therapeutically to restore mGlu2 function in AUD patients, thereby reducing the propensity to relapse.
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Affiliation(s)
- Kevin Domanegg
- Institute of Psychopharmacology, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, 69115 Heidelberg, Germany
| | - Wolfgang H. Sommer
- Institute of Psychopharmacology, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, 69115 Heidelberg, Germany
- Bethanien Hospital for Psychiatry, Psychosomatics, and Psychotherapy Greifswald, 17489 Greifswald, Germany
| | - Marcus W. Meinhardt
- Institute of Psychopharmacology, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, 69115 Heidelberg, Germany
- Department of Molecular Neuroimaging, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, 69115 Heidelberg, Germany
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41
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Acuff SF, MacKillop J, Murphy JG. A contextualized reinforcer pathology approach to addiction. NATURE REVIEWS PSYCHOLOGY 2023; 2:309-323. [PMID: 37193018 PMCID: PMC10028332 DOI: 10.1038/s44159-023-00167-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/21/2023] [Indexed: 03/24/2023]
Abstract
Behavioural economic accounts of addiction conceptualize harmful drug use as an operant reinforcer pathology, emphasizing that a drug is consumed because of overvaluation of smaller immediate rewards relative to larger delayed rewards (delay discounting) and high drug reinforcing value (drug demand). These motivational processes are within-individual determinants of behaviour. A third element of learning theory posits that harmful drug use depends on the relative constraints on access to other available activities and commodities in the choice context (alternative reinforcers), reflecting the substantial influence of environmental factors. In this Perspective, we integrate alternative reinforcers into the contemporary behavioural economic account of harmful drug use - the contextualized reinforcer pathology model - and review empirical literature across the translational spectrum in support of this model. Furthermore, we consider how increases in drug-related mortality and health disparities in addiction can be understood and potentially ameliorated via a contextualized reinforcer pathology model in which lack of alternative reinforcement is a major risk factor for addiction.
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Affiliation(s)
| | - James MacKillop
- Peter Boris Centre for Addictions Research, Department of Psychiatry and Behavioural Neurosciences, McMaster University/St Joseph’s Healthcare Hamilton, Hamilton, Ontario Canada
- Homewood Research Institute, Guelph, Ontario, Canada
| | - James G. Murphy
- Department of Psychology, University of Memphis, Memphis, TN USA
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42
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Liu Y, Masina F, Ridderinkhof KR, Pezzetta R. Addiction as a brain disease? A meta-regression comparison of error-related brain potentials between addiction and neurological diseases. Neurosci Biobehav Rev 2023; 148:105127. [PMID: 36921702 DOI: 10.1016/j.neubiorev.2023.105127] [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: 11/05/2022] [Revised: 03/08/2023] [Accepted: 03/09/2023] [Indexed: 03/14/2023]
Abstract
The notion that addiction is a "brain disorder" is widespread. However, there is a lack of evidence on the degree of disorder in terms of error processing in addiction. The present meta-analysis aimed at shedding light on this by comparing error-processes with populations with well-recognized brain disorders. We included 17 addiction and 32 neurological disorder studies that compared error-related negativity (ERN) or error positivity (Pe) amplitudes/latencies between experimental and healthy-control groups. Meta-regression analyses were performed for the intergroup comparison and other moderators. Both diagnoses were accompanied by a diminished ERN amplitude, although the degree of impairment was marginally larger in neurological disorders. Neurological disorders presented shorter ERN latencies than addiction when compared with controls. The two groups did not differ in Pe amplitude/latency. Except for a reduced ERN amplitude found along with aging, no other moderator contributed significantly to divergent findings about these four ERP indexes. The results support the brain disease model of addiction, while stressing the importance of quantifying the degrees of brain dysfunctions as a next step.
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Affiliation(s)
- Yang Liu
- Department of Psychology, School of Education, Shanghai Normal University, Shanghai, China.
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43
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Lee H, Jeon Y, Yoo C, Seon H, Park J, Hwang M, Baek K, Chung D. Persistent impacts of smoking on resting-state EEG in male chronic smokers and past-smokers with 20 years of abstinence. Sci Rep 2023; 13:3907. [PMID: 36890138 PMCID: PMC9995515 DOI: 10.1038/s41598-023-29547-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 02/06/2023] [Indexed: 03/10/2023] Open
Abstract
Smoking is a severe addictive health risk behavior and notorious for the high likelihood of relapse after attempted cessation. Such an addictive pattern in smoking has been associated with neurobiological changes in the brain. However, little is known whether the neural changes associated with chronic smoking persist after a long period of successful abstinence. To address this question, we examined resting state EEG (rsEEG) in chronic smokers who have been smoking for 20 years or more, past-smokers who have been successfully abstaining for 20 years or more, and never-smokers. Both current-smokers and past-smokers showed significantly decreased relative theta power than never-smokers, showcasing persistent effect of smoking on the brain. Other rsEEG features in alpha frequency band demonstrated distinctive patterns associated with active smoking, such that compared to never-smokers, only current-smokers, but not past-smokers, showed significantly higher relative power, EEG reactivity-power changes between eyes-closed and eyes-open conditions-, and coherence between channels. Furthermore, individual variabilities across these rsEEG biomarkers were accounted for by individuals' self-reported smoking history and nicotine dependence in current- and past- smokers. These data suggest the persistent effect of smoking on the brain even after sustained remission for 20 years.
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Affiliation(s)
- Hyeji Lee
- Department of Biomedical Engineering, Ulsan National Institute of Science and Technology, 50 UNIST-Gil, Ulsan, 44919, South Korea.,Department of Psychology, The University of Edinburgh, Edinburgh, UK
| | - Yoonji Jeon
- School of Biomedical Convergence Engineering, Pusan National University, 49 Busandaehak-Ro, Yangsan, Gyeongsangnam-Do, 50612, South Korea
| | - Cheolin Yoo
- Department of Occupational and Environmental Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, South Korea
| | - HeeYoung Seon
- Department of Biomedical Engineering, Ulsan National Institute of Science and Technology, 50 UNIST-Gil, Ulsan, 44919, South Korea
| | - Jiwon Park
- Department of Biomedical Engineering, Ulsan National Institute of Science and Technology, 50 UNIST-Gil, Ulsan, 44919, South Korea
| | - Minho Hwang
- Department of Biomedical Engineering, Ulsan National Institute of Science and Technology, 50 UNIST-Gil, Ulsan, 44919, South Korea
| | - Kwangyeol Baek
- School of Biomedical Convergence Engineering, Pusan National University, 49 Busandaehak-Ro, Yangsan, Gyeongsangnam-Do, 50612, South Korea.
| | - Dongil Chung
- Department of Biomedical Engineering, Ulsan National Institute of Science and Technology, 50 UNIST-Gil, Ulsan, 44919, South Korea.
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44
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Doyle WS, Huskinson SL. Environmental Uncertainty and Substance Use Disorders: A Behavior Analytic Perspective. POLICY INSIGHTS FROM THE BEHAVIORAL AND BRAIN SCIENCES 2023; 10:96-103. [PMID: 38550572 PMCID: PMC10978010 DOI: 10.1177/23727322231152451] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/01/2024]
Abstract
Substance use disorder (SUD) and drug overdose deaths represent major economic, health, and safety issues in the United States. The psychology of uncertainty provides a mechanism for understanding, reducing, and controlling the damage from substance misuse. Illicit drugs (such as heroin or cocaine) are uncertain in their availability, quality, and acquisition (the time and effort required to obtain them) compared with nondrug-related alternatives (such as consumable goods, hobbies, or paychecks). Furthermore, the severity and likelihood of negative outcomes associated with drug use likewise are uncertain. Such uncertainties worsen substance use outcomes. The current review conveys what is known about the impact of uncertainty on substance use: laboratory investigations of uncertain time and effort required to obtain a substance and uncertain drug quality show uncertainty exacerbates harm. Furthermore, uncertain negative outcomes are not likely to deter substance use in individuals with a SUD. Finally, several policy implications include access to agonist medications; creating a safer drug supply; access to clean syringes/needles, naloxone, and safe-injection sites; and ending incarceration for substance use.
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Affiliation(s)
- William S. Doyle
- Program in Neuroscience, University of Mississippi Medical Center, Jackson, MS USA
| | - Sally L. Huskinson
- Program in Neuroscience, University of Mississippi Medical Center, Jackson, MS USA
- Division of Neurobiology and Behavior Research, Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, MS, USA
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45
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Koban L, Wager TD, Kober H. A neuromarker for drug and food craving distinguishes drug users from non-users. Nat Neurosci 2023; 26:316-325. [PMID: 36536243 DOI: 10.1038/s41593-022-01228-w] [Citation(s) in RCA: 35] [Impact Index Per Article: 35.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 11/01/2022] [Indexed: 12/24/2022]
Abstract
Craving is a core feature of substance use disorders. It is a strong predictor of substance use and relapse and is linked to overeating, gambling, and other maladaptive behaviors. Craving is measured via self-report, which is limited by introspective access and sociocultural contexts. Neurobiological markers of craving are both needed and lacking, and it remains unclear whether craving for drugs and food involve similar mechanisms. Across three functional magnetic resonance imaging studies (n = 99), we used machine learning to identify a cross-validated neuromarker that predicts self-reported intensity of cue-induced drug and food craving (P < 0.0002). This pattern, which we term the Neurobiological Craving Signature (NCS), includes ventromedial prefrontal and cingulate cortices, ventral striatum, temporal/parietal association areas, mediodorsal thalamus and cerebellum. Importantly, NCS responses to drug versus food cues discriminate drug users versus non-users with 82% accuracy. The NCS is also modulated by a self-regulation strategy. Transfer between separate neuromarkers for drug and food craving suggests shared neurobiological mechanisms. Future studies can assess the discriminant and convergent validity of the NCS and test whether it responds to clinical interventions and predicts long-term clinical outcomes.
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Affiliation(s)
- Leonie Koban
- Paris Brain Institute (ICM), Inserm, CNRS, Sorbonne Université, Paris, France.
- Centre de Recherche en Neurosciences de Lyon (CRNL), CNRS, INSERM, Université Claude Bernard Lyon 1, Bron, France.
| | - Tor D Wager
- Department of Psychological and Brain Sciences, Dartmouth College, Hanover, NH, USA.
| | - Hedy Kober
- Department of Psychiatry and Psychology, Yale University, New Haven, CT, USA.
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Domi E, Barchiesi R, Barbier E. Epigenetic Dysregulation in Alcohol-Associated Behaviors: Preclinical and Clinical Evidence. Curr Top Behav Neurosci 2023. [PMID: 36717533 DOI: 10.1007/7854_2022_410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Alcohol use disorder (AUD) is characterized by loss of control over intake and drinking despite harmful consequences. At a molecular level, AUD is associated with long-term neuroadaptations in key brain regions that are involved in reward processing and decision-making. Over the last decades, a great effort has been made to understand the neurobiological basis underlying AUD. Epigenetic mechanisms have emerged as an important mechanism in the regulation of long-term alcohol-induced gene expression changes. Here, we review the literature supporting a role for epigenetic processes in AUD. We particularly focused on the three most studied epigenetic mechanisms: DNA methylation, Histone modification and non-coding RNAs. Clinical studies indicate an association between AUD and DNA methylation both at the gene and global levels. Using behavioral paradigms that mimic some of the characteristics of AUD, preclinical studies demonstrate that changes in epigenetic mechanisms can functionally impact alcohol-associated behaviors. While many studies support a therapeutic potential for targeting epigenetic enzymes, more research is needed to fully understand their role in AUD. Identification of brain circuits underlying alcohol-associated behaviors has made major advances in recent years. However, there are very few studies that investigate how epigenetic mechanisms can affect these circuits or impact the neuronal ensembles that promote alcohol-associated behaviors. Studies that focus on the role of circuit-specific and cell-specific epigenetic changes for clinically relevant alcohol behaviors may provide new insights on the functional role of epigenetic processes in AUD.
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Affiliation(s)
- Esi Domi
- Department of Biomedical and Clinical Sciences, Center for Social and Affective Neuroscience, Linköping University, Linköping, Sweden
- School of Pharmacy, Pharmacology Unit, Center for Neuroscience, University of Camerino, Camerino, Italy
| | - Riccardo Barchiesi
- Department of Neuroscience, Waggoner Center for Alcohol and Alcohol Addiction Research, University of Texas at Austin, Austin, TX, USA
| | - Estelle Barbier
- Department of Biomedical and Clinical Sciences, Center for Social and Affective Neuroscience, Linköping University, Linköping, Sweden.
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Nuñez-delMoral A, Bianchi PC, Brocos-Mosquera I, Anesio A, Palombo P, Camarini R, Cruz FC, Callado LF, Vialou V, Erdozain AM. The Matricellular Protein Hevin Is Involved in Alcohol Use Disorder. Biomolecules 2023; 13:biom13020234. [PMID: 36830603 PMCID: PMC9953008 DOI: 10.3390/biom13020234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 01/16/2023] [Accepted: 01/21/2023] [Indexed: 01/27/2023] Open
Abstract
Astrocytic-secreted matricellular proteins have been shown to influence various aspects of synaptic function. More recently, they have been found altered in animal models of psychiatric disorders such as drug addiction. Hevin (also known as Sparc-like 1) is a matricellular protein highly expressed in the adult brain that has been implicated in resilience to stress, suggesting a role in motivated behaviors. To address the possible role of hevin in drug addiction, we quantified its expression in human postmortem brains and in animal models of alcohol abuse. Hevin mRNA and protein expression were analyzed in the postmortem human brain of subjects with an antemortem diagnosis of alcohol use disorder (AUD, n = 25) and controls (n = 25). All the studied brain regions (prefrontal cortex, hippocampus, caudate nucleus and cerebellum) in AUD subjects showed an increase in hevin levels either at mRNA or/and protein levels. To test if this alteration was the result of alcohol exposure or indicative of a susceptibility factor to alcohol consumption, mice were exposed to different regimens of intraperitoneal alcohol administration. Hevin protein expression was increased in the nucleus accumbens after withdrawal followed by a ethanol challenge. The role of hevin in AUD was determined using an RNA interference strategy to downregulate hevin expression in nucleus accumbens astrocytes, which led to increased ethanol consumption. Additionally, ethanol challenge after withdrawal increased hevin levels in blood plasma. Altogether, these results support a novel role for hevin in the neurobiology of AUD.
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Affiliation(s)
- Amaia Nuñez-delMoral
- Department of Pharmacology, University of the Basque Country, UPV/EHU, 48940 Leioa, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain
| | - Paula C. Bianchi
- Department of Pharmacology, Universidade Federal de São Paulo-UNIFESP, São Paulo 04023-062, Brazil
| | - Iria Brocos-Mosquera
- Department of Pharmacology, University of the Basque Country, UPV/EHU, 48940 Leioa, Spain
| | - Augusto Anesio
- Department of Pharmacology, Universidade Federal de São Paulo-UNIFESP, São Paulo 04023-062, Brazil
| | - Paola Palombo
- Department of Pharmacology, Universidade Federal de São Paulo-UNIFESP, São Paulo 04023-062, Brazil
| | - Rosana Camarini
- Department of Pharmacology, Instituto de Ciências Biomédicas, Universidade de São Paulo, São Paulo 05508-000, Brazil
| | - Fabio C. Cruz
- Department of Pharmacology, Universidade Federal de São Paulo-UNIFESP, São Paulo 04023-062, Brazil
| | - Luis F. Callado
- Department of Pharmacology, University of the Basque Country, UPV/EHU, 48940 Leioa, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain
- Biocruces-Bizkaia Health Research Institute, 48903 Barakaldo, Spain
| | - Vincent Vialou
- Institute of Biology Paris Seine, Neuroscience Paris Seine, CNRS UMR8246, INSERM U1130, Sorbonne Université, 75005 Paris, France
- Correspondence: (V.V.); (A.M.E.); Tel.: +33-1-44-27-60-98 (V.V.); +34-601-28-48 (A.M.E.)
| | - Amaia M. Erdozain
- Department of Pharmacology, University of the Basque Country, UPV/EHU, 48940 Leioa, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain
- Correspondence: (V.V.); (A.M.E.); Tel.: +33-1-44-27-60-98 (V.V.); +34-601-28-48 (A.M.E.)
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48
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Behavior matters for neuroscience and neuroscience matters for behavior. Neurosci Biobehav Rev 2023; 144:104963. [PMID: 36402226 DOI: 10.1016/j.neubiorev.2022.104963] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 10/31/2022] [Indexed: 11/18/2022]
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49
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Kanti AK, Specka M, Scherbaum N, Bonnet U. [Comparative Harm/Benefit Analysis of Various Psychotropic Substances from the Perspective of German Drug Users and Addiction Medicine Experts - A Contribution to Psychoeducation of Substance-Addicted Individuals and Restriction/Legalization Debates]. FORTSCHRITTE DER NEUROLOGIE-PSYCHIATRIE 2022. [PMID: 36522164 DOI: 10.1055/a-1971-9558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND To date, we cannot find any current international comparative study on the assessment of a benefit/harm profile of various licit and illicit psychoactive substances conducted by adult drug users and addiction experts as well. Particularly, there is no study from the German-speaking area of Western Europe. METHODS In addition to the data already published by 101 German addiction medicine experts (published in this journal, [1]), we carried out interviews using a structured questionnaire with 100 German substance dependent users, residing in acute and rehabilitation clinical setting, to evaluate 34 psychoactive substances regarding their health and social harm potential for users and others as well as their potential benefit. RESULTS Both, users and experts estimated traditional illicit drugs, such as heroin, crack/cocaine and methamphetamine, to be particularly harmful. Synthetic cannabinoids, alcohol and benzodiazepines were in the upper midfield, cannabis and psychotropic mushrooms in the lower midfield, and gabapentinoids at the bottom of the harm rankings of both, users and experts. In comparison with the experts, the users estimated methadone and benzodiazepines to be significantly more harmful. In the benefit analysis, users rated traditional illicit drugs including cannabis and psychotropic mushrooms as well as nicotine as significantly more useful than the experts. In contrast to the experts (traditional illicit drugs), the users did not assess any substance as very harmful and very useless at the same time. Only a few users reported to have experiences with opioid analgesics which, however, did not differ between the users´ and experts´ harm/benefit-assessments. Neither users nor experts predicted cannabis-legalization to change the overall risk potential of cannabis. Specific cognitive valuation biases seemed to be prominent in both groups. CONCLUSION This study presents first harm/benefit assessments of psychotropic substances from the perspective of German addiction medicine experts and drug users. The results can be valuable to the psychoeducation of substance-addicted individuals and to current restriction or legalization debates.
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Affiliation(s)
- Ann-Kristin Kanti
- Klinik für Innere Medizin, Evangelisches Krankenhaus Castrop-Rauxel, (Akademisches Lehrkrankenhaus der Universität Duisburg-Essen), Castrop-Rauxel, Deutschland
| | - Michael Specka
- LVR-Klinikum Essen, Klinik für Psychiatrie und Psychotherapie, Medizinische Fakultät, Universität Duisburg-Essen, Essen, Deutschland
| | - Norbert Scherbaum
- LVR-Klinikum Essen, Klinik für Psychiatrie und Psychotherapie, Medizinische Fakultät, Universität Duisburg-Essen, Essen, Deutschland
| | - Udo Bonnet
- LVR-Klinikum Essen, Klinik für Psychiatrie und Psychotherapie, Medizinische Fakultät, Universität Duisburg-Essen, Essen, Deutschland
- Klinik für Psychiatrie, Psychotherapie und Psychosomatik, Evangelisches Krankenhaus Castrop-Rauxel, (Akademisches Lehrkrankenhaus der Universität Duisburg-Essen), Castrop-Rauxel, Deutschland
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Spironolactone as a potential new pharmacotherapy for alcohol use disorder: convergent evidence from rodent and human studies. Mol Psychiatry 2022; 27:4642-4652. [PMID: 36123420 DOI: 10.1038/s41380-022-01736-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 08/02/2022] [Accepted: 08/08/2022] [Indexed: 12/14/2022]
Abstract
Evidence suggests that spironolactone, a nonselective mineralocorticoid receptor (MR) antagonist, modulates alcohol seeking and consumption. Therefore, spironolactone may represent a novel pharmacotherapy for alcohol use disorder (AUD). In this study, we tested the effects of spironolactone in a mouse model of alcohol drinking (drinking-in-the-dark) and in a rat model of alcohol dependence (vapor exposure). We also investigated the association between spironolactone receipt for at least 60 continuous days and change in self-reported alcohol consumption, using the Alcohol Use Disorders Identification Test-Consumption (AUDIT-C), in a pharmacoepidemiologic cohort study in the largest integrated healthcare system in the US. Spironolactone dose-dependently reduced the intake of sweetened or unsweetened alcohol solutions in male and female mice. No effects of spironolactone were observed on drinking of a sweet solution without alcohol, food or water intake, motor coordination, alcohol-induced ataxia, or blood alcohol levels. Spironolactone dose-dependently reduced operant alcohol self-administration in dependent and nondependent male and female rats. In humans, a greater reduction in alcohol consumption was observed among those who received spironolactone, compared to propensity score-matched individuals who did not receive spironolactone. The largest effects were among those who reported hazardous/heavy episodic alcohol consumption at baseline (AUDIT-C ≥ 8) and those exposed to ≥ 50 mg/day of spironolactone. These convergent findings across rodent and human studies demonstrate that spironolactone reduces alcohol use and support the hypothesis that this medication may be further studied as a novel pharmacotherapy for AUD.
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