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Durazzo TC, Kraybill EP, Stephens LH, May AC, Meyerhoff DJ. Pro-atherogenic medical conditions are associated with widespread regional brain metabolite abnormalities in those with alcohol use disorder. Alcohol Alcohol 2024; 59:agae055. [PMID: 39127890 DOI: 10.1093/alcalc/agae055] [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: 05/15/2024] [Revised: 07/24/2024] [Accepted: 07/31/2024] [Indexed: 08/12/2024] Open
Abstract
AIMS Widespread brain metabolite abnormalities in those with alcohol use disorder (AUD) were reported in numerous studies, but the effects of the pro-atherogenic conditions of hypertension, type 2 diabetes mellitus, hepatitis C seropositivity, and hyperlipidemia on metabolite levels were not considered. These conditions were associated with brain metabolite abnormalities in those without AUD. We predicted treatment-seeking individuals with AUD and pro-atherogenic conditions (Atherogenic+) demonstrate lower regional metabolite markers of neuronal viability [N-acetylaspartate (NAA)] and cell membrane turnover/synthesis [choline-containing compounds (Cho)], compared with those with AUD without pro-atherogenic conditions (Atherogenic-) and healthy controls (CON). METHODS Atherogenic+ (n = 59) and Atherogenic- (n = 51) and CON (n = 49) completed a 1.5 T proton magnetic resonance spectroscopic imaging study. Groups were compared on NAA, Cho, total creatine, and myoinositol in cortical gray matter (GM), white matter (WM), and select subcortical regions. RESULTS Atherogenic+ had lower frontal GM and temporal WM NAA than CON. Atherogenic+ showed lower parietal GM, frontal, parietal and occipital WM and lenticular nuclei NAA level than Atherogenic- and CON. Atherogenic- showed lower frontal GM and WM NAA than CON. Atherogenic+ had lower Cho level than CON in the frontal GM, parietal WM, and thalamus. Atherogenic+ showed lower frontal WM and cerebellar vermis Cho than Atherogenic- and CON. CONCLUSIONS Findings suggest proatherogenic conditions in those with AUD were associated with increased compromise of neuronal integrity and cell membrane turnover/synthesis. The greater metabolite abnormalities observed in Atherogenic+ may relate to increased oxidative stress-related compromise of neuronal and glial cell structure and/or impaired arterial vasoreactivity/lumen viability.
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Affiliation(s)
- Timothy C Durazzo
- Mental Illness Research and Education Clinical Centers, VA Palo Alto Health Care System, 3801 Miranda Ave. (151Y), Palo Alto, CA 94304, United States
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Road, Stanford, CA 94305, United States
| | - Eric P Kraybill
- Mental Illness Research and Education Clinical Centers, VA Palo Alto Health Care System, 3801 Miranda Ave. (151Y), Palo Alto, CA 94304, United States
| | - Lauren H Stephens
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Road, Stanford, CA 94305, United States
| | - April C May
- Mental Illness Research and Education Clinical Centers, VA Palo Alto Health Care System, 3801 Miranda Ave. (151Y), Palo Alto, CA 94304, United States
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Road, Stanford, CA 94305, United States
| | - Dieter J Meyerhoff
- Center for Imaging of Neurodegenerative Diseases (CIND), San Francisco VA Medical Center, 4150 Clement St. (114M) San Francisco, CA 94121, United States
- Department of Radiology and Biomedical Imaging, University of California, 505 Parnassus St., San Francisco, CA 94143, United States
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Powell A, Sumnall H, Kullu C, Owens L, Montgomery C. Changes in processing speed during early abstinence from alcohol dependence. J Psychopharmacol 2024; 38:551-561. [PMID: 38804547 PMCID: PMC11179317 DOI: 10.1177/02698811241254830] [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: 05/29/2024]
Abstract
BACKGROUND Processing speed is a task-independent construct underpinning more complex goal-related abilities. Processing speed is impaired in alcohol dependence (AD) and is linked to relapse, as are the functions it underpins. Reliable measurement of processing speed may allow tracking of AD recovery trajectories and identify patients requiring additional support. AIMS To assess changes in reaction time (RT) from baseline (at the start of a detoxification programme) across early abstinence. METHODS Vibrotactile RT was assessed in early recovery between days 3 and 7 of treatment in 66 individuals with AD (25 females; aged 19-74, 44.60 ± 10.60 years) and against 35 controls tested on one occasion (19 females; 41.00 ± 13.60), using two multivariate multiple regressions. A mixed multivariate analysis of covariance (MANCOVA) of available AD data (n = 45) assessed change in RT between timepoints and between treatment settings (outpatient vs inpatient). RESULTS The group (AD vs control) significantly predicted choice RT at baseline and follow-up but did not significantly predict simple RT or RT variability, which is inconsistent with previous findings. At follow-up, mental fatigue was also predicted by the group, and MANCOVA indicated that this had worsened in inpatients but improved in outpatients. CONCLUSIONS Recovery of RT measures so early in the treatment journey was not in line with previous research which indicates persisting deficits. The interaction between setting and timepoint indicates that despite being typically less medically complex, outpatients require ongoing support and monitoring during their recovery.
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Affiliation(s)
- Anna Powell
- School of Psychology, Liverpool John Moores University, Liverpool, UK
- Liverpool Centre for Alcohol Research, Liverpool, UK
| | - Harry Sumnall
- Liverpool Centre for Alcohol Research, Liverpool, UK
- Public Health Institute, Liverpool John Moores University, Liverpool, UK
| | - Cecil Kullu
- Mersey Care NHS Foundation Trust, Liverpool, UK
| | - Lynn Owens
- Liverpool Centre for Alcohol Research, Liverpool, UK
- University of Liverpool, Liverpool, UK
| | - Catharine Montgomery
- School of Psychology, Liverpool John Moores University, Liverpool, UK
- Liverpool Centre for Alcohol Research, Liverpool, UK
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Padula CB, McCalley DM, Tenekedjieva LT, MacNiven K, Rauch A, Morales JM, Knutson B, Humphreys K, Williams LM, Durazzo TC. A pilot, randomized clinical trial: Left dorsolateral prefrontal cortex intermittent theta burst stimulation improves treatment outcomes in veterans with alcohol use disorder. ALCOHOL, CLINICAL & EXPERIMENTAL RESEARCH 2024; 48:164-177. [PMID: 38197808 DOI: 10.1111/acer.15224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 10/19/2023] [Accepted: 11/05/2023] [Indexed: 01/11/2024]
Abstract
BACKGROUND Transcranial magnetic stimulation (TMS) offers a promising treatment avenue to modulate brain function in alcohol use disorder (AUD). To the best of our knowledge, this pilot study is the first randomized, double-blind, sham-controlled trial to deliver intermittent theta burst stimulation to the left dorsolateral prefrontal cortex (DLPFC) among US veterans with AUD. We hypothesized that 20 sessions of real TMS are tolerable and feasible. As a secondary line of inquiry, we hypothesized that, relative to sham TMS, individuals receiving real TMS would experience greater reductions in 6-month relapse rates, anhedonia, and alcohol cue-reactivity. METHODS Veterans (n = 17, one woman) were enrolled in a double-blind, sham-controlled trial (2-3 sessions/day; 7-10 days; 600 pulses/session; 20 sessions). Pre- and posttreatment assessments included responses to self-report questionnaires and functional magnetic resonance imaging measures of alcohol cue-reactivity. Alcohol consumption was assessed for 6 months. Linear mixed-effects models were constructed to predict posttreatment craving, mood, and cue-reactivity. RESULTS Individuals who received active iTBS (n = 8) were less likely to relapse within 3 months after treatment than the sham-treated group (n = 9) (OR = 12.0). Greater reductions in anhedonia were observed following active iTBS (Cohen's d = -0.59), relative to sham (d = -0.25). Alcohol cue-reactivity was reduced following active iTBS and increased following sham within the left insula (d = -0.19 vs. 0.51), left thalamus (d = -0.28 vs. 0.77), right insula (d = 0.18 vs. 0.52), and right thalamus (d = -0.06 vs. 0.62). CONCLUSIONS Relative to sham, we demonstrate that 20 sessions of real left DLPFC iTBS reduced the likelihood of relapse for at least 3 months. The potential utility of this approach is underscored by observed decreases in anhedonia and alcohol cue-reactivity-strong predictors of relapse among veterans. These initial data offer a valuable set of effect sizes to inform future clinical trials in this patient population.
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Affiliation(s)
- Claudia B Padula
- Sierra Pacific Mental Illness Research Education and Clinical Center (MIRECC), Veterans Affairs Palo Alto Healthcare System, Palo Alto, California, USA
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California, USA
| | - Daniel M McCalley
- Sierra Pacific Mental Illness Research Education and Clinical Center (MIRECC), Veterans Affairs Palo Alto Healthcare System, Palo Alto, California, USA
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California, USA
| | - Lea-Tereza Tenekedjieva
- Sierra Pacific Mental Illness Research Education and Clinical Center (MIRECC), Veterans Affairs Palo Alto Healthcare System, Palo Alto, California, USA
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California, USA
| | - Kelly MacNiven
- Department of Psychology, Stanford University, Stanford, California, USA
| | - Andrew Rauch
- Department of Psychology, Loyola University Chicago, Chicago, Illinois, USA
| | - Jairelisse Morales Morales
- Sierra Pacific Mental Illness Research Education and Clinical Center (MIRECC), Veterans Affairs Palo Alto Healthcare System, Palo Alto, California, USA
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California, USA
| | - Brian Knutson
- Department of Psychology, Stanford University, Stanford, California, USA
| | - Keith Humphreys
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California, USA
- Center for Innovation to Implementation, Veterans Affairs Palo Alto Healthcare System, Menlo Park, California, USA
| | - Leanne M Williams
- Sierra Pacific Mental Illness Research Education and Clinical Center (MIRECC), Veterans Affairs Palo Alto Healthcare System, Palo Alto, California, USA
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California, USA
| | - Timothy C Durazzo
- Sierra Pacific Mental Illness Research Education and Clinical Center (MIRECC), Veterans Affairs Palo Alto Healthcare System, Palo Alto, California, USA
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California, USA
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Wang D, Yin Y, Yuan W, Li B, Wang H, Hu J, Chen M, Gong Y, Yuan TF, Yu T. Post-error slowing predicts for relapse in individuals with alcohol use disorder. J Psychiatr Res 2023; 161:441-448. [PMID: 37059028 DOI: 10.1016/j.jpsychires.2023.03.039] [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] [Received: 10/30/2022] [Revised: 03/09/2023] [Accepted: 03/27/2023] [Indexed: 04/16/2023]
Abstract
BACKGROUND Relapse characterizes addiction. The cognitive phenotype underlying relapse in individuals with alcohol use disorder (AUD) remain unelucidated. Here we aimed to investigate the potential changes in behavioral adjustment in AUD, and the association with relapse. METHOD Forty-seven subjects with AUD at Shandong Mental Health Center completed the stop-signal task, the PACS, the Beck Depression Inventory and the State-Trait anxiety questionnaires. Thirty age-matched male healthy subjects served as the control group (HC). In the follow-up, twenty-one subjects remained abstinent, while twenty-six subjects relapsed. Independent sample t-test was applied to measure differences between two groups and logistic regression analysis was conducted to explore the potential predictors on relapse. RESULTS The results showed that there were significant differences in stop signal reaction time (SSRT) and trigger failure between the AUD and HC groups. Relapsed group showed longer post-error slowing (PES) when compared to the non-relapsed group. The PES could predict relapse in alcohol use disorder. CONCLUSION Individuals with AUD showed impaired inhibitory control, which may predict relapse.
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Affiliation(s)
- Duanwei Wang
- Shandong Mental Health Center, Jinan, Shandong, China
| | - Yuanyuan Yin
- School of Mental Healthy, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Wei Yuan
- Shandong Mental Health Center, Jinan, Shandong, China
| | - Bin Li
- Shandong Mental Health Center, Jinan, Shandong, China
| | - Hairong Wang
- Shandong Mental Health Center, Jinan, Shandong, China
| | - Ji Hu
- School of Life Sciences, ShanghaiTech University, Shanghai, China
| | - Meng Chen
- Brain and Cognitive Neuroscience Research Center, Liaoning Normal University, Dalian, China
| | - Yuandong Gong
- Shandong Mental Health Center, Jinan, Shandong, China.
| | - Ti-Fei Yuan
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Co-Innovation Center of Neuroregeneration, Nantong University, Nantong, China.
| | - Tiangui Yu
- Shandong Mental Health Center, Jinan, Shandong, China.
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Martelli C, Artiges E, Miranda R, Romeo B, Petillion A, Aubin HJ, Amirouche A, Chanraud S, Benyamina A, Martinot JL. Caudate gray matter volumes and risk of relapse in Type A alcohol-dependent patients: A 7-year MRI follow-up study. Front Psychiatry 2023; 14:1067326. [PMID: 36873223 PMCID: PMC9975333 DOI: 10.3389/fpsyt.2023.1067326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 01/20/2023] [Indexed: 02/17/2023] Open
Abstract
BACKGROUND Whether alteration in regional brain volumes can be detected in Type A alcoholics both at baseline and after a long follow-up remains to be confirmed. Therefore, we examined volume alterations at baseline, and longitudinal changes in a small follow-up subsample. METHODS In total of 26 patients and 24 healthy controls were assessed at baseline using magnetic resonance imaging and voxel-based morphometry, among which 17 patients and 6 controls were re-evaluated 7 years later. At baseline, regional cerebral volumes of patients were compared to controls. At follow-up, three groups were compared: abstainers (n = 11, more than 2 years of abstinence), relapsers (n = 6, <2 years of abstinence), and controls (n = 6). RESULTS The cross-sectional analyses detected, at both times, higher caudate nuclei volumes bilaterally in relapsers compared to abstainers. In abstainers, the longitudinal analysis indicated recovery of normal gray matter volumes in the middle and inferior frontal gyrus, and in the middle cingulate, while white matter volumes recovery was detected in the corpus callosum and in anterior and superior white matter specific regions. CONCLUSIONS Overall, the present investigation revealed larger caudate nuclei in the relapser AUD patient group both at baseline and at follow-up in the cross-sectional analyses. This finding suggest that a higher caudate volume could be a candidate risk factor of relapse. In patients with specific type A alcohol-dependence, we showed that long-term recovery in fronto-striato-limbic GM and WM volumes occurs during long-term abstinence. These results support the crucial role of frontal circuitry in AUD.
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Affiliation(s)
- Catherine Martelli
- Institut National de la Santé et de la Recherche Médicale (INSERM) Research Unit 1299 "Trajectoires développementales en psychiatrie", École Normale Supérieure Paris-Saclay, Université Paris-Saclay, Centre National de la Recherche Scientifique (CNRS) 9010, Centre Borelli, Gif-sur-Yvette, France.,Department of Psychiatry and Addictology, Assistance Publique - Hôpitaux de Paris, Paul-Brousse Hospital, Villejuif, France.,Psychiatry-Comorbidities-Addictions Research Unit (PSYCOMADD), Paris-Saclay University, Gif-sur-Yvette, France
| | - Eric Artiges
- Institut National de la Santé et de la Recherche Médicale (INSERM) Research Unit 1299 "Trajectoires développementales en psychiatrie", École Normale Supérieure Paris-Saclay, Université Paris-Saclay, Centre National de la Recherche Scientifique (CNRS) 9010, Centre Borelli, Gif-sur-Yvette, France.,Department of Psychiatry, Établissement Public de Santé (EPS) Barthélemy Durand, Etampes, France
| | - Rubén Miranda
- Institut National de la Santé et de la Recherche Médicale (INSERM) Research Unit 1299 "Trajectoires développementales en psychiatrie", École Normale Supérieure Paris-Saclay, Université Paris-Saclay, Centre National de la Recherche Scientifique (CNRS) 9010, Centre Borelli, Gif-sur-Yvette, France.,Department of Psychiatry and Addictology, Assistance Publique - Hôpitaux de Paris, Paul-Brousse Hospital, Villejuif, France.,Psychiatry-Comorbidities-Addictions Research Unit (PSYCOMADD), Paris-Saclay University, Gif-sur-Yvette, France
| | - Bruno Romeo
- Department of Psychiatry and Addictology, Assistance Publique - Hôpitaux de Paris, Paul-Brousse Hospital, Villejuif, France.,Psychiatry-Comorbidities-Addictions Research Unit (PSYCOMADD), Paris-Saclay University, Gif-sur-Yvette, France
| | - Amélie Petillion
- Department of Psychiatry and Addictology, Assistance Publique - Hôpitaux de Paris, Paul-Brousse Hospital, Villejuif, France.,Psychiatry-Comorbidities-Addictions Research Unit (PSYCOMADD), Paris-Saclay University, Gif-sur-Yvette, France
| | - Henri-Jean Aubin
- Department of Psychiatry and Addictology, Assistance Publique - Hôpitaux de Paris, Paul-Brousse Hospital, Villejuif, France.,Institut National de la Santé et de la Recherche Médicale Research Unit 1018, Centre de Recherche en Epidémiologie et Santé des Populations (CESP), Paris, France
| | - Ammar Amirouche
- Department of Psychiatry and Addictology, Assistance Publique - Hôpitaux de Paris, Paul-Brousse Hospital, Villejuif, France.,Psychiatry-Comorbidities-Addictions Research Unit (PSYCOMADD), Paris-Saclay University, Gif-sur-Yvette, France
| | - Sandra Chanraud
- Paris Sciences & Lettres (PSL) Research University-École Pratique des Hautes Études (EPHE), Paris, France.,Institut de Neurosciences Cognitives et Intégratives d'Aquitaine (INCIA), Centre National de la Recherche Scientifique (CNRS), Unité Mixte de Recherche (UMR) 5287, University of Bordeaux, Bordeaux, France
| | - Amine Benyamina
- Department of Psychiatry and Addictology, Assistance Publique - Hôpitaux de Paris, Paul-Brousse Hospital, Villejuif, France.,Psychiatry-Comorbidities-Addictions Research Unit (PSYCOMADD), Paris-Saclay University, Gif-sur-Yvette, France
| | - Jean-Luc Martinot
- Institut National de la Santé et de la Recherche Médicale (INSERM) Research Unit 1299 "Trajectoires développementales en psychiatrie", École Normale Supérieure Paris-Saclay, Université Paris-Saclay, Centre National de la Recherche Scientifique (CNRS) 9010, Centre Borelli, Gif-sur-Yvette, France
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Kumar L, Skrzynski CJ, Creswell KG. Meta-analysis of associations between empathy and alcohol use and problems in clinical and non-clinical samples. Addiction 2022; 117:2793-2804. [PMID: 35546448 PMCID: PMC9796795 DOI: 10.1111/add.15941] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 04/13/2022] [Indexed: 01/07/2023]
Abstract
AIMS To (1) measure the aggregated effect size of empathy deficits in individuals with alcohol use disorder (AUD) compared with healthy controls, (2) measure the aggregated effect sizes for associations between lower empathy and heavier alcohol consumption and more alcohol problems in non-clinical samples and (3) identify potential moderators on the variability of effect sizes across studies in these meta-analyses. METHOD PsycINFO, PubMed and Google Scholar were searched following a pre-registered International Prospective Register of Systematic Reviews (PROSPERO) protocol (CRD42021225392) and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology. We meta-analyzed (using random-effects models) mean differences in empathy between individuals with AUD compared with healthy controls and associations between empathy and alcohol consumption and alcohol problems in non-clinical samples. A total of 714 participants were included in the meta-analysis on clinical samples; 3955 were included in the meta-analyses on non-clinical samples. RESULTS Individuals with AUD reported significantly lower empathy than healthy controls [Hedges' g = -0.53, 95% confidence interval (CI) = -0.91, -0.16, k = 9, P < 0.01, Q = 40.09, I2 = 80.04]. Study quality [Q = 1.88, degrees of freedom (d.f.) = 1, P = 0.17] and gender (β = -0.006, Z = -0.60, P = 0.55) were not moderators. Increases in age corresponded to an increase in effect size (β = 0.095, Z = 3.34, P < 0.001). Individuals with AUD (versus healthy controls) had significantly lower cognitive (Hedges' g = -0.44, CI = -0.79, -0.10, P < 0.05), but not affective empathy (Hedges' g = -0.19, CI = -0.51, 0.14, P = 0.27), and the difference between these was significant (Z = 2.34, k = 6, P < 0.01). In non-clinical samples, individuals with lower (versus higher) empathy reported heavier alcohol consumption (r = -0.12, CI = -0.15, -0.09, k = 11, P < 0.001, Q = 9.68, I2 = 0.00) and more alcohol problems (r = -0.08, CI = -0.14, -0.01, k = 7, P = 0.021, Q = 6.55, I2 = 8.34). There was no significant heterogeneity across studies. CONCLUSION Individuals with alcohol use disorder appear to show deficits in empathy compared with healthy controls. Deficits are particularly pronounced for older individuals and for cognitive (versus affective) empathy. In non-clinical samples, lower empathy appears to be associated with heavier alcohol consumption and more alcohol problems.
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Affiliation(s)
- Lakshmi Kumar
- Department of PsychologyCarnegie Mellon UniversityPittsburghPA
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7
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Kumar L, Skrzynski CJ, Creswell KG. Systematic review and meta-analysis on the association between theory of mind and alcohol problems in non-clinical samples. Alcohol Clin Exp Res 2022; 46:1944-1952. [PMID: 36117380 PMCID: PMC9722547 DOI: 10.1111/acer.14943] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 08/08/2022] [Accepted: 09/12/2022] [Indexed: 02/01/2023]
Abstract
BACKGROUND Deficits in theory of mind (ToM) found in individuals with alcohol use disorder (AUD) are often thought to result from prolonged heavy alcohol use. However, links between deficits in ToM and greater alcohol problems are often also present in non-clinical samples (e.g., adolescents and young adults) who may not have a similar long-lasting history of alcohol consumption as individuals with AUD. The current study is the first to systematically review and meta-analyze results from studies examining associations between lower ToM and greater alcohol problems in non-clinical samples. Evidence of reliable associations in these non-clinical samples would support the idea that deficits in ToM might also precede the emergence of AUD. METHODS PsycINFO, PubMed, and Google Scholar were searched according to our preregistered International Prospective Register of Systematic Reviews (PROSPERO) protocol (CRD42021225392) and following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology. We systematically reviewed sample characteristics and ToM measures in identified articles. We then meta-analyzed the findings of association between ToM and alcohol problems in non-clinical samples using random effects models. RESULTS Nearly all studies used a measure of ToM that assessed the ability to infer the mental states of others based on eye region cues. Meta-analytic results demonstrated that lower ToM was associated with more alcohol problems (r = -0.16, k = 6, CI = [-0.26, -0.04], p < 0.01, Q = 15.55, I2 = 67.85), and there was significant heterogeneity across studies. Gender (ß = 0.0003, CI = [-0.006, 0.007], z = 0.09, p = 0.93), age (ß = -0.008, CI = [-0.03, 0.01], z = -0.82, p = 0.42), and study quality (ß = -0.10, CI = [-0.35, 0.15], z = -0.82, p = 0.41) did not explain the heterogeneity. CONCLUSION In non-clinical samples, lower ToM is associated with more alcohol problems, indicative of a small effect size. Future longitudinal studies are needed to explore whether socio-cognitive deficits may also serve as a risk factor for alcohol misuse.
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Affiliation(s)
- Lakshmi Kumar
- Department of Psychology, Carnegie Mellon University, 5000 Forbes Avenue, Pittsburgh, PA, 15213, USA
| | - Carillon J. Skrzynski
- Department of Psychology and Neuroscience, University of Colorado Boulder, 1600 Pleasant St., Boulder, CO, 80309, USA
| | - Kasey G. Creswell
- Department of Psychology, Carnegie Mellon University, 5000 Forbes Avenue, Pittsburgh, PA, 15213, USA
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8
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Carlon HA, Hurlocker MC, Witkiewitz K. Mechanisms of quality-of-life improvement in treatment for alcohol use disorder. J Consult Clin Psychol 2022; 90:601-612. [PMID: 36066862 PMCID: PMC9899433 DOI: 10.1037/ccp0000750] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE For individuals in alcohol use disorder (AUD) treatment, many argue that holistic indicators such as quality of life (QoL) should be more consistently used in addition to drinking-related indicators. QoL increases from pre- to post-AUD treatment, but the mechanisms are unclear. The present study examined the roles of positive and negative affect in QoL change during AUD treatment and additionally explored the relationship between QoL change and medication adherence. METHOD We examined the mediating roles of end-of-treatment positive affect (i.e., vigor) and negative affect (i.e., stress and tension) in the relationship between baseline (BL) and 26-week QoL among participants in the Combined Pharmacotherapies and Behavioral Interventions for Alcohol Dependence study randomized to medication management (MM; n = 468) or medication management plus combined behavioral intervention (MMCBI; n = 479) for AUD. We also explored whether changes in QoL were associated with medication adherence. RESULTS Change in psychological health QoL was mediated by increased vigor (i.e., positive affect) and decreased stress, and change in environmental QoL was mediated by decreased stress. There were also differences by treatment group, with stress mediating changes in environmental QoL among participants in MM, and vigor mediating changes in psychological health QoL among participants in MMCBI. Medication adherence was not associated with greater QoL after controlling for posttreatment alcohol use. CONCLUSIONS The present study identified potential mechanisms of QoL change in AUD treatment, thus contributing to the growing knowledge surrounding alternative indicators of treatment success for AUD treatment and recovery. Targeting affective states and stress during treatment may improve QoL and recovery outcomes for persons with AUD. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Affiliation(s)
- Hannah A. Carlon
- Center on Alcohol, Substance Use, and Addictions, University of New Mexico, Department of Psychology, Albuquerque, NM, 87131, USA
| | - Margo C. Hurlocker
- Center on Alcohol, Substance Use, and Addictions, University of New Mexico, Department of Psychology, Albuquerque, NM, 87131, USA
| | - Katie Witkiewitz
- Center on Alcohol, Substance Use, and Addictions, University of New Mexico, Department of Psychology, Albuquerque, NM, 87131, USA
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9
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Bollen Z, Dormal V, Maurage P. How Should Transcranial Direct Current Stimulation be Used in Populations With Severe Alcohol Use Disorder? A Clinically Oriented Systematic Review. Clin EEG Neurosci 2022; 53:367-383. [PMID: 33733871 DOI: 10.1177/15500594211001212] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Background and rationale. Severe alcohol use disorder (SAUD) is a major public health concern, given its massive individual, interpersonal, and societal consequences. The available prevention and treatment programs have proven limited effectiveness, as relapse rates are still high in this clinical population. Developing effective interventions reducing the appearance and persistence of SAUD thus constitutes an experimental and clinical priority. Among the new therapeutic approaches, there is a growing interest for noninvasive neuromodulation techniques, and particularly for transcranial direct current stimulation (tDCS) as an adjunctive treatment in neuropsychiatric disorders, including SAUD. Methods. We propose a systematic review, based on preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines, evaluating the available evidence on the effectiveness of tDCS to improve clinical interventions in SAUD. Results. We provide an integrative overview of studies applying tDCS in clinical populations with SAUD, together with a standardized methodological quality assessment. We show that the currently available data remain inconsistent. Some data suggested that tDCS can (1) reduce craving, relapse or alcohol-cue reactivity and (2) improve cognitive control and inhibition. However, other studies did not observe any beneficial effect of tDCS in SAUD. Conclusions. Capitalizing on the identified strengths and shortcomings of available results, we present evidence-based clinical guidelines to integrate tDCS in current clinical settings and to combine it with neurocognitive training.
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Affiliation(s)
- Zoé Bollen
- Louvain Experimental Psychopathology Research Group (LEP), Psychological Science Research Institute, 83415UCLouvain, Louvain-la-Neuve, Belgium
| | - Valérie Dormal
- Louvain Experimental Psychopathology Research Group (LEP), Psychological Science Research Institute, 83415UCLouvain, Louvain-la-Neuve, Belgium
| | - Pierre Maurage
- Louvain Experimental Psychopathology Research Group (LEP), Psychological Science Research Institute, 83415UCLouvain, Louvain-la-Neuve, Belgium
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10
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Haywood D, Baughman FD, Mullan BA, Heslop KR. What Accounts for the Factors of Psychopathology? An Investigation of the Neurocognitive Correlates of Internalising, Externalising, and the p-Factor. Brain Sci 2022; 12:421. [PMID: 35447951 PMCID: PMC9030002 DOI: 10.3390/brainsci12040421] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 03/11/2022] [Accepted: 03/20/2022] [Indexed: 11/16/2022] Open
Abstract
Neurocognitive deficits have been consistently associated with a wide range of psychopathology and are proposed to not only be a consequence of the development of psychopathology but also directly involved in its aetiology. However, there is no clear understanding of what neurocognitive processes are particularly important to mental health. In this paper, we explored the association between neurocognitive abilities and the factors derived from structural models of psychopathology. Four hundred participants from a representative community sample completed measures of symptomology and substance use, as well as 8 neurocognitive tasks. We found a correlated-factors model, with internalising and externalising as the higher-order factors, and a single-factor model with only the p-factor, to be good fits for the data. Tasks that measured the speed of processing were significantly associated with internalising, externalising, and the p-factor, and accounted for significant amounts of unique variance in the factors after accounting for the common variance of the other tasks. Tasks that measured working memory, shifting, and inhibition were not significantly associated with psychopathology factors. Our findings suggest that neurocognitive abilities may not be differentially associated with psychopathology factors, but that speed of processing is a common correlate of the factors. We emphasise the importance of examining neurocognitive abilities and psychopathology on the individual level.
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Affiliation(s)
- Darren Haywood
- Discipline of Psychology, School of Population Health, Curtin University, Perth 6845, Australia or (D.H.); (F.D.B.)
- Mental Health, St. Vincent’s Hospital, Melbourne 3065, Australia
| | - Frank D. Baughman
- Discipline of Psychology, School of Population Health, Curtin University, Perth 6845, Australia or (D.H.); (F.D.B.)
| | - Barbara A. Mullan
- Discipline of Psychology, School of Population Health, Curtin University, Perth 6845, Australia or (D.H.); (F.D.B.)
| | - Karen R. Heslop
- Curtin School of Nursing, Curtin University, Perth 6845, Australia;
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11
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Padula CB, Tenekedjieva LT, McCalley DM, Al-Dasouqi H, Hanlon CA, Williams LM, Kozel FA, Knutson B, Durazzo TC, Yesavage JA, Madore MR. Targeting the Salience Network: A Mini-Review on a Novel Neuromodulation Approach for Treating Alcohol Use Disorder. Front Psychiatry 2022; 13:893833. [PMID: 35656355 PMCID: PMC9152026 DOI: 10.3389/fpsyt.2022.893833] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 04/11/2022] [Indexed: 11/24/2022] Open
Abstract
Alcohol use disorder (AUD) continues to be challenging to treat despite the best available interventions, with two-thirds of individuals going on to relapse by 1 year after treatment. Recent advances in the brain-based conceptual framework of addiction have allowed the field to pivot into a neuromodulation approach to intervention for these devastative disorders. Small trials of repetitive transcranial magnetic stimulation (rTMS) have used protocols developed for other psychiatric conditions and applied them to those with addiction with modest efficacy. Recent evidence suggests that a TMS approach focused on modulating the salience network (SN), a circuit at the crossroads of large-scale networks associated with AUD, may be a fruitful therapeutic strategy. The anterior insula or dorsal anterior cingulate cortex may be particularly effective stimulation sites given emerging evidence of their roles in processes associated with relapse.
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Affiliation(s)
- Claudia B Padula
- Mental Illness Research Education and Clinical Center, VA Palo Alto Health Care System, Palo Alto, CA, United States.,Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, United States
| | - Lea-Tereza Tenekedjieva
- Mental Illness Research Education and Clinical Center, VA Palo Alto Health Care System, Palo Alto, CA, United States.,Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, United States
| | - Daniel M McCalley
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, United States.,Department of Neurosciences, Medical University of South Carolina, Charleston, SC, United States
| | - Hanaa Al-Dasouqi
- Mental Illness Research Education and Clinical Center, VA Palo Alto Health Care System, Palo Alto, CA, United States
| | - Colleen A Hanlon
- Department of Cancer Biology, Wake Forest School of Medicine, Winston-Salem, NC, United States
| | - Leanne M Williams
- Mental Illness Research Education and Clinical Center, VA Palo Alto Health Care System, Palo Alto, CA, United States.,Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, United States
| | - F Andrew Kozel
- Department of Behavioral Sciences and Social Medicine, Florida State University College of Medicine, Florida State University, Tallahassee, FL, United States
| | - Brian Knutson
- Department of Psychology, Stanford University, Stanford, CA, United States
| | - Timothy C Durazzo
- Mental Illness Research Education and Clinical Center, VA Palo Alto Health Care System, Palo Alto, CA, United States.,Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, United States
| | - Jerome A Yesavage
- Mental Illness Research Education and Clinical Center, VA Palo Alto Health Care System, Palo Alto, CA, United States.,Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, United States
| | - Michelle R Madore
- Mental Illness Research Education and Clinical Center, VA Palo Alto Health Care System, Palo Alto, CA, United States.,Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, United States
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12
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Raabe FJ, Wagner E, Weiser J, Brechtel S, Popovic D, Adorjan K, Pogarell O, Hoch E, Koller G. Classical blood biomarkers identify patients with higher risk for relapse 6 months after alcohol withdrawal treatment. Eur Arch Psychiatry Clin Neurosci 2021; 271:891-902. [PMID: 32627047 PMCID: PMC8236027 DOI: 10.1007/s00406-020-01153-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 06/16/2020] [Indexed: 11/30/2022]
Abstract
This naturalistic study among patients with alcohol dependence examined whether routine blood biomarkers could help to identify patients with high risk for relapse after withdrawal treatment. In a longitudinal study with 6-month follow-up among 133 patients with alcohol dependence who received inpatient alcohol withdrawal treatment, we investigated the usefulness of routine blood biomarkers and clinical and sociodemographic factors for potential outcome prediction and risk stratification. Baseline routine blood biomarkers (gamma-glutamyl transferase [GGT], alanine aminotransferase [ALT/GPT], aspartate aminotransferase [AST/GOT], mean cell volume of erythrocytes [MCV]), and clinical and sociodemographic characteristics were recorded at admission. Standardized 6 months' follow-up assessed outcome variables continuous abstinence, days of continuous abstinence, daily alcohol consumption and current abstinence. The combined threshold criterion of an AST:ALT ratio > 1.00 and MCV > 90.0 fl helped to identify high-risk patients. They had lower abstinence rates (P = 0.001), higher rates of daily alcohol consumption (P < 0.001) and shorter periods of continuous abstinence (P = 0.027) compared with low-risk patients who did not meet the threshold criterion. Regression analysis confirmed our hypothesis that the combination criterion is an individual baseline variable that significantly predicted parts of the respective outcome variances. Routinely assessed indirect alcohol biomarkers help to identify patients with high risk for relapse after alcohol withdrawal treatment. Clinical decision algorithms to identify patients with high risk for relapse after alcohol withdrawal treatment could include classical blood biomarkers in addition to clinical and sociodemographic items.
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Affiliation(s)
- Florian J Raabe
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Nussbaumstrasse 7, 80336, Munich, Germany.
- International Max Planck Research School for Translational Psychiatry (IMPRS-TP), Kraepelinstrasse 2-10, 80804, Munich, Germany.
| | - Elias Wagner
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Nussbaumstrasse 7, 80336, Munich, Germany
| | - Judith Weiser
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Nussbaumstrasse 7, 80336, Munich, Germany
| | - Sarah Brechtel
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Nussbaumstrasse 7, 80336, Munich, Germany
| | - David Popovic
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Nussbaumstrasse 7, 80336, Munich, Germany
- International Max Planck Research School for Translational Psychiatry (IMPRS-TP), Kraepelinstrasse 2-10, 80804, Munich, Germany
| | - Kristina Adorjan
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Nussbaumstrasse 7, 80336, Munich, Germany
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Nussbaumstrasse 7, 80336, Munich, Germany
| | - Oliver Pogarell
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Nussbaumstrasse 7, 80336, Munich, Germany
| | - Eva Hoch
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Nussbaumstrasse 7, 80336, Munich, Germany
- Division of Clinical Psychology and Psychological Treatment, Department of Psychology, LMU Munich, Leopoldstrasse 13, 80802, Munich, Germany
| | - Gabriele Koller
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Nussbaumstrasse 7, 80336, Munich, Germany
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13
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Durazzo TC, Meyerhoff DJ. Changes of frontal cortical subregion volumes in alcohol dependent individuals during early abstinence: associations with treatment outcome. Brain Imaging Behav 2021; 14:1588-1599. [PMID: 31197582 DOI: 10.1007/s11682-019-00089-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
We previously reported that at 1-and-4 weeks of sobriety, those who relapsed after treatment demonstrated significantly smaller total frontal cortical volume than individuals who maintained abstinence for at least 12 months post treatment. The segmentation method employed did not permit examination of frontal subregions that serve as nodes of the executive, salience and emotional regulation networks; structural abnormalities in these circuits are associated with relapse in those seeking treatment for alcohol use disorders (AUD). The primary goal of this study was to determine if frontal cortical subregion volume recovery during early abstinence is associated with long-term abstinence from alcohol. We compared bilateral components of the dorsal prefrontal cortex, orbitofrontal cortex, anterior cingulate cortex and insula volumes, at 1 and 4 weeks of abstinence, between individuals who resumed drinking within 12 months of treatment (Relapsers) those who showed sustained abstinence over 12 months following treatment (Abstainers) and healthy Controls. At 1 and 4 weeks of sobriety, Relapsers demonstrated significantly smaller volumes than Controls in 15 of 20 regions of interest, while Abstainers only had smaller volumes than Controls in 5 of 20 regions. In Relapsers, increasing volumes over 1 month in multiple frontal subregions and the insula were associated with longer duration of abstinence after treatment. The persistent bilateral frontal and insula volume deficits in Relapsers over 4 weeks from last alcohol use may have implications for neurostimulation methods targeting anterior frontal/insula regions, and represent an endophenotype that differentiates those who respond more favorably to available psychosocial and pharmacological interventions.
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Affiliation(s)
- Timothy C Durazzo
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA.
- Mental Illness Research and Education Clinical Centers (151Y) and Sierra-Pacific War Related Illness and Injury Study Centers, VA Palo Alto Health Care System, 3801 Miranda Ave, Palo Alto, CA, 94304, USA.
| | - Dieter J Meyerhoff
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA
- Center for Imaging of Neurodegenerative Diseases, San Francisco VA Medical Center, San Francisco, CA, USA
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14
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Pervin Z, Stephen JM. Effect of alcohol on the central nervous system to develop neurological disorder: pathophysiological and lifestyle modulation can be potential therapeutic options for alcohol-induced neurotoxication. AIMS Neurosci 2021; 8:390-413. [PMID: 34183988 PMCID: PMC8222771 DOI: 10.3934/neuroscience.2021021] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 03/01/2021] [Indexed: 12/06/2022] Open
Abstract
The central nervous system (CNS) is the major target for adverse effects of alcohol and extensively promotes the development of a significant number of neurological diseases such as stroke, brain tumor, multiple sclerosis (MS), Alzheimer's disease (AD), and amyotrophic lateral sclerosis (ALS). Excessive alcohol consumption causes severe neuro-immunological changes in the internal organs including irreversible brain injury and it also reacts with the defense mechanism of the blood-brain barrier (BBB) which in turn leads to changes in the configuration of the tight junction of endothelial cells and white matter thickness of the brain. Neuronal injury associated with malnutrition and oxidative stress-related BBB dysfunction may cause neuronal degeneration and demyelination in patients with alcohol use disorder (AUD); however, the underlying mechanism still remains unknown. To address this question, studies need to be performed on the contributing mechanisms of alcohol on pathological relationships of neurodegeneration that cause permanent neuronal damage. Moreover, alcohol-induced molecular changes of white matter with conduction disturbance in neurotransmission are a likely cause of myelin defect or axonal loss which correlates with cognitive dysfunctions in AUD. To extend our current knowledge in developing a neuroprotective environment, we need to explore the pathophysiology of ethanol (EtOH) metabolism and its effect on the CNS. Recent epidemiological studies and experimental animal research have revealed the association between excessive alcohol consumption and neurodegeneration. This review supports an interdisciplinary treatment protocol to protect the nervous system and to improve the cognitive outcomes of patients who suffer from alcohol-related neurodegeneration as well as clarify the pathological involvement of alcohol in causing other major neurological disorders.
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Affiliation(s)
- Zinia Pervin
- Department of Biomedical Engineering, University of New Mexico, Albuquerque, NM 87131, USA
| | - Julia M Stephen
- The Mind Research Network and Lovelace Biomedical and Environmental Research Institute, Albuquerque, NM 87106, USA
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15
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Januszko P, Gmaj B, Piotrowski T, Kopera M, Klimkiewicz A, Wnorowska A, Wołyńczyk-Gmaj D, Brower KJ, Wojnar M, Jakubczyk A. Delta resting-state functional connectivity in the cognitive control network as a prognostic factor for maintaining abstinence: An eLORETA preliminary study. Drug Alcohol Depend 2021; 218:108393. [PMID: 33158664 DOI: 10.1016/j.drugalcdep.2020.108393] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 10/11/2020] [Accepted: 10/26/2020] [Indexed: 12/28/2022]
Abstract
BACKGROUND Cortical regions that support cognitive control are increasingly well recognized, but the functional mechanisms that promote such control over emotional and behavioral hyperreactivity to alcohol in recently abstinent alcohol-dependent patients are still insufficiently understood. This study aimed to identify neurophysiological biomarkers of maintaining abstinence in alcohol-dependent individuals after alcohol treatment by investigating the resting-state EEG-based functional connectivity in the cognitive control network (CCN). METHODS Lagged phase synchronization between CCN areas by means of eLORETA as well as the Barratt Impulsiveness Scale (BIS-11) and Beck Depression Inventory (BDI) were assessed in abstinent alcohol-dependent patients recruited from treatment centers. A preliminary prospective study design was used to classify participants into those who did and did not maintain abstinence during a follow-up period (median 12 months) after discharge from residential treatment. RESULTS Alcohol-dependent individuals, who maintained abstinence (N = 18), showed significantly increased lagged phase synchronization between the left dorsolateral prefrontal cortex (DLPFC) and the left posterior parietal cortex (IPL) as well as between the right anterior insula cortex/frontal operculum (IA/FO) and the right inferior frontal junction (IFJ) in the delta band compared to those who later relapsed (N = 16). Regression analysis showed that the increased left frontoparietal delta connectivity in the early period of abstinence significantly predicted maintaining abstinence over the ensuing 12 months. Furthermore, right frontoinsular delta connectivity correlated negatively with impulsivity and depression measures. CONCLUSIONS These results suggest that the increased delta resting-state functional connectivity in the CCN may be a promising neurophysiological predictor of maintaining abstinence in individuals with alcohol dependence.
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Affiliation(s)
- Piotr Januszko
- Department of Psychiatry, Medical University of Warsaw, Nowowiejska 27, 00-665 Warsaw, Poland
| | - Bartłomiej Gmaj
- Department of Psychiatry, Medical University of Warsaw, Nowowiejska 27, 00-665 Warsaw, Poland.
| | - Tadeusz Piotrowski
- Department of Psychiatry, Medical University of Warsaw, Nowowiejska 27, 00-665 Warsaw, Poland
| | - Maciej Kopera
- Department of Psychiatry, Medical University of Warsaw, Nowowiejska 27, 00-665 Warsaw, Poland
| | - Anna Klimkiewicz
- Department of Psychiatry, Medical University of Warsaw, Nowowiejska 27, 00-665 Warsaw, Poland
| | - Anna Wnorowska
- Department of Psychiatry, Medical University of Warsaw, Nowowiejska 27, 00-665 Warsaw, Poland
| | - Dorota Wołyńczyk-Gmaj
- Department of Psychiatry, Medical University of Warsaw, Nowowiejska 27, 00-665 Warsaw, Poland
| | - Kirk J Brower
- Department of Psychiatry, Addiction Center, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Marcin Wojnar
- Department of Psychiatry, Medical University of Warsaw, Nowowiejska 27, 00-665 Warsaw, Poland; Department of Psychiatry, Addiction Center, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Andrzej Jakubczyk
- Department of Psychiatry, Medical University of Warsaw, Nowowiejska 27, 00-665 Warsaw, Poland
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16
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Desfosses M, Meadows H, Jackson M, Crowe SF. The Relationship Between Neuropsychological Functioning and Mental Health Outcomes of Chronic Alcohol Users Involved in Counselling: Prediction of Treatment Outcome. AUSTRALIAN PSYCHOLOGIST 2020. [DOI: 10.1111/ap.12071] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Melissa Desfosses
- School of Psychological Science, Faculty of Science, Technology and Engineering, La Trobe University,
| | - Holly Meadows
- School of Psychological Science, Faculty of Science, Technology and Engineering, La Trobe University,
| | - Martin Jackson
- School of Psychological Science, Faculty of Science, Technology and Engineering, La Trobe University,
| | - Simon F Crowe
- School of Psychological Science, Faculty of Science, Technology and Engineering, La Trobe University,
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17
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Predicting relapse after alcohol use disorder treatment in a high-risk cohort: The roles of anhedonia and smoking. J Psychiatr Res 2020; 126:1-7. [PMID: 32403028 PMCID: PMC8476113 DOI: 10.1016/j.jpsychires.2020.04.003] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 03/05/2020] [Accepted: 04/17/2020] [Indexed: 12/15/2022]
Abstract
On average, two-thirds of individuals treated for alcohol use disorder (AUD) relapse within six months. There is a critical need to identify modifiable risk factors associated with relapse that can be addressed during AUD treatment. Candidate factors include mood disorders and cigarette smoking, which frequently co-occur with AUD. We predicted that co-occurrence of mood disorders, cigarette smoking, and other modifiable conditions will predict relapse within six months of AUD treatment. Ninety-five Veterans, 23-91 years old, completed assessments of multiple characteristics including demographic information, co-occurring psychiatric disorders, and medical conditions during residential treatment for AUD. Participants' alcohol consumption was monitored over six months after participation. Logistic regression was used to determine if, mood disorders, cigarette smoking status, alcohol consumption, educational level, and comorbid general medical conditions are associated with relapse after AUD treatment. Sixty-nine percent of Veterans (n = 66) relapsed within six months of study while 31% remained abstinent (n = 29). While education, comorbid general medical conditions, and mood disorder diagnoses were not predictors of relapse, Veterans with greater symptoms of anhedonia, active smokers, and fewer days of abstinence prior to treatment showed significantly greater odds for relapse within six months. Anhedonia and cigarette smoking are modifiable risk factors, and effective treatment of underlying anhedonic symptoms and implementation of smoking cessation concurrent with AUD-focused interventions may decrease risk of relapse.
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18
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Durazzo TC, Nguyen LC, Meyerhoff DJ. Medical Conditions Linked to Atherosclerosis Are Associated With Magnified Cortical Thinning in Individuals With Alcohol Use Disorders. Alcohol Alcohol 2020; 55:382-390. [PMID: 32445335 PMCID: PMC7307314 DOI: 10.1093/alcalc/agaa034] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 03/19/2020] [Accepted: 04/09/2020] [Indexed: 01/21/2023] Open
Abstract
AIMS Magnetic resonance imaging (MRI) studies report widespread cortical thinning in individuals with alcohol use disorder (AUD), but did not consider potential effects of pro-atherogenic conditions such as hypertension, type 2 diabetes mellitus, hepatitis C seropositivity and hyperlipidemia on cortical thickness. The conditions are associated with regional cortical thinning in those without AUD. We predicted that individuals with concurrent AUD and pro-atherogenic conditions demonstrate the greatest regional cortical thinning in areas most vulnerable to decreased perfusion. METHODS Treatment-seeking individuals with AUD (n = 126) and healthy controls (CON; n = 49) completed a 1.5 T MRI study. Regional cortical thickness was quantitated via FreeSurfer. Individuals with AUD and pro-atherogenic conditions (Atherogenic+), AUD without pro-atherogenic conditions (Atherogenic-) and CON were compared on regional cortical thickness. RESULTS Individuals with AUD showed significant bilateral cortical thinning compared to CON, but Atherogenic+ demonstrated the most widespread and greatest magnitude of regional thinning, while Atherogenic- had reduced thickness primarily in anterior frontal and posterior parietal lobes. Atherogenic+ also showed a thinner cortex than Atherogenic- in lateral orbitofrontal and dorso/dorsolateral frontal cortex, mesial and lateral temporal and inferior parietal regions. CONCLUSIONS Our results demonstrate significant bilateral cortical thinning in individuals with AUD relative to CON, but the distribution and magnitude were influenced by comorbid pro-atherogenic conditions. The magnitude of cortical thinning in Atherogenic+ strongly corresponded to cortical watershed areas susceptible to decreased perfusion, which may result in morphometric abnormalities. The findings indicate that pro-atherogenic conditions may contribute to cortical thinning in those seeking treatment for AUD.
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Affiliation(s)
- Timothy C Durazzo
- Mental Illness Research and Education Clinical Centers, VA Palo Alto Health Care System, Palo Alto, CA, USA
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Linh-Chi Nguyen
- Mental Illness Research and Education Clinical Centers, VA Palo Alto Health Care System, Palo Alto, CA, USA
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Dieter J Meyerhoff
- Center for Imaging of Neurodegenerative Diseases (CIND), San Francisco VA Medical Center, San Francisco, CA, USA
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA
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19
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Durazzo TC, Meyerhoff DJ. Cigarette smoking history is associated with poorer recovery in multiple neurocognitive domains following treatment for an alcohol use disorder. Alcohol 2020; 85:135-143. [PMID: 31923562 PMCID: PMC8751294 DOI: 10.1016/j.alcohol.2019.12.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Revised: 12/17/2019] [Accepted: 12/22/2019] [Indexed: 12/17/2022]
Abstract
Cigarette smoking is associated with neurocognitive dysfunction in various populations, including those seeking treatment for an alcohol use disorder (AUD). This study compared the rate and extent of recovery on measures of processing speed, executive functions, general intelligence, visuospatial skills and working memory in treatment-seeking alcohol dependent individuals (ALC) who were never-smokers (nvsALC), former-smoker (fsALC), and active smokers (asALC), over approximately 8 months of abstinence from alcohol. Methods: ALC participants were evaluated at approximately 1 month of abstinence (AP1; n = 132) and reassessed after 8 months of sobriety (AP2; n = 54). Never-smoking controls (CON; n = 33) completed a baseline and follow-up (n = 19) assessment approximately 9 months later. Domains evaluated were executive functions, general intelligence, processing speed, visuospatial skills and working memory; a domain composite was formed from the arithmetic average of the foregoing domains. nvsALC showed greater improvement than fsALC, asALC and CON on most domains over the AP1-AP2 interval. fsALC demonstrated greater recovery than asALC on all domains except visuospatial skills; fsALC also showed greater improvements than CON on general intelligence, working memory and domain composite. asALC did not show significant improvement on any domain over the AP1-AP2 interval. At 8 months of abstinence, asALC were inferior to CON and nvsALC on multiple domains, fsALC performed worse than nvsALC on several domains, but nvsALC were not different from CON on any domain. Our results provide robust evidence that smoking status influenced the rate and extent of neurocognitive recovery between 1 and 8 months of abstinence in this ALC cohort. Chronic smoking in AUD likely contributes to the considerable heterogeneity observed in neurocognitive recovery during extended abstinence. The findings provide additional strong support for the benefits of smoking cessation and the increasing clinical movement to offer smoking cessation resources concurrent with treatment for AUD.
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Affiliation(s)
- Timothy C Durazzo
- Mental Illness Research and Education Clinical Centers, VA Palo Alto Health Care System, San Francisco, CA, USA; Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicinecisco, San Francisco, CA, USA.
| | - Dieter J Meyerhoff
- Center for Imaging of Neurodegenerative Diseases (CIND), San Francisco VA Medical Center, San Francisco, CA, USA; Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA
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20
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Morley KC, Lagopoulos J, Logge W, Chitty K, Moustafa AA, Haber PS. Brain N-Acetyl Aspartate and associations with cognitive impairment in alcohol dependent patients. J Clin Exp Neuropsychol 2019; 42:111-117. [DOI: 10.1080/13803395.2019.1685078] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Kirsten C. Morley
- NHMRC Centre of Research Excellence in Mental Health and Substance Use, Central Clinical School, Sydney Medical School, University of Sydney, Sydney, Australia
| | - Jim Lagopoulos
- Sunshine Coast Mind and Neuroscience – Thompson Institute, University of Sunshine Coast, Maroochydore, Australia
| | - Warren Logge
- NHMRC Centre of Research Excellence in Mental Health and Substance Use, Central Clinical School, Sydney Medical School, University of Sydney, Sydney, Australia
| | - Kate Chitty
- School of Pharmacology, Sydney Medical School, University of Sydney, Sydney, Australia
| | - Ahmed A. Moustafa
- School of Social Sciences and Psychology, Western Sydney University, Sydney, Australia
| | - Paul S. Haber
- NHMRC Centre of Research Excellence in Mental Health and Substance Use, Central Clinical School, Sydney Medical School, University of Sydney, Sydney, Australia
- Drug Health Services, Royal Prince Alfred Hospital, Sydney, Australia
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21
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Zou Y, Murray DE, Durazzo TC, Schmidt TP, Murray TA, Meyerhoff DJ. White matter microstructural correlates of relapse in alcohol dependence. Psychiatry Res Neuroimaging 2018; 281:92-100. [PMID: 30273793 PMCID: PMC6204088 DOI: 10.1016/j.pscychresns.2018.09.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2017] [Revised: 09/14/2018] [Accepted: 09/14/2018] [Indexed: 12/15/2022]
Abstract
Identification of neural correlates of relapse to alcohol after treatment is clinically important as it may inform better substance abuse treatment. Few studies have specifically analyzed the white matter microstructure in treatment seekers as it might relate to relapse risk versus long-term abstinence. Using 4 Tesla diffusion tensor imaging, we compared two groups of one-month-abstinent treatment-seekers, who were classified based on their drinking status between six and nine months after treatment initiation. We hypothesized that subsequent relapsers had greater white matter microstructural deficits in specific brain regions than long-term abstainers. At one month of abstinence, 37 future relapsers versus 25 future abstainers had lower fractional anisotropy (a measure of axonal organization and membrane integrity) in the corpus callosum and right stria terminalis/fornix, higher diffusivity in the genu of the corpus callosum, left and right stria terminalis/fornix, and lower diffusivity in left anterior corona radiata. These differences existed despite similar lifetime and recent drinking and smoking histories in the groups. Longer smoking duration in relapsers was associated with lower fractional anisotropy in right stria terminalis/fornix. The study identified specific microstructural biomarkers of alcohol relapse risk in adults, contributing to the definition of a neurobiological relapse risk profile in alcohol use disorder.
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Affiliation(s)
- Yukai Zou
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN 47906, United States; College of Veterinary Medicine, Purdue University, West Lafayette, IN 47906, United States
| | - Donna E Murray
- Center for Imaging of Neurodegenerative Diseases (CIND), San Francisco VA Medical Center, San Francisco, CA 94121, United States; Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA 94143, United States
| | - Timothy C Durazzo
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA 94305, United States; Mental Illness Research Mental Illness Research and Education Clinical Centers, Sierra-Pacific War Related Illness and Injury Study Center, VA Palo Alto Health Care System, Palo Alto, CA 94304, United States
| | - Thomas P Schmidt
- Center for Imaging of Neurodegenerative Diseases (CIND), San Francisco VA Medical Center, San Francisco, CA 94121, United States
| | - Troy A Murray
- Center for Imaging of Neurodegenerative Diseases (CIND), San Francisco VA Medical Center, San Francisco, CA 94121, United States
| | - Dieter J Meyerhoff
- Center for Imaging of Neurodegenerative Diseases (CIND), San Francisco VA Medical Center, San Francisco, CA 94121, United States; Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA 94143, United States.
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22
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Psychiatric comorbidities associated with a positive screening using the Montreal Cognitive Assessment (MoCA) test in subjects with severe alcohol use disorder. Drug Alcohol Depend 2018; 191:266-269. [PMID: 30153608 DOI: 10.1016/j.drugalcdep.2018.07.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Revised: 07/03/2018] [Accepted: 07/09/2018] [Indexed: 11/21/2022]
Abstract
BACKGROUND Patients with severe alcohol use disorder (SAUD) frequently show cognitive deficits that can be efficiently identified using screening tools such as the Montreal Cognitive Assessment (MoCA) test. These cognitive deficits, which reduce the efficacy of therapeutic interventions and may contribute to dropout and relapse, could be, however, partly due to a treatable other cause. Accordingly, this exploratory study examined whether psychiatric comorbid disorders can induce a positive MoCA screening among recently detoxified SAUD subjects. METHODS One hundred recently detoxified patients with SAUD were divided into two groups according to whether they presented cognitive deficits using the MoCA. Groups were compared for demographic data, SAUD severity, impulsivity, and psychiatric comorbidities. The significant parameters were then introduced in a logistic regression model to establish their relative contributions in a positive MoCA status in SAUD subjects. RESULTS Among the significant parameters revealed by the bivariable analyses, agoraphobia and current depressive episode were found to be significant predictors of the MoCA status in the multivariable comparisons. CONCLUSIONS A positive MoCA screening for cognitive impairments among post-detoxification SAUD patients could also be related to comorbid agoraphobia and depressive episode rather than to SAUD itself. A comprehensive psychiatric assessment must be performed in SAUD patients so that other potential causes of cognitive deficits, in particular with regard to mood and anxiety disorders, can be identified and treated.
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Schulte T, Jung YC, Sullivan EV, Pfefferbaum A, Serventi M, Müller-Oehring EM. The neural correlates of priming emotion and reward systems for conflict processing in alcoholics. Brain Imaging Behav 2017; 11:1751-1768. [PMID: 27815773 PMCID: PMC5418124 DOI: 10.1007/s11682-016-9651-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Emotional dysregulation in alcoholism (ALC) may result from disturbed inhibitory mechanisms. We therefore tested emotion and alcohol cue reactivity and inhibitory processes using negative priming. To test the neural correlates of cue reactivity and negative priming, 26 ALC and 26 age-matched controls underwent functional MRI performing a Stroop color match-to-sample task. In cue reactivity trials, task-irrelevant emotion and alcohol-related pictures were interspersed between color samples and color words. In negative priming trials, pictures primed the semantic content of an alcohol or emotion Stroop word. Behaviorally, both groups showed response facilitation to picture cue trials and response inhibition to primed trials. For cue reactivity to emotion and alcohol pictures, ALC showed midbrain-limbic activation. By contrast, controls activated frontoparietal executive control regions. Greater midbrain-hippocampal activation in ALC correlated with higher amounts of lifetime alcohol consumption and higher anxiety. With negative priming, ALC exhibited frontal cortical but not midbrain-hippocampal activation, similar to the pattern observed in controls. Higher frontal activation to alcohol-priming correlated with less craving and to emotion-priming with fewer depressive symptoms. The findings suggest that neurofunctional systems in ALC can be primed to deal with upcoming emotion- and alcohol-related conflict and can overcome the prepotent midbrain-limbic cue reactivity response.
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Affiliation(s)
- T Schulte
- Neuroscience Program, Biosciences Division, SRI International, Menlo Park, CA, 94025-3493, USA.
- Pacific Graduate School of Psychology, Palo Alto University, Palo Alto, CA, USA.
| | - Y-C Jung
- Deptartment of Psychiatry & Beh. Sci, Stanford University, Stanford, CA, USA
- Department of Psychiatry, Yonsei University College of Medicine, Seoul, South Korea
| | - E V Sullivan
- Deptartment of Psychiatry & Beh. Sci, Stanford University, Stanford, CA, USA
| | - A Pfefferbaum
- Neuroscience Program, Biosciences Division, SRI International, Menlo Park, CA, 94025-3493, USA
- Deptartment of Psychiatry & Beh. Sci, Stanford University, Stanford, CA, USA
| | - M Serventi
- Neuroscience Program, Biosciences Division, SRI International, Menlo Park, CA, 94025-3493, USA
- Deptartment of Psychiatry & Beh. Sci, Stanford University, Stanford, CA, USA
| | - E M Müller-Oehring
- Neuroscience Program, Biosciences Division, SRI International, Menlo Park, CA, 94025-3493, USA
- Deptartment of Psychiatry & Beh. Sci, Stanford University, Stanford, CA, USA
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24
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Rupp CI, Derntl B, Osthaus F, Kemmler G, Fleischhacker WW. Impact of Social Cognition on Alcohol Dependence Treatment Outcome: Poorer Facial Emotion Recognition Predicts Relapse/Dropout. Alcohol Clin Exp Res 2017; 41:2197-2206. [DOI: 10.1111/acer.13522] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Accepted: 10/02/2017] [Indexed: 11/28/2022]
Affiliation(s)
- Claudia I. Rupp
- Department of Psychiatry, Psychotherapy, and Psychosomatics; Division of Psychiatry I; Medical University Innsbruck; Innsbruck Austria
| | - Birgit Derntl
- Department of Psychiatry and Psychotherapy; Medical University Tübingen; Tübingen Germany
- Werner Reichardt Center for Integrative Neuroscience; University of Tübingen; Tübingen Germany
- LEAD Graduate School; University of Tübingen; Tübingen Germany
| | - Friederike Osthaus
- Department of Psychiatry, Psychotherapy, and Psychosomatics; Division of Psychiatry I; Medical University Innsbruck; Innsbruck Austria
| | - Georg Kemmler
- Department of Psychiatry, Psychotherapy, and Psychosomatics; Division of Psychiatry I; Medical University Innsbruck; Innsbruck Austria
| | - W. Wolfgang Fleischhacker
- Department of Psychiatry, Psychotherapy, and Psychosomatics; Division of Psychiatry I; Medical University Innsbruck; Innsbruck Austria
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25
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Durazzo TC, Mon A, Gazdzinski S, Meyerhoff DJ. Regional brain volume changes in alcohol-dependent individuals during early abstinence: associations with relapse following treatment. Addict Biol 2017; 22:1416-1425. [PMID: 27329647 DOI: 10.1111/adb.12420] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Revised: 04/26/2016] [Accepted: 05/13/2016] [Indexed: 12/15/2022]
Abstract
Cross-sectional structural magnetic resonance (MR) imaging studies of individuals with an alcohol use disorder (AUD) report that those who relapse after treatment, relative to individuals who maintain a period of extended abstinence, show greater morphological abnormalities in multiple brain regions near the inception of treatment, particularly in the frontal lobe. However, given the cross-sectional design of previous studies, it is unclear if the baseline morphological differences between future abstainers and relapsers were maintained over the course of early recovery. The primary goal of this study was to determine if frontal lobe tissue volume recovery during early abstinence is associated with long-term abstinence from alcohol. We compared frontal, parietal, temporal and occipital grey matter (GM) and white matter (WM) volumes, at 1 and 4 weeks of abstinence, among individuals who resumed alcohol consumption within 12 months of treatment (Relapsers) and those who showed sustained abstinence over 12 months following treatment (Abstainers). At 1 and 4 weeks of sobriety, both Abstainers and Relapsers demonstrated significantly smaller GM volumes than Controls in the majority of ROIs, but Relapsers exhibited significantly smaller bilateral frontal GM volumes than Abstainers. No significant group differences were observed for any WM region of interest. The persistent bilateral frontal GM volume deficits in Relapsers over 4 weeks from last alcohol use may represent an endophenotype that differentiates those who respond more favorably to the typical psychosocial and pharmacological interventions provided for AUD.
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Affiliation(s)
- Timothy C. Durazzo
- Department of Psychiatry and Behavioral Sciences; Stanford University School of Medicine; USA
- Mental Illness Research and Education Clinical Centers and Sierra-Pacific War Related Illness and Injury Study Center; VA Palo Alto Health Care System; USA
| | - Anderson Mon
- Department of Biomedical Engineering; School of Engineering Sciences University of Ghana; Legon Ghana
| | | | - Dieter J. Meyerhoff
- Department of Radiology and Biomedical Imaging; University of California; San Francisco USA
- Center for Imaging of Neurodegenerative Diseases; San Francisco VA Medical Center; USA
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26
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Coccaro EF, Keedy SK, Gorka SM, King AC, Fanning JR, Lee RJ, Phan KL. Differential fMRI BOLD responses in amygdala in intermittent explosive disorder as a function of past Alcohol Use Disorder. Psychiatry Res Neuroimaging 2016; 257:5-10. [PMID: 27693977 PMCID: PMC6323646 DOI: 10.1016/j.pscychresns.2016.09.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Revised: 09/01/2016] [Accepted: 09/06/2016] [Indexed: 11/25/2022]
Abstract
BACKGROUND Individuals with intermittent explosive disorder (IED) were previously found to exhibit amygdala (AMYG) hyperactivation to anger faces during functional magnetic resonance imaging (fMRI). However, acute alcohol consumption, and/or life history of alcoholism, may blunt amygdala responses to negative emotional stimuli. Thus, we examined the influence of a past history of DSM-5 Alcohol Use Disorder (AUD) on the fMRI BOLD AMYG response to anger faces in IED. METHOD Forty-two IED participants, 18 with a past history of AUD (IED+AUD) and 24 without Past AUD (IED), and 32 healthy control (HC) participants, underwent fMRI scanning while viewing blocks of angry, fearful, and happy faces. RESULTS Compared to HC and IED+AUD participants, IED subjects exhibited greater AMYG responses to angry, but not to fear or happy, faces in the left AMYG. There were no group differences in responses to anger, fear, or happy, faces in the OFC. CONCLUSION These findings suggest the possibility of a longstanding effect of AUD on AMYG response in IED to anger-related stimuli and highlight the possibility that history of AUD should be considered as an important factor in the interpretation of fMRI studies involving the AMYG response to negative emotional stimuli.
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Affiliation(s)
- Emil F Coccaro
- Department of Psychiatry and Behavioral Neuroscience, the University of Chicago, Chicago, IL, USA.
| | - Sarah K Keedy
- Department of Psychiatry and Behavioral Neuroscience, the University of Chicago, Chicago, IL, USA
| | - Stephanie M Gorka
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA
| | - Andrea C King
- Department of Psychiatry and Behavioral Neuroscience, the University of Chicago, Chicago, IL, USA
| | - Jennifer R Fanning
- Department of Psychiatry and Behavioral Neuroscience, the University of Chicago, Chicago, IL, USA
| | - Royce J Lee
- Department of Psychiatry and Behavioral Neuroscience, the University of Chicago, Chicago, IL, USA
| | - K Luan Phan
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA; Mental Health Service Line, Jesse Brown VA Medical Center, Chicago, IL, USA
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27
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Durazzo TC, Meyerhoff DJ. Psychiatric, Demographic, and Brain Morphological Predictors of Relapse After Treatment for an Alcohol Use Disorder. Alcohol Clin Exp Res 2016; 41:107-116. [PMID: 27883214 DOI: 10.1111/acer.13267] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Accepted: 10/14/2016] [Indexed: 02/04/2023]
Abstract
BACKGROUND Relapse in alcohol use disorders (AUD) is related to a complex interplay among multiple biological, psychiatric, psychological, and psychosocial factors, which may change dynamically during and after treatment. At treatment entry for AUD, morphological abnormalities in anterior frontal regions and the insula have been observed in those who ultimately relapse following treatment. The goal of this study was to determine whether anterior frontal and insula measures of brain thickness, surface area, and volume predict posttreatment drinking status (i.e., relapser or abstainer) over an extended period after outpatient treatment for AUD, while concurrently considering common psychiatric, psychological, and psychosocial factors previously associated with relapse. METHODS Alcohol-dependent individuals (n = 129) were followed for 18 months after treatment to determine posttreatment drinking status (abstainers [n = 47] or relapsers [n = 82]). Brain morphometrics were derived from FreeSurfer. Receiver operating characteristic (ROC) curve analysis was used to identify the regional brain thickness, surface area, and volume (all scaled to intracranial volume), demographic, psychiatric, other substance use (e.g., cigarette smoking), and alcohol consumption variables, obtained at entry into treatment, that best predicted posttreatment drinking status. Survival analyses determined variables that were related to duration of abstinence after treatment. RESULTS ROC analyses indicated that mood disorders, education, and volumes of the right caudal anterior cingulate cortex (ACC), right rostral ACC, and total right frontal gray matter were significant predictors of posttreatment drinking status. Among relapsers, survival analyses showed smokers and individuals with a comorbid medical condition relapsed earlier after treatment. Additionally, a greater frequency of smokers relapsed within 6 months of AUD treatment. CONCLUSIONS Results reinforce that relapse in AUD is a function of multiple biological, psychiatric, psychological, and psychosocial factors. Effective treatment of depressive disorders and cigarette smoking concurrent with AUD-focused interventions may promote better treatment outcomes.
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Affiliation(s)
- Timothy C Durazzo
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California.,Mental Illness Research and Education Clinical Centers and Sierra-Pacific War Related Illness and Injury Study Center, VA Palo Alto Health Care System, Palo Alto, California
| | - Dieter J Meyerhoff
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California.,Center for Imaging of Neurodegenerative Diseases, San Francisco VA Medical Center, San Francisco, California
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28
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Nixon SJ, Prather R, Lewis B. Sex differences in alcohol-related neurobehavioral consequences. HANDBOOK OF CLINICAL NEUROLOGY 2016; 125:253-72. [PMID: 25307580 DOI: 10.1016/b978-0-444-62619-6.00016-1] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
In this chapter, we review existing research regarding sex differences in alcohol's effects on neurobehavioral functions/processes. Drawn largely from laboratory studies, literature regarding acute alcohol administration and chronic alcohol misuse is explored focusing on commonly employed neuropsychologic domains (e.g., executive function, visuospatial skills, learning and memory, gait and balance), neurophysiologic measures (e.g., electroencephalography and event-related potentials), and structural and functional neuroimaging (e.g., magnetic resonance imaging (MRI), functional MRI, diffusion tensor imaging, positron emission tomography, and magnetic resonance spectroscopy). To provide a historical perspective on the development of these questions, we have included reference to early and more recent research. Additionally, specific biases, knowledge gaps, and continuing controversies are noted.
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Affiliation(s)
- Sara Jo Nixon
- Department of Psychiatry, University of Florida, Gainesville, FL, USA; Department of Psychology, University of Florida, Gainesville, FL, USA.
| | - Robert Prather
- Department of Psychiatry, University of Florida, Gainesville, FL, USA
| | - Ben Lewis
- Department of Psychiatry, University of Florida, Gainesville, FL, USA
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29
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Zahr NM, Carr RA, Rohlfing T, Mayer D, Sullivan EV, Colrain IM, Pfefferbaum A. Brain metabolite levels in recently sober individuals with alcohol use disorder: Relation to drinking variables and relapse. Psychiatry Res 2016; 250:42-49. [PMID: 27035062 PMCID: PMC5426815 DOI: 10.1016/j.pscychresns.2016.01.015] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2015] [Revised: 01/05/2016] [Accepted: 01/14/2016] [Indexed: 11/23/2022]
Abstract
Magnetic resonance spectroscopy (MRS) studies in alcohol use disorder (AUD) typically report lower levels of N-acetylaspartate (NAA) and choline-containing compounds (Cho) in several brain regions. Metabolite levels, however, are labile and can be affected by several competing factors, some related to drinking variables.. This in vivo MRS study included 20 recently sober (19.6±12.6 days) individuals with AUD and 15 controls. MRS was performed in single voxels placed in frontal white matter and thalamic regions using Constant-Time Point Resolved Spectroscopy (CT-PRESS) for absolute quantification of NAA, Cho, total creatine (tCr), and glutamate (Glu). A trend toward a thalamic NAA deficit in the total AUD group compared with controls was attributable to the subgroup of alcoholics who relapsed 3 or so months after scanning. In the total AUD group, frontal and thalamic NAA and Cho levels were lower with more recent drinking; frontal and thalamic Cho levels were also lower in AUD individuals with past stimulant abuse. Thalamic Cho levels were higher in binge-drinking AUD individuals and in those with longer length of alcohol dependence. MRS-visible metabolite peaks appear to be modulated by variables related to drinking behaviors, suggesting a sensitivity of MRS in tracking and predicting the dynamic course of alcoholism.
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Affiliation(s)
- Natalie M Zahr
- Psychiatry & Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Road, Stanford, CA 94305, USA; Center for Health Sciences, SRI International, Menlo Park, CA 94025, USA.
| | - Rebecca A Carr
- Center for Health Sciences, SRI International, Menlo Park, CA 94025, USA
| | - Torsten Rohlfing
- Center for Health Sciences, SRI International, Menlo Park, CA 94025, USA
| | - Dirk Mayer
- Center for Health Sciences, SRI International, Menlo Park, CA 94025, USA; Diagnostic Radiology and Nuclear Medicine, University of Maryland, School of Medicine, Baltimore, MD 21201, USA
| | - Edith V Sullivan
- Psychiatry & Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Road, Stanford, CA 94305, USA
| | - Ian M Colrain
- Center for Health Sciences, SRI International, Menlo Park, CA 94025, USA
| | - Adolf Pfefferbaum
- Psychiatry & Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Road, Stanford, CA 94305, USA; Center for Health Sciences, SRI International, Menlo Park, CA 94025, USA
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30
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[Alcohol-related neuropsychological impairments: Nature, impact and detection]. Presse Med 2016; 45:1124-1132. [PMID: 27039333 DOI: 10.1016/j.lpm.2016.01.030] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2015] [Revised: 01/15/2016] [Accepted: 01/20/2016] [Indexed: 01/13/2023] Open
Abstract
Alcohol-related neuropsychological deficits result from chronic and excessive alcohol consumption and are associated with structural and functional damage of Papez's circuit and frontocerebellar circuit. Alcohol-related cognitive deficits are heterogeneous but especially affect executive functions and memory abilities. They result in difficulties to change alcohol behavior combined with a tendency for patients to overestimate their capacity to succeed. Alcohol-related cognitive deficits could be a risk-factor for relapse since they hamper patients to benefit fully from treatment (especially when based on relapse prevention). Screening tools usable by non-psychologists are available and can be completed by an extensive neuropsychological examination conducted by a neuropsychologist when necessary. Alcohol treatment should be adjusted to take alcohol-related cognitive deficits into account, by promoting longer treatment in healthy environment for example. Improvements of alcohol treatment options, including specific neuropsychological rehabilitation, are required for patients with persistent alcohol-related cognitive deficits.
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31
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Li W, Zhu J, Li Q, Ye J, Chen J, Liu J, Li Z, Li Y, Yan X, Wang Y, Wang W. Brain white matter integrity in heroin addicts during methadone maintenance treatment is related to relapse propensity. Brain Behav 2016; 6:e00436. [PMID: 27110449 PMCID: PMC4834937 DOI: 10.1002/brb3.436] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2015] [Revised: 09/06/2015] [Accepted: 12/16/2015] [Indexed: 12/12/2022] Open
Abstract
INTRODUCTION Cognitive deficits caused by heroin-induced white matter (WM) impairments hinder addicts' engagement in and benefit from treatment. The predictive value of WM integrity in heroin addicts during methadone maintenance treatment (MMT) for future relapse is unclear. METHODS Forty-eight MMT patients were given baseline diffusion tensor imaging scans and divided into heroin relapsers (HR, 25 cases) and abstainers (HA, 23 cases) according to the results of 6-month follow-up. Intergroup comparisons were performed for fractional anisotropy (FA), radial diffusivity (RD), and axial diffusivity (AD). The correlation between diffusion tensor imaging indices and the degree of heroin relapse was analyzed. RESULTS Compared with HA group, HR group had reduced FA in the right retrolenticular part, left anterior and posterior limb of internal capsule, bilateral anterior corona radiata, and right external capsule. Three out of the six regions showed increased RD, with no changes in AD. The FA and AD values in the left posterior limb of internal capsule correlated negatively with the heroin-positive urinalysis rate within follow-up. CONCLUSIONS Lower WM integrity in MMT patients may add to neurobiological factors associated with relapse to heroin use. Strategies for improving WM integrity provide a new perspective to prevent future relapse to heroin abuse.
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Affiliation(s)
- Wei Li
- Department of Radiology Tangdu Hospital The Fourth Military Medical University Xi'an Shaanxi China
| | - Jia Zhu
- Department of Radiology Tangdu Hospital The Fourth Military Medical University Xi'an Shaanxi China
| | - Qiang Li
- Department of Radiology Tangdu Hospital The Fourth Military Medical University Xi'an Shaanxi China
| | - Jianjun Ye
- Department of Radiology Tangdu Hospital The Fourth Military Medical University Xi'an Shaanxi China
| | - Jiajie Chen
- Department of Radiology Tangdu Hospital The Fourth Military Medical University Xi'an Shaanxi China
| | - Jierong Liu
- Department of Radiology Tangdu Hospital The Fourth Military Medical University Xi'an Shaanxi China
| | - Zhe Li
- Department of Radiology Tangdu Hospital The Fourth Military Medical University Xi'an Shaanxi China
| | - Yongbin Li
- Department of Radiology Tangdu Hospital The Fourth Military Medical University Xi'an Shaanxi China
| | - Xuejiao Yan
- Department of Radiology Tangdu Hospital The Fourth Military Medical University Xi'an Shaanxi China
| | - Yarong Wang
- Department of Radiology Tangdu Hospital The Fourth Military Medical University Xi'an Shaanxi China
| | - Wei Wang
- Department of Radiology Tangdu Hospital The Fourth Military Medical University Xi'an Shaanxi China
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32
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Manning V, Teo HC, Guo S, Wong KE, Li TK. Neurocognitive Functioning and Treatment Outcome Following Detoxification Among Asian Alcohol-Dependent Inpatients. Subst Use Misuse 2016; 51:193-205. [PMID: 26771240 DOI: 10.3109/10826084.2015.1092985] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND The prevalence of alcohol use disorders in Asia is increasing and relapse among treated populations remains the norm, not the exception. The extent to which cognitive impairment influences clinical outcome remains unclear, with research dominated by studies of Caucasian populations. OBJECTIVES This study examines behavioral and self-reported cognitive functioning in detoxified alcohol-dependent (AD) patients in Singapore and its association with outcome. METHODS The cognitive performance of 30 recently-detoxified AD inpatients and 30 demographically-matched controls was compared using visuospatial memory, working memory, set-shifting, planning and reflection impulsivity tests of the CANTAB®, and self-reported dysexecutive symptoms and everyday cognitive difficulties. Patients' alcohol use and self-reported cognitive functioning were reassessed 3-months post-discharge. RESULTS Compared to matched controls, AD inpatients exhibited significantly poorer fluid intelligence, visuospatial memory, working memory, set-shifting flexibility and planning/organization, but not reflection impulsivity. In support of Western studies, a significant proportion (three-quarters) were "clinically impaired" on subtests. Significant reductions were observed in alcohol units, frequency and dependency scores at follow-up, though improvements in self-reported cognitive functioning were limited to abstainers. Baseline cognitive performance did not differentiate those who had abstained from alcohol and relapsed at follow-up. CONCLUSIONS/IMPORTANCE Memory and executive functioning impairments were evident among Asian AD patients alongside self-reported cognitive difficulties, thus cognitively demanding psychological interventions may have limited impact during early detoxification. Future studies can build on these findings, with larger samples and measurement of moderating and mediating factors to extend our understanding of how cognitive impairment influences outcome.
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Affiliation(s)
- Victoria Manning
- a Institute of Mental Health, National Addictions Management Service , Singapore , Singapore.,b Turning Point, Eastern Health , Melbourne , Australia.,c Eastern Health Clinical School , Monash University , Melbourne , Australia
| | - Hui Chin Teo
- a Institute of Mental Health, National Addictions Management Service , Singapore , Singapore
| | - Song Guo
- a Institute of Mental Health, National Addictions Management Service , Singapore , Singapore
| | - Kim Eng Wong
- a Institute of Mental Health, National Addictions Management Service , Singapore , Singapore
| | - Ting-Kai Li
- d Department of Psychiatry , Duke University , Durham , North Carolina , USA
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33
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Durazzo TC, Mon A, Gazdzinski S, Yeh PH, Meyerhoff DJ. Serial longitudinal magnetic resonance imaging data indicate non-linear regional gray matter volume recovery in abstinent alcohol-dependent individuals. Addict Biol 2015; 20:956-67. [PMID: 25170881 DOI: 10.1111/adb.12180] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
The trajectory of regional volume changes during the first year of sustained abstinence in those recovering from an alcohol use disorder is unclear because previous research typically employed only two assessment points. To better understand the trajectory of regional brain volume recovery in treatment-seeking alcohol-dependent individuals (ALC), regional brain volumes were measured after 1 week, 1 month and 7.5 months of sustained abstinence via magnetic resonance imaging at 1.5 T. ALC showed significant volume increases in frontal, parietal and occipital gray matter (GM) and white matter (WM), total cortical GM and total lobar WM, thalamus and cerebellum, and decreased ventricular volume over 7.5 months of abstinence. Volume increases in regional GM were significantly greater over 1 week to 1 month than from 1 month to 7.5 months of abstinence, indicating a non-linear rate of change in regional GM over 7.5 months. Overall, regional lobar WM showed linear volume increases over 7.5 months. With increasing age, smoking ALC showed lower frontal and total cortical GM volume recovery than non-smoking ALC. Despite significant volume increases, ALC showed smaller GM volumes in all regions, except the frontal cortex, than controls after 7.5 months of abstinence. ALC and controls showed no regional WM volume differences at any assessment point. In non-smoking ALC only, increasing regional GM and WM volumes were related to improving processing speed. Findings may indicate a differential rate of recovery of cell types/cellular components contributing to GM and WM volume during early abstinence, and that GM volume deficits persist after 7.5 months of sustained sobriety in this ALC cohort.
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Affiliation(s)
- Timothy C. Durazzo
- Center for Imaging of Neurodegenerative Diseases (CIND); San Francisco VA Medical Center; San Francisco CA USA
- Department of Radiology and Biomedical Imaging; University of California San Francisco; San Francisco CA USA
| | - Anderson Mon
- Center for Imaging of Neurodegenerative Diseases (CIND); San Francisco VA Medical Center; San Francisco CA USA
- Department of Radiology and Biomedical Imaging; University of California San Francisco; San Francisco CA USA
| | - Stefan Gazdzinski
- Center for Imaging of Neurodegenerative Diseases (CIND); San Francisco VA Medical Center; San Francisco CA USA
- Department of Radiology and Biomedical Imaging; University of California San Francisco; San Francisco CA USA
| | - Ping-Hong Yeh
- Center for Imaging of Neurodegenerative Diseases (CIND); San Francisco VA Medical Center; San Francisco CA USA
- Department of Radiology and Biomedical Imaging; University of California San Francisco; San Francisco CA USA
| | - Dieter J. Meyerhoff
- Center for Imaging of Neurodegenerative Diseases (CIND); San Francisco VA Medical Center; San Francisco CA USA
- Department of Radiology and Biomedical Imaging; University of California San Francisco; San Francisco CA USA
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Alhassoon OM, Sorg SF, Stern MJ, Hall MG, Wollman SC. Neuroimaging in alcohol-use disorders: clinical implications and future directions. FUTURE NEUROLOGY 2015. [DOI: 10.2217/fnl.15.17] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Advances in clinical research have led to significant alterations in diagnostic criteria for alcohol-use disorders (AUD). Neuroimaging techniques are now being called upon to shed light on the validity and clinical utility of diagnostic criteria. For example, craving has recently been added to the diagnostic criteria of AUD based mainly on neurobiological research. In addition to understanding the nuances of the craving process, neuroimaging techniques are helping determine the biological factors that contribute to the onset and maintenance of the disorder and offer insight into the mechanisms underlying treatment. The purpose of this review is to provide a clinically relevant summary of the neuroimaging research that has impacted our understanding of the etiology, treatment and recovery in AUD.
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Affiliation(s)
- Omar M Alhassoon
- California School of Professional Psychology, Clinical Psychology PhD Program, 10455 Pomerado Road, San Diego, CA 92131, USA
- Department of Psychiatry, University of California, 9500 Gilman Dr, La Jolla, San Diego, CA 92093, USA
| | - Scott F Sorg
- Department of Psychiatry, University of California, 9500 Gilman Dr, La Jolla, San Diego, CA 92093, USA
| | - Mark J Stern
- California School of Professional Psychology, Clinical Psychology PhD Program, 10455 Pomerado Road, San Diego, CA 92131, USA
| | - Matthew G Hall
- California School of Professional Psychology, Clinical Psychology PhD Program, 10455 Pomerado Road, San Diego, CA 92131, USA
| | - Scott C Wollman
- California School of Professional Psychology, Clinical Psychology PhD Program, 10455 Pomerado Road, San Diego, CA 92131, USA
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Whittom A, Villarreal A, Soni M, Owusu-Duku B, Meshram A, Rajkowska G, Stockmeier CA, Miguel-Hidalgo JJ. Markers of apoptosis induction and proliferation in the orbitofrontal cortex in alcohol dependence. Alcohol Clin Exp Res 2015; 38:2790-9. [PMID: 25421516 DOI: 10.1111/acer.12559] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2014] [Accepted: 08/29/2014] [Indexed: 11/30/2022]
Abstract
BACKGROUND Alcohol-dependent (ALC) subjects exhibit glial and neuronal pathology in the prefrontal cortex (PFC). However, in many patients, neurophysiological disturbances are not associated with catastrophic cell depletion despite prolonged alcohol abuse. It is still unclear how some relevant markers of a cell's propensity to degenerate or proliferate are changed in the PFC of ALC subjects without major neurological disorders. METHODS Levels of pro-apoptotic caspase 8 (C8), X-linked inhibitor of apoptosis protein (XIAP), direct IAP binding protein with low pI (DIABLO), proliferating cell nuclear antigen (PCNA), and density of cells immunoreactive for proliferation marker Ki-67 (Ki-67-IR) were measured postmortem in the left orbitofrontal cortex (OFC) of 29 subjects with alcohol dependence and 23 nonpsychiatric comparison subjects. RESULTS Alcohol subjects had significantly higher levels of the 14 kDa C8 fragment (C8-14), an indicator of C8 activation. However, there was no change in the levels of DIABLO, XIAP, or in the DIABLO/XIAP ratio. PCNA protein level and density of Ki-67-IR cells were not significantly changed in alcoholics, although PCNA levels were increased in older ALC subjects as compared to controls. CONCLUSIONS Significant increase of a C8 activation indicator was found in alcoholism, but without significant changes in XIAP level, DIABLO/XIAP ratio, or Ki-67 labeling. These results would help to explain the absence of catastrophic cell loss in the PFC of many Brigman subjects, while still being consistent with an alcoholism-related vulnerability to slow decline in glial cells and neurons in the OFC of alcoholics.
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Affiliation(s)
- Angela Whittom
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, Mississippi
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Silverstein PS, Kumar S, Kumar A. HIV-1, HCV and alcohol in the CNS: potential interactions and effects on neuroinflammation. Curr HIV Res 2015; 12:282-92. [PMID: 25053363 DOI: 10.2174/1570162x12666140721122956] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2014] [Revised: 06/01/2014] [Accepted: 06/01/2014] [Indexed: 01/01/2023]
Abstract
Approximately 25% of the HIV-1 positive population is also infected with HCV. The effects of alcohol on HIV-1 or HCV infection have been a research topic of interest due to the high prevalence of alcohol use in these infected patient populations. Although it has long been known that HIV-1 infects the brain, it has only been a little more than a decade since HCV infection of the CNS has been characterized. Both viruses are capable of infecting and replicating in microglia and increasing the expression of proinflammatory cytokines and chemokines, including IL-6 and IL-8. Investigations focusing on the effects of HIV-1, HCV or alcohol on neuroinflammation have demonstrated that these agents are capable of acting through overlapping signaling pathways, including MAPK signaling molecules. In addition, HIV-1, HCV and alcohol have been demonstrated to increase permeability of the blood-brain barrier. Patients infected with either HIV-1 or HCV, or those who use alcohol, exhibit metabolic abnormalities in the CNS that result in altered levels of n-acetyl aspartate, choline and creatine in various regions of the brain. Treatment of HIV/HCV co-infection in alcohol users is complicated by drug-drug interactions, as well as the effects of alcohol on drug metabolism. The drug-drug interactions between the antiretrovirals and the antivirals, as well as the effects of alcohol on drug metabolism, complicate existing models of CNS penetration, making it difficult to assess the efficacy of treatment on CNS infection.
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Affiliation(s)
| | | | - Anil Kumar
- Division of Pharmacology and Toxicology, School of Pharmacy, University of Missouri-Kansas City, Kansas City, MO 64108, USA.
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Kose S, Steinberg JL, Moeller FG, Gowin JL, Zuniga E, Kamdar ZN, Schmitz JM, Lane SD. Neural correlates of impulsive aggressive behavior in subjects with a history of alcohol dependence. Behav Neurosci 2015; 129:183-96. [PMID: 25664566 DOI: 10.1037/bne0000038] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Alcohol-related aggression is a complex and problematic phenomenon with profound public health consequences. We examined neural correlates potentially moderating the relationship between human aggressive behavior and chronic alcohol use. Thirteen subjects meeting DSM-IV criteria for past alcohol-dependence in remission (AD) and 13 matched healthy controls (CONT) participated in an fMRI study adapted from a laboratory model of human aggressive behavior (Point Subtraction Aggression Paradigm, or PSAP). Blood oxygen level dependent (BOLD) activation was measured during bouts of operationally defined aggressive behavior, during postprovocation periods, and during monetary-reinforced behavior. Whole brain voxelwise random-effects analyses found group differences in brain regions relevant to chronic alcohol use and aggressive behavior (e.g., emotional and behavioral control). Behaviorally, AD subjects responded on both the aggressive response and monetary response options at significantly higher rates than CONT. Whole brain voxelwise random-effects analyses revealed significant group differences in response to provocation (monetary subtractions), with CONT subjects showing greater activation in frontal and prefrontal cortex, thalamus, and hippocampus. Collapsing data across all subjects, regression analyses of postprovocation brain activation on aggressive response rate revealed significant positive regression slopes in precentral gyrus and parietal cortex; and significant negative regression slopes in orbitofrontal cortex, prefrontal cortex, caudate, thalamus, and middle temporal gyrus. In these collapsed analyses, response to provocation and aggressive behavior were associated with activation in brain regions subserving inhibitory and emotional control, sensorimotor integration, and goal directed motor activity.
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Affiliation(s)
- Samet Kose
- Department of Psychiatry, University of Texas Medical School at Houston
| | - Joel L Steinberg
- Institute for Drug and Alcohol Studies, Virginia Commonwealth University School of Medicine
| | - F Gerard Moeller
- Institute for Drug and Alcohol Studies, Virginia Commonwealth University School of Medicine
| | - Joshua L Gowin
- Intramural Research Program, National Institute on Alcohol Abuse and Alcoholism
| | - Edward Zuniga
- Institute for Drug and Alcohol Studies, Virginia Commonwealth University School of Medicine
| | | | - Joy M Schmitz
- Department of Psychiatry, University of Texas Medical School at Houston
| | - Scott D Lane
- Department of Psychiatry, University of Texas Medical School at Houston
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Flórez G, Saiz PA, García-Portilla P, De Cos FJ, Dapía S, Alvarez S, Nogueiras L, Bobes J. Predictors of posttreatment drinking outcomes in patients with alcohol dependence. Eur Addict Res 2015; 21:19-30. [PMID: 25358471 DOI: 10.1159/000358194] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2013] [Accepted: 12/23/2013] [Indexed: 11/19/2022]
Abstract
AIM This cohort study examined how predictors of alcohol dependence treatment outcomes work together over time by comparing pretreatment and posttreatment predictors. METHODS A sample of 274 alcohol-dependent patients was recruited and assessed at baseline, 6 months after treatment initiation (end of the active intervention phase), and 18 months after treatment initiation (end of the 12-month research follow-up phase). At each assessment point, the participants completed a battery of standardized tests [European Addiction Severity Index (EuropASI), Obsessive Compulsive Drinking Scale (OCDS), Alcohol Timeline Followback (TLFB), Fagerström, and International Personality Disorder Examination (IPDE)] that measured symptom severity and consequences; biological markers of alcohol consumption were also tested at each assessment point. A sequential strategy with univariate and multivariate analyses was used to identify how pretreatment and posttreatment predictors influence outcomes up to 1 year after treatment. RESULTS Pretreatment variables had less predictive power than posttreatment ones. OCDS scores and biological markers of alcohol consumption were the most significant variables for the prediction of posttreatment outcomes. Prior pharmacotherapy treatment and relapse prevention interventions were also associated with posttreatment outcomes. CONCLUSIONS The findings highlight the positive impact of pharmacotherapy during the first 6 months after treatment initiation and of relapse prevention during the first year after treatment and how posttreatment predictors are more important than pretreatment predictors.
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Affiliation(s)
- Gerardo Flórez
- Addiction Treatment Unit, Department of Psychiatry CHUO, Galician Health System, Ourense, Spain
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Trick L, Kempton MJ, Williams SCR, Duka T. Impaired fear recognition and attentional set-shifting is associated with brain structural changes in alcoholic patients. Addict Biol 2014; 19:1041-54. [PMID: 25123156 PMCID: PMC4282104 DOI: 10.1111/adb.12175] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
Alcoholic patients with multiple detoxifications/relapses show cognitive and emotional deficits. We performed structural magnetic resonance imaging and examined performance on a cognitive flexibility task (intra-extradimensional set shift and reversal; IED). We also presented subjects with fearful, disgust and anger facial emotional expressions. Participants were abstaining, multiply detoxified (MDTx; n = 12) or singly detoxified patients (SDTx; n = 17) and social drinker controls (n = 31). Alcoholic patients were less able than controls to change their behavior in accordance with the changing of the rules in the IED and they were less accurate in recognizing fearful expressions in particular. They also showed lower gray matter volume compared with controls in frontal brain areas, including inferior frontal cortex (IFC) and insula that mediate emotional processing, inferior parietal lobule and medial frontal cortex that mediate attentional and motor planning processes, respectively. Impairments in performance and some of the regional decreases in gray matter were greater in MDTx. Gray matter volume in IFC in patients was negatively correlated with the number of detoxifications, whereas inferior parietal lobule was negatively correlated with the control over drinking score (impaired control over drinking questionnaire). Performance in IED was also negatively correlated with gray matter volume in IFC/BA47, whereas recognition of fearful faces was positively correlated with the IFC gray matter. Repeated episodes of detoxification from alcohol, related to severity of dependency, are coupled with altered brain structure in areas of emotional regulation, attention and motor planning. Such changes may confer increased inability to switch behavior according to environmental demands and social incompetence, contributing to relapse.
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Affiliation(s)
| | - Matthew J. Kempton
- Department of Neuroimaging; Institute of Psychiatry; King's College London; UK
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Durazzo TC, Pennington DL, Schmidt TP, Meyerhoff DJ. Effects of cigarette smoking history on neurocognitive recovery over 8 months of abstinence in alcohol-dependent individuals. Alcohol Clin Exp Res 2014; 38:2816-25. [PMID: 25336410 DOI: 10.1111/acer.12552] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2014] [Accepted: 08/12/2014] [Indexed: 11/30/2022]
Abstract
BACKGROUND This study compared the rate and extent of recovery on measures of learning and memory, processing speed, and working memory in treatment-seeking alcohol-dependent individuals (ALC) who were never smokers (nvsALC), former smokers (fsALC), and active smokers (asALC) over the first 8 months of sustained abstinence from alcohol. Assessments after 1 week, 1 month, and 8 months of abstinence in ALC enabled a comparison of the rates of neurocognitive changes from 1 week to 1 month versus 1 to 8 months of abstinence. METHODS ALC and never-smoking controls were administered standardized measures of auditory-verbal and visuospatial learning and memory, processing speed, and working memory. Controls completed a baseline assessment and a follow-up approximately 9 months later. RESULTS Over 8 months of abstinence, asALC showed poorer recovery than nvsALC on visuospatial learning, and both fsALC and asALC recovered less than nvsALC on processing speed measures. The corresponding recovery rates for the ALC group, as a whole, were greater from 1 week to 1 month than from 1 to 8 months of abstinence; these findings were largely driven by improvements in nvsALC. The recovery levels for fsALC on most measures were similar to those in asALC. Additionally, over 8 months, asALC showed significantly less improvement with increasing age than nvsALC on measures of processing speed and learning and memory. At 8 months of abstinence, asALC were inferior to controls and nvsALC on multiple measures, fsALC performed worse than nvsALC on several tests, but nvsALC were not different from controls on any measure. CONCLUSIONS Overall, ALC showed rapid improvement on measures of visuospatial learning and processing speed during the first month of abstinence from alcohol. Results also provide robust evidence that smoking status influenced the rate and level of neurocognitive recovery over 8 months of abstinence in this ALC cohort.
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Affiliation(s)
- Timothy C Durazzo
- Center for Imaging of Neurodegenerative Diseases (CIND) , San Francisco VA Medical Center, San Francisco, California; Department of Radiology and Biomedical Imaging , University of California, San Francisco, California
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Segobin SH, Chételat G, Le Berre AP, Lannuzel C, Boudehent C, Vabret F, Eustache F, Beaunieux H, Pitel AL. Relationship between brain volumetric changes and interim drinking at six months in alcohol-dependent patients. Alcohol Clin Exp Res 2014; 38:739-48. [PMID: 24483366 DOI: 10.1111/acer.12300] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2013] [Accepted: 09/04/2013] [Indexed: 11/26/2022]
Abstract
BACKGROUND Chronic alcohol consumption results in brain damage potentially reversible with abstinence. It is however difficult to gauge the degree of recovery of brain tissues with abstinence since changes are subtle and a significant portion of patients relapse. State-of-the-art morphometric methods are increasingly used in neuroimaging studies to detect subtle brain changes at a voxel level. Our aim was to use the most refined morphometric methods to observe in alcohol dependence the relationship between volumetric changes and interim drinking over a 6-month follow-up. METHODS Overall, 19 patients with alcohol dependence received volumetric T1-weighted magnetic resonance imaging (MRI) after detoxification. A 6-month follow-up study was then conducted, during which 11 of them received a second MRI scan. First, correlations were conducted between gray matter (GM) and white matter (WM) volumes of patients at alcohol treatment entry and the amount of alcohol consumed between treatment entry and follow-up. Second, longitudinal analyses were performed from pairs of MRI scans using tensor-based morphometry in the 11 patients, and correlations were computed between the resultant Jacobian maps of GM and WM and interim drinking. RESULTS Our preliminary results showed that, among others, alcoholics with smaller thalamus at alcohol treatment entry tended to resume with heavy alcohol consumption (p < 0.005 uncorrected [unc.]). Our longitudinal study revealed an overall inverse relationship between recovery of brain structures like the cerebellum, striatum, and cingulate gyrus, and the amount of alcohol consumed over the 6-month follow-up (p < 0.005 unc.). The recovery could be observed not only with strict abstinence but also in cases of moderate resumption of alcohol consumption, when there had been no drastic relapse into alcohol dependence. CONCLUSIONS Those preliminary findings indicate that the volume of the thalamus at treatment entry may have an influence on subsequent interim drinking. There is recovery of certain brain regions even when patients resume with moderate, but not drastic, alcohol consumption.
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Meyerhoff DJ. Brain proton magnetic resonance spectroscopy of alcohol use disorders. HANDBOOK OF CLINICAL NEUROLOGY 2014; 125:313-37. [PMID: 25307583 DOI: 10.1016/b978-0-444-62619-6.00019-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
This chapter critically reviews brain proton magnetic resonance spectroscopy ((1)H MRS) studies performed since 1994 in individuals with alcohol use disorders (AUD). We describe the neurochemicals that can be measured in vivo at the most common magnetic field strengths, summarize our knowledge about their general brain functions, and briefly explain some basic human (1)H MRS methods. Both cross-sectional and longitudinal research of individuals in treatment and of treatment-naïve individuals with AUD are discussed and interpreted on the basis of reported neuropathology. As AUDs are highly comorbid with chronic cigarette smoking and illicit substance abuse, we also summarize reports on their respective influences on regional proton metabolite levels. After reviewing research on neurobiologic correlates of relapse and genetic influences on brain metabolite levels, we finish with suggestions on future directions for (1)H MRS studies in AUDs. The review demonstrates that brain metabolic alterations associated with AUDs as well as their cognitive correlates are not simply a consequence of chronic alcohol consumption. Future MR research of AUDs in general has to be better prepared - and supported - to study clinically complex relationships between personality characteristics, comorbidities, neurogenetics, lifestyle, and living environment, as all these factors critically affect an individual's neurometabolic profile. (1)H MRS is uniquely positioned to tackle these complexities by contributing to a comprehensive biopsychosocial profile of individuals with AUD: it can provide non-invasive biochemical information on select regions of the brain at comparatively low overall cost for the ultimate purpose of informing more efficient treatments of AUDs.
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Affiliation(s)
- Dieter J Meyerhoff
- Center for Imaging of Neurodegenerative Diseases, San Francisco Veterans Affairs Medical Center, Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA.
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Naim-Feil J, Fitzgerald PB, Bradshaw JL, Lubman DI, Sheppard D. Neurocognitive deficits, craving, and abstinence among alcohol-dependent individuals following detoxification. Arch Clin Neuropsychol 2013; 29:26-37. [PMID: 24334264 DOI: 10.1093/arclin/act090] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Alcohol dependence, a chronic relapsing disorder, is characterized by an impaired ability to regulate compulsive urges to consume alcohol. Very few empirical studies have examined the presence of these executive deficits, how they relate to craving, and the enduring nature of these deficits during abstinence. As such, the current study aimed to characterize these cognitive deficits within a sample of 24 alcohol-dependent participants post-detoxification and 23 non-alcohol-dependent participants. Participants were administered the Sustained Attention to Response Task to measure response inhibition and sustained attention and the Random Number Generation Task to examine executive deficits. Correlations between cognitive performance and clinical measures of alcohol dependence were examined. As predicted, the alcohol-dependent group exhibited poorer performance across the domains of response inhibition, executive function, and attentional control. Cognitive performance was related to clinical measures of craving and years of alcohol consumption, whereas the duration of abstinence was not associated with improved cognitive performance. These findings highlight the need for therapeutic strategies to target these enduring neurocognitive deficits in improving the treatment of alcohol dependence.
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Affiliation(s)
- Jodie Naim-Feil
- Monash Alfred Psychiatry Research Centre, The Alfred and Monash University, Central Clinical School, Prahran, Victoria, Australia
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Hermens DF, Lee RSC, De Regt T, Lagopoulos J, Naismith SL, Scott EM, Hickie IB. Neuropsychological functioning is compromised in binge drinking young adults with depression. Psychiatry Res 2013; 210:256-62. [PMID: 23721946 DOI: 10.1016/j.psychres.2013.05.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2012] [Revised: 04/26/2013] [Accepted: 05/04/2013] [Indexed: 11/27/2022]
Abstract
For many young people, binge drinking is the most common form of alcohol misuse, particularly in those with a depressive disorder. Nonetheless, relatively little is known about the effects that the combination of depression and binge drinking has on neuropsychological outcomes. This study aimed to determine whether binge drinkers with depression show more pronounced neuropsychological dysfunction compared to their peers with depression alone or binge drinking alone. Neuropsychological testing was conducted on help-seeking young people (18-30 years) recently diagnosed with a depressive disorder and classified as either 'binge drinkers' (n=43) or 'non-bingers' (n=48). Two healthy control groups (i.e. binge drinkers, n=24 and non-bingers, n=21) were additionally recruited and also underwent the same testing. Qualitatively, binge-drinking patients with depression performed consistently below controls, depression alone, or binge drinking alone. In keeping with our hypotheses, visual learning and memory was significantly reduced in depressed binge drinkers, whereas mental flexibility was reduced at a trend level. There were no significant differences in neuropsychological performance in depressed alone or binge drinking alone individuals compared to controls. The findings suggest that when treating young people with a depressive disorder, strategies targeting binge drinking may contribute to preventing potential neurobiological changes underlying poorer long-term clinical outcomes.
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Affiliation(s)
- Daniel F Hermens
- Clinical Research Unit, Brain & Mind Research Institute, University of Sydney, Australia.
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Levola J, Kaskela T, Holopainen A, Sabariego C, Tourunen J, Cieza A, Pitkänen T. Psychosocial difficulties in alcohol dependence: a systematic review of activity limitations and participation restrictions. Disabil Rehabil 2013; 36:1227-39. [DOI: 10.3109/09638288.2013.837104] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Abé C, Mon A, Hoefer ME, Durazzo TC, Pennington DL, Schmidt TP, Meyerhoff DJ. Metabolic abnormalities in lobar and subcortical brain regions of abstinent polysubstance users: magnetic resonance spectroscopic imaging. Alcohol Alcohol 2013; 48:543-51. [PMID: 23797281 DOI: 10.1093/alcalc/agt056] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
AIMS The aim of the study was to explore neurometabolic and associated cognitive characteristics of patients with polysubstance use (PSU) in comparison with patients with predominant alcohol use using proton magnetic resonance spectroscopy. METHODS Brain metabolite concentrations were examined in lobar and subcortical brain regions of three age-matched groups: 1-month-abstinent alcohol-dependent PSU, 1-month-abstinent individuals dependent on alcohol alone (ALC) and light drinking controls (CON). Neuropsychological testing assessed cognitive function. RESULTS While CON and ALC had similar metabolite levels, persistent metabolic abnormalities (primarily higher myo-inositol) were present in temporal gray matter, cerebellar vermis and lenticular nuclei of PSU. Moreover, lower cortical gray matter concentration of the neuronal marker N-acetylaspartate within PSU correlated with higher cocaine (but not alcohol) use quantities and with a reduced cognitive processing speed. CONCLUSIONS These metabolite group differences reflect cellular/astroglial injury and/or dysfunction in alcohol-dependent PSU. Associations of other metabolite concentrations with neurocognitive performance suggest their functional relevance. The metabolic alterations in PSU may represent polydrug abuse biomarkers and/or potential targets for pharmacological and behavioral PSU-specific treatment.
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Affiliation(s)
- Christoph Abé
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA
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Abé C, Mon A, Durazzo TC, Pennington DL, Schmidt TP, Meyerhoff DJ. Polysubstance and alcohol dependence: unique abnormalities of magnetic resonance-derived brain metabolite levels. Drug Alcohol Depend 2013; 130:30-7. [PMID: 23122599 PMCID: PMC3624044 DOI: 10.1016/j.drugalcdep.2012.10.004] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2012] [Revised: 09/26/2012] [Accepted: 10/05/2012] [Indexed: 12/21/2022]
Abstract
BACKGROUND Although comorbid substance misuse is common in alcohol dependence, and polysubstance abusers (PSU) represent the largest group of individuals seeking treatment for drug abuse today, we know little about potential brain abnormalities in this population. Brain magnetic resonance spectroscopy studies of mono-substance use disorders (e.g., alcohol or cocaine) reveal abnormal levels of cortical metabolites (reflecting neuronal integrity, cell membrane turnover/synthesis, cellular bioenergetics, gliosis) and altered concentrations of glutamate and γ-aminobutyric acid (GABA). The concurrent misuse of several substances may have unique and different effects on brain biology and function compared to any mono-substance misuse. METHODS High field brain magnetic resonance spectroscopy at 4 T and neurocognitive testing were performed at one month of abstinence in 40 alcohol dependent individuals (ALC), 28 alcohol dependent PSU and 16 drug-free controls. Absolute metabolite concentrations were calculated in anterior cingulate (ACC), parieto-occipital (POC) and dorso-lateral prefrontal cortices (DLPFC). RESULTS Compared to ALC, PSU demonstrated significant metabolic abnormalities in the DLPFC and strong trends to lower GABA in the ACC. Metabolite levels in ALC and light drinking controls were statistically equivalent. Within PSU, lower DLPFC GABA levels are related to greater cocaine consumption. Several cortical metabolite concentrations were associated with cognitive performance. CONCLUSIONS While metabolite concentrations in ALC at one month of abstinence were largely normal, PSU showed persistent and functionally significant metabolic abnormalities, primarily in the DLPFC. Our results point to specific metabolic deficits as biomarkers in polysubstance misuse and as targets for pharmacological and behavioral PSU-specific treatment.
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Affiliation(s)
- Christoph Abé
- Department of Radiology and Biomedical Imaging, University of California, San Francisco and Center for Imaging of Neurodegenerative Diseases, Veterans Administration Medical Center San Francisco, CA 94121, USA.
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Durazzo TC, Pennington DL, Schmidt TP, Mon A, Abé C, Meyerhoff DJ. Neurocognition in 1-month-abstinent treatment-seeking alcohol-dependent individuals: interactive effects of age and chronic cigarette smoking. Alcohol Clin Exp Res 2013; 37:1794-803. [PMID: 23682867 DOI: 10.1111/acer.12140] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2012] [Accepted: 03/07/2013] [Indexed: 11/28/2022]
Abstract
BACKGROUND Increasing age and chronic cigarette smoking are independently associated with adverse effects on multiple aspects of neurocognition in those seeking treatment for alcohol use disorders. However, the potential interactive effects of age and cigarette smoking on neurocognition in early abstinent alcohol-dependent individuals (ALC) have not investigated. METHODS Cross-sectional performances of never-smoking healthy comparison participants (nvsCOM; n = 39) and 1-month-abstinent, treatment-seeking, never-smoking (nvsALC; n = 30), former-smoking (fsALC; n = 21), and actively smoking (asALC; n = 68) ALC were compared on a comprehensive neurocognitive battery. Domains of functioning evaluated were cognitive efficiency, executive functions, fine motor skills, general intelligence, learning and memory, processing speed, visuospatial functions and working memory. Participants were between 26 and 71 years of age at the time of assessment. RESULTS asALC showed steeper age-related effects than nvsCOM on the domains of visuospatial learning, auditory-verbal memory, cognitive efficiency, executive functions, processing speed, and fine motor skills. In pairwise comparisons, fsALC and asALC performed more poorly than both nvsCOM and nvsALC on multiple domains; nvsCOM and nvsALC showed no significant differences. Domain scores for the ALC groups generally fell in the low-to-high-average range of functioning. A clinically significant level of impairment was apparent in only 25% of ALC participants on visuospatial learning, visuospatial memory, and fine motor skills domains. Measures of alcohol use or consumption were not significantly related to neurocognition in the ALC cohorts. CONCLUSIONS The age-related findings suggest that the combination of active chronic smoking and alcohol dependence in this 1-month-abstinent ALC cohort was associated with greater than normal age-related effects in multiple domains. In general, a low level of clinically significant impairment was observed in the alcohol-dependent participants. The findings from this study, in conjunction with previous research, strongly support smoking cessation interventions for those seeking treatment for alcohol and substance use disorders.
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Affiliation(s)
- Timothy C Durazzo
- Center for Imaging of Neurodegenerative Diseases (CIND) , San Francisco VA Medical Center, San Francisco, California; Department of Radiology and Biomedical Imaging, University of California, San Francisco, California
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Claus ED, Feldstein Ewing SW, Filbey FM, Hutchison KE. Behavioral control in alcohol use disorders: relationships with severity. J Stud Alcohol Drugs 2013. [PMID: 23200160 DOI: 10.15288/jsad.2013.74.141] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE The current study examined the relationship between severity of alcohol use disorders (AUDs) and the neural circuits that underlie response inhibition and error monitoring. In addition, we explored pre- and post-inhibition trial processes to determine the potential causal mechanisms responsible for disinhibition in AUDs. METHOD One hundred sixty-four individuals with a range of drinking from non-treatment-seeking adults with problematic alcohol use to treatment-seeking adults with alcohol dependence completed a Go/NoGo task while undergoing functional magnetic resonance imaging. RESULTS Correlations between signal change during response inhibition and a composite measure of AUD severity revealed significant negative relationships in right insula/inferior frontal gyrus, pregenual anterior cingulate cortex, and inferior parietal lobe. Relationships with error monitoring-related response largely overlapped with that of correct inhibitions but also included rostral anterior cingulate cortex and left inferior frontal gyrus, such that more severe AUDs were associated with reduced response in these regions. Last, examination of pre- and postinhibition processes suggested that more severe AUDs are associated with greater engagement of motor response circuits before inhibition trials, suggesting greater pre-potent tendencies that may lead to disinhibition. CONCLUSIONS The current results extend previous work by examining how variation in AUD severity is related to neural response during response inhibition and potential causal mechanisms responsible for impaired inhibitory control. More severe AUDs were associated with reduced engagement of neural circuits involved in behavioral control and enhanced pre-potent responding. This altered control may contribute to the progression of AUDs, as well as relapse after treatment.
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Affiliation(s)
- Eric D Claus
- The Mind Research Network and Lovelace Biomedical and Environmental Research Institute, Albuquerque, NM 87106, USA.
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Monnig MA, Tonigan JS, Yeo RA, Thoma RJ, McCrady BS. White matter volume in alcohol use disorders: a meta-analysis. Addict Biol 2013; 18:581-92. [PMID: 22458455 DOI: 10.1111/j.1369-1600.2012.00441.x] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Atrophy of brain white matter (WM) often is considered a signature injury of alcohol use disorders (AUDs). However, investigations into AUD-related changes in WM volume have yielded complex findings that are difficult to synthesize in a narrative review. The objective of this study was to obtain an averaged effect size (ES) for WM volume reduction associated with AUD diagnosis and to test potential moderators of ES. Study inclusion criteria were: (1) English language; (2) peer reviewed; (3) published before December 2011; (4) use of magnetic resonance imaging (MRI); (5) human participants; (6) inclusion of AUD group; (7) inclusion of non-AUD comparison group; and (8) reporting or testing of total or cerebral WM volume. Moderators included study design, MRI methodology and AUD characteristics. Nineteen studies with a total of 1302 participants (70% male) were included, and calculated ESs were confirmed by the corresponding author for 12 studies. The magnitude of the averaged ES adjusted for small sample bias (Hedges' g) for WM reduction in AUDs was 0.304 (standard error = 0.134, range = -0.57-1.21). Hierarchical linear modeling indicated that the overall ES differed significantly from 0, t(18) = 2.257, P = 0.037, and that the distribution of the 19 ESs showed significant heterogeneity beyond sampling error, χ(2) (18) = 52.400, P < 0.001. Treatment-seeking status and length of abstinence were significant moderators of ES distribution. These results are suggestive of WM recovery with sustained abstinence and point to the need for further investigation of factors related to treatment-seeking status.
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Affiliation(s)
- Mollie A Monnig
- Center on Alcoholism, Substance Abuse, and Addictions, University of New Mexico, 2650 Yale Boulevard SE, Albuquerque, NM 87106, USA.
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