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Tap SC. The potential of 5-methoxy-N,N-dimethyltryptamine in the treatment of alcohol use disorder: A first look at therapeutic mechanisms of action. Addict Biol 2024; 29:e13386. [PMID: 38600715 PMCID: PMC11007263 DOI: 10.1111/adb.13386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 12/24/2023] [Accepted: 02/13/2024] [Indexed: 04/12/2024]
Abstract
Alcohol use disorder (AUD) remains one of the most prevalent psychiatric disorders worldwide with high economic costs. Current treatment options show modest efficacy and relapse rates are high. Furthermore, there are increases in the treatment gap and few new medications have been approved in the past 20 years. Recently, psychedelic-assisted therapy with psilocybin and lysergic acid diethylamide has garnered significant attention in the treatment of AUD. Yet, they require significant amounts of therapist input due to prolonged subjective effects (~4-12 h) leading to high costs and impeding implementation. Accordingly, there is an increasing interest in the rapid and short-acting psychedelic 5-methoxy-N,N-dimethyltryptamine (5-MeO-DMT). This paper offers a first look at potential therapeutic mechanisms for AUD by reviewing the current literature on 5-MeO-DMT. Primarily, 5-MeO-DMT is able to induce mystical experiences and ego-dissolution together with increases in psychological flexibility and mindfulness. This could decrease AUD symptoms through the alleviation of psychiatric mood-related comorbidities consistent with the negative reinforcement and self-medication paradigms. In addition, preliminary evidence indicates that 5-MeO-DMT modulates neural oscillations that might subserve ego-dissolution (increases in gamma), psychological flexibility and mindfulness (increases in theta), and the reorganization of executive control networks (increases in coherence across frequencies) that could improve emotion regulation and inhibition. Finally, animal studies show that 5-MeO-DMT is characterized by neuroplasticity, anti-inflammation, 5-HT2A receptor agonism, and downregulation of metabotropic glutamate receptor 5 with clinical implications for AUD and psychiatric mood-related comorbidities. The paper concludes with several recommendations for future research to establish the purported therapeutic mechanisms of action.
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Affiliation(s)
- Stephan C. Tap
- Department of PsychiatryGroningen University Medical CenterGroningenThe Netherlands
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2
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Schrock JM. Accelerated aging in people living with HIV: The neuroimmune feedback model. Brain Behav Immun Health 2024; 36:100737. [PMID: 38356933 PMCID: PMC10864877 DOI: 10.1016/j.bbih.2024.100737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 01/02/2024] [Accepted: 02/04/2024] [Indexed: 02/16/2024] Open
Abstract
People living with HIV (PLWH) experience earlier onset of aging-related comorbidities compared to their counterparts without HIV. This paper lays out a theoretical model to explain why PLWH experience accelerated aging. Briefly, the model is structured as follows. PLWH experience disproportionately heavy burdens of psychosocial stress across the life course. This psychosocial stress increases risks for depressive symptoms and problematic substance use. Depressive symptoms and problematic substance use interfere with long-term adherence to antiretroviral therapy (ART). Lower ART adherence, in turn, exacerbates the elevated systemic inflammation stemming from HIV infection. This inflammation increases risks for aging-related comorbidities. Systemic inflammation also reduces connectivity in the brain's central executive network (CEN), a large-scale brain network that is critical for coping with stressful circumstances. This reduced capacity for coping with stress leads to further increases in depressive symptoms and problematic substance use. Together, these changes form a neuroimmune feedback loop that amplifies the impact of psychosocial stress on aging-related comorbidities. In this paper, I review the existing evidence relevant to this model and highlight directions for future research.
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Affiliation(s)
- Joshua M. Schrock
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, 625 N. Michigan Avenue, Suite 1400, Chicago, IL, 60611, United states
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3
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Rice LC, Langan MT, Cheng DT, Sheu YS, Peterburs J, Hua J, Qin Q, Rilee JJ, Faulkner ML, Mathena JR, Munro CA, Wand GS, McCaul ME, Desmond JE. Disrupted executive cerebro-cerebellar functional connectivity in alcohol use disorder. ALCOHOL, CLINICAL & EXPERIMENTAL RESEARCH 2024; 48:33-47. [PMID: 38206281 PMCID: PMC10784638 DOI: 10.1111/acer.15219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 10/30/2023] [Accepted: 10/30/2023] [Indexed: 01/12/2024]
Abstract
BACKGROUND Alcohol use disorder (AUD) affects 283 million people worldwide and its prevalence is increasing. Despite the role of the cerebellum in executive control and its sensitivity to alcohol, few studies have assessed its involvement in AUD-relevant functional networks. The goal of this study is to compare resting-state functional connectivity (FC) patterns in abstinent adults with a history of AUD and controls (CTL). We hypothesized that group differences in cerebro-cerebellar FC would be present, particularly within the frontoparietal/executive control network (FPN). METHODS Twenty-eight participants completed a resting-state functional magnetic resonance imaging (rsfMRI) study. CTL participants had no history of AUD, comorbid psychological conditions, or recent heavy drinking and/or drug use. AUD participants had a history of AUD, with sobriety for at least 30 days prior to data collection. Multivariate pattern analysis, an agnostic, whole-brain approach, was used to identify regions with significant differences in FC between groups. Seed-based analyses were then conducted to determine the directionality and extent of these FC differences. Associations between FC strength and executive function were assessed using correlations with Wisconsin Card Sorting Test (WCST) performance. RESULTS There were significant group differences in FC in nodes of the FPN, ventral attention network, and default mode network. Post hoc analyses predominantly identified FC differences within the cerebro-cerebellar FPN, with AUD showing significantly less FC within the FPN. In AUD, FC strength between FPN clusters identified in the multivariate pattern analysis (MVPA) analysis (Left Crus II, Right Frontal Cortex) was positively associated with performance on the WCST. CONCLUSIONS Our results show less engagement of the FPN in individuals with AUD than in CTL. FC strength within this network was positively associated with performance on the WCST. These findings suggest that long-term heavy drinking alters cerebro-cerebellar FC, particularly within networks that are involved in executive function.
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Affiliation(s)
- Laura C. Rice
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | | | | | - Yi-Shin Sheu
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Jutta Peterburs
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Institute for Systems Medicine & Department of Human Medicine, MSH Medical School Hamburg, Germany
| | - Jun Hua
- Neurosection, Division of MRI Research, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD, USA
| | - Qin Qin
- Neurosection, Division of MRI Research, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD, USA
| | | | | | | | | | - Gary S. Wand
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Mary E. McCaul
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - John E. Desmond
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
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van Oort J, Diazgranados N, George DT, Horneffer Y, Schwandt M, Goldman D, Momenan R. Preliminary evidence for changes in frontoparietal network connectivity in the early abstinence period in alcohol use disorder: a longitudinal resting-state functional magnetic resonance imaging study. Front Psychiatry 2023; 14:1185770. [PMID: 37575566 PMCID: PMC10420071 DOI: 10.3389/fpsyt.2023.1185770] [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: 03/14/2023] [Accepted: 07/07/2023] [Indexed: 08/15/2023] Open
Abstract
The early abstinence period is a crucial phase in alcohol use disorder (AUD) in which patients have to find a new equilibrium and may start recovery, or conversely, relapse. However, the changes in brain functions during this key period are still largely unknown. We set out to study longitudinal changes in large-scale brain networks during the early abstinence period using resting-state scans. We scanned AUD patients twice in a well-controlled inpatient setting, with the first scan taking place shortly after admission and the second scan 4 weeks (±9 days) later near the end of the treatment period. We studied 37 AUD patients (22 males) and 27 healthy controls (16 males). We focused on three networks that are affected in AUD and underly core symptom dimensions in this disorder: the frontoparietal networks (left and right FPN) and default mode network (DMN). Both the whole brain and within network connectivity of these networks were studied using dual regression. Finally, we explored correlations between these brain networks and various neuropsychological and behavioral measures. In contrast to the controls (Z = -1.081, p = 0.280), the AUD patients showed a decrease in within left FPN connectivity (Z = -2.029, p = 0.042). However, these results did not survive a strict Bonferroni correction. The decrease in left FPN connectivity during the early abstinence period in AUD may reflect an initially upregulated FPN, which recovers to a lower resting-state connectivity level during subsequent weeks of abstinence. The AUD patients showed a trend for a positive association between the change in left FPN connectivity and trait anxiety (rs = 0.303, p = 0.068), and a trend for a negative association between the change in left FPN connectivity and delay discounting (rs = -0.283, p = 0.089) (uncorrected for multiple comparisons). This suggests that the FPN might be involved in top-down control of impulsivity and anxiety, which are important risk factors for relapse. Although there were no statistically significant results (after multiple comparison correction), our preliminary findings encourage further research into the dynamic neuroadaptations during the clinically crucial early abstinence period and could inform future study designs.
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Affiliation(s)
- Jasper van Oort
- Clinical NeuroImaging Research Core, National Institute on Alcohol Abuse and Alcoholism, National Institute of Health, Bethesda, MD, United States
| | - Nancy Diazgranados
- Office of the Clinical Director, National Institute on Alcohol Abuse and Alcoholism, National Institute of Health, Bethesda, MD, United States
| | - David T. George
- Office of the Clinical Director, National Institute on Alcohol Abuse and Alcoholism, National Institute of Health, Bethesda, MD, United States
| | - Yvonne Horneffer
- Office of the Clinical Director, National Institute on Alcohol Abuse and Alcoholism, National Institute of Health, Bethesda, MD, United States
| | - Melanie Schwandt
- Office of the Clinical Director, National Institute on Alcohol Abuse and Alcoholism, National Institute of Health, Bethesda, MD, United States
| | - David Goldman
- Office of the Clinical Director, National Institute on Alcohol Abuse and Alcoholism, National Institute of Health, Bethesda, MD, United States
| | - Reza Momenan
- Clinical NeuroImaging Research Core, National Institute on Alcohol Abuse and Alcoholism, National Institute of Health, Bethesda, MD, United States
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5
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Camchong J, Roediger D, Fiecas M, Gilmore CS, Kushner M, Kummerfeld E, Mueller BA, Lim KO. Frontal tDCS reduces alcohol relapse rates by increasing connections from left dorsolateral prefrontal cortex to addiction networks. Brain Stimul 2023; 16:1032-1040. [PMID: 37348702 PMCID: PMC10530485 DOI: 10.1016/j.brs.2023.06.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 04/27/2023] [Accepted: 06/19/2023] [Indexed: 06/24/2023] Open
Abstract
BACKGROUND Brain-based interventions are needed to address persistent relapse in alcohol use disorder (AUD). Neuroimaging evidence suggests higher frontal connectivity as well as higher within-network connectivity of theoretically defined addiction networks are associated with reduced relapse rates and extended abstinence during follow-up periods. OBJECTIVE /Hypothesis: A longitudinal randomized double-blind sham-controlled clinical trial investigated whether a non-invasive neuromodulation intervention delivered during early abstinence can (i) modulate connectivity of addiction networks supporting abstinence and (ii) improve relapse rates. HYPOTHESES Active transcranial direct current stimulation (tDCS) will (i) increase connectivity of addiction networks known to support abstinence and (ii) reduce relapse rates. METHODS Short-term abstinent AUD participants (n = 60) were assigned to 5 days of either active tDCS or sham during cognitive training. Causal discovery analysis (CDA) examined the directional influence from left dorsolateral prefrontal cortex (LDLPFC, stimulation site) to addiction networks that support abstinence. RESULTS Active tDCS had an effect on the average strength of CDA-determined connectivity from LDLPFC to the incentive salience and negative emotionality addiction networks - increasing in the active tDCS group only. Active tDCS had an effect on relapse rates following the intervention, with lower probability of relapse in the active tDCS vs. sham. Active tDCS showed an unexpected sex-dependent effect on relapse rates. CONCLUSION Our results suggest that LDLPFC stimulation delivered during early abstinence has an effect on addiction networks supporting abstinence and on relapse rates. The unexpected sex-dependent neuromodulation effects need to be further examined in larger clinical trials.
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Affiliation(s)
- Jazmin Camchong
- University of Minnesota Department of Psychiatry and Behavioral Sciences, 2312 S. 6th St., Floor 2, Suite F-275, Minneapolis, MN, 55454, USA.
| | - Donovan Roediger
- University of Minnesota Department of Psychiatry and Behavioral Sciences, 2312 S. 6th St., Floor 2, Suite F-275, Minneapolis, MN, 55454, USA
| | - Mark Fiecas
- University of Minnesota School of Public Health, 420 Delaware St SE, Minneapolis, MN, 55455, USA
| | - Casey S Gilmore
- University of Minnesota Department of Psychiatry and Behavioral Sciences, 2312 S. 6th St., Floor 2, Suite F-275, Minneapolis, MN, 55454, USA; Minneapolis VA Health Care System, Geriatrics Research Education and Clinical Center (GRECC), 1 Veterans Dr., Minneapolis, MN, 55417, USA
| | - Matt Kushner
- University of Minnesota Department of Psychiatry and Behavioral Sciences, 2312 S. 6th St., Floor 2, Suite F-275, Minneapolis, MN, 55454, USA
| | - Erich Kummerfeld
- University of Minnesota Institute for Health Informatics, 8-100 Phillips-Wangensteen Building, 516 Delaware Street SE, Minneapolis, MN, 55455, USA
| | - Bryon A Mueller
- University of Minnesota Department of Psychiatry and Behavioral Sciences, 2312 S. 6th St., Floor 2, Suite F-275, Minneapolis, MN, 55454, USA
| | - Kelvin O Lim
- University of Minnesota Department of Psychiatry and Behavioral Sciences, 2312 S. 6th St., Floor 2, Suite F-275, Minneapolis, MN, 55454, USA; Minneapolis VA Health Care System, Geriatrics Research Education and Clinical Center (GRECC), 1 Veterans Dr., Minneapolis, MN, 55417, USA
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6
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Gullett JM, DeFelice J, Richards VL, Porges EC, Cohen RA, Govind V, Salan T, Wang Y, Zhou Z, Cook RL. Resting state connectivity in people living with HIV before and after stopping heavy drinking. Front Psychiatry 2023; 14:1102368. [PMID: 37265553 PMCID: PMC10230054 DOI: 10.3389/fpsyt.2023.1102368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 04/07/2023] [Indexed: 06/03/2023] Open
Abstract
Background Heavy alcohol use in people living with HIV (PLWH) has widespread negative effects on neural functioning. It remains unclear whether experimentally-induced reduction in alcohol use could reverse these effects. We sought to determine the effects of 30-days drinking cessation/reduction on resting state functional connectivity in people with and without HIV. Methods Thirty-five participants (48.6% PLWH) demonstrating heavy alcohol use attempted to stop drinking for 30 days via contingency management (CM). MRI was acquired at baseline and after thirty days, and functional connectivity across five resting-state fMRI (rsfMRI) networks was calculated with the Conn toolbox for Matlab and examined in relation to transdermal alcohol concentration (TAC) recorded by the ankle-worn secure continuous remote alcohol monitor (SCRAM) and self-reported alcohol use (timeline follow-back; TLFB). Associations between alcohol use and reduction, HIV status, functional connectivity, and change in functional connectivity across five major rsfMRI networks were determined relative to the pre- and post-CM timepoints. Results Baseline resting-state functional connectivity was not significantly associated with average TAC-AUC during the pre-CM period, though higher self-reported alcohol use over the preceding 30 days was significantly associated with higher baseline connectivity within the Dorsal Attention Network (DAN; p-FDR < 0.05). Baseline connectivity within the Salience network was significantly negatively related to objective drinking reduction after intervention (DAN; p-FDR < 0.05), whereas baseline connectivity within the Limbic network was positively associated with self-reported drinking reduction (p-FDR < 0.05). Change in between-networks functional connectivity after intervention was significantly positively associated with biosensor-confirmed drinking reduction such that higher reduction was associated with stronger connectivity between the limbic and fronto-parietal control networks (p-FDR < 0.05). PLWH with lower DAN connectivity at baseline demonstrated poorer alcohol reduction than those with higher DAN connectivity at baseline. Discussion Lower resting-state functional connectivity of the Salience network significantly predicted stronger drinking reduction across all participants, suggesting a potential biomarker for reduced susceptibility to the environmental and social cues that often make alcohol use reduction attempts unsuccessful. Increased between-networks connectivity was observed in participants with higher alcohol reduction after CM, suggesting a positive benefit to brain connectivity associated with reduced drinking. PLWH with lower baseline DAN connectivity may not benefit as greatly from CM for alcohol reduction.
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Affiliation(s)
- Joseph M. Gullett
- Center for Cognitive Aging and Memory, Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, United States
| | - Jason DeFelice
- Center for Cognitive Aging and Memory, Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, United States
| | - Veronica L. Richards
- Department of Epidemiology, University of Florida, Gainesville, FL, United States
- Edna Bennett Pierce Prevention Research Center, The Pennsylvania State University, University Park, PA, United States
| | - Eric C. Porges
- Center for Cognitive Aging and Memory, Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, United States
| | - Ronald A. Cohen
- Center for Cognitive Aging and Memory, Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, United States
| | - Varan Govind
- Department of Radiology, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Teddy Salan
- University of Miami, Coral Gables, United States
| | - Yan Wang
- Department of Epidemiology, University of Florida, Gainesville, FL, United States
| | - Zhi Zhou
- Department of Epidemiology, University of Florida, Gainesville, FL, United States
| | - Robert L. Cook
- Department of Epidemiology, University of Florida, Gainesville, FL, United States
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7
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Flook EA, Feola B, Benningfield MM, Silveri MM, Winder DG, Blackford JU. Alterations in BNST Intrinsic Functional Connectivity in Early Abstinence from Alcohol Use Disorder. Alcohol Alcohol 2023; 58:298-307. [PMID: 36847484 PMCID: PMC10168710 DOI: 10.1093/alcalc/agad006] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 01/03/2023] [Accepted: 01/22/2023] [Indexed: 03/01/2023] Open
Abstract
AIMS Maintaining abstinence from alcohol use disorder (AUD) is extremely challenging, partially due to increased symptoms of anxiety and stress that trigger relapse. Rodent models of AUD have identified that the bed nucleus of the stria terminalis (BNST) contributes to symptoms of anxiety-like behavior and drug-seeking during abstinence. In humans, however, the BNST's role in abstinence remains poorly understood. The aims of this study were to assess BNST network intrinsic functional connectivity in individuals during abstinence from AUD compared to healthy controls and examine associations between BNST intrinsic functional connectivity, anxiety and alcohol use severity during abstinence. METHODS The study included resting state fMRI scans from participants aged 21-40 years: 20 participants with AUD in abstinence and 20 healthy controls. Analyses were restricted to five pre-selected brain regions with known BNST structural connections. Linear mixed models were used to test for group differences, with sex as a fixed factor given previously shown sex differences. RESULTS BNST-hypothalamus intrinsic connectivity was lower in the abstinent group relative to the control group. There were also pronounced sex differences in both the group and individual analyses; many of the findings were specific to men. Within the abstinent group, anxiety was positively associated with BNST-amygdala and BNST-hypothalamus connectivity, and men, not women, showed a negative relationship between alcohol use severity and BNST-hypothalamus connectivity. CONCLUSIONS Understanding differences in connectivity during abstinence may help explain the clinically observed anxiety and depression symptoms during abstinence and may inform the development of individualized treatments.
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Affiliation(s)
- Elizabeth A Flook
- Department of Psychiatry, University of Pennsylvania, 3535 Market Street, Philadelphia, PA 19104, USA
- Vanderbilt University School of Medicine, 1161 21st Ave S # D3300, Nashville, TN 37232, USA
- Vanderbilt Center for Addiction Research, Vanderbilt University, 2215 Garland Ave, Nashville, TN 37232, USA
| | - Brandee Feola
- Department of Psychiatry and Behavioral Science, Vanderbilt University Medical Center, 1601 23rd Avenue South, Nashville, TN 37212, USA
| | - Margaret M Benningfield
- Vanderbilt University School of Medicine, 1161 21st Ave S # D3300, Nashville, TN 37232, USA
- Vanderbilt Center for Addiction Research, Vanderbilt University, 2215 Garland Ave, Nashville, TN 37232, USA
- Department of Psychiatry and Behavioral Science, Vanderbilt University Medical Center, 1601 23rd Avenue South, Nashville, TN 37212, USA
| | - Marisa M Silveri
- Neurodevelopmental Laboratory on Addictions and Mental Health, Brain Imaging Center, McLean Hospital, 115 Mill St, Belmont, MA 02478, USA
- Department of Psychiatry, Harvard Medical School, 401 Park Drive, Boston, MA 02215, USA
| | - Danny G Winder
- Vanderbilt Center for Addiction Research, Vanderbilt University, 2215 Garland Ave, Nashville, TN 37232, USA
- Department of Molecular Physiology and Biophysics, Vanderbilt University, 2215 Garland Avenue, Nashville, TN 37212, USA
- Department of Pharmacology, Vanderbilt University, 465 21st Avenue South, Nashville, TN 37240, USA
| | - Jennifer Urbano Blackford
- Vanderbilt Center for Addiction Research, Vanderbilt University, 2215 Garland Ave, Nashville, TN 37232, USA
- Department of Psychiatry and Behavioral Science, Vanderbilt University Medical Center, 1601 23rd Avenue South, Nashville, TN 37212, USA
- Munroe-Meyer Institute, University of Nebraska Medical Center, 6902 Pine Street, Omaha, NE 68106, USA
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8
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Stout DM, Harlé KM, Norman SB, Simmons AN, Spadoni AD. Resting-state connectivity subtype of comorbid PTSD and alcohol use disorder moderates improvement from integrated prolonged exposure therapy in Veterans. Psychol Med 2023; 53:332-341. [PMID: 33926595 PMCID: PMC10880798 DOI: 10.1017/s0033291721001513] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
BACKGROUND Posttraumatic stress disorder (PTSD) and alcohol use disorder (AUD) are highly comorbid and are associated with significant functional impairment and inconsistent treatment outcomes. Data-driven subtyping of this clinically heterogeneous patient population and the associated underlying neural mechanisms are highly needed to identify who will benefit from psychotherapy. METHODS In 53 comorbid PTSD/AUD patients, resting-state functional magnetic resonance imaging was collected prior to undergoing individual psychotherapy. We used a data-driven approach to subgroup patients based on directed connectivity profiles. Connectivity subgroups were compared on clinical measures of PTSD severity and heavy alcohol use collected at pre- and post-treatment. RESULTS We identified a subgroup of patients associated with improvement in PTSD symptoms from integrated-prolonged exposure therapy. This subgroup was characterized by lower insula to inferior parietal cortex (IPC) connectivity, higher pregenual anterior cingulate cortex (pgACC) to posterior midcingulate cortex connectivity and a unique pgACC to IPC path. We did not observe any connectivity subgroup that uniquely benefited from integrated-coping skills or subgroups associated with change in alcohol consumption. CONCLUSIONS Data-driven approaches to characterize PTSD/AUD subtypes have the potential to identify brain network profiles that are implicated in the benefit from psychological interventions - setting the stage for future research that targets these brain circuit communication patterns to boost treatment efficacy.
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Affiliation(s)
- Daniel M. Stout
- Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System, San Diego, CA, USA
- Research Service, VA San Diego Healthcare System, San Diego, CA, USA
- Department of Psychiatry, University of California San Diego, San Diego, CA, USA
| | - Katia M. Harlé
- Research Service, VA San Diego Healthcare System, San Diego, CA, USA
- Department of Psychiatry, University of California San Diego, San Diego, CA, USA
| | - Sonya B. Norman
- Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System, San Diego, CA, USA
- Research Service, VA San Diego Healthcare System, San Diego, CA, USA
- Department of Psychiatry, University of California San Diego, San Diego, CA, USA
- National Center for PTSD, White River Junction, Vermont, USA
| | - Alan N. Simmons
- Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System, San Diego, CA, USA
- Research Service, VA San Diego Healthcare System, San Diego, CA, USA
- Department of Psychiatry, University of California San Diego, San Diego, CA, USA
| | - Andrea D. Spadoni
- Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System, San Diego, CA, USA
- Research Service, VA San Diego Healthcare System, San Diego, CA, USA
- Department of Psychiatry, University of California San Diego, San Diego, CA, USA
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9
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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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10
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Li C, Dai W, Miao S, Xie W, Yu S. Medication overuse headache and substance use disorder: A comparison based on basic research and neuroimaging. Front Neurol 2023; 14:1118929. [PMID: 36937526 PMCID: PMC10017752 DOI: 10.3389/fneur.2023.1118929] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 02/10/2023] [Indexed: 03/06/2023] Open
Abstract
It has yet to be determined whether medication overuse headache (MOH) is an independent disorder or a combination of primary headache and substance addiction. To further explore the causes of MOH, we compared MOH with substance use disorder (SUD) in terms of the brain regions involved to draw more targeted conclusions. In this review, we selected alcohol use disorder (AUD) as a representative SUD and compared MOH and AUD from two aspects of neuroimaging and basic research. We found that in neuroimaging studies, there were many overlaps between AUD and MOH in the reward circuit, but the extensive cerebral cortex damage in AUD was more serious than that in MOH. This difference was considered to reflect the sensitivity of the cortex structure to alcohol damage. In future research, we will focus on the central amygdala (CeA), prefrontal cortex (PFC), orbital-frontal cortex (OFC), hippocampus, and other brain regions for interventions, which may have unexpected benefits for addiction and headache symptoms in MOH patients.
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11
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Maillard A, Laniepce A, Segobin S, Lahbairi N, Boudehent C, Vabret F, Cabé N, Pitel AL. Prognostic factors for low-risk drinking and relapse in alcohol use disorder: A multimodal analysis. Addict Biol 2022; 27:e13243. [PMID: 36301210 DOI: 10.1111/adb.13243] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 09/23/2022] [Accepted: 09/27/2022] [Indexed: 01/24/2023]
Abstract
This study aims to specify the determinants of low-risk alcohol drinking and relapse at different time points after detoxification in patients with severe alcohol use disorder (AUD). Fifty-four patients with AUD and 36 healthy controls (HC) were evaluated early in abstinence (T1). They underwent clinical, neuropsychological and neuroimaging (structural MRI and 18 FDG-PET) investigations. Patients with AUD were subsequently classified as "low-risk drinkers" (LR) or "relapsers" (R) based on their alcohol drinking at 6 months (T2) and 1 year (T3) after discharge, using their medical record or self-reported drinking estimation at follow-up. Based on the alcohol status at T2 and compared with HC, only R had alexithymia, lower grey matter volume in the midbrain and hypermetabolism in the cerebellum and hippocampi. Based on the alcohol status at T3 and compared with HC, only R had more severe nicotinic dependence, lower episodic and working memory performance, lower grey matter volume in the amygdala, ventromedial prefrontal cortex and anterior cingulate gyrus and hypermetabolism in cerebellum, hippocampi and anterior cingulate gyrus. Moreover, R had bilateral frontal hypometabolism, whereas LR only presented right frontal hypometabolism. Nicotine dependence, memory impairments and structural brain abnormalities in regions involved in impulsivity and decision-making might contribute to a 1-year relapse. Treatment outcome at 1 year may also be associated with an imbalance between a hypermetabolism of the limbic system and a hypometabolism of the frontal executive system. Finally, cerebellar hypermetabolism and alexithymia may be determinants of relapse at both 6 months and 1 year.
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Affiliation(s)
- Angéline Maillard
- Normandie Univ, UNICAEN, PSL Université Paris, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, Neuropsychologie et Imagerie de la Mémoire Humaine, Caen, France
| | - Alice Laniepce
- Normandie Univ, UNICAEN, PSL Université Paris, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, Neuropsychologie et Imagerie de la Mémoire Humaine, Caen, France.,Normandie Univ, UNICAEN, INSERM, PhIND "Physiopathology and Imaging of Neurological Disorders", Institut Blood and Brain at Caen-Normandie, Cyceron, Caen, France.,Normandie Univ, UNIROUEN, CRFDP (EA7475), Rouen, France
| | - Shailendra Segobin
- Normandie Univ, UNICAEN, PSL Université Paris, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, Neuropsychologie et Imagerie de la Mémoire Humaine, Caen, France
| | - Najlaa Lahbairi
- Normandie Univ, UNICAEN, PSL Université Paris, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, Neuropsychologie et Imagerie de la Mémoire Humaine, Caen, France
| | - Céline Boudehent
- Normandie Univ, UNICAEN, PSL Université Paris, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, Neuropsychologie et Imagerie de la Mémoire Humaine, Caen, France.,Normandie Univ, UNICAEN, INSERM, PhIND "Physiopathology and Imaging of Neurological Disorders", Institut Blood and Brain at Caen-Normandie, Cyceron, Caen, France.,Service d'Addictologie, Centre Hospitalier Universitaire de Caen, Caen, France
| | - François Vabret
- Normandie Univ, UNICAEN, PSL Université Paris, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, Neuropsychologie et Imagerie de la Mémoire Humaine, Caen, France.,Normandie Univ, UNICAEN, INSERM, PhIND "Physiopathology and Imaging of Neurological Disorders", Institut Blood and Brain at Caen-Normandie, Cyceron, Caen, France.,Service d'Addictologie, Centre Hospitalier Universitaire de Caen, Caen, France
| | - Nicolas Cabé
- Normandie Univ, UNICAEN, PSL Université Paris, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, Neuropsychologie et Imagerie de la Mémoire Humaine, Caen, France.,Normandie Univ, UNICAEN, INSERM, PhIND "Physiopathology and Imaging of Neurological Disorders", Institut Blood and Brain at Caen-Normandie, Cyceron, Caen, France.,Service d'Addictologie, Centre Hospitalier Universitaire de Caen, Caen, France
| | - Anne-Lise Pitel
- Normandie Univ, UNICAEN, PSL Université Paris, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, Neuropsychologie et Imagerie de la Mémoire Humaine, Caen, France.,Normandie Univ, UNICAEN, INSERM, PhIND "Physiopathology and Imaging of Neurological Disorders", Institut Blood and Brain at Caen-Normandie, Cyceron, Caen, France.,Institut Universitaire de France (IUF), Paris, France
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12
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Yao G, Wei L, Jiang T, Dong H, Baeken C, Wu GR. Neural mechanisms underlying empathy during alcohol abstinence: evidence from connectome-based predictive modeling. Brain Imaging Behav 2022; 16:2477-2486. [PMID: 35829876 DOI: 10.1007/s11682-022-00702-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 06/20/2022] [Accepted: 06/27/2022] [Indexed: 01/10/2023]
Abstract
Empathy impairments have been linked to alcohol dependence even during abstinent periods. Nonetheless, the neural underpinnings of abstinence-induced empathy deficits remain unclear. In this study, we employed connectome-based predictive modeling (CPM) by using whole brain resting-state functional connectivity (rs-FC) to predict empathy capability of abstinent alcoholics (n = 47) versus healthy controls (n = 59). In addition, the generalizability of the predictive model (i.e., one group treated as a training dataset and another one treated as a test dataset) was performed to determine whether healthy controls and abstinent alcoholics share common neural fingerprints of empathy. Our results showed that abstinent alcoholics relative to healthy controls had decreased empathy capacity. Although no predictive models were observed in the abstinence group, we found that individual empathy scores in the healthy group can be reliably predicted by functional connectivity from the default mode network (DMN) to the sensorimotor network (SMN), occipital network, and cingulo-opercular network (CON). Moreover, the identified connectivity fingerprints of healthy controls could be generalized to predict empathy in the abstinence group. These findings indicate that neural circuits accounting for empathy may be disrupted by alcohol use and the impaired degree varies greatly among abstinent individuals. The large inter-individual variation may impede identification of the predictive model of empathy in alcohol abstainers.
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Affiliation(s)
- Guanzhong Yao
- Key Laboratory of Cognition and Personality, Faculty of Psychology, Southwest University, Chongqing, China
| | - Luqing Wei
- School of Psychology, Jiangxi Normal University, Nanchang, China.
| | - Ting Jiang
- Key Laboratory of Cognition and Personality, Faculty of Psychology, Southwest University, Chongqing, China
| | - Hui Dong
- Key Laboratory of Cognition and Personality, Faculty of Psychology, Southwest University, Chongqing, China
| | - Chris Baeken
- Faculty of Medicine and Health Sciences, Department of Head and Skin, Ghent Experimental Psychiatry (GHEP) lab, Ghent University, Ghent, Belgium.,Department of Psychiatry, University Hospital (UZBrussel), Brussels, Belgium.,Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands
| | - Guo-Rong Wu
- Key Laboratory of Cognition and Personality, Faculty of Psychology, Southwest University, Chongqing, China. .,Faculty of Medicine and Health Sciences, Department of Head and Skin, Ghent Experimental Psychiatry (GHEP) lab, Ghent University, Ghent, Belgium.
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13
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Martínez-Maldonado A, Rubio G, Sion A, Jurado-Barba R. Brain oscillatory functioning after long-term alcohol abstinence. Int J Psychophysiol 2022; 177:240-248. [PMID: 35662565 DOI: 10.1016/j.ijpsycho.2022.05.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 05/26/2022] [Accepted: 05/27/2022] [Indexed: 10/18/2022]
Abstract
The heterogeneity of the population with alcohol use disorder (AUD) sometimes makes the knowledge generated in areas such as neuroscience appear to be contradictory. One aspect that may help elucidate this apparent contradiction is controlling for certain variables that are not usually controlled, such as the abstinence time in people with AUD. This research aims to study the neuroelectrical oscillations in people with AUD with longer and shorter abstinence time in comparison with healthy individuals. We recruited twenty-nine individuals with AUD with abstinence time longer than fifteen days and shorter than six months (STA), twenty-six individuals with AUD with abstinence time longer than six months and shorter than thirteen months (LTA), and sixteen healthy individuals (HC). All participants underwent electroencephalographic recording in resting-state with eyes closed. The oscillatory activity obtained was analyzed to obtain the spectral power and phase synchronization level. Regarding the obtained spectral power results, these revealed that the STA group showed higher theta band power and lower alpha band power than the LTA and HC groups. The obtained results at the phase synchronization level also show two main results. On the one hand, the STA group showed lower alpha band phase synchronization than the LTA and HC groups. On the other hand, the HC group showed higher beta band phase synchronization than the STA and LTA groups. In conclusion, the obtained results reflect that abstinence maintenance for six or more months appears to produce an important oscillatory brain functioning normalization in people with AUD.
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Affiliation(s)
- Andrés Martínez-Maldonado
- Biomedical Research Institute Hospital 12 de Octubre, Av. Cordoba, no number, 28041 Madrid, Spain; Psychology Department, Faculty of Education & Health, Camilo José Cela University, Urb. Villafranca del Castillo, Rd. Castillo de Alarcón, 49, 28692 Villanueva de la Cañada, Madrid, Spain.
| | - Gabriel Rubio
- Biomedical Research Institute Hospital 12 de Octubre, Av. Cordoba, no number, 28041 Madrid, Spain; Faculty of Medicine, The Complutense University of Madrid, Rd. Ramón y Cajal, no number, 28040 Madrid, Spain; Addictive Diseases Network, Carlos III Health Institute, Rd. Sinesio Delgado, 4, 28029 Madrid, Spain
| | - Ana Sion
- Addictive Diseases Network, Carlos III Health Institute, Rd. Sinesio Delgado, 4, 28029 Madrid, Spain; Psychobiology and Behavioral Sciences Department, Faculty of Psychology, The Complutense University of Madrid, The Somosaguas Campus, Pozuelo de Alarcón, no number, 28223 Madrid, Spain
| | - Rosa Jurado-Barba
- Biomedical Research Institute Hospital 12 de Octubre, Av. Cordoba, no number, 28041 Madrid, Spain; Psychology Department, Faculty of Education & Health, Camilo José Cela University, Urb. Villafranca del Castillo, Rd. Castillo de Alarcón, 49, 28692 Villanueva de la Cañada, Madrid, Spain
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14
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Smart K, Worhunsky PD, Scheinost D, Angarita GA, Esterlis I, Carson RE, Krystal JH, O'Malley SS, Cosgrove KP, Hillmer AT. Multimodal neuroimaging of metabotropic glutamate 5 receptors and functional connectivity in alcohol use disorder. Alcohol Clin Exp Res 2022; 46:770-782. [PMID: 35342968 PMCID: PMC9117461 DOI: 10.1111/acer.14816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 03/15/2022] [Accepted: 03/19/2022] [Indexed: 12/01/2022]
Abstract
BACKGROUND People recovering from alcohol use disorder (AUD) show altered resting brain connectivity. The metabotropic glutamate 5 (mGlu5) receptor is an important regulator of synaptic plasticity potentially linked with synchronized brain activity and a target of interest in treating AUD. The goal of this work was to assess potential relationships of brain connectivity at rest with mGlu5 receptor availability in people with AUD at two time points early in abstinence. METHODS Forty-eight image data sets were acquired with a multimodal neuroimaging battery that included resting-state functional magnetic resonance imaging (fMRI) and mGlu5 receptor positron emission tomography (PET) with the radiotracer [18 F]FPEB. Participants with AUD (n = 14) were scanned twice, at approximately 1 and 4 weeks after beginning supervised abstinence. [18 F]FPEB PET results were published previously. Primary comparisons of fMRI outcomes were performed between the AUD group and healthy controls (HCs; n = 23) and assessed changes over time within the AUD group. Relationships between resting-state connectivity measures and mGlu5 receptor availability were explored within groups. RESULTS Compared to HCs, global functional connectivity of the orbitofrontal cortex was higher in the AUD group at 4 weeks of abstinence (p = 0.003), while network-level functional connectivity within the default mode network (DMN) was lower (p < 0.04). Exploratory multimodal analyses showed that mGlu5 receptor availability was correlated with global connectivity across all brain regions (HCs, r = 0.41; AUD group at 1 week of abstinence, r = 0.50 and at 4 weeks, r = 0.46; all p < 0.0001). Furthermore, a component of cortical and striatal mGlu5 availability was correlated with connectivity between the DMN and salience networks in HCs (r = 0.60, p = 0.003) but not in the AUD group (p > 0.3). CONCLUSIONS These preliminary findings of altered global and network connectivity during the first month of abstinence from drinking may reflect the loss of efficient network function, while exploratory relationships with mGlu5 receptor availability suggest a potential glutamatergic relationship with network coherence.
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Affiliation(s)
- Kelly Smart
- Yale PET Center, Yale School of Medicine, New Haven, Connecticut, USA.,Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, Connecticut, USA
| | - Patrick D Worhunsky
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA
| | - Dustin Scheinost
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, Connecticut, USA.,Department of Biomedical Engineering, Yale School of Engineering & Applied Science, New Haven, Connecticut, USA
| | - Gustavo A Angarita
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA
| | - Irina Esterlis
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA
| | - Richard E Carson
- Yale PET Center, Yale School of Medicine, New Haven, Connecticut, USA.,Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, Connecticut, USA.,Department of Biomedical Engineering, Yale School of Engineering & Applied Science, New Haven, Connecticut, USA
| | - John H Krystal
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA
| | | | - Kelly P Cosgrove
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, Connecticut, USA.,Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA
| | - Ansel T Hillmer
- Yale PET Center, Yale School of Medicine, New Haven, Connecticut, USA.,Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, Connecticut, USA.,Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA.,Department of Biomedical Engineering, Yale School of Engineering & Applied Science, New Haven, Connecticut, USA
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15
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Differentiating Individuals with and without Alcohol Use Disorder Using Resting-State fMRI Functional Connectivity of Reward Network, Neuropsychological Performance, and Impulsivity Measures. Behav Sci (Basel) 2022; 12:bs12050128. [PMID: 35621425 PMCID: PMC9137599 DOI: 10.3390/bs12050128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 04/11/2022] [Accepted: 04/27/2022] [Indexed: 11/17/2022] Open
Abstract
Individuals with alcohol use disorder (AUD) may manifest an array of neural and behavioral abnormalities, including altered brain networks, impaired neurocognitive functioning, and heightened impulsivity. Using multidomain measures, the current study aimed to identify specific features that can differentiate individuals with AUD from healthy controls (CTL), utilizing a random forests (RF) classification model. Features included fMRI-based resting-state functional connectivity (rsFC) across the reward network, neuropsychological task performance, and behavioral impulsivity scores, collected from thirty abstinent adult males with prior history of AUD and thirty CTL individuals without a history of AUD. It was found that the RF model achieved a classification accuracy of 86.67% (AUC = 93%) and identified key features of FC and impulsivity that significantly contributed to classifying AUD from CTL individuals. Impulsivity scores were the topmost predictors, followed by twelve rsFC features involving seventeen key reward regions in the brain, such as the ventral tegmental area, nucleus accumbens, anterior insula, anterior cingulate cortex, and other cortical and subcortical structures. Individuals with AUD manifested significant differences in impulsivity and alterations in functional connectivity relative to controls. Specifically, AUD showed heightened impulsivity and hypoconnectivity in nine connections across 13 regions and hyperconnectivity in three connections involving six regions. Relative to controls, visuo-spatial short-term working memory was also found to be impaired in AUD. In conclusion, specific multidomain features of brain connectivity, impulsivity, and neuropsychological performance can be used in a machine learning framework to effectively classify AUD individuals from healthy controls.
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16
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Grundinger N, Gerhardt S, Karl D, Mann K, Kiefer F, Vollstädt-Klein S. The effects of nalmefene on the impulsive and reflective system in alcohol use disorder: A resting-state fMRI study. Psychopharmacology (Berl) 2022; 239:2471-2489. [PMID: 35426492 PMCID: PMC9293828 DOI: 10.1007/s00213-022-06137-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 03/31/2022] [Indexed: 11/12/2022]
Abstract
RATIONALE Central aspects of alcohol use disorder (AUD) are the irresistible desire for alcohol and impaired control over its intake. According to the triadic neurocognitive model of addiction, this arises from aberrant functioning of different neural and cognitive systems: an impulsive system, a reflective system, and the abnormal dynamics between both systems based on an insular-dependent system. OBJECTIVES In this study, we examined the effects of a single dose of nalmefene on resting-state functional connectivity (rsFC) patterns within and between these addiction-related neural systems in AUD. METHODS Non-treatment seeking participants with AUD (N = 17; 19-66 years, 6 female) took part in a randomized, placebo-controlled, double-blind, crossover study and received either a single dose of 18 mg nalmefene or a placebo. Using seed-based correlation analyses on resting-state functional magnetic resonance imaging data, we examined the effects of nalmefene on key nodes related to the (1) impulsive system; (2) reflective system; (3) salience network; and (4) default mode network. RESULTS Under nalmefene, participants showed reduced rsFC between components of the impulsive system (Nucleus accumbens-putamen/pallidum/insula). Reduced rsFC was found between elements of the reflective system and impulsive system (orbitofrontal cortex-insula/putamen/pallidum), salience network (orbitofrontal cortex-insula/inferior frontal gyrus), and default mode network (lateral prefrontal cortex-precuneus/cuneus). Components of the salience network showed both increased (anterior cingulate cortex) and decreased (insular cortex) rsFC to elements of the reflective system. CONCLUSION A single dose of nalmefene impacts rsFC and alters the interaction between key nodes of addiction-related neural systems in non-treatment seeking participants with AUD. Nalmefene may normalize rsFC patterns by weakening the impulsive system while strengthening the reflective system. TRIAL REGISTRATION clinicaltrials.gov: NCT02372318.
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Affiliation(s)
- Nadja Grundinger
- grid.413757.30000 0004 0477 2235Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, University of Heidelberg, Medical Faculty Mannheim, PO Box 12 21 20, 68072 Mannheim, Germany
| | - Sarah Gerhardt
- grid.413757.30000 0004 0477 2235Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, University of Heidelberg, Medical Faculty Mannheim, PO Box 12 21 20, 68072 Mannheim, Germany
| | - Damian Karl
- grid.413757.30000 0004 0477 2235Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, University of Heidelberg, Medical Faculty Mannheim, PO Box 12 21 20, 68072 Mannheim, Germany
| | - Karl Mann
- grid.413757.30000 0004 0477 2235Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, University of Heidelberg, Medical Faculty Mannheim, PO Box 12 21 20, 68072 Mannheim, Germany
| | - Falk Kiefer
- grid.413757.30000 0004 0477 2235Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, University of Heidelberg, Medical Faculty Mannheim, PO Box 12 21 20, 68072 Mannheim, Germany ,grid.7700.00000 0001 2190 4373Feuerlein Center On Translational Addiction Medicine (FCTS), University of Heidelberg, Heidelberg, Germany ,grid.7700.00000 0001 2190 4373Mannheim Center for Translational Neurosciences (MCTN), Medical Faculty of Mannheim, University of Heidelberg, Mannheim, Germany
| | - Sabine Vollstädt-Klein
- Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, University of Heidelberg, Medical Faculty Mannheim, PO Box 12 21 20, 68072, Mannheim, Germany. .,Mannheim Center for Translational Neurosciences (MCTN), Medical Faculty of Mannheim, University of Heidelberg, Mannheim, Germany.
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17
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Wu F, Dong P, Wu G, Deng J, Ni Z, Gao X, Li P, Li B, Yuan J, Sun H. Impulsive trait mediates the relationship between white matter integrity of prefrontal-striatal circuits and the severity of dependence in alcoholism. Front Psychiatry 2022; 13:985948. [PMID: 36159935 PMCID: PMC9490322 DOI: 10.3389/fpsyt.2022.985948] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 08/15/2022] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Alcohol dependence (AD) remains one of the major public health concerns. Impulsivity plays a central role in the transfer from recreational alcohol use to dependence and relapse. White matter dysfunction has been implicated in alcohol addiction behaviors and impulsivity. However, little is known about the role of systematic striatal structural connections underlying the mechanism of impulsive traits in AD. METHODS In our study, we used seed-based classification by probabilistic tractography with five target masks of striatal circuits to explore the differences in white matter integrity (fractional anisotropy, FA) in AD male patients (N = 51) and healthy controls (N = 27). We mainly explored the correlation between FA of the striatal circuits and impulsive traits (Barratt Impulsiveness Scale, BIS-11), and the mediation role of impulsivity in white matter integrity and the severity of alcohol dependence. RESULTS Compared with healthy controls, AD showed much lower FA in the left and right striatum-supplementary motor area (SMA) and left striatum-amygdala. We also found the decreased FA of right striatum-vlPFC was correlated with higher impulsivity. Besides, the relationship between reduced FA of right striatum-vlPFC and severity of dependence could be mediated by impulsivity. CONCLUSION In our study, we found disrupted white matter integrity in systematic striatal circuits in AD and the decreased FA of right striatum-vlPFC was correlated with higher impulsivity in AD. Our main findings provide evidence for reduced white matter integrity of systematic striatal circuits and the underlying mechanisms of impulsivity in male AD individuals.
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Affiliation(s)
- Fei Wu
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University, Beijing, China
| | - Ping Dong
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University, Beijing, China
| | - Guowei Wu
- Chinese Institute for Brain Research, Beijing, China
| | - Jiahui Deng
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University, Beijing, China
| | - Zhaojun Ni
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University, Beijing, China
| | - Xuejiao Gao
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University, Beijing, China
| | - Peng Li
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University, Beijing, China
| | - Bing Li
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University, Beijing, China
| | - Junliang Yuan
- Department of Neurology, Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University, Beijing, China
| | - Hongqiang Sun
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University, Beijing, China
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18
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Dannenhoffer CA, Robertson MM, Macht VA, Mooney SM, Boettiger CA, Robinson DL. Chronic alcohol exposure during critical developmental periods differentially impacts persistence of deficits in cognitive flexibility and related circuitry. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2021; 160:117-173. [PMID: 34696872 DOI: 10.1016/bs.irn.2021.07.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Cognitive flexibility in decision making depends on prefrontal cortical function and is used by individuals to adapt to environmental changes in circumstances. Cognitive flexibility can be measured in the laboratory using a variety of discrete, translational tasks, including those that involve reversal learning and/or set-shifting ability. Distinct components of flexible behavior rely upon overlapping brain circuits, including different prefrontal substructures that have separable impacts on decision making. Cognitive flexibility is impaired after chronic alcohol exposure, particularly during development when the brain undergoes rapid maturation. This review examines how cognitive flexibility, as indexed by reversal and set-shifting tasks, is impacted by chronic alcohol exposure in adulthood, adolescent, and prenatal periods in humans and animal models. We also discuss areas for future study, including mechanisms that may contribute to the persistence of cognitive deficits after developmental alcohol exposure and the compacting consequences from exposure across multiple critical periods.
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Affiliation(s)
- C A Dannenhoffer
- Bowles Center for Alcohol Studies, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - M M Robertson
- Department of Psychology and Neuroscience, University of North Carolina, Chapel Hill, NC, United States
| | - Victoria A Macht
- Bowles Center for Alcohol Studies, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - S M Mooney
- Nutrition Research Institute and Department of Nutrition, University of North Carolina, Chapel Hill, NC, United States
| | - C A Boettiger
- Bowles Center for Alcohol Studies, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States; Department of Psychology and Neuroscience, University of North Carolina, Chapel Hill, NC, United States; Neuroscience Curriculum, University of North Carolina, Chapel Hill, NC, United States; Biomedical Research Imaging Center, University of North Carolina, Chapel Hill, NC, United States
| | - Donita L Robinson
- Bowles Center for Alcohol Studies, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States; Department of Psychiatry, University of North Carolina, Chapel Hill, NC, United States; Neuroscience Curriculum, University of North Carolina, Chapel Hill, NC, United States.
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19
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Bracht T, Soravia L, Moggi F, Stein M, Grieder M, Federspiel A, Tschümperlin R, Batschelet HM, Wiest R, Denier N. The role of the orbitofrontal cortex and the nucleus accumbens for craving in alcohol use disorder. Transl Psychiatry 2021; 11:267. [PMID: 33947835 PMCID: PMC8097061 DOI: 10.1038/s41398-021-01384-w] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 04/12/2021] [Accepted: 04/19/2021] [Indexed: 02/03/2023] Open
Abstract
This study aimed to investigate structural and functional alterations of the reward system and the neurobiology of craving in alcohol use disorder (AUD). We hypothesized reduced volume of the nucleus accumbens (NAcc), reduced structural connectivity of the segment of the supero-lateral medial forebrain bundle connecting the orbitofrontal cortex (OFC) with the NAcc (OFC-NAcc), and reduced resting-state OFC-NAcc functional connectivity (FC). Furthermore, we hypothesized that craving is related to an increase of OFC-NAcc FC. Thirty-nine recently abstinent patients with AUD and 18 healthy controls (HC) underwent structural (T1w-MP2RAGE, diffusion-weighted imaging (DWI)) and functional (resting-state fMRI) MRI-scans. Gray matter volume of the NAcc, white matter microstructure (fractional anisotropy (FA)) and macrostructure (tract length) of the OFC-NAcc connection and OFC-NAcc FC were compared between AUD and HC using a mixed model MANCOVA controlling for age and gender. Craving was assessed using the thoughts subscale of the obsessive-compulsive drinking scale (OCDS) scale and was correlated with OFC-NAcc FC. There was a significant main effect of group. Results were driven by a volume reduction of bilateral NAcc, reduced FA in the left hemisphere, and reduced tract length of bilateral OFC-NAcc connections in AUD patients. OFC-NAcc FC did not differ between groups. Craving was associated with increased bilateral OFC-NAcc FC. In conclusion, reduced volume of the NAcc and reduced FA and tract length of the OFC-NAcc network suggest structural alterations of the reward network in AUD. Increased OFC-NAcc FC is associated with craving in AUD, and may contribute to situational alcohol-seeking behavior in AUD.
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Affiliation(s)
- Tobias Bracht
- University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland.
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland.
| | - Leila Soravia
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
- Clinic Suedhang, Kirchlindach, Switzerland
| | - Franz Moggi
- University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Maria Stein
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology, University of Bern, Bern, Switzerland
| | - Matthias Grieder
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Andrea Federspiel
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Raphaela Tschümperlin
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Hallie M Batschelet
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Roland Wiest
- Institute of Diagnostic and Interventional Neuroradiology, University of Bern, Bern, Switzerland
| | - Niklaus Denier
- University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
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20
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Strosche A, Zhang X, Kirsch M, Hermann D, Ende G, Kiefer F, Vollstädt‐Klein S. Investigation of brain functional connectivity to assess cognitive control over cue-processing in Alcohol Use Disorder. Addict Biol 2021; 26:e12863. [PMID: 31908107 DOI: 10.1111/adb.12863] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 10/19/2019] [Accepted: 11/26/2019] [Indexed: 12/15/2022]
Abstract
Alcohol Use Disorder has been associated with impairments of functional connectivity between neural networks underlying reward processing and cognitive control. Evidence for aberrant functional connectivity between the striatum, insula, and frontal cortex in alcohol users exists at rest, but not during cue-exposure. In this study, we investigated functional connectivity changes during a cue-reactivity task across different subgroups of alcohol consumers. Ninety-six participants (ranging from light social to heavy social drinkers and nonabstinent dependent to abstinent dependent drinkers) were examined. A functional magnetic resonance imaging cue-reactivity paradigm was administered, during which alcohol-related and neutral stimuli were presented. Applying psychophysiological interaction analyses, we found: (a) Abstinent alcohol-dependent patients compared with non-abstinent dependent drinkers showed a greater increase of functional connectivity of the ventral striatum and anterior insula with the anterior cingulate cortex and dorsolateral prefrontal cortex during the presentation of alcohol cues compared with neutral cues. (b) Subjective craving correlated positively with functional connectivity change between the posterior insula and the medial orbitofrontal cortex and negatively with functional connectivity change between the ventral striatum and the anterior cingulate cortex, dorsolateral prefrontal cortex, and lateral orbitofrontal cortex. (c) Compulsivity of alcohol use correlated positively with functional connectivity change between the dorsolateral prefrontal cortex and the ventral striatum, anterior insula, and posterior insula. Results suggest increased cognitive control over cue-processing in abstinent alcohol-dependent patients, compensating high levels of cue-provoked craving and compulsive use. Clinical trial registration details: ClinicalTrials.gov ID: NCT00926900.
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Affiliation(s)
- Alicia Strosche
- Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, Medical Faculty Mannheim University of Heidelberg Heidelberg Germany
| | - Xiaochu Zhang
- CAS Key Laboratory of Brain Function and Disease and School of Life Sciences University of Science and Technology of China Hefei Anhui China
- Hefei Medical Research Center on Alcohol Addiction Anhui Mental Health Center Hefei China
- Academy of Psychology and Behavior Tianjin Normal University Tianjin China
| | - Martina Kirsch
- Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, Medical Faculty Mannheim University of Heidelberg Heidelberg Germany
| | - Derik Hermann
- Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, Medical Faculty Mannheim University of Heidelberg Heidelberg Germany
| | - Gabriele Ende
- Department of Neuroimaging, Central Institute of Mental Health, Medical Faculty Mannheim University of Heidelberg Heidelberg Germany
| | - Falk Kiefer
- Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, Medical Faculty Mannheim University of Heidelberg Heidelberg Germany
| | - Sabine Vollstädt‐Klein
- Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, Medical Faculty Mannheim University of Heidelberg Heidelberg Germany
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21
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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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22
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Abstract
Alcohol use disorder (AUD) commonly is associated with compromise in neurobiological and/or neurobehavioral processes. The severity of this compromise varies across individuals and outcomes, as does the degree to which recovery of function is achieved. This narrative review first summarizes neurobehavioral, neurophysiological, structural, and neurochemical aberrations/deficits that are frequently observed in people with AUD after detoxification. Subsequent sections review improvements across these domains during recovery, taking into account modulators of recovery to the extent permitted. Where appropriate, the discussion includes work integrating outcomes across domains, leveraging the strengths of diverse experimental methods. Interventions to ameliorate neurobiological or neurobehavioral deficits do not constitute a primary objective of this review. However, their consideration is a logical inclusion. Therefore, a limited introduction to existing methods is also presented.
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Affiliation(s)
- Sara Jo Nixon
- Department of Psychiatry, University of Florida, Gainesville, Florida.,Center for Addiction Research & Education, University of Florida, Gainesville, Florida
| | - Ben Lewis
- Department of Psychiatry, University of Florida, Gainesville, Florida.,Center for Addiction Research & Education, University of Florida, Gainesville, Florida
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23
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Abstract
Sex differences may play a critical role in modulating how chronic or heavy alcohol use impacts the brain to cause the development of alcohol use disorder (AUD). AUD is a multifaceted and complex disorder driven by changes in key neurobiological structures that regulate executive function, memory, and stress. A three-stage framework of addiction (binge/intoxication; withdrawal/negative affect; preoccupation/anticipation) has been useful for conceptualizing the complexities of AUD and other addictions. Initially, alcohol drinking causes short-term effects that involve signaling mediated by several neurotransmitter systems such as dopamine, corticotropin releasing factor, and glutamate. With continued intoxication, alcohol leads to dysfunctional behaviors that are thought to be due in part to alterations of these and other neurotransmitter systems, along with alterations in neural pathways connecting prefrontal and limbic structures. Using the three-stage framework, this review highlights examples of research examining sex differences in drinking and differential modulation of neural systems contributing to the development of AUD. New insights addressing the role of sex differences in AUD are advancing the field forward by uncovering the complex interactions that mediate vulnerability.
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Affiliation(s)
| | - Heather N Richardson
- Department of Psychological and Brain Sciences at the University of Massachusetts, Amherst, Massachusetts
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24
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Kamarajan C, Ardekani BA, Pandey AK, Chorlian DB, Kinreich S, Pandey G, Meyers JL, Zhang J, Kuang W, Stimus AT, Porjesz B. Random Forest Classification of Alcohol Use Disorder Using EEG Source Functional Connectivity, Neuropsychological Functioning, and Impulsivity Measures. Behav Sci (Basel) 2020; 10:bs10030062. [PMID: 32121585 PMCID: PMC7139327 DOI: 10.3390/bs10030062] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Revised: 02/26/2020] [Accepted: 02/28/2020] [Indexed: 12/16/2022] Open
Abstract
: Individuals with alcohol use disorder (AUD) manifest a variety of impairments that can be attributed to alterations in specific brain networks. The current study aims to identify features of EEG-based functional connectivity, neuropsychological performance, and impulsivity that can classify individuals with AUD (N = 30) from unaffected controls (CTL, N = 30) using random forest classification. The features included were: (i) EEG source functional connectivity (FC) of the default mode network (DMN) derived using eLORETA algorithm, (ii) neuropsychological scores from the Tower of London test (TOLT) and the visual span test (VST), and (iii) impulsivity factors from the Barratt impulsiveness scale (BIS). The random forest model achieved a classification accuracy of 80% and identified 29 FC connections (among 66 connections per frequency band), 3 neuropsychological variables from VST (total number of correctly performed trials in forward and backward sequences and average time for correct trials in forward sequence) and all four impulsivity scores (motor, non-planning, attentional, and total) as significantly contributing to classifying individuals as either AUD or CTL. Although there was a significant age difference between the groups, most of the top variables that contributed to the classification were not significantly correlated with age. The AUD group showed a predominant pattern of hyperconnectivity among 25 of 29 significant connections, indicating aberrant network functioning during resting state suggestive of neural hyperexcitability and impulsivity. Further, parahippocampal hyperconnectivity with other DMN regions was identified as a major hub region dysregulated in AUD (13 connections overall), possibly due to neural damage from chronic drinking, which may give rise to cognitive impairments, including memory deficits and blackouts. Furthermore, hypoconnectivity observed in four connections (prefrontal nodes connecting posterior right-hemispheric regions) may indicate a weaker or fractured prefrontal connectivity with other regions, which may be related to impaired higher cognitive functions. The AUD group also showed poorer memory performance on the VST task and increased impulsivity in all factors compared to controls. Features from all three domains had significant associations with one another. These results indicate that dysregulated neural connectivity across the DMN regions, especially relating to hyperconnected parahippocampal hub as well as hypoconnected prefrontal hub, may potentially represent neurophysiological biomarkers of AUD, while poor visual memory performance and heightened impulsivity may serve as cognitive-behavioral indices of AUD.
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Affiliation(s)
- Chella Kamarajan
- Henri Begleiter Neurodynamics Lab, Department of Psychiatry, SUNY Downstate Health Sciences University, Brooklyn, NY 11203, USA; (A.K.P.); (D.B.C.); (S.K.); (G.P.); (J.L.M.); (J.Z.); (W.K.); (A.T.S.); (B.P.)
- Correspondence: ; Tel.: +1-718-270-2913
| | - Babak A. Ardekani
- Center for Biomedical Imaging and Neuromodulation, Nathan S. Kline Institute for Psychiatric Research, Orangeburg, NY 10962, USA;
- Department of Psychiatry, NYU School of Medicine, New York, NY 10016, USA
| | - Ashwini K. Pandey
- Henri Begleiter Neurodynamics Lab, Department of Psychiatry, SUNY Downstate Health Sciences University, Brooklyn, NY 11203, USA; (A.K.P.); (D.B.C.); (S.K.); (G.P.); (J.L.M.); (J.Z.); (W.K.); (A.T.S.); (B.P.)
| | - David B. Chorlian
- Henri Begleiter Neurodynamics Lab, Department of Psychiatry, SUNY Downstate Health Sciences University, Brooklyn, NY 11203, USA; (A.K.P.); (D.B.C.); (S.K.); (G.P.); (J.L.M.); (J.Z.); (W.K.); (A.T.S.); (B.P.)
| | - Sivan Kinreich
- Henri Begleiter Neurodynamics Lab, Department of Psychiatry, SUNY Downstate Health Sciences University, Brooklyn, NY 11203, USA; (A.K.P.); (D.B.C.); (S.K.); (G.P.); (J.L.M.); (J.Z.); (W.K.); (A.T.S.); (B.P.)
| | - Gayathri Pandey
- Henri Begleiter Neurodynamics Lab, Department of Psychiatry, SUNY Downstate Health Sciences University, Brooklyn, NY 11203, USA; (A.K.P.); (D.B.C.); (S.K.); (G.P.); (J.L.M.); (J.Z.); (W.K.); (A.T.S.); (B.P.)
| | - Jacquelyn L. Meyers
- Henri Begleiter Neurodynamics Lab, Department of Psychiatry, SUNY Downstate Health Sciences University, Brooklyn, NY 11203, USA; (A.K.P.); (D.B.C.); (S.K.); (G.P.); (J.L.M.); (J.Z.); (W.K.); (A.T.S.); (B.P.)
| | - Jian Zhang
- Henri Begleiter Neurodynamics Lab, Department of Psychiatry, SUNY Downstate Health Sciences University, Brooklyn, NY 11203, USA; (A.K.P.); (D.B.C.); (S.K.); (G.P.); (J.L.M.); (J.Z.); (W.K.); (A.T.S.); (B.P.)
| | - Weipeng Kuang
- Henri Begleiter Neurodynamics Lab, Department of Psychiatry, SUNY Downstate Health Sciences University, Brooklyn, NY 11203, USA; (A.K.P.); (D.B.C.); (S.K.); (G.P.); (J.L.M.); (J.Z.); (W.K.); (A.T.S.); (B.P.)
| | - Arthur T. Stimus
- Henri Begleiter Neurodynamics Lab, Department of Psychiatry, SUNY Downstate Health Sciences University, Brooklyn, NY 11203, USA; (A.K.P.); (D.B.C.); (S.K.); (G.P.); (J.L.M.); (J.Z.); (W.K.); (A.T.S.); (B.P.)
| | - Bernice Porjesz
- Henri Begleiter Neurodynamics Lab, Department of Psychiatry, SUNY Downstate Health Sciences University, Brooklyn, NY 11203, USA; (A.K.P.); (D.B.C.); (S.K.); (G.P.); (J.L.M.); (J.Z.); (W.K.); (A.T.S.); (B.P.)
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25
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Kamarajan C, Ardekani BA, Pandey AK, Kinreich S, Pandey G, Chorlian DB, Meyers JL, Zhang J, Bermudez E, Stimus AT, Porjesz B. Random Forest Classification of Alcohol Use Disorder Using fMRI Functional Connectivity, Neuropsychological Functioning, and Impulsivity Measures. Brain Sci 2020; 10:brainsci10020115. [PMID: 32093319 PMCID: PMC7071377 DOI: 10.3390/brainsci10020115] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Revised: 02/12/2020] [Accepted: 02/18/2020] [Indexed: 12/22/2022] Open
Abstract
Individuals with alcohol use disorder (AUD) are known to manifest a variety of neurocognitive impairments that can be attributed to alterations in specific brain networks. The current study aims to identify specific features of brain connectivity, neuropsychological performance, and impulsivity traits that can classify adult males with AUD (n = 30) from healthy controls (CTL, n = 30) using the Random Forest (RF) classification method. The predictor variables were: (i) fMRI-based within-network functional connectivity (FC) of the Default Mode Network (DMN), (ii) neuropsychological scores from the Tower of London Test (TOLT), and the Visual Span Test (VST), and (iii) impulsivity factors from the Barratt Impulsiveness Scale (BIS). The RF model, with a classification accuracy of 76.67%, identified fourteen DMN connections, two neuropsychological variables (memory span and total correct scores of the forward condition of the VST), and all impulsivity factors as significantly important for classifying participants into either the AUD or CTL group. Specifically, the AUD group manifested hyperconnectivity across the bilateral anterior cingulate cortex and the prefrontal cortex as well as between the bilateral posterior cingulate cortex and the left inferior parietal lobule, while showing hypoconnectivity in long-range anterior-posterior and interhemispheric long-range connections. Individuals with AUD also showed poorer memory performance and increased impulsivity compared to CTL individuals. Furthermore, there were significant associations among FC, impulsivity, neuropsychological performance, and AUD status. These results confirm the previous findings that alterations in specific brain networks coupled with poor neuropsychological functioning and heightened impulsivity may characterize individuals with AUD, who can be efficiently identified using classification algorithms such as Random Forest.
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Affiliation(s)
- Chella Kamarajan
- Henri Begleiter Neurodynamics Lab, Department of Psychiatry, SUNY Downstate Health Sciences University, Brooklyn, NY 11203, USA; (A.K.P.); (S.K.); (G.P.); (D.B.C.); (J.L.M.); (J.Z.); (A.T.S.); (B.P.)
- Correspondence: ; Tel.: +1-718-270-2913
| | - Babak A. Ardekani
- Center for Biomedical Imaging and Neuromodulation, Nathan S. Kline Institute for Psychiatric Research, Orangeburg, NY 10962, USA;
- Department of Psychiatry, NYU School of Medicine, New York, NY 10016, USA;
| | - Ashwini K. Pandey
- Henri Begleiter Neurodynamics Lab, Department of Psychiatry, SUNY Downstate Health Sciences University, Brooklyn, NY 11203, USA; (A.K.P.); (S.K.); (G.P.); (D.B.C.); (J.L.M.); (J.Z.); (A.T.S.); (B.P.)
| | - Sivan Kinreich
- Henri Begleiter Neurodynamics Lab, Department of Psychiatry, SUNY Downstate Health Sciences University, Brooklyn, NY 11203, USA; (A.K.P.); (S.K.); (G.P.); (D.B.C.); (J.L.M.); (J.Z.); (A.T.S.); (B.P.)
| | - Gayathri Pandey
- Henri Begleiter Neurodynamics Lab, Department of Psychiatry, SUNY Downstate Health Sciences University, Brooklyn, NY 11203, USA; (A.K.P.); (S.K.); (G.P.); (D.B.C.); (J.L.M.); (J.Z.); (A.T.S.); (B.P.)
| | - David B. Chorlian
- Henri Begleiter Neurodynamics Lab, Department of Psychiatry, SUNY Downstate Health Sciences University, Brooklyn, NY 11203, USA; (A.K.P.); (S.K.); (G.P.); (D.B.C.); (J.L.M.); (J.Z.); (A.T.S.); (B.P.)
| | - Jacquelyn L. Meyers
- Henri Begleiter Neurodynamics Lab, Department of Psychiatry, SUNY Downstate Health Sciences University, Brooklyn, NY 11203, USA; (A.K.P.); (S.K.); (G.P.); (D.B.C.); (J.L.M.); (J.Z.); (A.T.S.); (B.P.)
| | - Jian Zhang
- Henri Begleiter Neurodynamics Lab, Department of Psychiatry, SUNY Downstate Health Sciences University, Brooklyn, NY 11203, USA; (A.K.P.); (S.K.); (G.P.); (D.B.C.); (J.L.M.); (J.Z.); (A.T.S.); (B.P.)
| | - Elaine Bermudez
- Department of Psychiatry, NYU School of Medicine, New York, NY 10016, USA;
| | - Arthur T. Stimus
- Henri Begleiter Neurodynamics Lab, Department of Psychiatry, SUNY Downstate Health Sciences University, Brooklyn, NY 11203, USA; (A.K.P.); (S.K.); (G.P.); (D.B.C.); (J.L.M.); (J.Z.); (A.T.S.); (B.P.)
| | - Bernice Porjesz
- Henri Begleiter Neurodynamics Lab, Department of Psychiatry, SUNY Downstate Health Sciences University, Brooklyn, NY 11203, USA; (A.K.P.); (S.K.); (G.P.); (D.B.C.); (J.L.M.); (J.Z.); (A.T.S.); (B.P.)
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26
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Sousa SS, Sampaio A, Marques P, López-Caneda E, Gonçalves ÓF, Crego A. Functional and structural connectivity of the executive control network in college binge drinkers. Addict Behav 2019; 99:106009. [PMID: 31487578 DOI: 10.1016/j.addbeh.2019.05.033] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Revised: 05/29/2019] [Accepted: 05/30/2019] [Indexed: 01/06/2023]
Abstract
Binge Drinking (BD) is a pattern of excessive alcohol consumption highly prevalent among college students, and has been associated with structural and functional alterations of brain networks. Recent advances in the resting-state connectivity analysis have boosted the research of the network-level connectivity disturbances associated with many psychiatric and neurological disorders, including addiction. Accordingly, atypical functional connectivity patterns in resting-state networks such as the Executive Control Network (ECN) have been found in substance users and alcohol-dependent individuals. In this study, we assessed for the first time the ECN functional and structural connectivity in a group of 34 college students, 20 (10 women) binge drinkers (BDs) in comparison with a group of 14 (8 women) alcohol abstinent controls (AACs). Overall, our findings documented increased resting-state functional connectivity (rsFC) in the BDs left middle frontal cortex of the left ECN in comparison to the AACs, while no structural connectivity differences were observed between groups. Pearson correlations revealed a positive association between the left middle frontal gyrus rsFC and the frequency of BD episodes per month, in the BD group. These findings suggest that maintaining a pattern of acute and intermittent alcohol consumption during important stages of brain development, as the transition from adolescence to adulthood, is associated with impaired ECN rsFC despite no group differences being yet noticed in the ECN structural connectivity.
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Affiliation(s)
- Sónia S Sousa
- Psychological Neuroscience Lab, CIPsi, School of Psychology, University of Minho, Campus Gualtar, 4710-057 Braga, Portugal.
| | - Adriana Sampaio
- Psychological Neuroscience Lab, CIPsi, School of Psychology, University of Minho, Campus Gualtar, 4710-057 Braga, Portugal
| | - Paulo Marques
- Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Campus Gualtar, 4710-057 Braga, Portugal; ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Eduardo López-Caneda
- Psychological Neuroscience Lab, CIPsi, School of Psychology, University of Minho, Campus Gualtar, 4710-057 Braga, Portugal
| | - Óscar F Gonçalves
- Psychological Neuroscience Lab, CIPsi, School of Psychology, University of Minho, Campus Gualtar, 4710-057 Braga, Portugal; Spaulding Neuromodulation Center, Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Massachusetts General Hospital. Harvard Medical School, Charlestown campus: 79/96 13th Street, Charlestown, MA 02129, USA; Department of Applied Psychology, Bouvé College of Health Sciences, Northeastern University, 404 International Village, Boston, MA 02115, USA
| | - Alberto Crego
- Psychological Neuroscience Lab, CIPsi, School of Psychology, University of Minho, Campus Gualtar, 4710-057 Braga, Portugal
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Gerchen MF, Rentsch A, Kirsch M, Kiefer F, Kirsch P. Shifts in the functional topography of frontal cortex-striatum connectivity in alcohol use disorder. Addict Biol 2019; 24:1245-1253. [PMID: 30468293 DOI: 10.1111/adb.12692] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Revised: 10/09/2018] [Accepted: 10/09/2018] [Indexed: 11/27/2022]
Abstract
Frontostriatal circuits are centrally involved in the selection of behavioral programs and play a prominent role in alcohol use disorder (AUD) as well as other mental disorders. However, how frontal regions change their striatal connectivity to implement adaptive cognitive control is still not fully understood. Here, we developed an approach for functional magnetic resonance imaging (fMRI) connectivity analysis in which we change the focus from connectivity to individual voxels towards spatial information about the location of strongest functional connectivity. In resting state data of n = 66 participants with AUD and n = 40 healthy controls (HC) we used the approach to estimate frontostriatal connectivity gradients consistent with nonhuman primate tract-tracing studies, characterized for each frontal voxel the striatal peak connectivity location on this gradient (PeaCoG), and tested for group differences and associations with clinical variables. We identified a cluster in the right orbitofrontal cortex (rOFC) with a peak connectivity shift towards ventral striatal regions in AUD. Reduced variability of rOFC striatal peak connectivity in the AUD group suggests a "clamping" to the ventral striatum as the underlying effect. Within the AUD group striatal peak connectivity in the superior frontal gyrus was associated with self-efficacy to abstain from alcohol, in the medial frontal and dorsolateral prefrontal cortex with alcohol dependency, and in the right inferior frontal gyrus with the urge to consume alcohol. Our results demonstrate that the functional topography of frontostriatal circuits exhibits interindividual variability, which provides insight into frontostriatal network adaptations in AUD and potentially other mental disorders.
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Affiliation(s)
- Martin Fungisai Gerchen
- Department of Clinical PsychologyCentral Institute of Mental Health, University of Heidelberg/Medical Faculty Mannheim Mannheim Germany
- Bernstein Center for Computational Neuroscience Heidelberg/Mannheim Mannheim Germany
| | - Alena Rentsch
- Department of Clinical PsychologyCentral Institute of Mental Health, University of Heidelberg/Medical Faculty Mannheim Mannheim Germany
| | - Martina Kirsch
- Department of Addiction Behavior and Addiction Medicine, Central Institute of Mental HealthUniversity of Heidelberg/Medical Faculty Mannheim Mannheim Germany
| | - Falk Kiefer
- Department of Addiction Behavior and Addiction Medicine, Central Institute of Mental HealthUniversity of Heidelberg/Medical Faculty Mannheim Mannheim Germany
| | - Peter Kirsch
- Department of Clinical PsychologyCentral Institute of Mental Health, University of Heidelberg/Medical Faculty Mannheim Mannheim Germany
- Bernstein Center for Computational Neuroscience Heidelberg/Mannheim Mannheim Germany
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Sullivan EV, Pfefferbaum A. Brain-behavior relations and effects of aging and common comorbidities in alcohol use disorder: A review. Neuropsychology 2019; 33:760-780. [PMID: 31448945 PMCID: PMC7461729 DOI: 10.1037/neu0000557] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVE Alcohol use disorder (AUD) is a complex, dynamic condition that waxes and wanes with unhealthy drinking episodes and varies in drinking patterns and effects on brain structure and function with age. Its excessive use renders chronically heavy drinkers vulnerable to direct alcohol toxicity and a variety of comorbidities attributable to nonalcohol drug misuse, viral infections, and accelerated or premature aging. AUD affects widespread brain systems, commonly, frontolimbic, frontostriatal, and frontocerebellar networks. METHOD AND RESULTS Multimodal assessment using selective neuropsychological testing and whole-brain neuroimaging provides evidence for AUD-related specific brain structure-function relations established with double dissociations. Longitudinal study using noninvasive imaging provides evidence for brain structural and functional improvement with sustained sobriety and further decline with relapse. Functional imaging suggests the possibility that some alcoholics in recovery can compensate for impairment by invoking brain systems typically not used for a target task but that can enable normal-level performance. CONCLUSIONS Evidence for AUD-aging interactions, indicative of accelerated aging, together with increasing alcohol consumption in middle-age and older adults, put aging drinkers at special risk for developing cognitive decline and possibly dementia. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Affiliation(s)
- Edith V. Sullivan
- Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, CA
| | - Adolf Pfefferbaum
- Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, CA
- Center for Health Sciences, SRI International, Menlo Park, CA
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29
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Wilcox CE, Abbott CC, Calhoun VD. Alterations in resting-state functional connectivity in substance use disorders and treatment implications. Prog Neuropsychopharmacol Biol Psychiatry 2019; 91:79-93. [PMID: 29953936 PMCID: PMC6309756 DOI: 10.1016/j.pnpbp.2018.06.011] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Revised: 06/18/2018] [Accepted: 06/23/2018] [Indexed: 02/06/2023]
Abstract
Substance use disorders (SUD) are diseases of the brain, characterized by aberrant functioning in the neural circuitry of the brain. Resting state functional connectivity (rsFC) can illuminate these functional changes by measuring the temporal coherence of low-frequency fluctuations of the blood oxygenation level-dependent magnetic resonance imaging signal in contiguous or non-contiguous regions of the brain. Because this data is easy to obtain and analyze, and therefore fairly inexpensive, it holds promise for defining biological treatment targets in SUD, which could help maximize the efficacy of existing clinical interventions and develop new ones. In an effort to identify the most likely "treatment targets" obtainable with rsFC we summarize existing research in SUD focused on 1) the relationships between rsFC and functionality within important psychological domains which are believed to underlie relapse vulnerability 2) changes in rsFC from satiety to deprived or abstinent states 3) baseline rsFC correlates of treatment outcome and 4) changes in rsFC induced by treatment interventions which improve clinical outcomes and reduce relapse risk. Converging evidence indicates that likely "treatment target" candidates, emerging consistently in all four sections, are reduced connectivity within executive control network (ECN) and between ECN and salience network (SN). Other potential treatment targets also show promise, but the literature is sparse and more research is needed. Future research directions include data-driven prediction analyses and rsFC analyses with longitudinal datasets that incorporate time since last use into analysis to account for drug withdrawal. Once the most reliable biological markers are identified, they can be used for treatment matching, during preliminary testing of new pharmacological compounds to establish clinical potential ("target engagement") prior to carrying out costly clinical trials, and for generating hypotheses for medication repurposing.
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Fede SJ, Grodin EN, Dean SF, Diazgranados N, Momenan R. Resting state connectivity best predicts alcohol use severity in moderate to heavy alcohol users. Neuroimage Clin 2019; 22:101782. [PMID: 30921611 PMCID: PMC6438989 DOI: 10.1016/j.nicl.2019.101782] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Revised: 02/07/2019] [Accepted: 03/14/2019] [Indexed: 01/12/2023]
Abstract
BACKGROUND In the United States, 13% of adults are estimated to have alcohol use disorder (AUD). Most studies examining the neurobiology of AUD treat individuals with this disorder as a homogeneous group; however, the theories of the neurocircuitry of AUD call for a quantitative and dimensional approach. Previous imaging studies find differences in brain structure, function, and resting-state connectivity in AUD, but few use a multimodal approach to understand the association between severity of alcohol use and the brain differences. METHODS Adults (ages 22-60) with problem drinking patterns (n = 59) completed a behavioral and neuroimaging protocol at the National Institutes of Health. Alcohol severity was quantified with the Alcohol Use Disorders Identification Test (AUDIT). In a 3 T MRI scanner, participants underwent a structural MRI as well as resting-state, monetary incentive delay, and face matching fMRI scans. Machine learning was applied and trained using the neural data from MRI scanning. The model was tested for generalizability in a validation sample (n = 24). RESULTS The resting state-connectivity features model best predicted AUD severity in the naïve sample, compared to task fMRI, structural MRI, combined MRI features, or demographic features. Network connectivity features between salience network, default mode network, executive control network, and sensory networks explained 33% of the variance associated with AUDIT in this model. CONCLUSIONS These findings indicate that the neural effects of AUD vary according to severity. Our results emphasize the utility of resting state fMRI as a neuroimaging biomarker for quantitative clinical evaluation of AUD.
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Affiliation(s)
- Samantha J Fede
- Clinical NeuroImaging Research Core, National Institute of Alcohol Abuse and Alcoholism, National Institutes of Health, 10 Center Drive, Bethesda, MD 20814, MSC 1108, United States.
| | - Erica N Grodin
- Clinical NeuroImaging Research Core, National Institute of Alcohol Abuse and Alcoholism, National Institutes of Health, 10 Center Drive, Bethesda, MD 20814, MSC 1108, United States
| | - Sarah F Dean
- Clinical NeuroImaging Research Core, National Institute of Alcohol Abuse and Alcoholism, National Institutes of Health, 10 Center Drive, Bethesda, MD 20814, MSC 1108, United States
| | - Nancy Diazgranados
- Office of Clinical Director, National Institute of Alcohol Abuse and Alcoholism, National Institutes of Health, 10 Center Drive, Bethesda, MD 20814, MSC 1108, United States
| | - Reza Momenan
- Clinical NeuroImaging Research Core, National Institute of Alcohol Abuse and Alcoholism, National Institutes of Health, 10 Center Drive, Bethesda, MD 20814, MSC 1108, United States.
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Correas A, López-Caneda E, Beaton L, Holguín SR, García-Moreno LM, Antón-Toro LF, Cadaveira F, Maestú F, Marinkovic K. Decreased event-related theta power and phase-synchrony in young binge drinkers during target detection: An anatomically-constrained MEG approach. J Psychopharmacol 2019; 33:335-346. [PMID: 30355025 PMCID: PMC6401286 DOI: 10.1177/0269881118805498] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
BACKGROUND The prevalence of binge drinking has risen in recent years. It is associated with a range of neurocognitive deficits among adolescents and young emerging adults who are especially vulnerable to alcohol use. Attention is an essential dimension of executive functioning and attentional disturbances may be associated with hazardous drinking. The aim of the study was to examine the oscillatory neural dynamics of attentional control during visual target detection in emerging young adults as a function of binge drinking. METHOD In total, 51 first-year university students (18 ± 0.6 years) were assigned to light drinking ( n = 26), and binge drinking ( n = 25) groups based on their alcohol consumption patterns. A high-density magnetoencephalography signal was combined with structural magnetic resonance imaging in an anatomically constrained magnetoencephalography model to estimate event-related source power in a theta (4-7 Hz) frequency band. Phase-locked co-oscillations were further estimated between the principally activated regions during task performance. RESULTS Overall, the greatest event-related theta power was elicited by targets in the right inferior frontal cortex and it correlated with performance accuracy and selective attention scores. Binge drinkers exhibited lower theta power and dysregulated oscillatory synchrony to targets in the right inferior frontal cortex, which correlated with higher levels of alcohol consumption. CONCLUSIONS These results confirm that a highly interactive network in the right inferior frontal cortex subserves attentional control, revealing the importance of theta oscillations and neural synchrony for attentional capture and contextual maintenance. Attenuation of theta power and synchronous interactions in binge drinkers may indicate early stages of suboptimal integrative processing in young, highly functioning binge drinkers.
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Affiliation(s)
- Angeles Correas
- Department of Psychology, San Diego State University, San Diego, USA
| | - Eduardo López-Caneda
- Neuropsychophysiology Lab, Research Center on Psychology (CIPsi), School of Psychology, University of Minho, Braga, Portugal
| | - Lauren Beaton
- Department of Psychology, San Diego State University, San Diego, USA
| | | | - Luis Miguel García-Moreno
- Department of Psychobiology and Methodology in Behavioral Sciences, Complutense University of Madrid, Madrid, Spain
| | - Luis F. Antón-Toro
- Laboratory of Cognitive and Computational Neuroscience (UCM-UPM), Centre of Biomedical Technology (CTB), Madrid, Spain
| | - Fernando Cadaveira
- Department of Clinical Psychology and Psychobiology, University of Santiago de Compostela, Spain
| | - Fernando Maestú
- Laboratory of Cognitive and Computational Neuroscience (UCM-UPM), Centre of Biomedical Technology (CTB), Madrid, Spain
- Department of Experimental Psychology, Complutense University of Madrid, Spain
- Network of Center for Biomedical Research (CIBER-bbn), Madrid, Spain
| | - Ksenija Marinkovic
- Department of Psychology, San Diego State University, San Diego, USA
- Department of Radiology, University of California at San Diego, San Diego, USA
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Halcomb ME, Chumin EJ, Goñi J, Dzemidzic M, Yoder KK. Aberrations of anterior insular cortex functional connectivity in nontreatment-seeking alcoholics. Psychiatry Res Neuroimaging 2019; 284:21-28. [PMID: 30640144 PMCID: PMC6668713 DOI: 10.1016/j.pscychresns.2018.12.016] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Revised: 12/11/2018] [Accepted: 12/31/2018] [Indexed: 01/28/2023]
Abstract
An emergent literature suggests that resting state functional magnetic resonance imaging (rsfMRI) functional connectivity (FC) patterns are aberrant in alcohol use disorder (AUD) populations. The salience network (SAL) is an established set of brain regions prominent in salience attribution and valuation, and includes the anterior insular cortex (AIC). The SAL is thought to play a role in AUD through directing increased attention to interoceptive cues of intoxication. There is very little information on the salience network (SAL) in AUD, and, in particular, there are no data on SAL FC in currently drinking, nontreatment seeking individuals with AUD (NTS). rsfMRI data from 16 NTS and 21 social drinkers (SD) were compared using FC correlation maps from ten seed regions of interest in the bilateral AIC. As anticipated, SD subjects demonstrated greater insular FC with frontal and parietal regions. We also found that, compared to SD, NTS had higher insular FC with hippocampal and medial orbitofrontal regions. The apparent overactivity in brain networks involved in salience, learning, and behavioral control in NTS suggests possible mechanisms in the development and maintenance of AUD.
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Affiliation(s)
- Meredith E Halcomb
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN, USA; Indiana University Center for Neuroimaging, Indiana University School of Medicine, Indianapolis, IN, USA; Department of Neurology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Evgeny J Chumin
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN, USA; Indiana University Center for Neuroimaging, Indiana University School of Medicine, Indianapolis, IN, USA; Stark Neurosciences Research Institute, Indiana University School of Medicine, Indiananpolis, IN, USA; Department of Neurology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Joaquín Goñi
- Purdue Institute for Integrative Neuroscience, Purdue University, West Lafayette, IN, USA.; Department of Neurology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Mario Dzemidzic
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN, USA; Indiana University Center for Neuroimaging, Indiana University School of Medicine, Indianapolis, IN, USA; Department of Neurology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Karmen K Yoder
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN, USA; Indiana University Center for Neuroimaging, Indiana University School of Medicine, Indianapolis, IN, USA; Stark Neurosciences Research Institute, Indiana University School of Medicine, Indiananpolis, IN, USA; Department of Neurology, Indiana University School of Medicine, Indianapolis, IN, USA; Department of Psychology, Indiana University Purdue University Indianapolis, Indianapolis, IN, USA.
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Guo L, Zhou F, Zhang N, Kuang H, Feng Z. Frequency-Specific Abnormalities Of Functional Homotopy In Alcohol Dependence: A Resting-State Functional Magnetic Resonance Imaging Study. Neuropsychiatr Dis Treat 2019; 15:3231-3245. [PMID: 31819451 PMCID: PMC6875289 DOI: 10.2147/ndt.s221010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Accepted: 10/28/2019] [Indexed: 11/23/2022] Open
Abstract
PURPOSE Alcohol dependence (AD) is a relapsing mental disorder, typically occurring with concurrent tobacco misuse. Studies have reported disruption of the structural connectivity between hemispheres in the brain of individuals with AD. However, alterations in interhemispheric interactions and the specificity of frequency bands in individuals with AD remain unknown. Voxel-mirrored homotopic connectivity (VMHC) allows examination of functional interactions between mirrored interhemispheric voxels. Here, we use VMHC to investigate homotopic connectivity in AD and alcohol and nicotine co-dependence (AND) subjects. PATIENTS AND METHODS VMHC and seed-based functional connectivity (FC) in 24 AD, 30 AND, and 35 sex-, age-, and education-matched healthy control (HC) subjects were calculated for different frequency bands (slow-5, slow-4, and typical bands). RESULTS Individuals with AD demonstrated significantly reduced VMHC in bilateral cerebellum posterior lobe (CPL) and increased VMHC in bilateral middle frontal gyrus (MFG) compared to that in HCs in the typical and slow-4 bands; higher VMHC in the MFG was positively correlated with the dependence-severity score. In all bands of the VMHC analysis, no significant differences were found between the AND and other groups. Subsequent seed-based FC analysis demonstrated all regions with abnormal VMHC exhibited altered FC with its counterpart in the contralateral hemisphere in the typical and slow-4 frequency bands. The FC value between bilateral CPL within AD subjects negatively correlated with alcohol intake. CONCLUSION Our findings provide further evidence of the role of disruptions within the brain circuitry supporting cognitive control in the development of AD. Alterations in neural activities in the CPL and MFG might be a biomarker of dependence severity in AD patients as assessed using clinical questionnaire and features. Because of the frequency specificity in VMHC, we must consider frequency effects in future AD functional magnetic resonance imaging studies.
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Affiliation(s)
- Linghong Guo
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province, People's Republic of China
| | - Fuqing Zhou
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province, People's Republic of China
| | - Ning Zhang
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province, People's Republic of China
| | - Hongmei Kuang
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province, People's Republic of China
| | - Zhen Feng
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province, People's Republic of China
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Camchong J, Collins PF, Becker MP, Lim KO, Luciana M. Longitudinal Alterations in Prefrontal Resting Brain Connectivity in Non-Treatment-Seeking Young Adults With Cannabis Use Disorder. Front Psychiatry 2019; 10:514. [PMID: 31404267 PMCID: PMC6670783 DOI: 10.3389/fpsyt.2019.00514] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Accepted: 07/01/2019] [Indexed: 12/20/2022] Open
Abstract
Background: Cannabis is increasingly perceived as a harmless drug by recreational users, yet chronic use may impact brain changes into adulthood. Repeated cannabis exposure has been associated with enduring synaptic changes in executive control and reward networks. It is important to determine whether there are brain functional alterations within these networks in individuals that do not seek treatment for chronic cannabis abuse. Methods: This longitudinal study compared resting-state functional connectivity changes in executive control and reward networks between 23 non-treatment-seeking young adults with cannabis use disorder (6 females; baseline age M = 19.3 ± 1.18) and 21 age-matched controls (10 females; baseline age M = 19.4 ± 0.65) to determine group differences in the temporal trajectories of resting-state functional connectivity across a 2-year span. Results: Results showed i) significant increases in resting-state functional connectivity between the caudal anterior cingulate cortex and precentral and parietal regions over time in the control group, but not in the cannabis use disorder group, and ii) sustained lower resting-state functional connectivity of anterior cingulate cortex seeds with frontal and thalamic regions in the cannabis use disorder group vs. the age-matched controls. Resting-state functional connectivity strength was correlated with cannabis use patterns in the cannabis use disorder sample. Conclusion: Longitudinal alterations in intrinsic functional organization of executive control networks found in non-treatment-seeking young adults with cannabis use disorder (when compared to age-matched controls) may impact regulatory control over substance use behavior. Current findings were limited to examining executive control and reward networks seeded in ACC and NAcc, respectively. Future studies with larger sample sizes and enough power are needed to conduct exploratory analyses examining rsFC of other networks beyond those within the scope of the current study.
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Affiliation(s)
- Jazmin Camchong
- Department of Psychiatry, University of Minnesota, Minneapolis, MN, United States
| | - Paul F Collins
- Department of Psychology, University of Minnesota, Minneapolis, MN, United States
| | - Mary P Becker
- Department of Psychiatry, Hennepin Healthcare, Richfield, MN, United States
| | - Kelvin O Lim
- Department of Psychiatry, University of Minnesota, Minneapolis, MN, United States
| | - Monica Luciana
- Department of Psychology, University of Minnesota, Minneapolis, MN, United States
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Zhornitsky S, Zhang S, Ide JS, Chao HH, Wang W, Le TM, Leeman RF, Bi J, Krystal JH, Li CSR. Alcohol Expectancy and Cerebral Responses to Cue-Elicited Craving in Adult Nondependent Drinkers. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2018; 4:493-504. [PMID: 30711509 DOI: 10.1016/j.bpsc.2018.11.012] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Revised: 11/21/2018] [Accepted: 11/28/2018] [Indexed: 12/29/2022]
Abstract
BACKGROUND Positive alcohol expectancy (AE) contributes to excessive drinking. Many imaging studies have examined cerebral responses to alcohol cues and how these regional processes related to problem drinking. However, it remains unclear how AE relates to cue response and whether AE mediates the relationship between cue response and problem drinking. METHODS A total of 61 nondependent drinkers were assessed with the Alcohol Expectancy Questionnaire and Alcohol Use Disorder Identification Test and underwent functional magnetic resonance imaging while exposed to alcohol and neutral cues. Imaging data were processed and analyzed with published routines, and mediation analyses were conducted to examine the interrelationships among global positive score of the Alcohol Expectancy Questionnaire, Alcohol Use Disorder Identification Test score, and regional responses to alcohol versus neutral cues. RESULTS Alcohol as compared with neutral cues engaged the occipital, retrosplenial, and medial orbitofrontal cortex as well as the left caudate head and red nucleus. The bilateral thalamus showed a significant correlation in cue response and in left superior frontal cortical connectivity with global positive score in a linear regression. Mediation analyses showed that global positive score completely mediated the relationship between thalamic cue activity as well as superior frontal cortical connectivity and Alcohol Use Disorder Identification Test score. The alternative models that AE contributed to problem drinking and, in turn, thalamic cue activity and connectivity were not supported. CONCLUSIONS The findings suggest an important role of the thalamic responses to alcohol cues in contributing to AE and at-risk drinking in nondependent drinkers. AEs may reflect a top-down modulation of the thalamic processing of alcohol cues, influencing the pattern of alcohol use.
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Affiliation(s)
- Simon Zhornitsky
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
| | - Sheng Zhang
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
| | - Jaime S Ide
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
| | - Herta H Chao
- Department of Medicine, Yale University School of Medicine, New Haven, Connecticut; VA Connecticut Healthcare System, West Haven, Connecticut
| | - Wuyi Wang
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
| | - Thang M Le
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
| | - Robert F Leeman
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut; Department of Health Education & Behavior, University of Florida, Gainesville, Florida
| | - Jinbo Bi
- Department of Computer Science & Engineering, School of Engineering, University of Connecticut, Storrs, Connecticut; Department of Community Medicine and Health Care, School of Medicine, University of Connecticut Health Center, Farmington, Connecticut
| | - John H Krystal
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut; Department of Neuroscience, Yale University School of Medicine, New Haven, Connecticut; Interdepartmental Neuroscience Program, Yale University, New Haven, Connecticut
| | - Chiang-Shan R Li
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut; Department of Neuroscience, Yale University School of Medicine, New Haven, Connecticut; Interdepartmental Neuroscience Program, Yale University, New Haven, Connecticut.
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Zhornitsky S, Ide JS, Wang W, Chao HH, Zhang S, Hu S, Krystal JH, Li CSR. Problem Drinking, Alcohol Expectancy, and Thalamic Resting-State Functional Connectivity in Nondependent Adult Drinkers. Brain Connect 2018; 8:487-502. [PMID: 30198312 PMCID: PMC6207153 DOI: 10.1089/brain.2018.0633] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Alcohol misuse is associated with thalamic dysfunction. The thalamus comprises subnuclei that relay and integrate information between cortical and subcortical structures. However, it is unclear how the subnuclei contribute to thalamic dysfunctions in problem drinking. We investigated resting-state functional connectivity (rsFC) of thalamic subregions in 107 nondependent drinkers (57 women), using masks delineated by white matter tractography. Thalamus was parceled into motor, somatosensory, visual, premotor, frontal association, parietal association, and temporal association subregions. Whole-brain linear regression, each against Alcohol Use Disorders Identification Test (AUDIT) and positive alcohol expectancy (AE) score with age as a covariate, was performed for each seed, for men and women combined, and separately. Overall, problem drinking was associated with increased thalamic connectivities, whereas AE was associated with a mixed pattern of increased and decreased connectivities. Motor, premotor, somatosensory, and frontal association thalamic connectivity with bilateral caudate head was positively correlated with AUDIT score in men and women combined. Connectivity of the right caudate head with frontal association and premotor thalamus was also positively correlated with AE score in men and women combined. In contrast, motor and premotor thalamic connectivity with a number of cortical and subcortical structures showed sex differences in the correlation each with AUDIT and AE score. In mediation analyses, AE score completely mediated the correlation between thalamic caudate connectivity and AUDIT score, whereas the model where AE contributed to problem drinking and, in turn, altered thalamic caudate connectivity was not supported. To conclude, thalamic subregional rsFCs showed both shared and distinct changes and sex differences in association with problem drinking and AE. Increased thalamic caudate connectivity may contribute to problem drinking via enhanced AE. The findings suggest the importance of examining thalamic subdivisions and sex in investigating the functional roles of thalamus in problem drinking.
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Affiliation(s)
- Simon Zhornitsky
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
| | - Jaime S. Ide
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
| | - Wuyi Wang
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
| | - Herta H. Chao
- Department of Medicine, Yale University School of Medicine, New Haven, Connecticut
- VA Connecticut Healthcare System, West Haven, Connecticut
| | - Sheng Zhang
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
| | - Sien Hu
- Department of Psychology, State University of New York, Oswego, New York
| | - John H. Krystal
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
- Department of Neuroscience, Yale University School of Medicine, New Haven, Connecticut
- Interdepartmental Neuroscience Program, Yale University School of Medicine, New Haven, Connecticut
| | - Chiang-shan R. Li
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
- Department of Neuroscience, Yale University School of Medicine, New Haven, Connecticut
- Interdepartmental Neuroscience Program, Yale University School of Medicine, New Haven, Connecticut
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Zhu X, Du X, Kerich M, Lohoff FW, Momenan R. Random forest based classification of alcohol dependence patients and healthy controls using resting state MRI. Neurosci Lett 2018; 676:27-33. [PMID: 29626649 DOI: 10.1016/j.neulet.2018.04.007] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Revised: 03/19/2018] [Accepted: 04/02/2018] [Indexed: 12/19/2022]
Abstract
Currently, classification of alcohol use disorder (AUD) is made on clinical grounds; however, robust evidence shows that chronic alcohol use leads to neurochemical and neurocircuitry adaptations. Identifications of the neuronal networks that are affected by alcohol would provide a more systematic way of diagnosis and provide novel insights into the pathophysiology of AUD. In this study, we identified network-level brain features of AUD, and further quantified resting-state within-network, and between-network connectivity features in a multivariate fashion that are classifying AUD, thus providing additional information about how each network contributes to alcoholism. Resting-state fMRI were collected from 92 individuals (46 controls and 46 AUDs). Probabilistic Independent Component Analysis (PICA) was used to extract brain functional networks and their corresponding time-course for AUD and controls. Both within-network connectivity for each network and between-network connectivity for each pair of networks were used as features. Random forest was applied for pattern classification. The results showed that within-networks features were able to identify AUD and control with 87.0% accuracy and 90.5% precision, respectively. Networks that were most informative included Executive Control Networks (ECN), and Reward Network (RN). The between-network features achieved 67.4% accuracy and 70.0% precision. The between-network connectivity between RN-Default Mode Network (DMN) and RN-ECN contribute the most to the prediction. In conclusion, within-network functional connectivity offered maximal information for AUD classification, when compared with between-network connectivity. Further, our results suggest that connectivity within the ECN and RN are informative in classifying AUD. Our findings suggest that machine-learning algorithms provide an alternative technique to quantify large-scale network differences and offer new insights into the identification of potential biomarkers for the clinical diagnosis of AUD.
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Affiliation(s)
- Xi Zhu
- Clinical NeuroImaging Research Core, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD, United States.
| | - Xiaofei Du
- Data Scientist Team, Adtheorent, New York, NY, United States
| | - Mike Kerich
- Clinical NeuroImaging Research Core, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD, United States
| | - Falk W Lohoff
- Section on Clinical Genomics and Experimental Therapeutics, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD, United States
| | - Reza Momenan
- Clinical NeuroImaging Research Core, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD, United States.
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Vergara VM, Weiland BJ, Hutchison KE, Calhoun VD. The Impact of Combinations of Alcohol, Nicotine, and Cannabis on Dynamic Brain Connectivity. Neuropsychopharmacology 2018; 43:877-890. [PMID: 29134961 PMCID: PMC5809800 DOI: 10.1038/npp.2017.280] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Revised: 10/07/2017] [Accepted: 11/02/2017] [Indexed: 01/05/2023]
Abstract
Alcohol, nicotine, and cannabis are among the most commonly used drugs. A prolonged and combined use of these substances can alter normal brain wiring in different ways depending on the consumed cocktail mixture. Brain connectivity alterations and their change with time can be assessed using functional magnetic resonance imaging (fMRI) because of its spatial and temporal content. Here, we estimated dynamic functional network connectivity (dFNC) as derived from fMRI data to investigate the effects of single or combined use of alcohol, nicotine, and cannabis. Data from 534 samples were grouped according to their substance use combination as controls (CTR), smokers (SMK), drinkers (DRN), smoking-and-drinking subjects (SAD), marijuana users (MAR), smoking-and-marijuana users (SAM), marijuana-and-drinking users (MAD), and users of all three substances (ALL). The DRN group tends to exhibit decreased connectivity mainly in areas of sensorial and motor control, a result supported by the dFNC outcome and the alcohol use disorder identification test. This trend dominated the SAD group and in a weaker manner MAD and ALL. Nicotine consumers were characterized by an increment of connectivity between dorsal striatum and sensorimotor areas. Where possible, common and separate effects were identified and characterized by the analysis of dFNC data. Results also suggest that a combination of cannabis and nicotine have more contrasting effects on the brain than a single use of any of these substances. On the other hand, marijuana and alcohol might follow an additive effect trend. We concluded that all of the substances have an impact on brain connectivity, but the effect differs depending on the dFNC state analyzed.
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Affiliation(s)
- Victor M Vergara
- The Mind Research Network and Lovelace Biomedical and Environmental Research Institute, Albuquerque, NM, USA,The Mind Research Network, Lovelace Biomedical and Environmental Research Institute, 1101 Yale Boulevard, Albuquerque, NM 87106, USA, Tel: +1 505 272 5028, Fax: +1 505 272 8002, E-mail:
| | - Barbara J Weiland
- Departments of Psychology and Neuroscience, University of Colorado, Boulder, CO, USA
| | - Kent E Hutchison
- Departments of Psychology and Neuroscience, University of Colorado, Boulder, CO, USA
| | - Vince D Calhoun
- The Mind Research Network and Lovelace Biomedical and Environmental Research Institute, Albuquerque, NM, USA
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de Beaurepaire R. A Review of the Potential Mechanisms of Action of Baclofen in Alcohol Use Disorder. Front Psychiatry 2018; 9:506. [PMID: 30459646 PMCID: PMC6232933 DOI: 10.3389/fpsyt.2018.00506] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Accepted: 09/25/2018] [Indexed: 12/17/2022] Open
Abstract
Baclofen, a GABA-B receptor agonist, is a promising treatment for alcohol use disorder (AUD). Its mechanism of action in this condition is unknown. GABA-B receptors interact with many biological systems potentially involved in AUD, including transduction pathways and neurotransmitter systems. Preclinical studies have shown that GABA-B receptors are involved in memory storage and retrieval, reward, motivation, mood and anxiety; neuroimaging studies in humans show that baclofen produces region-specific alterations in cerebral activity; GABA-B receptor activation may have neuroprotective effects; baclofen also has anti-inflammatory properties that may be of interest in the context of addiction. However, none of these biological effects fully explain the mechanism of action of baclofen in AUD. Data from clinical studies have provided a certain number of elements which may be useful for the comprehension of its mechanism of action: baclofen typically induces a state of indifference toward alcohol; the effective dose of baclofen in AUD is extremely variable from one patient to another; higher treatment doses correlate with the severity of the addiction; many of the side effects of baclofen resemble those of alcohol, raising the possibility that baclofen acts as a substitution drug; usually, however, there is no tolerance to the effects of baclofen during long-term AUD treatment. In the present article, the biological effects of baclofen are reviewed in the light of its clinical effects in AUD, assuming that, in many instances, clinical effects can be reliable indicators of underlying biological processes. In conclusion, it is proposed that baclofen may suppress the Pavlovian association between cues and rewards through an action in a critical part of the dopaminergic network (the amygdala), thereby normalizing the functional connectivity in the reward network. It is also proposed that this action of baclofen is made possible by the fact that baclofen and alcohol act on similar brain systems in certain regions of the brain.
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40
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Cardenas VA, Price M, Fein G. EEG coherence related to fMRI resting state synchrony in long-term abstinent alcoholics. Neuroimage Clin 2017; 17:481-490. [PMID: 29159061 PMCID: PMC5684581 DOI: 10.1016/j.nicl.2017.11.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2017] [Revised: 10/23/2017] [Accepted: 11/06/2017] [Indexed: 11/29/2022]
Abstract
Recent work suggests that faulty co-activation or synchrony of multiple brain regions comprising "networks," or an imbalance between opposing brain networks, is important in alcoholism. Previous studies showed higher fMRI resting state synchrony (RSS) within the executive control (inhibitory control and emotion regulation) networks and lower RSS within the appetitive drive network in long-term (multi-year) abstinent alcoholics (LTAA) vs. non substance abusing controls (NSAC). Our goal was to identify EEG networks that are correlated with the appetitive drive and executive function networks identified with fMRI in our previous alcohol studies. We used parallel ICA for multimodal data fusion for the 20 LTAA and 21 NSAC that had both usable fMRI and 64-channel EEG data. Our major result was that parallel ICA identified a pair of components that significantly separated NSAC from LTAA and were correlated with each other. Examination of the resting-state fMRI seed-correlation map component showed higher bilateral nucleus accumbens seed-correlation in the dorsolateral prefrontal cortex bilaterally and lower seed-correlation in the thalamus. This single component thus encompassed both the executive control and appetitive drive networks, consistent with our previous work. The correlated EEG coherence component showed mostly higher theta and alpha coherence in LTAA compared to NSAC, and lower gamma coherence in LTAA compared to NSAC. The EEG theta and alpha coherence results suggest enhanced top-down control in LTAA and the gamma coherence results suggest impaired appetitive drive in LTAA. Our results support the notion that fMRI RSS is reflected in spontaneous EEG, even when the EEG and fMRI are not obtained simultaneously.
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Affiliation(s)
- Valerie A Cardenas
- Neurobehavioral Research, Inc., 77 Ho'okele Street, 3rd Floor, Kahului, Maui, HI 96732, USA.
| | - Mathew Price
- Neurobehavioral Research, Inc., 77 Ho'okele Street, 3rd Floor, Kahului, Maui, HI 96732, USA; Cogency, Cape Town, South Africa.
| | - George Fein
- Neurobehavioral Research, Inc., 77 Ho'okele Street, 3rd Floor, Kahului, Maui, HI 96732, USA; Department of Medicine and Psychology, University of Hawai'i, Honolulu, HI 96822, USA.
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41
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Crane NA, Gorka SM, Weafer J, Langenecker SA, de Wit H, Phan KL. Preliminary Evidence for Disrupted Nucleus Accumbens Reactivity and Connectivity to Reward in Binge Drinkers. Alcohol Alcohol 2017; 52:647-654. [PMID: 29016710 PMCID: PMC5860287 DOI: 10.1093/alcalc/agx062] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Revised: 08/14/2017] [Accepted: 08/23/2017] [Indexed: 11/13/2022] Open
Abstract
AIMS Dysfunctional brain reward circuitry, particularly in the nucleus accumbens (NAcc), has been proposed as a risk factor for alcohol use disorder (AUD). This risk factor may be evident in binge drinkers (BD), who are at high risk for developing AUD. We examined whole-brain and NAcc reactivity to reward in BD compared to non-binge drinkers (NBD), hypothesizing that groups would differ in their neural reactivity and connectivity. METHODS Healthy BD (N = 27) and NBD (N = 23)-none meeting AUD criteria-completed a reward-guessing game, the 'Doors' task, during functional magnetic resonance imaging. We conducted an exploratory whole-brain search for group differences, but given our a priori hypotheses, we also extracted activation from the NAcc to examine reactivity during reward (Win > Loss) and functional connectivity (FC) to the prefrontal cortex. RESULTS Compared to NBD, BD exhibited greater activation in both the right and left NAcc during reward relative to loss. Additionally, NBD drinkers exhibited positive FC between the NAcc and dorsal anterior cingulate (dACC) whereas the BD showed negative FC between these regions. Furthermore, less NAcc-dACC FC was related to more past month alcohol use. CONCLUSIONS Our results provide preliminary evidence that BD exhibit greater NAcc activation during reward receipt relative to loss. This is consistent with the broader AUD literature and suggests aberrant neural reactivity may precede disorder onset. In addition, BD exhibited less NAcc-dACC FC, perhaps reflecting deficient regulation of activation to rewards compared to losses. This profile of reward brain circuitry could represent neural correlates of vulnerability for AUD. SHORT SUMMARY Healthy binge drinkers, at risk for alcohol use disorder, exhibited greater nucleus accumbens activation during reward relative to loss. In addition, binge drinkers exhibited reduced connectivity between the nucleus accumbens and dorsal anterior cingulate, which was associated with more past month alcohol use.
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Affiliation(s)
- Natania A Crane
- Department of Psychiatry, University of Illinois at Chicago, 1747 W Roosevelt Rd Chicago, IL 60608, USA
| | - Stephanie M Gorka
- Department of Psychiatry, University of Illinois at Chicago, 1747 W Roosevelt Rd Chicago, IL 60608, USA
| | - Jessica Weafer
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, 5841 S Maryland Ave Chicago, IL 60637, USA
| | - Scott A Langenecker
- Department of Psychiatry, University of Illinois at Chicago, 1747 W Roosevelt Rd Chicago, IL 60608, USA
| | - Harriet de Wit
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, 5841 S Maryland Ave Chicago, IL 60637, USA
| | - K. Luan Phan
- Department of Psychiatry, University of Illinois at Chicago, 1747 W Roosevelt Rd Chicago, IL 60608, USA
- Mental Health Service Line, Jesse Brown VA Medical Center, 820 S Damen Ave Chicago, IL 60612, USA
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42
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Fein G, Cardenas VA. P3b amplitude is not reduced in abstinent alcoholics with a current MDD. Alcohol 2017; 63:33-42. [PMID: 28847380 DOI: 10.1016/j.alcohol.2017.03.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Revised: 03/01/2017] [Accepted: 03/01/2017] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND AIMS In two studies of long-term abstinent alcoholics (LTAAs), we found that about 17% had a current major depressive disorder (MDD). We tested the hypothesis that LTAAs with a current MDD diagnosis do not exhibit the reduced P3b event-related potential amplitude endophenotype for alcoholism. This is consistent with the majority of LTAAs with a current MDD having developed alcohol dependence via self-medication of their MDD rather than their alcohol dependence arising from the alcoholism endophenotype. We revisited the P3b data from the two LTAAs studies, comparing LTAAs with a current MDD vs. LTAAs without a current MDD to each other and to non-substance abusing controls (NSACs). In northern California, 48 LTAAs and 48 non-substance abusing controls were studied, while in Honolulu, 105 LTAAs and 77 NSACs were studied. A total of 26 LTAAs had a current MDD (10 in California and 16 in Honolulu). The difference in P3b amplitude and latency (measured in targets-standards) in a 3-condition visual oddball paradigm was compared to MDD diagnoses gathered using the computerized Diagnostic Interview Schedule. Across both study sites, LTAAs without a current MDD (either with no lifetime MDD or a lifetime, but not current MDD) had lower P3b amplitudes than NSACs. In contrast, P3b amplitudes in LTAAs with a current MDD did not differ from controls. We conclude that alcohol dependence in LTAAs with a current MDD did not derive from the alcoholism endophenotype. This group may not exhibit the externalizing diathesis characterized by impulsive, disinhibited behavior and may have developed alcohol dependence via excessive drinking in an attempt to self-medicate their MDD. These results have major implications for targeted treatments of alcoholism and comorbid MDD.
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Affiliation(s)
- George Fein
- Neurobehavioral Research, Inc., 77 Ho'okele Street, 3rd Floor, Kahului, HI 96732, USA; Department of Medicine and Psychology, University of Hawaii, Honolulu, HI 96822, USA.
| | - Valerie A Cardenas
- Neurobehavioral Research, Inc., 77 Ho'okele Street, 3rd Floor, Kahului, HI 96732, USA
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43
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Kim S, Im S, Lee J, Lee SG. Disrupted Control Network Connectivity in Abstinent Patients with Alcohol Dependence. Psychiatry Investig 2017; 14:325-332. [PMID: 28539951 PMCID: PMC5440435 DOI: 10.4306/pi.2017.14.3.325] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2016] [Revised: 04/20/2016] [Accepted: 04/23/2016] [Indexed: 01/11/2023] Open
Abstract
OBJECTIVE Alcohol causes damage to the brain and is associated with various functional impairments. However, much of the brain damage can be reversed by abstaining for enough time. This study aims to investigate the patterns and degrees of brain function in abstinent patients with alcohol dependence by using resting-state functional connectivity. METHODS 26 male patients with alcohol dependence (alcohol group) and 28 age-matched male healthy volunteers (control group) were recruited from a mental hospital and the community, respectively. Using 3T MRI scan data, the resting-state functional connectivity of the task-negative and task-positive networks was determined and compared between the groups. RESULTS There were no significant group differences in the resting-state functional connectivity in the default mode or in the salience and sensorimotor networks. Compared with the control group, the alcohol group showed significantly lower functional connectivity in the executive control network, especially in the cingulo-opercular network and, in some regions of interest, the dorsal attention network. CONCLUSION This finding suggests that some brain networks do not normalize their functions after abstinence from drinking, and these results may be helpful in future research to investigate the mechanisms for craving alcohol and alcohol relapse prevention.
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Affiliation(s)
- Siekyeong Kim
- Department of Psychiatry, Chungbuk National University College of Medicine, Cheongju, Republic of Korea
| | - Sungjin Im
- Department of Psychiatry, Yemidam Hospital, Cheongju, Republic of Korea
| | - Jeonghwan Lee
- Department of Psychiatry, Chungbuk National University College of Medicine, Cheongju, Republic of Korea
| | - Sang-Gu Lee
- Department of Psychiatry, Yesarang Mental Hospital, Cheongju, Republic of Korea
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44
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Fein G, Camchong J, Cardenas VA, Stenger A. Resting state synchrony in long-term abstinent alcoholics: Effects of a current major depressive disorder diagnosis. Alcohol 2017; 59:17-25. [PMID: 28262184 DOI: 10.1016/j.alcohol.2016.11.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Revised: 11/18/2016] [Accepted: 11/21/2016] [Indexed: 10/20/2022]
Abstract
Alcoholism is characterized by a lack of control over an impulsive and compulsive drive toward excessive alcohol consumption despite significant negative consequences; our previous work demonstrated that successful abstinence is characterized by decreased resting-state synchrony (RSS) as measured with functional magnetic resonance imaging (fMRI), within appetitive drive networks and increased RSS in emotion regulation and inhibitory executive control networks. Our hypothesis is that LTAA (Long-Term Abstinent Alcoholics) with a current major depressive disorder (MDD) drank primarily to deal with the negative affect associated with their MDD and not because of a heightened externalizing diathesis (including heightened appetitive drive), and consequently, in achieving and maintaining abstinence, such individuals would not exhibit the RSS adaptations characteristic of pure alcoholics. We studied 69 NSAC (Non Substance Abusing Controls) and 40 LTAA (8 with current MDD, 32 without a current MDD) using resting-state fMRI and seed based connectivity analyses. In the inhibitory executive control network (nucleus accumbens vs. left dorsolateral prefrontal cortex), LTAA with a current MDD showed increased synchrony compared to NSAC. In the emotion regulation executive control network (subgenual anterior cingulate cortex vs. right dorsolateral prefrontal cortex), LTAA with current MDD did not show increased RSS. In the appetitive drive networks (nucleus accumbens vs, aspects of the caudate nucleus and thalamus), LTAA with a current MDD did not show a reduction of RSS compared to NSAC, but LTAA without a current MDD did. These results suggest different pathways to their alcohol dependence in LTAA with vs. without a current MDD, and different patterns of brain activity in long-term abstinence, suggesting different treatment needs.
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45
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Zahr NM, Pfefferbaum A, Sullivan EV. Perspectives on fronto-fugal circuitry from human imaging of alcohol use disorders. Neuropharmacology 2017; 122:189-200. [PMID: 28118989 DOI: 10.1016/j.neuropharm.2017.01.018] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2016] [Revised: 01/18/2017] [Accepted: 01/19/2017] [Indexed: 01/18/2023]
Abstract
Descriptions of the cognitive functions affected by alcohol use disorders (AUD) often highlight dysfunction of executive processes such attention, inhibitory control, working memory, and cognitive flexibility. Such complex cognitive functions have historically been ascribed to the prefrontal cortex. AUD, however, disrupts extensive areas of the brain. Structural and functional MRI studies suggest a central role for degradation of circuitry originating in the prefrontal cortex including nodes in widespread brain regions. This review features fronto-fugal circuits affected by AUD including frontocerebellar, frontolimbic, and frontostriatal networks and their relations to the salient, enduring, and debilitating cognitive and motor deficits reported in AUD. This article is part of the Special Issue entitled "Alcoholism".
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Affiliation(s)
- Natalie M Zahr
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Rd., Stanford, CA 94305, USA; Neuroscience Department, SRI International, 333 Ravenswood Ave., Menlo Park, CA 94025, USA.
| | - Adolf Pfefferbaum
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Rd., Stanford, CA 94305, USA; Neuroscience Department, SRI International, 333 Ravenswood Ave., Menlo Park, CA 94025, USA
| | - Edith V Sullivan
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Rd., Stanford, CA 94305, USA
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46
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Zhu X, Cortes CR, Mathur K, Tomasi D, Momenan R. Model-free functional connectivity and impulsivity correlates of alcohol dependence: a resting-state study. Addict Biol 2017; 22:206-217. [PMID: 26040546 DOI: 10.1111/adb.12272] [Citation(s) in RCA: 106] [Impact Index Per Article: 15.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Alcohol dependence is characterized by impulsiveness toward consumption despite negative consequences. Although neuro-imaging studies have implicated some regions underlying this disorder, there is little information regarding its large-scale connectivity pattern. This study investigated the within- and between-network functional connectivity (FC) in alcohol dependence and examined its relationship with clinical impulsivity measures. Using probabilistic independent component analysis on resting-state functional magnetic resonance imaging (rs-fMRI) data from 25 alcohol-dependent (AD) and 26 healthy control (HC) participants, we compared the within- and between-network FC between AD and HC. Then, the relationship between FC and impulsiveness as measured by the Barratt Impulsiveness Scale (BIS-11), the UPPS-P Impulsive Scale and the delay discounting task (DDT), was explored. Compared with HC, AD exhibited increased within-network FC in salience (SN), default mode (DMN), orbitofrontal cortex (OFCN), left executive control (LECN) and amygdala-striatum (ASN) networks. Increased between-network FC was found among LECN, ASN and SN. Between-network FC correlations were significantly negative between Negative-Urgency and OFCN pairs with right executive control network (RECN), anterior DMN (a-DMN) and posterior DMN (p-DMN) in AD. DDT was significantly correlated with the between-network FC among the LECN, a-DMN and SN in AD. These findings add evidence to the concept of altered within-network FC and also highlight the role of between-network FC in the pathophysiology of AD. Additionally, this study suggests differential neurobiological bases for different clinical measures of impulsivity that may be used as a systems-level biomarker for alcohol dependence severity and treatment efficacy.
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Affiliation(s)
- Xi Zhu
- Section on Brain Electrophysiology and Imaging; LCTS; National Institute on Alcohol Abuse and Alcoholism; National Institutes of Health; Bethesda MD USA
| | - Carlos R. Cortes
- Section on Brain Electrophysiology and Imaging; LCTS; National Institute on Alcohol Abuse and Alcoholism; National Institutes of Health; Bethesda MD USA
| | - Karan Mathur
- Section on Brain Electrophysiology and Imaging; LCTS; National Institute on Alcohol Abuse and Alcoholism; National Institutes of Health; Bethesda MD USA
| | - Dardo Tomasi
- Laboratory of Neuroimaging; National Institute on Alcohol Abuse and Alcoholism; National Institutes of Health; Bethesda MD USA
| | - Reza Momenan
- Section on Brain Electrophysiology and Imaging; LCTS; National Institute on Alcohol Abuse and Alcoholism; National Institutes of Health; Bethesda MD USA
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47
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Kohno M, Dennis LE, McCready H, Hoffman WF. Executive Control and Striatal Resting-State Network Interact with Risk Factors to Influence Treatment Outcomes in Alcohol-Use Disorder. Front Psychiatry 2017; 8:182. [PMID: 28993741 PMCID: PMC5622290 DOI: 10.3389/fpsyt.2017.00182] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Accepted: 09/11/2017] [Indexed: 12/20/2022] Open
Abstract
Alterations within mesocorticolimbic terminal regions commonly occur with alcohol use disorder (AUD). As pathological drug-seeking behavior may arise as a consequence of alcohol-induced neuroadaptations, it is critical to understand how such changes increase the likelihood of relapse. This report examined resting-state functional connectivity (RSFC) using both a seed-based and model-free approach in individuals in treatment for AUD and how dysregulation of network connectivity contributes to treatment outcomes. In order to provide a mechanism by which neural networks promote relapse, interactive effects of mesocorticolimbic connectivity and AUD risk factors in treatment completers and non-completers were examined. AUD group showed stronger RSFC between striatum, insula, and anterior cingulate cortex than controls. Within the AUD group, non-completers compared to completers showed enhanced RSFC between (1) striatum-insula, (2) executive control network (ECN)-amygdala, and (3) basal ganglia/salience network and striatum, precuneus, and insula. Completers showed enhanced RSFC between striatum-right dorsolateral prefrontal cortex. Furthermore, completers and non-completers differed in relationships between RSFC and relapse risk factors, where non-completers exhibited positive associations between craving intensity and RSFC of striatum-insula and ECN-amygdala. These findings provide evidence for interactions between corticolimbic connectivity in AUD and craving and establish an important link between network connectivity and dynamic risk factors that contribute to relapse. Results demonstrate that relapse vulnerability is attributed to craving dysregulation manifested by enhanced connectivity in striato-limbic regions and diminished corticostriatal connectivity.
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Affiliation(s)
- Milky Kohno
- Department of Psychiatry, Oregon Health & Science University, Portland, OR, United States.,Department of Behavioral Neuroscience, Oregon Health & Science University, Portland, OR, United States.,Methamphetamine Abuse Research Center, Portland, OR, United States
| | - Laura E Dennis
- Department of Psychiatry, Oregon Health & Science University, Portland, OR, United States.,Department of Behavioral Neuroscience, Oregon Health & Science University, Portland, OR, United States.,Methamphetamine Abuse Research Center, Portland, OR, United States
| | - Holly McCready
- Department of Psychiatry, Oregon Health & Science University, Portland, OR, United States.,Department of Behavioral Neuroscience, Oregon Health & Science University, Portland, OR, United States.,Methamphetamine Abuse Research Center, Portland, OR, United States
| | - William F Hoffman
- Department of Psychiatry, Oregon Health & Science University, Portland, OR, United States.,Department of Behavioral Neuroscience, Oregon Health & Science University, Portland, OR, United States.,Methamphetamine Abuse Research Center, Portland, OR, United States.,Mental Health and Clinical Neurosciences Division, Portland, OR, United States.,Research Service Veterans Affairs Portland Healthcare System, Portland, OR, United States
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48
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Zakiniaeiz Y, Scheinost D, Seo D, Sinha R, Constable RT. Cingulate cortex functional connectivity predicts future relapse in alcohol dependent individuals. NEUROIMAGE-CLINICAL 2016; 13:181-187. [PMID: 27981033 PMCID: PMC5144743 DOI: 10.1016/j.nicl.2016.10.019] [Citation(s) in RCA: 58] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Revised: 10/04/2016] [Accepted: 10/24/2016] [Indexed: 01/09/2023]
Abstract
Alcohol dependence is a chronic relapsing illness. Alcohol and stress cues have consistently been shown to increase craving and relapse risk in recovering alcohol dependent (AUD) patients. However, differences in functional connectivity in response to these cues have not been studied using data-driven approaches. Here, voxel-wise connectivity is used in a whole-brain investigation of functional connectivity differences associated with alcohol and stress cues and to examine whether these differences are related to subsequent relapse. In Study 1, 45, 4- to 8-week abstinent, recovering AUD patients underwent functional magnetic resonance imaging during individualized imagery of alcohol, stress, and neutral cues. Relapse measures were collected prospectively for 90 days post-discharge from inpatient treatment. AUD patients showed blunted anterior (ACC), mid (MCC) and posterior cingulate cortex (PCC), voxel-wise connectivity responses to stress compared to neutral cues and blunted PCC response to alcohol compared to neutral cues. Using Cox proportional hazard regression, weaker connectivity in ACC and MCC during neutral exposure was associated with longer time to relapse (better recovery outcome). Similarly, greater connectivity in PCC during alcohol-cue compared to stress cue was associated with longer time to relapse. In Study 2, a sub-group of 30 AUD patients were demographically-matched to 30 healthy control (HC) participants for group comparisons. AUD compared to HC participants showed reduced cingulate connectivity during alcohol and stress cues. Using novel data-driven approaches, the cingulate cortex emerged as a key region in the disruption of functional connectivity during alcohol and stress-cue processing in AUD patients and as a marker of subsequent alcohol relapse. AUD patients showed blunted cingulate connectivity to alcohol and stress cues. Cingulate connectivity predicted time to relapse in AUD patients. Greater PCC connectivity during alcohol cues predicted longer time to relapse. AUD vs. HC subjects showed less cingulate connectivity to alcohol and stress cues. The cingulate cortex emerged as a marker of subsequent alcohol relapse.
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Affiliation(s)
- Yasmin Zakiniaeiz
- Interdepartmental Neuroscience Program, Yale University School of Medicine, New Haven, CT, United States
| | - Dustin Scheinost
- Department Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, CT, United States
| | - Dongju Seo
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Rajita Sinha
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - R Todd Constable
- Interdepartmental Neuroscience Program, Yale University School of Medicine, New Haven, CT, United States; Department Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, CT, United States; Department of Neurosurgery, Yale University School of Medicine, New Haven, CT, United States
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Abstract
Alcohol use disorder (AUD) represents a major public health issue due to its prevalence and severe health consequences. It may affect several aspects of an individual's life including work and relationships, and it also increases risk for additional problems such as brain injury. The causes and outcomes of AUD are varied; thus, attempting to understand this complex phenomenon requires investigation from multiple perspectives. Magnetic resonance imaging (MRI) is a powerful means to investigate brain anatomical and functional alterations related to AUD. Recent advances in MRI methods allow better investigation of the alterations to structural and functional brain networks in AUD. Here, we focus on findings from studies using multiple MRI techniques, which converge to support the considerable vulnerability of frontal systems. Indeed, MRI studies provide evidence for a "disconnection syndrome" which could be involved in the poor behavioral control observed in AUD.
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50
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Resting state functional connectivity analysis for addiction medicine. PROGRESS IN BRAIN RESEARCH 2016; 224:155-73. [DOI: 10.1016/bs.pbr.2015.07.015] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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