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Kipping M, Mai-Lippold SA, Herbert BM, Desdentado L, Kammer T, Pollatos O. Insights into interoceptive and emotional processing: Lessons from studies on insular HD-tDCS. Psychophysiology 2024; 61:e14639. [PMID: 38946148 DOI: 10.1111/psyp.14639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 05/03/2024] [Accepted: 06/17/2024] [Indexed: 07/02/2024]
Abstract
Interoception, the processing of internal bodily signals, is proposed as the fundamental mechanism underlying emotional experiences. Interoceptive and emotional processing appear distorted in psychiatric disorders. However, our understanding of the neural structures involved in both processes remains limited. To explore the feasibility of enhancing interoception and emotion, we conducted two studies using high-definition transcranial direct current stimulation (HD-tDCS) applied to the right anterior insula. In study one, we compared the effects of anodal HD-tDCS and sham tDCS on interoceptive abilities (sensibility, confidence, accuracy, emotional evaluation) in 52 healthy subjects. Study two additionally included physical activation through ergometer cycling at the beginning of HD-tDCS and examined changes in interoceptive and emotional processing in 39 healthy adults. In both studies, HD-tDCS was applied in a single-blind cross-over online design with two separate sessions. Study one yielded no significant effects of HD-tDCS on interoceptive dimensions. In study two, significant improvements in interoceptive sensibility and confidence were observed over time with physical preactivation, while no differential effects were found between sham and insula stimulation. The expected enhancement of interoceptive and emotional processing following insula stimulation was not observed. We conclude that HD-tDCS targeting the insula does not consistently increase interoceptive or emotional variables. The observed increase in interoceptive sensibility may be attributed to the activation of the interoceptive network through physical activity or training effects. Future research on HD-tDCS involving interoceptive network structures could benefit from protocols targeting larger regions within the network, rather than focusing solely on insula stimulation.
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Affiliation(s)
- Miriam Kipping
- Clinical and Health Psychology, Institute of Psychology and Education, Ulm University, Ulm, Germany
| | - Sandra A Mai-Lippold
- Clinical and Health Psychology, Institute of Psychology and Education, Ulm University, Ulm, Germany
| | - Beate M Herbert
- Biological Psychology and Experimental Psychopathology, Charlotte-Fresenius-University, Munich, Germany
- Department Psychology, Clinical Psychology and Psychotherapy, University of Tuebingen, Tuebingen, Germany
| | - Lorena Desdentado
- Polibienestar Research Institute, University of Valencia, Valencia, Spain
- CIBER of Physiopathology of Obesity and Nutrition (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
| | - Thomas Kammer
- Section for Neurostimulation, Department of Psychiatry, Ulm University, Ulm, Germany
| | - Olga Pollatos
- Clinical and Health Psychology, Institute of Psychology and Education, Ulm University, Ulm, Germany
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2
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Del Brutto OH, Rumbea DA, Mera RM. Binge drinking and progression of white matter hyperintensities of presumed vascular origin in older men. J Stroke Cerebrovasc Dis 2024; 33:107886. [PMID: 39094720 DOI: 10.1016/j.jstrokecerebrovasdis.2024.107886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 07/17/2024] [Accepted: 07/24/2024] [Indexed: 08/04/2024] Open
Abstract
BACKGROUND Information on trajectories of diffuse subcortical brain damage of vascular origin associated with binge drinking in older adults is limited. We sought to evaluate the impact of this drinking pattern on the progression of white matter hyperintensities (WMH) of presumed vascular origin in individuals aged ≥60 years taken from the community. METHODS Following a longitudinal prospective design, participants of the Atahualpa Project Cohort received interviews to assess patterns of alcohol intake as well as baseline and follow-up brain MRIs. Only men were included because alcohol consumption in women is negligible and tend not to engage in binge drinking in our studied population. Poisson regression models were fitted to assess the incidence rate ratio of WMH progression by patterns of alcohol use (binge drinking or not), after adjusting for demographics, level of education and cardiovascular risk factors. RESULTS The study included 114 men aged ≥60 years (mean age: 65.1±5.4 years). Thirty-seven participants (32%) reported binge drinking for more than 30 years. Follow-up MRIs revealed WMH progression in 45 participants (39%) after a median of 7.2 years. In unadjusted analysis, the risk of WMH progression among individuals with binge drinking was 2.08 (95% C.I.: 1.16-3.73). After adjustment for age, education level and vascular risk factors, participants with this drinking pattern were 2.75 times (95% C.I.: 1.42-5.30) more likely to have WMH progression than those who did not. CONCLUSIONS Study results show an independent association between binge drinking and WMH progression in community-dwelling older men.
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Affiliation(s)
- Oscar H Del Brutto
- School of Medicine and Research Center, Universidad Espíritu Santo - Ecuador, Samborondón, Ecuador.
| | - Denisse A Rumbea
- School of Medicine and Research Center, Universidad Espíritu Santo - Ecuador, Samborondón, Ecuador
| | - Robertino M Mera
- Biostatistics/Epidemiology, Freenome, Inc., South San Francisco, CA, USA
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3
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London G, Hida H, Kagaya A, Yamawaki S, Machizawa MG. Assessment on interoceptive awareness on alcohol use and gambling disorders reveals dissociable interoceptive abilities linked to external and internal dependencies: Practical use of Body Perception Questionnaire Very Short Form (BPQ-VSF) in clinical settings. Neuropsychopharmacol Rep 2024; 44:361-370. [PMID: 38470402 PMCID: PMC11144623 DOI: 10.1002/npr2.12424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 01/15/2024] [Accepted: 02/02/2024] [Indexed: 03/13/2024] Open
Abstract
Interoception is one of the pivotal cognitive functions for mechanisms of our body awareness, and malfunction of the interoceptive network is thought to be associated with mental illness, including addiction. Within addictive disorders, substance-based and non-substance-based addictions are known to hold dissociable reward systems. However, little is known about how interoceptive awareness between these addiction sub-types would differ. Subjective interoceptive awareness was assessed among patients with alcohol use disorder (n = 50) who were subsequently hospitalized or remained out-patient and gambling addiction (n = 41) by the Body Awareness component of the Japanese version of the Body Perception Questionnaire (BPQ-VSFBA-J) and compared them against healthy control (n = 809). Both addiction groups showed significantly lower BPQ than the control, with no substantial differences between inpatients and outpatients for alcohol samples. Notably, BPQ scores for gambling patients were significantly lower than those for the alcohol group. This evidence may suggest a putative role of interoceptive ability on the severity of behavioral addiction over substance-based addiction.
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Affiliation(s)
- Giselle London
- College of Liberal ArtsTemple UniversityPhiladelphiaPAUSA
| | - Hiroko Hida
- College of Liberal ArtsTemple UniversityPhiladelphiaPAUSA
- Xiberlinc, Inc.TokyoJapan
| | - Ariyuki Kagaya
- KONUMA Memorial Institute of Addiction and Mental HealthHiroshimaJapan
- Senogawa HospitalHiroshimaJapan
- Yokogawaekimae ClinicHiroshimaJapan
| | - Shigeto Yamawaki
- Center for Brain, Mind & KANSEI Sciences ResearchHiroshima UniversityHiroshimaJapan
| | - Maro G. Machizawa
- Xiberlinc, Inc.TokyoJapan
- Center for Brain, Mind & KANSEI Sciences ResearchHiroshima UniversityHiroshimaJapan
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4
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Taylor A, Adank DN, Young PA, Quan Y, Nabit BP, Winder DG. Forced Abstinence from Volitional Ethanol Intake Drives a Vulnerable Period of Hyperexcitability in BNST-Projecting Insular Cortex Neurons. J Neurosci 2024; 44:e1121232023. [PMID: 38050120 PMCID: PMC10860622 DOI: 10.1523/jneurosci.1121-23.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 10/26/2023] [Accepted: 11/13/2023] [Indexed: 12/06/2023] Open
Abstract
The insular cortex (IC) integrates sensory and interoceptive cues to inform downstream circuitry executing adaptive behavioral responses. The IC communicates with areas involved canonically in stress and motivation. IC projections govern stress and ethanol recruitment of bed nucleus of the stria terminalis (BNST) activity necessary for the emergence of negative affective behaviors during alcohol abstinence. Here, we assess the impact of the chronic drinking forced abstinence (CDFA) volitional home cage ethanol intake paradigm on synaptic and excitable properties of IC neurons that project to the BNST (IC→BNST). Using whole-cell patch-clamp electrophysiology, we investigated IC→BNST circuitry 24 h or 2 weeks following forced abstinence (FA) in female C57BL6/J mice. We find that IC→BNST cells are transiently more excitable following acute ethanol withdrawal. In contrast, in vivo ethanol exposure via intraperitoneal injection, ex vivo via ethanol wash, and acute FA from a natural reward (sucrose) all failed to alter excitability. In situ hybridization studies revealed that at 24 h post FA BK channel mRNA expression is reduced in IC. Further, pharmacological inhibition of BK channels mimicked the 24 h FA phenotype, while BK activation was able to decrease AP firing in control and 24 h FA subjects. All together these data suggest a novel mechanism of homeostatic plasticity that occurs in the IC→BNST circuitry following chronic drinking.
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Affiliation(s)
- Anne Taylor
- Vanderbilt Brain Institute, Vanderbilt University, Nashville, Tennessee 37235
- Vanderbilt Center for Addiction Research, Vanderbilt University, Nashville, Tennessee 37235
| | - Danielle N Adank
- Vanderbilt Brain Institute, Vanderbilt University, Nashville, Tennessee 37235
- Vanderbilt Center for Addiction Research, Vanderbilt University, Nashville, Tennessee 37235
| | - Phoebe A Young
- Vanderbilt Center for Addiction Research, Vanderbilt University, Nashville, Tennessee 37235
| | - Yizhen Quan
- Vanderbilt Center for Addiction Research, Vanderbilt University, Nashville, Tennessee 37235
| | - Brett P Nabit
- Vanderbilt Center for Addiction Research, Vanderbilt University, Nashville, Tennessee 37235
- Department of Pharmacology, Vanderbilt University, Nashville, Tennessee 37235
| | - Danny G Winder
- Vanderbilt Brain Institute, Vanderbilt University, Nashville, Tennessee 37235
- Vanderbilt Center for Addiction Research, Vanderbilt University, Nashville, Tennessee 37235
- Department of Molecular Physiology and Biophysics, Vanderbilt University, Nashville, Tennessee 37235
- Department of Pharmacology, Vanderbilt University, Nashville, Tennessee 37235
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Esmaeilzadeh Kiabani N, Kazemi R, Hadipour AL, Khomami S, Kalloch B, Hlawitschka M. Targeting the insula with transcranial direct current stimulation; A simulation study. Psychiatry Res Neuroimaging 2023; 335:111718. [PMID: 37738706 DOI: 10.1016/j.pscychresns.2023.111718] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 08/26/2023] [Accepted: 09/11/2023] [Indexed: 09/24/2023]
Abstract
Insula is considered an important region of the brain in the generation and maintenance of a wide range of psychiatric symptoms, possibly due to being key in fundamental functions such as interoception and cognition in general. Investigating the possibility of targeting this area using non-invasive brain stimulation techniques can open new possibilities to probe the normal and abnormal functioning of the brain and potentially new treatment protocols to alleviate symptoms of different psychiatric disorders. In the current study, COMETS2, a MATLAB based toolbox was used to simulate the magnitude of the current density and electric field in the brain caused by different transcranial direct current stimulation (tDCS) protocols to find an optimum montage to target the insula and its 6 subregions for three different current intensities, namely 2, 3, and 4 mA. Frontal and occipital regions were found to be optimal candidate regions.. The results of the current study showed that it is viable to reach the insula and its individual subregions using tDCS.
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Affiliation(s)
| | - Reza Kazemi
- Faculty of Entrepreneurship, University of Tehran, Tehran, Iran.
| | - Abed L Hadipour
- Department of Cognitive Sciences, University of Messina, Messina, Italy
| | - Sanaz Khomami
- Department of Psychology, South Tehran Branch, Islamic Azad University, Tehran, Iran
| | - Benjamin Kalloch
- Max Planck Institute for Human Cognitive and Brain Sciences, Instiute of Biomedical Engineering and Informatics, Germany & Technische Universität Ilmenau, Ilmenau, Leipzig, Germany
| | - Mario Hlawitschka
- Faculty of Computer Science and Media, Leipzig University of Applied Science, Leipzig, Germany
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Honarvar F, Arfaie S, Edalati H, Ghasroddashti A, Solgi A, Mashayekhi MS, Mofatteh M, Ren LY, Kwan ATH, Keramatian K. Neuroanatomical predictors of problematic alcohol consumption in adolescents: a systematic review of longitudinal studies. Alcohol Alcohol 2023; 58:455-471. [PMID: 37553844 DOI: 10.1093/alcalc/agad049] [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: 04/14/2023] [Revised: 06/30/2023] [Accepted: 07/04/2023] [Indexed: 08/10/2023] Open
Abstract
AIMS This study aimed to systematically review the literature on neuroanatomical predictors of future problematic drinking in adolescents. METHODS Using PRISMA guidelines, a systematic review was conducted to evaluate neuroanatomical predictors of problematic alcohol consumption in adolescents. EMBASE, MEDLINE, and PsycINFO databases were searched from inception to 6 January 2023. Studies were included if they were original, had a prospective design, had a sample size of at least 12, had a follow-up period of at least 1 year, had at least one structural neuroimaging scan before 18 with no prior alcohol use, and had alcohol use as the primary outcome. Studies were excluded if they had animals only and were not in English. Risk of bias was conducted using the CASP tool. RESULTS Out of 1412 studies identified, 19 studies met the criteria, consisting of 11 gray matter (n = 4040), 5 white matter (n = 319), and 3 assessing both (n = 3608). Neuroanatomical predictors of future problematic drinking in adolescents were reported to be distributed across various brain regions such as the orbitofrontal cortex and paralimbic regions. However, the findings were largely heterogeneous. CONCLUSIONS This is the first systematic review to map out the existing literature on neuroanatomical predictors of problematic drinking in adolescents. Future research should focus on the aforementioned regions to determine their role in predicting future problematic drinking with more certainty.
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Affiliation(s)
- Faraz Honarvar
- School of Medicine, Queen's University, 80 Barrie Street, Kingston, Ontario K7L 3N6, Canada
- Temerty Faculty of Medicine, University of Toronto, 1 King's College Circle, Toronto, Ontario M5S 1A8, Canada
| | - Saman Arfaie
- Department of Neurology and Neurosurgery, McGill University, Irving Ludmer Building1033 Pine Avenue West, room 310, Montréal, Québec H3A 1A1, Canada
- Faculty of Medicine, McGill University, 3605 Rue de la Montagne, Montréal, Québec H3G 2M1, Canada
- Department of Molecular and Cell Biology, University of California Berkeley, Weill Hall, #3200, Berkeley, CA 94720, United States
| | - Hanie Edalati
- Institut national de psychiatrie légale Philippe-Pinel, Université de Montréal, 10905 Boulevard Henri-Bourassa E, Montreal, Québec, H1C 1H1, Canada
- Centre for Research on Children and Families, McGill University, Room 155, Suite 100, Tour Est550 Sherbrooke Ouest, Montreal, Québec H3A 1B9, Canada
| | - Arashk Ghasroddashti
- School of Medicine, Queen's University, 80 Barrie Street, Kingston, Ontario K7L 3N6, Canada
| | - Arad Solgi
- School of Kinesiology & Health Science, York University, Norman Bethune CollegeRoom 3414700 Keele St, Toronto, Ontario M3J 1P3, Canada
| | | | - Mohammad Mofatteh
- School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, 97 Lisburn Rd, Belfast BT9 7BL, United Kingdom
| | - Lily Yuxi Ren
- Lane Medical Library and Knowledge Management Center, Stanford Medicine, Stanford University, 300 Pasteur Dr, Stanford, CA 94305, United States
| | - Angela T H Kwan
- Faculty of Medicine, University of Ottawa, Roger Guindon Hall, 451 Smyth Rd #2044, Ottawa, Ontario K1H 8M5, Canada
| | - Kamyar Keramatian
- Department of Psychiatry, University of British Columbia, 2255 Wesbrook Mall, Vancouver, British Columbia V6T 2A1, Canada
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Weidacker K, Kim SG, Buhl-Callesen M, Jensen M, Pedersen MU, Thomsen KR, Voon V. The prediction of resilience to alcohol consumption in youths: insular and subcallosal cingulate myeloarchitecture. Psychol Med 2022; 52:2032-2042. [PMID: 33143793 DOI: 10.1017/s0033291720003852] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND The prediction of alcohol consumption in youths and particularly biomarkers of resilience, is critical for early intervention to reduce the risk of subsequent harmful alcohol use. METHODS At baseline, the longitudinal relaxation rate (R1), indexing grey matter myelination (i.e. myeloarchitecture), was assessed in 86 adolescents/young adults (mean age = 21.76, range: 15.75-26.67 years). The Alcohol Use Disorder Identification Test (AUDIT) was assessed at baseline, 1- and 2-year follow-ups (12- and 24-months post-baseline). We used a whole brain data-driven approach controlled for age, gender, impulsivity and other substance and behavioural addiction measures, such as problematic cannabis use, drug use-related problems, internet gaming, pornography use, binge eating, and levels of externalization, to predict the change in AUDIT scores from R1. RESULTS Greater baseline bilateral anterior insular and subcallosal cingulate R1 (cluster-corrected family-wise error p < 0.05) predict a lower risk for harmful alcohol use (measured as a reduction in AUDIT scores) at 2-year follow-up. Control analyses show that other grey matter measures (local volume or fractional anisotropy) did not reveal such an association. An atlas-based machine learning approach further confirms the findings. CONCLUSIONS The insula is critically involved in predictive coding of autonomic function relevant to subjective alcohol cue/craving states and risky decision-making processes. The subcallosal cingulate is an essential node underlying emotion regulation and involved in negative emotionality addiction theories. Our findings highlight insular and cingulate myeloarchitecture as a potential protective biomarker that predicts resilience to alcohol misuse in youths, providing novel identifiers for early intervention.
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Affiliation(s)
| | - Seung-Goo Kim
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- Department of Psychology and Neuroscience, Duke University, Durham, North Carolina, USA
| | - Mette Buhl-Callesen
- Centre for Alcohol and Drug Research, School of Business and Social Sciences, University of Aarhus, Aarhus, Denmark
| | - Mads Jensen
- Center of Functionally Integrative Neuroscience, MINDLab, Aarhus University, Aarhus, Denmark
| | - Mads Uffe Pedersen
- Centre for Alcohol and Drug Research, School of Business and Social Sciences, University of Aarhus, Aarhus, Denmark
| | - Kristine Rømer Thomsen
- Centre for Alcohol and Drug Research, School of Business and Social Sciences, University of Aarhus, Aarhus, Denmark
| | - Valerie Voon
- Department of Psychiatry, University of Cambridge, Cambridge, UK
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Pérez-García JM, Suárez-Suárez S, Doallo S, Cadaveira F. Effects of binge drinking during adolescence and emerging adulthood on the brain: A systematic review of neuroimaging studies. Neurosci Biobehav Rev 2022; 137:104637. [PMID: 35339481 DOI: 10.1016/j.neubiorev.2022.104637] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 01/19/2022] [Accepted: 03/21/2022] [Indexed: 02/07/2023]
Abstract
Binge drinking (BD) is a common pattern of alcohol consumption which is generating great concern because of its deleterious consequences. We selected 33 neuroimaging studies of healthy young binge drinkers (BDs) by following PRISMA guidelines. This review provides a comprehensive overview of the relationship between BD and neurocognitive anomalies reported across magnetic resonance studies. Moreover, this work is the first in which results of relatively new imaging techniques, such as resting-state functional connectivity (RS-FC) and neurite orientation dispersion and density imaging (NODDI), have been reviewed using a systematic procedure. We established strict inclusion criteria in order to isolate the various potential effects of BD on the adolescent brain. Two authors independently evaluated the methodological quality, assessing different aspects related to sample size, and statistical correction methods, which are of particular importance in neuroimaging studies. BD is associated with structural and functional anomalies in several cortical and subcortical brain regions intimately involved in the control and regulation of impulsive or risky behaviours, as well as in the processing of reinforcing stimuli.
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Affiliation(s)
- Jose Manuel Pérez-García
- Department of Clinical Psychology and Psychobiology, Universidade de Santiago de Compostela, Santiago de Compostela, Galicia, Spain.
| | - Samuel Suárez-Suárez
- Department of Clinical Psychology and Psychobiology, Universidade de Santiago de Compostela, Santiago de Compostela, Galicia, Spain.
| | - Sonia Doallo
- Department of Clinical Psychology and Psychobiology, Universidade de Santiago de Compostela, Santiago de Compostela, Galicia, Spain.
| | - Fernando Cadaveira
- Department of Clinical Psychology and Psychobiology, Universidade de Santiago de Compostela, Santiago de Compostela, Galicia, Spain.
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Wiśniewski P, Maurage P, Jakubczyk A, Trucco EM, Suszek H, Kopera M. Alcohol use and interoception - A narrative review. Prog Neuropsychopharmacol Biol Psychiatry 2021; 111:110397. [PMID: 34224795 PMCID: PMC8380667 DOI: 10.1016/j.pnpbp.2021.110397] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Revised: 05/31/2021] [Accepted: 06/29/2021] [Indexed: 01/29/2023]
Abstract
Interoception, defined as the ability to perceive and interpret body signals, may play an important role in alcohol use disorder (AUD). Earlier studies suggested an association between interoception impairment and known risk factors for AUD (e.g., alexithymia, emotion dysregulation, impulsivity, pain). Neurobiological studies show that the neurotoxicity of alcohol affects various elements of the interoceptive system (especially the insula) at structural and functional levels, with differential short/long term impacts. Conversely, primary interoceptive impairments may promote alcohol consumption and foster the evolution towards addiction. Despite convincing evidence demonstrating that interoception impairment may be an important contributor to the development and course of AUD, only a few studies directly evaluated interoceptive abilities in AUD. The research shows that interoceptive accuracy, the objective component of interoception, is lower in AUD individuals, and is correlated with craving and emotion dysregulation. Interoceptive sensibility is in turn higher in AUD individuals compared to healthy controls. Moreover, there is evidence that therapy focused on improving the ability to sense signals from the body in addiction treatment is effective. However, important methodological limitations in interoceptive measures persist, and it is therefore necessary to further investigate the associations between interoception and AUD.
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Affiliation(s)
- Paweł Wiśniewski
- Department of Psychiatry, Medical University of Warsaw, Warsaw, Poland.
| | - Pierre Maurage
- Louvain Experimental Psychopathology research group (LEP), Psychological Sciences Research Institute, UCLouvain, Louvain-la-Neuve, Belgium
| | - Andrzej Jakubczyk
- Department of Psychiatry, Medical University of Warsaw, Warsaw, Poland
| | - Elisa M Trucco
- Department of Psychology, Center for Children and Families, Florida International University, Miami, FL, USA; Department of Psychiatry, Addiction Center, University of Michigan, Ann Arbor, MI, USA
| | - Hubert Suszek
- Department of Psychology, University of Warsaw, Warsaw, Poland
| | - Maciej Kopera
- Department of Psychiatry, Medical University of Warsaw, Warsaw, Poland
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10
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Interoception and alcohol: Mechanisms, networks, and implications. Neuropharmacology 2021; 200:108807. [PMID: 34562442 DOI: 10.1016/j.neuropharm.2021.108807] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 09/20/2021] [Accepted: 09/21/2021] [Indexed: 01/25/2023]
Abstract
Interoception refers to the perception of the internal state of the body and is increasingly being recognized as an important factor in mental health disorders. Drugs of abuse produce powerful interoceptive states that are upstream of behaviors that drive and influence drug intake, and addiction pathology is impacted by interoceptive processes. The goal of the present review is to discuss interoceptive processes related to alcohol. We will cover physiological responses to alcohol, how interoceptive states can impact drinking, and the recruitment of brain networks as informed by clinical research. We also review the molecular and brain circuitry mechanisms of alcohol interoceptive effects as informed by preclinical studies. Finally, we will discuss emerging treatments with consideration of interoception processes. As our understanding of the role of interoception in drug and alcohol use grows, we suggest that the convergence of information provided by clinical and preclinical studies will be increasingly important. Given the complexity of interoceptive processing and the multitude of brain regions involved, an overarching network-based framework can provide context for how focused manipulations modulate interoceptive processing as a whole. In turn, preclinical studies can systematically determine the roles of individual nodes and their molecular underpinnings in a given network, potentially suggesting new therapeutic targets and directions. As interoceptive processing drives and influences motivation, emotion, and subsequent behavior, consideration of interoception is important for our understanding of processes that drive ongoing drinking and relapse.
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11
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Campbell EJ, Lawrence AJ. It's more than just interoception: The insular cortex involvement in alcohol use disorder. J Neurochem 2021; 157:1644-1651. [PMID: 33486788 DOI: 10.1111/jnc.15310] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 01/13/2021] [Accepted: 01/14/2021] [Indexed: 12/24/2022]
Abstract
Understanding brain structures and circuits impacted by alcohol use disorder is critical for improving our future prevention techniques and treatment options. A brain region that has recently gained traction for its involvement in substance use disorder is the insular cortex. This brain region is multi-functional and spatially complex, resulting in a relative lack of understanding of the involvement of the insular cortex in alcohol use disorder. Here we discuss the role of the insular cortex in alcohol use disorder, particularly during periods of abstinence and in response to alcohol and alcohol-related cues and contexts. We also discuss a broader role of the insular in alcohol-associated risky decision making and impulse control. Finally, we canvas potential challenges associated with targeting the insular cortex to treat individuals with alcohol use disorder.
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Affiliation(s)
- Erin J Campbell
- The Florey Institute of Neuroscience and Mental Health, Parkville, Vic, Australia.,Florey Department of Neuroscience and Mental Health, The University of Melbourne, Melbourne, Vic, Australia
| | - Andrew J Lawrence
- The Florey Institute of Neuroscience and Mental Health, Parkville, Vic, Australia.,Florey Department of Neuroscience and Mental Health, The University of Melbourne, Melbourne, Vic, Australia
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12
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Ibrahim C, Rubin-Kahana DS, Pushparaj A, Musiol M, Blumberger DM, Daskalakis ZJ, Zangen A, Le Foll B. The Insula: A Brain Stimulation Target for the Treatment of Addiction. Front Pharmacol 2019; 10:720. [PMID: 31312138 PMCID: PMC6614510 DOI: 10.3389/fphar.2019.00720] [Citation(s) in RCA: 68] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Accepted: 06/05/2019] [Indexed: 12/15/2022] Open
Abstract
Substance use disorders (SUDs) are a growing public health concern with only a limited number of approved treatments. However, even approved treatments are subject to limited efficacy with high long-term relapse rates. Current treatment approaches are typically a combination of pharmacotherapies and behavioral counselling. Growing evidence and technological advances suggest the potential of brain stimulation techniques for the treatment of SUDs. There are three main brain stimulation techniques that are outlined in this review: transcranial magnetic stimulation (TMS), transcranial direct current stimulation (tDCS), and deep brain stimulation (DBS). The insula, a region of the cerebral cortex, is known to be involved in critical aspects underlying SUDs, such as interoception, decision making, anxiety, pain perception, cognition, mood, threat recognition, and conscious urges. This review focuses on both the preclinical and clinical evidence demonstrating the role of the insula in addiction, thereby demonstrating its promise as a target for brain stimulation. Future research should evaluate the optimal parameters for brain stimulation of the insula, through the use of relevant biomarkers and clinical outcomes for SUDs.
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Affiliation(s)
- Christine Ibrahim
- Translational Addiction Research Laboratory, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Pharmacology, University of Toronto, Toronto, ON, Canada
| | - Dafna S. Rubin-Kahana
- Translational Addiction Research Laboratory, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Abhiram Pushparaj
- Qunuba Sciences, Toronto, ON, Canada
- Ironstone Product Development, Toronto, ON, Canada
| | | | - Daniel M. Blumberger
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Temerty Centre for Therapeutic Brain Intervention, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Zafiris J. Daskalakis
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Temerty Centre for Therapeutic Brain Intervention, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Abraham Zangen
- Department of Life Sciences and the Zlotowski Center for Neuroscience, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Bernard Le Foll
- Translational Addiction Research Laboratory, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Pharmacology, University of Toronto, Toronto, ON, Canada
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Addictions Division, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Institute of Medical Sciences, University of Toronto, Toronto, ON, Canada
- Alcohol Research and Treatment Clinic, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
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13
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Lannoy S, Dormal V, Billieux J, Maurage P. Enhancement motivation to drink predicts binge drinking in adolescence: a longitudinal study in a community sample. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2019; 45:304-312. [PMID: 30601035 DOI: 10.1080/00952990.2018.1550089] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Binge drinking, characterized by alternations between intense alcohol intakes and abstinence periods, is the most frequent alcohol-consumption pattern among adolescents and is associated with cognitive impairments. OBJECTIVES It appears crucial to disentangle the psychological factors involved in the emergence of binge drinking in adolescence, and centrally the role played by drinking motives, which are related to binge drinking. METHODS This longitudinal study explored the role of drinking motives (i.e., social order, conformity, enhancement, coping) in the emergence of binge drinking among 144 adolescents (56.3% girls) from the community, who were assessed for alcohol consumption and drinking motives at two times (T1/T2), with a 1-year interval. After data checking, 101 adolescents (12-15 years old; 56.4% girls) constituted the final sample. RESULTS Strong relationships were found between drinking motives and binge drinking. Regression analyses were computed to determine how drinking motives at T1 predicted binge drinking at T2, while controlling for global alcohol use. The statistical model explained 60% of the binge-drinking variance. In particular, enhancement motivation (i.e., the search for the enjoyable sensations felt when drinking) constituted the unique predictor of future binge drinking. Conversely, social motives did not predict binge drinking. CONCLUSION These findings highlight the central role of enhancement motivation (e.g., focusing on the positive expectancies towards alcohol) in youths' alcohol consumption and call for the development of preventive interventions. The previously reported relationship between social motives and college drinking does not seem to play a key role in the early steps of binge drinking.
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Affiliation(s)
- Séverine Lannoy
- a Laboratory for Experimental Psychopathology, Psychological Science Research Institute , Université catholique de Louvain , Louvain-la-Neuve , Belgium
| | - Valérie Dormal
- a Laboratory for Experimental Psychopathology, Psychological Science Research Institute , Université catholique de Louvain , Louvain-la-Neuve , Belgium
| | - Joël Billieux
- b Addictive and Compulsive Behaviours Lab, Institute for Health and Behaviour , University of Luxembourg , Esch-sur-Alzette , Luxembourg
| | - Pierre Maurage
- a Laboratory for Experimental Psychopathology, Psychological Science Research Institute , Université catholique de Louvain , Louvain-la-Neuve , Belgium
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14
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Betka S, Pfeifer G, Garfinkel S, Prins H, Bond R, Sequeira H, Duka T, Critchley H. How Do Self-Assessment of Alexithymia and Sensitivity to Bodily Sensations Relate to Alcohol Consumption? Alcohol Clin Exp Res 2017; 42:81-88. [DOI: 10.1111/acer.13542] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Accepted: 10/25/2017] [Indexed: 12/21/2022]
Affiliation(s)
- Sophie Betka
- Brighton and Sussex Medical School; Clinical Imaging Science Centre; Brighton United Kingdom
- Behavioural and Clinical Neuroscience; School of Psychology; University of Sussex; Brighton United Kingdom
- SCALab; CNRS UMR 9193; University of Lille; Lille France
| | - Gaby Pfeifer
- Brighton and Sussex Medical School; Clinical Imaging Science Centre; Brighton United Kingdom
| | - Sarah Garfinkel
- Brighton and Sussex Medical School; Clinical Imaging Science Centre; Brighton United Kingdom
- Sackler Centre for Consciousness Science; University of Sussex; Brighton United Kingdom
| | - Hielke Prins
- Brighton and Sussex Medical School; Clinical Imaging Science Centre; Brighton United Kingdom
- Sackler Centre for Consciousness Science; University of Sussex; Brighton United Kingdom
| | - Rod Bond
- Behavioural and Clinical Neuroscience; School of Psychology; University of Sussex; Brighton United Kingdom
| | | | - Theodora Duka
- Behavioural and Clinical Neuroscience; School of Psychology; University of Sussex; Brighton United Kingdom
| | - Hugo Critchley
- Brighton and Sussex Medical School; Clinical Imaging Science Centre; Brighton United Kingdom
- Sackler Centre for Consciousness Science; University of Sussex; Brighton United Kingdom
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15
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Belin-Rauscent A, Daniel ML, Puaud M, Jupp B, Sawiak S, Howett D, McKenzie C, Caprioli D, Besson M, Robbins TW, Everitt BJ, Dalley JW, Belin D. From impulses to maladaptive actions: the insula is a neurobiological gate for the development of compulsive behavior. Mol Psychiatry 2016; 21:491-9. [PMID: 26370145 DOI: 10.1038/mp.2015.140] [Citation(s) in RCA: 74] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2015] [Revised: 07/15/2015] [Accepted: 08/10/2015] [Indexed: 02/06/2023]
Abstract
Impulsivity is an endophenotype of vulnerability for compulsive behaviors. However, the neural mechanisms whereby impulsivity facilitates the development of compulsive disorders, such as addiction or obsessive compulsive disorder, remain unknown. We first investigated, in rats, anatomical and functional correlates of impulsivity in the anterior insular (AI) cortex by measuring both the thickness of, and cellular plasticity markers in, the AI with magnetic resonance imaging and in situ hybridization of the immediate early gene zif268, respectively. We then investigated the influence of bilateral AI cortex lesions on the high impulsivity trait, as measured in the five-choice serial reaction time task (5-CSRTT), and the associated propensity to develop compulsivity as measured by high drinking levels in a schedule-induced polydipsia procedure (SIP). We demonstrate that the AI cortex causally contributes to individual vulnerability to impulsive-compulsive behavior in rats. Motor impulsivity, as measured by premature responses in the 5-CSRTT, was shown to correlate with the thinness of the anterior region of the insular cortex, in which highly impulsive (HI) rats expressed lower zif268 mRNA levels. Lesions of AI reduced impulsive behavior in HI rats, which were also highly susceptible to develop compulsive behavior as measured in a SIP procedure. AI lesions also attenuated both the development and the expression of SIP. This study thus identifies the AI as a novel neural substrate of maladaptive impulse control mechanisms that may facilitate the development of compulsive disorders.
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Affiliation(s)
- A Belin-Rauscent
- Department of Pharmacology, University of Cambridge, Cambridge, UK.,Behavioral and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK
| | - M-L Daniel
- Inserm CIC-1402, Université de Poitiers, Poitiers, France
| | - M Puaud
- Department of Pharmacology, University of Cambridge, Cambridge, UK.,Behavioral and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK
| | - B Jupp
- Behavioral and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK.,Department of Psychology, University of Cambridge, Cambridge, UK
| | - S Sawiak
- Behavioral and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK
| | - D Howett
- Department of Pharmacology, University of Cambridge, Cambridge, UK
| | - C McKenzie
- Department of Pharmacology, University of Cambridge, Cambridge, UK
| | - D Caprioli
- Behavioral Neuroscience Branch, Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, Baltimore, MD, USA
| | - M Besson
- Neurobiologie Intégrative des Systèmes Cholinergiques, Institut Pasteur, Paris, France
| | - T W Robbins
- Behavioral and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK.,Department of Psychology, University of Cambridge, Cambridge, UK
| | - B J Everitt
- Behavioral and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK.,Department of Psychology, University of Cambridge, Cambridge, UK
| | - J W Dalley
- Behavioral and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK.,Department of Psychology, University of Cambridge, Cambridge, UK.,Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - D Belin
- Department of Pharmacology, University of Cambridge, Cambridge, UK.,Behavioral and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK
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16
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Yip SW, Lacadie CM, Sinha R, Mayes LC, Potenza MN. Prenatal cocaine exposure, illicit-substance use and stress and craving processes during adolescence. Drug Alcohol Depend 2016; 158:76-85. [PMID: 26627911 PMCID: PMC4698087 DOI: 10.1016/j.drugalcdep.2015.11.012] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2015] [Revised: 11/03/2015] [Accepted: 11/04/2015] [Indexed: 11/19/2022]
Abstract
BACKGROUND Prenatal cocaine exposure (PCE) is associated with increased rates of illicit-substance use during adolescence. In addition, both PCE and illicit-substance use are associated with alterations in cortico-striato-limbic neurocircuitry, development of which is ongoing throughout adolescence. However, the relationship between illicit-substance use, PCE and functional neural responses has not previously been assessed concurrently. METHODS Sixty-eight adolescents were recruited from an ongoing longitudinal study of childhood and adolescent development. All participants had been followed since birth. Functional magnetic resonance imaging (fMRI) data were acquired during presentation of personalized stressful, favorite-food and neutral/relaxing imagery scripts and compared between 46 PCE and 22 non-prenatally-drug-exposed (NDE) adolescents with and without lifetime illicit-substance use initiation. Data were analyzed using multi-level ANOVAs (pFWE<.05). RESULTS There was a significant three-way interaction between illicit-substance use, PCE status and cue condition on neural responses within primarily cortical brain regions, including regions of the left and right insula. Among PCE versus NDE adolescents, illicit-substance use was associated with decreased subcortical and increased cortical activity during the favorite-food condition, whereas the opposite pattern of activation was observed during the neutral/relaxing condition. Among PCE versus NDE adolescents, illicit-substance use during stress processing was associated with decreased activity in cortical and subcortical regions including amygdala, hippocampus and prefrontal cortex. Neural activity within cortico-striato-limbic regions was significantly negatively associated with subjective ratings of anxiety and craving among illicit-substance users, but not among non-users. CONCLUSIONS These findings suggest different neural substrates of experimentation with illicit drugs between adolescents with and without in utero cocaine exposure.
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Affiliation(s)
- Sarah W Yip
- CASAColumbia, Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States.
| | - Cheryl M Lacadie
- Department of Diagnostic Radiology, 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; Child Study Center, Yale University School of Medicine, New Haven, CT, United States; Department of Neurobiology, Yale University School of Medicine, New Haven, CT, United States
| | - Linda C Mayes
- Child Study Center, Yale University School of Medicine, New Haven, CT, United States; Departments of Epidemiology, Pediatrics and Psychology, Yale University School of Medicine, New Haven, CT, United States
| | - Marc N Potenza
- CASAColumbia, Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States; Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States; Child Study Center, Yale University School of Medicine, New Haven, CT, United States; Department of Neurobiology, Yale University School of Medicine, New Haven, CT, United States
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17
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Berk L, Stewart JL, May AC, Wiers RW, Davenport PW, Paulus MP, Tapert SF. Under pressure: adolescent substance users show exaggerated neural processing of aversive interoceptive stimuli. Addiction 2015; 110:2025-36. [PMID: 26234745 PMCID: PMC4644498 DOI: 10.1111/add.13090] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2015] [Revised: 04/30/2015] [Accepted: 07/28/2015] [Indexed: 01/01/2023]
Abstract
AIMS Adolescents with substance use disorders (SUD) exhibit hyposensitivity to pleasant internally generated (interoceptive) stimuli and hypersensitivity to external rewarding stimuli. It is unclear whether similar patterns exist for aversive interoceptive stimuli. We compared activation in the insular cortex and other brain regions during the anticipation and experience of aversive stimuli between adolescents with SUD and those without. DESIGN Cross-sectional experimental study with two groups. PARTICIPANTS Adolescents (ages 15-17 years) with an alcohol or marijuana SUD (n=18) and healthy comparison subjects (CON, n=15). Participants were recruited by distributing flyers at local high schools. SETTING Keck Imaging Center, University of California San Diego, CA, USA. MEASUREMENTS Behavioral and neural responses to a continuous performance task with inspiratory breathing load recorded during an fMRI session. Questionnaires assessed life-time drug use, anxiety, sensation-seeking, impulsivity, affect and bodily awareness. Visual analog scales assessed drug craving and breathing load responses. FINDINGS Across subjects, experience of breathing load elicited greater bilateral anterior and posterior insula (AI and PI, respectively) activation than anticipation (F(1,31)=4.16, P<0.05). SUD exhibited greater left AI and bilateral PI activation during breathing load than anticipation, compared with CON (F(1,31)=4.16, P<0.05). In contrast, CON showed greater activation during anticipation than breathing load in left PI, compared with SUD (F(1,31)=4.16, P<0.05). CONCLUSIONS Adolescents with alcohol and marijuana substance use disorders may be hypersensitive to aversive interoceptive stimuli.
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Affiliation(s)
- Lotte Berk
- University of California San Diego, Department of Psychiatry, USA
| | | | - April C. May
- University of California San Diego, Department of Psychiatry, USA
| | - Reinout W. Wiers
- University of Amsterdam, Developmental Psychology, The Netherlands
| | - Paul W. Davenport
- University of Florida, Department of Physiology, Gainesville, FL USA
| | - Martin P. Paulus
- University of California San Diego, Department of Psychiatry, USA,Laureate Institute For Brain Research, Tulsa OK, USA,Veterans Affairs San Diego Healthcare System, USA
| | - Susan F. Tapert
- University of California San Diego, Department of Psychiatry, USA,Veterans Affairs San Diego Healthcare System, USA,Correspondence concerning this article should be addressed to: Susan Tapert, 3350 La Jolla Village Drive 116B, San Diego, CA 92161. Phone: (858) 552-8585. Fax: (858) 552-7414.
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18
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Neuroscience of alcohol for addiction medicine: Neurobiological targets for prevention and intervention in adolescents. PROGRESS IN BRAIN RESEARCH 2015; 223:215-35. [PMID: 26806778 DOI: 10.1016/bs.pbr.2015.07.027] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/13/2023]
Abstract
Structural and functional neuroimaging studies indicate that heavy alcohol use during adolescence may be neurotoxic to the brain. This chapter reviews the neuroimaging findings in cross-sectional and longitudinal studies of adolescent heavy alcohol users. These youth exhibit reductions in prefrontal, hippocampal, and cerebellar brain volume, decreased frontoparietal, and increased frontolimbic white matter integrity, as well as alterations in blood oxygen level-dependent response during working memory, inhibitory control, verbal encoding, decision making, and reward processing-some of which appear to differ between males and females. Although some exist, additional longitudinal studies will significantly advance addiction medicine by aiding prevention scientists and treatment providers to develop neurobiologically informed ways of strengthening neural networks prior to and after the onset of heavy alcohol use, thereby promoting healthy cognitive functioning across the adolescent period.
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19
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Vatsalya V, Gowin JL, Schwandt ML, Momenan R, Coe MA, Cooke ME, Hommer DW, Bartlett S, Heilig M, Ramchandani VA. Effects of Varenicline on Neural Correlates of Alcohol Salience in Heavy Drinkers. Int J Neuropsychopharmacol 2015; 18:pyv068. [PMID: 26209857 PMCID: PMC4675979 DOI: 10.1093/ijnp/pyv068] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND Preclinical and emerging clinical evidence indicates that varenicline, a nicotinic partial agonist approved for smoking cessation, attenuates alcohol seeking and consumption. Reductions of alcohol craving have been observed under varenicline treatment and suggest effects of the medication on alcohol reward processing, but this hypothesis remains untested. METHODS In this double-blind, placebo-controlled randomized experimental medicine study, 29 heavy drinkers underwent a functional magnetic resonance imaging scan after 2 weeks of varenicline (2mg/d) or placebo administration. During functional magnetic resonance imaging, participants performed the Alcohol-Food Incentive Delay task, where they could earn points for snacks or alcohol. At baseline and after 3 weeks of medication, participants underwent intravenous alcohol self-administration sessions in the laboratory. RESULTS During the functional magnetic resonance imaging scan, participants in the varenicline group (N=17) reported lower feelings of happiness and excitement on subjective mood scales when anticipating alcohol reward compared with the placebo group (N=12). Linear mixed effects analysis revealed that anticipation of alcohol reward was associated with significant blood oxygen level dependent activation of the ventral striatum, amygdala, and posterior insula in the placebo group; this activation was attenuated in the varenicline group. The varenicline group showed no difference in intravenous alcohol self-administration relative to the placebo group for either session. Participants with higher insula activation when anticipating alcohol reward showed higher alcohol self-administration behavior across groups. CONCLUSIONS Our findings suggest that varenicline decreases blood oxygen level dependent activation in striato-cortico-limbic regions associated with motivation and incentive salience of alcohol in heavy drinkers. This mechanism may underlie the clinical effectiveness of varenicline in reducing alcohol intake and indicates its potential utility as a pharmacotherapy for alcohol use disorders.
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Affiliation(s)
- Vatsalya Vatsalya
- Section on Human Psychopharmacology, Laboratory of Clinical and Translational Studies, National Institute on Alcohol Abuse and Alcoholism, Bethesda, Maryland (Drs Vatsalya, Gowin, Coe, Cooke, and Ramchandani); Laboratory of Clinical and Translational Studies, National Institute on Alcohol Abuse and Alcoholism, Bethesda, Maryland (Drs Schwandt and Heilig); Section on Brain Electrophysiology and Imaging, Laboratory of Clinical and Translational Studies, National Institute on Alcohol Abuse and Alcoholism, Bethesda, Maryland (Drs Momenan and Hommer); Translational Research Institute, Institute for Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia (Dr Bartlett).V.V. current affiliation: University of Louisville and Robley Rex VAMC, Louisville, Kentucky
| | - Joshua L Gowin
- Section on Human Psychopharmacology, Laboratory of Clinical and Translational Studies, National Institute on Alcohol Abuse and Alcoholism, Bethesda, Maryland (Drs Vatsalya, Gowin, Coe, Cooke, and Ramchandani); Laboratory of Clinical and Translational Studies, National Institute on Alcohol Abuse and Alcoholism, Bethesda, Maryland (Drs Schwandt and Heilig); Section on Brain Electrophysiology and Imaging, Laboratory of Clinical and Translational Studies, National Institute on Alcohol Abuse and Alcoholism, Bethesda, Maryland (Drs Momenan and Hommer); Translational Research Institute, Institute for Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia (Dr Bartlett).V.V. current affiliation: University of Louisville and Robley Rex VAMC, Louisville, Kentucky
| | - Melanie L Schwandt
- Section on Human Psychopharmacology, Laboratory of Clinical and Translational Studies, National Institute on Alcohol Abuse and Alcoholism, Bethesda, Maryland (Drs Vatsalya, Gowin, Coe, Cooke, and Ramchandani); Laboratory of Clinical and Translational Studies, National Institute on Alcohol Abuse and Alcoholism, Bethesda, Maryland (Drs Schwandt and Heilig); Section on Brain Electrophysiology and Imaging, Laboratory of Clinical and Translational Studies, National Institute on Alcohol Abuse and Alcoholism, Bethesda, Maryland (Drs Momenan and Hommer); Translational Research Institute, Institute for Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia (Dr Bartlett).V.V. current affiliation: University of Louisville and Robley Rex VAMC, Louisville, Kentucky
| | - Reza Momenan
- Section on Human Psychopharmacology, Laboratory of Clinical and Translational Studies, National Institute on Alcohol Abuse and Alcoholism, Bethesda, Maryland (Drs Vatsalya, Gowin, Coe, Cooke, and Ramchandani); Laboratory of Clinical and Translational Studies, National Institute on Alcohol Abuse and Alcoholism, Bethesda, Maryland (Drs Schwandt and Heilig); Section on Brain Electrophysiology and Imaging, Laboratory of Clinical and Translational Studies, National Institute on Alcohol Abuse and Alcoholism, Bethesda, Maryland (Drs Momenan and Hommer); Translational Research Institute, Institute for Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia (Dr Bartlett).V.V. current affiliation: University of Louisville and Robley Rex VAMC, Louisville, Kentucky
| | - Marion A Coe
- Section on Human Psychopharmacology, Laboratory of Clinical and Translational Studies, National Institute on Alcohol Abuse and Alcoholism, Bethesda, Maryland (Drs Vatsalya, Gowin, Coe, Cooke, and Ramchandani); Laboratory of Clinical and Translational Studies, National Institute on Alcohol Abuse and Alcoholism, Bethesda, Maryland (Drs Schwandt and Heilig); Section on Brain Electrophysiology and Imaging, Laboratory of Clinical and Translational Studies, National Institute on Alcohol Abuse and Alcoholism, Bethesda, Maryland (Drs Momenan and Hommer); Translational Research Institute, Institute for Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia (Dr Bartlett).V.V. current affiliation: University of Louisville and Robley Rex VAMC, Louisville, Kentucky
| | - Megan E Cooke
- Section on Human Psychopharmacology, Laboratory of Clinical and Translational Studies, National Institute on Alcohol Abuse and Alcoholism, Bethesda, Maryland (Drs Vatsalya, Gowin, Coe, Cooke, and Ramchandani); Laboratory of Clinical and Translational Studies, National Institute on Alcohol Abuse and Alcoholism, Bethesda, Maryland (Drs Schwandt and Heilig); Section on Brain Electrophysiology and Imaging, Laboratory of Clinical and Translational Studies, National Institute on Alcohol Abuse and Alcoholism, Bethesda, Maryland (Drs Momenan and Hommer); Translational Research Institute, Institute for Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia (Dr Bartlett).V.V. current affiliation: University of Louisville and Robley Rex VAMC, Louisville, Kentucky
| | - Daniel W Hommer
- Section on Human Psychopharmacology, Laboratory of Clinical and Translational Studies, National Institute on Alcohol Abuse and Alcoholism, Bethesda, Maryland (Drs Vatsalya, Gowin, Coe, Cooke, and Ramchandani); Laboratory of Clinical and Translational Studies, National Institute on Alcohol Abuse and Alcoholism, Bethesda, Maryland (Drs Schwandt and Heilig); Section on Brain Electrophysiology and Imaging, Laboratory of Clinical and Translational Studies, National Institute on Alcohol Abuse and Alcoholism, Bethesda, Maryland (Drs Momenan and Hommer); Translational Research Institute, Institute for Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia (Dr Bartlett).V.V. current affiliation: University of Louisville and Robley Rex VAMC, Louisville, Kentucky
| | - Selena Bartlett
- Section on Human Psychopharmacology, Laboratory of Clinical and Translational Studies, National Institute on Alcohol Abuse and Alcoholism, Bethesda, Maryland (Drs Vatsalya, Gowin, Coe, Cooke, and Ramchandani); Laboratory of Clinical and Translational Studies, National Institute on Alcohol Abuse and Alcoholism, Bethesda, Maryland (Drs Schwandt and Heilig); Section on Brain Electrophysiology and Imaging, Laboratory of Clinical and Translational Studies, National Institute on Alcohol Abuse and Alcoholism, Bethesda, Maryland (Drs Momenan and Hommer); Translational Research Institute, Institute for Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia (Dr Bartlett).V.V. current affiliation: University of Louisville and Robley Rex VAMC, Louisville, Kentucky
| | - Markus Heilig
- Section on Human Psychopharmacology, Laboratory of Clinical and Translational Studies, National Institute on Alcohol Abuse and Alcoholism, Bethesda, Maryland (Drs Vatsalya, Gowin, Coe, Cooke, and Ramchandani); Laboratory of Clinical and Translational Studies, National Institute on Alcohol Abuse and Alcoholism, Bethesda, Maryland (Drs Schwandt and Heilig); Section on Brain Electrophysiology and Imaging, Laboratory of Clinical and Translational Studies, National Institute on Alcohol Abuse and Alcoholism, Bethesda, Maryland (Drs Momenan and Hommer); Translational Research Institute, Institute for Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia (Dr Bartlett).V.V. current affiliation: University of Louisville and Robley Rex VAMC, Louisville, Kentucky
| | - Vijay A Ramchandani
- Section on Human Psychopharmacology, Laboratory of Clinical and Translational Studies, National Institute on Alcohol Abuse and Alcoholism, Bethesda, Maryland (Drs Vatsalya, Gowin, Coe, Cooke, and Ramchandani); Laboratory of Clinical and Translational Studies, National Institute on Alcohol Abuse and Alcoholism, Bethesda, Maryland (Drs Schwandt and Heilig); Section on Brain Electrophysiology and Imaging, Laboratory of Clinical and Translational Studies, National Institute on Alcohol Abuse and Alcoholism, Bethesda, Maryland (Drs Momenan and Hommer); Translational Research Institute, Institute for Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia (Dr Bartlett).V.V. current affiliation: University of Louisville and Robley Rex VAMC, Louisville, Kentucky.
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