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Zahr NM. Alcohol Use Disorder and Dementia: A Review. Alcohol Res 2024; 44:03. [PMID: 38812709 PMCID: PMC11135165 DOI: 10.35946/arcr.v44.1.03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2024] Open
Abstract
PURPOSE By 2040, 21.6% of Americans will be over age 65, and the population of those older than age 85 is estimated to reach 14.4 million. Although not causative, older age is a risk factor for dementia: every 5 years beyond age 65, the risk doubles; approximately one-third of those older than age 85 are diagnosed with dementia. As current alcohol consumption among older adults is significantly higher compared to previous generations, a pressing question is whether drinking alcohol increases the risk for Alzheimer's disease or other forms of dementia. SEARCH METHODS Databases explored included PubMed, Web of Science, and ScienceDirect. To accomplish this narrative review on the effects of alcohol consumption on dementia risk, the literature covered included clinical diagnoses, epidemiology, neuropsychology, postmortem pathology, neuroimaging and other biomarkers, and translational studies. Searches conducted between January 12 and August 1, 2023, included the following terms and combinations: "aging," "alcoholism," "alcohol use disorder (AUD)," "brain," "CNS," "dementia," "Wernicke," "Korsakoff," "Alzheimer," "vascular," "frontotemporal," "Lewy body," "clinical," "diagnosis," "epidemiology," "pathology," "autopsy," "postmortem," "histology," "cognitive," "motor," "neuropsychological," "magnetic resonance," "imaging," "PET," "ligand," "degeneration," "atrophy," "translational," "rodent," "rat," "mouse," "model," "amyloid," "neurofibrillary tangles," "α-synuclein," or "presenilin." When relevant, "species" (i.e., "humans" or "other animals") was selected as an additional filter. Review articles were avoided when possible. SEARCH RESULTS The two terms "alcoholism" and "aging" retrieved about 1,350 papers; adding phrases-for example, "postmortem" or "magnetic resonance"-limited the number to fewer than 100 papers. Using the traditional term, "alcoholism" with "dementia" resulted in 876 citations, but using the currently accepted term "alcohol use disorder (AUD)" with "dementia" produced only 87 papers. Similarly, whereas the terms "Alzheimer's" and "alcoholism" yielded 318 results, "Alzheimer's" and "alcohol use disorder (AUD)" returned only 40 citations. As pertinent postmortem pathology papers were published in the 1950s and recent animal models of Alzheimer's disease were created in the early 2000s, articles referenced span the years 1957 to 2024. In total, more than 5,000 articles were considered; about 400 are herein referenced. DISCUSSION AND CONCLUSIONS Chronic alcohol misuse accelerates brain aging and contributes to cognitive impairments, including those in the mnemonic domain. The consensus among studies from multiple disciplines, however, is that alcohol misuse can increase the risk for dementia, but not necessarily Alzheimer's disease. Key issues to consider include the reversibility of brain damage following abstinence from chronic alcohol misuse compared to the degenerative and progressive course of Alzheimer's disease, and the characteristic presence of protein inclusions in the brains of people with Alzheimer's disease, which are absent in the brains of those with AUD.
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Affiliation(s)
- Natalie M Zahr
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California. Center for Health Sciences, SRI International, Menlo Park, California
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2
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Durazzo TC, Stephens LH, Meyerhoff DJ. Regional cortical thickness recovery with extended abstinence after treatment in those with alcohol use disorder. Alcohol 2024; 114:51-60. [PMID: 37657667 PMCID: PMC10902196 DOI: 10.1016/j.alcohol.2023.08.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 07/31/2023] [Accepted: 08/22/2023] [Indexed: 09/03/2023]
Abstract
Several cross-sectional investigations reported widespread cortical thinning in those with alcohol use disorder (AUD). The few longitudinal studies investigating cortical thickness changes during abstinence are limited to the first month of sobriety. Consequently, cortical thickness changes during extended abstinence in those with AUD is unclear. In this study, AUD participants were studied at approximately 1 week (n = 68), 1 month (n = 88), and 7.3 months (n = 40) of abstinence. Forty-five never-smoking controls (CON) completed a baseline study, and 15 were reassessed after approximately 9.6 months. Participants completed magnetic resonance imaging studies at 1.5T, and cortical thickness for 34 bilateral regions of interest (ROI) was quantitated with FreeSurfer. AUD participants demonstrated significant linear thickness increases in 25/34 ROI over 7.3 months of abstinence. The rate of change from 1 week to 1 month was greater than 1 month to 7.3 months in 19/34 ROIs. Proatherogenic conditions were associated with lower thickness recovery in anterior frontal, inferior parietal, and lateral/mesial temporal regions. After 7.3 months of abstinence, AUD participants were statistically equivalent to CON on cortical thickness in 24/34 ROIs; the cortical thickness differences between AUD and CON in the banks superior temporal gyrus, post central, posterior cingulate, superior parietal, supramarginal, and superior frontal cortices were driven by thinner cortices in AUD with proatherogenic conditions relative to CON. In actively smoking AUD, increasing pack-years was associated with decreasing thickness recovery primarily in the anterior frontal ROIs. Widespread bilateral cortical thickness recovery over 7.3 months of abstinence was the central finding for this AUD cohort. The longitudinal and cross-sectional findings for AUD with proatherogenic suggests alterations in perfusion or vascular integrity may relate to structural recovery in those with AUD. These results support the adaptive and beneficial effects of sustained sobriety on brain structural recovery in people with AUD.
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Affiliation(s)
- Timothy C Durazzo
- Sierra-Pacific Mental Illness Research and Education Clinical Centers, Veterans Administration Palo Alto Health Care System, Palo Alto, CA, United States; Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, United States.
| | - Lauren H Stephens
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, United States
| | - Dieter J Meyerhoff
- Center for Imaging of Neurodegenerative Diseases (CIND), San Francisco Veterans Administration Medical Center, San Francisco, CA, United States; Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, United States
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Durazzo TC, Stephens LH, Kraybill EP, May AC, Meyerhoff DJ. Regional cortical brain volumes at treatment entry relates to post treatment WHO risk drinking levels in those with alcohol use disorder. Drug Alcohol Depend 2024; 255:111082. [PMID: 38219355 PMCID: PMC10895709 DOI: 10.1016/j.drugalcdep.2024.111082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 12/08/2023] [Accepted: 12/28/2023] [Indexed: 01/16/2024]
Abstract
BACKGROUND Abstinence following treatment for alcohol use disorder (AUD) is associated with significant improvements in psychiatric and physical health, however, recent studies suggest resumption of low risk levels of alcohol use can also be beneficial. The present study assessed whether post-treatment levels of alcohol use were associated with cortical brain volumedifferences at treatment entry. METHODS Individuals seeking treatment for AUD (n=75) and light/non-drinking controls (LN, n=51) underwent 1.5T magnetic resonance imaging. The volumes of 34 bilateral cortical regions of interest (ROIs) were quantitated via FreeSurfer. Individuals with AUD were classified according to post-treatment alcohol consumption using the WHO risk drinking levels (abstainers: AB; low risk: RL; or higher risk: RH). Regional volumes for AB, RL and RH, at treatment entry, were compared to LN. RESULTS Relative to LN, AB demonstrated smaller volumes in 18/68 (26%), RL in 24/68 (35%) and RH in 34/68 (50%) ROIs with the largest magnitude volume differences observed between RH and LN. RH and RL reported a higher frequency of depressive disorders than AB. Among RH and RL, level of depressive and anxiety symptomatology were associated with daily number of drinks consumed after treatment. CONCLUSIONS Volumetric differences, at treatment entry, in brain regions implicated in executive function and salience networks corresponded with post-treatment alcohol consumption levels suggesting that pre-existing differences in neural integrity may contribute to treatment outcomes. Depressive and anxiety symptomatology was also associated with brain morphometrics and alcohol use patterns, highlighting the importance of effectively targeting these conditions during AUD treatment.
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Affiliation(s)
- Timothy C Durazzo
- Sierra-Pacific Mental Illness Research and Education Clinical Centers, VA Palo Alto Health Care System, USA; Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, USA.
| | - Lauren H Stephens
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, USA
| | - Eric P Kraybill
- Sierra-Pacific Mental Illness Research and Education Clinical Centers, VA Palo Alto Health Care System, USA
| | - April C May
- Sierra-Pacific Mental Illness Research and Education Clinical Centers, VA Palo Alto Health Care System, USA; Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, USA
| | - Dieter J Meyerhoff
- Center for Imaging of Neurodegenerative Diseases (CIND), San Francisco VA Medical Center, San Francisco, CA, USA; Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA
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Angerville B, Jurdana MA, Martinetti MP, Sarba R, Nguyen-Khac É, Naassila M, Dervaux A. Alcohol-related cognitive impairments in patients with and without cirrhosis. Alcohol Alcohol 2024; 59:agae008. [PMID: 38366913 DOI: 10.1093/alcalc/agae008] [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: 09/11/2023] [Revised: 01/17/2024] [Accepted: 01/26/2024] [Indexed: 02/19/2024] Open
Abstract
AIMS up to 80% of patients with alcohol use disorder display cognitive impairments. Some studies have suggested that alcohol-related cognitive impairments could be worsened by hepatic damage. The primary objective of this study was to compare mean scores on the Brief Evaluation of Alcohol-Related Neurocognitive Impairments measure between alcohol use disorder patients with (CIR+) or without cirrhosis (CIR-). METHODS we conducted a prospective case-control study in a hepatology department of a university hospital. All patients were assessed using the Evaluation of Alcohol-Related Neuropsychological Impairments test. RESULTS a total of 82 patients (50 CIR+, 32 CIR-) were included in this study. CIR- patients were significantly younger than CIR+ patients (respectively, 45.5 ± 6.8 vs 60.1 ± 9.0; P < .0001). After adjusting for age and educational level, the mean Evaluation of Alcohol-Related Neuropsychological Impairments total scores in the CIR+ group were significantly lower than in the group of CIR- patients (14.1 ± 0.7 vs 7.8 ± 0.4, respectively, P < .0001). The mean subscores on delayed verbal memory, alphabetical ordination, alternating verbal fluency, visuospatial abilities, and ataxia subtests were also significantly lower in the CIR+ than in the CIR- group (respectively, 1.9 ± 0.2 vs 2.8 ± 0.2; 1.8 ± 0.2 vs 2.7 ± 0.2; 2.2 ± 0.2 vs 3.6 ± 0.2; 0.7 ± 0.2 vs 1.6 ± 0.2; 0.7 ± 0.2 vs 3.1 ± 0.2; P < .0001 for all comparisons). CONCLUSIONS in the present study, alcohol use disorder patients with cirrhosis presented more severe cognitive impairments than those without cirrhosis. Longitudinal studies are needed to investigate how cirrhosis can influence cognitive impairments.
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Affiliation(s)
- Bernard Angerville
- Filière universitaire d'addictologie, EPS Barthélémy Durand, Étampes, 91150, France
- Université de Picardie Jules Verne, Centre Universitaire de Recherche en Santé, INSERM UMR 1247, Groupe de Recherche sur l'Alcool & les Pharmacodépendances, Amiens, 80000, France
| | - Marie-Alix Jurdana
- Université de Picardie Jules Verne, Centre Universitaire de Recherche en Santé, INSERM UMR 1247, Groupe de Recherche sur l'Alcool & les Pharmacodépendances, Amiens, 80000, France
| | | | - Ruxandra Sarba
- Département d'Hépato-Gastroenterologie, CHU d'Amiens, Amiens, 80000, France
| | - Éric Nguyen-Khac
- Université de Picardie Jules Verne, Centre Universitaire de Recherche en Santé, INSERM UMR 1247, Groupe de Recherche sur l'Alcool & les Pharmacodépendances, Amiens, 80000, France
- Département d'Hépato-Gastroenterologie, CHU d'Amiens, Amiens, 80000, France
| | - Mickael Naassila
- Université de Picardie Jules Verne, Centre Universitaire de Recherche en Santé, INSERM UMR 1247, Groupe de Recherche sur l'Alcool & les Pharmacodépendances, Amiens, 80000, France
| | - Alain Dervaux
- Filière universitaire d'addictologie, EPS Barthélémy Durand, Étampes, 91150, France
- Université de Picardie Jules Verne, Centre Universitaire de Recherche en Santé, INSERM UMR 1247, Groupe de Recherche sur l'Alcool & les Pharmacodépendances, Amiens, 80000, France
- Laboratoire de recherche PSYCHOMADD, Université paris Saclay, Villejuif, 94800, France
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Powell A, Sumnall H, Smith J, Kuiper R, Montgomery C. Recovery of neuropsychological function following abstinence from alcohol in adults diagnosed with an alcohol use disorder: Systematic review of longitudinal studies. PLoS One 2024; 19:e0296043. [PMID: 38166127 PMCID: PMC10760842 DOI: 10.1371/journal.pone.0296043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 12/05/2023] [Indexed: 01/04/2024] Open
Abstract
BACKGROUND Alcohol use disorders (AUD) associate with structural and functional brain differences, including impairments in neuropsychological function; however, reviews (mostly cross-sectional) are inconsistent with regards to recovery of such functions following abstinence. Recovery is important, as these impairments associate with treatment outcomes and quality of life. OBJECTIVE(S) To assess neuropsychological function recovery following abstinence in individuals with a clinical AUD diagnosis. The secondary objective was to assess predictors of neuropsychological recovery in AUD. METHODS Following the preregistered protocol (PROSPERO: CRD42022308686), APA PsycInfo, EBSCO MEDLINE, CINAHL, and Web of Science Core Collection were searched between 1999-2022. Study reporting follows the Joanna Briggs Institute (JBI) Manual for Evidence Synthesis, study quality was assessed using the JBI Checklist for Cohort Studies. Eligible studies were those with a longitudinal design that assessed neuropsychological recovery following abstinence from alcohol in adults with a clinical diagnosis of AUD. Studies were excluded if participant group was defined by another or co-morbid condition/injury, or by relapse. Recovery was defined as function reaching 'normal' performance. RESULTS Sixteen studies (AUD n = 783, controls n = 390) were selected for narrative synthesis. Most functions demonstrated recovery within 6-12 months, including sub-domains within attention, executive function, perception, and memory, though basic processing speed and working memory updating/tracking recovered earlier. Additionally, verbal fluency was not impaired at baseline (while verbal function was not assessed compared to normal levels), and concept formation and reasoning recovery was inconsistent. CONCLUSIONS These results provide evidence that recovery of most functions is possible. While overall robustness of results was good, methodological limitations included lack of control groups, additional methods to self-report to confirm abstinence, description/control for attrition, statistical control of confounds, and of long enough study durations to capture change.
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Affiliation(s)
- Anna Powell
- School of Psychology, Faculty of Health, Liverpool John Moores University, Liverpool, United Kingdom
- Liverpool Centre for Alcohol Research, University of Liverpool, Liverpool, United Kingdom
| | - Harry Sumnall
- Liverpool Centre for Alcohol Research, University of Liverpool, Liverpool, United Kingdom
- Public Health Institute, Faculty of Health, Liverpool John Moores University, Liverpool, United Kingdom
| | - Jessica Smith
- Liverpool Centre for Alcohol Research, University of Liverpool, Liverpool, United Kingdom
- Public Health Institute, Faculty of Health, Liverpool John Moores University, Liverpool, United Kingdom
| | - Rebecca Kuiper
- School of Psychology, Faculty of Health, Liverpool John Moores University, Liverpool, United Kingdom
- Liverpool Centre for Alcohol Research, University of Liverpool, Liverpool, United Kingdom
| | - Catharine Montgomery
- School of Psychology, Faculty of Health, Liverpool John Moores University, Liverpool, United Kingdom
- Liverpool Centre for Alcohol Research, University of Liverpool, Liverpool, United Kingdom
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Staudt J, Kok T, de Haan HA, Walvoort SJW, Egger JIM. Neurocognitive Recovery in Abstinent Patients with Alcohol Use Disorder: A Scoping Review for Associated Factors. Neuropsychiatr Dis Treat 2023; 19:2039-2054. [PMID: 37790802 PMCID: PMC10544223 DOI: 10.2147/ndt.s424017] [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: 06/25/2023] [Accepted: 08/25/2023] [Indexed: 10/05/2023] Open
Abstract
Objective Studies have reported inconsistent results regarding the extent to which neurocognitive recovery occurs in abstinent patients with alcohol use disorder (AUD). In addition to abstinence, other factors may have influenced this process and contributed to the inconsistencies. This review examines the factors investigated in this regard and describes the possible influence of each factor based on the evidence collected. Methodology PubMed was systematically searched for articles published between January 2000 and July 2023. Longitudinal humane studies investigating neurocognitive recovery in abstinent adult AUD patients were included. Studies with a cross-sectional design were excluded, as were studies that did not classify AUD according to the DSM-IV or 5 criteria, only examined binge use, did not report neuropsychological outcomes or duration of abstinence, or where neurological disorders were present. Results Sixteen categories of factors were distinguished from 31 full-text articles. Consistent patterns were found, indicating an association between neurocognitive recovery and the "smoking" and 'brain volume" factors. Consistent patterns were also found indicating that there is no relationship with "quantities of alcohol used" and "education level." A similar consistent pattern was also found for "polysubstance use", "gender" and "verbal reading", but the number of studies is considered limited. The association with "age" is studied frequently but with inconsistent findings. The remaining eight factors were regarded as understudied. Conclusion The clearest patterns emerging from the evidence are a predominantly negative influence of smoking on neurocognitive recovery, associations between changes in brain area volume and neurocognitive recovery, and no association between neurocognitive recovery and the amount of alcohol consumed, as measured by self-report, nor with educational attainment. Future research on the understudied factors and factors with inconsistent evidence is needed, preferably through longitudinal designs with multiple assessment periods starting after at least two weeks of abstinence.
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Affiliation(s)
- Jeroen Staudt
- Tactus Addiction Treatment, Deventer, the Netherlands
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, the Netherlands
| | - Tim Kok
- Tactus Addiction Treatment, Deventer, the Netherlands
| | - Hein A de Haan
- Tactus Addiction Treatment, Deventer, the Netherlands
- Nijmegen Institute for Scientist Practitioners in Addiction, Radboud University, Nijmegen, the Netherlands
| | | | - Jos I M Egger
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, the Netherlands
- Centre of Excellence for Korsakoff and Alcohol Related Cognitive Disorders, Vincent van Gogh Institute for Psychiatry, Venray, the Netherlands
- Centre of Excellence for Neuropsychiatry, Vincent van Gogh Institute for Psychiatry, Venray, the Netherlands
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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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Yan H, Xiao S, Fu S, Gong J, Qi Z, Chen G, Chen P, Tang G, Su T, Yang Z, Wang Y. Functional and structural brain abnormalities in substance use disorder: A multimodal meta-analysis of neuroimaging studies. Acta Psychiatr Scand 2023; 147:345-359. [PMID: 36807120 DOI: 10.1111/acps.13539] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 01/19/2023] [Accepted: 02/12/2023] [Indexed: 02/23/2023]
Abstract
INTRODUCTION Numerous neuroimaging studies of resting-state functional imaging and voxel-based morphometry (VBM) have revealed that patients with substance use disorder (SUD) may present brain abnormalities, but their results were inconsistent. This multimodal neuroimaging meta-analysis aimed to estimate common and specific alterations in SUD patients by combining information from all available studies of spontaneous functional activity and gray matter volume (GMV). METHODS A whole-brain meta-analysis on resting-state functional imaging and VBM studies was conducted using the Seed-based d Mapping with Permutation of Subject Images (SDM-PSI) software, followed by multimodal overlapping to comprehensively investigate function and structure of the brain in SUD. RESULTS In this meta-analysis, 39 independent studies with 47 datasets related to resting-state functional brain activity (1444 SUD patients; 1446 healthy controls [HCs]) were included, as well as 77 studies with 89 datasets for GMV (3457 SUD patients; 3774 HCs). Patients with SUD showed the decreased resting-state functional brain activity in the bilateral anterior cingulate cortex/medial prefrontal cortex (ACC/mPFC). For the VBM meta-analysis, patients with SUD showed the reduced GMV in the bilateral ACC/mPFC, insula, thalamus extending to striatum, and left sensorimotor cortex. CONCLUSIONS This multimodal meta-analysis exhibited that SUD shows common impairment in both function and structure in the ACC/mPFC, suggesting that the deficits in functional and structural domains could be correlated together. In addition, a few regions exhibited only structural impairment in SUD, including the insula, thalamus, striatum, and sensorimotor areas.
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Affiliation(s)
- Hong Yan
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou, China
- Institute of Molecular and Functional Imaging, Jinan University, Guangzhou, China
| | - Shu Xiao
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou, China
- Institute of Molecular and Functional Imaging, Jinan University, Guangzhou, China
| | - Siying Fu
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou, China
- Institute of Molecular and Functional Imaging, Jinan University, Guangzhou, China
| | - Jiaying Gong
- Institute of Molecular and Functional Imaging, Jinan University, Guangzhou, China
- Department of Radiology, Six Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Zhangzhang Qi
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou, China
- Institute of Molecular and Functional Imaging, Jinan University, Guangzhou, China
| | - Guanmao Chen
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou, China
- Institute of Molecular and Functional Imaging, Jinan University, Guangzhou, China
| | - Pan Chen
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou, China
- Institute of Molecular and Functional Imaging, Jinan University, Guangzhou, China
| | - Guixian Tang
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou, China
- Institute of Molecular and Functional Imaging, Jinan University, Guangzhou, China
| | - Ting Su
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou, China
- Institute of Molecular and Functional Imaging, Jinan University, Guangzhou, China
| | - Zibin Yang
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou, China
- Institute of Molecular and Functional Imaging, Jinan University, Guangzhou, China
| | - Ying Wang
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou, China
- Institute of Molecular and Functional Imaging, Jinan University, Guangzhou, China
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Sullivan EV, Pfefferbaum A. Alcohol use disorder: Neuroimaging evidence for accelerated aging of brain morphology and hypothesized contribution to age-related dementia. Alcohol 2023; 107:44-55. [PMID: 35781021 DOI: 10.1016/j.alcohol.2022.06.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Revised: 05/31/2022] [Accepted: 06/09/2022] [Indexed: 12/22/2022]
Abstract
Excessive alcohol use curtails longevity by rendering intoxicated individuals vulnerable to heightened risk from accidents, violence, and alcohol poisoning, and makes chronically heavy drinkers vulnerable to acceleration of age-related medical and psychiatric conditions that can be life threatening (Yoon, Chen, Slater, Jung, & White, 2020). Thus, studies of factors influencing age-alcohol interactions must consider the potential that the alcohol use disorder (AUD) population may not represent the oldest ages of the unaffected population and may well have accrued comorbidities associated with both AUD and aging itself. Herein, we focus on the aging of the brains of men and women with AUD, keeping AUD contextual factors in mind. Knowledge of the potential influence of the AUD-associated co-factors on the condition of brain structure may lead to identifying modifiable risk factors to avert physical declines and may reverse or arrest further AUD-related degradation of the brain. In this narrative review, we 1) describe quantitative, controlled studies of brain macrostructure and microstructure of adults with AUD, 2) consider the possibility of recovery of brain integrity through harm reduction with sustained abstinence or reduced drinking, and 3) speculate on the ramifications of accelerated aging in AUD as contributing to age-related dementia.
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Affiliation(s)
- Edith V Sullivan
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, United States.
| | - Adolf Pfefferbaum
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, United States; Center for Health Sciences, SRI International, Menlo Park, CA, United States
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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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11
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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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12
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Piekarski DJ, Zahr NM, Zhao Q, Sullivan EV, Pfefferbaum A. Alcohol's effects on the mouse brain are modulated by age and sex. Addict Biol 2022; 27:e13209. [PMID: 36001428 PMCID: PMC9539709 DOI: 10.1111/adb.13209] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 05/05/2022] [Accepted: 06/27/2022] [Indexed: 11/30/2022]
Abstract
Binge alcohol consumption is common among adolescents and may impair normal brain development. Emerging, longitudinal studies in adolescents suggest that the effects of binge alcohol exposure on brain structure differ between sexes. To test the hypothesis that the effects of binge alcohol exposure on developmental brain growth trajectories are influenced by age of exposure and sex, adolescent and adult, male and female C57Bl/6 mice (n = 32), were exposed to a binge‐like ethanol (EtOH) exposure paradigm (i.e., 5 cycles of 2 on/2 off days of 5 g/kg EtOH intraperitoneal) or served as saline controls. Longitudinal structural magnetic resonance imaging was acquired at baseline, following binge EtOH exposure, and after 2 weeks of recovery. Alcohol treatment showed interactions with age and sex in altering whole brain volume: adolescents of both sexes demonstrated inhibited whole brain growth relative to their control counterparts, although significance was only attained in female mice which showed a larger magnitude response to EtOH compared to male mice. In region of interest analyses, the somatosensory cortex and cerebellum showed inhibited growth in male and female adolescent mice exposed to EtOH, but the difference relative to controls did not reach multiple comparison‐corrected statistical significance. These data suggest that in mice exposed to binge EtOH treatment, adolescent age of exposure and female sex may confer a higher risk to the detrimental effects of EtOH on brain structure and reinforce the need for direct testing of both sexes.
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Affiliation(s)
| | - Natalie M. Zahr
- Department of Psychiatry and Behavioral Sciences Stanford University School of Medicine Stanford California USA
| | - Qingyu Zhao
- Department of Psychiatry and Behavioral Sciences Stanford University School of Medicine Stanford California USA
| | - Edith V. Sullivan
- Department of Psychiatry and Behavioral Sciences Stanford University School of Medicine Stanford California USA
| | - Adolf Pfefferbaum
- Neuroscience Program SRI International Menlo Park California USA
- Department of Psychiatry and Behavioral Sciences Stanford University School of Medicine Stanford California USA
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13
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Nieto SJ, Grodin EN, Burnette EM, Cahill CM, Ray LA. Pain Catastrophizing Is Associated With Increased Alcohol Cue-Elicited Neural Activity Among Individuals With Alcohol Use Disorder. Alcohol Alcohol 2022; 57:727-733. [PMID: 35788255 DOI: 10.1093/alcalc/agac029] [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: 09/23/2021] [Revised: 05/31/2022] [Accepted: 06/03/2022] [Indexed: 11/13/2022] Open
Abstract
AIMS The current study examined the association between pain catastrophizing and alcohol cue-elicited brain activation in individuals with alcohol use disorder (AUD). METHODS Non-treatment seeking heavy drinkers with AUD (n = 45; 28 males) completed self-report measures of pain catastrophizing and alcohol use/problems as part of a clinical trial of the neuroimmune modulator ibudilast. Participants were randomized to either placebo (n = 25) or ibudilast (n = 20) and completed an functional magnetic resonance imaging (fMRI) scan to assess neural activation to alcohol cues 1 week into the medication trial. Multiple linear regression examined whether pain catastrophizing predicted cue-induced activation in a priori regions of interest, namely the dorsal and ventral striatum (VS). An exploratory whole-brain analysis was conducted to assess the relationship between pain catastrophizing and neural alcohol cue reactivity. RESULTS Pain catastrophizing predicted greater cue-induced activation in the dorsal (b = 0.006; P = 0.03) but not VS controlling for medication. Pain catastrophizing was positively associated with neural activation to alcohol cues in regions including the bilateral thalamus, left precuneus and left frontal pole. CONCLUSION Greater pain catastrophizing is associated with greater cue-induced neural activation in brain regions sub-serving habits and compulsive alcohol use. These findings provide initial support for a neural mechanism by which pain catastrophizing may drive alcohol craving among individuals with AUD.
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Affiliation(s)
- Steven J Nieto
- Department of Psychology, University of California at Los Angeles, Los Angeles, CA, USA
| | - Erica N Grodin
- Department of Psychology, University of California at Los Angeles, Los Angeles, CA, USA
| | - Elizabeth M Burnette
- Department of Psychology, University of California at Los Angeles, Los Angeles, CA, USA
| | - Catherine M Cahill
- Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, Los Angeles, CA, USA.,Shirley & Stefan Hatos Center for Neuropharmacology, University of California at Los Angeles, Los Angeles, CA, USA.,Jane & Terry Semel Institute for Neuroscience and Human Behavior, University of California at Los Angeles, Los Angeles, CA, USA
| | - Lara A Ray
- Department of Psychology, University of California at Los Angeles, Los Angeles, CA, USA.,Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, Los Angeles, CA, USA.,Shirley & Stefan Hatos Center for Neuropharmacology, University of California at Los Angeles, Los Angeles, CA, USA.,Jane & Terry Semel Institute for Neuroscience and Human Behavior, University of California at Los Angeles, Los Angeles, CA, USA
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14
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Parvaz MA, Rabin RA, Adams F, Goldstein RZ. Structural and functional brain recovery in individuals with substance use disorders during abstinence: A review of longitudinal neuroimaging studies. Drug Alcohol Depend 2022; 232:109319. [PMID: 35077955 PMCID: PMC8885813 DOI: 10.1016/j.drugalcdep.2022.109319] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 01/17/2022] [Indexed: 01/26/2023]
Abstract
BACKGROUND Neuroimaging studies reveal structural and functional including neurochemical brain abnormalities in individuals with substance use disorders compared to healthy controls. However, whether and to what extent such dysfunction is reversible with abstinence remains unclear, and a review of studies with longitudinal within-subject designs is lacking. We performed a systematic review of longitudinal neuroimaging studies to explore putative brain changes associated with abstinence in treatment-seeking individuals with substance use disorders. METHODS Following PRISMA guidelines, we examined articles published up to May 2021 that employed a neuroimaging technique and assessed neurobiological recovery in treatment-seeking participants at a minimum of two time-points separated by a period of abstinence (longer than 24 h apart) or significant reduction in drug use. RESULTS Forty-five studies met inclusion criteria. Encouragingly, in this limited but growing literature, the majority of studies demonstrated at least partial neurobiological recovery with abstinence. Structural recovery appeared to occur predominantly in frontal cortical regions, the insula, hippocampus, and cerebellum. Functional and neurochemical recovery was similarly observed in prefrontal cortical regions but also in subcortical structures. The onset of structural recovery appears to precede neurochemical recovery, which begins soon after cessation (particularly for alcohol); functional recovery may require longer periods of abstinence. CONCLUSIONS The literature is still growing and more studies are warranted to better understand abstinence-mediated neural recovery in individuals with substance use disorders. Elucidating the temporal dynamics between neuronal recovery and abstinence will enable evidence-based planning for more effective and targeted treatment of substance use disorders, potentially pre-empting relapse.
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Affiliation(s)
- Muhammad A Parvaz
- Department of Pyschiatry, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA.
| | - Rachel A. Rabin
- Department of Psychiatry, McGill University and The Douglas Mental Health University Institute, Montreal, Quebec H4H 1R3
| | - Faith Adams
- Department of Pyschiatry, Icahn School of Medicine at Mount Sinai, New York, NY 10029,Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY 10029
| | - Rita Z. Goldstein
- Department of Pyschiatry, Icahn School of Medicine at Mount Sinai, New York, NY 10029,Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY 10029
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15
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The neurobiology of drug addiction: cross-species insights into the dysfunction and recovery of the prefrontal cortex. Neuropsychopharmacology 2022; 47:276-291. [PMID: 34408275 PMCID: PMC8617203 DOI: 10.1038/s41386-021-01153-9] [Citation(s) in RCA: 48] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 08/02/2021] [Accepted: 08/06/2021] [Indexed: 01/03/2023]
Abstract
A growing preclinical and clinical body of work on the effects of chronic drug use and drug addiction has extended the scope of inquiry from the putative reward-related subcortical mechanisms to higher-order executive functions as regulated by the prefrontal cortex. Here we review the neuroimaging evidence in humans and non-human primates to demonstrate the involvement of the prefrontal cortex in emotional, cognitive, and behavioral alterations in drug addiction, with particular attention to the impaired response inhibition and salience attribution (iRISA) framework. In support of iRISA, functional and structural neuroimaging studies document a role for the prefrontal cortex in assigning excessive salience to drug over non-drug-related processes with concomitant lapses in self-control, and deficits in reward-related decision-making and insight into illness. Importantly, converging insights from human and non-human primate studies suggest a causal relationship between drug addiction and prefrontal insult, indicating that chronic drug use causes the prefrontal cortex damage that underlies iRISA while changes with abstinence and recovery with treatment suggest plasticity of these same brain regions and functions. We further dissect the overlapping and distinct characteristics of drug classes, potential biomarkers that inform vulnerability and resilience, and advancements in cutting-edge psychological and neuromodulatory treatment strategies, providing a comprehensive landscape of the human and non-human primate drug addiction literature as it relates to the prefrontal cortex.
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16
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Nutt D, Hayes A, Fonville L, Zafar R, Palmer EO, Paterson L, Lingford-Hughes A. Alcohol and the Brain. Nutrients 2021; 13:3938. [PMID: 34836193 PMCID: PMC8625009 DOI: 10.3390/nu13113938] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 11/01/2021] [Accepted: 11/02/2021] [Indexed: 12/20/2022] Open
Abstract
Alcohol works on the brain to produce its desired effects, e.g., sociability and intoxication, and hence the brain is an important organ for exploring subsequent harms. These come in many different forms such as the consequences of damage during intoxication, e.g., from falls and fights, damage from withdrawal, damage from the toxicity of alcohol and its metabolites and altered brain structure and function with implications for behavioral processes such as craving and addiction. On top of that are peripheral factors that compound brain damage such as poor diet, vitamin deficiencies leading to Wernicke-Korsakoff syndrome. Prenatal alcohol exposure can also have a profound impact on brain development and lead to irremediable changes of fetal alcohol syndrome. This chapter briefly reviews aspects of these with a particular focus on recent brain imaging results. Cardiovascular effects of alcohol that lead to brain pathology are not covered as they are dealt with elsewhere in the volume.
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Affiliation(s)
- David Nutt
- Neuropsychopharmacology Unit, Division of Psychiatry, Department of Brain Sciences, Hammersmith Hospital, Imperial College London, London W12 ONN, UK; (A.H.); (L.F.); (R.Z.); (E.O.C.P.); (L.P.); (A.L.-H.)
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17
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Yang R, He L, Zhang Z, Zhou W, Liu J. The Higher Parietal Cortical Thickness in Abstinent Methamphetamine Patients Is Correlated With Functional Connectivity and Age of First Usage. Front Hum Neurosci 2021; 15:705863. [PMID: 34526885 PMCID: PMC8435861 DOI: 10.3389/fnhum.2021.705863] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 08/09/2021] [Indexed: 01/11/2023] Open
Abstract
Aim This study aimed to explore the changes of cortical thickness in abstinent methamphetamine (MA) patients compared with healthy controls. Materials and Methods Three-tesla structural and functional magnetic resonance imaging (MRI) was obtained from 38 abstinent methamphetamine-dependent (AMD) patients and 32 demographically equivalent healthy controls. The cortical thickness was assessed using FreeSurfer software. General linear model was used to get brain regions with significant different cortical thickness between groups (p < 0.05, Monte Carlo simulation corrected). The mean cortical thickness value and functional connectivity with all other brain regions was extracted from those significant regions. Moreover, correlation coefficients were calculated in the AMD group to assess the relations between the mean cortical thickness, functional connectivity and age when they first took MA and the duration of both MA use and abstinence. Results The AMD group showed significant cortical thickness increase in one cluster located in the parietal cortex, including right posterior central gyrus, supramarginal gyrus, and superior parietal lobule. In addition, cortical thickness values of those regions were all significant and negatively correlated with the age when patients first used MA. The cortical thickness of right posterior gyrus were positively correlated with its functional connectivities with left middle frontal gyrus and both left and right medial orbitofrontal gyrus. Conclusion The higher cortical thickness in the parietal cortex of the AMD group is in agreement with findings in related studies of increased glucose metabolism and gray matter volume. Importantly, the negative correlation between parietal cortical thickness and age of first MA suggested that adolescent brains are more vulnerable to MA’s neurotoxic effect.
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Affiliation(s)
- Ru Yang
- Department of Radiology, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Lei He
- Department of Radiology, The Second Xiangya Hospital, Central South University, Changsha, China.,Department of Radiology, The First People's Hospital of Yueyang, Yueyang, China
| | - Zhixue Zhang
- Department of Radiology, The First Hospital of Hunan University of Chinese Medicine, Changsha, China
| | - Wenming Zhou
- Department of Radiology, The First People's Hospital of Yueyang, Yueyang, China
| | - Jun Liu
- Department of Radiology, The Second Xiangya Hospital, Central South University, Changsha, China
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18
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Thompson BL, Maleki N, Kelly JF, Sy KTL, Oscar-Berman M. Brain, behavioral, affective, and sex correlates of recovery from alcohol use disorders. Alcohol Clin Exp Res 2021; 45:1578-1595. [PMID: 34432298 DOI: 10.1111/acer.14658] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 05/31/2021] [Accepted: 06/08/2021] [Indexed: 12/23/2022]
Abstract
BACKGROUND Recovery from alcohol use disorders (AUDs) consists of salutary changes in behavior and affect. While evidence suggests that recovery-related behavioral changes, such as abstinence, emerge in tandem with both neural and affective changes, the precise relationships among these changes are unknown. To understand these relationships, we examined associations between the duration of abstinence (DOA), affective states, and neuroimaging-based structural measures of the brain reward system (BRS) in AUD men (AUDM ) and AUD women (AUDW ). METHODS Participants were community respondents from the Boston area comprising right-handed abstinent individuals with AUD (n = 60; 30 men) and controls without AUD (NC; n = 60; 29 men). Multivariate linear regressions compared short-/mid-term abstainers (≤5 years), long-term abstainers (>5 years), and the NC group on measures of BRS volume (3T magnetic resonance imaging scans) and measures of affect (Profile of Mood States [POMS]; Multiple Affect Adjective Check List [MAACL]; Hamilton Rating Scale for Depression [HRSD]). Analyses contrasted sex differences and accounted for age, education, drinking severity, and verbal IQ. RESULTS Compared to the NC group, short-/mid-term abstainers exhibited larger posterior insular volume (total (β = 0.019, 95% CI: 0.004, 0.034)), higher negative affect (POMS Mood Disturbance (β = 27.8, 95% CI: 11.56, 44.04), and lower positive affect (POMS Vigor (β = -4.89, 95% CI: -9.06, -0.72)). Compared to the NC group, Long-term abstainers exhibited significantly smaller volumes of aggregate anterior cingulate cortex (β = -0.06, 95% CI: -0.113, -0.008) and higher HRSD scores (β = 1.56, 95% CI: 0.14, 2.98). Relative to AUDM , AUDW exhibited significantly larger right anterior insular volumes (β = 0.03, 95% CI: 0.01, 0.06) and significantly greater MAACL Positive Affect scores (β = 7.56, 95% CI: 0.59, 11.55) in association with DOA. CONCLUSIONS We found that differences in abstinence from alcohol were correlated with differences in both neural recovery and affective dimensions of recovery from AUDs. The observed sex differences extend evidence of dimorphic effects of AUDs and recovery on brain structure and function. Future longitudinal research will test inferences concerning the directionality of these relationships.
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Affiliation(s)
- Benjamin L Thompson
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT, USA.,Psychology Research Service, VA Healthcare System, Boston, MA, USA
| | - Nasim Maleki
- Psychology Research Service, VA Healthcare System, Boston, MA, USA.,Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - John F Kelly
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Karla Therese L Sy
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Marlene Oscar-Berman
- Psychology Research Service, VA Healthcare System, Boston, MA, USA.,Departments of Anatomy and Neurobiology, Psychiatry and Neurology, Boston University School of Medicine, Boston, MA, USA
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19
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Durazzo TC, Meyerhoff DJ. Changes of frontal cortical subregion volumes in alcohol dependent individuals during early abstinence: associations with treatment outcome. Brain Imaging Behav 2021; 14:1588-1599. [PMID: 31197582 DOI: 10.1007/s11682-019-00089-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
We previously reported that at 1-and-4 weeks of sobriety, those who relapsed after treatment demonstrated significantly smaller total frontal cortical volume than individuals who maintained abstinence for at least 12 months post treatment. The segmentation method employed did not permit examination of frontal subregions that serve as nodes of the executive, salience and emotional regulation networks; structural abnormalities in these circuits are associated with relapse in those seeking treatment for alcohol use disorders (AUD). The primary goal of this study was to determine if frontal cortical subregion volume recovery during early abstinence is associated with long-term abstinence from alcohol. We compared bilateral components of the dorsal prefrontal cortex, orbitofrontal cortex, anterior cingulate cortex and insula volumes, at 1 and 4 weeks of abstinence, between individuals who resumed drinking within 12 months of treatment (Relapsers) those who showed sustained abstinence over 12 months following treatment (Abstainers) and healthy Controls. At 1 and 4 weeks of sobriety, Relapsers demonstrated significantly smaller volumes than Controls in 15 of 20 regions of interest, while Abstainers only had smaller volumes than Controls in 5 of 20 regions. In Relapsers, increasing volumes over 1 month in multiple frontal subregions and the insula were associated with longer duration of abstinence after treatment. The persistent bilateral frontal and insula volume deficits in Relapsers over 4 weeks from last alcohol use may have implications for neurostimulation methods targeting anterior frontal/insula regions, and represent an endophenotype that differentiates those who respond more favorably to available psychosocial and pharmacological interventions.
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Affiliation(s)
- Timothy C Durazzo
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA.
- Mental Illness Research and Education Clinical Centers (151Y) and Sierra-Pacific War Related Illness and Injury Study Centers, VA Palo Alto Health Care System, 3801 Miranda Ave, Palo Alto, CA, 94304, USA.
| | - Dieter J Meyerhoff
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA
- Center for Imaging of Neurodegenerative Diseases, San Francisco VA Medical Center, San Francisco, CA, USA
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20
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Visuoperceptive Impairments in Severe Alcohol Use Disorder: A Critical Review of Behavioral Studies. Neuropsychol Rev 2021; 31:361-384. [PMID: 33591477 DOI: 10.1007/s11065-020-09469-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Accepted: 11/29/2020] [Indexed: 01/13/2023]
Abstract
The present literature review is aimed at offering a comprehensive and critical view of behavioral data collected during the past seventy years concerning visuoperception in severe alcohol use disorders (AUD). To pave the way for a renewal of research and clinical approaches in this very little understood field, this paper (1) provides a critical review of previous behavioral studies exploring visuoperceptive processing in severe AUD, (2) identifies the alcohol-related parameters and demographic factors that influence the deficits, and (3) addresses the limitations of this literature and their implications for current clinical strategies. By doing so, this review highlights the presence of visuoperceptive deficits but also shows how the lack of in-depth studies exploring the visual system in this clinical population results in the current absence of integration of these deficits in the dominant models of vision. Given the predominance of vision in everyday life, we stress the need to better delineate the extent, the specificity, and the actual implications of the deficits for severe AUD.
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21
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Creupelandt C, D'Hondt F, Maurage P. Neural correlates of visuoperceptive changes in severe alcohol use disorder: A critical review of neuroimaging and electrophysiological findings. J Neurosci Res 2021; 99:1253-1275. [PMID: 33550638 DOI: 10.1002/jnr.24799] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 01/04/2021] [Accepted: 01/06/2021] [Indexed: 01/04/2023]
Abstract
Visuoperceptive deficits are frequently reported in severe alcohol use disorder (SAUD) and are considered as pervasive and persistent in time. While this topic of investigation has previously driven researchers' interest, far fewer studies have focused on visuoperception in SAUD since the '90s, leaving open central questions regarding the origin and implications of these deficits. To renew research in the field and provide a solid background to work upon, this paper reviews the neural correlates of visuoperception in SAUD, based on data from neuroimaging and electrophysiological studies. Results reveal structural and functional changes within the visual system but also in the connections between occipital and frontal areas. We highlight the lack of integration of these findings in the dominant models of vision which stress the dynamic nature of the visual system and consider the presence of both bottom-up and top-down cerebral mechanisms. Visuoperceptive changes are also discussed in the framework of long-lasting debates regarding the influence of demographic and alcohol-related factors, together stressing the presence of inter-individual differences. Capitalizing on this review, we provide guidelines to inform future research, and ultimately improve clinical care.
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Affiliation(s)
- Coralie Creupelandt
- Louvain Experimental Psychopathology Research Group (UCLEP), Faculté de Psychologie, Psychological Sciences Research Institute (IPSY), UCLouvain, Louvain-la-Neuve, Belgium
| | - Fabien D'Hondt
- Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Lille, France.,CHU Lille, Clinique de Psychiatrie, CURE, Lille, France.,Centre National de Ressources et de Résilience Lille-Paris (CN2R), Lille, France
| | - Pierre Maurage
- Louvain Experimental Psychopathology Research Group (UCLEP), Faculté de Psychologie, Psychological Sciences Research Institute (IPSY), UCLouvain, Louvain-la-Neuve, Belgium
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22
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Alcohol. Alcohol 2021. [DOI: 10.1016/b978-0-12-816793-9.00001-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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23
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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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24
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Chang L, Liang H, Kandel SR, He JJ. Independent and Combined Effects of Nicotine or Chronic Tobacco Smoking and HIV on the Brain: A Review of Preclinical and Clinical Studies. J Neuroimmune Pharmacol 2020; 15:658-693. [PMID: 33108618 DOI: 10.1007/s11481-020-09963-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 09/25/2020] [Indexed: 02/07/2023]
Abstract
Tobacco smoking is highly prevalent among HIV-infected individuals. Chronic smokers with HIV showed greater cognitive deficits and impulsivity, and had more psychopathological symptoms and greater neuroinflammation than HIV non-smokers or smokers without HIV infection. However, preclinical studies that evaluated the combined effects of HIV-infection and tobacco smoking are scare. The preclinical models typically used cell cultures or animal models that involved specific HIV viral proteins or the administration of nicotine to rodents. These preclinical models consistently demonstrated that nicotine had neuroprotective and anti-inflammatory effects, leading to cognitive enhancement. Although the major addictive ingredient in tobacco smoking is nicotine, chronic smoking does not lead to improved cognitive function in humans. Therefore, preclinical studies designed to unravel the interactive effects of chronic tobacco smoking and HIV infection are needed. In this review, we summarized the preclinical studies that demonstrated the neuroprotective effects of nicotine, the neurotoxic effects of the HIV viral proteins, and the scant literature on nicotine or tobacco smoke in HIV transgenic rat models. We also reviewed the clinical studies that evaluated the neurotoxic effects of tobacco smoking, HIV infection and their combined effects on the brain, including studies that evaluated the cognitive and behavioral assessments, as well as neuroimaging measures. Lastly, we compared the different approaches between preclinical and clinical studies, identified some gaps and proposed some future directions. Graphical abstract Independent and combined effects of HIV and tobacco/nicotine. Left top and bottom panels: Both clinical studies of HIV infected persons and preclinical studies using viral proteins in vitro or in vivo in animal models showed that HIV infection could lead to neurotoxicity and neuroinflammation. Right top and bottom panels: While clinical studies of tobacco smoking consistently showed deleterious effects of smoking, clinical and preclinical studies that used nicotine show mild cognitive enhancement, neuroprotective and possibly anti-inflammatory effects. In the developing brain, however, nicotine is neurotoxic. Middle overlapping panels: Clinical studies of persons with HIV who were smokers typically showed additive deleterious effects of HIV and tobacco smoking. However, in the preclinical studies, when nicotine was administered to the HIV-1 Tg rats, the neurotoxic effects of HIV were attenuated, but tobacco smoke worsened the inflammatory cascade.
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Affiliation(s)
- Linda Chang
- Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, 670 W. Baltimore Street, HSF III, Baltimore, MD, 21201, USA.
- Department of Neurology, University of Maryland School of Medicine, Baltimore, MD, USA.
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
- Department of Medicine, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI, USA.
| | - Huajun Liang
- Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, 670 W. Baltimore Street, HSF III, Baltimore, MD, 21201, USA
| | - Suresh R Kandel
- Department of Microbiology and Immunology, Chicago Medical School, Center for Cancer Cell Biology, Immunology and Infection, Rosalind Franklin University, 3333 Green Bay Road, Basic Science Building 2.300, North Chicago, IL, 60064, USA
| | - Johnny J He
- Department of Microbiology and Immunology, Chicago Medical School, Center for Cancer Cell Biology, Immunology and Infection, Rosalind Franklin University, 3333 Green Bay Road, Basic Science Building 2.300, North Chicago, IL, 60064, USA.
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25
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Bach P, Koopmann A, Bumb JM, Vollstädt-Klein S, Reinhard I, Rietschel M, Witt SH, Wiedemann K, Kiefer F. Leptin predicts cortical and subcortical gray matter volume recovery in alcohol dependent patients: A longitudinal structural magnetic resonance imaging study. Horm Behav 2020; 124:104749. [PMID: 32387173 DOI: 10.1016/j.yhbeh.2020.104749] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 03/24/2020] [Accepted: 03/26/2020] [Indexed: 11/25/2022]
Abstract
The neuroprotective effects of leptin and its role in addictive disorders has been highlighted by several recent studies. However, its potential effects on morphological alterations in alcohol dependence are yet to be investigated. Associations between leptin and the longitudinal courses of gray matter volume (GMV) and cortical thickness (CT) were investigated in N = 62 alcohol-dependent patients that underwent structural magnetic resonance imaging after a mean abstinence of 12 (baseline) and 27 days (follow-up) respectively. Blood samples were collected at baseline to determine leptin levels. A cohort of N = 74 healthy individuals served as a reference sample. At baseline, alcohol-dependent patients compared to healthy controls displayed smaller GMV in the insula, parts of the superior, middle and inferior frontal gyri and hippocampal regions and thinner CT in the insula, parts of the superior and middle frontal cortices, the lateral orbitofrontal cortex and parts of the occipital and lingual cortices that partially recovered during abstinence (pFWE < 0.05). In alcohol-dependent patients, leptin was a significant predictor of GMV and CT recovery in the areas that showed the strongest whole-brain effects, specifically GMV in the right insula (R2 = 0.070, pFDR = 0.040) and left inferior frontal triangular gyrus (R2 = 0.076, pFDR = 0.040), as well as CT in the left insula (R2 = 0.158, pFDR = 0.004) and right superior frontal cortex (R2 = 0.180, pFDR = 0.004). Present results support the role of leptin in predicting GMV and CT recovery during the first month of abstinence in alcohol-dependent patients.
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Affiliation(s)
- Patrick Bach
- Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Germany; Feuerlein Center on Translational Addiction Medicine (FCTS), University of Heidelberg, Germany.
| | - Anne Koopmann
- Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Germany; Feuerlein Center on Translational Addiction Medicine (FCTS), University of Heidelberg, Germany
| | - J Malte Bumb
- Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Germany; Feuerlein Center on Translational Addiction Medicine (FCTS), University of Heidelberg, Germany
| | - Sabine Vollstädt-Klein
- Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Germany; Feuerlein Center on Translational Addiction Medicine (FCTS), University of Heidelberg, Germany
| | - Iris Reinhard
- Department of Biostatistics, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Germany
| | - Marcella Rietschel
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Germany
| | - Stephanie H Witt
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Germany
| | - Klaus Wiedemann
- Department of Psychiatry & Psychotherapy, University Medical Center, Hamburg, Martinistr. 52, 20246 Hamburg, Germany
| | - Falk Kiefer
- Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Germany; Feuerlein Center on Translational Addiction Medicine (FCTS), University of Heidelberg, Germany
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26
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Sullivan EV. The Many Levels of Relapse to Drinking: Commentary on Meyerhoff and Durazzo (ACER 2020). Alcohol Clin Exp Res 2020; 44:1714-1716. [PMID: 32623744 DOI: 10.1111/acer.14409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 06/26/2020] [Indexed: 12/01/2022]
Affiliation(s)
- Edith V Sullivan
- From the, Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, California, USA
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27
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Meyerhoff DJ, Durazzo TC. Not All Is Lost for Relapsers: Relapsers With Low WHO Risk Drinking Levels and Complete Abstainers Have Comparable Regional Gray Matter Volumes. Alcohol Res 2020. [PMCID: PMC7383772 DOI: 10.1111/acer.14377] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Affiliation(s)
- Dieter J. Meyerhoff
- From the Center for Imaging of Neurodegenerative Diseases (CIND) (DJM) San Francisco VA Medical Center San Francisco California
- Department of Radiology and Biomedical Imaging (DJM) University of California San Francisco California
| | - Timothy C. Durazzo
- Mental Illness Research and Education Clinical Centers (TCD) VA Palo Alto Health Care System Palo Alto California
- Department of Psychiatry and Behavioral Sciences (TCD) Stanford University School of Medicine Stanford California
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28
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Maillard A, Poussier H, Boudehent C, Lannuzel C, Vicente A, Vabret F, Cabe N, Pitel AL. Short-term neuropsychological recovery in alcohol use disorder: A retrospective clinical study. Addict Behav 2020; 105:106350. [PMID: 32070907 DOI: 10.1016/j.addbeh.2020.106350] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 02/04/2020] [Accepted: 02/07/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND Neuropsychological impairments found in recently detoxified patients with alcohol use disorder (AUD) can limit the benefit of psychosocial treatments and increase the risk of relapse. These neuropsychological deficits are reversible with abstinence. The aim of this retrospective clinical study was to investigate whether a short-term stay as inpatients in a convalescent home enables neuropsychological deficits observed in recently detoxified AUD patients to recover and even performance to return to normal. METHODS Neuropsychological data were collected in 84 AUD patients. Five neuropsychological components were assessed before and after a three-week stay in a convalescent home offering multidisciplinary support. Baseline and follow-up performance were compared in the entire group of patients and in subgroups defined by the nature and intensity of the therapy (OCCASIONAL: occasional occupational and physical therapy; INTENSIVE: intensive occupational and physical therapy and neuropsychological training). RESULTS In the entire group of patients, neuropsychological performance significantly improved between baseline and follow-up for all 5 components and even returned to a normal level for 4 of them. The ratio of patients with impaired performance was significantly lower at follow-up than baseline examination for 3 components in the INTENSIVE group only. CONCLUSION Recently detoxified AUD patients with cognitive deficits benefit from a short-term stay in an environment ensuring sobriety and healthy nutrition. Cognitive recovery may be enhanced by intensive care including neuropsychological training. Alcohol programs could be postponed in patients with cognitive deficits in order to offer psychosocial treatment when patients are cognitively able to benefit from it.
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Rolland B, Dricot L, Creupelandt C, Maurage P, De Timary P. Respective influence of current alcohol consumption and duration of heavy drinking on brain morphological alterations in alcohol use disorder. Addict Biol 2020; 25:e12751. [PMID: 30963660 DOI: 10.1111/adb.12751] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Revised: 02/28/2019] [Accepted: 03/06/2019] [Indexed: 01/29/2023]
Abstract
Numerous studies have explored the morphological differences of the brain between subjects with alcohol use disorder (AUD) and control subjects, but very few have investigated the impact of the duration of alcohol use disorder (DAD) and current level of alcohol consumption (CAC) within AUD subjects using magnetic resonance imaging (MRI). We compared the morphological MRI of 44 controls and 66 AUD subjects, recruited at the end of a detoxification program. Additional analyses within the AUD group determined which specific alterations were respectively associated with DAD and CAC using: (1) Bonferroni-corrected multivariable linear regressions to explore the DAD/CAC impact on brain volumes and (2) a general linear model (GLM module of FreeSurfer's Qdec) and Monte Carlo simulation to correct for multiple comparisons (P < 0.05) to explore the DAD/CAC impact on cortical thickness and volumes. Analyses were adjusted for age and tobacco use. CAC and DAD were significantly correlated (ρ = 0.25, P < 0.0001), and sensitivity analyses were conducted with and without both CAC and DAD included in the same model. While the AUD-control comparisons globally reproduced preexisting findings, within-AUD analyses found that CAC was inversely correlated with cortical thickness and gray matter volume in a bilateral dorsal band of the temporal lobe, including the fusiform and parahippocampal gyri. For DAD, only a left and more ventral temporal band that partially overlapped the CAC-associated area was found in cortical thickness analyses. No significant volumetric result was reached after a Bonferroni correction. CAC and, to a lesser extent, DAD were thus associated with specific, though partially overlapping, temporal surface-based signatures.
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Affiliation(s)
- Benjamin Rolland
- Centre de Recherche en Neurosciences de LyonUniversity Lyon, UCBL, INSERM U1028, CNRS UMR5292 Bron France
- CH Le Vinatier, Service Universitaire d'Addictologie de Lyon (SUAL), Bron France
- Institute of NeuroscienceUniversité Catholique de Louvain Louvain‐la‐Neuve Belgium
| | - Laurence Dricot
- Institute of NeuroscienceUniversité Catholique de Louvain Louvain‐la‐Neuve Belgium
- Department of Adult Psychiatry, Cliniques Universitaires Saint‐Luc Brussels Belgium
| | - Coralie Creupelandt
- Institute of NeuroscienceUniversité Catholique de Louvain Louvain‐la‐Neuve Belgium
- Department of Adult Psychiatry, Cliniques Universitaires Saint‐Luc Brussels Belgium
- Laboratory for Experimental Psychopathology (LEP), Psychological Science Research InstituteUniversité Catholique de Louvain Louvain‐la‐Neuve Belgium
| | - Pierre Maurage
- Institute of NeuroscienceUniversité Catholique de Louvain Louvain‐la‐Neuve Belgium
- Laboratory for Experimental Psychopathology (LEP), Psychological Science Research InstituteUniversité Catholique de Louvain Louvain‐la‐Neuve Belgium
| | - Philippe De Timary
- Institute of NeuroscienceUniversité Catholique de Louvain Louvain‐la‐Neuve Belgium
- Department of Adult Psychiatry, Cliniques Universitaires Saint‐Luc Brussels Belgium
- Laboratory for Experimental Psychopathology (LEP), Psychological Science Research InstituteUniversité Catholique de Louvain Louvain‐la‐Neuve Belgium
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30
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Creupelandt C, D'Hondt F, Maurage P. Towards a Dynamic Exploration of Vision, Cognition and Emotion in Alcohol-Use Disorders. Curr Neuropharmacol 2019; 17:492-506. [PMID: 30152285 PMCID: PMC6712295 DOI: 10.2174/1570159x16666180828100441] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Revised: 07/30/2018] [Accepted: 08/17/2018] [Indexed: 11/23/2022] Open
Abstract
Abstract: Visuoperceptive impairments are among the most frequently reported deficits in alcohol-use disorders, but only very few studies have investigated their origin and interactions with other categories of dysfunctions. Besides, these deficits have generally been interpreted in a linear bottom-up perspective, which appears very restrictive with respect to the new models of vision developed in healthy populations. Indeed, new theories highlight the predictive nature of the visual system and demonstrate that it interacts with higher-level cognitive functions to generate top-down predictions. These models nota-bly posit that a fast but coarse visual analysis involving magnocellular pathways helps to compute heuristic guesses regard-ing the identity and affective value of inputs, which are used to facilitate conscious visual recognition. Building on these new proposals, the present review stresses the need to reconsider visual deficits in alcohol-use disorders as they might have cru-cial significance for core features of the pathology, such as attentional bias, loss of inhibitory control and emotion decoding impairments. Centrally, we suggest that individuals with severe alcohol-use disorders could present with magnocellular dam-age and we defend a dynamic explanation of the deficits. Rather than being restricted to high-level processes, deficits could start at early visual stages and then extend and potentially intensify during following steps due to reduced cerebral connec-tivity and dysfunctional cognitive/emotional regions. A new research agenda is specifically provided to test these hypotheses.
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Affiliation(s)
- Coralie Creupelandt
- Laboratory for Experimental Psychopathology, Psychological Science Research Institute, Université catholique de Louvain, Louvain-la-Neuve, Belgium.,SCALab-Sciences Cognitives et Sciences Affectives, CNRS, UMR 9193, Université de Lille, Lille, France
| | - Fabien D'Hondt
- SCALab-Sciences Cognitives et Sciences Affectives, CNRS, UMR 9193, Université de Lille, Lille, France.,CHU Lille, Clinique de Psychiatrie, CURE, Lille, France
| | - Pierre Maurage
- Laboratory for Experimental Psychopathology, Psychological Science Research Institute, Université catholique de Louvain, Louvain-la-Neuve, Belgium
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Ceccarini J, Leurquin-Sterk G, Crunelle CL, de Laat B, Bormans G, Peuskens H, Van Laere K. Recovery of Decreased Metabotropic Glutamate Receptor 5 Availability in Abstinent Alcohol-Dependent Patients. J Nucl Med 2019; 61:256-262. [PMID: 31481578 DOI: 10.2967/jnumed.119.228825] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Accepted: 07/19/2019] [Indexed: 12/21/2022] Open
Abstract
Animal models of alcohol dependence and relapse demonstrate an important role of the glutamatergic system, in particular, cerebral metabotropic glutamate receptor 5 (mGluR5). 18F-3-fluoro-5-[(pyridin-3-yl)ethynyl]benzonitrile (18F-FPEB) PET has revealed that chronic alcohol use leads to decreased limbic mGluR5 availability, which was associated with less craving. Here, we tested whether the state of decreased mGluR5 availability in alcohol-dependent patients normalizes during abstinence (at 2 and 6 mo of detoxification) and whether initial mGluR5 imaging parameters can predict individual relapse. Methods: 18F-FPEB scans were performed for 16 recently detoxified alcohol-dependent patients (baseline condition), 2 mo after detoxification (n = 10), and 6 mo after detoxification (n = 8); 32 age- and sex-matched controls were included for comparison. mGluR5 availability was quantified by the 18F-FPEB total distribution volume using both voxel-by-voxel and volume-of-interest analyses. During follow-up, craving was assessed using the Desire for Alcohol Questionnaire, and alcohol consumption was assessed using the timeline follow-back method and monitored by hair ethyl glucuronide analysis. Results: During abstinence, alcohol-dependent patients showed sustained recovered mGluR5 availability in cortical and subcortical regions compared with the baseline, up to the levels observed in controls, after 6 mo in most areas except for the hippocampus, nucleus accumbens, and thalamus. Higher striatopallidal mGluR5 availability was observed at the baseline in patients who had a relapse during the 6-mo follow-up period (+25.1%). Also, normalization of striatal mGluR5 to control levels was associated with reduced craving ("desire and intention to drink" and "negative reinforcement"; r = 0.72-0.94). Conclusion: Reduced cerebral mGluR5 availability in alcohol-dependent patients recovers during abstinence and is associated with reduced craving. Higher striatal mGluR5 availability in alcohol-dependent users may be associated with long-term relapse.
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Affiliation(s)
- Jenny Ceccarini
- Department of Nuclear Medicine and Molecular Imaging, UZ Leuven, Leuven, Belgium .,Department of Imaging and Pathology, KU Leuven, Leuven, Belgium
| | - Gil Leurquin-Sterk
- Department of Nuclear Medicine and Molecular Imaging, UZ Leuven, Leuven, Belgium.,Department of Imaging and Pathology, KU Leuven, Leuven, Belgium
| | - Cleo Lina Crunelle
- Toxicological Center, University of Antwerp, Wilrijk, Belgium.,Department of Psychiatry, Universitair Ziekenhuis Brussel, Brussels, Belgium
| | - Bart de Laat
- Department of Nuclear Medicine and Molecular Imaging, UZ Leuven, Leuven, Belgium.,Department of Imaging and Pathology, KU Leuven, Leuven, Belgium.,MoSAIC, Molecular Small Animal Imaging Center, KU Leuven, Leuven, Belgium
| | - Guy Bormans
- Laboratory for Radiopharmacy, KU Leuven, Leuven, Belgium
| | - Hendrik Peuskens
- University Psychiatric Center, KU Leuven, Kortenberg, Belgium; and.,Kliniek Broeders Alexianen, Tienen, Belgium
| | - Koen Van Laere
- Department of Nuclear Medicine and Molecular Imaging, UZ Leuven, Leuven, Belgium.,Department of Imaging and Pathology, KU Leuven, Leuven, Belgium.,MoSAIC, Molecular Small Animal Imaging Center, KU Leuven, Leuven, Belgium
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De Ternay J, Naassila M, Nourredine M, Louvet A, Bailly F, Sescousse G, Maurage P, Cottencin O, Carrieri PM, Rolland B. Therapeutic Prospects of Cannabidiol for Alcohol Use Disorder and Alcohol-Related Damages on the Liver and the Brain. Front Pharmacol 2019; 10:627. [PMID: 31214036 PMCID: PMC6554654 DOI: 10.3389/fphar.2019.00627] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Accepted: 05/15/2019] [Indexed: 12/12/2022] Open
Abstract
Background: Cannabidiol (CBD) is a natural component of cannabis that possesses a widespread and complex immunomodulatory, antioxidant, anxiolytic, and antiepileptic properties. Much experimental data suggest that CBD could be used for various purposes in alcohol use disorder (AUD) and alcohol-related damage on the brain and the liver. Aim: To provide a rationale for using CBD to treat human subjects with AUD, based on the findings of experimental studies. Methods: Narrative review of studies pertaining to the assessment of CBD efficiency on drinking reduction, or on the improvement of any aspect of alcohol-related toxicity in AUD. Results: Experimental studies find that CBD reduces the overall level of alcohol drinking in animal models of AUD by reducing ethanol intake, motivation for ethanol, relapse, anxiety, and impulsivity. Moreover, CBD reduces alcohol-related steatosis and fibrosis in the liver by reducing lipid accumulation, stimulating autophagy, modulating inflammation, reducing oxidative stress, and by inducing death of activated hepatic stellate cells. Finally, CBD reduces alcohol-related brain damage, preventing neuronal loss by its antioxidant and immunomodulatory properties. Conclusions: CBD could directly reduce alcohol drinking in subjects with AUD. Any other applications warrant human trials in this population. By reducing alcohol-related steatosis processes in the liver, and alcohol-related brain damage, CBD could improve both hepatic and neurocognitive outcomes in subjects with AUD, regardless of the individual's drinking trajectory. This might pave the way for testing new harm reduction approaches in AUD, in order to protect the organs of subjects with an ongoing AUD.
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Affiliation(s)
- Julia De Ternay
- Service Universitaire d’Addictologie de Lyon (SUAL), Bron, France
| | - Mickaël Naassila
- Université de Picardie Jules Verne, Centre Universitaire de Recherche en Santé, INSERM UMR 1247, Groupe de Recherche sur l’Alcool & les Pharmacodépendances, Amiens, France
| | | | - Alexandre Louvet
- Service des maladies de l’appareil digestif, CHU Lille, Universitéde Lille and INSERM U995, Lille, France
| | - François Bailly
- Service d’Addictologie et d’Hépatologie, GHN, HCL, Lyon, France
| | - Guillaume Sescousse
- Université de Lyon, UCBL, Centre de Recherche en Neurosciences de Lyon (CRNL), Inserm U1028, CNRS UMR5292, PSYR2, Bron, France
| | - Pierre Maurage
- Laboratory for Experimental Psychopathology (LEP), Psychological Science Research Institute, Université catholique de Louvain, Louvain-la-Neuve, Belgium
| | - Olivier Cottencin
- CHU de Lille, Université Lille, service d’addictologie, CNRS, UMR 9193, SCALab, équipe psyCHIC, Lille, France
| | - Patrizia Maria Carrieri
- INSERM, UMR_S 912, Sciences Economiques & Sociales de la Santé et Traitement de l’Information Médicale (SESSTIM), Marseille, France
| | - Benjamin Rolland
- Service Universitaire d’Addictologie de Lyon (SUAL), Bron, France
- Université de Lyon, UCBL, Centre de Recherche en Neurosciences de Lyon (CRNL), Inserm U1028, CNRS UMR5292, PSYR2, Bron, France
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Reese ED, Conway CC, Anand D, Bauer DJ, Daughters SB. Distress tolerance trajectories following substance use treatment. J Consult Clin Psychol 2019; 87:645-656. [PMID: 31008636 DOI: 10.1037/ccp0000403] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
OBJECTIVE Distress tolerance (DT), the ability to withstand aversive internal states, represents an important risk factor for substance use relapse and a potential treatment target. Neurobiological research in substance using populations suggests that continued substance use could erode DT, whereas abstinence could bolster it. The current study characterized trajectories of behavioral and self-reported indices of DT and examined the prospective effect of substance use on DT trajectories among those seeking treatment for substance use. METHOD Individuals (N = 263, Mage = 42.68, SD = 11.8, 70.7% male, 94.7% African American) in residential substance use treatment completed subjective (Distress Tolerance Scale) and behavioral (Mirror Tracing Persistence Task-computerized version) DT measures, as well as report of daily substance use (timeline follow-back) over 5 assessment time-points from pretreatment to 12 months posttreatment. Latent curve modeling estimated DT trajectories and their associations with substance use behavior, including abstinence duration (days until first use) and substance use frequency (percentage of substance use days between assessments). RESULTS Self-reported and behavioral DT indicators both exhibited positive, nonlinear change over time (standardized slope parameter estimates: Distress Tolerance Scale β = 0.61, p < .01; Mirror Tracing Persistence Task β = 0.34, p < .01). Abstinence duration was associated with greater improvement in behavioral (β = .20, p = .03) DT specifically. Frequency of use was statistically significantly associated with attenuated behavioral DT at 6-month (β = -.12, p = .03) and 12-month follow-ups (β = -.08, p = .045). CONCLUSIONS DT appears to improve appreciably posttreatment, and return to substance use may shape the degree of this improvement. Collectively, these findings support the conceptualization of DT as a malleable treatment target and emphasize the benefit of abstinence on improvement in DT. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Affiliation(s)
- Elizabeth D Reese
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill
| | | | - Deepika Anand
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill
| | - Daniel J Bauer
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill
| | - Stacey B Daughters
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill
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Korponay C, Kosson DS, Decety J, Kiehl KA, Koenigs M. Brain Volume Correlates with Duration of Abstinence from Substance Abuse in a Region-Specific and Substance-Specific Manner. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2019; 2:626-635. [PMID: 29308437 DOI: 10.1016/j.bpsc.2017.03.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Background Human neuroimaging studies indicate that the loss of brain volume associated with substance abuse may be recovered during abstinence. Subcortical and prefrontal cortical regions involved in reward and decision-making are among the regions most consistently implicated in damage and recovery from substance abuse, but the relative capacities of these different brain regions to recover volume during abstinence remains unclear, and it is unknown whether recovery capacities depend on the substance that was abused. Methods Voxel-based morphometry in a prison inmate sample (n=107) of long-term abstinent former regular users (FRUs) and former light users (FLUs) of alcohol, cocaine, and/or cannabis. Cross-sectional indicators of volume recovery were operationalized as 1) positive correlation between abstinence duration and volume in FRUs and 2) absence of lower volume in FRUs compared to FLUs. Results In FRUs of alcohol, abstinence duration positively correlated with volume in subcortical regions (particularly the putamen and amygdala) but not prefrontal regions; lower prefrontal but not subcortical volume was observed in FRUs compared to FLUs. In FRUs of cocaine, abstinence duration positively correlated with volume in both subcortical regions (particularly the nucleus accumbens) and prefrontal regions; lower volume was not observed in either subcortical or prefrontal regions in FRUs. In FRUs of cannabis, abstinence duration positively correlated with subcortical but not prefrontal volume; lower prefrontal but not subcortical volume was observed in FRUs. Conclusions Subcortical structures displayed indicators of volume recovery across FRUs of all three substances, whereas prefrontal regions displayed indicators of volume recovery only in FRUs of cocaine.
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Affiliation(s)
- Cole Korponay
- Department of Psychiatry, University of Wisconsin-Madison, 6001 Research Park, Boulevard, Madison, Wisconsin, 53719, USA.,Neuroscience Training Program, University of Wisconsin-Madison, 1111 Highland Avenue, Madison, WI, 53705, USA
| | - David S Kosson
- Department of Psychology, Rosalind Franklin University of Medicine and Science, 3333 Green Bay Road, North Chicago, Illinois, 60064, USA
| | - Jean Decety
- Department of Psychology, University of Chicago, 5848 South University Avenue, Chicago, Illinois, 60637, USA
| | - Kent A Kiehl
- The non-profit MIND Research Network, an affiliate of Lovelace Biomedical and Environmental Research Institute, 1101 Yale C NE, Albuquerque, New Mexico, 87131, USA.,Departments of Psychology, Neuroscience, and Law, University of New Mexico, 1 University of New Mexico MSC03 2220, Albuquerque, New Mexico, 87131, USA
| | - Michael Koenigs
- Department of Psychiatry, University of Wisconsin-Madison, 6001 Research Park, Boulevard, Madison, Wisconsin, 53719, USA
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Hirsiger S, Hänggi J, Germann J, Vonmoos M, Preller KH, Engeli EJE, Kirschner M, Reinhard C, Hulka LM, Baumgartner MR, Chakravarty MM, Seifritz E, Herdener M, Quednow BB. Longitudinal changes in cocaine intake and cognition are linked to cortical thickness adaptations in cocaine users. NEUROIMAGE-CLINICAL 2019; 21:101652. [PMID: 30639181 PMCID: PMC6412021 DOI: 10.1016/j.nicl.2019.101652] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Revised: 12/04/2018] [Accepted: 01/02/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND Cocaine use has been consistently associated with decreased gray matter volumes in the prefrontal cortex. However, it is unclear if such neuroanatomical abnormalities depict either pre-existing vulnerability markers or drug-induced consequences. Thus, this longitudinal MRI study investigated neuroplasticity and cognitive changes in relation to altered cocaine intake. METHODS Surface-based morphometry, cocaine hair concentration, and cognitive performance were measured in 29 cocaine users (CU) and 38 matched controls at baseline and follow-up. Based on changes in hair cocaine concentration, CU were classified either as Decreasers (n = 15) or Sustained Users (n = 14). Surface-based morphometry measures did not include regional tissue volumes. RESULTS At baseline, CU displayed reduced cortical thickness (CT) in lateral frontal regions, and smaller cortical surface area (CSA) in the anterior cingulate cortex, compared to controls. In Decreasers, CT of the lateral frontal cortex increased whereas CT within the same regions tended to further decrease in Sustained Users. In contrast, no changes were found for CSA and subcortical structures. Changes in CT were linked to cognitive performance changes and amount of cocaine consumed over the study period. CONCLUSIONS These results suggest that frontal abnormalities in CU are partially drug-induced and can recover with decreased substance use. Moreover, recovery of frontal CT is accompanied by improved cognitive performance confirming that cognitive decline associated with cocaine use is potentially reversible.
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Affiliation(s)
- Sarah Hirsiger
- Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland.
| | - Jürgen Hänggi
- Division Neuropsychology, Department of Psychology, University of Zurich, Zurich, Switzerland
| | - Jürgen Germann
- Cerebral Imaging Center, Douglas Mental Health University Institute, McGill University, Montreal, QC, Canada
| | - Matthias Vonmoos
- Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Katrin H Preller
- Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Etna J E Engeli
- Center for Addictive Disorders, Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland; Zurich Center for Integrative Human Physiology, University of Zurich, Zurich, Switzerland
| | - Matthias Kirschner
- Center for Addictive Disorders, Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Caroline Reinhard
- Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Lea M Hulka
- Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Markus R Baumgartner
- Center of Forensic Hairanalytics, Institute of Forensic Medicine, University of Zurich, Zurich, Switzerland
| | - Mallar M Chakravarty
- Cerebral Imaging Center, Douglas Mental Health University Institute, McGill University, Montreal, QC, Canada; Departments of Psychiatry and Biomedical and Biological Engineering, McGill University, Montreal, QC, Canada
| | - Erich Seifritz
- Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland; Neuroscience Center Zurich, University of Zurich and Swiss Federal Institute of Technology Zurich, Zurich, Switzerland
| | - Marcus Herdener
- Center for Addictive Disorders, Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Boris B Quednow
- Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland; Neuroscience Center Zurich, University of Zurich and Swiss Federal Institute of Technology Zurich, Zurich, Switzerland.
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Huang AS, Mitchell JA, Haber SN, Alia-Klein N, Goldstein RZ. The thalamus in drug addiction: from rodents to humans. Philos Trans R Soc Lond B Biol Sci 2019; 373:rstb.2017.0028. [PMID: 29352027 DOI: 10.1098/rstb.2017.0028] [Citation(s) in RCA: 65] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/24/2017] [Indexed: 02/07/2023] Open
Abstract
Impairments in response inhibition and salience attribution (iRISA) have been proposed to underlie the clinical symptoms of drug addiction as mediated by cortico-striatal-thalamo-cortical networks. The bulk of evidence supporting the iRISA model comes from neuroimaging research that has focused on cortical and striatal influences with less emphasis on the role of the thalamus. Here, we highlight the importance of the thalamus in drug addiction, focusing on animal literature findings on thalamic nuclei in the context of drug-seeking, structural and functional changes of the thalamus as measured by imaging studies in human drug addiction, particularly during drug cue and non-drug reward processing, and response inhibition tasks. Findings from the animal literature suggest that the paraventricular nucleus of the thalamus, the lateral habenula and the mediodorsal nucleus may be involved in the reinstatement, extinction and expression of drug-seeking behaviours. In support of the iRISA model, the human addiction imaging literature demonstrates enhanced thalamus activation when reacting to drug cues and reduced thalamus activation during response inhibition. This pattern of response was further associated with the severity of, and relapse in, drug addiction. Future animal studies could widen their field of focus by investigating the specific role(s) of different thalamic nuclei in different phases of the addiction cycle. Similarly, future human imaging studies should aim to specifically delineate the structure and function of different thalamic nuclei, for example, through the application of advanced imaging protocols at higher magnetic fields (7 Tesla).This article is part of a discussion meeting issue 'Of mice and mental health: facilitating dialogue between basic and clinical neuroscientists'.
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Affiliation(s)
- Anna S Huang
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | - Suzanne N Haber
- Department of Pharmacology and Physiology, School of Medicine, University of Rochester, Rochester, NY, USA
| | - Nelly Alia-Klein
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Rita Z Goldstein
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA .,Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Charlet K, Rosenthal A, Lohoff FW, Heinz A, Beck A. Imaging resilience and recovery in alcohol dependence. Addiction 2018; 113:1933-1950. [PMID: 29744956 PMCID: PMC6128779 DOI: 10.1111/add.14259] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2015] [Revised: 01/26/2016] [Accepted: 04/25/2018] [Indexed: 12/15/2022]
Abstract
BACKGROUND AND AIMS Resilience and recovery are of increasing importance in the field of alcohol dependence (AD). This paper describes how imaging studies in man can be used to assess the neurobiological correlates of resilience and, if longitudinal, of disease trajectories, progression rates and markers for recovery to inform treatment and prevention options. METHODS Original papers on recovery and resilience in alcohol addiction and its neurobiological correlates were identified from PubMed and have been analyzed and condensed within a systematic literature review. RESULTS Findings deriving from functional magnetic resonance imaging (fMRI) and positron emission tomography (PET) studies have identified links between increased resilience and less task-elicited neural activation within the basal ganglia, and benefits of heightened neural pre-frontal cortex (PFC) engagement regarding resilience in a broader sense; namely, resilience against relapse in early abstinence of AD. Furthermore, findings consistently propose at least partial recovery of brain glucose metabolism and executive and general cognitive functioning, as well as structural plasticity effects throughout the brain of alcohol-dependent patients during the course of short-, medium- and long-term abstinence, even when patients only lowered their alcohol consumption to a moderate level. Additionally, specific factors were found that appear to influence these observed brain recovery processes in AD, e.g. genotype-dependent neuronal (re)growth, gender-specific neural recovery effects, critical interfering effects of psychiatric comorbidities, additional smoking or marijuana influences or adolescent alcohol abuse. CONCLUSIONS Neuroimaging research has uncovered neurobiological markers that appear to be linked to resilience and improved recovery capacities that are furthermore influenced by various factors such as gender or genetics. Consequently, future system-oriented approaches may help to establish a broad neuroscience-based research framework for alcohol dependence.
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Affiliation(s)
- Katrin Charlet
- Section on Clinical Genomics and Experimental Therapeutics, National Institute on Alcohol Abuse and Alcoholism (NIAAA), National Institutes of Health (NIH), Bethesda, MD, USA,Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité – Universitätsmedizin Berlin, Germany
| | - Annika Rosenthal
- Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité – Universitätsmedizin Berlin, Germany
| | - Falk W. Lohoff
- Section on Clinical Genomics and Experimental Therapeutics, National Institute on Alcohol Abuse and Alcoholism (NIAAA), National Institutes of Health (NIH), Bethesda, MD, USA
| | - Andreas Heinz
- Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité – Universitätsmedizin Berlin, Germany
| | - Anne Beck
- Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité – Universitätsmedizin Berlin, Germany
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38
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Labisso WL, Raulin AC, Nwidu LL, Kocon A, Wayne D, Erdozain AM, Morentin B, Schwendener D, Allen G, Enticott J, Gerdes HK, Johnson L, Grzeskowiak J, Drizou F, Tarbox R, Osna NA, Kharbanda KK, Callado LF, Carter WG. The Loss of α- and β-Tubulin Proteins Are a Pathological Hallmark of Chronic Alcohol Consumption and Natural Brain Ageing. Brain Sci 2018; 8:brainsci8090175. [PMID: 30208635 PMCID: PMC6162390 DOI: 10.3390/brainsci8090175] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Revised: 08/19/2018] [Accepted: 09/02/2018] [Indexed: 02/05/2023] Open
Abstract
Repetitive excessive alcohol intoxication leads to neuronal damage and brain shrinkage. We examined cytoskeletal protein expression in human post-mortem tissue from Brodmann's area 9 of the prefrontal cortex (PFC). Brain samples from 44 individuals were divided into equal groups of 11 control, 11 alcoholic, 11 non-alcoholic suicides, and 11 suicide alcoholics matched for age, sex, and post-mortem delay. Tissue from alcoholic cohorts displayed significantly reduced expression of α- and β-tubulins, and increased levels of acetylated α-tubulin. Protein levels of histone deacetylase-6 (HDAC6), and the microtubule-associated proteins MAP-2 and MAP-tau were reduced in alcoholic cohorts, although for MAPs this was not significant. Tubulin gene expressions increased in alcoholic cohorts but not significantly. Brains from rats administered alcohol for 4 weeks also displayed significantly reduced tubulin protein levels and increased α-tubulin acetylation. PFC tissue from control subjects had reduced tubulin protein expression that was most notable from the sixth to the eighth decade of life. Collectively, loss of neuronal tubulin proteins are a hallmark of both chronic alcohol consumption and natural brain ageing. The reduction of cytosolic tubulin proteins could contribute to the brain volumetric losses reported for alcoholic patients and the elderly.
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Affiliation(s)
- Wajana L Labisso
- School of Medicine, University of Nottingham, Royal Derby Hospital Centre, Derby DE22 3DT, UK.
- School of Medicine, Addis Ababa University, Addis Ababa 1000, Ethiopia.
| | - Ana-Caroline Raulin
- School of Medicine, University of Nottingham, Royal Derby Hospital Centre, Derby DE22 3DT, UK.
- École nationale supérieure de chimie de Montpellier, 34090 Montpellier, France.
| | - Lucky L Nwidu
- School of Medicine, University of Nottingham, Royal Derby Hospital Centre, Derby DE22 3DT, UK.
- Department of Experimental Pharmacology and Toxicology, University of Port Harcourt, Port Harcourt 500262, Rivers State, Nigeria.
| | - Artur Kocon
- School of Medicine, University of Nottingham, Royal Derby Hospital Centre, Derby DE22 3DT, UK.
| | - Declan Wayne
- School of Medicine, University of Nottingham, Royal Derby Hospital Centre, Derby DE22 3DT, UK.
| | - Amaia M Erdozain
- School of Medicine, University of Nottingham, Royal Derby Hospital Centre, Derby DE22 3DT, UK.
- Department of Pharmacology, University of the Basque Country, Leioa-Erandio 48940, Spain.
- Centro de Investigación Biomédica en Red de Salud Mental, Madrid 28029, Spain.
| | - Benito Morentin
- Section of Forensic Pathology, Basque Institute of Legal Medicine, Bilbao 48001, Spain.
| | - Daniela Schwendener
- School of Medicine, University of Nottingham, Royal Derby Hospital Centre, Derby DE22 3DT, UK.
| | - George Allen
- School of Medicine, University of Nottingham, Royal Derby Hospital Centre, Derby DE22 3DT, UK.
| | - Jack Enticott
- School of Medicine, University of Nottingham, Royal Derby Hospital Centre, Derby DE22 3DT, UK.
| | - Henry K Gerdes
- School of Medicine, University of Nottingham, Royal Derby Hospital Centre, Derby DE22 3DT, UK.
| | - Laura Johnson
- School of Medicine, University of Nottingham, Royal Derby Hospital Centre, Derby DE22 3DT, UK.
| | - John Grzeskowiak
- School of Medicine, University of Nottingham, Royal Derby Hospital Centre, Derby DE22 3DT, UK.
| | - Fryni Drizou
- School of Medicine, University of Nottingham, Royal Derby Hospital Centre, Derby DE22 3DT, UK.
| | - Rebecca Tarbox
- School of Medicine, University of Nottingham, Royal Derby Hospital Centre, Derby DE22 3DT, UK.
| | - Natalia A Osna
- Research Service, Veterans Affairs Nebraska-Western Iowa Health Care System, Omaha, NE 68105, USA.
- Departments of Internal Medicine and Biochemistry & Molecular Biology, University of Nebraska Medical Center, Omaha, NE 68105, USA.
| | - Kusum K Kharbanda
- Research Service, Veterans Affairs Nebraska-Western Iowa Health Care System, Omaha, NE 68105, USA.
- Departments of Internal Medicine and Biochemistry & Molecular Biology, University of Nebraska Medical Center, Omaha, NE 68105, USA.
| | - Luis F Callado
- Department of Pharmacology, University of the Basque Country, Leioa-Erandio 48940, Spain.
- Centro de Investigación Biomédica en Red de Salud Mental, Madrid 28029, Spain.
| | - Wayne G Carter
- School of Medicine, University of Nottingham, Royal Derby Hospital Centre, Derby DE22 3DT, UK.
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Zou X, Durazzo TC, Meyerhoff DJ. Regional Brain Volume Changes in Alcohol-Dependent Individuals During Short-Term and Long-Term Abstinence. Alcohol Clin Exp Res 2018; 42:1062-1072. [PMID: 29672876 DOI: 10.1111/acer.13757] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Accepted: 04/09/2018] [Indexed: 11/29/2022]
Abstract
BACKGROUND Widespread brain atrophy in alcohol-dependent individuals (ALC) has been consistently documented in pathological and magnetic resonance imaging (MRI) studies. Longitudinal MRI studies have shown that the regional brain volume losses in ALC are partially reversible during abstinence from alcohol. The goal of this study was to determine volume reductions in cortical and subcortical regions functionally important to substance use behavior and their changes during short-term (1 week to 1 month) and long-term abstinence (1 to 7 months) from alcohol. The regions of interest (ROIs) were as follows: anterior cingulate cortex (ACC), dorsolateral prefrontal cortex (DLPFC), orbitofrontal cortex (OFC), insula, amygdala, and hippocampus. METHODS A total of 85 unique ALC were assessed at 1 week (n = 65), 1 month (n = 82), and 7 months (n = 36) of abstinence. In addition, 17 light/nondrinking healthy controls (CON) were assessed at baseline and follow-up over a 10-month interval. Regional brain volumes were derived from FreeSurfer. Cross-sectional statistical analyses using 1-way analysis of variance or Fisher's exact test were applied to identify group differences. Longitudinal statistical analyses using linear mixed models were applied to identify regional volume increases and nonlinear volume recovery trajectories. RESULTS We demonstrated significant regional volume reductions in ACC, DLPFC, and hippocampus. Older age was associated with smaller DLPFC and OFC, and higher average monthly drinking over 1 year prior to study was associated with smaller OFC. We also demonstrated significant volume increases of all ROIs except amygdala in ALC and significant nonlinear volume recovery trajectories of DLPFC, OFC, and insula. CONCLUSIONS Results showed significant volume reductions in key regions of the executive control, salience, and emotion networks in ALC at entry into treatment and significant volume increases during short-term and long-term abstinence that were nonlinear over the entire abstinence period for the DLPFC, OFC, and insula. This gray matter plasticity during alcohol abstinence may have important neurobiological and neurocognitive implications in ALC, and it may contribute to an individual's ability to maintain abstinence from alcohol at different phases.
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Affiliation(s)
- Xiaowei Zou
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California.,Center for Imaging of Neurodegenerative Diseases (CIND), Veterans Administration Medical Center, San Francisco, California
| | - Timothy C Durazzo
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California.,Mental Illness Research and Education Clinical Centers and Sierra-Pacific War Related Illness and Injury Study Center, VA Palo Alto Health Care System, Livermore, California
| | - Dieter J Meyerhoff
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California.,Center for Imaging of Neurodegenerative Diseases (CIND), Veterans Administration Medical Center, San Francisco, California
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40
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Zhang Z, He L, Huang S, Fan L, Li Y, Li P, Zhang J, Liu J, Yang R. Alteration of Brain Structure With Long-Term Abstinence of Methamphetamine by Voxel-Based Morphometry. Front Psychiatry 2018; 9:722. [PMID: 30618890 PMCID: PMC6306455 DOI: 10.3389/fpsyt.2018.00722] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Accepted: 12/07/2018] [Indexed: 12/12/2022] Open
Abstract
Background: A large portion of previous studies that have demonstrated brain gray matter reduction in individuals who use methamphetamine (MA) have focused on short-term abstinence, but few studies have focused on the effects of long-term abstinence of methamphetamine on brain structures. Materials and Methods: Our study includes 40 healthy controls and 44 abstinent methamphetamine-dependent (AMD) subjects who have abstained for at least 14 months. For every AMD subject, the age when they first used MA, the total time of MA use, the frequency of MA use in the last month before abstinence, the duration of abstinence and the craving score were recorded. Here we used magnetic resonance imaging (MRI) to measure the gray matter volume (GMV) of each subject with voxel-based morphometry method. Two-sample t-test (AlphaSim corrected) was performed to obtain brain regions with different gray matter volume (GMV) between groups. In addition, partial correlation coefficients adjusted for age, years of education, smoking, and drinking were calculated in the AMD group to assess associations between the mean GMV values in significant clusters and variables of MA use and abstinence. Results: Compared with the healthy control group, AMD group showed increased gray matter volumes in the bilateral cerebellum and decreased volumes in the right calcarine and right cuneus. Moreover, GMV of left cerebellum are positively correlated with the duration of abstinence in the AMD group (p = 0.040, r = 0.626). Conclusions: The present study showed that the gray matter volume in some brain regions is abnormal in the AMD subjects with long-term abstinence. Changes in gray matter volume of visual and cognitive function regions suggested that these areas play important roles in the progress of MA addiction and abstinence. In addition, positive correlation between GMV of the left cerebellum crus and duration of abstinence suggested that prolonged abstinence is beneficial to cognitive function recovery.
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Affiliation(s)
- Zhixue Zhang
- Department of Radiology, The Second Xiangya Hospital, Central South University, Changsha, China.,Department of Radiology, The First Hospital of Hunan University of Chinese Medicine, Changsha, China
| | - Lei He
- Department of Radiology, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Shucai Huang
- Department of Psychiatry, The Fourth People's Hospital of Wuhu, Wuhu, China
| | - Lidan Fan
- Department of Radiology, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Yining Li
- Department of Radiology, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Ping Li
- Department of Radiology, The First Hospital of Hunan University of Chinese Medicine, Changsha, China
| | - Jun Zhang
- Hunan Judicial Police Academy, Changsha, China
| | - Jun Liu
- Department of Radiology, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Ru Yang
- Department of Radiology, The Second Xiangya Hospital, Central South University, Changsha, China
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Durazzo TC, Mon A, Gazdzinski S, Meyerhoff DJ. Regional brain volume changes in alcohol-dependent individuals during early abstinence: associations with relapse following treatment. Addict Biol 2017; 22:1416-1425. [PMID: 27329647 DOI: 10.1111/adb.12420] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Revised: 04/26/2016] [Accepted: 05/13/2016] [Indexed: 12/15/2022]
Abstract
Cross-sectional structural magnetic resonance (MR) imaging studies of individuals with an alcohol use disorder (AUD) report that those who relapse after treatment, relative to individuals who maintain a period of extended abstinence, show greater morphological abnormalities in multiple brain regions near the inception of treatment, particularly in the frontal lobe. However, given the cross-sectional design of previous studies, it is unclear if the baseline morphological differences between future abstainers and relapsers were maintained over the course of early recovery. The primary goal of this study was to determine if frontal lobe tissue volume recovery during early abstinence is associated with long-term abstinence from alcohol. We compared frontal, parietal, temporal and occipital grey matter (GM) and white matter (WM) volumes, at 1 and 4 weeks of abstinence, among individuals who resumed alcohol consumption within 12 months of treatment (Relapsers) and those who showed sustained abstinence over 12 months following treatment (Abstainers). At 1 and 4 weeks of sobriety, both Abstainers and Relapsers demonstrated significantly smaller GM volumes than Controls in the majority of ROIs, but Relapsers exhibited significantly smaller bilateral frontal GM volumes than Abstainers. No significant group differences were observed for any WM region of interest. The persistent bilateral frontal GM volume deficits in Relapsers over 4 weeks from last alcohol use may represent an endophenotype that differentiates those who respond more favorably to the typical psychosocial and pharmacological interventions provided for AUD.
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Affiliation(s)
- Timothy C. Durazzo
- Department of Psychiatry and Behavioral Sciences; Stanford University School of Medicine; USA
- Mental Illness Research and Education Clinical Centers and Sierra-Pacific War Related Illness and Injury Study Center; VA Palo Alto Health Care System; USA
| | - Anderson Mon
- Department of Biomedical Engineering; School of Engineering Sciences University of Ghana; Legon Ghana
| | | | - Dieter J. Meyerhoff
- Department of Radiology and Biomedical Imaging; University of California; San Francisco USA
- Center for Imaging of Neurodegenerative Diseases; San Francisco VA Medical Center; USA
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Petit G, Luminet O, Cordovil de Sousa Uva M, Zorbas A, Maurage P, de Timary P. Differential spontaneous recovery across cognitive abilities during detoxification period in alcohol-dependence. PLoS One 2017; 12:e0176638. [PMID: 28767647 PMCID: PMC5540274 DOI: 10.1371/journal.pone.0176638] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2016] [Accepted: 04/13/2017] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE There is a lack of consensus regarding the extent to which cognitive dysfunctions may recover upon cessation of alcohol intake by alcohol-dependents (AD), and the divergent findings are most likely due to methodological differences between the various studies. The present study was aimed at conducting a very strict longitudinal study of cognitive recovery in terms of assessment points, the duration of abstinence, control of age and duration of the addiction, and by use of individual analyses in addition to mean group comparisons. Our study further focused on the 2-3 week phase of alcohol detoxification that is already known to positively affect many biological, emotional, motivational, as well as neural variables, followed by longer-term therapies for which good cognitive functioning is needed. METHODS 41 AD inpatients undergoing a detoxification program, and 41 matched controls, were evaluated twice in terms of five cognitive functions (i.e., short-term memory, working memory, inhibition, cognitive flexibility, and verbal fluency) within a three-week interval [on the first day (T1) and the 18th day (T2) of abstinence for AD patients]. Emotional (positive and negative affectivity and depression) and motivational (craving) variables were also measured at both evaluation times. RESULTS Although verbal fluency, short-term memory, and cognitive flexibility did not appear to be affected, the patients exhibited impaired inhibition and working memory at T1. While no recovery of inhibition was found to occur, the average working memory performance of the patients was comparable to that of the controls at T2. Improvements in emotional and motivational dimensions were also observed, although they did not correlate with the ones in working memory. Individual analysis showed that not all participants were impaired or recover the same functions. CONCLUSIONS While inhibition deficits appear to persist after 18 days of detoxification, deficits in working memory, which is a central component of cognition, are greatly reduced after alcohol detoxification. Individual differences in the trajectory of recovery do arise however, and it might be worth implementing individual assessments of impaired functions at the end of the detoxification phase in order to maximize the chances of success in longer-term treatments and abstinence.
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Affiliation(s)
- Géraldine Petit
- Research Institute for Psychological Sciences, Université catholique de Louvain, Louvain-la-Neuve, Belgium
- Department of Adult Psychiatry, Saint-Luc Academic Hospital, Université catholique de Louvain, Brussels, Belgium
- Laboratory for Experimental Psychopathology, Psychological Sciences Research Institute, Université catholique de Louvain, Louvain-la-Neuve, Belgium
- Institute of Neuroscience, Université catholique de Louvain, Louvain-la-Neuve, Belgium
| | - Olivier Luminet
- Research Institute for Psychological Sciences, Université catholique de Louvain, Louvain-la-Neuve, Belgium
- The Belgian National Fund for Scientific Research (FRS-FNRS), Brussels, Belgium
| | - Mariana Cordovil de Sousa Uva
- Research Institute for Psychological Sciences, Université catholique de Louvain, Louvain-la-Neuve, Belgium
- Department of Adult Psychiatry, Saint-Luc Academic Hospital, Université catholique de Louvain, Brussels, Belgium
| | - Alexis Zorbas
- Research Institute for Psychological Sciences, Université catholique de Louvain, Louvain-la-Neuve, Belgium
- Department of Adult Psychiatry, Saint-Luc Academic Hospital, Université catholique de Louvain, Brussels, Belgium
| | - Pierre Maurage
- Research Institute for Psychological Sciences, Université catholique de Louvain, Louvain-la-Neuve, Belgium
- Laboratory for Experimental Psychopathology, Psychological Sciences Research Institute, Université catholique de Louvain, Louvain-la-Neuve, Belgium
- The Belgian National Fund for Scientific Research (FRS-FNRS), Brussels, Belgium
| | - Philippe de Timary
- Department of Adult Psychiatry, Saint-Luc Academic Hospital, Université catholique de Louvain, Brussels, Belgium
- Laboratory for Experimental Psychopathology, Psychological Sciences Research Institute, Université catholique de Louvain, Louvain-la-Neuve, Belgium
- Institute of Neuroscience, Université catholique de Louvain, Louvain-la-Neuve, Belgium
- Unité Intégrée d’Hépatologie, Saint-Luc Academic Hospital, Université catholique de Louvain, Brussels, Belgium
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Effects of abstinence and chronic cigarette smoking on white matter microstructure in alcohol dependence: Diffusion tensor imaging at 4T. Drug Alcohol Depend 2017; 175:42-50. [PMID: 28384535 PMCID: PMC5444327 DOI: 10.1016/j.drugalcdep.2017.01.032] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Revised: 12/21/2016] [Accepted: 01/22/2017] [Indexed: 11/24/2022]
Abstract
BACKGROUND We previously reported widespread microstructural deficits of brain white matter in alcohol-dependent individuals (ALC) compared to light drinkers in a small 1.5T diffusion tensor imaging study employing tract-based spatial statistics. Using a larger dataset acquired at 4T, the present study is an extension that investigated the effects of alcohol consumption, abstinence from alcohol, and comorbid cigarette smoking on white matter microstructure. METHODS Tract-based spatial statistics were performed on 20 1-week-abstinent ALC, 52 1-month-abstinent ALC, and 30 controls. Regional measures of fractional anisotropy (FA) and mean diffusivity (MD) in the significant clusters were compared by Analysis of Covariance. The metrics were correlated with substance use history and behavioral measures. RESULTS 1-week-abstinent ALC showed lower FA than controls in the corpus callosum, right cingulum, external capsule, and hippocampus. At 1 month of abstinence, only the FA in the body of the corpus callosum of ALC remained significantly different from controls. Some regional FA deficits correlated with more severe measures of drinking and smoking histories but only weakly with mood and impulsivity measures. CONCLUSION White matter microstructure is abnormal during early abstinence in alcohol dependent treatment seekers and recovers into the normal range within about four weeks. The compromised white matter was related to substance use severity, mood, and impulsivity. Our findings suggest that ALC may benefit from interventions that facilitate normalization of DTI metrics to maintain abstinence, via smoking cessation, cognitive-based therapy, and perhaps pharmacology to support remyelination.
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Wade NE, Padula CB, Anthenelli RM, Nelson E, Eliassen J, Lisdahl KM. Blunted amygdala functional connectivity during a stress task in alcohol dependent individuals: A pilot study. Neurobiol Stress 2017; 7:74-79. [PMID: 28626785 PMCID: PMC5466595 DOI: 10.1016/j.ynstr.2017.05.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2016] [Revised: 05/23/2017] [Accepted: 05/30/2017] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Scant research has been conducted on neural mechanisms underlying stress processing in individuals with alcohol dependence (AD). We examined neural substrates of stress in AD individuals compared with controls using an fMRI task previously shown to induce stress, assessing amygdala functional connectivity to medial prefrontal cortex (mPFC). MATERIALS AND METHODS For this novel pilot study, 10 abstinent AD individuals and 11 controls completed a modified Trier stress task while undergoing fMRI acquisition. The amygdala was used as a seed region for whole-brain seed-based functional connectivity analysis. RESULTS After controlling for family-wise error (p = 0.05), there was significantly decreased left and right amygdala connectivity with frontal (specifically mPFC), temporal, parietal, and cerebellar regions. Subjective stress, but not craving, increased from pre-to post-task. CONCLUSIONS This study demonstrated decreased connectivity between the amygdala and regions important for stress and emotional processing in long-term abstinent individuals with AD. These results suggest aberrant stress processing in individuals with AD even after lengthy periods of abstinence.
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Affiliation(s)
- Natasha E. Wade
- Department of Psychology, University of Wisconsin-Milwaukee, 2441 E. Hartford Ave, Milwaukee, WI 53211, USA
| | - Claudia B. Padula
- Sierra Pacific Mental Illness Research, Education, and Clinical Center, VA, Palo Alto, USA
- Health Care System and Department of Psychiatry and Behavioral Sciences, Stanford University, 3801 Miranda Ave, Palo Alto, CA 93403, USA
| | - Robert M. Anthenelli
- Department of Psychiatry, University of California, San Diego, Health Sciences, 9500 Gilman Drive, La Jolla, CA 92093-0603, USA
| | - Erik Nelson
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, PO Box 670559, Cincinnati, OH, USA
| | - James Eliassen
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, PO Box 670559, Cincinnati, OH, USA
| | - Krista M. Lisdahl
- Department of Psychology, University of Wisconsin-Milwaukee, 2441 E. Hartford Ave, Milwaukee, WI 53211, USA
- Corresponding author.
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Sex disparities in substance abuse research: Evaluating 23 years of structural neuroimaging studies. Drug Alcohol Depend 2017; 173:92-98. [PMID: 28212516 PMCID: PMC5581940 DOI: 10.1016/j.drugalcdep.2016.12.019] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Revised: 12/02/2016] [Accepted: 12/16/2016] [Indexed: 01/06/2023]
Abstract
BACKGROUND Sex differences in brain structure and clinical course of substance use disorders underscores the need to include women in structural brain imaging studies. The NIH has supported the need for research to address sex differences. We evaluated female enrollment in substance abuse structural brain imaging research and the methods used to study sex differences in substance effects. METHODS Structural brain imaging studies published through 2016 (n=230) were evaluated for number of participants by sex and substance use status and methods used to evaluate sex differences. Temporal trends in the numbers of participants by sex and substance use status were analyzed. We evaluated how often sex effects were appropriately analyzed and the proportion of studies that found sex by substance interactions on volumetric measures. RESULTS Female enrollment increased over time, but remained significantly lower than male enrollment (p=0.01), with the greatest bias for alcohol and opiate studies. 79% of studies included both sexes; however, 74% did not evaluate sex effects or used an analytic approach that precluded detection of sex by substance use interactions. 85% of studies that stratified by sex reported different substance effects on brain volumes. Only 33% of studies examining two-way interactions found significant interactions, highlighting that many studies were underpowered to detect interactions. CONCLUSIONS Although female participation in substance use studies of brain morphometry has increased, sex disparity persists. Studying adequate numbers of both sexes and employing correct analytic approaches is critical for understanding sex differences in brain morphometric changes in substance abuse.
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Abstract
The simultaneous and/or concurrent use of licit and illicit substances (polysubstance use, PSU) is most common today. Structural magnetic resonance imaging (MRI) has been applied extensively to study individuals ostensibly using a single substance. These studies have produced a picture of regional gray matter and white matter alterations with each substance or class of substances. Very few studies measured regional brain morphometry in today's polysubstance users. This limited data suggest morphometric alterations with PSU that are not simply additive but often different from those of monosubstance users. Specifically, subcortical volume enlargements are observed that may be tied to mechanisms that also oppose volume reductions in cortical brain regions, thereby underestimating actual cortical atrophy. The complex actions of polysubstance use on brain structure and function need greater scrutiny with strong methodological approaches to inform more efficient treatment of polysubstance users.
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Affiliation(s)
- Dieter J Meyerhoff
- Department of Radiology and Biomedical Imaging, University of California San Francisco, and Veterans Administration Medical Center, San Francisco, CA 94121, USA
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Bullock K, Cservenka A, Ray LA. Severity of alcohol dependence is negatively related to hypothalamic and prefrontal cortical gray matter density in heavy drinking smokers. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2016; 43:281-290. [PMID: 27996310 DOI: 10.1080/00952990.2016.1257632] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND While research has examined brain structure in individuals who use alcohol or nicotine, heavy drinking smokers comprise a unique subpopulation of substance users for whom less is known about the relationship between alcohol or nicotine use and structural brain abnormalities. OBJECTIVES The present study examined gray matter morphometry in a sample of 39 heavy drinking smokers (24 males, 15 females) in relation to alcohol and nicotine dependence and quantity of use. METHODS Traditional voxel-based morphometry techniques were employed for preprocessing of imaging data. One multiple regression analysis for alcohol and nicotine dependence severity and another for alcohol and nicotine quantity of use were conducted, while controlling for age, gender, and total intracranial volume (ICV). RESULTS Alcohol dependence severity was significantly negatively associated with gray matter density in the hypothalamus (p < 0.001, uncorrected) and the right superior frontal gyrus (p < 0.001, uncorrected), while controlling for nicotine dependence severity, age, gender, and ICV. There were no significant relationships observed with respect to nicotine dependence severity, the quantity of alcohol use, or the quantity of nicotine use variables and gray matter density. CONCLUSIONS These findings suggest that within heavy drinking smokers, alcohol dependence severity is significantly related to alterations in brain structure, while this effect is not seen for the quantity of alcohol or nicotine use, or severity of nicotine dependence. The current findings help clarify the contribution of alcohol and nicotine effects on brain structure, which could aid in understanding their neurocognitive consequences in heavy drinking smokers.
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Affiliation(s)
- Kyle Bullock
- a Department of Psychology , University of California , Los Angeles , CA , USA
| | - Anita Cservenka
- b School of Psychological Science , Oregon State University , Corvallis , OR , USA
| | - Lara A Ray
- a Department of Psychology , University of California , Los Angeles , CA , USA.,c Department of Psychiatry and Biobehavioral Sciences , University of California , Los Angeles , CA , USA.,d Brain Research Institute , University of California , Los Angeles , CA , USA
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Durazzo TC, Meyerhoff DJ. Psychiatric, Demographic, and Brain Morphological Predictors of Relapse After Treatment for an Alcohol Use Disorder. Alcohol Clin Exp Res 2016; 41:107-116. [PMID: 27883214 DOI: 10.1111/acer.13267] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Accepted: 10/14/2016] [Indexed: 02/04/2023]
Abstract
BACKGROUND Relapse in alcohol use disorders (AUD) is related to a complex interplay among multiple biological, psychiatric, psychological, and psychosocial factors, which may change dynamically during and after treatment. At treatment entry for AUD, morphological abnormalities in anterior frontal regions and the insula have been observed in those who ultimately relapse following treatment. The goal of this study was to determine whether anterior frontal and insula measures of brain thickness, surface area, and volume predict posttreatment drinking status (i.e., relapser or abstainer) over an extended period after outpatient treatment for AUD, while concurrently considering common psychiatric, psychological, and psychosocial factors previously associated with relapse. METHODS Alcohol-dependent individuals (n = 129) were followed for 18 months after treatment to determine posttreatment drinking status (abstainers [n = 47] or relapsers [n = 82]). Brain morphometrics were derived from FreeSurfer. Receiver operating characteristic (ROC) curve analysis was used to identify the regional brain thickness, surface area, and volume (all scaled to intracranial volume), demographic, psychiatric, other substance use (e.g., cigarette smoking), and alcohol consumption variables, obtained at entry into treatment, that best predicted posttreatment drinking status. Survival analyses determined variables that were related to duration of abstinence after treatment. RESULTS ROC analyses indicated that mood disorders, education, and volumes of the right caudal anterior cingulate cortex (ACC), right rostral ACC, and total right frontal gray matter were significant predictors of posttreatment drinking status. Among relapsers, survival analyses showed smokers and individuals with a comorbid medical condition relapsed earlier after treatment. Additionally, a greater frequency of smokers relapsed within 6 months of AUD treatment. CONCLUSIONS Results reinforce that relapse in AUD is a function of multiple biological, psychiatric, psychological, and psychosocial factors. Effective treatment of depressive disorders and cigarette smoking concurrent with AUD-focused interventions may promote better treatment outcomes.
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Affiliation(s)
- Timothy C Durazzo
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California.,Mental Illness Research and Education Clinical Centers and Sierra-Pacific War Related Illness and Injury Study Center, VA Palo Alto Health Care System, Palo Alto, California
| | - Dieter J Meyerhoff
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California.,Center for Imaging of Neurodegenerative Diseases, San Francisco VA Medical Center, San Francisco, California
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Pennington DL, Durazzo TC, Schmidt TP, Abé C, Mon A, Meyerhoff DJ. Alcohol use disorder with and without stimulant use: brain morphometry and its associations with cigarette smoking, cognition, and inhibitory control. PLoS One 2015; 10:e0122505. [PMID: 25803861 PMCID: PMC4372577 DOI: 10.1371/journal.pone.0122505] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2014] [Accepted: 02/11/2015] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVE Little is known about the effects of polysubstance use and cigarette smoking on brain morphometry. This study examined neocortical brain morphometric differences between abstinent polysubstance dependent and alcohol-only dependent treatment seekers (ALC) as well as light drinking controls (CON), the associations of cigarette smoking in these polysubstance users (PSU), and morphometric relationships to cognition and inhibitory control. METHODS All participants completed extensive neuropsychological assessments and 4 Tesla brain magnetic resonance imaging. PSU and ALC were abstinent for one month at the time of study. Parcellated morphological data (volume, surface area, thickness) were obtained with FreeSurfer methodology for the following bilateral components: dorso-prefrontal cortex (DPFC), anterior cingulate cortex (ACC), orbitofrontal cortex (OFC), and insula. Regional group differences were examined and structural data correlated with domains of cognition and inhibitory control. RESULTS PSU had significantly smaller left OFC volume and surface area and trends to smaller right DPFC volume and surface area compared to CON; PSU did not differ significantly from ALC on these measures. PSU, however, had significantly thinner right ACC than ALC. Smoking PSU had significantly larger right OFC surface area than non-smoking PSU. No significant relationships between morphometry and quantity/frequency of substance use, alcohol use, or age of onset of heavy drinking were observed. PSU exhibited distinct relationships between brain structure and processing speed, cognitive efficiency, working memory and inhibitory control that were not observed in ALC or CON. CONCLUSION Polysubstance users have unique morphometric abnormalities and structure-function relationships when compared to individuals dependent only on alcohol and light drinking controls. Chronic cigarette smoking is associated with structural brain irregularities in polysubstance users. Further elucidation of these distinctive characteristics could help inform the development of targeted and thus potentially more effective treatments in this large but understudied population.
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Affiliation(s)
- David L. Pennington
- Addiction Research Program, Veterans Administration Medical Center, San Francisco, California, United States of America
- Northern California Institute for Research and Education, San Francisco, California, United States of America
- * E-mail:
| | - Timothy C. Durazzo
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, California, United States of America
- Center for Imaging of Neurodegenerative Diseases, Veterans Administration Medical Center, San Francisco, California, United States of America
| | - Thomas P. Schmidt
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, California, United States of America
| | - Christoph Abé
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Anderson Mon
- School of Applied Sciences and Statistics, Koforidua Polytechnic, Ghana
| | - Dieter J. Meyerhoff
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, California, United States of America
- Center for Imaging of Neurodegenerative Diseases, Veterans Administration Medical Center, San Francisco, California, United States of America
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