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Kurihara K, Enoki H, Shinzato H, Takaesu Y, Kondo T. Cluster analysis of patients with alcohol use disorder featuring alexithymia, depression, and diverse drinking behavior. Neuropsychopharmacol Rep 2024. [PMID: 38773706 DOI: 10.1002/npr2.12449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Revised: 04/18/2024] [Accepted: 05/05/2024] [Indexed: 05/24/2024] Open
Abstract
AIM This study aimed to identify subgroups of alcohol use disorder (AUD) based on a multidimensional combination of alexithymia, depression, and diverse drinking behavior. METHOD We recruited 176 patients with AUD, which were initially divided into non-alexithymic (n = 130) and alexithymic (n = 46) groups using a cutoff score of 61 on the Toronto Alexithymia Scale (TAS-20). Subsequently, the profiles of the two groups were compared. Thereafter, a two-stage cluster analysis using hierarchical and K-means methods was performed with the Z-scores from the TAS-20, the Quick Inventory of Depressive Symptomatology Self-Report Japanese Version, the 12-item questionnaire for quantitative assessment of depressive mixed state, and the 20-item questionnaire for drinking behavior pattern. RESULTS In the first analysis, Alexithymic patients with AUD showed greater depressive symptoms and more pathological drinking behavior patterns than those without alexithymia. Cluster analysis featuring alexithymia, depression, and drinking behavior identified three subtypes: Cluster 1 (core AUD type) manifesting pathological drinking behavior highlighting automaticity; Cluster 2 (late-onset type) showing relatively late-onset alcohol use and fewer depressive symptoms or pathological drinking behavior; and Cluster 3 (alexithymic type) characterized by alexithymia, depression, and pathological drinking behavior featuring greater coping with negative affect. CONCLUSION The multidimensional model with alexithymia, depression, and diverse drinking behavior provided possible practical classification of AUD. The alexithymic subtype may require more caution, and additional support for negative affect may be necessary due to accompanying mood problems and various maladaptive drinking behaviors.
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Affiliation(s)
- Kazuhiro Kurihara
- Department of Neuropsychiatry, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Hiroyuki Enoki
- Major in Clinical Psychology, Graduate School of Psychological Sciences, Hiroshima International University, Hiroshima, Japan
| | - Hotaka Shinzato
- Department of Neuropsychiatry, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Yoshikazu Takaesu
- Department of Neuropsychiatry, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Tsuyoshi Kondo
- Department of Neuropsychiatry, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
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Cheng Y, Magnard R, Langdon AJ, Lee D, Janak PH. Chronic Ethanol Exposure Produces Persistent Impairment in Cognitive Flexibility and Decision Signals in the Striatum. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.03.10.584332. [PMID: 38585868 PMCID: PMC10996555 DOI: 10.1101/2024.03.10.584332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/09/2024]
Abstract
Lack of cognitive flexibility is a hallmark of substance use disorders and has been associated with drug-induced synaptic plasticity in the dorsomedial striatum (DMS). Yet the possible impact of altered plasticity on real-time striatal neural dynamics during decision-making is unclear. Here, we identified persistent impairments induced by chronic ethanol (EtOH) exposure on cognitive flexibility and striatal decision signals. After a substantial withdrawal period from prior EtOH vapor exposure, male, but not female, rats exhibited reduced adaptability and exploratory behavior during a dynamic decision-making task. Reinforcement learning models showed that prior EtOH exposure enhanced learning from rewards over omissions. Notably, neural signals in the DMS related to the decision outcome were enhanced, while those related to choice and choice-outcome conjunction were reduced, in EtOH-treated rats compared to the controls. These findings highlight the profound impact of chronic EtOH exposure on adaptive decision-making, pinpointing specific changes in striatal representations of actions and outcomes as underlying mechanisms for cognitive deficits.
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Affiliation(s)
- Yifeng Cheng
- Department Psychological and Brain Sciences, Krieger School of Arts and Sciences, Johns Hopkins University, Baltimore, MD
| | - Robin Magnard
- Department Psychological and Brain Sciences, Krieger School of Arts and Sciences, Johns Hopkins University, Baltimore, MD
| | - Angela J. Langdon
- Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, MD
| | - Daeyeol Lee
- Department Psychological and Brain Sciences, Krieger School of Arts and Sciences, Johns Hopkins University, Baltimore, MD
- Zanvyl Krieger Mind/Brain Institute, Krieger School of Arts and Sciences, Johns Hopkins University, Baltimore, MD
- Department of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, MD
- Kavli Neuroscience Discovery Institute, Johns Hopkins University, Baltimore, MD
| | - Patricia H. Janak
- Department Psychological and Brain Sciences, Krieger School of Arts and Sciences, Johns Hopkins University, Baltimore, MD
- Department of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, MD
- Kavli Neuroscience Discovery Institute, Johns Hopkins University, Baltimore, MD
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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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Billaux P, Maurage P, Cabé N, Laniepce A, Segobin S, Pitel AL. Insular volumetry in severe alcohol use disorder and Korsakoff's syndrome through an anatomical parcellation: Let us go back to basics. Addict Biol 2023; 28:e13324. [PMID: 37753561 DOI: 10.1111/adb.13324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 07/25/2023] [Accepted: 07/28/2023] [Indexed: 09/28/2023]
Abstract
Functional neuroimaging has demonstrated the key role played by the insula in severe alcohol use disorder (sAUD), notably through its involvement in craving and body signals processing. However, the anatomical counterpart of these functional modifications in sAUD patients with and without neurological complications remains largely unexplored, especially using state-of-the-art parcellation tools. We thus compared the grey matter volume of insular subregions (form anterior to posterior: anterior inferior cortex, anterior short gyrus, middle short gyrus, posterior short gyrus, anterior long gyrus, posterior long gyrus) in 50 recently detoxified patients with sAUD, 19 patients with Korsakoff's syndrome (KS) and 36 healthy controls (HC). We used a mixed linear model analysis to explore group differences in the six subregions grey matter volume and lateralization differences. Insular macrostructure was globally affected to the same extent in sAUD with and without KS, indicating that these brain abnormalities may be related to alcohol consumption per se, rather than to the presence of alcohol-related neurological complications. Insular atrophy showed a right-sided lateralization effect and was especially marked in the posterior insula, a region associated with visceral information processing and the embodiment effect of a substance, from which craving arises. Anatomical damages might thus underlie the previously reported altered insular activations and their behavioural counterparts.
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Affiliation(s)
- Pauline Billaux
- Louvain Experimental Psychopathology research group (LEP), Psychological Science Research Institute, UCLouvain, Louvain-la-Neuve, Belgium
| | - Pierre Maurage
- Louvain Experimental Psychopathology research group (LEP), Psychological Science Research Institute, UCLouvain, Louvain-la-Neuve, Belgium
| | - Nicolas Cabé
- Normandie Univ, UNICAEN, INSERM, PhIND, Physiopathology and Imaging of Neurological Disorders, Institut Blood and Brain at Caen-Normandie, Cyceron, Caen, France
- Service d'Addictologie, Centre Hospitalier Universitaire de Caen, Caen, France
| | - Alice Laniepce
- Normandie Univ, UNICAEN, INSERM, PhIND, Physiopathology and Imaging of Neurological Disorders, Institut Blood and Brain at Caen-Normandie, Cyceron, Caen, France
- Normandie Univ, UNIROUEN, CRFDP (EA7475), Rouen, France
| | - Shailendra Segobin
- Normandie Univ, UNICAEN, PSL Université Paris, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, Neuropsychologie et Imagerie de la Mémoire Humaine, Caen, France
| | - Anne-Lise Pitel
- Normandie Univ, UNICAEN, INSERM, PhIND, Physiopathology and Imaging of Neurological Disorders, Institut Blood and Brain at Caen-Normandie, Cyceron, Caen, France
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