1
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Beck A, Ebrahimi C, Rosenthal A, Charlet K, Heinz A. The Dopamine System in Mediating Alcohol Effects in Humans. Curr Top Behav Neurosci 2023. [PMID: 36705911 DOI: 10.1007/7854_2022_415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Brain-imaging studies show that the development and maintenance of alcohol use disorder (AUD) is determined by a complex interaction of different neurotransmitter systems and multiple psychological factors. In this context, the dopaminergic reinforcement system appears to be of fundamental importance. We focus on the excitatory and depressant effects of acute versus chronic alcohol intake and its impact on dopaminergic neurotransmission. Furthermore, we describe alterations in dopaminergic neurotransmission as associated with symptoms of alcohol dependence. We specifically focus on neuroadaptations to chronic alcohol consumption and their effect on central processing of alcohol-associated and reward-related stimuli. Altered reward processing, complex conditioning processes, impaired reinforcement learning, and increased salience attribution to alcohol-associated stimuli enable alcohol cues to drive alcohol seeking and consumption. Finally, we will discuss how the neurobiological and neurochemical mechanisms of alcohol-associated alterations in reward processing and learning can interact with stress, cognition, and emotion processing.
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Affiliation(s)
- Anne Beck
- Faculty of Health, Health and Medical University, Potsdam, Germany
| | - Claudia Ebrahimi
- Department of Psychiatry and Neurosciences, Charité - Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt- Universität zu Berlin, Berlin, Germany
| | - Annika Rosenthal
- Department of Psychiatry and Neurosciences, Charité - Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt- Universität zu Berlin, Berlin, Germany
| | - Katrin Charlet
- Department of Psychiatry and Neurosciences, Charité - Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt- Universität zu Berlin, Berlin, Germany
| | - Andreas Heinz
- Department of Psychiatry and Neurosciences, Charité - Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt- Universität zu Berlin, Berlin, Germany.
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2
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Bralet MC, Mitelman SA, Goodman CR, Lincoln S, Hazlett EA, Buchsbaum MS. Fluorodeoxyglucose positron emission tomography scans in patients with alcohol use disorder. Alcohol Clin Exp Res 2022; 46:994-1010. [PMID: 35451074 DOI: 10.1111/acer.14845] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 03/17/2022] [Accepted: 04/16/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Diminished uptake of fluorodeoxyglucose (FDG) has been observed in patients with alcohol use disorder (AUD) but little statistical contrast of the regional brain deficits has been undertaken. This study examined prefrontal cortex inter-regional Brodmann area differences to delineate patterns associated with behavioral, neurotransmitter, and general toxicity hypotheses of cerebral involvement in AUD. METHODS We obtained data from FDG positron emission tomography (PET) and anatomical magnetic resonance imaging (MRI) for 87 patients with AUD and 41 age- and sex-matched healthy volunteers. Patients were alcohol dependent and had negative breathalyzer tests at the time of imaging. They were assessed with the Beck Depression Inventory, Alcohol Urge Questionnaire, Obsessive Compulsive Drinking Scale, Spielberger State/Trait Anxiety Scale, Buss-Durkee Hostility Inventory, and the Drinker Inventory of Consequences (DrInC). PET images were co-registered to MRI and both voxel × voxel statistical mapping and stereotaxic regions of interest were obtained. RESULTS Compared with healthy volunteers, patients with AUD had lower relative metabolic rates in the frontal, temporal, and parietal lobes, localizable most prominently to the dorsolateral and nearly all orbital prefrontal cortex, superior temporal gyrus, and inferior parietal lobule. In contrast, metabolic rates in the medial orbitofrontal and anterior cingulate cortex, and the subcortical structures (thalamus, cerebellum, ventral striatum, and the dorsal raphe nucleus) in patients were significantly greater. The severity of alcohol-related consequences as assessed by the DrInC scale was most highly associated with lower metabolism in the caudate, dorsolateral prefrontal, frontopolar, and anteroposterior cingulate cortex. CONCLUSIONS Despite widespread metabolic abnormalities, decreases in AUD were most marked in frontal executive areas, consistent with diminished impulse control, and increases were most prominent in the striatum and cingulate areas, consistent with a suppressed reward system.
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Affiliation(s)
- Marie-Cécile Bralet
- Crisalid Unit (FJ5), CHI Clermont de l'Oise, Clermont, France.,Inserm Unit U669, Maison de Solenn, Universities Paris, Paris, France.,GDR 3557 Recherche Psychiatrie, Paris, France
| | - Serge A Mitelman
- Departments of Psychiatry and Neuroscience, Icahn School of Medicine at Mount Sinai, New York, New York, USA.,Department of Psychiatry, Division of Child and Adolescent Psychiatry, Elmhurst Hospital Center, Elmhurst, New York, USA
| | - Chelain R Goodman
- Department of Radiation Oncology, Division of Radiation Oncology, University of Texas, Austin, Texas, USA
| | - Samantha Lincoln
- Departments of Psychiatry and Neuroscience, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Erin A Hazlett
- Departments of Psychiatry and Neuroscience, Icahn School of Medicine at Mount Sinai, New York, New York, USA.,Mental Illness Research, Education, and Clinical Center (VISN 2), James J. Peters VAMC, Bronx, New York, USA
| | - Monte S Buchsbaum
- Departments of Psychiatry and Radiology, University of California, San Diego, San Diego, California, USA.,Departments of Psychiatry and Radiology, University of California, Irvine, Irvine, California, USA
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3
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Yang W, Zhang M, Tang F, Du Y, Fan L, Luo J, Yan C, Wang S, Zhang J, Yuan K, Liu J. Recovery of superior frontal gyrus cortical thickness and resting-state functional connectivity in abstinent heroin users after 8 months of follow-up. Hum Brain Mapp 2022; 43:3164-3175. [PMID: 35324057 PMCID: PMC9188969 DOI: 10.1002/hbm.25841] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 02/11/2022] [Accepted: 03/06/2022] [Indexed: 12/28/2022] Open
Abstract
Compared with healthy controls, heroin users (HUs) show evidence of structural and functional brain alterations. However, little is known about the possibility of brain recovery after protracted heroin abstinence. The purpose of this study was to investigate whether brain recovery is possible after protracted abstinence in HUs. A total of 108 subjects with heroin addiction completed structural and functional scans, and 61 of those subjects completed 8-month follow-up scans. Resting-state data and 3D-T1 MR images were collected for all participants, first at baseline and again after 8 months. Cognitive function and craving were measured by the Trail Making Test-A (TMT-A) and Visual Analog Scale for Craving, respectively. The cortical thickness and resting-state functional connectivity (RSFC) differences were then analyzed and compared between baseline and follow-up, and correlations were obtained between neuroimaging and behavioral changes. HUs demonstrated improved cognition (shorter TMT-A time) and reduced craving at the follow-up (HU2) relative to baseline (HU1), and the cortical thickness in the bilateral superior frontal gyrus (SFG) was significantly greater at HU2 than at HU1. Additionally, the RSFC of the left SFG with the inferior frontal gyrus (IFG), insula, and nucleus accumbens and that of the right SFG with the IFG, insula and orbitofrontal cortex (OFC) were increased at HU2. The changes in TMT-A time were negatively correlated with the RSFC changes between the left SFG and the bilateral IFG, the bilateral caudate, and the right insula. The changes in craving were negatively correlated with the RSFC changes between the left OFC and the bilateral SFG. Our results demonstrated that impaired frontal-limbic neurocircuitry can be partially restored, which might enable improved cognition as well as reduced craving in substance-abusing individuals. We provided novel scientific evidence for the partial recovery of brain circuits implicated in cognition and craving after protracted abstinence.
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Affiliation(s)
- Wenhan Yang
- Department of Radiology, Second Xiangya Hospital of Central South University, Changsha, China
| | - Min Zhang
- School of Life Science and Technology, Xidian University, Xi'an, China.,Engineering Research Center of Molecular and Neuroimaging, Ministry of Education, Xi'an, China
| | - Fei Tang
- Department of Radiology, Second Xiangya Hospital of Central South University, Changsha, China
| | - Yanyao Du
- Department of Radiology, Second Xiangya Hospital of Central South University, Changsha, China
| | - Li Fan
- Department of Radiology, Second Xiangya Hospital of Central South University, Changsha, China
| | - Jing Luo
- Department of Radiology, Second Xiangya Hospital of Central South University, Changsha, China
| | - Cui Yan
- Department of Radiology, Second Xiangya Hospital of Central South University, Changsha, China
| | - Shicong Wang
- School of Life Science and Technology, Xidian University, Xi'an, China.,Engineering Research Center of Molecular and Neuroimaging, Ministry of Education, Xi'an, China
| | - Jun Zhang
- Hunan Judicial Police Academy, Changsha, China
| | - Kai Yuan
- School of Life Science and Technology, Xidian University, Xi'an, China.,Engineering Research Center of Molecular and Neuroimaging, Ministry of Education, Xi'an, China.,Xi'an Key Laboratory of Intelligent Sensing and Regulation of Trans-Scale Life Information, School of Life Science and Technology, Xidian University, Xi'an, China.,Inner Mongolia Key Laboratory of Pattern Recognition and Intelligent Image Processing, School of Information Engineering, Inner Mongolia University of Science and Technology, Baotou, China
| | - Jun Liu
- Department of Radiology, Second Xiangya Hospital of Central South University, Changsha, China
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4
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Sinha R, Fogelman N, Wemm S, Angarita G, Seo D, Hermes G. Alcohol withdrawal symptoms predict corticostriatal dysfunction that is reversed by prazosin treatment in alcohol use disorder. Addict Biol 2022; 27:e13116. [PMID: 34856641 PMCID: PMC9872962 DOI: 10.1111/adb.13116] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 10/31/2021] [Accepted: 11/03/2021] [Indexed: 01/27/2023]
Abstract
Chronic alcohol use increases risk of alcohol withdrawal symptoms (AW) and disrupts stress biology and resilient coping, thereby promoting excessive alcohol intake. Chronic alcohol intake and multiple alcohol detoxifications are known to impair brain medial prefrontal cortex (mPFC) and striatal functioning, regions involved in regulating stress, craving and alcohol intake. In two related studies, we examined whether AW predicts this functional brain pathology and whether Prazosin versus Placebo treatment may reverse these effects. In Study 1, patients with Alcohol Use Disorder (AUD) (N = 45) with varying AW levels at treatment entry were assessed to examine AW effects on corticostriatal responses to stress, alcohol cue and neutral visual images with functional magnetic resonance imaging (fMRI). In Study 2, 23 AUD patients entering a 12-week randomised controlled trial (RCT) of Prazosin, an alpha1 adrenergic antagonist that decreased withdrawal-related alcohol intake in laboratory animals, participated in two fMRI sessions at pretreatment and also at week 9-10 of chronic treatment (Placebo: N = 13; Prazosin: N = 10) to assess Prazosin treatment effects on alcohol-related cortico-striatal dysfunction. Study 1 results indicated that higher AW predicted greater disruption in brain mPFC and striatal response to stress and alcohol cues (p < 0.001, family-wise error [FWE] correction) and also subsequently greater heavy drinking days (HDD) in early treatment (p < 0.01). In Study 2, Prazosin versus Placebo treatment reversed mPFC-striatal dysfunction (p < 0.001, FWE), which in turn predicted fewer drinking days (p < 0.01) during the 12-week treatment period. These results indicate that AW is a significant predictor of alcohol-related prefrontal-striatal dysfunction, and Prazosin treatment reversed these effects that in turn contributed to improved alcohol treatment outcomes.
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Affiliation(s)
- Rajita Sinha
- Yale Stress Center, Yale University School of Medicine, New Haven, Connecticut, USA
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
- Department of Neuroscience, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Nia Fogelman
- Yale Stress Center, Yale University School of Medicine, New Haven, Connecticut, USA
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Stephanie Wemm
- Yale Stress Center, Yale University School of Medicine, New Haven, Connecticut, USA
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Gustavo Angarita
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Dongju Seo
- Yale Stress Center, Yale University School of Medicine, New Haven, Connecticut, USA
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Gretchen Hermes
- Yale Stress Center, Yale University School of Medicine, New Haven, Connecticut, USA
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
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5
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Different Effects of Alcohol Exposure on Action and Outcome-Related Orbitofrontal Cortex Activity. eNeuro 2021; 8:ENEURO.0052-21.2021. [PMID: 33785522 PMCID: PMC8174034 DOI: 10.1523/eneuro.0052-21.2021] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 03/12/2021] [Accepted: 03/18/2021] [Indexed: 11/21/2022] Open
Abstract
Alcohol dependence can result in long-lasting deficits to decision-making and action control. Neurobiological investigations have identified orbitofrontal cortex (OFC) as important for outcome-related contributions to goal-directed actions during decision-making. Prior work has shown that alcohol dependence induces long-lasting changes to OFC function that persist into protracted withdrawal and disrupts goal-directed control over actions. However, it is unclear whether these changes in function alter representation of action and outcome-related neural activity in OFC. Here, we used the well-validated chronic intermittent ethanol (CIE) exposure and withdrawal procedure to model alcohol dependence in mice and performed in vivo extracellular recordings during an instrumental task in which lever-press actions made for a food outcome. We found alcohol dependence disrupted goal-directed action control and increased OFC activity associated with lever-pressing but decreased OFC activity during outcome-related epochs. The ability to decode outcome-related information, but not action information, from OFC activity following CIE exposure was reduced. Hence, chronic alcohol exposure induced a long-lasting disruption to OFC function such that activity associated with actions was enhanced, but OFC activity contributions to outcome-related information was diminished. This has important implications for hypotheses regarding compulsive and habitual phenotypes observed in addiction.
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6
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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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7
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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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8
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Shields CN, Gremel CM. Review of Orbitofrontal Cortex in Alcohol Dependence: A Disrupted Cognitive Map? Alcohol Clin Exp Res 2020; 44:1952-1964. [PMID: 32852095 PMCID: PMC8261866 DOI: 10.1111/acer.14441] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 08/13/2020] [Indexed: 12/18/2022]
Abstract
Alcoholism is a persistent worldwide problem associated with long-lasting impairments to decision making processes. Some aspects of dysfunction are thought to reflect alcohol-induced changes to relevant brain areas such as the orbitofrontal cortex (OFC). In this review, we will examine how chronic alcohol exposure alters OFC function to potentially contribute to maladaptive decision making, and explore experimental behavioral approaches that may be better suited to test whether alcohol dependence disrupts OFC's function. We argue that although past works suggest impairments in aspects of OFC function, more information may be gained by specifically targeting tasks to the broader function of OFC as put forth by the recent hypothesis of OFC as a "cognitive map" of task space. Overall, we suggest that such a focus could provide a better understanding of how OFC function changes in alcohol dependence, and could inform better assessment tools and treatment options for clinicians working with this population.
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Affiliation(s)
- Chloe N. Shields
- Department of Psychology, University of California San Diego, La Jolla, CA 92093, USA
| | - Christina M. Gremel
- Department of Psychology, University of California San Diego, La Jolla, CA 92093, USA
- The Neurosciences Graduate Program, University of California San Diego, La Jolla, CA 92093, USA
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9
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10
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Ritz L, Segobin S, Lannuzel C, Laniepce A, Boudehent C, Cabé N, Eustache F, Vabret F, Beaunieux H, Pitel AL. Cerebellar Hypermetabolism in Alcohol Use Disorder: Compensatory Mechanism or Maladaptive Plasticity? Alcohol Clin Exp Res 2019; 43:2212-2221. [DOI: 10.1111/acer.14158] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Accepted: 07/17/2019] [Indexed: 12/14/2022]
Affiliation(s)
- Ludivine Ritz
- UNICAEN LPCN Normandie Univ Caen France
- Neuropsychologie et Imagerie de la Mémoire Humaine CHU de Caen U1077, INSERM EPHE PSL Research University UNICAEN Normandie Univ Caen France
| | - Shailendra Segobin
- Neuropsychologie et Imagerie de la Mémoire Humaine CHU de Caen U1077, INSERM EPHE PSL Research University UNICAEN Normandie Univ Caen France
| | - Coralie Lannuzel
- Neuropsychologie et Imagerie de la Mémoire Humaine CHU de Caen U1077, INSERM EPHE PSL Research University UNICAEN Normandie Univ Caen France
| | - Alice Laniepce
- Neuropsychologie et Imagerie de la Mémoire Humaine CHU de Caen U1077, INSERM EPHE PSL Research University UNICAEN Normandie Univ Caen France
| | - Céline Boudehent
- Neuropsychologie et Imagerie de la Mémoire Humaine CHU de Caen U1077, INSERM EPHE PSL Research University UNICAEN Normandie Univ Caen France
- Service d'Addictologie Centre Hospitalier Universitaire de Caen Caen France
| | - Nicolas Cabé
- Neuropsychologie et Imagerie de la Mémoire Humaine CHU de Caen U1077, INSERM EPHE PSL Research University UNICAEN Normandie Univ Caen France
- Service d'Addictologie Centre Hospitalier Universitaire de Caen Caen France
| | - Francis Eustache
- Neuropsychologie et Imagerie de la Mémoire Humaine CHU de Caen U1077, INSERM EPHE PSL Research University UNICAEN Normandie Univ Caen France
| | - François Vabret
- Neuropsychologie et Imagerie de la Mémoire Humaine CHU de Caen U1077, INSERM EPHE PSL Research University UNICAEN Normandie Univ Caen France
- Service d'Addictologie Centre Hospitalier Universitaire de Caen Caen France
| | - Hélène Beaunieux
- UNICAEN LPCN Normandie Univ Caen France
- Neuropsychologie et Imagerie de la Mémoire Humaine CHU de Caen U1077, INSERM EPHE PSL Research University UNICAEN Normandie Univ Caen France
| | - Anne Lise Pitel
- Neuropsychologie et Imagerie de la Mémoire Humaine CHU de Caen U1077, INSERM EPHE PSL Research University UNICAEN Normandie Univ Caen France
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11
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Tomasi DG, Wiers CE, Shokri-Kojori E, Zehra A, Ramirez V, Freeman C, Burns J, Kure Liu C, Manza P, Kim SW, Wang GJ, Volkow ND. Association Between Reduced Brain Glucose Metabolism and Cortical Thickness in Alcoholics: Evidence of Neurotoxicity. Int J Neuropsychopharmacol 2019; 22:548-559. [PMID: 31369670 PMCID: PMC6754735 DOI: 10.1093/ijnp/pyz036] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 06/12/2019] [Accepted: 07/15/2019] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Excessive alcohol consumption is associated with reduced cortical thickness (CT) and lower cerebral metabolic rate of glucose (CMRGlu), but the correlation between these 2 measures has not been investigated. METHODS We tested the association between CT and cerebral CMRGlu in 19 participants with alcohol use disorder (AUD) and 20 healthy controls. Participants underwent 2-Deoxy-2-[18F]fluoroglucose positron emission tomography to map CMRGlu and magnetic resonance imaging to assess CT. RESULTS Although performance accuracy on a broad range of cognitive domains did not differ significantly between AUD and HC, AUD had widespread decreases in CT and CMRGlu. CMRGlu, normalized to cerebellum (rCMRGlu), showed significant correlation with CT across participants. Although there were large group differences in CMRGlu (>17%) and CT (>6%) in medial orbitofrontal and BA 47, the superior parietal cortex showed large reductions in CMRGlu (~17%) and minimal CT differences (~2.2%). Though total lifetime alcohol (TLA) was associated with CT and rCMRGlu, the causal mediation analysis revealed significant direct effects of TLA on rCMRGlu but not on CT, and there were no significant mediation effects of TLA, CT, and rCMRGlu. CONCLUSIONS The significant correlation between decrements in CT and CMRGlu across AUD participants is suggestive of alcohol-induced neurotoxicity, whereas the findings that the most metabolically affected regions in AUD had minimal atrophy and vice versa indicates that changes in CT and CMRGlu reflect distinct responses to alcohol across brain regions.
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Affiliation(s)
- Dardo G Tomasi
- National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD,Correspondence: Dardo Tomasi, PhD, 10 Center Dr, Rm B2L124, Bethesda, MD 20892-1013 ()
| | - Corinde E Wiers
- National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD
| | | | - Amna Zehra
- National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD
| | - Veronica Ramirez
- National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD
| | - Clara Freeman
- National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD
| | - Jamie Burns
- National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD
| | | | - Peter Manza
- National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD
| | - Sung W Kim
- National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD
| | - Gene-Jack Wang
- National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD
| | - Nora D Volkow
- National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD,National Institute on Drug Abuse, Bethesda, MD
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12
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Is Trazodone Contramid Useful in Inducing Patients to Refrain From Using Cocaine After Detoxification, so Avoiding Early Relapse? A Case Series. ADDICTIVE DISORDERS & THEIR TREATMENT 2019. [DOI: 10.1097/adt.0000000000000157] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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13
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Cannella N, Ubaldi M, Masi A, Bramucci M, Roberto M, Bifone A, Ciccocioppo R. Building better strategies to develop new medications in Alcohol Use Disorder: Learning from past success and failure to shape a brighter future. Neurosci Biobehav Rev 2019; 103:384-398. [PMID: 31112713 DOI: 10.1016/j.neubiorev.2019.05.014] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 05/10/2019] [Accepted: 05/15/2019] [Indexed: 12/11/2022]
Abstract
Alcohol Use Disorder (AUD) is a chronic disease that develops over the years. The complexity of the neurobiological processes contributing to the emergence of AUD and the neuroadaptive changes occurring during disease progression make it difficult to improve treatments. On the other hand, this complexity offers researchers the possibility to explore new targets. Over years of intense research several molecules were tested in AUD; in most cases, despite promising preclinical data, the clinical efficacy appeared insufficient to justify futher development. A prototypical example is that of corticotropin releasing factor type 1 receptor (CRF1R) antagonists that showed significant effectiveness in animal models of AUD but were largely ineffective in humans. The present article attempts to analyze the most recent venues in the development of new medications in AUD with a focus on the most promising drug targets under current exploration. Moreover, we delineate the importance of using a more integrated translational framework approach to correlate preclinical findings and early clinical data to enhance the probability to validate biological targets of interest.
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Affiliation(s)
- Nazzareno Cannella
- School of Pharmacy, Pharmacology Unit, University of Camerino, 62032 Camerino, Italy
| | - Massimo Ubaldi
- School of Pharmacy, Pharmacology Unit, University of Camerino, 62032 Camerino, Italy
| | - Alessio Masi
- School of Pharmacy, Pharmacology Unit, University of Camerino, 62032 Camerino, Italy
| | - Massimo Bramucci
- School of Pharmacy, Pharmacology Unit, University of Camerino, 62032 Camerino, Italy
| | - Marisa Roberto
- The Scripps Research Institute, Department of Neuroscience, La Jolla, CA, USA
| | - Angelo Bifone
- Center for Neuroscience and Cognitive Systems @UniTn, Istituto Italiano di Tecnologia, Corso Bettini 31, 38068 Rovereto, Italy; Department of Molecular Biotechnology and Health Science, University of Torino, Italy
| | - Roberto Ciccocioppo
- School of Pharmacy, Pharmacology Unit, University of Camerino, 62032 Camerino, Italy.
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14
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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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15
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Lundgaard I, Wang W, Eberhardt A, Vinitsky HS, Reeves BC, Peng S, Lou N, Hussain R, Nedergaard M. Beneficial effects of low alcohol exposure, but adverse effects of high alcohol intake on glymphatic function. Sci Rep 2018; 8:2246. [PMID: 29396480 PMCID: PMC5797082 DOI: 10.1038/s41598-018-20424-y] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Accepted: 01/18/2018] [Indexed: 12/16/2022] Open
Abstract
Prolonged intake of excessive amounts of ethanol is known to have adverse effects on the central nervous system (CNS). Here we investigated the effects of acute and chronic ethanol exposure and withdrawal from chronic ethanol exposure on glymphatic function, which is a brain-wide metabolite clearance system connected to the peripheral lymphatic system. Acute and chronic exposure to 1.5 g/kg (binge level) ethanol dramatically suppressed glymphatic function in awake mice. Chronic exposure to 1.5 g/kg ethanol increased GFAP expression and induced mislocation of the astrocyte-specific water channel aquaporin 4 (AQP4), but decreased the levels of several cytokines. Surprisingly, glymphatic function increased in mice treated with 0.5 g/kg (low dose) ethanol following acute exposure, as well as after one month of chronic exposure. Low doses of chronic ethanol intake were associated with a significant decrease in GFAP expression, with little change in the cytokine profile compared with the saline group. These observations suggest that ethanol has a J-shaped effect on the glymphatic system whereby low doses of ethanol increase glymphatic function. Conversely, chronic 1.5 g/kg ethanol intake induced reactive gliosis and perturbed glymphatic function, which possibly may contribute to the higher risk of dementia observed in heavy drinkers.
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Affiliation(s)
- Iben Lundgaard
- Center for Translational Neuromedicine, Department of Neurosurgery, University of Rochester, Rochester, NY, 14642, USA.
| | - Wei Wang
- Center for Translational Neuromedicine, Department of Neurosurgery, University of Rochester, Rochester, NY, 14642, USA
| | - Allison Eberhardt
- Center for Translational Neuromedicine, Department of Neurosurgery, University of Rochester, Rochester, NY, 14642, USA
| | - Hanna Sophia Vinitsky
- Center for Translational Neuromedicine, Department of Neurosurgery, University of Rochester, Rochester, NY, 14642, USA
| | - Benjamin Cameron Reeves
- Center for Translational Neuromedicine, Department of Neurosurgery, University of Rochester, Rochester, NY, 14642, USA
| | - Sisi Peng
- Center for Translational Neuromedicine, Department of Neurosurgery, University of Rochester, Rochester, NY, 14642, USA
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Nanhong Lou
- Center for Translational Neuromedicine, Department of Neurosurgery, University of Rochester, Rochester, NY, 14642, USA
| | - Rashad Hussain
- Center for Translational Neuromedicine, Department of Neurosurgery, University of Rochester, Rochester, NY, 14642, USA
| | - Maiken Nedergaard
- Center for Translational Neuromedicine, Department of Neurosurgery, University of Rochester, Rochester, NY, 14642, USA
- Center for Basic and Translational Neuroscience, University of Copenhagen, 2200, Copenhagen, Denmark
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16
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Zhang H, Jin Y, Chan JSY, Yang FC, Cui F. Dysfunctional Early Processing of Facial Expressions in Hazardous Drinkers: Evidence from an ERP Study. Sci Rep 2017; 7:13360. [PMID: 29042636 PMCID: PMC5645385 DOI: 10.1038/s41598-017-13935-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Accepted: 10/03/2017] [Indexed: 12/16/2022] Open
Abstract
Chronic alcohol intoxication impairs multiple cognitive functions. According to the dual system model (DSM), the development of alcohol dependence (AD) involves the imbalance between the automatic-affective system and the reflective system. However, the cognitive functions of non-AD hazardous drinkers (HDs) remain unclear. The present study aimed to explore how the HDs process facial expressions differently from the healthy subjects. Sixteen HDs and seventeen control subjects (CSs) completed an emotional working memory (WM) task while the electroencephalogram (EEG) was recorded. We found that there was no significant group difference in behavioral performance between the two groups. In the ERP data, relative to the CSs, the HDs showed delayed latencies of P1 and N170. Moreover, the CSs showed significant differences between the amplitudes of neural/fear and disgust expressions while these differences were insignificant in the HDs. The current results suggest that the main deficits in the processing of facial expression in HDs existed in the early automatic-affective system instead of in the reflective system.
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Affiliation(s)
- Hui Zhang
- School of Health Management and Education, Capital Medical University, Beijing, China
| | - Yi Jin
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China
| | - John S Y Chan
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China
| | - Feng-Chi Yang
- School of Health Management and Education, Capital Medical University, Beijing, China.
| | - Fang Cui
- Shenzhen Key Laboratory of Affective and Social Cognitive Science, Shenzhen University, Shenzhen, China.
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17
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Gispert JD, Figueiras FP, Vengeliene V, Herance JR, Rojas S, Spanagel R. Changes in cerebral [ 18F]-FDG uptake induced by acute alcohol administration in a rat model of alcoholism. Behav Brain Res 2017; 327:29-33. [PMID: 28347826 DOI: 10.1016/j.bbr.2017.03.038] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Revised: 03/21/2017] [Accepted: 03/23/2017] [Indexed: 10/19/2022]
Abstract
Several [18F]-FDG positron emission tomography (PET) studies in alcoholics have consistently reported decreases in overall brain glucose metabolism at rest and following acute alcohol administration. However, changes in cerebral glucose utilization associated with the transition to addiction are not well understood and require longitudinal translational imaging studies in animal models of alcoholism. Here, we studied brain glucose uptake in alcohol drinking rats in order to provide convergent evidence to what has previously been reported in human studies. Brain glucose metabolism was measured by [18F]-FDG microPET imaging in different male Wistar rat groups: short-term drinking (three months), long-term drinking (twelve months) and alcohol-naïve. Global and regional cerebral glucose uptake was measured at rest and following acute alcohol administration. We showed that alcohol significantly reduced the whole-brain glucose metabolism. This effect was most pronounced in the parietal cortex and cerebellum. Alcohol-induced decreases in brain [18F]-FDG uptake was most apparent in alcohol-naïve rats, less intense in short-term drinkers and absent in long-term drinkers. The latter finding indicates the occurrence of tolerance to the intoxicating effects of alcohol in long-term drinking individuals. In contrast, some regions, like the ventral striatum and entorhinal cortex, showed enhanced metabolic activity, an effect that did not undergo tolerance during long-term alcohol consumption. Our findings are comparable to those described in human studies using the same methodology. We conclude that [18F]-FDG PET studies in rat models of alcoholism provide good translation and can be used for future longitudinal studies investigating alterations in brain function during different stages of the addiction cycle.
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Affiliation(s)
- Juan D Gispert
- Barcelonabeta Brain Research Center, Pasqual Maragall Foundation, Barcelona, Spain
| | - Francisca P Figueiras
- Institut d'Alta Tecnologia, Parc de Recerca Biomèdica de Barcelona (IAT- PRBB), CRC Corporació Sanitària, Barcelona, Spain
| | - Valentina Vengeliene
- Institute of Psychopharmacology, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - José R Herance
- Vall d'Hebron Research Institute (VHIR), Barcelona, Spain
| | - Santiago Rojas
- Department of Morphological Sciences, Faculty of Medicine, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Spain.
| | - Rainer Spanagel
- Institute of Psychopharmacology, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
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18
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Grynberg D, Maurage P, Nandrino JL. Preserved Affective Sharing But Impaired Decoding of Contextual Complex Emotions in Alcohol Dependence. Alcohol Clin Exp Res 2017; 41:779-785. [PMID: 28092119 DOI: 10.1111/acer.13330] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Accepted: 01/04/2017] [Indexed: 11/29/2022]
Abstract
BACKGROUND Prior research has repeatedly shown that alcohol dependence is associated with a large range of impairments in psychological processes, which could lead to interpersonal deficits. Specifically, it has been suggested that these interpersonal difficulties are underpinned by reduced recognition and sharing of others' emotional states. However, this pattern of deficits remains to be clarified. This study thus aimed to investigate whether alcohol dependence is associated with impaired abilities in decoding contextual complex emotions and with altered sharing of others' emotions. METHODS Forty-one alcohol-dependent individuals (ADI) and 37 matched healthy individuals completed the Multifaceted Empathy Test, in which they were instructed to identify complex emotional states expressed by individuals in contextual scenes and to state to what extent they shared them. RESULTS Compared to healthy individuals, ADI were impaired in identifying negative (Cohen's d = 0.75) and positive (Cohen's d = 0.46) emotional states but, conversely, presented preserved abilities in sharing others' emotional states. CONCLUSIONS This study shows that alcohol dependence is characterized by an impaired ability to decode complex emotional states (both positive and negative), despite the presence of complementary contextual cues, but by preserved emotion-sharing. Therefore, these results extend earlier data describing an impaired ability to decode noncontextualized emotions toward contextualized and ecologically valid emotional states. They also indicate that some essential emotional competences such as emotion-sharing are preserved in alcohol dependence, thereby offering potential therapeutic levers.
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Affiliation(s)
- Delphine Grynberg
- Sciences Cognitives et Sciences Affectives, CNRS, CHU Lille, UMR 9193, Université de Lille, Lille, France
| | - Pierre Maurage
- Laboratory for Experimental Psychopathology, Psychological Science Research Institute, Université catholique de Louvain, Louvain-la-Neuve, Belgium
| | - Jean-Louis Nandrino
- Sciences Cognitives et Sciences Affectives, CNRS, CHU Lille, UMR 9193, Université de Lille, Lille, France
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19
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Cabé N, Laniepce A, Ritz L, Lannuzel C, Boudehent C, Vabret F, Eustache F, Beaunieux H, Pitel AL. Troubles cognitifs dans l’alcoolodépendance : intérêt du dépistage dans l’optimisation des prises en charge. Encephale 2016; 42:74-81. [DOI: 10.1016/j.encep.2015.12.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Accepted: 12/08/2015] [Indexed: 02/08/2023]
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20
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FDG-PET Contributions to the Pathophysiology of Memory Impairment. Neuropsychol Rev 2015; 25:326-55. [PMID: 26319237 DOI: 10.1007/s11065-015-9297-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2015] [Accepted: 08/04/2015] [Indexed: 10/23/2022]
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21
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Murray DE, Durazzo TC, Mon A, Schmidt TP, Meyerhoff DJ. Brain perfusion in polysubstance users: relationship to substance and tobacco use, cognition, and self-regulation. Drug Alcohol Depend 2015; 150:120-8. [PMID: 25772434 PMCID: PMC4387082 DOI: 10.1016/j.drugalcdep.2015.02.022] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2014] [Revised: 02/17/2015] [Accepted: 02/17/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND Brain perfusion is altered in both alcohol dependence and stimulant dependence. Although most substance users also abuse/depend on alcohol concurrently (polysubstance users; PSU), rigorous perfusion research in PSU is limited. Also, the relationships of perfusion abnormalities with cognition, impulsivity, or decision making are not well known. METHODS Arterial spin labeling MRI and neuropsychological measures assessed perfusion levels and neurocognition in 20 alcohol-dependent individuals with comorbid-stimulant dependence (PSU), 26 individuals dependent on alcohol only (ALC), and 31 light/non-drinking controls (LD). The patient groups included smokers and non-smokers. RESULTS ALC had lower perfusion than LD in subcortical and cortical brain regions including the brain reward/executive oversight system (BREOS). Contrary to our hypothesis, regional perfusion was generally not lower in PSU than ALC. However, smoking PSU had lower perfusion than smoking ALC in several regions, including BREOS. Lower BREOS perfusion related to greater drinking severity in smoking substance users and to greater smoking severity in smoking ALC. Lower regional perfusion in ALC and PSU correlated with worse performance in different cognitive domains; smoking status affected perfusion-cognition relationships in ALC only. Lower BREOS perfusion in both substance using groups related to higher impulsivity. CONCLUSION Although regional perfusion was not decreased in PSU as a group, the combination of cigarette smoking and polysubstance use is strongly related to hypoperfusion in important cortical and subcortical regions. As lower perfusion relates to greater smoking severity, worse cognition and higher impulsivity, smoking cessation is warranted for treatment-seeking PSU and ALC.
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Affiliation(s)
- Donna E. Murray
- Center for Imaging of Neurodegenerative Diseases (CIND), San Francisco VA Medical Center, San Francisco, CA,Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA,Please send correspondence to: Donna E. Murray, Center for Imaging of Neurodegenerative Diseases (114M), San Francisco VA Medical Center, 4150 Clement Street (114M), San Francisco, CA 94121, USA, Office: 415-221-4810 x2553, Fax: 415-668-2864,
| | - Timothy C. Durazzo
- Center for Imaging of Neurodegenerative Diseases (CIND), San Francisco VA Medical Center, San Francisco, CA,Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA
| | - Anderson Mon
- School of Applied Sciences and Statistics, Koforidua Polytechnic, Ghana
| | - Thomas P. Schmidt
- Center for Imaging of Neurodegenerative Diseases (CIND), San Francisco VA Medical Center, San Francisco, CA,Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA
| | - Dieter J. Meyerhoff
- Center for Imaging of Neurodegenerative Diseases (CIND), San Francisco VA Medical Center, San Francisco, CA,Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA
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22
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Alcohol decreases baseline brain glucose metabolism more in heavy drinkers than controls but has no effect on stimulation-induced metabolic increases. J Neurosci 2015; 35:3248-55. [PMID: 25698759 DOI: 10.1523/jneurosci.4877-14.2015] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
During alcohol intoxication, the human brain increases metabolism of acetate and decreases metabolism of glucose as energy substrate. Here we hypothesized that chronic heavy drinking facilitates this energy substrate shift both for baseline and stimulation conditions. To test this hypothesis, we compared the effects of alcohol intoxication (0.75 g/kg alcohol vs placebo) on brain glucose metabolism during video stimulation (VS) versus when given with no stimulation (NS), in 25 heavy drinkers (HDs) and 23 healthy controls, each of whom underwent four PET-(18)FDG scans. We showed that resting whole-brain glucose metabolism (placebo-NS) was lower in HD than controls (13%, p = 0.04); that alcohol (compared with placebo) decreased metabolism more in HD (20 ± 13%) than controls (9 ± 11%, p = 0.005) and in proportion to daily alcohol consumption (r = 0.36, p = 0.01) but found that alcohol did not reduce the metabolic increases in visual cortex from VS in either group. Instead, VS reduced alcohol-induced decreases in whole-brain glucose metabolism (10 ± 12%) compared with NS in both groups (15 ± 13%, p = 0.04), consistent with stimulation-related glucose metabolism enhancement. These findings corroborate our hypothesis that heavy alcohol consumption facilitates use of alternative energy substrates (i.e., acetate) for resting activity during intoxication, which might persist through early sobriety, but indicate that glucose is still favored as energy substrate during brain stimulation. Our findings are consistent with reduced reliance on glucose as the main energy substrate for resting brain metabolism during intoxication (presumably shifting to acetate or other ketones) and a priming of this shift in HDs, which might make them vulnerable to energy deficits during withdrawal.
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23
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Lee S, Lee E, Ku J, Yoon KJ, Namkoong K, Jung YC. Disruption of orbitofronto-striatal functional connectivity underlies maladaptive persistent behaviors in alcohol-dependent patients. Psychiatry Investig 2013; 10:266-72. [PMID: 24302950 PMCID: PMC3843019 DOI: 10.4306/pi.2013.10.3.266] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2012] [Revised: 01/16/2013] [Accepted: 01/16/2013] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE Alcohol dependence is characterized by persistent alcohol-seeking despite negative consequences. Previous studies suggest that maladaptive persistent behaviors reflect alcohol-induced brain changes that cause alterations in the cortico-striatal-limbic circuit. METHODS Twenty one alcohol dependent patients and 24 age-matched healthy controls performed a decision-making task during functional MRI. We defined the medial orbitofrontal cortex (mOFC) as a region-of-interest and performed seed-based functional connectivity analysis. RESULTS Healthy controls were more flexible in adapting an alternative behavioral strategy, which correlated with stronger mOFC-dorsal striatum functional connectivity. In contrast, alcohol dependent patients persisted to the first established behavioral strategy. The mOFC-dorsal striatum functional connectivity was impaired in the alcohol-dependent patients, but increased in correlation with the duration of abstinence. CONCLUSION Our findings support that the disruption of the mOFC-striatal circuitry contribute to the maldaptive persistent behaviors in alcohol dependent patients.
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Affiliation(s)
- Seojung Lee
- Department of Psychiatry and Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Eun Lee
- Department of Psychiatry and Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jeonghun Ku
- Department of Biomedical Engineering, Keimyung University, Daegu, Republic of Korea
| | - Kang-Jun Yoon
- Department of Neurosurgery, St. Peter's Hospital, Seoul, Republic of Korea
| | - Kee Namkoong
- Department of Psychiatry and Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Young-Chul Jung
- Department of Psychiatry and Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
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24
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Ubaldi M, Bifone A, Ciccocioppo R. Translational approach to develop novel medications on alcohol addiction: focus on neuropeptides. Curr Opin Neurobiol 2013; 23:684-91. [PMID: 23648086 DOI: 10.1016/j.conb.2013.04.009] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2013] [Revised: 04/09/2013] [Accepted: 04/11/2013] [Indexed: 11/28/2022]
Abstract
Research on alcohol and drug dependence has shown that the development of addiction depends on a complex interplay of psychological factors, genetic or epigenetic predisposing factors, and neurobiological adaptations induced by drug consumption. A greater understanding of the mechanisms leading to alcohol abuse will allow researchers to identify genetic variation that corresponds to a specific biological vulnerability to addiction, thus defining robust endophenotypes that might help deconstruct these complex syndromes into more tractable components. To this end, it is critical to develop a translational framework that links alterations at the molecular level, to changes in neuronal function, and ultimately to changes at the behavioral and clinical levels. Translational phenotypes can be identified by the combination of animal and human studies designed to elucidate the neurofunctional, anatomical and pharmacological mechanisms underlying the etiology of alcohol addiction. The present article offers an overview of medication development in alcoholism with a focus on the critical aspect of translational research. Moreover, significant examples of promising targets from neuropeptidergic systems, namely nociceptin/orphanin FQ and neuropeptide S are given.
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Affiliation(s)
- Massimo Ubaldi
- School of Pharmacy, Pharmacology Unit, University of Camerino, 62032, Camerino, Italy
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25
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Shumway ST, Bradshaw SD, Harris KS, Baker AK. Important Factors of Early Addiction Recovery and Inpatient Treatment. ALCOHOLISM TREATMENT QUARTERLY 2013. [DOI: 10.1080/07347324.2013.747313] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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26
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Gozzi A, Agosta F, Massi M, Ciccocioppo R, Bifone A. Reduced limbic metabolism and fronto-cortical volume in rats vulnerable to alcohol addiction. Neuroimage 2012; 69:112-9. [PMID: 23261637 DOI: 10.1016/j.neuroimage.2012.12.015] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2012] [Revised: 12/07/2012] [Accepted: 12/10/2012] [Indexed: 11/25/2022] Open
Abstract
Alcohol abuse is associated with long-term reductions in fronto-cortical volume and limbic metabolism. However, an unanswered question in alcohol research is whether these alterations are the sole consequence of chronic alcohol use, or contain heritable contributions reflecting biological propensity toward ethanol addiction. Animal models of genetic predisposition to alcohol dependence can be used to investigate the role of inborn brain abnormalities in the aetiology of alcoholism. Here we used magnetic resonance imaging (MRI) in the Marchigian-Sardinian (msP) alcohol-preferring rats to assess the presence of inherited structural or functional brain alterations. Alcohol-naïve msP (N=22) and control rats (N=26) were subjected to basal cerebral blood volume (bCBV) mapping followed by voxel-based morphometry (VBM) of grey matter and tract-based spatial statistics mapping of white matter fractional anisotropy. msP rats exhibited significantly reduced bCBV, an established marker of resting brain function, in focal cortico-limbic and thalamic areas, together with reduced grey matter volume in the thalamus, ventral tegmental area, insular and cingulate cortex. No statistically significant differences in fractional anisotropy were observed between groups. These findings highlight the presence of inborn grey matter and metabolic abnormalities in alcohol-naïve msP rats, the localization and sign of which are remarkably similar to those mapped in abstinent alcoholics and subjects at high risk for alcohol dependence. Collectively, these results point for a significant role of heritable neurofunctional brain alterations in biological propensity toward ethanol addiction, and support the translational use of advanced imaging methods to describe the circuital determinants of vulnerability to drug addiction.
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Affiliation(s)
- Alessandro Gozzi
- Istituto Italiano di Tecnologia, Center for Nanotechnology Innovation, Pisa, & Center for Neuroscience and Cognitive Systems at UniTn, Rovereto, Italy.
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27
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Adinoff B, Braud J, Devous MD, Harris TS. Caudolateral orbitofrontal regional cerebral blood flow is decreased in abstinent cocaine-addicted subjects in two separate cohorts. Addict Biol 2012; 17:1001-12. [PMID: 22129494 DOI: 10.1111/j.1369-1600.2011.00414.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The orbitofrontal cortex (OFC) is crucial for the inhibition of extraneous stimuli, evaluation of aversive information and emotional regulation-all behaviors impaired in cocaine addiction. Previous studies suggest that cocaine-addicted subjects have decreased basal activity in the OFC. In this study, we examined regional cerebral blood flow (rCBF) during a saline infusion in two independent populations of abstinent cocaine- (and mostly nicotine-) addicted (n=33 and 26) and healthy control (n=35 and 20) men and women. Isolated rCBF decreases (P<0.001) were observed in the left caudolateral OFC, as well as left superior temporal cortex, in cocaine-addicted subjects relative to controls in both cohorts and bilaterally in the combined cohort. An anatomically defined region of the caudolateral OFC showed similar findings and were evident in both male and female addicted subjects. The reliability of these findings across two cohorts reveals a functional disruption in the lateral OFC, a brain region implicated in the evaluation of behavior-terminating stimuli. This may contribute to an addicted individual's persistent drug use despite negative consequences.
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Affiliation(s)
- Bryon Adinoff
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX 75390-8564, USA.
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28
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Infralimbic and dorsal raphé microinjection of the 5-HT(1B) receptor agonist CP-93,129: attenuation of aggressive behavior in CFW male mice. Psychopharmacology (Berl) 2012; 222:117-28. [PMID: 22222863 PMCID: PMC3707119 DOI: 10.1007/s00213-011-2629-1] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2011] [Accepted: 12/18/2011] [Indexed: 12/26/2022]
Abstract
RATIONALE Aggressive behavior and impaired impulse control have been associated with dysregulations in the serotonergic system and with impaired functioning of the prefrontal cortex. 5-HT(1B) receptors have been shown to specifically modulate several types of offensive aggression. OBJECTIVE This study aims to characterize the relative importance of two populations of 5-HT(1B) receptors in the dorsal raphé nucleus (DRN) and infralimbic cortex (ILC) in the modulation of aggressive behavior. METHODS Male CFW mice were conditioned on a fixed-ratio 5 schedule of reinforcement to self-administer a 6% (w/v) alcohol solution. Mice repeatedly engaged in 5-min aggressive confrontations until aggressive behavior stabilized. Next, a cannula was implanted into either the DRN or the ILC. After recovery, mice were tested for aggression after self-administration of either 1.0 g/kg alcohol or water prior to a microinjection of the 5-HT(1B) agonist, CP-93,129 (0-1.0 μg/infusion). RESULTS In both the DRN and ILC, CP-93,129 reduced aggressive behaviors after both water and alcohol self-administration. Intra-raphé CP-93,129 dose-dependently reduced both aggressive and locomotor behaviors. However, the anti-aggressive effects of intra-cortical CP-93,129 were behaviorally specific. CONCLUSIONS These findings highlight the importance of the serotonergic system in the modulation of aggression and suggest that the behaviorally specific effects of 5-HT(1B) receptor agonists are regionally selective. 5-HT(1B) receptors in a medial subregion of the prefrontal cortex, the ILC, appear to be critically involved in the attenuation of species-typical levels of aggression.
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Perez-Rodriguez MM, Hazlett EA, Rich EL, Ripoll LH, Weiner DM, Spence N, Goodman M, Koenigsberg HW, Siever LJ, New AS. Striatal activity in borderline personality disorder with comorbid intermittent explosive disorder: sex differences. J Psychiatr Res 2012; 46:797-804. [PMID: 22464337 PMCID: PMC3645307 DOI: 10.1016/j.jpsychires.2012.02.014] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2011] [Revised: 02/17/2012] [Accepted: 02/23/2012] [Indexed: 11/20/2022]
Abstract
Borderline Personality Disorder (BPD) is associated with behavioral and emotional dysregulation, particularly in social contexts; however, the underlying pathophysiology at the level of brain function is not well understood. Previous studies found abnormalities in frontal cortical and limbic areas suggestive of poor frontal regulation of downstream brain regions. However, the striatum, which is closely connected with the medial frontal cortices and plays an important role in motivated behaviors and processing of rewarding stimuli, has been understudied in BPD. Here we hypothesized that, in addition to frontal dysfunction, BPD patients may show abnormal striatal function. In this study, 38 BPD patients with intermittent explosive disorder (BPD-IED) and 36 healthy controls (HC) participated in the Point Subtraction Aggression Paradigm (PSAP), a computer game played with a fictitious other player. (18)Fluoro-deoxyglucose positron emission tomography (FDG-PET) measured relative glucose metabolism (rGMR) within caudate and putamen in response to aggression-provoking and non-provoking versions of the PSAP. Male BPD-IED patients had significantly lower striatal rGMR than all other groups during both conditions, although male and female BPD-IED patients did not differ in clinical or behavioral measures. These sex differences suggest differential involvement of frontal-striatal circuits in BPD-IED, and are discussed in relation to striatal involvement in affective learning and social decision-making.
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Affiliation(s)
- M. Mercedes Perez-Rodriguez
- Department of Psychiatry, Mount Sinai School of Medicine, New York, NY, USA
- Mental Illness Research, Education and Clinical Center, James J. Peters Veterans Affairs Medical Center, Bronx, NY, USA
| | - Erin A. Hazlett
- Department of Psychiatry, Mount Sinai School of Medicine, New York, NY, USA
- Mental Illness Research, Education and Clinical Center, James J. Peters Veterans Affairs Medical Center, Bronx, NY, USA
| | - Erin L. Rich
- Department of Psychiatry, Mount Sinai School of Medicine, New York, NY, USA
- Helen Wills Neuroscience Institute, University of California Berkeley, Berkeley, CA
| | - Luis H. Ripoll
- Department of Psychiatry, Mount Sinai School of Medicine, New York, NY, USA
- Mental Illness Research, Education and Clinical Center, James J. Peters Veterans Affairs Medical Center, Bronx, NY, USA
| | - Daniel M. Weiner
- Department of Psychiatry, Mount Sinai School of Medicine, New York, NY, USA
| | - Nicole Spence
- Department of Psychiatry, Mount Sinai School of Medicine, New York, NY, USA
| | - Marianne Goodman
- Department of Psychiatry, Mount Sinai School of Medicine, New York, NY, USA
- Mental Illness Research, Education and Clinical Center, James J. Peters Veterans Affairs Medical Center, Bronx, NY, USA
| | - Harold W. Koenigsberg
- Department of Psychiatry, Mount Sinai School of Medicine, New York, NY, USA
- Mental Illness Research, Education and Clinical Center, James J. Peters Veterans Affairs Medical Center, Bronx, NY, USA
| | - Larry J. Siever
- Department of Psychiatry, Mount Sinai School of Medicine, New York, NY, USA
- Mental Illness Research, Education and Clinical Center, James J. Peters Veterans Affairs Medical Center, Bronx, NY, USA
| | - Antonia S. New
- Department of Psychiatry, Mount Sinai School of Medicine, New York, NY, USA
- Mental Illness Research, Education and Clinical Center, James J. Peters Veterans Affairs Medical Center, Bronx, NY, USA
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Jordaan GP, Warwick JM, Nel DG, Hewlett R, Emsley R. Alcohol-induced psychotic disorder: brain perfusion and psychopathology--before and after anti-psychotic treatment. Metab Brain Dis 2012; 27:67-77. [PMID: 22147223 DOI: 10.1007/s11011-011-9273-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2011] [Accepted: 11/22/2011] [Indexed: 11/24/2022]
Abstract
Alcohol-induced psychotic disorder (AIPD) also known as alcohol hallucinosis is a rare complication of alcohol abuse. The pathogenesis and treatment of AIPD are still unclear. Few prospective treatment studies are available but case reports generally suggest that anti-psychotic treatment is effective. Brain imaging changes in relation to treatment response have also not been studied except for case reports. The aim of this study was to investigate the effect of anti-psychotic treatment on psychopathology and regional cerebral blood flow (rCBF) in patients with AIPD before and after 6 weeks of treatment. Nineteen patients with AIPD were assessed by the Positive and Negative Syndrome Scale (PANSS) and single photon emission computed tomography (SPECT) before and after 6-weeks of open-label treatment with a fixed dose of haloperidol (5 mg/day). Highly significant improvements were noted on the positive, general and total scores of the PANSS. Post-treatment increased rCBF to the left caudate and left frontal lobe was noted. Changes in frontal, temporal, parietal, occipital, thalamic and cerebellar rCBF showed significant negative correlations with the degree of symptom improvement, suggesting dysfunction of these areas in AIPD. Psychopathological and rCBF findings suggest reversible generalised cerebral dysfunction in AIPD.
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Affiliation(s)
- Gerhard P Jordaan
- Department of Psychiatry, Faculty of Health Sciences, University of Stellenbosch, P.O. Box 19063, Tygerberg 7505, Cape Town, South Africa.
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Changes in Affect and Drinking Outcomes in a Pharmacobehavioral Trial for Alcohol Dependence. ADDICTIVE DISORDERS & THEIR TREATMENT 2012; 11:14-25. [PMID: 22368517 DOI: 10.1097/adt.0b013e31821e1072] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE: Despite extensive research exploring affect in alcohol dependent individuals in recovery, empirical research on affective changes over the course of psychosocial treatment and their role on drinking outcomes has been minimal. The present study examined the relationship between changes in positive affect (PA), negative affect (NA), and drinking outcomes during a pharmacobehavioral trial. METHOD: Data for these post-hoc exploratory analyses were derived from a clinical trial of 321 alcohol dependent male and female individuals. The study design had four treatment arms for medication: three levels of dose of ondansetron as well as a control condition (placebo). All participants received weekly cognitive behavioral therapy for twelve weeks. We conducted an exploratory evaluation of changes in negative and positive affect and drinking behavior over time during the treatment phase of the trial using multilevel modeling. RESULTS: Participants experienced substantial reductions in drinking, decreases in NA, and increases in PA over the course of treatment. Individuals who experienced increases in PA over the course of treatment significantly reduced their drinking in subsequent weeks, while those who had reductions in NA only experienced reductions in drinking later in treatment if they also reported increases in PA. These results support the role of affect regulation in treatment. CONCLUSIONS: These results suggest that affective change during the course of treatment may serve as one potential mechanism of action for changes in drinking behavior. The interaction between reductions in NA and increases in PA may be particularly important in promoting new coping skills and reducing drinking.
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Rominger A, Cumming P, Xiong G, Koller G, Böning G, Wulff M, Zwergal A, Förster S, Reilhac A, Munk O, Soyka M, Wängler B, Bartenstein P, la Fougère C, Pogarell O. [18F]Fallypride PET measurement of striatal and extrastriatal dopamine D 2/3 receptor availability in recently abstinent alcoholics. Addict Biol 2012; 17:490-503. [PMID: 22023291 DOI: 10.1111/j.1369-1600.2011.00355.x] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Positron emission tomography (PET) shows reduced binding of the dopamine D(2/3) antagonist [(11) C]raclopride in striatum of withdrawn psychostimulant abusers, but not consistently in patients with alcohol dependence (AD). We make first use of the high affinity ligand [(18) F]fallypride to obtain serial measures of D(2/3) receptor availability in striatal and extrastriatal regions of AD patients undergoing detoxification. Seventeen patients (mean age 44 ± 5y) with AD and 14 age-matched healthy volunteers participated. Each patient underwent [(18) F]fallypride PET upon hospital admission, and again 1-2 weeks later; two patients achieving abstinence, and two with substantial harm reduction had additional PET follow-up at 1 year. Dynamic 180-minute PET recordings were used for volume of interest (VOI)-based and voxel-wise analysis of [(18) F]fallypride binding potential (BP(ND) ). Mean baseline BP(ND) in striatum of the AD patients (15.7 ± 3.6) was unaltered during short-term follow-up, and did not differ from that in healthy controls (16.8 ± 3.0); however, BP(ND) was 10-20% lower in thalamus, hippocampus, and insular and temporal cortex of the AD patients (P < 0.05). Age-dependent declines in BP(ND) were very small in controls, but more pronounced and widespread in the AD group. Striatal and thalamic BP(ND) increased by 30% in four patients with long-term abstinence or reduced alcohol consumption. VOI-based [(18) F]fallypride PET analyses revealed group differences in D(2/3) receptor availability primarily in extra-striatal regions. Age-related loss of dopamine D(2/3) receptors was more pronounced in AD patients. Receptor availability was unaltered by acute withdrawal, but increased in the subgroup of patients with long-term follow-up, suggesting reversibility of receptor changes.
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Affiliation(s)
- Axel Rominger
- Department of Nuclear Medicine, Ludwig-Maximilians-University of Munich, Germany.
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Parvaz MA, Alia-Klein N, Woicik PA, Volkow ND, Goldstein RZ. Neuroimaging for drug addiction and related behaviors. Rev Neurosci 2011; 22:609-24. [PMID: 22117165 PMCID: PMC3462350 DOI: 10.1515/rns.2011.055] [Citation(s) in RCA: 101] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
In this review, we highlight the role of neuroimaging techniques in studying the emotional and cognitive-behavioral components of the addiction syndrome by focusing on the neural substrates subserving them. The phenomenology of drug addiction can be characterized by a recurrent pattern of subjective experiences that includes drug intoxication, craving, bingeing, and withdrawal with the cycle culminating in a persistent preoccupation with obtaining, consuming, and recovering from the drug. In the past two decades, imaging studies of drug addiction have demonstrated deficits in brain circuits related to reward and impulsivity. The current review focuses on studies employing positron emission tomography (PET), functional magnetic resonance imaging (fMRI), and electroencephalography (EEG) to investigate these behaviors in drug-addicted human populations. We begin with a brief account of drug addiction followed by a technical account of each of these imaging modalities. We then discuss how these techniques have uniquely contributed to a deeper understanding of addictive behaviors.
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Affiliation(s)
- Muhammad A. Parvaz
- Medical Department, Brookhaven National Laboratory, 30 Bell Ave., Bldg. 490, Upton, NY 11973-5000, USA
| | - Nelly Alia-Klein
- Medical Department, Brookhaven National Laboratory, 30 Bell Ave., Bldg. 490, Upton, NY 11973-5000, USA
| | - Patricia A. Woicik
- Medical Department, Brookhaven National Laboratory, 30 Bell Ave., Bldg. 490, Upton, NY 11973-5000, USA
| | - Nora D. Volkow
- National Institute of Drug Abuse, Bethesda, MD 20892, USA
| | - Rita Z. Goldstein
- Medical Department, Brookhaven National Laboratory, 30 Bell Ave., Bldg. 490, Upton, NY 11973-5000, USA
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Newberg AB, Moss AS, Monti DA, Alavi A. Positron emission tomography in psychiatric disorders. Ann N Y Acad Sci 2011; 1228:E13-25. [DOI: 10.1111/j.1749-6632.2011.06162.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Kiluk BD, Nich C, Carroll KM. Neurocognitive indicators predict results of an informed-consent quiz among substance-dependent treatment seekers entering a randomized clinical trial. J Stud Alcohol Drugs 2011; 71:704-12. [PMID: 20731975 DOI: 10.15288/jsad.2010.71.704] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE This study sought to determine the extent to which key aspects of a clinical trial's protocol were recalled by participants entering a clinical trial for alcohol and illicit substance-use treatment after standard informed-consent procedures, as well as to explore the possible relationships between recall, neuropsychological functioning, and substance-use outcomes. METHOD Before entering a randomized clinical trial testing the effectiveness of a computer-based training version of cognitive-behavioral therapy, 76 participants (55% male) meeting criteria for current substance dependence (according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition) completed a 14-item true/false quiz that assessed their comprehension of basic information provided in the consent form. RESULTS Only 15% of participants correctly answered all 14 consent quiz items. The percentage of correct recall was associated with measures of intelligence (r= .29, p = .01) and attention (r = -.26, p = .04). Quiz scores were also moderately associated with the amount of substance use during the treatment period (r = -.26, p = .03). CONCLUSIONS These findings highlight the importance of formally evaluating research participants' understanding of the informed-consent process, and they call to attention the potential utility of a brief neuropsychological screening to identify individuals in need of enhanced consent procedures, particularly within vulnerable populations, such as substance users.
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Affiliation(s)
- Brian D Kiluk
- Department of Psychiatry, Division of Substance Abuse, Yale University School of Medicine, 950 Campbell Avenue, 151D, West Haven, Connecticut 06516, USA.
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Lyvers M, Tobias-Webb J. Effects of acute alcohol consumption on executive cognitive functioning in naturalistic settings. Addict Behav 2010; 35:1021-8. [PMID: 20655148 DOI: 10.1016/j.addbeh.2010.06.022] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2010] [Revised: 06/14/2010] [Accepted: 06/27/2010] [Indexed: 10/19/2022]
Abstract
Laboratory studies have demonstrated that acute alcohol intoxication can disrupt performance on neuropsychological tests of executive cognitive functioning such as the Wisconsin Card Sorting Test (WCST). However, the generalizability of such findings to typical self-regulated alcohol intake in social settings can be questioned. In the present study, 86 young adults were recruited at Australian bars to perform a computer version of the WCST. Participants displayed blood alcohol concentrations (BACs) across a range from 0 to 0.15%. Although self-report measures of typical alcohol consumption, impulsivity, and frontal lobe related everyday functioning were all intercorrelated in line with other recent findings, multiple regression indicated that these measures did not predict perseverative errors (PE) nor non-perseverative errors (NPE) on the WCST, whereas BAC uniquely predicted PE but not NPE. The results were consistent with a dose-dependent selective disruption of prefrontal cortical functioning by alcohol. There were no differences in performance between participants tested on the ascending limb of the BAC curve and those tested on the descending limb. Alcohol-associated perseveration may reflect the inhibitory effect of alcohol-induced dopamine release in the prefrontal cortex.
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Guillot CR, Fanning JR, Bullock JS, McCloskey MS, Berman ME. Effects of alcohol on tests of executive functioning in men and women: a dose response examination. Exp Clin Psychopharmacol 2010; 18:409-17. [PMID: 20939644 PMCID: PMC3968820 DOI: 10.1037/a0021053] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Alcohol has been shown to affect performance on tasks associated with executive functioning. However, studies in this area have generally been limited to a single dose or gender or have used small sample sizes. The purpose of this study was to provide a more nuanced and systematic examination of alcohol's effects on commonly used tests of executive functioning at multiple dosages in both men and women. Research volunteers (91 women and 94 men) were randomly assigned to one of four drink conditions (alcohol doses associated with target blood alcohol concentrations of .000%, .050%, .075%, and .100%). Participants then completed three tasks comprising two domains of executive functioning: two set shifting tasks, the Trail Making Test and a computerized version of the Wisconsin Card Sorting Task, and a response inhibition task, the GoStop Impulsivity Paradigm. Impaired performance on set shifting tasks was found at the .100% and .075% dosages, but alcohol intoxication did not impair performance on the GoStop. No gender effects emerged. Thus, alcohol negatively affects set shifting at moderately high levels of intoxication in both men and women, likely attributable to alcohol's interference with prefrontal cortex function. Although it is well established that alcohol negatively affects response inhibition as measured by auditory stop-signal tasks, alcohol does not appear to exert a negative effect on response inhibition as measured by the GoStop, a visual stop-signal task.
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Affiliation(s)
- Casey R. Guillot
- Department of Psychology, The University of Southern Mississippi, 118 College Drive #5025, Hattiesburg, MS 39406
| | - Jennifer R. Fanning
- Department of Psychology, The University of Southern Mississippi, 118 College Drive #5025, Hattiesburg, MS 39406
| | - Joshua S. Bullock
- Department of Psychology, The University of Southern Mississippi, 118 College Drive #5025, Hattiesburg, MS 39406
| | - Michael S. McCloskey
- The Department of Psychology, Weiss Hall, Temple University, 1701 North 13th Street, Philadelphia, PA 19122-6085
| | - Mitchell E. Berman
- Corresponding author. Department of Psychology, The University of Southern Mississippi, 118 College Drive #5025, Hattiesburg, MS 39406, Tel.: +1-601-266-4570; fax: +1-601-266-5580.
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Jordaan GP, Warwick JM, Hewlett R, Emsley R. Resting brain perfusion in alcohol-induced psychotic disorder: a comparison in patients with alcohol dependence, schizophrenia and healthy controls. Prog Neuropsychopharmacol Biol Psychiatry 2010; 34:479-85. [PMID: 20122978 DOI: 10.1016/j.pnpbp.2010.01.018] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2009] [Revised: 01/25/2010] [Accepted: 01/25/2010] [Indexed: 10/19/2022]
Abstract
INTRODUCTION Alcohol-induced psychotic disorder (AIPD), also known as alcohol hallucinosis, is a rare complication of alcohol abuse. The underlying pathophysiology is poorly understood, and the disorder needs to be differentiated from alcohol withdrawal delirium and schizophrenia. No brain-imaging studies in AIPD have been reported to date. Case reports of brain imaging in AIPD suggest possible dysfunction in the thalamus, basal ganglia, frontal lobes and cerebellum. Our aim was to prospectively compare resting brain perfusion (rCBF) in patients with AIPD, uncomplicated alcohol dependence, schizophrenia and healthy volunteers. METHODS Single photon emission computed tomography (SPECT) was utilized to compare rCBF in patients with AIPD (n=19), schizophrenia (n=16), uncomplicated alcohol dependence (n=20) and healthy volunteers (n=19). RESULTS Increased rCBF was demonstrated in the right calcarine area in patients with AIPD compared to healthy volunteers, with a trend towards increased rCBF to the frontal and temporal lobes and the right pallidum. Decreased left sided rCBF to the putamen, parietal, mid-frontal and mid-temporal lobes and heterogenous flow to the cerebellum were demonstrated in patients with AIPD when compared to patients with uncomplicated alcohol dependence. The left posterior cingulate and right cerebellum showed higher and lower rCBF respectively in patients with AIPD compared to patients with schizophrenia. CONCLUSION Our findings implicate the right occipital lobe and possibly the cerebellum in the pathogenesis of AIPD and have similarities with those previously reported in alcohol withdrawal. Reduced rCBF to the frontal lobes, thalamus and basal ganglia in AIPD as suggested in previous case reports could not be confirmed.
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Affiliation(s)
- G P Jordaan
- Department of Psychiatry, Faculty of Health Sciences, University of Stellenbosch, Cape Town, South Africa.
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Abstract
The prefrontal cortex occupies the anterior portion of the frontal lobes and is thought to be one of the most complex anatomical and functional structures of the mammalian brain. Its major role is to integrate and interpret inputs from cortical and sub-cortical structures and use this information to develop purposeful responses that reflect both present and future circumstances. This includes both action-oriented sequences involved in obtaining rewards and inhibition of behaviors that pose undue risk or harm to the individual. Given the central role in initiating and regulating these often complex cognitive and behavioral responses, it is no surprise that alcohol has profound effects on the function of the prefrontal cortex. In this chapter, we review the basic anatomy and physiology of the prefrontal cortex and discuss what is known about the actions of alcohol on the function of this brain region. This includes a review of both the human and animal literature including information on the electrophysiological and behavioral effects that follow acute and chronic exposure to alcohol. The chapter concludes with a discussion of unanswered questions and areas needing further investigation.
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Tikkanen R, Sjöberg RL, Ducci F, Goldman D, Holi M, Tiihonen J, Virkkunen M. Effects of MAOA-genotype, alcohol consumption, and aging on violent behavior. Alcohol Clin Exp Res 2009; 33:428-34. [PMID: 19120058 PMCID: PMC2768292 DOI: 10.1111/j.1530-0277.2008.00853.x] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Environmental factors appear to interact with a functional polymorphism (MAOA-LPR) in the promoter region of the monoamine oxidase A gene (MAOA) in determining some forms of antisocial behavior. However, how MAOA-LPR modulates the effects of other factors such as alcohol consumption related to antisocial behavior is not completely understood. METHODS This study examines the conjunct effect of MAOA-LPR, alcohol consumption, and aging on the risk for violent behavior. Recidivism in severe impulsive violent behavior was assessed after 7 to 15 years in a sample of 174 Finnish alcoholic offenders, the majority of whom exhibited antisocial or borderline personality disorder or both, and featured impulsive temperament traits. RESULTS The risk for committing new acts of violence increased by 2.3% for each kilogram of increase in yearly mean alcohol consumption (p = 0.004) and decreased by 7.3% for every year among offenders carrying the high activity MAOA genotype. In contrast, alcohol consumption and aging failed to affect violent behavior in the low activity MAOA genotyped offenders. MAOA-LPR showed no main effect on the risk for recidivistic violence. CONCLUSIONS Violent offenders carrying the high activity MAOA genotype differ in several ways from carriers with the low activity MAOA risk allele previously associated with antisocial behavior. Finnish high activity MAOA genotyped risk alcoholics exhibiting antisocial behavior, high alcohol consumption, and abnormal alcohol-related impulsive and uncontrolled violence might represent an etiologically distinct alcohol dependence subtype.
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Affiliation(s)
- Roope Tikkanen
- Institute of Clinical Medicine, Department of Psychiatry, University of Helsinki, Helsinki, Finland.
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Profound decreases in dopamine release in striatum in detoxified alcoholics: possible orbitofrontal involvement. J Neurosci 2007; 27:12700-6. [PMID: 18003850 DOI: 10.1523/jneurosci.3371-07.2007] [Citation(s) in RCA: 323] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
The value of rewards (natural rewards and drugs) is associated with dopamine increases in the nucleus accumbens and varies as a function of context. The prefrontal cortex has been implicated in the context dependency of rewards and in the fixated high value that drugs have in addiction, although the mechanisms are not properly understood. Here we test the hypothesis that the prefrontal cortex regulates the value of rewards by modulating dopamine increases in nucleus accumbens and that this regulation is disrupted in addicted subjects. We used positron emission tomography to evaluate the activity of the prefrontal cortex (measuring brain glucose metabolism with [18F]fluorodeoxyglucose) and dopamine increases (measured with [11C]raclopride, a D2/D3 receptor ligand with binding that is sensitive to endogenous dopamine) induced by the stimulant drug methylphenidate in 20 controls and 20 detoxified alcoholics, most of whom smoked. In all subjects, methylphenidate significantly increased dopamine in striatum. In ventral striatum (where the nucleus accumbens is located) and in putamen, dopamine increases were associated with the rewarding effects of methylphenidate (drug liking and high) and were profoundly attenuated in alcoholics (70 and 50% lower than controls, respectively). In controls, but not in alcoholics, metabolism in orbitofrontal cortex (region involved with salience attribution) was negatively associated with methylphenidate-induced dopamine increases in ventral striatum. These results are consistent with the hypothesis that the orbitofrontal cortex modulates the value of rewards by regulating the magnitude of dopamine increases in the ventral striatum and that disruption of this regulation may underlie the decreased sensitivity to rewards in addicted subjects.
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Yücel M, Lubman DI, Solowij N, Brewer WJ. Understanding drug addiction: a neuropsychological perspective. Aust N Z J Psychiatry 2007; 41:957-68. [PMID: 17999268 DOI: 10.1080/00048670701689444] [Citation(s) in RCA: 116] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The purpose of the present review is to describe the neuropsychological correlates of long-term substance abuse and to discuss the findings within the context of premorbid vulnerabilities, comorbidity and adolescent neurodevelopment. The authors critically review key findings from the neuropsychological literature related to the long-term sequelae of alcohol, cannabis, inhalant, opiates, psychostimulants and ecstasy use. Leading electronic databases such as PubMed were searched to identify relevant studies published in the past 20 years. References identified from bibliographies of pertinent articles and books in the field were also collected and selectively reviewed. Across substances, individuals with long-term abuse consistently demonstrate neuropsychological impairments of executive (inhibitory) control, working memory and decision making, together with neurobiological abnormalities involving frontotemporal and basal ganglia circuits. In some instances these deficits are dose dependent, implying that they are a direct consequence of prolonged drug exposure. However, comorbid behavioural, personality and mental health problems are common among drug-using populations and are associated with similar neuropsychological deficits. Presented herein is a neuropsychological model of addictive behaviour that highlights the complex interplay between cognition, brain maturation, psychopathology and drug exposure.
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Affiliation(s)
- Murat Yücel
- ORYGEN Research Centre, Department of Psychiatry, University of Melbourne, Melbourne, Victoria, Australia.
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Akine Y, Kato M, Muramatsu T, Umeda S, Mimura M, Asai Y, Tanada S, Obata T, Ikehira H, Kashima H, Suhara T. Altered brain activation by a false recognition task in young abstinent patients with alcohol dependence. Alcohol Clin Exp Res 2007; 31:1589-97. [PMID: 17624993 DOI: 10.1111/j.1530-0277.2007.00453.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Heavy alcohol intake induces both structural and functional changes in the central nervous system. Recent research developments converged on the idea that even in patients with alcohol dependence without apparent structural brain changes, some cognitive impairment exists, and associated functional change could be visualized by neuroimaging techniques. However, these data were from old (more than 50 years) patients using working memory and response inhibition tasks. Whether young abstinent patients show aberrant signs of brain activation is a matter of interest, specifically by the long-term memory retrieval task. METHODS Subjects were 9 young patients with alcohol dependence with long-term abstinent (8 males and 1 female) and age- and education-matched 9 healthy controls (7 males and 2 females). We used a modified false recognition task in a functional MRI study. RESULTS The young patients with alcohol dependence showed reduced activation in the right dorsolateral prefrontal cortex, anterior cingulate cortex (ACC), left pulvinar in the thalamus, and in the right ventral striatum, although behavioral performances and regional patterns of brain activation were similar between patients and controls. CONCLUSIONS Long-term memory retrieval induced altered activations in prefrontal lobes, ACC, thalamus, and ventral striatum in young patients with alcohol dependence. These findings were correspondent to deficits of goal directed behavior, monitoring the erroneous responses, memory function, and drug-seeking behavior. Furthermore, these reduced activations can be considered as latent "lesions," suggesting subclinical pathology in alcoholic brains.
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Affiliation(s)
- Yoshihide Akine
- Department of Molecular Neuroimaging, Molecular Imaging Center, National Institute of Radiological Sciences, Chiba, Japan
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Hildebrandt H, Brokate B, Hoffmann E, Kröger B, Eling P. Conditional Responding is Impaired in Chronic Alcoholics. J Clin Exp Neuropsychol 2007; 28:631-45. [PMID: 16723313 DOI: 10.1080/13803390590949520] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Bechara (2003) describes a model for disturbances in executive functions related to addiction. This model involves deficits in decision-making and in suppressing pre-potent representations or response patterns. We tested this model in 29 individuals with long-term heavy alcohol dependency and compared their performance with that of 20 control subjects. Only individuals without memory impairment, with normal intelligence and normal visual response times were included. We examined word fluency, object alternation, spatial stimulus-response incompatibility, extra-dimensional shift learning and decision-making using the Gambling task. We subtracted the performance in a control condition from that of the executive condition, in order to focus specifically on the executive component of each task. Only the object alternation and incompatibility tasks revealed significant differences between the group of alcoholics and the control group. Moreover, response times in the object alternation task correlated with duration of alcohol dependency. The results do not argue in favor of a specific deficit in decision-making or in shifting between relevant representations. We conclude that long-term alcohol abuse leads to an impairment in conditional responding, provided the response depends on former reactions or the inhibition of pre-potent response patterns.
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Camp MC, Mayfield RD, McCracken M, McCracken L, Alcantara AA. Neuroadaptations of Cdk5 in cholinergic interneurons of the nucleus accumbens and prefrontal cortex of inbred alcohol-preferring rats following voluntary alcohol drinking. Alcohol Clin Exp Res 2006; 30:1322-35. [PMID: 16899035 DOI: 10.1111/j.1530-0277.2006.00160.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Neurobiological studies have identified brain areas and related molecular mechanisms involved in alcohol abuse and dependence. Specific cell types in these brain areas and their role in alcohol-related behaviors, however, have not yet been identified. This study examined the involvement of cholinergic cells in inbred alcohol-preferring rats following 1 month of alcohol drinking. Cyclin-dependent kinase 5 (Cdk5) immunoreactivity (IR), a marker of neuronal plasticity, was examined in cholinergic neurons of the nucleus accumbens (NuAcc) and prefrontal cortex (PFC) and other brain areas implicated in alcohol drinking, using dual immunocytochemical (ICC) procedures. Single Cdk5 IR was also examined in several brain areas implicated in alcohol drinking. METHODS The experimental group self-administered alcohol using a 2-bottle-choice test paradigm with unlimited access to 10% (v/v) alcohol and water for 23 h/d for 1 month. An average of 6 g/kg alcohol was consumed daily. Control animals received identical treatment, except that both bottles contained water. Rats were perfused and brain sections were processed for ICC procedures. RESULTS Alcohol drinking resulted in a 51% increase in Cdk5 IR cholinergic interneurons in the shell NuAcc, while in the PFC there was a 51% decrease in the percent of Cdk5 IR cholinergic interneurons in the infralimbic region and a 46% decrease in Cdk5 IR cholinergic interneurons in the prelimbic region. Additionally, single Cdk5 IR revealed a 42% increase in the central nucleus of the amygdala (CNA). CONCLUSIONS This study identified Cdk5 neuroadaptation in cholinergic interneurons of the NuAcc and PFC and in other neurons of the CNA following 1 month of alcohol drinking. These findings contribute to our understanding of the cellular and molecular basis of alcohol drinking and toward the development of improved region and cell-specific pharmacotherapeutic and behavioral treatment programs for alcohol abuse and alcoholism.
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Gazdzinski S, Durazzo T, Jahng GH, Ezekiel F, Banys P, Meyerhoff D. Effects of chronic alcohol dependence and chronic cigarette smoking on cerebral perfusion: a preliminary magnetic resonance study. Alcohol Clin Exp Res 2006; 30:947-58. [PMID: 16737452 PMCID: PMC2533315 DOI: 10.1111/j.1530-0277.2006.00108.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Although approximately 80% of individuals with alcohol use disorders are chronic smokers and despite reported associations between chronic cigarette smoking and lower cerebral perfusion in nonalcoholics, previous brain perfusion studies with alcoholics did not account for the potential effects of concurrent chronic cigarette smoking. METHODS One-week-abstinent alcohol-dependent individuals in treatment (ALC) [19 smokers (sALC) and 10 nonsmokers (nsALC)] and 19 healthy light drinking, nonsmoking control participants (nsLD) were scanned with a pulsed arterial spin labeling method to measure cerebral perfusion without an exogenous contrast agent. Studies were performed with 2 different postlabeling delay times (time from labeling pulse to the excitation pulse; PLD=1,500 ms and PLD=1,200 ms) to assess the potential effect of arterial blood transit time on the perfusion. Average gray matter (GM) and white matter (WM) perfusion for the frontal and parietal lobes were calculated for each hemisphere from voxels containing at least 90% GM and 100% WM. RESULTS At PLD=1,500 ms, multivariate analyses compared ALC (combined sALC and nsALC) with nsLD (p=0.04) and contrasted sALC, nsALC, and nsLD (p=0.006). ALC, as a group, showed 13% lower frontal GM perfusion (p=0.005) and 8% lower parietal GM perfusion than nsLD (p=0.03). With ALC separated into smokers and nonsmokers, sALC showed 19% lower frontal GM perfusion (p=0.001) and 12% lower parietal GM perfusion than nsLD (p=0.004). In sALC, a higher number of cigarettes smoked per day was associated with lower perfusion. Overall, regional perfusion did not differ significantly between nsALC and nsLD. Results obtained with PLD=1,200 ms generally confirmed the 1,500 ms findings. CONCLUSIONS This study provides preliminary evidence that chronic cigarette smoking adversely affects cerebral perfusion in frontal and parietal GM of 1-week-abstinent alcohol-dependent individuals. These results are in line with our spectroscopic and structural magnetic resonance studies that suggest chronic cigarette smoking compounds the detrimental effects of alcohol dependence on brain neurobiology.
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Affiliation(s)
- Stefan Gazdzinski
- Magnetic Resonance Unit, San Francisco Veterans Administration Medical Center, San Francisco, California 94121, USA.
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Adinoff B, Williams MJ, Best SE, Harris TS, Chandler P, Devous MD. Sex differences in medial and lateral orbitofrontal cortex hypoperfusion in cocaine-dependent men and women. ACTA ACUST UNITED AC 2006; 3:206-22. [PMID: 17081954 PMCID: PMC1987362 DOI: 10.1016/s1550-8579(06)80209-3] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/14/2006] [Indexed: 11/30/2022]
Abstract
BACKGROUND The different clinical trajectories of cocaine-dependent men and women may be a consequence of distinct neurobiological substrates. Hypoperfusion of the orbitofrontal cortex (OFC) has previously been reported in individuals addicted to cocaine and has been posited as a biological mediator of relapse due to impulsivity or impaired decision making. OBJECTIVE This study assessed regional cerebral blood flow (rCBF) between abstinent cocaine-dependent men and women and sex-matched healthy controls. METHODS Cocaine-dependent subjects were abstinent from cocaine for 11 to 28 days and had no other major mental health or substance use disorders. rCBF was assessed with single photon emission computed tomography after administration of a placebo saline infusion. A resting scan was also obtained in a subset of cocaine-dependent and control men. RESULTS In the 35 cocaine-dependent and 37 healthy control subjects examined, a sex-by-group effect was observed for the left lateral (P=0.001), right lateral (P=0.002), and medial (P<0.02) OFC. Cocaine-dependent men demonstrated significantly lower right and left lateral, but not medial, OFC rCBF compared with sex-matched healthy controls after placebo infusion (P<or=0.001). Similar bilateral OFC decreases were observed in male cocaine-dependent subjects at rest. In contrast, cocaine-dependent women showed lower rCBF in the medial, but not lateral, OFC relative to sex-matched healthy controls after placebo infusion (P<0.01). Male cocaine-dependent subjects also showed decreased rCBF (P<0.01) in the bilateral anterolateral temporal cortex and anterior cingulate, whereas decreased rCBF was observed in female cocaine-dependent subjects in the bilateral superior frontal gyri. Large and diffuse areas of increased rCBF were observed after placebo infusion in cocaine-dependent men, but not in women, relative to sex-matched healthy controls. CONCLUSIONS rCBF appears to be reduced in the bilateral OFC in cocaine-dependent men and in the medial OFC in cocaine-dependent women. Sex differences in the medial and lateral OFC rCBF may be relevant to understanding relapse characteristics differentiating men and women addicted to cocaine.
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Affiliation(s)
- Bryon Adinoff
- Department of Psychiatry, University of Texas Southwestern Medical Center, and VA North Texas Health Care System, Dallas, Texas 75390-8564, USA.
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Lochner C, Stein DJ. Does work on obsessive-compulsive spectrum disorders contribute to understanding the heterogeneity of obsessive-compulsive disorder? Prog Neuropsychopharmacol Biol Psychiatry 2006; 30:353-61. [PMID: 16458405 DOI: 10.1016/j.pnpbp.2005.11.004] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/02/2005] [Indexed: 11/28/2022]
Abstract
BACKGROUND There is a growing literature on the concept of an obsessive-compulsive spectrum of disorders. Here, we consider the different dimensions on which obsessive-compulsive spectrum (OCSDs) lie, and focus on how the concepts from this literature may help understand the heterogeneity of obsessive-compulsive disorder (OCD). METHODS A computerized literature search (MEDLINE: 1964-2005) was used to collect studies addressing different dimensions on which the OCSDs lie. Against this backdrop, we report on a cluster analysis of OCSDs within OCD. RESULTS OCSDs may lie on several different dimensions. Our cluster analysis found that in OCD there were 3 clusters of OCD spectrum symptoms: (1) "Reward deficiency" (including trichotillomania, pathological gambling, hypersexual disorder and Tourette's disorder), (2) "Impulsivity" (including compulsive shopping, kleptomania, eating disorders, self-injury and intermittent explosive disorder), and (3) "Somatic" (including body dysmorphic disorder and hypochondriasis). CONCLUSIONS It is unlikely that OC symptoms and disorders fall on any single phenomenological dimension; instead, multiple different constructs may be required to map this nosological space. Although there is evidence for the validity of some of the relevant dimensions, additional work is required to delineate more fully the endophenotypes that underlie OC symptoms and disorders.
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Affiliation(s)
- Christine Lochner
- MRC Unit on Anxiety Disorders, Department of Psychiatry, University of Stellenbosch, South Africa.
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Calhoun VD, Carvalho K, Astur R, Pearlson GD. Using Virtual Reality to Study Alcohol Intoxication Effects on the Neural Correlates of Simulated Driving. Appl Psychophysiol Biofeedback 2005; 30:285-306. [PMID: 16167192 DOI: 10.1007/s10484-005-6384-0] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The use of virtual reality in the form of simulated tasks can provide a realistic environment in which to study complex naturalistic behaviors. Many of the behavioral effects of alcohol intoxication are well known, but there is relatively little imaging evidence examining how alcohol exposure might transiently modulate brain function, especially in the context of task performance. In this review, we provide a brief synopsis of previous work using functional magnetic resonance imaging (fMRI) to study the neural correlates of alcohol intoxication. We describe in detail two studies from our published work, the first involving a visual perception paradigm, and the second involving virtual reality through a naturalistic behavior; simulated driving. Participants received single-blind individualized doses of beverage alcohol designed to produce blood alcohol content (BAC) of 0.04 and 0.08 or placebo. Subjects were fMRI scanned after training to asymptote performance. In both studies we found specific circuits that were differentially modulated by alcohol, we revealed both global and local effects of alcohol, and we examined relationships between behavior, brain function, and alcohol blood levels.
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Affiliation(s)
- V D Calhoun
- Olin Neuropsychiatry Research Center, Institute of Living, 200 Retreat Ave., Hartford, Connecticut 06106, USA.
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