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Starski P, Morningstar MD, Katner SN, Frasier RM, De Oliveira Sergio T, Wean S, Lapish CC, Hopf FW. Neural Activity in the Anterior Insula at Drinking Onset and Licking Relates to Compulsion-Like Alcohol Consumption. J Neurosci 2024; 44:e1490232023. [PMID: 38242696 PMCID: PMC10904088 DOI: 10.1523/jneurosci.1490-23.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 11/20/2023] [Accepted: 12/10/2023] [Indexed: 01/21/2024] Open
Abstract
Much remains unknown about the etiology of compulsion-like alcohol drinking, where consumption persists despite adverse consequences. The role of the anterior insula (AIC) in emotion, motivation, and interoception makes this brain region a likely candidate to drive challenge-resistant behavior, including compulsive drinking. Indeed, subcortical projections from the AIC promote compulsion-like intake in rats and are recruited in heavy-drinking humans during compulsion for alcohol, highlighting the importance of and need for more information about AIC activity patterns that support aversion-resistant responding. Single-unit activity was recorded in the AIC from 15 male rats during alcohol-only and compulsion-like consumption. We found three sustained firing phenotypes, sustained-increase, sustained-decrease, and drinking-onset cells, as well as several firing patterns synchronized with licking. While many AIC neurons had session-long activity changes, only neurons with firing increases at drinking onset had greater activity under compulsion-like conditions. Further, only cells with persistent firing increases maintained activity during pauses in licking, suggesting roles in maintaining drive for alcohol during breaks. AIC firing was not elevated during saccharin drinking, similar to lack of effect of AIC inhibition on sweet fluid intake in many studies. In addition, we observed subsecond changes in AIC neural activity tightly entrained to licking. One lick-synched firing pattern (determined for all licks in a session) predicted compulsion-like drinking, while a separate lick-associated pattern correlated with greater consumption across alcohol intake conditions. Collectively, these data provide a more integrated model for the role of AIC firing in compulsion-like drinking, with important relevance for how the AIC promotes sustained motivated responding more generally.
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Affiliation(s)
- Phillip Starski
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis 46202, Indiana
| | - Mitch D Morningstar
- Department of Psychology, IU-Purdue University Indianapolis, Indianapolis 46202, Indiana
| | - Simon N Katner
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis 46202, Indiana
| | - Raizel M Frasier
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis 46202, Indiana
| | | | - Sarah Wean
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis 46202, Indiana
| | - Christopher C Lapish
- Department of Anatomy, Cell Biology, and Physiology, IU School of Medicine, Indianapolis 46202, Indiana
- Stark Neurosciences Research Institute, Indianapolis 46202, Indiana
| | - F Woodward Hopf
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis 46202, Indiana
- Stark Neurosciences Research Institute, Indianapolis 46202, Indiana
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2
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Starski PA, De Oliveira Sergio T, Hopf FW. Using lickometry to infer differential contributions of salience network regions during compulsion-like alcohol drinking. ADDICTION NEUROSCIENCE 2023; 7:100102. [PMID: 38736902 PMCID: PMC11086682 DOI: 10.1016/j.addicn.2023.100102] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 05/14/2024]
Abstract
Alcohol use disorder extracts substantial personal, social and clinical costs, and continued intake despite negative consequences (compulsion-like consumption) can contribute strongly. Here we discuss lickometry, a simple method where lick times are determined across a session, while analysis across many aspects of licking can offer important insights into underlying psychological and action strategies, including their brain mechanisms. We first describe studies implicating anterior insula (AIC) and dorsal medial prefrontal cortex (dMPF) in compulsion-like responding for alcohol, then review work suggesting that AIC/ventral frontal cortex versus dMPF regulate different aspects of behavior (oral control and overall response strategy, versus moment-to-moment action organization). We then detail our lickometer work comparing alcohol-only drinking (AOD) and compulsion-like drinking under moderate- or higher-challenge (ModChD or HiChD, using quinine-alcohol). Many studies have suggested utilization of one of two main strategies, with higher motivation indicated by more bouts, and greater palatability suggested by longer, faster bouts. Instead, ModChD shows decreased variability in many lick measures, which is unexpected but consistent with the suggested importance of automaticity for addiction. Also surprising is that HiChD retains several behavior changes seen with ModChD, reduced tongue variability and earlier bout start, even though intake is otherwise disrupted. Since AIC-related measures are retained under both moderate- and higher-challenge, we propose a novel hypothesis that AIC sustains overall commitment regardless of challenge level, while disordered licking during HiChD mirrors the effects of dMPF inhibition. Thus, while AIC provides overall drive despite challenge, the ability to act is ultimately determined within the dMPF.
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Affiliation(s)
- Phillip A. Starski
- Indiana University School of Medicine, Department of Psychiatry, Indianapolis IN, USA
| | | | - Frederic W. Hopf
- Indiana University School of Medicine, Department of Psychiatry, Indianapolis IN, USA
- Stark Neurosciences Research Institute, Indianapolis IN, USA
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3
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Lee JK, Yoon BN, Kim DW, Ryu HS, Jang I, Kim H, Han SH. Factors affecting contralateral wrist surgery after one carpal tunnel release in bilateral carpal tunnel syndrome. HAND SURGERY & REHABILITATION 2022; 41:688-694. [PMID: 36150692 DOI: 10.1016/j.hansur.2022.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 08/28/2022] [Accepted: 09/08/2022] [Indexed: 01/04/2023]
Abstract
Carpal tunnel syndrome (CTS) can be bilateral, with varying incidence. Carpal tunnel release (CTR) in one wrist may relieve the symptoms of the contralateral wrist, avoiding the need for second surgery; conversely, the symptoms may persist or worsen, requiring contralateral surgery in some cases. The present study investigated whether surgical treatment was finally required for the non-operated CTS wrist, and in what cases non-operative treatment was possible. We compared baseline characteristics, risk factors and electrodiagnostic data between CTS patients who underwent only unilateral CTR and those who subsequently underwent bilateral surgery at various time intervals. This single-center retrospective study included 188 patients with bilateral CTS managed between 2010 and 2020; 137 patients (group 1, 73%) underwent only unilateral CTR, and 51 (group 2, 27%) subsequently underwent contralateral CTR. In group 1, contralateral CTS symptoms were assessed in 4 categories and compared to the presenting symptoms in the index wrist. There were no significant differences in age, gender, preoperative symptom duration, body status, addictive behavior, electrodiagnostic study or comorbidities, other than a higher rate of dialysis in group 2. The contralateral wrist showed partial or complete symptom relief in 57% of patients undergoing unilateral CTR. High BMI and history of diabetes were risk factors for persistent severe CTS or subsequent contralateral CTR.
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Affiliation(s)
- Jun-Ku Lee
- Department of Orthopedic Surgery, National Health Insurance Service Ilsan Hospital, 100, Ilsan-ro, Ilsandong-gu, Goyang-si, 10444 Gyeonggi-do, Republic of Korea.
| | - Byung-Nam Yoon
- Department of Neurology, Seoul Paik Hospital, Inje University College of Medicine, Mareunnae-ro 9, Jung-gu, 04551 Seoul, Republic of Korea.
| | - Dong Won Kim
- Department of Orthopedic Surgery, CHA Bundang Medical Center, CHA University School of Medicine, 351 Yatap-dong, Bundang-gu, Seongnam-si, 13497 Gyeonggi-do, Republic of Korea.
| | - Han-Seung Ryu
- Department of Orthopedic Surgery, CHA Bundang Medical Center, CHA University School of Medicine, 351 Yatap-dong, Bundang-gu, Seongnam-si, 13497 Gyeonggi-do, Republic of Korea.
| | - Inseok Jang
- Department of Orthopedic Surgery, CHA Bundang Medical Center, CHA University School of Medicine, 351 Yatap-dong, Bundang-gu, Seongnam-si, 13497 Gyeonggi-do, Republic of Korea.
| | - Hyunkyo Kim
- Department of Orthopedic Surgery, Department of Orthopedic Surgery, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, 03722 Seoul, Republic of Korea.
| | - Soo-Hong Han
- Department of Orthopedic Surgery, CHA Bundang Medical Center, CHA University School of Medicine, 351 Yatap-dong, Bundang-gu, Seongnam-si, 13497 Gyeonggi-do, Republic of Korea.
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4
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Katner SN, Sentir AM, Steagall KB, Ding ZM, Wetherill L, Hopf FW, Engleman EA. Modeling Aversion Resistant Alcohol Intake in Indiana Alcohol-Preferring (P) Rats. Brain Sci 2022; 12:brainsci12081042. [PMID: 36009105 PMCID: PMC9406111 DOI: 10.3390/brainsci12081042] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 07/26/2022] [Accepted: 08/02/2022] [Indexed: 12/26/2022] Open
Abstract
With the substantial social and medical burden of addiction, there is considerable interest in understanding risk factors that increase the development of addiction. A key feature of alcohol use disorder (AUD) is compulsive alcohol (EtOH) drinking, where EtOH drinking becomes “inflexible” after chronic intake, and animals, such as humans with AUD, continue drinking despite aversive consequences. Further, since there is a heritable component to AUD risk, some work has focused on genetically-selected, EtOH-preferring rodents, which could help uncover critical mechanisms driving pathological intake. In this regard, aversion-resistant drinking (ARD) takes >1 month to develop in outbred Wistar rats (and perhaps Sardinian-P EtOH-preferring rats). However, ARD has received limited study in Indiana P-rats, which were selected for high EtOH preference and exhibit factors that could parallel human AUD (including front-loading and impulsivity). Here, we show that P-rats rapidly developed compulsion-like responses for EtOH; 0.4 g/L quinine in EtOH significantly reduced female and male intake on the first day of exposure but had no effect after one week of EtOH drinking (15% EtOH, 24 h free-choice paradigm). Further, after 4−5 weeks of EtOH drinking, males but not females showed resistance to even higher quinine (0.5 g/L). Thus, P-rats rapidly developed ARD for EtOH, but only males developed even stronger ARD with further intake. Finally, rats strongly reduced intake of quinine-adulterated water after 1 or 5 weeks of EtOH drinking, suggesting no changes in basic quinine sensitivity. Thus, modeling ARD in P-rats may provide insight into mechanisms underlying genetic predispositions for compulsive drinking and lead to new treatments for AUDs.
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Affiliation(s)
- Simon N. Katner
- Department of Psychiatry, Institute of Psychiatric Research, Indiana University School of Medicine, Indianapolis, IN 46202, USA
- Stark Neuroscience Research Institute, Indiana University School of Medicine, Indianapolis, IN 46202, USA
| | - Alena M. Sentir
- Department of Psychiatry, Institute of Psychiatric Research, Indiana University School of Medicine, Indianapolis, IN 46202, USA
- Stark Neuroscience Research Institute, Indiana University School of Medicine, Indianapolis, IN 46202, USA
| | - Kevin B. Steagall
- Department of Psychiatry, Institute of Psychiatric Research, Indiana University School of Medicine, Indianapolis, IN 46202, USA
- Stark Neuroscience Research Institute, Indiana University School of Medicine, Indianapolis, IN 46202, USA
| | - Zheng-Ming Ding
- Departments of Anesthesiology and Perioperative Medicine and Pharmacology, Pennsylvania State University College of Medicine, 700 HMC Crescent Road, Hershey, PA 17033, USA
| | - Leah Wetherill
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN 46202, USA
| | - Frederic W. Hopf
- Department of Psychiatry, Institute of Psychiatric Research, Indiana University School of Medicine, Indianapolis, IN 46202, USA
- Stark Neuroscience Research Institute, Indiana University School of Medicine, Indianapolis, IN 46202, USA
| | - Eric A. Engleman
- Department of Psychiatry, Institute of Psychiatric Research, Indiana University School of Medicine, Indianapolis, IN 46202, USA
- Stark Neuroscience Research Institute, Indiana University School of Medicine, Indianapolis, IN 46202, USA
- Correspondence:
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Lee JH, Lee JK, Park JS, Kim DH, Baek JH, Yoon BN, Kim S, Ha C, Cho WM, Han SH. Characteristics of surgically treated Guyon canal syndrome: A multicenter retrospective study. J Plast Reconstr Aesthet Surg 2022; 75:3269-3278. [PMID: 35654688 DOI: 10.1016/j.bjps.2022.04.049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Revised: 03/01/2022] [Accepted: 04/12/2022] [Indexed: 11/16/2022]
Abstract
Guyon canal (GC) syndrome is a rare peripheral neuropathy involving the distal part of the ulnar nerve. Several causes are associated with GC syndrome, including anatomic variations, space-occupying tumors, and trauma. Because of disease rarity, the only reported studies of GC syndrome are case series with small sample size. We conducted a multicenter study to identify the basic characteristics of patients with surgically treated GC syndrome and the risk factors for the disease. This retrospective multicenter study was conducted between January 2001 and December 2020. We screened 70 patients who underwent GC release surgery by seven hand surgeons at six institutes. A total of 56 patients were included in this study, including 38 patients (67.9%) who underwent isolated GC decompression and 18 (32.1%) who underwent combined peripheral nerve decompression. The mean patient age was 48.4 years (range: 20-89 years), and 40 patients (71.4%) were male. The average preoperative symptom duration was 18.5 months, and most patients were office workers. Ultrasound was positive for GC syndrome in 7/10 patients evaluated, CT in 2/5, MRI in 17/23, and electrodiagnostic studies in 35/44. The most common cause of GC syndrome was tumor (n = 23), followed by idiopathic (n = 17), trauma (n = 12), anatomic variants (n = 3), and inflammation (n = 3). In conclusion, most patients with GC syndrome in this study were male and had symptoms in one wrist. The most common cause of GC syndrome in this study was a tumor, including a ganglion cyst. Level of Evidence: Level IV case series.
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Affiliation(s)
- Jae Hoon Lee
- Department of Orthopaedic Surgery, Kyung Hee University Hospital at Gangdong, School of Medicine, Kyung Hee University, Seoul, Republic of Korea.
| | - Jun-Ku Lee
- Department of Orthopaedic Surgery, National Health Insurance Service Ilsan Hospital, Goyang-si, Republic of Korea.
| | - Jin Sung Park
- Department of Orthopedic Surgery, Yeson Hospital, 206 Bucheon-ro, Bucheon-si, Gyeonggi-do, 14555, Republic of Korea
| | - Dong Hee Kim
- Departments of Orthopaedic Surgery, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Republic of Korea
| | - Jong Hun Baek
- Department of Orthopaedic surgery. College of medicine. Kyung Hee university. Seoul. Republic of Korea, Republic of Korea.
| | - Byung-Nam Yoon
- Department of Neurology, Seoul Paik Hospital, Inje University College of Medicine, Seoul, Republic of Korea
| | - Segi Kim
- Department of Orthopaedic Surgery, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam-si, Gyeonggi-do, Republic of Korea
| | - Cheungsoo Ha
- Department of Orthopaedic Surgery, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam-si, Gyeonggi-do, Republic of Korea
| | - Weong Min Cho
- Department of Orthopaedic Surgery, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam-si, Gyeonggi-do, Republic of Korea.
| | - Soo-Hong Han
- Department of Orthopaedic Surgery, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam-si, Gyeonggi-do, Republic of Korea.
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Lin TT, Hu CC, Hsu YC, Wang CC, Chiang SW, Wang CY, Chang WC, Huang GS. Utility of magnetic resonance spectroscopy and diffusion-weighted imaging for detecting changes in the femoral head in divers with hip pain at risk for dysbaric osteonecrosis. Quant Imaging Med Surg 2022; 12:43-52. [PMID: 34993059 DOI: 10.21037/qims-21-148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 06/02/2021] [Indexed: 11/06/2022]
Abstract
BACKGROUND Ischemia before the development of dysbaric osteonecrosis (DON) in femoral heads has never been investigated. We assessed whether quantitative magnetic resonance spectroscopy (MRS) and diffusion weighted imaging (DWI) could detect dysbaric changes in divers with hip pain. METHODS This IRB-approved exploratory study recruited 17 divers [9 with hip pain (Group 1); 8 asymptomatic (Group 2)] with normal findings on radiographs and conventional magnetic resonance imaging scans were age-, gender- and body-mass-index matched to 17 non-divers as controls (Group 1C, 2C). Apparent diffusion coefficients (ADCs) and MRS spectra were obtained from regions/voxels of interest on the femoral heads of all subjects. LCModel was used to determine water content, lipid composition, and the unsaturation index in bone marrow. Mann-Whitney non-parametric test was used to compare results of quantitative MRS and ADCs of ipsilateral femoral heads between divers and controls. RESULTS MRS of the ipsilateral femoral heads revealed higher water (peak: 4.7 ppm) content, lower total lipid fraction (TLF), and higher unsaturation index (UI) of lipids in Group 1 than in Group 2 (water: P=0.040; UI: P=0.022) and Group 1C (water: P=0.027; TLF: P=0.039; UI: P=0.009). In contrast, femoral head ADCs were comparable between divers and controls. Five out of nine symptomatic divers were contacted for follow-up MRS and DWI studies, and the mean difference in water content in the femoral heads of patients with osteonecrosis was also higher than that in patients with symptom relief (osteonecrosis: 0.077±0.130 vs. symptom relief: 0.003±0.010). CONCLUSIONS Dysbaric change in the femoral heads of divers with hip pain can be detected using quantitative MRS, which reveals increases in water content and UI of lipids, and a decrease in TLF.
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Affiliation(s)
- Tsung-Tai Lin
- Department of Radiology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Cheng-Chuan Hu
- Department of Radiology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Yi-Chih Hsu
- Department of Radiology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Chih-Chien Wang
- Department of Orthopedic Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Shih-Wei Chiang
- Department of Radiology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Chao-Ying Wang
- Department and Graduate Institute of Biology and Anatomy, National Defense Medical Center, Taipei, Taiwan
| | - Wei-Chou Chang
- Department of Radiology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Guo-Shu Huang
- Department of Radiology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.,Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
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7
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Zhu X, Huang J, Huang S, Wen Y, Lan X, Wang X, Lu C, Wang Z, Fan N, Shang D. Combining Metabolomics and Interpretable Machine Learning to Reveal Plasma Metabolic Profiling and Biological Correlates of Alcohol-Dependent Inpatients: What About Tryptophan Metabolism Regulation? Front Mol Biosci 2021; 8:760669. [PMID: 34859050 PMCID: PMC8630631 DOI: 10.3389/fmolb.2021.760669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 10/18/2021] [Indexed: 11/13/2022] Open
Abstract
Alcohol dependence (AD) is a condition of alcohol use disorder in which the drinkers frequently develop emotional symptoms associated with a continuous alcohol intake. AD characterized by metabolic disturbances can be quantitatively analyzed by metabolomics to identify the alterations in metabolic pathways. This study aimed to: i) compare the plasma metabolic profiling between healthy and AD-diagnosed individuals to reveal the altered metabolic profiles in AD, and ii) identify potential biological correlates of alcohol-dependent inpatients based on metabolomics and interpretable machine learning. Plasma samples were obtained from healthy (n = 42) and AD-diagnosed individuals (n = 43). The plasma metabolic differences between them were investigated using liquid chromatography-tandem mass spectrometry (AB SCIEX® QTRAP 4500 system) in different electrospray ionization modes with scheduled multiple reaction monitoring scans. In total, 59 and 52 compounds were semi-quantitatively measured in positive and negative ionization modes, respectively. In addition, 39 metabolites were identified as important variables to contribute to the classifications using an orthogonal partial least squares-discriminant analysis (OPLS-DA) (VIP > 1) and also significantly different between healthy and AD-diagnosed individuals using univariate analysis (p-value < 0.05 and false discovery rate < 0.05). Among the identified metabolites, indole-3-carboxylic acid, quinolinic acid, hydroxy-tryptophan, and serotonin were involved in the tryptophan metabolism along the indole, kynurenine, and serotonin pathways. Metabolic pathway analysis revealed significant changes or imbalances in alanine, aspartate, glutamate metabolism, which was possibly the main altered pathway related to AD. Tryptophan metabolism interactively influenced other metabolic pathways, such as nicotinate and nicotinamide metabolism. Furthermore, among the OPLS-DA-identified metabolites, normetanephrine and ascorbic acid were demonstrated as suitable biological correlates of AD inpatients from our model using an interpretable, supervised decision tree classifier algorithm. These findings indicate that the discriminatory metabolic profiles between healthy and AD-diagnosed individuals may benefit researchers in illustrating the underlying molecular mechanisms of AD. This study also highlights the approach of combining metabolomics and interpretable machine learning as a valuable tool to uncover potential biological correlates. Future studies should focus on the global analysis of the possible roles of these differential metabolites and disordered metabolic pathways in the pathophysiology of AD.
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Affiliation(s)
- Xiuqing Zhu
- Department of Pharmacy, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China.,Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, China
| | - Jiaxin Huang
- Department of Substance Dependence, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China
| | - Shanqing Huang
- Department of Pharmacy, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China
| | - Yuguan Wen
- Department of Pharmacy, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China.,Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, China
| | - Xiaochang Lan
- Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, China.,Department of Substance Dependence, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China
| | - Xipei Wang
- Department of Medical Sciences, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Chuanli Lu
- Guangzhou Rely Medical Diagnostic Technology Co. Ltd., Guangzhou, China
| | - Zhanzhang Wang
- Department of Pharmacy, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China.,Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, China
| | - Ni Fan
- Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, China.,Department of Substance Dependence, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China
| | - Dewei Shang
- Department of Pharmacy, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China.,Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, China
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Mannes ZL, Shmulewitz D, Livne O, Stohl M, Hasin DS. Correlates of mild, moderate, and severe Alcohol Use Disorder among adults with problem substance use: Validity implications for DSM-5. Alcohol Clin Exp Res 2021; 45:2118-2129. [PMID: 34581461 DOI: 10.1111/acer.14701] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 08/16/2021] [Accepted: 08/16/2021] [Indexed: 12/31/2022]
Abstract
BACKGROUND The DSM-5 definition of alcohol use disorder (AUD) has been well validated, but information is lacking on the extent to which alcohol use, comorbidity, and impairment are associated with the 3 DSM-5-defined AUD severity levels: mild, moderate, and severe. This study examined clinical and functional characteristics as predictors (validators) of these severity levels. METHODS Participants aged ≥18 years reporting current problem substance use (N = 588) were recruited between 2016 and 2019 and assessed for DSM-5 AUD and a set of potential validators: indicators of alcohol use severity (i.e., craving, binge drinking frequency, problematic use, and harmful drinking), psychiatric disorders, and functional impairment. Multinomial logistic regression models examined the association between the predictors and the 3 AUD severity levels (mild, moderate, and severe) vs the reference group, no AUD, controlling for sociodemographic characteristics and other substance use. RESULTS All alcohol use validators were associated with a greater likelihood of all 3 AUD severity levels compared with the no-AUD group. However, psychiatric disorders were associated only with severe AUD and participants with major depression (aOR = 2.44), posttraumatic stress disorder (aOR = 1.65), borderline personality disorder (aOR = 1.99), and antisocial personality disorder (aOR = 1.78) had a greater likelihood of severe AUD than the no-AUD group. Functioning validators were also associated only with severe AUD and participants with social (aOR = 1.87), physical (aOR = 1.62), or mental (aOR = 1.84) impairment had a greater likelihood of severe AUD than the no-AUD group. Many alcohol-related, psychiatric, and functioning validators were associated with greater odds of severe AUD than mild or moderate AUD. CONCLUSION This study supports the criterion validity of the DSM-5 tri-categorical measure of AUD. Specifically, results fully supported the validity of severe AUD by its associations with all predictors, whereas the validity of mild and moderate AUD was supported only by alcohol use predictor variables. Findings suggest the value of using severity-specific interventions utilizing the DSM-5 AUD.
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Affiliation(s)
- Zachary L Mannes
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York, USA.,New York State Psychiatric Institute, New York, New York, USA
| | - Dvora Shmulewitz
- New York State Psychiatric Institute, New York, New York, USA.,Department of Psychiatry, Columbia University Irving Medical Center, New York, New York, USA
| | - Ofir Livne
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York, USA.,New York State Psychiatric Institute, New York, New York, USA
| | - Malki Stohl
- New York State Psychiatric Institute, New York, New York, USA.,Department of Psychiatry, Columbia University Irving Medical Center, New York, New York, USA
| | - Deborah S Hasin
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York, USA.,New York State Psychiatric Institute, New York, New York, USA.,Department of Psychiatry, Columbia University Irving Medical Center, New York, New York, USA
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9
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Kapoor M, Chao MJ, Johnson EC, Novikova G, Lai D, Meyers JL, Schulman J, Nurnberger JI, Porjesz B, Liu Y, Foroud T, Edenberg HJ, Marcora E, Agrawal A, Goate A. Multi-omics integration analysis identifies novel genes for alcoholism with potential overlap with neurodegenerative diseases. Nat Commun 2021; 12:5071. [PMID: 34417470 PMCID: PMC8379159 DOI: 10.1038/s41467-021-25392-y] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 08/03/2021] [Indexed: 11/27/2022] Open
Abstract
Identification of causal variants and genes underlying genome-wide association study (GWAS) loci is essential to understand the biology of alcohol use disorder (AUD) and drinks per week (DPW). Multi-omics integration approaches have shown potential for fine mapping complex loci to obtain biological insights to disease mechanisms. In this study, we use multi-omics approaches, to fine-map AUD and DPW associations at single SNP resolution to demonstrate that rs56030824 on chromosome 11 significantly reduces SPI1 mRNA expression in myeloid cells and lowers risk for AUD and DPW. Our analysis also identifies MAPT as a candidate causal gene specifically associated with DPW. Genes prioritized in this study show overlap with causal genes associated with neurodegenerative disorders. Multi-omics integration analyses highlight, genetic similarities and differences between alcohol intake and disordered drinking, suggesting molecular heterogeneity that might inform future targeted functional and cross-species studies.
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Affiliation(s)
- Manav Kapoor
- Departments of Genetics and Genomic Sciences and Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | - Michael J Chao
- Departments of Genetics and Genomic Sciences and Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Emma C Johnson
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Gloriia Novikova
- Departments of Genetics and Genomic Sciences and Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Dongbing Lai
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Jacquelyn L Meyers
- Department of Psychiatry, State University of New York, Downstate Medical Center, Brooklyn, NY, USA
| | - Jessica Schulman
- Departments of Genetics and Genomic Sciences and Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - John I Nurnberger
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Bernice Porjesz
- Department of Psychiatry, State University of New York, Downstate Medical Center, Brooklyn, NY, USA
| | - Yunlong Liu
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Tatiana Foroud
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN, USA
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Howard J Edenberg
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN, USA
- Department of Biochemistry and Molecular Biology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Edoardo Marcora
- Departments of Genetics and Genomic Sciences and Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Arpana Agrawal
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Alison Goate
- Departments of Genetics and Genomic Sciences and Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
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10
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Lee JK, Yoon BN, Cho JW, Ryu HS, Han SH. Carpal Tunnel Release Despite Normal Nerve Conduction Studies in Carpal Tunnel Syndrome Patients. Ann Plast Surg 2021; 86:52-57. [PMID: 33141768 DOI: 10.1097/sap.0000000000002570] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE Carpal tunnel syndrome (CTS) is a common entrapment neuropathy, often requiring carpal tunnel release (CTR) surgery. Often, a nerve conduction study (NCS) is performed before CTR; however, there are various reports questioning the sensitivity of NCS, and some patients do undergo CTR despite normal NCS results. We had the following purposes: (1) to report clinical outcome of CTS patients who undergo CTR despite normal NCS, (2) to identify the characteristics and compare those with abnormal NCS patients in terms of basic features and risk factors, and (3) to analyze and compare normal and abnormal NCS results. MATERIALS AND METHODS Medical records of 546 CTS (30 normal NCS and 516 abnormal NCS) patients were retrospectively reviewed. Of 30 normal NCS patients, 7 were excluded, leaving 23 patients in the experimental group. We investigated the influence of age, sex, operative arm, and body mass index, as well as medical conditions known to be risk factors for CTS. In normal NCS patients, as a functional score, we investigated Boston carpal tunnel scores before and after CTR. The NCS results were compared in terms of median motor and median sensory testing. In normal NCS patients, NCS data were compared with that of the contralateral nonoperated wrists. RESULTS There were 18 women and 5 men in the normal NCS group (mean age 43.7 years). On physical examination, 22 (94.7%) patients showed a positive Tinel test, 19 (82.6%) showed a positive Phalen test, 8 (34.8%) complained of nocturnal paresthesia, and only 1 (4.3%) presented with thenar atrophy. In 19 of 23 patients, the Boston CTS scores showed significant improvement after CTR. Normal NCS patients were significantly younger and significantly heavier and more likely to be a current smoker. In NCS analysis of normal NCS patients, the operated wrists were closer to the reference values than nonoperated wrists. CONCLUSIONS Surgeons should evaluate the possibility of other combined lesions before CTR in normal NCS patients. Normal NCS can be present with a CTS diagnosis, especially in younger patients. Nevertheless, CTR after failed conservative management, despite normal NCS, could relieve subjective symptoms and function.
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Affiliation(s)
- Jun-Ku Lee
- From the Department of Orthopaedic Surgery
| | - Byung-Nam Yoon
- Department of Neurology, Seoul Paik Hospital, Inje University College of Medicine, Seoul
| | - Jin Woo Cho
- Department of Orthopaedic Surgery, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam-si, Gyeonggi-do, South Korea
| | - Han-Seung Ryu
- Department of Orthopaedic Surgery, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam-si, Gyeonggi-do, South Korea
| | - Soo-Hong Han
- Department of Orthopaedic Surgery, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam-si, Gyeonggi-do, South Korea
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11
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O'Toole BI, Gorman P, Catts SV. Military Combat, Posttraumatic Stress Disorder, and the Course of Alcohol Use Disorders in a Cohort of Australian Vietnam War Veterans. J Trauma Stress 2020; 33:709-719. [PMID: 32939901 DOI: 10.1002/jts.22588] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2019] [Revised: 06/17/2020] [Accepted: 06/21/2020] [Indexed: 01/19/2023]
Abstract
The present study examined the course of diagnosed alcohol use disorders (AUDs) in a cohort of Australian veterans of the Vietnam War (N = 388) who were assessed 22 and 36 years after returning home. Standardized interviews provided data on AUDs, posttraumatic stress disorder (PTSD), other psychiatric diagnoses, and combat exposure. Overall, 148 veterans (38.1%) had no history of alcohol-related diagnoses, 151 veterans (38.9%) had a past AUD diagnosis that was not current at the second assessment point, and 89 veterans (22.9%) had a current AUD diagnosis at the second assessment. Less education, lower intelligence test scores, and misconduct were individual risk factors for AUDs, as were first-interview diagnoses of PTSD, antisocial personality disorder, generalized anxiety, and dysthymia, but not depression; these variables were all nonsignificant after controlling for combat exposure and PTSD. Multinomial regression was used to assess the relative contributions of combat exposure and PTSD to the course of AUDs. Combat exposure and PTSD had different patterns of association with AUDs whereby combat exposure, but not PTSD, was associated with a history of AUDs, odds ratio (OR) = 1.02, but not with current AUDs, whereas PTSD, but not combat exposure, was associated with current AUDs, OR = 3.37. Current numbing and avoidance symptoms were associated with current AUDs, OR = 4.48. The results do not support a mutual maintenance model of PTSD and AUDs but are consistent with a self-medication model, which suggests treatment for PTSD may have beneficial effects on AUDs.
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Affiliation(s)
- Brian I O'Toole
- Brain and Mind Centre, University of Sydney, Sydney, Australia
| | - Patrick Gorman
- Brain and Mind Centre, University of Sydney, Sydney, Australia
| | - Stanley V Catts
- Brain and Mind Centre, University of Sydney, Sydney, Australia.,Department of Psychiatry, University of Queensland, Brisbane, Australia
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12
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Fernandes GS, Lewis G, Hammerton G, Abeysekera K, Mahedy L, Edwards A, Lewis G, Hickman M, Heron J. Alcohol consumption and internalising disorders in young adults of ALSPAC: a population-based study. J Epidemiol Community Health 2020; 74:1023-1027. [PMID: 32631846 PMCID: PMC8886795 DOI: 10.1136/jech-2020-213922] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 04/08/2020] [Accepted: 06/02/2020] [Indexed: 01/24/2023]
Abstract
Introduction Depression and harmful alcohol consumption contribute significantly to the global health burden, but in young adults, this relationship is under-researched and conflicted. The aim of this study was to determine the sex-based prevalence and the association between internalising disorders such as depression and alcohol use disorders. Method Using the Avon Longitudinal Study of Parents and Children, we assessed the sex-specific prevalence of International Classification of Diseases, Tenth Revision diagnosed generalised anxiety disorder (GAD), depression and fear-based anxieties (FBA) at 24 years (n=3572). We examined the association between internalising disorders and alcohol consumption using the Alcohol Use Disorder Identification Test for Consumption 5+ threshold and Diagnostic and Statistical Manual on Mental Disorders defined criteria for alcohol dependence. Results Women reported more GAD (11.6% vs 6.5%), depression (13.4% vs 6.9%) and FBA (1.3% vs 0.5%) than men (p<0.001). Harmful drinking, after adjustment for sex and socioeconomic status, was associated witha higher prevalence of depression (OR 1.8, 95% CI 1.3 to 2.4, p<0.001), anxiety (OR 1.4, 95% CI 1.0 to 2.0, p<0.001) and FBA (OR 2.4, 95% CI 1.04 to 5.56, p=0.009) compared with lower-risk drinkers. In contrast, hazardous drinking was associated with a lower prevalence of GAD (OR 0.69, 95% CI 0.54 to 0.88) and depression (OR 0.68, 95% CI 0.54 to 0.86) compared with lower-risk drinkers. Conclusions Young adults in the UK who drink harmfully are more likely to have depression and other internalising disorders. Further research should test whether there is a J-shaped relationship between alcohol consumption and mental health in young people and whether this varies across the life course.
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Affiliation(s)
- Gwen Sascha Fernandes
- Population Health Sciences, University of Bristol School of Social and Community Medicine, Bristol, UK
| | | | - Gemma Hammerton
- Population Health Sciences, University of Bristol School of Social and Community Medicine, Bristol, UK
| | - Kushala Abeysekera
- Population Health Sciences, University of Bristol School of Social and Community Medicine, Bristol, UK
| | - Liam Mahedy
- Population Health Sciences, University of Bristol School of Social and Community Medicine, Bristol, UK
| | - Alexis Edwards
- Virginia Institute for Psychiatric and Behavior Genetics, Richmond, Virginia, USA
| | | | - Matthew Hickman
- School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Jonathan Heron
- School of Social and Community Medicine, University of Bristol, Bristol, UK
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13
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Velarde-Ruiz Velasco JA, Higuera-de la Tijera MF, Castro-Narro GE, Zamarripa-Dorsey F, Abdo-Francis JM, Aiza Haddad I, Aldana Ledesma JM, Bielsa-Fernández MV, Cerda-Reyes E, Cisneros-Garza LE, Contreras-Omaña R, Reyes-Dorantes A, Fernández-Pérez NJ, García-Jiménez ES, Icaza-Chávez ME, Kershenobich-Stalnikowitz D, Lira-Pedrín MA, Moreno-Alcántar R, Pérez-Hernández JL, Ramos-Gómez MV, Rizo-Robles MT, Solana-Sentíes S, Torre-Delgadillo A. The Mexican consensus on alcoholic hepatitis. REVISTA DE GASTROENTEROLOGIA DE MEXICO (ENGLISH) 2020; 85:332-353. [PMID: 32532534 DOI: 10.1016/j.rgmx.2020.04.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 04/07/2020] [Indexed: 06/11/2023]
Abstract
Alcoholic hepatitis is a frequent condition in the Mexican population. It is characterized by acute-on-chronic liver failure, important systemic inflammatory response, and multiple organ failure. The severe variant of the disease implies elevated mortality. Therefore, the Asociación Mexicana de Gastroenterología and the Asociación Mexicana de Hepatología brought together a multidisciplinary team of health professionals to formulate the first Mexican consensus on alcoholic hepatitis, carried out utilizing the Delphi method and resulting in 37 recommendations. Alcohol-related liver disease covers a broad spectrum of pathologies that includes steatosis, steatohepatitis, different grades of fibrosis, and cirrhosis and its complications. Severe alcoholic hepatitis is defined by a modified Maddrey's discriminant function score ≥ 32 or by a Model for End-Stage Liver Disease (MELD) score equal to or above 21. There is currently no specific biomarker for its diagnosis. Leukocytosis with neutrophilia, hyperbilirubinemia (> 3 mg/dL), AST > 50 U/l (< 400 U/l), and an AST/ALT ratio > 1.5-2 can guide the diagnosis. Abstinence from alcohol, together with nutritional support, is the cornerstone of treatment. Steroids are indicated for severe disease and have been effective in reducing the 28-day mortality rate. At present, liver transplantation is the only life-saving option for patients that are nonresponders to steroids. Certain drugs, such as N-acetylcysteine, granulocyte-colony stimulating factor, and metadoxine, can be adjuvant therapies with a positive impact on patient survival.
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Affiliation(s)
- J A Velarde-Ruiz Velasco
- Servicio de Gastroenterología; Hospital Civil de Guadalajara Fray Antonio Alcalde, Guadalajara, Jalisco, México.
| | - M F Higuera-de la Tijera
- Servicio de Gastroenterología, Hospital General de México Dr. Eduardo Liceaga, Ciudad de México, México
| | - G E Castro-Narro
- Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México, México
| | | | | | - I Aiza Haddad
- Clínica de Enfermedades Hepáticas, Hospital Ángeles Lomas, Estado de México, México
| | - J M Aldana Ledesma
- Servicio de Gastroenterología; Hospital Civil de Guadalajara Fray Antonio Alcalde, Guadalajara, Jalisco, México
| | | | | | | | - R Contreras-Omaña
- Centro de Investigación en Enfermedades Hepáticas y Gastroenterología, Pachuca, Hidalgo, México
| | | | | | - E S García-Jiménez
- Servicio de Gastroenterología; Hospital Civil de Guadalajara Fray Antonio Alcalde, Guadalajara, Jalisco, México
| | | | | | - M A Lira-Pedrín
- Servicio de Medicina Interna y Gastroenterología. Hospital y Centro Médico del Prado, Tijuana, Baja California, México
| | - R Moreno-Alcántar
- Unidad Médica de Alta Especialidad, Hospital de Especialidades CMN SXXI, Ciudad de México, México
| | - J L Pérez-Hernández
- Servicio de Gastroenterología, Hospital General de México Dr. Eduardo Liceaga, Ciudad de México, México; Hospital Central Sur de Alta Especialidad Petróleos Mexicanos, Ciudad de México, México
| | - M V Ramos-Gómez
- Centro Médico Nacional 20 de Noviembre, Ciudad de México, México
| | - M T Rizo-Robles
- Unidad Médica de Alta Especialidad, Hospital de Especialidades CMN SXXI, Ciudad de México, México
| | | | - A Torre-Delgadillo
- Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México, México
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14
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Velarde-Ruiz Velasco J, Higuera-de la Tijera M, Castro-Narro G, Zamarripa-Dorsey F, Abdo-Francis J, Haddad IA, Aldana Ledesma J, Bielsa-Fernández M, Cerda-Reyes E, Cisneros-Garza L, Contreras-Omaña R, Reyes-Dorantes A, Fernández-Pérez N, García-Jiménez E, Icaza-Chávez M, Kershenobich-Stalnikowitz D, Lira-Pedrín M, Moreno-Alcántar R, Pérez-Hernández J, Ramos-Gómez M, Rizo-Robles M, Solana-Sentíes S, Torre-Delgadillo A. The Mexican consensus on alcoholic hepatitis. REVISTA DE GASTROENTEROLOGÍA DE MÉXICO (ENGLISH EDITION) 2020. [DOI: 10.1016/j.rgmxen.2020.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
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15
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Leong SL, Glue P, Manning P, Vanneste S, Lim LJ, Mohan A, De Ridder D. Anterior Cingulate Cortex Implants for Alcohol Addiction: A Feasibility Study. Neurotherapeutics 2020; 17:1287-1299. [PMID: 32323203 PMCID: PMC7641294 DOI: 10.1007/s13311-020-00851-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Abnormal neural activity, particularly in the rostrodorsal anterior cingulate cortex (rdACC), appears to be responsible for intense alcohol craving. Neuromodulation of the rdACC using cortical implants may be an option for individuals with treatment-resistant alcohol dependence. This study assessed the effectiveness and feasibility of suppressing alcohol craving using cortical implants of the rdACC using a controlled one-group pre- and post-test study design. Eight intractable alcohol-dependent participants (four males and four females) were implanted with two Lamitrode 44 electrodes over the rdACC bilaterally connected to an internal pulse generator (IPG). The primary endpoint, self-reported alcohol craving reduced by 60.7% (p = 0.004) post- compared to pre-stimulation. Adverse events occurred in four out of the eight participants. Electrophysiology findings showed that among responders, there was a post-stimulation decrease (p = 0.026) in current density at the rdACC for beta 1 band (13-18 Hz). Results suggest that rdACC stimulation using implanted electrodes may potentially be a feasible method for supressing alcohol craving in individuals with severe alcohol use disorder. However, to further establish safety and efficacy, larger controlled clinical trials are needed.
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Affiliation(s)
- Sook Ling Leong
- Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland.
- Department of Surgical Sciences, University of Otago, Dunedin, New Zealand.
| | - Paul Glue
- Department of Psychological Medicine, University of Otago, Dunedin, New Zealand
| | - Patrick Manning
- Department of Medicine, University of Otago, Dunedin, New Zealand
| | - Sven Vanneste
- Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
- Lab for Clinical and Integrative Neuroscience, School of Behavioral and Brain Sciences, University of Texas at Dallas, Richardson, TX, USA
| | - Louisa Joyce Lim
- Department of Surgical Sciences, University of Otago, Dunedin, New Zealand
| | - Anusha Mohan
- Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
| | - Dirk De Ridder
- Department of Surgical Sciences, University of Otago, Dunedin, New Zealand.
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Ghandour LA, Anouti S, Afifi RA. The impact of DSM classification changes on the prevalence of alcohol use disorder and 'diagnostic orphans' in Lebanese college youth: Implications for epidemiological research, health practice, and policy. PLoS One 2020; 15:e0233657. [PMID: 32502221 PMCID: PMC7274407 DOI: 10.1371/journal.pone.0233657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Accepted: 05/10/2020] [Indexed: 12/02/2022] Open
Abstract
Background Studies comparing prevalence of alcohol use disorder (AUD) using DSM-IV and DSM-5 diagnostic criteria in college students are limited. This study examines changes in AUD prevalence estimates using DSM-IV versus DSM-5 and characterizes the profile of DSM-5 “diagnostic orphans.” Methods and findings A college student sample (n = 1,155; mean age: 21 ±1.97) selected conveniently from six large private and public universities in Greater Beirut, Lebanon completed an anonymous survey in May 2016. The study response rate was 83.1%. Data on DSM-IV and DSM-5 AUD criteria were gathered from 582 past-year drinkers, of which 377 (65%) were screened to have DSM-IV abuse/dependence, and 203 (35%) to have any DSM-5 AUD (58% mild, 21% moderate, and 21% severe). Overall percent agreement between measures was 68% (kappa = 0.41). One hundred and ninety-one students met one DSM-5 AUD criterion only (i.e. “diagnostic orphans,” herein DOs), of which the majority (82%) endorsed “hazardous use.” Compared to past-year drinkers with zero-endorsed DSM-5 criteria, DOs were more likely to be aged 21 or above [OR = 1.57(1.21–2.03)], less likely to perceive their socioeconomic status (SES) as poorer vs. same as others [OR = 0.17(0.07–0.43)], more likely to drink 1–2 times/week vs. ≤3 times per month [OR = 2.24(1.44–3.49)], and more likely to report past-year cigarette smoking [OR = 2.16(1.10–4.24)]. When compared to past-year drinkers with DSM-5 AUD, DOs were more likely to be pursuing a graduate or medical degree (vs. undergraduate degree) [2.06 (1.09–3.89)], and to be living with parents most of the time vs. not [OR = 2.68(1.14–6.31)]. DOs (versus drinkers with AUD) were less likely to drink at a high frequency (3–4 times /week or more vs.≤3 times per month) [OR = 0.15(0.05–0.48)], and to report past-year waterpipe smoking [OR = 0.54(0.34–0.85)], but more likely to report past-year marijuana use [1.89(1.10–3.23)]. The findings are subject to recall bias and under-reporting and the study could not infer causality because temporality of associations cannot be established in a cross-sectional study design. Conclusions DSM-IV abuse/dependence prevalence rate was higher than DSM-5 AUD prevalence mainly due to the high percentage of students who engaged in “hazardous use”. The DO screen might capture a young person in transition between non-drinking/occasional drinking to drinking frequently/developing an AUD. The prevention, identification, and management of DOs may be critical components of a national alcohol harm-reduction policy.
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Affiliation(s)
- Lilian A. Ghandour
- Department of Epidemiology and Population Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
- * E-mail:
| | - Sirine Anouti
- Department of Epidemiology and Population Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Rima A. Afifi
- Department of Community and Behavioral Health, College of Public Health, University of Iowa, Iowa City, Iowa, United States of America
- Department of Health Promotion and Community Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
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Gupta I, Dandavate R, Gupta P, Agrawal V, Kapoor M. Recent advances in genetic studies of alcohol use disorders. CURRENT GENETIC MEDICINE REPORTS 2020; 8:27-34. [PMID: 33344068 PMCID: PMC7748121 DOI: 10.1007/s40142-020-00185-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
PURPOSE OF REVIEW Alcohol use disorder (AUD) is a complex genetic disorder with very high heritability. This polygenic disorder not only results in increased morbidity and mortality, it is also a substantial social and economic burden on families and the nation. For past three decades, several genetic studies were conducted to identify genes and pathways associated with AUD. This review aims to summarize past efforts and recent advances in genetic association studies of AUD and related traits. RECENT FINDINGS Initial genetic association studies achieved a limted success and suffered from low power due to small sample sizes. AUD is a polygenic trait and data from several thousands individuals was required to identify the genetic factors of small effect sizes. The scenario changed recently with technological advances and significant reduction in cost of the genome wide association analyses (GWAS). This enabled researchers to generate genomic data on mega biobanks and cohorts with access to extensive clinical and non-clinical phenotypes. Public access to data from biobanks and collaborative efforts of researchers lead to identification of several novel loci associated with AUDs and related traits. Efforts are now underway to identify the causal variants under the GWAS loci to identify target genes and biological mechanisms underpining AUDs. Many GWAS variants occur in promoter or enhancer regions of the genes and are involved in regulation of gene expression of causal genes. This, large amounts of "omics" data from projects such as "ENCODE", RoadMap and GTEx is also helping researchers to integrate "multi-omics" data to interpret functional significance of GWAS variants. SUMMARY With current review, we aim to present the recent advances in genetic and molecular studies of AUDs. Recent successes in genetic studies of AUDs will definetely motivate researchers and lead to better therapeutic interventions for this complex disorder.
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Affiliation(s)
| | - Rohan Dandavate
- Indian Institute of Science Education and Research, Bhopal, India
| | - Pallavi Gupta
- Indian Institute of Science Education and Research, Bhopal, India
| | - Viplav Agrawal
- Indian Institute of Science Education and Research, Bhopal, India
| | - Manav Kapoor
- Icahn School of Medicine at Mount Sinai, New york, USA
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18
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Kim H, Kim S, Seo J, Bae G, Kim K, Kang J. Effect of Single‐Dose, Oral Enzymatic Porcine Placental Extract on Pharmacokinetics of Alcohol and Liver Function in Rats. Alcohol Clin Exp Res 2020; 44:1018-1024. [DOI: 10.1111/acer.14319] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2019] [Accepted: 02/26/2020] [Indexed: 11/30/2022]
Affiliation(s)
- Hyun‐Jin Kim
- From the Department of Pharmacology College of Medicine Hanyang University Seoul South Korea
| | - Semi Kim
- From the Department of Pharmacology College of Medicine Hanyang University Seoul South Korea
| | - Jin‐Sook Seo
- From the Department of Pharmacology College of Medicine Hanyang University Seoul South Korea
| | | | | | - Ju‐Seop Kang
- From the Department of Pharmacology College of Medicine Hanyang University Seoul South Korea
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Blonigen D, Harris-Olenak B, Kuhn E, Humphreys K, Timko C, Dulin P. From "Step Away" to "Stand Down": Tailoring a Smartphone App for Self-Management of Hazardous Drinking for Veterans. JMIR Mhealth Uhealth 2020; 8:e16062. [PMID: 32053118 PMCID: PMC7055774 DOI: 10.2196/16062] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Revised: 11/11/2019] [Accepted: 11/14/2019] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND US military veterans who screen positive for hazardous drinking during primary care visits may benefit from a mobile app. Step Away is an evidence-based mobile intervention system for the self-management of hazardous drinking. However, Step Away was not designed for veterans, and differences between veterans and civilians could limit the reach and effectiveness of the app with this population. OBJECTIVE The primary objective of this study was to repurpose Step Away to address the needs and preferences of the veteran primary care population. The Method for Program Adaptation through Community Engagement (M-PACE) model was used to guide the adaptation process. This model can serve as a generalizable approach that other researchers and intervention developers can follow to systematically tailor mobile health tools for a new population. METHODS Veteran patients who screened positive for hazardous drinking during a primary care visit (n=12) and peer providers employed by the US Veterans Health Administration (n=11) were recruited to systematically review Step Away and provide feedback on its content and presentation via Web-based surveys and a semistructured interview. Participant feedback was reviewed through an iterative process by key stakeholders who adjudicated which suggested modifications to the app could enhance engagement and effectiveness with veterans while maintaining program integrity. RESULTS Usability ratings of the individual modules of Step Away were uniformly positive across patients and peers, as was the perceived utility of the app overall. Personalized feedback on the health consequences and costs of drinking, options for customization, and the measurement-based care capabilities of the app were viewed as facilitators of engagement. Conversely, lengthy text, small font, and a lack of interactive features were viewed as potential barriers with the older primary care population. Modifications to create a veteran version of the app (Stand Down: Think Before You Drink) included altering the appearance of the app to incorporate more veteran-centric content, adding links and options for resources and activities for veterans, and reducing the amount of text and adding veteran-specific references and common concerns and triggers for drinking in this population. CONCLUSIONS The M-PACE model provided a systematic approach to repurpose Step Away to fit the needs and preferences of veteran primary care patients who engage in hazardous drinking. Stand Down may serve as an innovative, low-cost means of expanding access to care for veterans who engage in hazardous drinking.
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Affiliation(s)
- Daniel Blonigen
- Department of Veterans Affairs Palo Alto Health Care System, Menlo Park, CA, United States
| | - Brooke Harris-Olenak
- Department of Veterans Affairs Palo Alto Health Care System, Menlo Park, CA, United States
| | - Eric Kuhn
- Department of Veterans Affairs Palo Alto Health Care System, Menlo Park, CA, United States
| | - Keith Humphreys
- Department of Veterans Affairs Palo Alto Health Care System, Menlo Park, CA, United States
| | - Christine Timko
- Department of Veterans Affairs Palo Alto Health Care System, Menlo Park, CA, United States
| | - Patrick Dulin
- University of Alaska-Anchorage, Anchorage, AK, United States
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Mignogna KM, Bacanu SA, Riley BP, Wolen AR, Miles MF. Cross-species alcohol dependence-associated gene networks: Co-analysis of mouse brain gene expression and human genome-wide association data. PLoS One 2019; 14:e0202063. [PMID: 31017905 PMCID: PMC6481773 DOI: 10.1371/journal.pone.0202063] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Accepted: 04/07/2019] [Indexed: 01/06/2023] Open
Abstract
Genome-wide association studies on alcohol dependence, by themselves, have yet to account for the estimated heritability of the disorder and provide incomplete mechanistic understanding of this complex trait. Integrating brain ethanol-responsive gene expression networks from model organisms with human genetic data on alcohol dependence could aid in identifying dependence-associated genes and functional networks in which they are involved. This study used a modification of the Edge-Weighted Dense Module Searching for genome-wide association studies (EW-dmGWAS) approach to co-analyze whole-genome gene expression data from ethanol-exposed mouse brain tissue, human protein-protein interaction databases and alcohol dependence-related genome-wide association studies. Results revealed novel ethanol-responsive and alcohol dependence-associated gene networks in prefrontal cortex, nucleus accumbens, and ventral tegmental area. Three of these networks were overrepresented with genome-wide association signals from an independent dataset. These networks were significantly overrepresented for gene ontology categories involving several mechanisms, including actin filament-based activity, transcript regulation, Wnt and Syndecan-mediated signaling, and ubiquitination. Together, these studies provide novel insight for brain mechanisms contributing to alcohol dependence.
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Affiliation(s)
- Kristin M. Mignogna
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, Virginia, United States of America
- VCU Alcohol Research Center, Virginia Commonwealth University, Richmond, Virginia, United States of America
- VCU Center for Clinical & Translational Research, Virginia Commonwealth University, Richmond, Virginia, United States of America
| | - Silviu A. Bacanu
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, Virginia, United States of America
- VCU Alcohol Research Center, Virginia Commonwealth University, Richmond, Virginia, United States of America
| | - Brien P. Riley
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, Virginia, United States of America
- VCU Alcohol Research Center, Virginia Commonwealth University, Richmond, Virginia, United States of America
| | - Aaron R. Wolen
- Department of Human and Molecular Genetics, Virginia Commonwealth University, Richmond, Virginia, United States of America
| | - Michael F. Miles
- VCU Alcohol Research Center, Virginia Commonwealth University, Richmond, Virginia, United States of America
- Department of Pharmacology and Toxicology, Virginia Commonwealth University, Richmond, Virginia, United States of America
- * E-mail:
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