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Weber A, Shevchenko Y, Gerhardt S, Hoffmann S, Kiefer F, Vollstädt-Klein S. Effectiveness of Reducing Craving in Alcohol Use Disorder Using a Serious Game (SALIENCE): Randomized Controlled Trial. JMIR Form Res 2023; 7:e42194. [PMID: 37934561 PMCID: PMC10664013 DOI: 10.2196/42194] [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: 08/25/2022] [Revised: 01/23/2023] [Accepted: 09/28/2023] [Indexed: 11/08/2023] Open
Abstract
BACKGROUND Alcohol use disorder (AUD) has become a major global health problem. Therapy for this condition is still a great challenge. Recently, it has become increasingly evident that computer-based training is a valuable addition to the treatment of addictive disorders. OBJECTIVE This study aims to evaluate the web-based serious game SALIENCE (Stop Alcohol in Everyday Life-New Choices and Evaluations) as an add-on therapy for AUD. It combines the cue-exposure therapy approach with elements of decision-making training, enhanced by interactive panoramic images. The effects of SALIENCE training on levels of craving, attention, and cognitive bias are investigated. METHODS In a randomized controlled trial, 62 participants with AUD undergoing 3 weeks of an extended alcohol detoxification program were randomly allocated to an intervention and a control group. A total of 49 individuals (mean age 44.04 y; 17/49, 35% female) completed all sessions and were included in the analysis. Only pretreatment data were available from the other 13 patients. Participants answered questionnaires related to alcohol consumption and craving and completed neuropsychological tasks at the beginning of the study and 2 weeks later to evaluate levels of attention and cognitive biases. During the 2-week period, 27 of the participants additionally performed the SALIENCE training for 30 minutes 3 times a week, for a total of 6 sessions. RESULTS We observed a significant decrease in craving in both groups: the control group (mean 15.59, SD 8.02 on the first examination day vs mean 13.18, SD 8.38 on the second examination day) and the intervention group (mean 15.19, SD 6.71 on the first examination day vs mean 13.30, SD 8.47 on the second examination day; F1,47=4.31; P=.04), whereas the interaction effect was not statistically significant (F1,47=0.06; P=.80). Results of the multiple linear regression controlling for individual differences between participants indicated a significantly greater decrease in craving (β=4.12; t36=2.34; P=.03) with the SALIENCE intervention. Participants with lower drinking in negative situations reduced their craving (β=.38; t36=3.01; P=.005) more than people with higher drinking in negative situations. CONCLUSIONS The general effectiveness of SALIENCE training as an add-on therapy in reducing alcohol craving was not confirmed. Nevertheless, taking into account individual differences (gender, duration of dependence, stress, anxiety, and drinking behavior in different situations), it was shown that SALIENCE training resulted in a larger reduction in craving than without. Notably, individuals who rarely consume alcohol due to negative affect profited the most from SALIENCE training. In addition to the beneficial effect of SALIENCE training, these findings highlight the relevance of individualized therapy for AUD, adapted to personal circumstances such as drinking motivation. TRIAL REGISTRATION ClinicalTrials.gov NCT03765476; https://clinicaltrials.gov/show/NCT03765476.
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Affiliation(s)
- Antonia Weber
- Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Yury Shevchenko
- Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- Research Methods, Assessment, and iScience, Department of Psychology, University of Konstanz, Konstanz, Germany
| | - Sarah Gerhardt
- Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Sabine Hoffmann
- Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Falk Kiefer
- Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- Mannheim Center for Translational Neurosciences (MCTN), Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- Feuerlein Center on Translational Addiction Medicine, Heidelberg University, Heidelberg, Germany
| | - Sabine Vollstädt-Klein
- Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
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Li C, Dai W, Miao S, Xie W, Yu S. Medication overuse headache and substance use disorder: A comparison based on basic research and neuroimaging. Front Neurol 2023; 14:1118929. [PMID: 36937526 PMCID: PMC10017752 DOI: 10.3389/fneur.2023.1118929] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 02/10/2023] [Indexed: 03/06/2023] Open
Abstract
It has yet to be determined whether medication overuse headache (MOH) is an independent disorder or a combination of primary headache and substance addiction. To further explore the causes of MOH, we compared MOH with substance use disorder (SUD) in terms of the brain regions involved to draw more targeted conclusions. In this review, we selected alcohol use disorder (AUD) as a representative SUD and compared MOH and AUD from two aspects of neuroimaging and basic research. We found that in neuroimaging studies, there were many overlaps between AUD and MOH in the reward circuit, but the extensive cerebral cortex damage in AUD was more serious than that in MOH. This difference was considered to reflect the sensitivity of the cortex structure to alcohol damage. In future research, we will focus on the central amygdala (CeA), prefrontal cortex (PFC), orbital-frontal cortex (OFC), hippocampus, and other brain regions for interventions, which may have unexpected benefits for addiction and headache symptoms in MOH patients.
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Xie JY, Li RH, Yuan W, Du J, Zhou DS, Cheng YQ, Xu XM, Liu H, Yuan TF. Advances in neuroimaging studies of alcohol use disorder (AUD). PSYCHORADIOLOGY 2022; 2:146-155. [PMID: 38665276 PMCID: PMC11003430 DOI: 10.1093/psyrad/kkac018] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 11/08/2022] [Accepted: 11/14/2022] [Indexed: 04/28/2024]
Abstract
Alcohol use disorder (AUD) is a worldwide problem and the most common substance use disorder. Chronic alcohol consumption may have negative effects on the body, the mind, the family, and even society. With the progress of current neuroimaging methods, an increasing number of imaging techniques are being used to objectively detect brain impairment induced by alcoholism and serve a vital role in the diagnosis, prognosis, and treatment assessment of AUD. This article organizes and analyzes the research on alcohol dependence concerning the main noninvasive neuroimaging methods, structural magnetic resonance imaging, functional magnetic resonance imaging, and electroencephalography, as well as the most common noninvasive brain stimulation - transcranial magnetic stimulation, and intersperses the article with joint intra- and intergroup studies, providing an outlook on future research directions.
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Affiliation(s)
- Ji-Yu Xie
- School of Mental Health, Wenzhou Medical University, Wenzho 325000, Zhejiangu, China
| | - Rui-Hua Li
- Shandong Mental Health Center, Shandong University, Jinan 250014, Shandong, China
| | - Wei Yuan
- Shandong Mental Health Center, Shandong University, Jinan 250014, Shandong, China
| | - Jiang Du
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai 200030, China
| | - Dong-Sheng Zhou
- Department of Psychiatry, Ningbo Kangning Hospital, Ningbo 315000, Zhejiang, China
| | - Yu-Qi Cheng
- Department of Psychiatry, First Affiliated Hospital of Kunming Medical University, Kunming 650000, Yunnan, China
| | - Xue-Ming Xu
- Department of Psychiatry, Taizhou Second People's Hospital, Taizhou 318000, Zhejiang, China
| | - Heng Liu
- Department of Radiology, the Affiliated Hospital of Zunyi Medical University, Medical Imaging Center of Guizhou Province, Zunyi 563000, Guizhou, China
| | - Ti-Fei Yuan
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai 200030, China
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Wall KM, Dell J, Lowell A, Potenza MN, Mayes LC, Rutherford HJV. Current Substance Use and Maternal Neural Responses to Infant Faces and Cries. Int J Ment Health Addict 2022. [DOI: 10.1007/s11469-022-00947-2] [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: 11/16/2022] Open
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O’Shields J, Baldwin-White A. Exploring the Role of Social Networking Sites in Alcohol Consumption among College Students: Which Platforms Have the Greatest Influence? ALCOHOLISM TREATMENT QUARTERLY 2022. [DOI: 10.1080/07347324.2022.2137447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Affiliation(s)
- Jay O’Shields
- School of Social Work, University of Georgia, Athens, Georgia, USA
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Alarefi A, Alhusaini N, Wang X, Tao R, Rui Q, Gao G, Pang L, Qiu B, Zhang X. Alcohol dependence inpatients classification with GLM and hierarchical clustering integration using fMRI data of alcohol multiple scenario cues. Exp Brain Res 2022; 240:2595-2605. [PMID: 36029312 DOI: 10.1007/s00221-022-06447-y] [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: 03/27/2022] [Accepted: 08/18/2022] [Indexed: 11/25/2022]
Abstract
Alterations in brain reactions to alcohol-related cues are a neurobiological characteristic of alcohol dependence (AD) and a prospective target for achieving substantial treatment effects. However, a robust prediction of the differences in inpatients' brain responses to alcohol cues during the treatment process is still required. This study offers a data-driven approach for classifying AD inpatients undertaking alcohol treatment protocols based on their brain responses to alcohol imagery with and without drinking actions. The brain activity of thirty inpatients with AD undergoing treatment was scanned using functional magnetic resonance imaging (fMRI) while seeing alcohol and matched non-alcohol images. The mean values of brain regions of interest (ROI) for alcohol-related brain responses were obtained using general linear modeling (GLM) and subjected to hierarchical clustering analysis. The proposed classification technique identified two distinct subgroups of inpatients. For the two types of cues, subgroup one exhibited significant activation in a wide range of brain regions, while subgroup two showed mainly decreased activation. The proposed technique may aid in detecting the vulnerability of the classified inpatient subgroups, which can suggest allocating the inpatients in the classified subgroups to more effective therapies and developing prognostic future relapse markers in AD.
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Affiliation(s)
- Abdulqawi Alarefi
- Department of Radiology, the First Affiliated Hospital of USTC, Hefei National Research Center for Physical Sciences at the Microscale and School of Life Science, Division of Life Science and Medicine, University of Science and Technology of China, Hefei, 230027, China
| | - Naji Alhusaini
- School of Computer and Information Engineering, Chuzhou University, Chuzhou, 239099, Anhui, China.,School of Computer Science and Technology, University of Science and Technology of China, Hefei, 230009, China
| | - Xunshi Wang
- Hefei Medical Research Center on Alcohol Addiction, Affiliated Psychological Hospital of Anhui Medical University, Hefei Fourth People's Hospital, Anhui Mental Health Center, Hefei, 230017, China
| | - Rui Tao
- Hefei Medical Research Center on Alcohol Addiction, Affiliated Psychological Hospital of Anhui Medical University, Hefei Fourth People's Hospital, Anhui Mental Health Center, Hefei, 230017, China
| | - Qinqin Rui
- Hefei Medical Research Center on Alcohol Addiction, Affiliated Psychological Hospital of Anhui Medical University, Hefei Fourth People's Hospital, Anhui Mental Health Center, Hefei, 230017, China
| | - Guoqing Gao
- Hefei Medical Research Center on Alcohol Addiction, Affiliated Psychological Hospital of Anhui Medical University, Hefei Fourth People's Hospital, Anhui Mental Health Center, Hefei, 230017, China
| | - Liangjun Pang
- Hefei Medical Research Center on Alcohol Addiction, Affiliated Psychological Hospital of Anhui Medical University, Hefei Fourth People's Hospital, Anhui Mental Health Center, Hefei, 230017, China
| | - Bensheng Qiu
- Centers for Biomedical Engineering, School of Information Science and Technology, University of Science and Technology of China, Hefei, 230027, Anhui, China
| | - Xiaochu Zhang
- Department of Radiology, the First Affiliated Hospital of USTC, Hefei National Research Center for Physical Sciences at the Microscale and School of Life Science, Division of Life Science and Medicine, University of Science and Technology of China, Hefei, 230027, China. .,Hefei Medical Research Center on Alcohol Addiction, Affiliated Psychological Hospital of Anhui Medical University, Hefei Fourth People's Hospital, Anhui Mental Health Center, Hefei, 230017, China. .,Centers for Biomedical Engineering, School of Information Science and Technology, University of Science and Technology of China, Hefei, 230027, Anhui, China. .,Application Technology Center of Physical Therapy to Brain Disorders, Institute of Advanced Technology, University of Science & Technology of China, Hefei, 230031, China.
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Differential association between the GLP1R gene variants and brain functional connectivity according to the severity of alcohol use. Sci Rep 2022; 12:13027. [PMID: 35906358 PMCID: PMC9338323 DOI: 10.1038/s41598-022-17190-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 07/21/2022] [Indexed: 11/08/2022] Open
Abstract
Growing evidence suggests that the glucagon-like peptide-1 (GLP-1) system is involved in mechanisms underlying alcohol seeking and consumption. Accordingly, the GLP-1 receptor (GLP-1R) has begun to be studied as a potential pharmacotherapeutic target for alcohol use disorder (AUD). The aim of this study was to investigate the association between genetic variation at the GLP-1R and brain functional connectivity, according to the severity of alcohol use. Participants were 181 individuals categorized as high-risk (n = 96) and low-risk (n = 85) alcohol use, according to their AUD identification test (AUDIT) score. Two uncommon single nucleotide polymorphisms (SNPs), rs6923761 and rs1042044, were selected a priori for this study because they encode amino-acid substitutions with putative functional consequences on GLP-1R activity. Genotype groups were based on the presence of the variant allele for each of the two GLP-1R SNPs of interest [rs6923761: AA + AG (n = 65), GG (n = 116); rs1042044: AA + AC (n = 114), CC (n = 67)]. Resting-state functional MRI data were acquired for 10 min and independent component (IC) analysis was conducted. Multivariate analyses of covariance (MANCOVA) examined the interaction between GLP-1R genotype group and AUDIT group on within- and between-network connectivity. For rs6923761, three ICs showed significant genotype × AUDIT interaction effects on within-network connectivity: two were mapped onto the anterior salience network and one was mapped onto the visuospatial network. For rs1042044, four ICs showed significant interaction effects on within-network connectivity: three were mapped onto the dorsal default mode network and one was mapped onto the basal ganglia network. For both SNPs, post-hoc analyses showed that in the group carrying the variant allele, high versus low AUDIT was associated with stronger within-network connectivity. No significant effects on between-network connectivity were found. In conclusion, genetic variation at the GLP-1R was differentially associated with brain functional connectivity in individuals with low versus high severity of alcohol use. Significant findings in the salience and default mode networks are particularly relevant, given their role in the neurobiology of AUD and addictive behaviors.
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Duan R, Jing L, Li Y, Gong Z, Yao Y, Wang W, Zhang Y, Cheng J, Peng Y, Li L, Jia Y. Altered Global Signal Topography in Alcohol Use Disorders. Front Aging Neurosci 2022; 14:803780. [PMID: 35250540 PMCID: PMC8888878 DOI: 10.3389/fnagi.2022.803780] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 01/24/2022] [Indexed: 12/15/2022] Open
Abstract
The most common symptom of patients with alcohol use disorders (AUD) is cognitive impairment that negatively affects abstinence. Presently, there is a lack of indicators for early diagnosis of alcohol-related cognitive impairment (ARCI). We aimed to assess the cognitive deficits in AUD patients with the help of a specific imaging marker for ARCI. Data-driven dynamic and static global signal topography (GST) methods were applied to explore the cross-talks between local and global neuronal activities in the AUD brain. Twenty-six ARCI, 54 AUD without cognitive impairment (AUD-NCI), and gender/age-matched 40 healthy control (HC) subjects were recruited for this study. We found that there was no significant difference with respect to voxel-based morphometry (VBM) and static GST between AUD-NCI and ARCI groups. And in dynamic GST measurements, the AUD-NCI patients had the highest coefficient of variation (CV) at the right insula, followed by ARCI and the HC subjects. In precuneus, the order was reversed. There was no significant correlation between the dynamic GST and behavioral scores or alcohol consumption. These results suggested that dynamic GST might have potential implications in understanding AUD pathogenesis and disease management.
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Affiliation(s)
- Ranran Duan
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Lijun Jing
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yanfei Li
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Zhe Gong
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yaobing Yao
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Weijian Wang
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Engineering Technology Research Center for Detection and Application of Brain Function of Henan Province, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Key Laboratory of Magnetic Resonance and Brain Function of Henan Province, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Key Laboratory of Brain Function and Cognitive Magnetic Resonance Imaging of Zhengzhou, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yong Zhang
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Engineering Technology Research Center for Detection and Application of Brain Function of Henan Province, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Key Laboratory of Magnetic Resonance and Brain Function of Henan Province, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Key Laboratory of Brain Function and Cognitive Magnetic Resonance Imaging of Zhengzhou, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Jingliang Cheng
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Engineering Technology Research Center for Detection and Application of Brain Function of Henan Province, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Key Laboratory of Magnetic Resonance and Brain Function of Henan Province, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Key Laboratory of Brain Function and Cognitive Magnetic Resonance Imaging of Zhengzhou, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Ying Peng
- Department of Neurology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Li Li
- Department of Anesthesiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
- *Correspondence: Li Li Yanjie Jia
| | - Yanjie Jia
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- *Correspondence: Li Li Yanjie Jia
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9
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Neurocircuitry of Mindfulness-Based Interventions for Substance Use Prevention and Recovery. CURRENT ADDICTION REPORTS 2021. [DOI: 10.1007/s40429-021-00396-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Kwon HG, Choi SH, Seo JH, Yang CH, Lee MY. Effects of acupuncture stimulation on brain activation induced by cue-elicited alcohol craving. Neural Regen Res 2021; 17:1059-1064. [PMID: 34558533 PMCID: PMC8552869 DOI: 10.4103/1673-5374.324849] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Acupuncture has been shown to be effective on alcohol use disorder. However, the underlying mechanism remains poorly understood. To investigate the effects of Shenmen (HT7) acupoint on brain activation induced by cue-elicited alcohol craving, 30 right-handed healthy light to moderate alcohol drinkers were recruited from the community. They were randomly assigned to undergo acupuncture either at HT7 (experimental acupoint, n = 15) or Jingqu (LU8, control acupoint, n = 15) acupoints. This randomized controlled study was performed in Daegu Haany University and Daegu-Gyeongbuk Medical Innovation Foundation, Republic of Korea. Recruitment and data collection were conducted from December 2018 to May 2019. The results showed that after acupuncture at HT7 acupoint, the activation of orbitofrontal cortex and dorsolateral prefrontal cortex was greatly increased, while the activation of dorsolateral prefrontal cortex was obviously reduced, and subject's craving for alcohol was reduced when he/she seeing alcohol-related video clips involving various alcohols (beer, wine, or soju) or drinking scenarios. Acupuncture at HT7 more greatly reduced subject's alcohol cravings than acupuncture at LU8 acupoint. These findings suggest that acupuncture can improve the self-control of mild to moderate social drinkers through the activation of the orbitofrontal cortex and dorsolateral prefrontal cortex, thereby reducing the craving for alcohol. The study protocol was approved by the Institutional Review Board of Daegu Haany University Korean Medicine Hospital, Republic of Korea (approval No. DHUMC-D-18026-PRO-02) on November 30, 2018.
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Affiliation(s)
- Hyeok Gyu Kwon
- Department of Physical Therapy, College of Health Science, Eulji University, Gyeonggi, Republic of Korea
| | - Seong Hun Choi
- Department of Anatomy and Histology, College of Oriental Medicine, Daegu Haany University, Gyeongsan, Republic of Korea
| | - Joon Ho Seo
- Department of Rehabilitation, Gyeongbuk Regional Rehabilitation Hospital, Gyeongsan, Republic of Korea
| | - Chae Ha Yang
- Department of Physiology, College of Korean Medicine, Daegu Haany University, Daegu, Republic of Korea
| | - Mi Young Lee
- Department of Physical Therapy, College of Biomedical Science, Daegu Haany University, Gyeongsan, Republic of Korea
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Zeng J, Yu S, Cao H, Su Y, Dong Z, Yang X. Neurobiological correlates of cue-reactivity in alcohol-use disorders: A voxel-wise meta-analysis of fMRI studies. Neurosci Biobehav Rev 2021; 128:294-310. [PMID: 34171325 DOI: 10.1016/j.neubiorev.2021.06.031] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 05/31/2021] [Accepted: 06/19/2021] [Indexed: 02/08/2023]
Abstract
Altered brain responses to alcohol-associated stimuli are a neural hallmark of alcohol-use disorder (AUD) and a promising target for pharmacotherapy. However, findings in cue-reactivity based functional MRI (fMRI) studies are inconclusive. To investigate the neural substrates of cue-reactivity and their relevance to treatment outcomes, alcohol craving and relapse in AUD patients, we performed five meta-analyses using signed differential mapping software. Our meta-analysis revealed that alcohol cues evoke greater cue-reactivity than neutral cues in the mesocorticolimbic circuit and lower reactivity in the parietal and temporal regions in AUD patients. Compared to controls, AUD individuals displayed hyperactivations in the medial prefrontal cortex and anterior/middle part of the cingulate cortex. After receiving AUD treatment, AUD patients exhibited greater activations in the precentral gyrus but reduced activations in the bilateral caudate nucleus, insula, right DLPFC, and left superior frontal gyrus. No significant results were found in cue-reactivity correlates of alcohol craving and relapse. Our results implicate cue-induced abnormalities in corticostriatal-limbic circuits may underline the pathophysiology of AUD, and have translational value for treatment development.
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Affiliation(s)
- Jianguang Zeng
- School of Economics and Business Administration, Chongqing University, Chongqing, 400044, China
| | - Shuxian Yu
- School of Economics and Business Administration, Chongqing University, Chongqing, 400044, China
| | - Hengyi Cao
- Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Hempstead, NY, USA; Division of Psychiatry Research, Zucker Hillside Hospital, Glen Oaks, NY, USA
| | - Yueyue Su
- School of Public Policy and Administration, Chongqing University, Chongqing, 400044, China
| | - Zaiquan Dong
- Department of Psychiatry, State Key Lab of Biotherapy, West China Hospital of Sichuan University, Chengdu, 610041, China
| | - Xun Yang
- School of Public Policy and Administration, Chongqing University, Chongqing, 400044, China.
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Abstract
Abstract
Purpose of Review
Current theories of alcohol use disorders (AUD) highlight the importance of Pavlovian and instrumental learning processes mainly based on preclinical animal studies. Here, we summarize available evidence for alterations of those processes in human participants with AUD with a focus on habitual versus goal-directed instrumental learning, Pavlovian conditioning, and Pavlovian-to-instrumental transfer (PIT) paradigms.
Recent Findings
The balance between habitual and goal-directed control in AUD participants has been studied using outcome devaluation or sequential decision-making procedures, which have found some evidence of reduced goal-directed/model-based control, but little evidence for stronger habitual responding. The employed Pavlovian learning and PIT paradigms have shown considerable differences regarding experimental procedures, e.g., alcohol-related or conventional reinforcers or stimuli.
Summary
While studies of basic learning processes in human participants with AUD support a role of Pavlovian and instrumental learning mechanisms in the development and maintenance of drug addiction, current studies are characterized by large variability regarding methodology, sample characteristics, and results, and translation from animal paradigms to human research remains challenging. Longitudinal approaches with reliable and ecologically valid paradigms of Pavlovian and instrumental processes, including alcohol-related cues and outcomes, are warranted and should be combined with state-of-the-art imaging techniques, computational approaches, and ecological momentary assessment methods.
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Agarwal K, Manza P, Leggio L, Livinski AA, Volkow ND, Joseph PV. Sensory cue reactivity: Sensitization in alcohol use disorder and obesity. Neurosci Biobehav Rev 2021; 124:326-357. [PMID: 33587959 DOI: 10.1016/j.neubiorev.2021.02.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 02/03/2021] [Accepted: 02/07/2021] [Indexed: 12/21/2022]
Abstract
Neuroimaging techniques to measure the function of the human brain such as electroencephalography (EEG), positron emission tomography (PET), and functional magnetic resonance imaging (fMRI), are powerful tools for understanding the underlying neural circuitry associated with alcohol use disorder (AUD) and obesity. The sensory (visual, taste and smell) paradigms used in neuroimaging studies represent an ideal platform to investigate the connection between the different neural circuits subserving the reward/executive control systems in these disorders, which may offer a translational mechanism for novel intervention predictions. Thus, the current review provides an integrated summary of the recent neuroimaging studies that have applied cue-reactivity paradigms and neuromodulation strategies to explore underlying alterations in neural circuitry as well in treatment strategies in AUD and obesity. Finally, we discuss literature on mechanisms associated with increased alcohol sensitivity post-bariatric surgery (BS) which offers guidance for future research to use sensory percepts in elucidating the relation of reward signaling in AUD development post-BS.
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Affiliation(s)
- Khushbu Agarwal
- National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, USA; National Institute of Nursing Research, Bethesda, MD, USA
| | - Peter Manza
- National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, USA
| | - Lorenzo Leggio
- National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, USA; National Institute on Drug Abuse, Bethesda and Baltimore, MD, USA
| | | | - Nora D Volkow
- National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, USA; National Institute on Drug Abuse, Bethesda and Baltimore, MD, USA
| | - Paule Valery Joseph
- National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, USA; National Institute of Nursing Research, Bethesda, MD, USA.
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Fukushima S, Kuga H, Oribe N, Mutou T, Yuzuriha T, Ozawa H, Ueno T. Correction: Behavioural cue reactivity to alcohol-related and non-alcohol-related stimuli among individuals with alcohol use disorder: An fMRI study with a visual task. PLoS One 2020; 15:e0242531. [PMID: 33180851 PMCID: PMC7660537 DOI: 10.1371/journal.pone.0242531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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