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Kirk-Provencher KT, Sloan ME, Andereas K, Erickson CJ, Hakimi RH, Penner AE, Gowin JL. Neural responses to reward, threat, and emotion regulation and transition to hazardous alcohol use. Alcohol Alcohol 2024; 59:agae043. [PMID: 38953742 PMCID: PMC11217988 DOI: 10.1093/alcalc/agae043] [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: 01/11/2024] [Revised: 05/13/2024] [Accepted: 06/19/2024] [Indexed: 07/04/2024] Open
Abstract
AIMS Reward processing and regulation of emotions are thought to impact the development of addictive behaviors. In this study, we aimed to determine whether neural responses during reward anticipation, threat appraisal, emotion reactivity, and cognitive reappraisal predicted the transition from low-level to hazardous alcohol use over a 12-month period. METHODS Seventy-eight individuals aged 18-22 with low-level alcohol use [i.e. Alcohol Use Disorder Identification Test (AUDIT) score <7] at baseline were enrolled. They completed reward-based and emotion regulation tasks during magnetic resonance imaging to examine reward anticipation, emotional reactivity, cognitive reappraisal, and threat anticipation (in the nucleus accumbens, amygdala, superior frontal gyrus, and insula, respectively). Participants completed self-report measures at 3-, 6-, 9-, and 12-month follow-up time points to determine if they transitioned to hazardous use (as defined by AUDIT scores ≥8). RESULTS Of the 57 participants who completed follow-up, 14 (24.6%) transitioned to hazardous alcohol use. Higher baseline AUDIT scores were associated with greater odds of transitioning to hazardous use (odds ratio = 1.73, 95% confidence interval 1.13-2.66, P = .005). Brain activation to reward, threat, and emotion regulation was not associated with alcohol use. Of the neural variables, the amygdala response to negative imagery was numerically larger in young adults who transitioned to hazardous use (g = 0.31), but this effect was not significant. CONCLUSIONS Baseline drinking levels were significantly associated with the transition to hazardous alcohol use. Studies with larger samples and longer follow-up should test whether the amygdala response to negative emotional imagery can be used to indicate a future transition to hazardous alcohol use.
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Affiliation(s)
- Katelyn T Kirk-Provencher
- Department of Radiology, School of Medicine, University of Colorado Anschutz Medical Campus, 12700 E. 19th Avenue, Aurora, CO 80045, United States
| | - Matthew E Sloan
- Addictions Division, Centre for Addiction and Mental Health, 1001 Queen St. W, Toronto, ON, M6J 1H4, Canada
- Department of Pharmacology and Toxicology, University of Toronto, 1 King's College Circle Toronto, ON, M5S 1A8, Canada
- Division of Neurosciences and Clinical Translation, Department of Psychiatry, University of Toronto, 250 College St. Toronto, ON, M5T 1R8, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 620 University Ave. Toronto, ON, M5G 2C1, Canada
- Department of Psychological Clinical Science, University of Toronto Scarborough, Toronto, ON, Canada
- Institute of Medical Science, University of Toronto, 1 King's College Circle Toronto, ON, M5S 1A8, Canada
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 479 Spadina Ave. Toronto, ON, M5S 2S1, Canada
| | - Keinada Andereas
- Department of Radiology, School of Medicine, University of Colorado Anschutz Medical Campus, 12700 E. 19th Avenue, Aurora, CO 80045, United States
| | - Cooper J Erickson
- Department of Radiology, School of Medicine, University of Colorado Anschutz Medical Campus, 12700 E. 19th Avenue, Aurora, CO 80045, United States
| | - Rosa H Hakimi
- Department of Radiology, School of Medicine, University of Colorado Anschutz Medical Campus, 12700 E. 19th Avenue, Aurora, CO 80045, United States
| | - Anne E Penner
- Department of Psychiatry, School of Medicine, University of Colorado Anschutz Medical Campus, 12700 E. 19th Avenue, Aurora, CO 80045, United States
| | - Joshua L Gowin
- Department of Radiology, School of Medicine, University of Colorado Anschutz Medical Campus, 12700 E. 19th Avenue, Aurora, CO 80045, United States
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Hurzeler T, Watt J, Logge W, Towers E, Suraev A, Lintzeris N, Haber P, Morley KC. Neuroimaging studies of cannabidiol and potential neurobiological mechanisms relevant for alcohol use disorders: a systematic review. J Cannabis Res 2024; 6:15. [PMID: 38509580 PMCID: PMC10956336 DOI: 10.1186/s42238-024-00224-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 03/03/2024] [Indexed: 03/22/2024] Open
Abstract
The underlying neurobiological mechanisms of cannabidiol's (CBD) management of alcohol use disorder (AUD) remains elusive.Aim We conducted a systematic review of neuroimaging literature investigating the effects of CBD on the brain in healthy participants. We then theorise the potential neurobiological mechanisms by which CBD may ameliorate various symptoms of AUD.Methods This review was conducted according to the PRISMA guidelines. Terms relating to CBD and neuroimaging were used to search original clinical research published in peer-reviewed journals.Results Of 767 studies identified by our search strategy, 16 studies satisfied our eligibility criteria. The results suggest that CBD modulates γ-Aminobutyric acid and glutamate signaling in the basal ganglia and dorso-medial prefrontal cortex. Furthermore, CBD regulates activity in regions associated with mesocorticolimbic reward pathways; salience, limbic and fronto-striatal networks which are implicated in reward anticipation; emotion regulation; salience processing; and executive functioning.Conclusion CBD appears to modulate neurotransmitter systems and functional connections in brain regions implicated in AUD, suggesting CBD may be used to manage AUD symptomatology.
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Affiliation(s)
- Tristan Hurzeler
- Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
- Translational Research in Alcohol, Edith Collins Centre, Sydney Local Health District, Sydney, Australia
| | - Joshua Watt
- Translational Research in Alcohol, Edith Collins Centre, Sydney Local Health District, Sydney, Australia
| | - Warren Logge
- Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
- Translational Research in Alcohol, Edith Collins Centre, Sydney Local Health District, Sydney, Australia
| | - Ellen Towers
- Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
- Translational Research in Alcohol, Edith Collins Centre, Sydney Local Health District, Sydney, Australia
| | - Anastasia Suraev
- Lambert Initiative for Cannabinoid Therapeutics, University of Sydney, Sydney, NSW, Australia
| | - Nicholas Lintzeris
- Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
- Drug and Alcohol Services, South Eastern Sydney Local Health District, Sydney, Australia
| | - Paul Haber
- Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
- Translational Research in Alcohol, Edith Collins Centre, Sydney Local Health District, Sydney, Australia
| | - Kirsten C Morley
- Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia.
- Translational Research in Alcohol, Edith Collins Centre, Sydney Local Health District, Sydney, Australia.
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Kosonogov V, Ntoumanis I, Hajiyeva G, Jääskeläinen I. The role of engagement and arousal in emotion regulation: an EEG study. Exp Brain Res 2024; 242:179-193. [PMID: 37994917 DOI: 10.1007/s00221-023-06741-3] [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: 07/18/2023] [Accepted: 11/02/2023] [Indexed: 11/24/2023]
Abstract
Cognitive reappraisal and expressive suppression are well-studied strategies of emotion regulation (ER). However, the results on their physiological basis are controversial. While in some studies, ER was accompanied by the inhibition of the nervous system, others suggested that ER even might increase arousal and engagement. We calculated the inter-subject correlation (ISC) and indices of engagement, valence and arousal of EEG during suppression, reappraisal, or natural watching of neutral and negative videos. First, both suppression and reappraisal provoked a higher ISC in comparison with watching negative or neutral videos. We consider this as a marker of engagement to the task and feedback processing required for ER. Second, the engagement index was lower during ER compared to watching negative videos in central electrodes, whereas both strategies provoked a higher engagement in frontal electrodes. Third, the arousal index of EEG was higher during all negative conditions; therefore, regulation required a certain level of arousal. In summary, different EEG measures seem to be sensitive to different aspects of ER.
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Affiliation(s)
- Vladimir Kosonogov
- International Laboratory of Social Neurobiology, Institute for Cognitive Neuroscience, HSE University, Krivokolenny 3, Moscow, Russia, 101000.
| | - Ioannis Ntoumanis
- International Laboratory of Social Neurobiology, Institute for Cognitive Neuroscience, HSE University, Krivokolenny 3, Moscow, Russia, 101000
| | - Gullu Hajiyeva
- International Laboratory of Social Neurobiology, Institute for Cognitive Neuroscience, HSE University, Krivokolenny 3, Moscow, Russia, 101000
| | - Iiro Jääskeläinen
- International Laboratory of Social Neurobiology, Institute for Cognitive Neuroscience, HSE University, Krivokolenny 3, Moscow, Russia, 101000
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Kirk-Provencher KT, Penner AE, McRae K, Gowin JL. Emotion regulation in young adults with family history of harmful alcohol use: A fMRI study. Drug Alcohol Depend 2023; 243:109752. [PMID: 36610254 PMCID: PMC9875721 DOI: 10.1016/j.drugalcdep.2022.109752] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 10/31/2022] [Accepted: 12/14/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Alcohol use disorder is associated with difficulties in emotion regulation and cognitive reappraisal. Family history of harmful alcohol use increases risk of substance use disorders, but no studies have examined whether family history is associated with altered neural activation during cognitive reappraisal relative to passive viewing of negative images in a sample of young adults without current substance use disorders. METHODS Participants (N = 75 with positive [n = 31] or negative [n = 44] family histories of harmful alcohol use) completed the emotion regulation task during an MRI scan, and the Emotion Regulation Questionnaire to assess use of emotion regulation and suppression strategies. Whole-brain analyses and amygdala region of interest analyses using linear mixed-effects models assessed family history group and cue effects on neural activation during the task. RESULTS The groups did not differ on trait reappraisal, suppression, or negative emotion following reappraisal. In general, group effects in whole-brain and amygdala activation during the cognitive reappraisal contrast indicated small effect sizes (2.2% of voxels had d>0.20) that were not significantly different. Participants with positive family histories engaged the right middle and superior frontal gyri to a greater extent than participants with negative family histories during the decrease-negative cue (t = 4.14, p = .001). CONCLUSIONS For at-risk young adults without current harmful substance use, family history of harmful alcohol use does not appear to be associated with disrupted emotion regulation when instructed to apply cognitive reappraisal. Reappraisal may be a feasible therapeutic target for those who develop a substance use disorder with associated emotion dysregulation.
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Affiliation(s)
- Katelyn T Kirk-Provencher
- Department of Radiology, School of Medicine, University of Colorado Anschutz Medical Campus, 12700 E. 19th Avenue, Aurora, CO 80045, United States.
| | - Anne E Penner
- Department of Psychiatry, School of Medicine, University of Colorado Anschutz Medical Campus, 13001 E. 17th Place, Aurora, CO 80045, United States.
| | - Kateri McRae
- Department of Psychology, University of Denver, 2155S. Race Street, Denver, CO 80208, United States.
| | - Joshua L Gowin
- Department of Radiology, School of Medicine, University of Colorado Anschutz Medical Campus, 12700 E. 19th Avenue, Aurora, CO 80045, United States.
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Vamvakopoulou IA, Fonville L, Hayes A, McGonigle J, Elliott R, Ersche KD, Flechais R, Orban C, Murphy A, Smith DG, Suckling J, Taylor EM, Deakin B, Robbins TW, Nutt DJ, Lingford-Hughes AR, Paterson LM. Selective D3 receptor antagonism modulates neural response during negative emotional processing in substance dependence. Front Psychiatry 2022; 13:998844. [PMID: 36339857 PMCID: PMC9627287 DOI: 10.3389/fpsyt.2022.998844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 09/20/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction Negative affective states contribute to the chronic-relapsing nature of addiction. Mesolimbic dopamine D3 receptors are well placed to modulate emotion and are dysregulated in substance dependence. Selective antagonists might restore dopaminergic hypofunction, thus representing a potential treatment target. We investigated the effects of selective D3 antagonist, GSK598809, on the neural response to negative emotional processing in substance dependent individuals and healthy controls. Methodology Functional MRI BOLD response was assessed during an evocative image task, 2 h following acute administration of GSK598809 (60 mg) or placebo in a multi-site, double-blind, pseudo-randomised, cross-over design. Abstinent drug dependent individuals (DD, n = 36) comprising alcohol-only (AO, n = 19) and cocaine-alcohol polydrug (PD, n = 17) groups, and matched controls (n = 32) were presented with aversive and neutral images in a block design (contrast of interest: aversive > neutral). Whole-brain mixed-effects and a priori ROI analyses tested for group and drug effects, with identical models exploring subgroup effects. Results No group differences in task-related BOLD signal were identified between DD and controls. However, subgroup analysis revealed greater amygdala/insular BOLD signal in PD compared with AO groups. Following drug administration, GSK598809 increased BOLD response across HC and DD groups in thalamus, caudate, putamen, and pallidum, and reduced BOLD response in insular and opercular cortices relative to placebo. Multivariate analyses in a priori ROIs revealed differential effects of D3 antagonism according to subgroup in substantia nigra; GSK598809 increased BOLD response in AO and decreased response in PD groups. Conclusion Acute GSK598809 modulates the BOLD response to aversive image processing, providing evidence that D3 antagonism may impact emotional regulation. Enhanced BOLD response within D3-rich mesolimbic regions is consistent with its pharmacology and with attenuation of substance-related hypodopaminergic function. However, the lack of group differences in task-related BOLD response and the non-specific effect of GSK598809 between groups makes it difficult to ascertain whether D3 antagonism is likely to be normalising or restorative in our abstinent populations. The suggestion of differential D3 modulation between AO and PD subgroups is intriguing, raising the possibility of divergent treatment responses. Further study is needed to determine whether D3 antagonism should be recommended as a treatment target in substance dependence.
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Affiliation(s)
- Ioanna A. Vamvakopoulou
- Division of Psychiatry, Department of Brain Sciences, Imperial College London, London, United Kingdom
| | - Leon Fonville
- Division of Psychiatry, Department of Brain Sciences, Imperial College London, London, United Kingdom
| | - Alexandra Hayes
- Division of Psychiatry, Department of Brain Sciences, Imperial College London, London, United Kingdom
| | - John McGonigle
- Division of Psychiatry, Department of Brain Sciences, Imperial College London, London, United Kingdom
| | - Rebecca Elliott
- Neuroscience and Psychiatry Unit, Institute of Brain, Behaviour and Mental Health, The University of Manchester, Manchester, United Kingdom
| | - Karen D. Ersche
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, United Kingdom
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
| | - Remy Flechais
- Division of Psychiatry, Department of Brain Sciences, Imperial College London, London, United Kingdom
| | - Csaba Orban
- Division of Psychiatry, Department of Brain Sciences, Imperial College London, London, United Kingdom
| | - Anna Murphy
- Neuroscience and Psychiatry Unit, Institute of Brain, Behaviour and Mental Health, The University of Manchester, Manchester, United Kingdom
| | - Dana G. Smith
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, United Kingdom
- Department of Psychology, University of Cambridge, Cambridge, United Kingdom
| | - John Suckling
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, United Kingdom
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
| | - Eleanor M. Taylor
- Neuroscience and Psychiatry Unit, Institute of Brain, Behaviour and Mental Health, The University of Manchester, Manchester, United Kingdom
| | - Bill Deakin
- Neuroscience and Psychiatry Unit, Institute of Brain, Behaviour and Mental Health, The University of Manchester, Manchester, United Kingdom
| | - Trevor W. Robbins
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, United Kingdom
- Department of Psychology, University of Cambridge, Cambridge, United Kingdom
| | - David J. Nutt
- Division of Psychiatry, Department of Brain Sciences, Imperial College London, London, United Kingdom
| | - Anne R. Lingford-Hughes
- Division of Psychiatry, Department of Brain Sciences, Imperial College London, London, United Kingdom
| | - Louise M. Paterson
- Division of Psychiatry, Department of Brain Sciences, Imperial College London, London, United Kingdom
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Mistarz N, Andersen K, Nielsen AS, Goudriaan AE, Michel TM, Skøt L, Anhøj SJ, Mellentin AI. Pharmacological compounds targeting emotional cognition in alcohol use disorder: A systematic review. Prog Neuropsychopharmacol Biol Psychiatry 2022; 116:110535. [PMID: 35182608 DOI: 10.1016/j.pnpbp.2022.110535] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 01/28/2022] [Accepted: 02/10/2022] [Indexed: 01/15/2023]
Abstract
Non-emotional (e.g., executive functions) and emotional cognitive (e.g., facial emotion recognition) impairments are a well-known aspect of alcohol use disorder (AUD). These deficits may impede on treatment outcomes, increase the risk of relapse, and lead to socio-occupational disabilities. Previous systematic reviews have examined the effectiveness of cognitive enhancing pharmacological agents (CEPAs) targeting non-emotional, but not emotional, cognition in AUD. Our aim was to systematically review the effectiveness of CEPAs targeting emotional cognition in subclinical and clinical AUD populations. A qualitative synthesis of controlled trials was conducted, and the studies were assessed for risk of bias. Eight studies were eligible (15 ≤ ns ≤ 143), and they all had a moderate risk of bias. Modafinil and nalmefene were the most examined agents, with the findings suggesting a potential beneficial effect of the agents on implicit emotional domains (i.e., reward processing). Methodological shortcomings and heterogeneous findings across the studies do not allow inferences about the effectiveness of these compounds in AUD. Future studies should examine CEPAs targeting emotional cognition in more detail.
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Affiliation(s)
- Nicolaj Mistarz
- Unit for Psychiatric Research, Department of Clinical Research, University of Southern Denmark, Odense C, Denmark.
| | - Kjeld Andersen
- Unit for Psychiatric Research, Department of Clinical Research, University of Southern Denmark, Odense C, Denmark
| | - Anette Søgaard Nielsen
- Unit for Psychiatric Research, Department of Clinical Research, University of Southern Denmark, Odense C, Denmark
| | - Anneke E Goudriaan
- Amsterdam University Medical Centre, Department of Psychiatry, University of Amsterdam, Amsterdam, the Netherlands; Amsterdam Institute for Addiction Research, Department of Research, Arkin, Amsterdam, the Netherlands
| | - Tanja Maria Michel
- Unit for Psychiatric Research, Department of Clinical Research, University of Southern Denmark, Odense C, Denmark
| | - Lotte Skøt
- Unit for Psychiatric Research, Department of Clinical Research, University of Southern Denmark, Odense C, Denmark
| | - Simon Jesper Anhøj
- Unit for Psychiatric Research, Department of Clinical Research, University of Southern Denmark, Odense C, Denmark
| | - Angelina Isabella Mellentin
- Unit for Psychiatric Research, Department of Clinical Research, University of Southern Denmark, Odense C, Denmark; Brain Research-Inter-Disciplinary Guided Excellence (BRIDGE), Department of Clinical Research, University of Southern Denmark, Odense C, Denmark
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Abdel Malek GS, Goudriaan AE, Kaag AM. The relationship between craving and insular morphometry in regular cocaine users: Does sex matter? Addict Biol 2022; 27:e13157. [PMID: 35229953 PMCID: PMC9286054 DOI: 10.1111/adb.13157] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 01/17/2022] [Accepted: 01/25/2022] [Indexed: 12/01/2022]
Abstract
While it has been suggested that cocaine use and relapse in women is more strongly related to stress‐relief craving, whereas cocaine use in men is more strongly related to reward craving, the neural mechanisms that underlie these differences are poorly understood. The aim of this study was to investigate sex‐dependent differences in insular morphometry and associations with craving, in a sample of regular cocaine users (CUs) and non‐drug using controls (non‐CUs). It was hypothesized that insular volume, thickness and surface area would be lower in CU women, compared with CU men and non‐CUs. It was furthermore hypothesized that insular morphometry, particularly insular thickness, would be negatively associated to reward craving in CU men, while being negatively associated with stress‐relief craving in CU women. In contrast to the hypothesis, we did not find evidence of sex‐specific differences in insular morphometry in CUs. However, sex‐specific association between stress‐relief craving and insular morphometry were found: Right insular volume was negatively associated with stress‐relief craving in CU women, whereas this association was positive in CU men. Additionally, right insular surface area was negatively associated with stress‐relief craving in cocaine‐using men, whereas this association was positive in cocaine‐using women. In conclusion, the current study provides first evidence of sex‐specific differences in the association between craving and insular morphometry in a sample of regular cocaine users. Although speculative, these sex‐specific alterations in insular morphometry may underlie higher stress‐induced craving and relapse in CU women compared with CU men.
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Affiliation(s)
- George S. Abdel Malek
- Department of Clinical, Neuro and Developmental Psychology Vrije University Amsterdam Amsterdam The Netherlands
| | - Anna E. Goudriaan
- Department of Psychiatry, Amsterdam University Medical Center University of Amsterdam Amsterdam The Netherlands
- Arkin Mental Health and Jellinek Amsterdam The Netherlands
- Amsterdam Institute for Addiction Research Amsterdam The Netherlands
| | - Anne Marije Kaag
- Department of Clinical, Neuro and Developmental Psychology Vrije University Amsterdam Amsterdam The Netherlands
- The Amsterdam Brain and Cognition Center (ABC) University of Amsterdam Amsterdam The Netherlands
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Li X, Li Z, Zou Z, Wu X, Gao H, Wang C, Zhou J, Qi F, Zhang M, He J, Qi X, Yan F, Dou S, Zhang H, Tong L, Li Y. Real-Time fMRI Neurofeedback Training Changes Brain Degree Centrality and Improves Sleep in Chronic Insomnia Disorder: A Resting-State fMRI Study. Front Mol Neurosci 2022; 15:825286. [PMID: 35283729 PMCID: PMC8904428 DOI: 10.3389/fnmol.2022.825286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 01/31/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundChronic insomnia disorder (CID) is considered a major public health problem worldwide. Therefore, innovative and effective technical methods for studying the pathogenesis and clinical comprehensive treatment of CID are urgently needed.MethodsReal-time fMRI neurofeedback (rtfMRI-NF), a new intervention, was used to train 28 patients with CID to regulate their amygdala activity for three sessions in 6 weeks. Resting-state fMRI data were collected before and after training. Then, voxel-based degree centrality (DC) method was used to explore the effect of rtfMRI-NF training. For regions with altered DC, we determined the specific connections to other regions that most strongly contributed to altered functional networks based on DC. Furthermore, the relationships between the DC value of the altered regions and changes in clinical variables were determined.ResultsPatients with CID showed increased DC in the right postcentral gyrus, Rolandic operculum, insula, and superior parietal gyrus and decreased DC in the right supramarginal gyrus, inferior parietal gyrus, angular gyrus, middle occipital gyrus, and middle temporal gyrus. Seed-based functional connectivity analyses based on the altered DC regions showed more details about the altered functional networks. Clinical scores in Pittsburgh sleep quality index, insomnia severity index (ISI), Beck depression inventory, and Hamilton anxiety scale decreased. Furthermore, a remarkable positive correlation was found between the changed ISI score and DC values of the right insula.ConclusionsThis study confirmed that amygdala-based rtfMRI-NF training altered the intrinsic functional hubs, which reshaped the abnormal functional connections caused by insomnia and improved the sleep of patients with CID. These findings contribute to our understanding of the neurobiological mechanism of rtfMRI-NF in insomnia treatment. However, additional double-blinded controlled clinical trials with larger sample sizes need to be conducted to confirm the effect of rtfMRI-NF from this initial study.
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Affiliation(s)
- Xiaodong Li
- Department of Radiology, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, Zhengzhou, China
| | - Zhonglin Li
- Department of Radiology, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, Zhengzhou, China
| | - Zhi Zou
- Department of Radiology, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, Zhengzhou, China
| | - Xiaolin Wu
- Department of Nuclear Medicine, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, Zhengzhou, China
| | - Hui Gao
- Henan Key Laboratory of Imaging and Intelligent Processing, PLA Strategic Support Force Information Engineering University, Zhengzhou, China
| | - Caiyun Wang
- Department of Radiology, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, Zhengzhou, China
| | - Jing Zhou
- Health Management Center, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, Zhengzhou, China
| | - Fei Qi
- Department of Radiology, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, Zhengzhou, China
| | - Miao Zhang
- Department of Radiology, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, Zhengzhou, China
| | - Junya He
- Department of Radiology, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, Zhengzhou, China
| | - Xin Qi
- Department of Radiology, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, Zhengzhou, China
| | - Fengshan Yan
- Department of Radiology, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, Zhengzhou, China
| | - Shewei Dou
- Department of Radiology, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, Zhengzhou, China
| | - Hongju Zhang
- Department of Neurology, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, Zhengzhou, China
| | - Li Tong
- Henan Key Laboratory of Imaging and Intelligent Processing, PLA Strategic Support Force Information Engineering University, Zhengzhou, China
- *Correspondence: Li Tong,
| | - Yongli Li
- Health Management Center, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, Zhengzhou, China
- Yongli Li,
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Huang Y, Chen X. Efficacy of Group Music Therapy Based on Emotion-Regulation Skills on Male Inpatients With Alcohol Dependence: A Randomized, Controlled Pilot Trial. Front Psychol 2021; 12:697617. [PMID: 34777089 PMCID: PMC8581445 DOI: 10.3389/fpsyg.2021.697617] [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: 04/19/2021] [Accepted: 10/07/2021] [Indexed: 11/13/2022] Open
Abstract
Objective: This study aimed to determine the benefits and feasibility of using group music therapy based on emotion-regulation skills to treat male inpatients with alcohol dependence (AD). Methods: We recruited male inpatients with alcohol dependence and randomly assigned those eligible for enrollment to either the study group or the control group. The study group received group music therapy along with treatment-as-usual (TAU), while the control group received only treatment-as-usual. Primary outcomes, including anxiety levels, sleep quality, and alcohol craving, were assessed at baseline and after 2 weeks of treatment. Secondary outcomes included feasibility measures such as dropout rates. We evaluated the acceptability of group music therapy based on semi-structured interviews and feedback from patients and therapists. Results: The average attendance rate of the study group patients who underwent group music therapy was 70.77%, and the drop-out rate was 7.69%. Based on intention-to-treat analysis, we found no differences in baseline assessments (p > 0.05). Assessment after 2 weeks of treatment showed that study group patients were less anxious, slept better, and had reduced alcohol cravings than control group patients. However, these differences were not statistically significant. Participants reported that group music therapy made them feel more relaxed and improved their mood. Conclusion: Group music therapy based on emotion-regulation skills is feasible with potential for efficacy and can be used to treat men with alcohol dependence in a closed inpatient environment. Further long-term research is required to gain a better understanding of the efficacy of using group music therapy to treat alcohol dependence.
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Affiliation(s)
- Yi Huang
- School of Humanities and Social Sciences, Binzhou Medical University, Yantai, China
| | - Xu Chen
- Department of Substance Abuse, Shandong Mental Health Center Affiliated to Shandong University, Jinan, China
- Department of Substance Abuse, Shandong Mental Health Center Affiliated to Jining Medical University, Jinan, China
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10
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Pan J, Chen G, Shan P, Chen C, Jiang D, Wang L, Li G, Chen M, Zhuo C, Fang T, Yu H. Plasma Orexin Levels Related to Altered Brain Activity During Abstinence in Patients with Alcohol Dependence. PSYCHIAT CLIN PSYCH 2021; 31:286-291. [PMID: 38765947 PMCID: PMC11079708 DOI: 10.5152/pcp.2021.20011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Accepted: 07/10/2020] [Indexed: 05/22/2024] Open
Abstract
Objectives In vivo studies have correlated brain activity with alcohol-seeking behavior, while clinical studies have identified altered brain activity in patients with alcohol dependence (AD) even during abstinence. We aimed to explore the relationship between plasma orexin levels, brain activity, and alcohol-craving scores in patients with AD. Methods In this pilot study, we evaluated 24 male patients with AD in remission and 25 male controls. Alcohol craving was assessed using the Obsessive Compulsive Drinking Scale (OCDS). An adapted MRI technique was used to assess global functional connectivity density (gFCD), and plasma orexin concentrations were measured by radioimmunoassay. Associations were analyzed by the Pearson correlation. Results Plasma orexin levels in AD patients in remission were significantly higher than those in the controls. OCDS scores correlated to orexin concentrations (r = 0.47, P < .05). Compared to the controls, all AD patients demonstrated reduced gFCD, primarily in the frontal, temporal, and parietal lobes, and increased gFCD in the accumbens nuclei and posterior insular cortex. Mean gFCD values in the accumbens nuclei significantly correlated to craving scores (r = 0.55, P < .05). Although assessed during abstinence, the reward circuits in AD patients exhibited increased activity. Orexin levels correlated to increased activity in the accumbens nuclei and craving scores. Conclusions The potential clinical utility of plasma orexin levels to assess the risk of relapse in AD patients in treatment and prevention programs deserves further study.
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Affiliation(s)
- Jianshe Pan
- Department of Psychiatry, Wenzhou Kangning Hospital, Wenzhou, Zhejiang Province, China
| | - Guangdong Chen
- Department of Psychiatric-Neuroimage Center, Radiology Center, Wenzhou Seventh People’s Hospital, Wenzhou, Zhejiang Province, China
| | - Peiwei Shan
- Department of Psychiatric-Neuroimage Center, Radiology Center, Wenzhou Seventh People’s Hospital, Wenzhou, Zhejiang Province, China
| | - Ce Chen
- Department of Psychiatric-Neuroimage Center, Radiology Center, Wenzhou Seventh People’s Hospital, Wenzhou, Zhejiang Province, China
| | - Deguo Jiang
- Department of Psychiatric-Neuroimage Center, Radiology Center, Wenzhou Seventh People’s Hospital, Wenzhou, Zhejiang Province, China
| | - Lina Wang
- Psychiatric-Neuroimaging-Genetics-Comorbidity (PNGC) Laboratory, Tianjin Anding Hospital, Nankai University Affiliated Anding Hospital, Tianjin Mental Health Center, Tianjin, China
| | - Gongying Li
- Department of Psychiatry, School of Mental Health, Jining Medical University, Jining, Shandong Province, China
| | - Min Chen
- Department of Psychiatry, School of Mental Health, Jining Medical University, Jining, Shandong Province, China
| | - Chuanjun Zhuo
- Department of Psychiatry, School of Mental Health, Jining Medical University, Jining, Shandong Province, China
| | - Tao Fang
- Laboratory of Neurology-Psychiatry Biological-Neuroimaging (NPBI-Lab), Tianjin Fourth Center Hospital, Tianjin, China
| | - Haiping Yu
- Department of Psychiatric-Neuroimage Center, Radiology Center, Wenzhou Seventh People’s Hospital, Wenzhou, Zhejiang Province, China
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11
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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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12
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Zhao Y, Caffo BS, Wang B, Li CSR, Luo X. A whole-brain modeling approach to identify individual and group variations in functional connectivity. Brain Behav 2021; 11:e01942. [PMID: 33210469 PMCID: PMC7821576 DOI: 10.1002/brb3.1942] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 10/19/2020] [Accepted: 10/22/2020] [Indexed: 12/28/2022] Open
Abstract
Resting-state functional connectivity is an important and widely used measure of individual and group differences. Yet, extant statistical methods are limited to linking covariates with variations in functional connectivity across subjects, especially at the voxel-wise level of the whole brain. This paper introduces a modeling approach that regresses whole-brain functional connectivity on covariates. Our approach is a mesoscale approach that enables identification of brain subnetworks. These subnetworks are composite of spatially independent components discovered by a dimension reduction approach (such as whole-brain group ICA) and covariate-related projections determined by the covariate-assisted principal regression, a recently introduced covariance matrix regression method. We demonstrate the efficacy of this approach using a resting-state fMRI dataset of a medium-sized cohort of subjects obtained from the Human Connectome Project. The results suggest that the approach may improve statistical power in detecting interaction effects of gender and alcohol on whole-brain functional connectivity, and in identifying the brain areas contributing significantly to the covariate-related differences in functional connectivity.
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Affiliation(s)
- Yi Zhao
- Department of Biostatistics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Brian S Caffo
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Bingkai Wang
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Chiang-Shan R Li
- Department of Psychiatry, Yale School of Medicine, The University of Texas Health Science Center at Houston, Houston, TX, USA.,Department of Neuroscience, Yale School of Medicine, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Xi Luo
- Department of Biostatistics and Data Science, The University of Texas Health Science Center at Houston, Houston, TX, USA
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13
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Lesions in the right Rolandic operculum are associated with self-rating affective and apathetic depressive symptoms for post-stroke patients. Sci Rep 2020; 10:20264. [PMID: 33219292 PMCID: PMC7679372 DOI: 10.1038/s41598-020-77136-5] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Accepted: 11/04/2020] [Indexed: 12/12/2022] Open
Abstract
Stroke survivors majorly suffered from post-stroke depression (PSD). The PSD diagnosis is commonly performed based on the clinical cut-off for psychometric inventories. However, we hypothesized that PSD involves spectrum symptoms (e.g., apathy, depression, anxiety, and stress domains) and severity levels. Therefore, instead of using the clinical cut-off, we suggested a data-driven analysis to interpret patient spectrum conditions. The patients’ psychological conditions were categorized in an unsupervised manner using the k-means clustering method, and the relationships between psychological conditions and quantitative lesion degrees were evaluated. This study involved one hundred sixty-five patient data; all patients were able to understand and perform self-rating psychological conditions (i.e., no aphasia). Four severity levels—low, low-to-moderate, moderate-to-high, and high—were observed for each combination of two psychological domains. Patients with worse conditions showed the significantly greater lesion degree at the right Rolandic operculum (part of Brodmann area 43). The dissimilarities between stress and other domains were also suggested. Patients with high stress were specifically associated with lesions in the left thalamus. Impaired emotion processing and stress-affected functions have been frequently related to those lesion regions. Those lesions were also robust and localized, suggesting the possibility of an objective for predicting psychological conditions from brain lesions.
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14
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Klugah-Brown B, Di X, Zweerings J, Mathiak K, Becker B, Biswal B. Common and separable neural alterations in substance use disorders: A coordinate-based meta-analyses of functional neuroimaging studies in humans. Hum Brain Mapp 2020; 41:4459-4477. [PMID: 32964613 PMCID: PMC7555084 DOI: 10.1002/hbm.25085] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 05/18/2020] [Accepted: 05/20/2020] [Indexed: 12/12/2022] Open
Abstract
Delineating common and separable neural alterations in substance use disorders (SUD) is imperative to understand the neurobiological basis of the addictive process and to inform substance‐specific treatment strategies. Given numerous functional MRI (fMRI) studies in different SUDs, a meta‐analysis could provide an opportunity to determine robust shared and substance‐specific alterations. The present study employed a coordinate‐based meta‐analysis covering fMRI studies in individuals with addictive cocaine, cannabis, alcohol, and nicotine use. The primary meta‐analysis demonstrated common alterations in primary dorsal striatal, and frontal circuits engaged in reward/salience processing, habit formation, and executive control across different substances and task‐paradigms. Subsequent sub‐analyses revealed substance‐specific alterations in frontal and limbic regions, with marked frontal and insula‐thalamic alterations in alcohol and nicotine use disorders respectively. Examining task‐specific alterations across substances revealed pronounced frontal alterations during cognitive processes yet stronger striatal alterations during reward‐related processes. Finally, an exploratory meta‐analysis revealed that neurofunctional alterations in striatal and frontal reward processing regions can already be determined with a high probability in studies with subjects with comparably short durations of use. Together the findings emphasize the role of dysregulations in frontostriatal circuits and dissociable contributions of these systems in the domains of reward‐related and cognitive processes which may contribute to substance‐specific behavioral alterations.
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Affiliation(s)
- Benjamin Klugah-Brown
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, Center for Information in Medicine, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, Sichuan, China
| | - Xin Di
- Department of Biomedical Engineering, New Jersey Institute of Technology, Newark, New Jersey, USA
| | - Jana Zweerings
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine, RWTH Aachen, Aachen, Germany.,JARA Translational Brain Medicine, RWTH Aachen, Aachen, Germany
| | - Klaus Mathiak
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine, RWTH Aachen, Aachen, Germany.,JARA Translational Brain Medicine, RWTH Aachen, Aachen, Germany
| | - Benjamin Becker
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, Center for Information in Medicine, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, Sichuan, China
| | - Bharat Biswal
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, Center for Information in Medicine, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, Sichuan, China.,Department of Biomedical Engineering, New Jersey Institute of Technology, Newark, New Jersey, USA
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15
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Rakesh D, Allen NB, Whittle S. Balancing act: Neural correlates of affect dysregulation in youth depression and substance use - A systematic review of functional neuroimaging studies. Dev Cogn Neurosci 2020; 42:100775. [PMID: 32452461 PMCID: PMC7139159 DOI: 10.1016/j.dcn.2020.100775] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Revised: 03/03/2020] [Accepted: 03/09/2020] [Indexed: 12/22/2022] Open
Abstract
Both depression and substance use problems have their highest incidence during youth (i.e., adolescence and emerging adulthood), and are characterized by emotion regulation deficits. Influential neurodevelopmental theories suggest that alterations in the function of limbic and frontal regions render youth susceptible to these deficits. However, whether depression and substance use in youth are associated with similar alterations in emotion regulation neural circuitry is unknown. In this systematic review we synthesized the results of functional magnetic resonance imaging (fMRI) studies investigating the neural correlates of emotion regulation in youth depression and substance use. Resting-state fMRI studies focusing on limbic connectivity were also reviewed. While findings were largely inconsistent within and between studies of depression and substance use, some patterns emerged. First, youth depression appears to be associated with exaggerated amygdala activity in response to negative stimuli; second, both depression and substance use appear to be associated with lower functional connectivity between the amygdala and prefrontal cortex during rest. Findings are discussed in relation to support for existing neurodevelopmental models, and avenues for future work are suggested, including studying neurodevelopmental trajectories from a network perspective.
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Affiliation(s)
- Divyangana Rakesh
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Melbourne, Victoria, Australia
| | - Nicholas B Allen
- Department of Psychology, University of Oregon, Eugene, Oregon, USA
| | - Sarah Whittle
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Melbourne, Victoria, Australia; Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Victoria, Australia.
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16
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Philip NS, Sorensen DO, McCalley DM, Hanlon CA. Non-invasive Brain Stimulation for Alcohol Use Disorders: State of the Art and Future Directions. Neurotherapeutics 2020; 17:116-126. [PMID: 31452080 PMCID: PMC7007491 DOI: 10.1007/s13311-019-00780-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Alcohol use disorders remain one of the leading causes of mortality and morbidity across the world, yet despite this impact, there are few treatment options for patients suffering from these disorders. To this end, non-invasive brain stimulation, most commonly utilizing technologies including transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS), has recently emerged as promising potential treatments for alcohol use disorders. Enthusiasm for these interventions is fueled by their non-invasive nature, generally favorable safety profile, and ability to target and modulate brain regions implicated in substance use disorders. In this paper, we describe the underlying principles behind these commonly used stimulation technologies, summarize existing experiments and randomized controlled trials, and provide an integrative summary with suggestions for future areas of research. Currently available data generally supports the use of non-invasive brain stimulation as a near-term treatment for alcohol use disorder, with important caveats regarding the use of stimulation in this patient population.
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Affiliation(s)
- Noah S Philip
- Center for Neurorestoration and Neurotechnology, Providence VA Medical Center, 830 Chalkstone Avenue, Providence, Rhode Island, 02908, USA.
- Alpert Medical School of Brown University, Providence, Rhode Island, 02903, USA.
| | - David O Sorensen
- Center for Neurorestoration and Neurotechnology, Providence VA Medical Center, 830 Chalkstone Avenue, Providence, Rhode Island, 02908, USA
| | - Daniel M McCalley
- Department of Psychiatry, Medical University of South Carolina, Charleston, South Carolina, 29412, USA
| | - Colleen A Hanlon
- Department of Psychiatry, Medical University of South Carolina, Charleston, South Carolina, 29412, USA
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17
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Jansen JM, van den Heuvel OA, van der Werf YD, de Wit SJ, Veltman DJ, van den Brink W, Goudriaan AE. The Effect of High-Frequency Repetitive Transcranial Magnetic Stimulation on Emotion Processing, Reappraisal, and Craving in Alcohol Use Disorder Patients and Healthy Controls: A Functional Magnetic Resonance Imaging Study. Front Psychiatry 2019; 10:272. [PMID: 31133889 PMCID: PMC6516054 DOI: 10.3389/fpsyt.2019.00272] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2018] [Accepted: 04/10/2019] [Indexed: 12/25/2022] Open
Abstract
Impaired cognitive-motivational functioning is present in many psychiatric disorders, including alcohol use disorder (AUD). Emotion regulation is a key intermediate factor, relating to the (cognitive) regulation of emotional and motivational states, such as in regulation of craving or negative emotions that may lead to relapse in alcohol use. These cognitive-motivational functions, including emotion regulation, are a target in cognitive behavioral therapy and may possibly be improved by neurostimulation techniques. The present between-subjects, single-blind study assesses the effects of sham-controlled high-frequency neuronavigated repetitive transcranial magnetic stimulation (10 Hz) of the right dorsolateral prefrontal cortex (dlPFC) on several aspects relevant for emotion regulation (emotion processing and reappraisal abilities) and related brain activity, as well as self-reported craving in a sample of alcohol use disorder patients (AUD; n = 39) and healthy controls (HC; n = 36). During the emotion reappraisal task, participants were instructed to either attend or reappraise their emotions related to the negative, positive, neutral, and alcohol-related images, after which they rated their experienced emotions. We found that repetitive transcranial magnetic stimulation (rTMS) reduces self-reported experienced emotions in response to positive and negative images in AUD patients, whereas experienced emotions were increased in response to neutral and positive images in HCs. In the functional magnetic resonance imaging (fMRI) analyses, we found that rTMS reduces right dlPFC activity during appraisal of affective images relative to sham stimulation only in AUD patients. We could not confirm our hypotheses regarding the effect of rTMS craving levels, or on reappraisal related brain function, since no significant effects of rTMS on craving or reappraisal related brain function were found. These findings imply that rTMS can reduce the emotional impact of images as reflected in blood oxygenation level-dependent (BOLD) response, especially in AUD patients. Future studies should replicate and expand the current study, for instance, by assessing the effect of multiple stimulation sessions on both explicit and implicit emotion regulation paradigms and craving, and assess the effect of rTMS within subgroups with specific addiction-relevant image preferences. Clinical Trial Registration: www.ClinicalTrials.gov, identifier NCT02557815.
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Affiliation(s)
- Jochem M Jansen
- Department of Psychiatry, Amsterdam Institute for Addiction Research, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands.,Institute for Criminal Law and Criminology, Faculty of Law, Leiden University, Leiden, Netherlands
| | - Odile A van den Heuvel
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands.,Department of Anatomy and Neurosciences, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Ysbrand D van der Werf
- Department of Anatomy and Neurosciences, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Stella J de Wit
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands.,Department of Anatomy and Neurosciences, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Dick J Veltman
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands.,Department of Anatomy and Neurosciences, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Wim van den Brink
- Department of Psychiatry, Amsterdam Institute for Addiction Research, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Anna E Goudriaan
- Department of Psychiatry, Amsterdam Institute for Addiction Research, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands.,Department of Research and Quality of Care, Arkin, Amsterdam, Netherlands
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