Jansen Jochem M, van Wingen Guido, van den Brink Wim, Goudriaan Anna E
Academic Medical Centre (AMC), Department of Psychiatry, University of Amsterdam, Amsterdam, The Netherlands; Amsterdam Institute for Addiction Research, University of Amsterdam, Amsterdam, The Netherlands.
Academic Medical Centre (AMC), Department of Psychiatry, University of Amsterdam, Amsterdam, The Netherlands.
Eur Neuropsychopharmacol. 2015 Dec;25(12):2230-9. doi: 10.1016/j.euroneuro.2015.09.019. Epub 2015 Oct 8.
Alcohol dependence is thought to result from an overactive neural motivation system and a deficient cognitive control system, and rebalancing these systems may mitigate excessive alcohol use. This study examines the differences in functional connectivity of the fronto-parietal cognitive control network (FPn) and the motivational network (striatum and orbitofrontal cortex) between alcohol dependent patients (ADPs) and healthy controls (HCs), and the effect of repetitive transcranial magnetic stimulation (rTMS) on these networks. This randomized controlled trial included 38 ADPs and 37 HCs, matched on age, gender and education. Participants were randomly assigned to sham or right dorsolateral prefrontal cortex (dlPFC) stimulation with rTMS. A 3T resting state functional Magnetic Resonance Imaging (fMRI) scan was acquired before and after active or sham 10Hz rTMS. Group differences of within and between network connectivity and the effect of rTMS on network connectivity was assessed using independent component analysis. Results showed higher connectivity within the left FPn (p=0.012) and the left fronto-striatal motivational network (p=0.03) in ADPs versus HCs, and a further increase in connectivity within the left FPn after active stimulation in ADPs. ADPs also showed higher connectivity between the left and the right FPns (p=0.025), and this higher connectivity was related to fewer alcohol related problems (r=0.30, p=0.06). The results show higher within and between network connectivity in ADPs and a further increase in fronto-parietal connectivity after right dlPFC rTMS in ADPs, suggesting that frontal rTMS may have a beneficial influence on cognitive control and may result in lower relapse rates.
酒精依赖被认为是由过度活跃的神经动机系统和功能不足的认知控制系统导致的,重新平衡这些系统可能会减少过度饮酒。本研究考察了酒精依赖患者(ADPs)与健康对照者(HCs)之间额顶叶认知控制网络(FPn)和动机网络(纹状体和眶额皮质)功能连接的差异,以及重复经颅磁刺激(rTMS)对这些网络的影响。这项随机对照试验纳入了38名ADPs和37名HCs,在年龄、性别和教育程度上进行了匹配。参与者被随机分配接受假刺激或右侧背外侧前额叶皮质(dlPFC)的rTMS刺激。在进行10Hz的主动或假rTMS刺激前后,对参与者进行了3T静息态功能磁共振成像(fMRI)扫描。使用独立成分分析评估网络内和网络间连接性的组间差异以及rTMS对网络连接性的影响。结果显示,与HCs相比,ADPs的左侧FPn(p = 0.012)和左侧额-纹状体动机网络(p = 0.03)内连接性更高,且ADPs在接受主动刺激后左侧FPn内的连接性进一步增加。ADPs还显示出左侧和右侧FPn之间的连接性更高(p = 0.025),且这种更高的连接性与较少的酒精相关问题有关(r = 0.30,p = 0.06)。结果表明,ADPs的网络内和网络间连接性更高,且在接受右侧dlPFC的rTMS刺激后,ADPs的额顶叶连接性进一步增加,这表明额叶rTMS可能对认知控制有有益影响,并可能导致更低的复发率。