Kohno Milky, Dennis Laura E, McCready Holly, Hoffman William F
Department of Psychiatry, Oregon Health & Science University, Portland, OR, United States.
Department of Behavioral Neuroscience, Oregon Health & Science University, Portland, OR, United States.
Front Psychiatry. 2017 Sep 25;8:182. doi: 10.3389/fpsyt.2017.00182. eCollection 2017.
Alterations within mesocorticolimbic terminal regions commonly occur with alcohol use disorder (AUD). As pathological drug-seeking behavior may arise as a consequence of alcohol-induced neuroadaptations, it is critical to understand how such changes increase the likelihood of relapse. This report examined resting-state functional connectivity (RSFC) using both a seed-based and model-free approach in individuals in treatment for AUD and how dysregulation of network connectivity contributes to treatment outcomes. In order to provide a mechanism by which neural networks promote relapse, interactive effects of mesocorticolimbic connectivity and AUD risk factors in treatment completers and non-completers were examined. AUD group showed stronger RSFC between striatum, insula, and anterior cingulate cortex than controls. Within the AUD group, non-completers compared to completers showed enhanced RSFC between (1) striatum-insula, (2) executive control network (ECN)-amygdala, and (3) basal ganglia/salience network and striatum, precuneus, and insula. Completers showed enhanced RSFC between striatum-right dorsolateral prefrontal cortex. Furthermore, completers and non-completers differed in relationships between RSFC and relapse risk factors, where non-completers exhibited positive associations between craving intensity and RSFC of striatum-insula and ECN-amygdala. These findings provide evidence for interactions between corticolimbic connectivity in AUD and craving and establish an important link between network connectivity and dynamic risk factors that contribute to relapse. Results demonstrate that relapse vulnerability is attributed to craving dysregulation manifested by enhanced connectivity in striato-limbic regions and diminished corticostriatal connectivity.
中脑边缘系统终末区域的改变在酒精使用障碍（AUD）中很常见。由于病理性的觅药行为可能是酒精诱导的神经适应性变化的结果，因此了解这些变化如何增加复发的可能性至关重要。本报告采用基于种子点和无模型的方法，研究了接受AUD治疗的个体的静息态功能连接（RSFC），以及网络连接失调如何影响治疗结果。为了提供神经网络促进复发的机制，研究了治疗完成者和未完成者中脑边缘系统连接性与AUD危险因素的交互作用。AUD组纹状体、岛叶和前扣带回皮质之间的RSFC比对照组更强。在AUD组中，与完成者相比，未完成者在以下区域之间表现出增强的RSFC：（1）纹状体-岛叶；（2）执行控制网络（ECN）-杏仁核；（3）基底神经节/突显网络与纹状体、楔前叶和岛叶。完成者在纹状体-右侧背外侧前额叶皮质之间表现出增强的RSFC。此外，完成者和未完成者在RSFC与复发危险因素的关系上存在差异，未完成者在渴望强度与纹状体-岛叶和ECN-杏仁核的RSFC之间表现出正相关。这些发现为AUD中皮质边缘系统连接性与渴望之间的相互作用提供了证据，并在网络连接性与导致复发的动态危险因素之间建立了重要联系。结果表明，复发易感性归因于纹状体-边缘区域连接性增强和皮质纹状体连接性减弱所表现出的渴望失调。
