Folco Kess L, Fridberg Daniel J, Arcurio Lindsay R, Finn Peter R, Heiman Julia R, James Thomas W
Department of Psychological and Brain Sciences, Indiana University, 1101 E 10th St, Bloomington, IN, 47405, USA.
Department of Psychiatry and Behavioral Neuroscience, The University of Chicago, Chicago, IL, USA.
Psychopharmacology (Berl). 2021 Jul;238(7):1867-1883. doi: 10.1007/s00213-021-05815-w. Epub 2021 Mar 19.
The co-occurrence of alcohol consumption and sexual activity is associated with increased risk for sexual assault, sexually transmitted disease, and unplanned pregnancy among young adult women with alcohol use disorder (AUD). There is considerable previous work demonstrating neural reactivity to alcohol cues in AUD. Because alcohol consumption and sexual behavior are both rewarding and tend to co-occur, sexual cues may produce similar neural reactivity in women with AUD, possibly indicating a shared mechanism underlying reactivity to both types of cues. Alternatively, reactivity to alcohol versus sexual cues may be distinct, suggesting domain-specific mechanisms.
We investigated whether the decision vulnerabilities in AUD women regarding sexual activity were related to differences in brain activation compared to control women.
Women with (n = 15) and without (n = 16) AUD completed a hypothetical decision-making task during fMRI that presented low- or high-risk scenarios involving visual sexual, appetitive, and neutral cues.
Results showed that sexual cues were more often endorsed by women with AUD compared to controls and elicited differential brain activation patterns in frontal, visual, and reward regions. During high-risk decisions, women with AUD failed to downregulate activation, causing hyperactivation compared to controls.
Visual sexual cues produced reactivity like that previously demonstrated for alcohol cues, suggesting a shared or domain-general mechanism for alcohol and sexual cue reactivity in women with AUD. Riskier sexual decisions in women with AUD may be a consequence of repeatedly pairing alcohol use and sexual activity, a characteristic behavior of this population.
在患有酒精使用障碍（AUD）的年轻成年女性中，饮酒与性活动同时出现与性侵犯、性传播疾病和意外怀孕风险增加有关。此前有大量研究表明，AUD患者对酒精线索存在神经反应。由于饮酒和性行为都具有奖赏性且往往同时发生，性线索可能在患有AUD的女性中产生类似的神经反应，这可能表明对这两种线索的反应存在共同机制。或者，对酒精线索与性线索的反应可能不同，提示存在领域特异性机制。
我们调查了与对照女性相比，患有AUD的女性在性活动方面的决策易损性是否与大脑激活差异有关。
患有（n = 15）和未患有（n = 16）AUD的女性在功能磁共振成像（fMRI）期间完成了一项假设性决策任务，该任务呈现了涉及视觉性、食欲性和中性线索的低风险或高风险场景。
结果显示，与对照组相比，患有AUD的女性更常认可性线索，并在额叶、视觉和奖赏区域引发了不同的大脑激活模式。在高风险决策期间，患有AUD的女性未能下调激活水平，与对照组相比导致过度激活。
视觉性线索产生的反应与先前酒精线索产生的反应相似，这表明患有AUD的女性对酒精和性线索的反应存在共同或领域通用机制。患有AUD的女性做出更具风险的性决策可能是反复将饮酒与性活动配对的结果，这是该人群的一种特征性行为。
