Grieder Matthias, Soravia Leila M, Tschuemperlin Raphaela M, Batschelet Hallie M, Federspiel Andrea, Schwab Simon, Morishima Yosuke, Moggi Franz, Stein Maria
Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland.
Clinic Suedhang, Kirchlindach, Switzerland.
Front Psychiatry. 2022 Jul 1;13:909992. doi: 10.3389/fpsyt.2022.909992. eCollection 2022.
Alcohol use disorder (AUD) is characterized by enhanced cue-reactivity and the opposing control processes being insufficient. The ability to inhibit reactions to alcohol-related cues, alcohol-specific inhibition, is thus crucial to AUD; and trainings strengthening this ability might increase treatment outcome. The present study investigated whether neurophysiological correlates of alcohol-specific inhibition (I) vary with craving, (II) predict drinking outcome in AUD and (III) are modulated by alcohol-specific inhibition training. A total of 45 recently abstinent patients with AUD and 25 controls participated in this study. All participants underwent functional magnetic resonance imaging (fMRI) during a Go-NoGo task with alcohol-related as well as neutral conditions. Patients with AUD additionally participated in a double-blind RCT, where they were randomized to either an alcohol-specific inhibition training or an active control condition (non-specific inhibition training). After the training, patients participated in a second fMRI measurement where the Go-NoGo task was repeated. Percentage of days abstinent was assessed as drinking outcome 3 months after discharge from residential treatment. Whole brain analyses indicated that in the right inferior frontal gyrus (rIFG), activation related to alcohol-specific inhibition varied with craving and predicted drinking outcome at 3-months follow-up. This neurophysiological correlate of alcohol-specific inhibition was however not modulated by the training version. Our results suggest that enhanced rIFG activation during alcohol-specific (compared to neutral) inhibition (I) is needed to inhibit responses when craving is high and (II) fosters sustained abstinence in patients with AUD. As alcohol-specific rIFG activation was not affected by the training, future research might investigate whether potential training effects on neurophysiology are better detectable with other methodological approaches.
酒精使用障碍(AUD)的特征是线索反应增强,而对抗性控制过程不足。因此,抑制对酒精相关线索反应的能力,即酒精特异性抑制,对AUD至关重要;加强这种能力的训练可能会提高治疗效果。本研究调查了酒精特异性抑制(I)的神经生理学相关性是否随渴望程度而变化,(II)是否能预测AUD患者的饮酒结果,以及(III)是否受酒精特异性抑制训练的调节。共有45名近期戒酒的AUD患者和25名对照者参与了本研究。所有参与者在一个包含酒精相关和中性条件的Go-NoGo任务中接受功能磁共振成像(fMRI)检查。AUD患者还参与了一项双盲随机对照试验,他们被随机分为酒精特异性抑制训练组或积极对照组(非特异性抑制训练组)。训练后,患者再次接受fMRI测量,重复Go-NoGo任务。戒酒天数百分比被评估为住院治疗出院3个月后的饮酒结果。全脑分析表明,在右侧额下回(rIFG),与酒精特异性抑制相关的激活随渴望程度而变化,并在3个月随访时预测饮酒结果。然而,这种酒精特异性抑制的神经生理学相关性并未受训练方式的调节。我们的结果表明,在酒精特异性(与中性相比)抑制过程中增强的rIFG激活(I)在渴望程度高时是抑制反应所必需的,并且(II)有助于AUD患者持续戒酒。由于酒精特异性rIFG激活不受训练影响,未来的研究可能会探讨是否采用其他方法能更好地检测到对神经生理学的潜在训练效果。