Logge Warren, Baillie Andrew, Haber Paul, Towers Ellen, Riordan Benjamin C, Morley Kirsten
Clinical School, Sydney Medical School, University of Sydney, NSW, Australia; Edith Collins Centre for Translational Research, Sydney Local Health District NSW, Australia.
Sydney School of Health Sciences, the University of Sydney, Australia.
Addict Behav. 2023 Jan;136:107462. doi: 10.1016/j.addbeh.2022.107462. Epub 2022 Aug 11.
Recent studies have suggested that females respond more favourably to baclofen treatment for alcohol use disorder. Females are generally more likely to drink to regulate stress reactivity and negative affect. This study thus aimed to evaluate the role of sex on the effect of baclofen on the relationship between daily alcohol consumption, stress and craving.
A network analysis of fluctuations using vectorized autoregressive modelling was used to explore the relationship between daily surveys of alcohol consumption, stress and craving from daily diary data over 84 days from a randomised controlled trial of baclofen (30 mg or 75 mg per day) versus placebo in 104 participants with alcohol dependence (1, 2). Symptom interrelations across patients and across time were examined including temporal networks (time lagged), contemporaneous and between-subjects networks, and were examined for placebo and baclofen stratified by sex.
Overall, between persons, there was a significant relationship between stress and drinking in placebo treated individuals in females (r = -0.70, p < 0.001) but not males (r = 0.32, p = 0.054) that was not observed in baclofen treated individuals. No relationship was observed between stress and drinking in the baclofen group for either sex (p's < 0.45).
There appears to be some sex-specific differences whereby baclofen abolishes an overall association between stress and drinking in females, but this is not observed in males. Network analyses may assist in elucidating the mechanism of action of alcohol pharmacotherapies such as baclofen and understanding which symptoms and mechanisms are key for effective interventions.
近期研究表明，女性对用于治疗酒精使用障碍的巴氯芬治疗反应更佳。女性通常更倾向于通过饮酒来调节应激反应性和负面情绪。因此，本研究旨在评估性别在巴氯芬对每日饮酒量、压力和渴望之间关系的影响中所起的作用。
使用矢量化自回归建模的波动网络分析，从一项针对104名酒精依赖参与者的巴氯芬（每天30毫克或75毫克）与安慰剂的随机对照试验的84天每日日记数据中，探索每日酒精摄入量、压力和渴望的每日调查之间的关系(1, 2)。检查了患者之间和不同时间的症状相互关系，包括时间网络（时间滞后）、同期网络和受试者间网络，并按性别对安慰剂和巴氯芬进行了分层检查。
总体而言，在个体之间，安慰剂治疗的女性个体中压力与饮酒之间存在显著关系（r = -0.70，p < 0.001），而男性中未观察到这种关系（r = 0.32，p = 0.054），在接受巴氯芬治疗的个体中未观察到这种关系。巴氯芬组中，无论男女，压力与饮酒之间均未观察到关系（p值 < 0.45）。
似乎存在一些性别特异性差异，即巴氯芬消除了女性压力与饮酒之间的总体关联，但在男性中未观察到这种情况。网络分析可能有助于阐明酒精药物疗法（如巴氯芬）的作用机制，并理解哪些症状和机制是有效干预的关键。
