Jakubiec Louise, Chirokoff Valentine, Abdallah Majd, Sanz-Arigita Ernesto, Dupuy Maud, Swendsen Joel, Berthoz Sylvie, Gierski Fabien, Guionnet Sarah, Misdrahi David, Serre Fuschia, Auriacombe Marc, Fatseas Melina
Centre National de la Recherche Scientifique (CNRS), Institut de Neurosciences Cognitives et Intégratives d'Aquitaine (INCIA), University of Bordeaux, UMR 5287, 33000 Bordeaux, France.
Department of Addictology, CHU Bordeaux, 33000 Bordeaux, France.
Biomedicines. 2022 Oct 28;10(11):2728. doi: 10.3390/biomedicines10112728.
Deficits in neurocognitive functioning are trait-like vulnerabilities that have been widely studied in persons with substance use disorders (SUD), but their role in the craving-use association and relapse vulnerability remains poorly understood. The main objectives of this study were to examine whether executive capacities moderate the magnitude of the craving-substance use relationship, and if this influence is correlated with the functional connectivity of cerebral networks, combining rsfMRI examinations and ecological momentary assessment (EMA). Eighty-six patients beginning outpatient treatment for alcohol, tobacco or cannabis addiction and 40 healthy controls completed neuropsychological tests followed by EMA to collect real-time data on craving. Fifty-four patients and 30 healthy controls also completed a resting-state fMRI before the EMA. Among the patients with SUD, better verbal fluency and resistance to interference capacities were associated with a greater propensity to use substances when the individual was experiencing craving. Preliminary rsfMRI results identified specific networks that interacted with executive performance capacities to influence the magnitude of the craving-use association. Individuals with better executive functioning may be more prone to relapse after craving episodes. Specifically, better resistance to interference and cognitive flexibility skills may reduce attention to distracting stimuli, leading to a greater awareness of craving and susceptibility to use substances.
神经认知功能缺陷是一种特质性易感性，在物质使用障碍（SUD）患者中已得到广泛研究，但其在渴望-使用关联及复发易感性中的作用仍知之甚少。本研究的主要目的是结合静息态功能磁共振成像（rsfMRI）检查和生态瞬时评估（EMA），检验执行能力是否会调节渴望与物质使用关系的强度，以及这种影响是否与脑网络的功能连接相关。86名开始接受酒精、烟草或大麻成瘾门诊治疗的患者和40名健康对照者完成了神经心理学测试，随后进行EMA以收集关于渴望的实时数据。54名患者和30名健康对照者在EMA之前还完成了静息态fMRI检查。在患有SUD的患者中，当个体出现渴望时，较好的语言流畅性和抗干扰能力与更高的物质使用倾向相关。初步的rsfMRI结果确定了与执行能力相互作用以影响渴望-使用关联强度的特定网络。执行功能较好的个体在渴望发作后可能更容易复发。具体而言，更好的抗干扰能力和认知灵活性技能可能会减少对干扰性刺激的关注，从而导致对渴望的更强意识以及对使用物质的易感性。
