Morawetz Carmen, Berboth Stella, Chirokoff Valentine, Chanraud Sandra, Misdrahi David, Serre Fuschia, Auriacombe Marc, Fatseas Melina, Swendsen Joel
Institute of Psychology, University of Innsbruck, Innsbruck, Austria.
Institute of Psychology, University of Innsbruck, Innsbruck, Austria.
Biol Psychiatry Cogn Neurosci Neuroimaging. 2023 Sep;8(9):940-955. doi: 10.1016/j.bpsc.2022.11.002. Epub 2022 Nov 10.
Substance use disorders (SUDs) are major contributors to morbidity and mortality rates worldwide, and this global burden is attributable in large part to the chronic nature of these conditions. Increased mood variability might represent a form of emotional dysregulation that may have particular significance for the risk of relapse in SUD, independent of mood severity or diagnostic status. However, the neural biomarkers that underlie mood variability remain poorly understood.
Ecological momentary assessment was used to assess mood variability, craving, and substance use in real time in 54 patients treated for addiction to alcohol, cannabis, or nicotine and 30 healthy control subjects. Such data were jointly examined relative to spectral dynamic causal modeling of effective brain connectivity within 4 networks involved in emotion generation and regulation.
Differences in effective connectivity were related to daily life variability of emotional states experienced by persons with SUD, and mood variability was associated with craving intensity. Relative to the control participants, effective connectivity was decreased for patients in the prefrontal control networks and increased in the emotion generation networks. Findings revealed that effective connectivity within the patient group was modulated by mood variability.
The intrinsic causal dynamics in large-scale neural networks underlying emotion regulation play a predictive role in a patient's susceptibility to experiencing mood variability (and, subsequently, craving) in daily life. The findings represent an important step toward informing interventional research through biomarkers of factors that increase the risk of relapse in persons with SUD.
物质使用障碍（SUDs）是全球发病率和死亡率的主要促成因素，而这种全球负担在很大程度上归因于这些疾病的慢性性质。情绪变异性增加可能代表一种情绪调节障碍形式，对于SUD复发风险可能具有特殊意义，与情绪严重程度或诊断状态无关。然而，情绪变异性背后的神经生物标志物仍知之甚少。
采用生态瞬时评估法实时评估54例接受酒精、大麻或尼古丁成瘾治疗的患者及30名健康对照者的情绪变异性、渴望程度和物质使用情况。这些数据与参与情绪产生和调节的4个网络内有效脑连接的频谱动态因果模型进行联合分析。
有效连接的差异与SUD患者所经历情绪状态的日常生活变异性有关，情绪变异性与渴望强度相关。相对于对照参与者，前额叶控制网络中的患者有效连接减少，而情绪产生网络中的有效连接增加。研究结果表明，患者组内的有效连接受情绪变异性调节。
情绪调节基础的大规模神经网络中的内在因果动态在患者日常生活中经历情绪变异性（以及随后的渴望）的易感性方面起预测作用。这些发现代表了通过增加SUD患者复发风险因素的生物标志物为干预研究提供信息的重要一步。
