Department of Addictive Behavior and Addiction Medicine, Medical Faculty Mannheim, Central Institute of Mental Health, University of Heidelberg, Mannheim, Germany.
Department of Addictive Behavior and Addiction Medicine, Medical Faculty Mannheim, Central Institute of Mental Health, University of Heidelberg, Mannheim, Germany; Mannheim Center of Translational Neuroscience (MCTN), University of Heidelberg, Medical Faculty Mannheim, Mannheim, Germany.
Biol Psychiatry Cogn Neurosci Neuroimaging. 2023 Jun;8(6):660-671. doi: 10.1016/j.bpsc.2022.12.008. Epub 2022 Dec 22.
Automated alcohol craving and habitual alcohol consumption characterize the later stages of alcohol use disorder (AUD). This study reanalyzed previously collected functional neuroimaging data in combination with the Craving Automated Scale for Alcohol (CAS-A) questionnaire to investigate the neural correlates and brain networks underlying automated drinking characterized by unawareness and nonvolition.
We assessed 49 abstinent male patients with AUD and 36 male healthy control participants during a functional magnetic resonance imaging-based alcohol cue-reactivity task. We performed whole-brain analyses examining the associations between CAS-A scores and other clinical instruments and neural activation patterns in the alcohol versus neutral contrast. Furthermore, we performed psychophysiological interaction analyses to assess the functional connectivity between predefined seed regions and other brain areas.
In patients with AUD, higher CAS-A scores correlated with greater activation in dorsal striatal, pallidal, and prefrontal regions, including frontal white matter, and with lower activation in visual and motor processing regions. Between-group psychophysiological interaction analyses showed extensive connectivity between the seed regions inferior frontal gyrus and angular gyrus and several frontal, parietal, and temporal brain regions in AUD versus healthy control participants.
The present study applied a new lens to previously acquired alcohol cue-reactivity functional magnetic resonance imaging data by correlating neural activation patterns with clinical CAS-A scores to elucidate potential neural correlates of automated alcohol craving and habitual alcohol consumption. Our results support previous findings showing that alcohol addiction is associated with hyperactivation in habit-processing regions, with hypoactivation in areas mediating motor and attention processing, and with general hyperconnectivity.
自动化的酒精渴求与习惯性饮酒是酒精使用障碍（AUD）后期的特征。本研究重新分析了先前收集的功能神经影像学数据，并结合酒精渴求自动化量表（CAS-A）问卷，以探究无意识和非意愿性自动化饮酒的神经基础和大脑网络。
我们评估了 49 名男性酒精使用障碍患者和 36 名男性健康对照者，在基于功能磁共振成像的酒精线索反应性任务期间进行了评估。我们进行了全脑分析，以考察 CAS-A 评分与其他临床工具之间的关联，并考察了在酒精与中性对比中大脑的激活模式。此外，我们进行了心理生理交互分析，以评估预设种子区域与其他脑区之间的功能连接。
在 AUD 患者中，较高的 CAS-A 评分与背侧纹状体、苍白球和前额叶区域（包括额叶白质）的更大激活相关，与视觉和运动处理区域的更低激活相关。组间心理生理交互分析显示，在 AUD 患者与健康对照者中，种子区域下额回和角回与多个额叶、顶叶和颞叶脑区之间存在广泛的连接。
本研究通过将神经激活模式与临床 CAS-A 评分相关联，为先前获得的酒精线索反应性功能磁共振成像数据提供了新的视角，以阐明自动化的酒精渴求与习惯性饮酒的潜在神经基础。我们的结果支持了先前的发现，即酒精成瘾与习惯处理区域的过度激活、介导运动和注意力处理的区域的激活不足以及整体过度连接有关。
