van Oort Jasper, Diazgranados Nancy, George David T, Horneffer Yvonne, Schwandt Melanie, Goldman David, Momenan Reza
Clinical NeuroImaging Research Core, National Institute on Alcohol Abuse and Alcoholism, National Institute of Health, Bethesda, MD, United States.
Office of the Clinical Director, National Institute on Alcohol Abuse and Alcoholism, National Institute of Health, Bethesda, MD, United States.
Front Psychiatry. 2023 Jul 28;14:1185770. doi: 10.3389/fpsyt.2023.1185770. eCollection 2023.
The early abstinence period is a crucial phase in alcohol use disorder (AUD) in which patients have to find a new equilibrium and may start recovery, or conversely, relapse. However, the changes in brain functions during this key period are still largely unknown. We set out to study longitudinal changes in large-scale brain networks during the early abstinence period using resting-state scans. We scanned AUD patients twice in a well-controlled inpatient setting, with the first scan taking place shortly after admission and the second scan 4 weeks (±9 days) later near the end of the treatment period. We studied 37 AUD patients (22 males) and 27 healthy controls (16 males). We focused on three networks that are affected in AUD and underly core symptom dimensions in this disorder: the frontoparietal networks (left and right FPN) and default mode network (DMN). Both the whole brain and within network connectivity of these networks were studied using dual regression. Finally, we explored correlations between these brain networks and various neuropsychological and behavioral measures. In contrast to the controls ( = -1.081, = 0.280), the AUD patients showed a decrease in within left FPN connectivity ( = -2.029, = 0.042). However, these results did not survive a strict Bonferroni correction. The decrease in left FPN connectivity during the early abstinence period in AUD may reflect an initially upregulated FPN, which recovers to a lower resting-state connectivity level during subsequent weeks of abstinence. The AUD patients showed a trend for a positive association between the change in left FPN connectivity and trait anxiety (r = 0.303, = 0.068), and a trend for a negative association between the change in left FPN connectivity and delay discounting (r = -0.283, = 0.089) (uncorrected for multiple comparisons). This suggests that the FPN might be involved in top-down control of impulsivity and anxiety, which are important risk factors for relapse. Although there were no statistically significant results (after multiple comparison correction), our preliminary findings encourage further research into the dynamic neuroadaptations during the clinically crucial early abstinence period and could inform future study designs.
早期戒酒期是酒精使用障碍（AUD）中的一个关键阶段，在此期间患者必须找到新的平衡，可能开始康复，反之也可能复发。然而，这一关键时期大脑功能的变化仍 largely unknown。我们着手使用静息态扫描研究早期戒酒期大规模脑网络的纵向变化。我们在一个控制良好的住院环境中对AUD患者进行了两次扫描，第一次扫描在入院后不久进行，第二次扫描在治疗期接近尾声时，即4周（±9天）后进行。我们研究了37名AUD患者（22名男性）和27名健康对照者（16名男性）。我们关注在AUD中受影响且是该障碍核心症状维度基础的三个网络：额顶叶网络（左、右FPN）和默认模式网络（DMN）。使用双回归研究了这些网络的全脑和网络内连通性。最后，我们探索了这些脑网络与各种神经心理学和行为测量之间的相关性。与对照组相比（= -1.081，= 0.280），AUD患者左FPN内连通性降低（= -2.029，= 0.042）。然而，这些结果在严格的Bonferroni校正后未通过检验。AUD患者在早期戒酒期左FPN连通性的降低可能反映了最初上调的FPN，在随后的戒酒几周内恢复到较低的静息态连通性水平。AUD患者显示出左FPN连通性变化与特质焦虑之间呈正相关趋势（r = 0.303，= 0.068），以及左FPN连通性变化与延迟折扣之间呈负相关趋势（r = -0.283，= 0.089）（未进行多重比较校正）。这表明FPN可能参与了对冲动性和焦虑的自上而下控制，而冲动性和焦虑是复发的重要危险因素。尽管没有统计学上的显著结果（在进行多重比较校正后），我们的初步发现鼓励进一步研究临床关键的早期戒酒期的动态神经适应性，并可为未来的研究设计提供参考。
