Department of Psychiatry and Psychotherapy CCM, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany.
Department of Psychiatry and Psychotherapy, Technische Universität Dresden, Dresden, Germany.
Addict Biol. 2023 Nov;28(11):e13339. doi: 10.1111/adb.13339.
Alcohol dependence (AD) is a debilitating disease associated with high relapse rates even after long periods of abstinence. Thus, elucidating neurobiological substrates of relapse risk is fundamental for the development of novel targeted interventions that could promote long-lasting abstinence. In the present study, we analysed resting-state functional magnetic resonance imaging (rsfMRI) data from a sample of recently detoxified patients with AD (n = 93) who were followed up for 12 months after rsfMRI assessment. Specifically, we employed graph theoretic analyses to compare functional brain network topology and functional connectivity between future relapsers (REL, n = 59), future abstainers (ABS, n = 28) and age- and gender-matched controls (CON, n = 83). Our results suggest increased whole-brain network segregation, decreased global network integration and overall blunted connectivity strength in REL compared with CON. Conversely, we found evidence for a comparable network architecture in ABS relative to CON. At the nodal level, REL exhibited decreased integration and decoupling between multiple brain systems compared with CON, encompassing regions associated with higher-order executive functions, sensory and reward processing. Among patients with AD, increased coupling between nodes implicated in reward valuation and salience attribution constitutes a particular risk factor for future relapse. Importantly, aberrant network organization in REL was consistently associated with shorter abstinence duration during follow-up, portending to a putative neural signature of relapse risk in AD. Future research should further evaluate the potential diagnostic value of the identified changes in network topology and functional connectivity for relapse prediction at the individual subject level.
酒精依赖（AD）是一种使人虚弱的疾病，即使在长时间禁欲后，复发率也很高。因此，阐明复发风险的神经生物学基础对于开发新的靶向干预措施至关重要，这些干预措施可以促进长期禁欲。在本研究中，我们分析了一组最近戒酒的 AD 患者（n=93）的静息态功能磁共振成像（rsfMRI）数据，这些患者在 rsfMRI 评估后随访了 12 个月。具体来说，我们采用图论分析比较了未来复发者（REL，n=59）、未来戒酒者（ABS，n=28）和年龄及性别匹配的对照组（CON，n=83）之间的功能脑网络拓扑和功能连接。我们的结果表明，与 CON 相比，REL 全脑网络的隔离程度增加，全局网络整合度降低，整体连接强度减弱。相反，我们发现 ABS 相对于 CON 具有相似的网络结构。在节点水平上，与 CON 相比，REL 显示出多个脑系统之间的整合和去耦减少，包括与高级执行功能、感觉和奖励处理相关的区域。在 AD 患者中，与奖励估值和显着性归因相关的节点之间的耦合增加是未来复发的一个特定风险因素。重要的是，REL 中异常的网络组织与随访期间禁欲时间较短有关，预示着 AD 中复发风险的潜在神经特征。未来的研究应进一步评估网络拓扑和功能连接的变化在个体预测复发方面的潜在诊断价值。
