Radoman Milena, Phan K Luan, Ajilore Olusola A, Gorka Stephanie M
Department of Radiology and Biomedical Imaging, Yale University, New Haven, Connecticut; Department of Psychiatry, University of Illinois at Chicago, Chicago, Illinois.
Department of Psychiatry and Behavioral Health, The Ohio State University, Columbus, Ohio.
Biol Psychiatry Cogn Neurosci Neuroimaging. 2025 Feb;10(2):213-221. doi: 10.1016/j.bpsc.2024.07.023. Epub 2024 Aug 6.
A developing theory and recent research suggest that heightened reactivity to uncertain stressors or threats may be an important individual difference factor that facilitates excessive drinking as a means of avoidance-based coping and characterizes individuals with current and past alcohol use disorder (AUD). Neuroimaging studies of unpredictable threat processing have repeatedly demonstrated activation of the anterior insula, anteromedial thalamus, and dorsal anterior cingulate cortex. In the current study, we aimed to understand how these 3 regions function as a network during anticipation of unpredictable threat (and predictable threat).
Participants were 43 adults (ages 21-30) with AUD and 26 healthy control participants. Functional magnetic resonance imaging and dynamic causal modeling were used to study interregional effective connectivities and predictable and unpredictable threat-related modulations thereof within this network. Parametric empirical Bayesian modeling was used to conduct between-group comparisons in effective connectivities.
During unpredictable threat trials, the increased projection from the right anteromedial thalamus to the right anterior insula was significantly present only in the AUD group. This directional influence was stronger among individuals who consumed more drinks per week on average. As expected, we found no group differences in modulatory changes to effective connectivities during predictable threat trials.
To our knowledge, this is the first study to examine directional interactions between key frontolimbic regions during anticipation of unpredictable and predictable threat and demonstrate the importance of bottom-up thalamic-insular projections during unpredictable threat processing in AUD. Prospective studies are warranted to determine whether this association is causal.
一种正在发展的理论和近期研究表明，对不确定应激源或威胁的高反应性可能是一个重要的个体差异因素，它促使过度饮酒成为一种基于回避的应对方式，并刻画了当前和过去患有酒精使用障碍（AUD）的个体特征。对不可预测威胁处理的神经影像学研究反复证明了前岛叶、丘脑前内侧和背侧前扣带回皮质的激活。在本研究中，我们旨在了解这三个区域在预期不可预测威胁（和可预测威胁）期间如何作为一个网络发挥作用。
参与者包括43名患有AUD的成年人（年龄21 - 30岁）和26名健康对照参与者。使用功能磁共振成像和动态因果模型来研究该网络内区域间的有效连接以及与可预测和不可预测威胁相关的调节。使用参数经验贝叶斯模型对有效连接进行组间比较。
在不可预测威胁试验期间，从右侧丘脑前内侧到右侧前岛叶的投射增加仅在AUD组中显著存在。这种定向影响在平均每周饮酒量更多的个体中更强。正如预期的那样，我们发现在可预测威胁试验期间，有效连接的调节变化没有组间差异。
据我们所知，这是第一项研究不可预测和可预测威胁预期期间关键额颞叶区域之间定向相互作用的研究，并证明了在AUD的不可预测威胁处理过程中自下而上的丘脑 - 岛叶投射的重要性。有必要进行前瞻性研究以确定这种关联是否具有因果关系。
