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1.
Alcohol Clin Exp Res ; 46(4): 530-541, 2022 04.
Artigo em Inglês | MEDLINE | ID: mdl-35229336

RESUMO

BACKGROUND: Simultaneous or concurrent use (co-use) of alcohol and cannabis is associated with greater use of both substances over time, academic difficulties, more severe substance use consequences, and adverse impacts on cognitive functioning than the use of a single substance or no substance use. This study examined potential neural mechanisms underlying co-use behaviors in comparison to single substance use. Specifically, we compared alcohol cue reactivity and stress-cue reactivity among individuals who reported frequent same-day co-use of alcohol and cannabis and individuals who reported only alcohol use. METHODS: The sample included 88 individuals (41 women) who reported only alcohol use and 24 individuals (8 women) who reported co-use of alcohol and cannabis on at least 50% of drinking occasions. All participants completed fMRI stress and alcohol cue reactivity tasks. Because of known sex effects on stress reactivity and alcohol cue reactivity, we tested sex by co-use interactions. RESULTS: During alcohol cue presentation, co-users had less activation in the thalamus and dorsomedial prefrontal cortex than alcohol-only users, effects that were driven by differences in responses to neutral cues. Examination of stress cue reactivity revealed sex by co-use interactions in the lingual gyrus, with women co-users showing a greater difference between negative and neutral cue reactivity than all other groups. In addition, women co-users had greater connectivity between the nucleus accumbens and both the medial orbitofrontal cortex and the rostral anterior cingulate cortex during negative cue presentation than the other groups. CONCLUSIONS: These results provide preliminary evidence of enhanced stress cue reactivity in individuals reporting co-use of alcohol and cannabis, particularly women co-users.


Assuntos
Cannabis , Transtornos Relacionados ao Uso de Substâncias , Encéfalo/diagnóstico por imagem , Agonistas de Receptores de Canabinoides , Sinais (Psicologia) , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino
2.
Addict Biol ; 25(1): e12684, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-30370960

RESUMO

Chronic exposure to alcohol and other drugs of abuse has been associated with deleterious consequences, including functional connectivity deficits within neural networks associated with executive control. Altered functional connectivity within the executive control network (ECN) might underlie the progressive inability to control consumption of alcohol and other drugs as substance use disorders progress. Genetic and epigenetic factors have been associated with substance use disorders (SUDs). For example, dopamine receptor 2 (DRD2) functioning has been associated with alcohol use disorder (AUD) and related phenotypes, including correlates of executive functioning. The present study aims to explore the relationship between a continuous measure of alcohol-related problems, epigenetic markers (methylation) within the DRD2 gene, and functional connectivity within the ECN among a sample of polysubstance users. A community sample of 658 subjects, whose consumption of alcohol, nicotine, and cannabis span across a spectrum of quantity and frequency of use, were obtained across previous studies in polysubstance using populations. Resting state functional magnetic resonance imaging was analyzed to identify intrinsic connectivity networks using a priori regions of interest. Methylation measurement of functionally relevant sites within the DRD2 gene was achieved via pyrosequencing. Regression-based models, including mediation and moderation models, tested the association between DRD2 methylation, functional connectivity within intrinsic neural networks (including the ECN), and severity of alcohol problems. Results suggest that average DRD2 methylation was negatively associated with right ECN (RECN) and left ECN (LECN) connectivity, but not associated with other networks tested, and DRD2 methylation was significantly associated with alcohol problems severity. Mediation models were not supported, although moderation models suggested that connectivity between edges within the RECN moderated the relationship between DRD2 methylation and AUD severity. Results support a theoretical model in which epigenetic factors are associated with neurobiological correlates of alcohol consumption among a sample of polysubstance users.


Assuntos
Alcoolismo/fisiopatologia , Encéfalo/fisiopatologia , Fumar Cigarros/fisiopatologia , Função Executiva/efeitos dos fármacos , Abuso de Maconha/fisiopatologia , Receptores de Dopamina D2/genética , Adulto , Alcoolismo/genética , Encéfalo/diagnóstico por imagem , Mapeamento Encefálico/métodos , Fumar Cigarros/genética , Feminino , Humanos , Imageamento por Ressonância Magnética/métodos , Masculino , Abuso de Maconha/genética , Metilação , Índice de Gravidade de Doença , Transtornos Relacionados ao Uso de Substâncias/genética , Transtornos Relacionados ao Uso de Substâncias/fisiopatologia
3.
Addict Biol ; 24(5): 1096-1108, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-30091823

RESUMO

Alcohol use disorders are associated with high craving and disruption of stress biology, but their role in behavioral alcohol motivation is less clear. We examined the effects of craving and cortisol responses on behavioral alcohol motivation to stress, alcohol cue and neutral-relaxing context cues, in addition to discrete alcohol cues, in demographically matched binge/heavy (BH) and moderate (MD) social drinkers. Subjects participated in a 3-day laboratory experiment of provocation by three personalized guided imagery contexts and discrete alcohol cues followed by the 'alcohol taste test' (ATT) to assess behavioral motivation, as measured by ATT intake. Post-ATT alcohol effects on craving and cortisol responses were also examined. Results indicate BH consumed significantly more alcohol than MD in the ATT. Stress and alcohol cue contexts, relative to neutral, led to significantly greater ATT intake across both groups, which also correlated positively with self-reported alcohol use in past 30 days. Stress and alcohol context and discrete alcohol cues each significantly increased alcohol craving, more so in the BH than MD, and significantly predicted greater ATT intake in BH only. The BH showed significantly lower cortisol responses than MD overall and blunted cortisol responses to cues predicted significantly greater ATT intake in the stress condition for BH and in the alcohol cue condition for MD. Higher ATT intake predicted greater cortisol response and higher craving post-ATT, and these effects were moderated by group status. In sum, findings suggest a role for sensitized context-induced craving and blunted cortisol responses in increased behavioral motivation for alcohol.


Assuntos
Consumo Excessivo de Bebidas Alcoólicas/psicologia , Fissura/fisiologia , Motivação/fisiologia , Estresse Psicológico/psicologia , Adulto , Biomarcadores/metabolismo , Proteínas de Caenorhabditis elegans , Sinais (Psicologia) , Feminino , Humanos , Hidrocortisona/metabolismo , Imaginação/fisiologia , Masculino , Paladar/fisiologia
4.
Addict Biol ; 22(2): 468-478, 2017 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-26537217

RESUMO

Previous research has shown that hyperactivation in ventral medial prefrontal cortex (VmPFC) and rostral anterior cingulate cortex (rACC) and high cortisol to corticotrophin ratio (cort:ACTH ratio) during neutral-relaxed states predict relapse in alcohol-dependent (AD) patients. Other studies have shown that VmPFC/rACC deactivation and blunted cortisol release to stress and alcohol cues are predictive of time to relapse and relapse severity. However, no previous study has assessed the relationship between these markers of central and peripheral nervous system dysfunction in AD participants and their potential joint effects on relapse risk. Forty early abstinent, treatment engaged AD patients underwent a laboratory experiment with exposure to neutral, alcohol and stress cues and a separate functional magnetic resonance imaging scan with similar cue exposure. Neutral-relaxed state cort:ACTH ratio was significantly associated with VmPFC hyperreactivity to neutral-relaxing cues, and also with hypoactivation in response to alcohol and stress cues in AD patients. Basal heart rate, neutral cort:ACTH ratio and neutral VmPFC hyperreactivty were each associated with risk of relapse. However, abnormal VmPFC activation and elevated cort:ACTH ratio overlap in predicting risk for relapse, and dysfunctional VmPFC response was the sole significant predictor of odds of relapse in a joint model of relapse risk. These findings suggest that the cort:ACTH ratio may serve as a peripheral marker of VmPFC brain dysfunction, while aberrant VmPFC responses need further evaluation as a potential biomarker of alcohol relapse risk in clinical outcome studies.


Assuntos
Alcoolismo/diagnóstico por imagem , Giro do Cíngulo/diagnóstico por imagem , Córtex Pré-Frontal/diagnóstico por imagem , Estresse Psicológico/diagnóstico por imagem , Adolescente , Hormônio Adrenocorticotrópico/metabolismo , Adulto , Alcoolismo/metabolismo , Alcoolismo/fisiopatologia , Sinais (Psicologia) , Feminino , Neuroimagem Funcional , Giro do Cíngulo/fisiopatologia , Frequência Cardíaca/fisiologia , Humanos , Hidrocortisona/metabolismo , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Córtex Pré-Frontal/fisiopatologia , Recidiva , Medição de Risco , Estresse Psicológico/metabolismo , Estresse Psicológico/fisiopatologia , Adulto Jovem
5.
Can J Psychiatry ; 61(3): 145-53, 2016 03.
Artigo em Inglês | MEDLINE | ID: mdl-27254089

RESUMO

A significant amount of neurobiological research regarding the development of alcohol use disorders (AUDs) has focused on alcohol-related activation and long-term alterations in the mesocortical dopaminergic reward pathways. However, alcohol does not only interact with brain reward systems. Many of its acute and chronic effects may be related to allostatic adaptations in hypothalamic and extrahypothalamic stress regulation pathways. For example, acute binge intoxication is associated with hypothalamically driven increases in blood cortisol, norepinephrine, and sex steroid metabolite levels. This may contribute to the development of mesocortical sensitization to alcohol. Furthermore, chronic alcohol exposure is associated with systemic dysregulation of the hypothalamic pituitary adrenal axis, sympathetic adrenal medullary system, and sex steroid systems. This dysregulation appears to manifest as neuroendocrine tolerance. In this review, we first summarize the literature suggesting that alcohol-induced alterations in these hypothalamic systems influence craving and contribute to the development of AUDs. We note that for women, the effects of alcohol on these neuroendocrine stress regulation systems may be influenced by the rhythmic variations of hormones and steroids across the menstrual cycle. Second, we discuss how changes in these systems may indicate progression of AUDs and increased risk of relapse in both sexes. Specifically, neuroendocrine tolerance may contribute to mesocortical sensitization, which in turn may lead to decreased prefrontal inhibitory control of the dopaminergic reward and hypothalamic stress systems. Thus, pharmacological strategies that counteract alcohol-associated changes in hypothalamic and extrahypothalamic stress regulation pathways may slow the development and progression of AUDs.


Assuntos
Transtornos Relacionados ao Uso de Álcool , Sistema Hipotálamo-Hipofisário , Sistema Hipófise-Suprarrenal , Transdução de Sinais/fisiologia , Estresse Psicológico , Transtornos Relacionados ao Uso de Álcool/metabolismo , Transtornos Relacionados ao Uso de Álcool/fisiopatologia , Humanos , Sistema Hipotálamo-Hipofisário/metabolismo , Sistema Hipotálamo-Hipofisário/fisiopatologia , Sistema Hipófise-Suprarrenal/metabolismo , Sistema Hipófise-Suprarrenal/fisiopatologia , Estresse Psicológico/metabolismo , Estresse Psicológico/fisiopatologia
6.
Alcohol Clin Exp Res ; 38(12): 3024-32, 2014 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-25581657

RESUMO

BACKGROUND: Positively reinforcing properties of alcohol are in part mediated by activation of the ventral striatum (VS). Alcohol-induced release of endogenous opioids is thought to contribute to this response. Preclinical studies show that the opioid antagonist naltrexone (NTX) can block this cascade, but its ability to do so in treatment-seeking alcoholics has not been examined. Our objective was to study the effects of NTX on alcohol-induced VS activation and on amygdala response to affective stimuli in treatment-seeking alcohol-dependent inpatients. METHODS: Sixty-three treatment-seeking alcoholics were randomized to receive NTX (50 mg) or placebo (PLC) daily. On Day 7, participants underwent an alcohol cue reactivity session, and craving was measured using the Penn Alcohol Craving Scale. On Day 9, participants received a saline infusion followed by an alcohol infusion and also viewed affective stimuli in a magnetic resonance scanner. RESULTS: Irrespective of medication treatment condition, the alcohol infusion did not activate the VS in the alcohol-dependent patients. Unexpectedly, VS activation was greater in NTX treated patients than in the PLC group. NTX treated patients also reported increased craving in response to alcohol cue exposure, and increased subjective response to alcohol ("high" and "intoxicated") compared to PLC subjects. No significant effects of alcohol infusion on brain response to affective stimuli were in the NTX or PLC groups. CONCLUSIONS: Unlike previous findings in social drinkers, a moderate level of intoxication did not activate the VS in treatment-seeking alcoholics. This is likely to reflect tolerance to the positively reinforcing properties of alcohol in this clinical population. Our findings may help explain the efficacy of NTX to reduce heavy drinking, but not to maintain abstinence.


Assuntos
Alcoolismo/tratamento farmacológico , Alcoolismo/metabolismo , Etanol/administração & dosagem , Naltrexona/uso terapêutico , Antagonistas de Entorpecentes/uso terapêutico , Estriado Ventral/metabolismo , Adulto , Alcoolismo/psicologia , Feminino , Humanos , Infusões Intravenosas , Masculino , Pessoa de Meia-Idade , Naltrexona/farmacologia , Antagonistas de Entorpecentes/farmacologia , Estimulação Luminosa , Resultado do Tratamento , Estriado Ventral/efeitos dos fármacos , Adulto Jovem
7.
Psychol Addict Behav ; 37(8): 1039-1051, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-37535554

RESUMO

OBJECTIVE: Rates of daily cannabis use and cannabis use disorder (CUD) are increasing in the United States. Prominent addiction theories suggest that stress potentiation of drug cue incentive salience is a central feature of disordered versus recreational drug use, which has been corroborated using a neurophysiological index of drug cue incentive salience (i.e., the late positive potential [LPP]) in adults who regularly use cannabis. However, the mechanism through which acute stress potentiates the cannabis LPP in CUD is unclear. METHOD: To address this gap, cannabis LPPs were measured before and after a stress induction in 95 adults who regularly use cannabis. Physiological (hypothalamic-pituitary-adrenal [HPA] axis, heart rate, skin conductance) and subjective stress reactivity were also measured. RESULTS: Based on prior work, we hypothesized that cortisol stress reactivity would predict poststress cannabis LPP enhancement in more severe CUD. The hypothesis was supported and specific to HPA-axis versus autonomic or subjective stress reactivity. CONCLUSIONS: Acute stress potentiation of the cannabis LPP, likely via HPA-axis activation, may be a biomarker of heavy/disordered cannabis use in adults who regularly use cannabis. (PsycInfo Database Record (c) 2023 APA, all rights reserved).


Assuntos
Cannabis , Abuso de Maconha , Transtornos Relacionados ao Uso de Substâncias , Adulto , Humanos , Sinais (Psicologia) , Motivação
8.
Drug Alcohol Depend ; 247: 109862, 2023 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-37062250

RESUMO

BACKGROUND: Given increasing rates of Cannabis Use Disorder (CUD), objective measures are needed that can reliably index risk and track cannabis use progression. Based on incentive sensitization models, neurophysiological reactivity to cannabis cues, measured with the electroencephalography-recorded late positive potential (LPP), may be a candidate biomarker. To serve as such, the cannabis cue-elicited LPP must demonstrate adequate retest reliability and sensitivity to cannabis use change. Moreover, incentive sensitization theory suggests that state-level contextual variables, such as acute stress, can impact drug cue reactivity. Therefore, the present study evaluated the three-month retest reliability of the cannabis cue-elicited LPP, recorded before and after a laboratory stress induction, as well as its sensitivity to cannabis use change. METHOD: Cannabis and neutral cue-elicited LPPs were measured in 102 adults reporting frequent cannabis use (86 % with current CUD) before and after an acute stress induction at two lab visits three-months apart. Physiological and subjective stress reactivity were also measured. RESULTS: Manipulation checks confirmed expected cannabis cue and acute stress effects. Cannabis cue-elicited LPP amplitudes showed significant three-month retest reliability of poor-to-fair through moderate-to-good size. Change in cannabis use frequency significantly predicted change in cannabis cue-elicited LPP amplitudes, particularly at post-stress. CONCLUSION: Consistent with incentive sensitization models of addiction, the cannabis cue-elicited LPP demonstrated trait-like, moderate three-month stability and responsivity to change in cannabis use behavior. Greater predictive validity of the post-stress LPP may arise through kindling effects of acute stress on incentive salience-related neural activity, which should be explored in future studies.


Assuntos
Cannabis , Abuso de Maconha , Adulto , Humanos , Motivação , Abuso de Maconha/diagnóstico , Sinais (Psicologia) , Reprodutibilidade dos Testes
9.
Neuropsychopharmacology ; 48(13): 1968-1974, 2023 12.
Artigo em Inglês | MEDLINE | ID: mdl-37717082

RESUMO

Neuroendocrine tolerance to alcohol, i.e., a blunted cortisol response to alcohol, has been linked to Ventromedial Prefrontal Cortex (VmPFC) alcohol cue reactivity and relapse risk in severe Alcohol Use Disorders (AUDs), but its role in the development of AUDs is not clear. Recent work suggests that blunted cortisol responses to alcohol cues in individuals who engage in binge drinking (BD) may play a role in motivation to consume larger amounts of alcohol, but the link between this dysregulated endocrine response and BD's neural responses to alcohol cues remains unclear. To examine this, two groups of participants were recruited based on their recent drinking history. Thirty-three BD and 31 non-binging, social drinkers (SD) were exposed to alcohol cues and water cues in two separate 7 T functional magnetic resonance imaging (fMRI) scans. Each scan was followed by the Alcohol Taste Test (ATT) of implicit motivation for alcohol and a post-experiment, one-month prospective measurement of their "real world" drinking behavior. During each scan session, blood plasma was collected repeatedly to examine the separate effects of alcohol cues and alcohol consumption on cortisol levels. Relative to water cues and SD, BD demonstrated blunted cortisol cue reactivity that was negatively associated with VmPFC cue reactivity. In BD, both blunted cortisol and greater VmPFC cue reactivity were related to immediate and future alcohol consumption in the month following the scans. Thus, neuroendocrine tolerance in BD may be associated with increased incentive salience of cues and contribute mechanistically to increased alcohol consumption seen in the development of AUDs.


Assuntos
Alcoolismo , Consumo Excessivo de Bebidas Alcoólicas , Humanos , Consumo de Bebidas Alcoólicas , Sinais (Psicologia) , Hidrocortisona , Estudos Prospectivos , Etanol , Água
10.
Brain Behav Immun Health ; 31: 100645, 2023 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-37484196

RESUMO

Objective and design: Preclinical studies suggest learned immune system responses to alcohol cues and consumption may contribute to alcohol's pharmacodynamic properties and/or Alcohol Use Disorder (AUD) pathogenesis. Mechanistically, these immune alterations may be associated with increased craving and alcohol consumption, both acutely and over time. We sought to characterize this relationship in a randomized, counter-balanced, crossover neuroimaging experiment which took place between June 2020-November 2021. Methods: Thirty-three binge drinkers (BD) and 31 non-binge, social drinkers (SD), matched for demographic and psychological variables, were exposed to alcohol cues and water cues in two separate 7 T functional magnetic resonance imaging (fMRI) scans. Each scan was followed by the Alcohol Taste Test (ATT) of implicit motivation for acute alcohol. Craving measures and blood cytokine levels were collected repeatedly during and after scanning to examine the effects of alcohol cues and alcohol consumption on craving levels, Tumor necrosis factor alpha (TNF-α), and Interleukin 6 (IL-6) levels. A post-experiment one-month prospective measurement of participants' "real world" drinking behavior was performed to approximate chronic effects. Results: BD demonstrated significantly higher peak craving and IL-6 levels than SD in response to alcohol cues and relative to water cues. Ventromedial Prefrontal Cortex (VmPFC) signal change in the alcohol-water contrast positively related to alcohol cue condition craving and IL-6 levels, relative to water cue condition craving and IL-6 levels, in BD only. Additionally, peak craving and IL-6 levels were each independently related to ATT alcohol consumption and the number of drinks consumed in the next month for BD, again after controlling for craving and IL-6 repones to water cues. However, TNF-α release in the alcohol cue condition was not related to craving, neural activation, IL-6 levels, immediate and future alcohol consumption in either group after controlling for water cue condition responses. Conclusions: In sum, BD show greater craving and IL-6 release in the alcohol cue condition than SD, both of which were associated with prefrontal cue reactivity, immediate alcohol consumption, and future alcohol consumption over the subsequent 30 days. Alcohol associated immune changes and craving effects on drinking behavior may be independent of one another or may be indicative of a common pathway by which immune changes in BD could influence motivation to consume alcohol. Trial registration: Clinical Trials NCT04412824.

11.
Curr Behav Neurosci Rep ; 8(4): 134-149, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36908333

RESUMO

Purpose of review: Given increases in the rates of alcohol and cannabis co-use among adolescents and young adults, this review aims to summarize literature on the effects of alcohol and cannabis co-use on neurocognitive functioning, brain structure, and brain function. Recent findings: The limited existing studies examining concurrent, recent, and lifetime alcohol and cannabis co-use suggest effects on the brain are likely multifaceted. The majority of studies report that co-use is associated with negative outcomes such as impaired cognitive function and significant alterations in key structural and functional regions of the brain, while others report null effects of co-use compared to non-substance using control and single-substance use groups. Summary: Current studies lack a general consensus on methodology, definitions of concurrent and simultaneous use, and neuroimaging approaches, which makes it challenging to draw strong conclusions about the effects of co-use. More studies are needed to explore the effects of co-use in the context of simultaneous alcohol and cannabis use.

12.
Front Hum Neurosci ; 15: 729836, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34790106

RESUMO

The hippocampus is one of the most phylogenetically preserved structures in the mammalian brain. Engaged in a host of diverse cognitive processes, there has been increasing interest in understanding how the hippocampus dynamically supports these functions. One of the lingering questions is how to reconcile the seemingly disparate cytoarchitectonic organization, which favors a dorsal-ventral layering, with the neurofunctional topography, which has strong support for longitudinal axis (anterior-posterior) and medial-lateral orientation. More recently, meta-analytically driven (e.g., big data) approaches have been employed, however, the question remains whether they are sensitive to important task-specific features such as context, cognitive processes recruited, or the type of stimulus being presented. Here, we used hierarchical clustering on functional magnetic resonance imaging (fMRI) data acquired from healthy individuals at 7T using a battery of tasks that engage the hippocampus to determine whether stimulus or task features influence cluster profiles in the left and right hippocampus. Our data suggest that resting state clustering appears to favor the cytoarchitectonic organization, while task-based clustering favors the neurofunctional clustering. Furthermore, encoding tasks were more sensitive to stimulus type than were recognition tasks. Interestingly, a face-name paired associate task had nearly identical clustering profiles for both the encoding and recognition conditions of the task, which were qualitatively morphometrically different than simple encoding of words or faces. Finally, corroborating previous research, the left hippocampus had more stable cluster profiles compared to the right hippocampus. Together, our data suggest that task-based and resting state cluster profiles are different and may account for the disparity or inconsistency in results across studies.

13.
Am J Psychiatry ; 177(11): 1048-1059, 2020 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-32854534

RESUMO

OBJECTIVE: Alcohol use disorder (AUD) is associated with neuroadaptations in brain stress and reward circuits. It is not known whether such neuroadaptations are affected by number of days of alcohol abstinence and whether they influence heavy drinking during the early treatment phase. The authors used a novel functional MRI (fMRI) approach to assess brain responses during sustained exposure to standardized visual stimuli of stressful, alcohol cue, and neutral control images combined with prospective assessment of drinking outcomes during early outpatient treatment, in two related studies. METHODS: In study 1, 44 treatment-entering patients with AUD and 43 demographically matched healthy control subjects participated in the fMRI experiment to identify dysfunctional responses associated with chronic alcohol abuse. In study 2, 69 treatment-entering patients with AUD were assessed for whether fMRI responses at treatment initiation were influenced by alcohol abstinence and were prospectively predictive of early heavy drinking outcomes. RESULTS: Relative to control subjects, patients with AUD showed significant hyperreactivity in the ventromedial prefrontal cortex (vmPFC) in response to neutral images, but significant hypoactivation in the vmPFC and ventral striatum in response to stress images and to alcohol cues relative to response to neutral images. In study 2, this specific prefrontal-ventral striatal dysfunction was associated with fewer days of alcohol abstinence and also predicted greater number heavy drinking days during the subsequent 2 weeks of treatment engagement. CONCLUSIONS: Number of days of alcohol abstinence at treatment initiation significantly affected functional disruption of the prefrontal-striatal responses to stress images and to alcohol cues in patients with AUD, and the severity of this disruption in turn predicted greater heavy drinking during early treatment. Treatments that target this functional prefrontal-striatal pathology could improve early treatment outcomes in AUD.


Assuntos
Abstinência de Álcool , Alcoolismo/patologia , Córtex Pré-Frontal/patologia , Estriado Ventral/patologia , Adulto , Alcoolismo/fisiopatologia , Alcoolismo/terapia , Encéfalo/diagnóstico por imagem , Estudos de Casos e Controles , Fissura/fisiologia , Feminino , Humanos , Hidrocortisona/sangue , Imageamento por Ressonância Magnética , Masculino , Oximetria , Córtex Pré-Frontal/diagnóstico por imagem , Córtex Pré-Frontal/fisiopatologia , Resultado do Tratamento , Estriado Ventral/diagnóstico por imagem , Estriado Ventral/fisiopatologia
14.
Alcohol ; 72: 75-88, 2018 11.
Artigo em Inglês | MEDLINE | ID: mdl-30322482

RESUMO

It is well known that vulnerability to stress is a risk factor for alcohol use disorder (AUD). Chronic alcohol use can result in neuroadaptations in cortico-striatal pathways and hypothalamic pituitary adrenal (HPA) axis function that are manifested in altered behavioral and cognitive control functions contributing to alcohol craving, compulsive motivation, consumption, and consequences. This symposium brings together studies utilizing novel approaches to help improve our understanding of stress - past, acute, and chronic - on alcohol seeking and consumption and related outcomes using a combination of human laboratory models, neuroimaging, and clinical measures. Examining factors that determine vulnerability as well as resilience to stress are of particular interest in the study of AUD because, in addition to increasing our understanding of the risk factors for AUD, such knowledge can be used to develop more effective treatments. Dr. Stangl presented a novel human experimental model that demonstrates, for the first time, stress-induced increases in alcohol self-administration in binge drinkers using a guided imagery paradigm combined with intravenous alcohol self-administration (IV-ASA). Dr. Blaine presented data demonstrating that glucocorticoid response to stress drives compulsive alcohol motivation and intake in binge/heavy drinkers. Dr. Plawecki presented data examining sex differences in the effect of two distinct stress paradigms - mood induction and abstinence - on IV-ASA in moderate drinkers. Dr. Schwandt presented clinical data providing a new perspective on the relationship between childhood trauma and AUD by suggesting possible underlying mechanisms that confer resilience, rather than vulnerability, to severe early life stress exposure.


Assuntos
Sobreviventes Adultos de Maus-Tratos Infantis/psicologia , Alcoolismo/psicologia , Consumo Excessivo de Bebidas Alcoólicas/psicologia , Depressores do Sistema Nervoso Central/administração & dosagem , Etanol/administração & dosagem , Estresse Psicológico/psicologia , Administração Intravenosa , Experiências Adversas da Infância , Humanos , Sistema Hipotálamo-Hipofisário , Personalidade , Sistema Hipófise-Suprarrenal , Resiliência Psicológica , Autoadministração , Fatores Sexuais
15.
Neuropharmacology ; 122: 136-147, 2017 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-28159647

RESUMO

In this review, we detail the clinical evidence supporting the role of psychological and physiological stress in instrumental motivation for alcohol consumption during the development of mild to moderate alcohol use disorders (AUDs) and in the compulsive, habitual alcohol consumption seen in severe, chronic, relapsing AUDs. Traditionally, the study of AUDs has focused on the direct and indirect effects of alcohol on striatal dopaminergic pathways and their role in the reinforcing effects of alcohol. However, growing evidence also suggests that alcohol directly stimulates the hypothalamic pituitary adrenal (HPA) axis and has effects on glucocorticoid receptors in extrahypothalamic, limbic forebrain, and medial Prefrontal Cortex (PFC) circuits, which contribute to the development of AUDs and their progression in severity, chronicity, and relapse risk. Evidence indicates HPA axis, glucocorticoid, and PFC dysfunction during protracted withdrawal and under high arousal conditions in those with severe AUDs, and novel evidence is also emerging to suggest HPA axis dysfunction with binge/heavy drinking, which is associated with motivation for alcohol in non-dependent individuals. Specifically, alcohol-associated alterations in HPA axis responses to stress and alcohol cues may serve as interoceptive physiological signals and facilitate conditioning mechanisms to influence alcohol motivation. Thus, this dysfunction may serve as a potential biomarker of both risk and of relapse. Based on this emerging data, we conceptualize and present early evidence for treatment targets that may improve PFC function and/or normalize HPA axis functioning and may be beneficial in the treatment and relapse prevention of AUDs. Finally, we suggest that individual differences in alcohol-related pathophysiology in these circuits may modulate treatment and recovery response, thereby supporting the need for building personalized medicine algorithms to understand and treat AUDs. This article is part of the Special Issue entitled "Alcoholism".


Assuntos
Alcoolismo/fisiopatologia , Encéfalo/fisiopatologia , Estresse Fisiológico , Estresse Psicológico , Consumo de Bebidas Alcoólicas/fisiopatologia , Alcoolismo/metabolismo , Alcoolismo/prevenção & controle , Animais , Glucocorticoides/metabolismo , Humanos , Sistema Hipotálamo-Hipofisário/fisiopatologia , Sistema Hipófise-Suprarrenal/fisiopatologia , Córtex Pré-Frontal/fisiopatologia , Recidiva
16.
Behav Processes ; 108: 65-70, 2014 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-25277702

RESUMO

The caudomedial nidopallium (NCM) is an important site for the storage of auditory memories, particularly song, in passerines. In zebra finches, males sing and females do not, but females use song to choose mates. The extent to which the NCM is necessary for female mate choice is not well understood. To investigate the role of NCM in partner preferences, adult female zebra finches were bilaterally implanted with chronic cannulae directed at the NCM. Lidocaine, a sodium channel blocker, or saline (control) was infused into the NCM of females using a repeated measures design. Females were then tested in 3 separate paradigms: song preference, sexual partner preference, and pairing behavior/partner preference. We hypothesized that lidocaine would increase interactions with males by decreasing song discrimination and that this would be further evident in the song discrimination task. Indeed, females, when treated with lidocaine, had no preference for males singing unaltered song over males singing distorted song. These same females, when treated with saline, demonstrated a significant preference for males singing normal song. Furthermore, females affiliated with males more after receiving lidocaine than after receiving saline in the pairing paradigm, although neither treatment led to the formation of a partner preference. Our results support the hypothesis that NCM plays an important role not only in song discrimination, but also affiliation with a male.


Assuntos
Percepção Auditiva/fisiologia , Comportamento Animal/fisiologia , Encéfalo/fisiologia , Tentilhões/fisiologia , Preferência de Acasalamento Animal/fisiologia , Comportamento Social , Vocalização Animal/fisiologia , Animais , Encéfalo/anatomia & histologia , Feminino , Masculino
17.
J Stud Alcohol Drugs ; 74(2): 233-44, 2013 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-23384371

RESUMO

OBJECTIVE: Preclinical studies implicate the gene encoding the alpha synuclein protein (SNCA) in the pathophysiology of alcohol dependence and dopamine neuron function. Results from clinical studies are less conclusive. Using neurobiological phenotypes in genetic studies, rather than typical heterogeneous diagnostic categories derived from self-report, may improve reliability across studies. This study aimed to examine whether polymorphisms in the SNCA gene were associated with alcohol taste cue-elicited responses in the brain, one such intermediate phenotype. METHOD: A total of 326 heavy drinkers who underwent an alcohol taste task during functional magnetic resonance imaging (fMRI) also were genotyped. Analyses focused on two previously identified SNCA variants (rs2583985 and rs356168) as well as 27 other single nucleotide polymorphisms from the Illumina Human1M BeadChip that were used in an exploratory analysis of the whole gene. Neurobiological phenotypes were defined as fMRI blood oxygenation level-dependent (BOLD) responses to alcohol taste cue (vs. a control cue) in seven regions of interest known to be involved in cue processing and rich in dopaminergic axon terminals. RESULTS: Polymorphisms in the SNCA gene were significantly correlated with BOLD activation. Specifically, the largest effect sizes and significance were seen for rs2583985 in paracingulate and caudate (focused analysis) and for rs1372522 in paracingulate (exploratory analysis). Activation in all regions of interest was correlated with alcohol-dependence severity. CONCLUSIONS: SNCA genotype was found to be associated with the degree of fMRI BOLD response during exposure to the taste of alcohol versus a control taste. This study also further validates the use of this alcohol taste task as an intermediate phenotype for alcohol-dependence severity.


Assuntos
Alcoolismo/fisiopatologia , Imageamento por Ressonância Magnética/métodos , Oxigênio/metabolismo , alfa-Sinucleína/genética , Adulto , Axônios , Encéfalo/fisiopatologia , Mapeamento Encefálico/métodos , Sinais (Psicologia) , Dopamina/metabolismo , Feminino , Neuroimagem Funcional , Humanos , Masculino , Polimorfismo de Nucleotídeo Único , Índice de Gravidade de Doença
18.
Neuropsychopharmacology ; 38(12): 2363-72, 2013 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-23708507

RESUMO

Enhanced motivational salience towards smoking cues is a consequence of chronic nicotine use, but the degree to which this value increases beyond that of other appetitive cues is unknown. In addition, it is unclear how connectivity between brain regions influences cue reactivity and how cue reactivity and functional connectivity are related to nicotine dependence severity. This study examined neural responses during the presentation of smoking cues and appetitive control cues, as well as functional connectivity in 116 smokers with a range of nicotine dependence severity. Smoking cues elicited greater response above baseline than food cues in orbitofrontal cortex (OFC) and supplementary motor area (SMA) and less deactivation below baseline in middle frontal gyrus, inferior parietal lobe, and middle temporal gyrus. Psychophysiological interaction (PPI) analysis using right OFC as a seed revealed increased connectivity with somatosensory cortex and lateral inferior parietal lobe during smoking cues compared with food cues. Similarly, a PPI analysis using left insula as a seed showed stronger connectivity with somatosensory cortex, right insula, OFC, and striatum. Finally, relationships with nicotine dependence scores showed enhanced response in insula and dorsal anterior cingulate cortex in the smoking vs food comparison, and increased connectivity between insula and circuits involved in motivated behavior. Combined, these results suggest that smokers engage attentional networks and default mode networks involved in self-referential processing to a greater degree during smoking cues. In addition, individuals with greater nicotine dependence severity show increased engagement of sensorimotor and motor preparation circuits, suggesting increased reliance on habitual behavior.


Assuntos
Encéfalo/fisiopatologia , Sinais (Psicologia) , Fumar , Tabagismo/fisiopatologia , Adolescente , Adulto , Atenção/fisiologia , Mapeamento Encefálico , Feminino , Alimentos , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Recompensa , Índice de Gravidade de Doença , Adulto Jovem
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