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Stress-Induced Sensitization of Insula Activation Predicts Alcohol Craving and Alcohol Use in Alcohol Use Disorder.

Authors
  • Bach, Patrick1
  • Zaiser, Judith2
  • Zimmermann, Sina2
  • Gessner, Tatjana2
  • Hoffmann, Sabine3
  • Gerhardt, Sarah2
  • Berhe, Oksana4
  • Bekier, Nina Kim2
  • Abel, Martin2
  • Radler, Philipp5
  • Langejürgen, Jens5
  • Tost, Heike4
  • Lenz, Bernd2
  • Vollstädt-Klein, Sabine6
  • Stallkamp, Jan7
  • Kirschbaum, Clemens8
  • Kiefer, Falk9
  • 1 Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, Medical Faculty Mannheim. Heidelberg University, Heidelberg, Germany; Feuerlein Center on Translational Addiction Medicine, University of Heidelberg, Heidelberg, Germany. Electronic address: [email protected]. , (Germany)
  • 2 Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, Medical Faculty Mannheim. Heidelberg University, Heidelberg, Germany. , (Germany)
  • 3 Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, Medical Faculty Mannheim. Heidelberg University, Heidelberg, Germany; Department of Biostatistics, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany. , (Germany)
  • 4 Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany. , (Germany)
  • 5 Fraunhofer Institute for Manufacturing Engineering and Automation Institute for Production Technology and Automation, Mannheim, Germany. , (Germany)
  • 6 Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, Medical Faculty Mannheim. Heidelberg University, Heidelberg, Germany; Mannheim Center for Translational Neurosciences, Medical Faculty of Mannheim, University of Heidelberg, Mannheim, Germany. , (Germany)
  • 7 Mannheim Institute for Intelligent Systems in Medicine, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany. , (Germany)
  • 8 Department of Psychology, Technical University Dresden, Dresden, Germany. , (Germany)
  • 9 Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, Medical Faculty Mannheim. Heidelberg University, Heidelberg, Germany; Feuerlein Center on Translational Addiction Medicine, University of Heidelberg, Heidelberg, Germany; Mannheim Center for Translational Neurosciences, Medical Faculty of Mannheim, University of Heidelberg, Mannheim, Germany. , (Germany)
Type
Published Article
Publication Date
Feb 01, 2024
Volume
95
Issue
3
Pages
245–255
Identifiers
DOI: 10.1016/j.biopsych.2023.08.024
PMID: 37678541
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Stress and alcohol cues trigger alcohol consumption and relapse in alcohol use disorder. However, the neurobiological processes underlying their interaction are not well understood. Thus, we conducted a randomized, controlled neuroimaging study to investigate the effects of psychosocial stress on neural cue reactivity and addictive behaviors. Neural alcohol cue reactivity was assessed in 91 individuals with alcohol use disorder using a validated functional magnetic resonance imaging (fMRI) task. Activation patterns were measured twice, at baseline and during a second fMRI session, prior to which participants were assigned to psychosocial stress (experimental condition) or a matched control condition or physical exercise (control conditions). Together with fMRI data, alcohol craving and cortisol levels were assessed, and alcohol use data were collected during a 12-month follow-up. Analyses tested the effects of psychosocial stress on neural cue reactivity and associations with cortisol levels, craving, and alcohol use. Compared with both control conditions, psychosocial stress elicited higher alcohol cue-induced activation in the left anterior insula (familywise error-corrected p < .05) and a stress- and cue-specific dynamic increase in insula activation over time (F22,968 = 2.143, p = .007), which was predicted by higher cortisol levels during the experimental intervention (r = 0.310, false discovery rate-corrected p = .016). Cue-induced insula activation was positively correlated with alcohol craving during fMRI (r = 0.262, false discovery rate-corrected p = .032) and alcohol use during follow-up (r = 0.218, false discovery rate-corrected p = .046). Results indicate a stress-induced sensitization of cue-induced activation in the left insula as a neurobiological correlate of the effects of psychosocial stress on alcohol craving and alcohol use in alcohol use disorder, which likely reflects changes in salience attribution and goal-directed behavior. Copyright © 2023 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

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