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Orbitofrontal structural markers of negative affect in alcohol dependence and their associations with heavy relapse-risk at 6 months post-treatment

Published online by Cambridge University Press:  23 March 2020

E. Zois ,
S. Vollstädt-Klein ,
S. Hoffmann ,
I. Reinhard ,
K. Charlet ,
A. Beck ,
A. Jorde ,
M. Kirsch ,
H. Walter  and
A. Heinz
...Show all authors
E. Zois*
Affiliation:
Department of addictive behaviour and addiction medicine, central institute of mental health, Mannheim, university of Heidelberg, Mannheim, Germany
S. Vollstädt-Klein
Affiliation:
Department of addictive behaviour and addiction medicine, central institute of mental health, Mannheim, university of Heidelberg, Mannheim, Germany
S. Hoffmann
Affiliation:
Department of addictive behaviour and addiction medicine, central institute of mental health, Mannheim, university of Heidelberg, Mannheim, Germany
I. Reinhard
Affiliation:
Department of biostatistics, central institute of mental health, Mannheim, university of Heidelberg, Mannheim, Germany
K. Charlet
Affiliation:
Department of psychiatry and psychotherapy, Charité-Universitätsmedizin Berlin, Berlin, Germany
A. Beck
Affiliation:
Department of psychiatry and psychotherapy, Charité-Universitätsmedizin Berlin, Berlin, Germany
A. Jorde
Affiliation:
Department of addictive behaviour and addiction medicine, central institute of mental health, Mannheim, university of Heidelberg, Mannheim, Germany
M. Kirsch
Affiliation:
Department of addictive behaviour and addiction medicine, central institute of mental health, Mannheim, university of Heidelberg, Mannheim, Germany
H. Walter
Affiliation:
Department of psychiatry and psychotherapy, Charité-Universitätsmedizin Berlin, Berlin, Germany
A. Heinz
Affiliation:
Department of psychiatry and psychotherapy, Charité-Universitätsmedizin Berlin, Berlin, Germany
F. Kiefer
Affiliation:
Department of addictive behaviour and addiction medicine, central institute of mental health, Mannheim, university of Heidelberg, Mannheim, Germany
*
* Corresponding author. Department of addictive and addiction medicine, central institute of mental health, medical faculty Mannheim/Heidelberg university, square J5, 68159 Mannheim, Germany. E-mail address[email protected] (E. Zois).
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Abstract

Background

Alcohol relapse is often occurring to regulate negative affect during withdrawal. On the neurobiological level, alcoholism is associated with gray matter (GM) abnormalities in regions that regulate emotional experience such as the orbitofrontal cortex (OFC). However, no study to our knowledge has investigated the neurobiological unpinning of affect in alcoholism at early withdrawal and the associations of OFC volume with long-term relapse risk.

Methods:

One hundred and eighty-two participants were included, 95 recently detoxified alcohol dependent patients (ADP) and 87 healthy controls (HC). We measured affective states using the positive and negative affect schedule (PANAS). We collected T1-weighted brain structural images and performed Voxel-based morphometry (VBM).

Results:

Findings revealed GM volume decrease in alcoholics in the prefrontal cortex (including medial OFC), anterior cingulate gyrus, and insula. GM volume in the medial OFC was positively associated with NA in the ADP group. Cox regression analysis predicted that risk to heavy relapse at 6 months increases with decreased GM volume in the medial OFC.

Conclusions:

Negative affect during alcohol withdrawal was positively associated with OFC volume. What is more, increased GM volume in the OFC also moderated risk to heavy relapse at 6 months. Reduced GM in the OFC poses as risk to recovery from alcohol dependence and provides valuable insights into transient negative affect states during withdrawal that can trigger relapse. Implications exist for therapeutic interventions signifying the OFC as a neurobiological marker to relapse and could explain the inability of ADP to regulate internal negative affective states.

Keywords

Alcohol dependenceMedial orbitofrontal cortexNegative affectRelapse riskGray matter
Type
Original article
Information
European Psychiatry , Volume 46 , October 2017 , pp. 16 - 22
Copyright
Copyright © European Psychiatric Association 2017

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Footnotes

Abbreviations: ADP, alcohol dependent patients AD, alcohol dependence HC, healthy controls OFC, orbitofrontal cortex PFC, prefrontal cortex PA, positive affect NA, negative affect PANAS, positive and negative affect schedule GM, gray matter VBM, Voxel-based morphometry MPRAGE, Magnetization-prepared Rapid Acquisition Gradient Echo

References

Russell, JACarroll, JMOn the bipolarity of positive and negative affect. Psychol Bull 1999;125:3–30.CrossRefGoogle ScholarPubMed
Gross, JJThe emerging field of emotion regulation: an integrative review. Rev Gen Psychol 1998;2:271–299.CrossRefGoogle Scholar
Aldao, ADixon-Gordon, KLBroadening the scope of research on emotion regulation strategies and psychopathology. Cogn Behav Ther 2014;43:22–33.CrossRefGoogle Scholar
Caetano, RNelson, SCunradi, CIntimate partner violence, dependence symptoms and social consequences from drinking among white, black and Hispanic couples in the United States. Am J Addict 2001;10 Suppl.:60–69.CrossRefGoogle ScholarPubMed
Cheetham, AAllen, NBYucel, MLubman, DIThe role of affective dysregulation in drug addiction. Clin Psychol Rev 2010;30:621–634.CrossRefGoogle ScholarPubMed
Heilig, MEgli, MCrabbe, JCBecker, HCAcute withdrawal, protracted abstinence and negative affect in alcoholism: are they linked?. Addict Biol 2010;15:169–184.CrossRefGoogle ScholarPubMed
Gilman, JMHommer, DWModulation of brain response to emotional images by alcohol cues in alcohol-dependent patients. Addict Biol 2008;13:423–434.CrossRefGoogle ScholarPubMed
Witkiewitz, KVillarroel, NADynamic association between negative affect and alcohol lapses following alcohol treatment. J Consult Clin Psychol 2009;77:633–644.CrossRefGoogle ScholarPubMed
Sinha, RFox, HCHong, KABergquist, KBhagwagar, ZSiedlarz, KMEnhanced negative emotion and alcohol craving, and altered physiological responses following stress and cue exposure in alcohol dependent individuals. Neuropsychopharmacology 2009;34:1198–1208.CrossRefGoogle ScholarPubMed
Koob, GKreek, MJStress, dysregulation of drug reward pathways, and the transition to drug dependence. Am J Psychiatry 2007;164:1149–1159.CrossRefGoogle ScholarPubMed
Seo, DSinha, RNeuroplasticity and predictors of alcohol recovery. Alcohol Res 2015;37:143–152.Google ScholarPubMed
Marek, RStrobel, CBredy, TWSah, PThe amygdala and medial prefrontal cortex: partners in the fear circuit. J Physiol 2013;591:2381–2391.CrossRefGoogle ScholarPubMed
Verdejo-Garcia, ABechara, ARecknor, ECPerez-Garcia, MExecutive dysfunction in substance dependent individuals during drug use and abstinence: an examination of the behavioral, cognitive and emotional correlates of addiction. J Int Neuropsychol Soc 2006;12:405–415.CrossRefGoogle Scholar
Bechara, ADamasio, ARDamasio, HAnderson, SWInsensitivity to future consequences following damage to human prefrontal cortex. Cognition 1994;50:7–15.CrossRefGoogle ScholarPubMed
Bechara, ADamasio, HDamasio, AREmotion, decision making and the orbitofrontal cortex. Cereb Cortex 2000;10:295–307.CrossRefGoogle ScholarPubMed
Turnbull, OHBowman, CHShanker, SDavies, JLEmotion-based learning: insights from the Iowa Gambling Task. Front Psychol 2014;5:162.CrossRefGoogle ScholarPubMed
Le Berre, APRauchs, GLa Joie, RMezenge, FBoudehent, CVabret, F, et al.Impaired decision-making and brain shrinkage in alcoholism. Eur Psychiatry 2014;29:125–133.CrossRefGoogle ScholarPubMed
Bechara, ADolan, SDenburg, NHindes, AAnderson, SWNathan, PEDecision-making deficits, linked to a dysfunctional ventromedial prefrontal cortex, revealed in alcohol and stimulant abusers. Neuropsychologia 2001;39:376–389.CrossRefGoogle ScholarPubMed
Bach, PKirsch, MHoffmann, SJorde, AMann, KFrank, J, et al.The effects of single nucleotide polymorphisms in glutamatergic neurotransmission genes on neural response to alcohol cues and craving. Addict Biol 2015;20:1022–1032.CrossRefGoogle ScholarPubMed
Camchong, JStenger, AFein, GResting-state synchrony during early alcohol abstinence can predict subsequent relapse. Cereb Cortex 2013;23:2086–2099.CrossRefGoogle ScholarPubMed
Charlet, KSchlagenhauf, FRichter, ANaundorf, KDornhof, LWeinfurtner, CE, et al.Neural activation during processing of aversive faces predicts treatment outcome in alcoholism. Addict Biol 2014;19:439–451.CrossRefGoogle ScholarPubMed
Tanabe, JTregellas, JRDalwani, MThompson, LOwens, ECrowley, T, et al.Medial orbitofrontal cortex gray matter is reduced in abstinent substance-dependent individuals. Biol Psychiatry 2009;65:160–164.CrossRefGoogle ScholarPubMed
Zois, EKiefer, FLemenager, TVollstadt-Klein, SMann, KFauth-Buhler, MFrontal cortex gray matter volume alterations in pathological gambling occur independently from substance use disorder. Addict Biol 2016;22:864–872CrossRefGoogle ScholarPubMed
Mon, ADurazzo, TCAbe, CGazdzinski, SPennington, DSchmidt, T, et al.Structural brain differences in alcohol-dependent individuals with and without comorbid substance dependence. Drug Alcohol Depend 2014;144:170–177.CrossRefGoogle ScholarPubMed
Rando, KHong, KIBhagwagar, ZLi, CSBergquist, KGuarnaccia, J, et al.Association of frontal and posterior cortical gray matter volume with time to alcohol relapse: a prospective study. Am J Psychiatry 2011;168:183–192.CrossRefGoogle ScholarPubMed
Mechtcheriakov, SBrenneis, CEgger, KKoppelstaetter, FSchocke, MMarksteiner, JA widespread distinct pattern of cerebral atrophy in patients with alcohol addiction revealed by voxel-based morphometry. J Neurol Neurosurg Psychiatry 2007;78:610–614.CrossRefGoogle ScholarPubMed
Conrod, PGaravan, HMackey, SLavoie, JGlahn, DEnigma Addiction Working G. 98. Cortical and subcortical differences between alcohol dependent individuals and controls: meta-analysis results from the Enigma-Addiction Working Group. Biol Psychiatry 2017;81:S41.CrossRefGoogle Scholar
Thayer, REHagerty, SLSabbineni, AClaus, EDHutchison, KEWeiland, BJNegative and interactive effects of sex, aging, and alcohol abuse on gray matter morphometry. Hum Brain Map 2016;37:2276–2292.CrossRefGoogle ScholarPubMed
Udo, TClifford, PRDavis, CMMaisto, SAAlcohol use post AUD treatment initiation as a predictor of later functioning. Am J Drug Alcohol Abuse 2009;35:128–132.CrossRefGoogle ScholarPubMed
Segobin, SHChetelat, GLe Berre, APLannuzel, CBoudehent, CVabret, F, et al.Relationship between brain volumetric changes and interim drinking at six months in alcohol-dependent patients. Alcohol Clin Exp Res 2014;38:739–748.CrossRefGoogle ScholarPubMed
Watson, DClark, LATellegen, ADevelopment and validation of brief measures of positive and negative affect: the PANAS scales. J Pers Soc Psychol 1988;54:1063–1070.CrossRefGoogle ScholarPubMed
Hautzinger, MBailer, MWorall, HKeller, FBDI Beck-Depressions-Inventar Testhandbuch 2. überarbeitete Auflage. Verlag Hans Huber; 1995.Google Scholar
Laux, LGlanzmann, PSchaffner, PSpielberger, CDDas State-Trait-Angstinventar Weinheim, Germany: Beltz; 1981Google Scholar
Zois, EVollstadt-Klein, SHoffmann, SReinhard, IBach, PCharlet, K, et al.GATA4 variant interaction with brain limbic structure and relapse risk: a voxel-based morphometry study. Eur Neuropsychopharmacol 2016;26:1431–7CrossRefGoogle ScholarPubMed
Ashburner, JFriston, KJWhy voxel-based morphometry should be used. NeuroImage 2001;14:1238–1243.CrossRefGoogle Scholar
Ashburner, JFriston, KJVoxel-based morphometry — the methods. NeuroImage 2000;11:805–821.CrossRefGoogle ScholarPubMed
Gallinat, JMeisenzahl, EJacobsen, LKKalus, PBierbrauer, JKienast, T, et al.Smoking and structural brain deficits: a volumetric MR investigation. Eur J Neurosci 2006;24:1744–1750.CrossRefGoogle ScholarPubMed
Demirakca, TEnde, GKammerer, NWelzel-Marquez, HHermann, DHeinz, A, et al.Effects of alcoholism and continued abstinence on brain volumes in both genders. Alcohol Clin Exp Res 2011;35:1678–1685.Google ScholarPubMed
Drevets, WCPrice, JLFurey, MLBrain structural and functional abnormalities in mood disorders: implications for neurocircuitry models of depression. Brain Struct Funct 2008;213:93–118.CrossRefGoogle ScholarPubMed
Tisserand, DJPruessner, JCSanz Arigita, EJvan Boxtel, MPEvans, ACJolles, J, et al.Regional frontal cortical volumes decrease differentially in aging: an MRI study to compare volumetric approaches and voxel-based morphometry. NeuroImage 2002;17:657–669.CrossRefGoogle ScholarPubMed
Barnes, JRidgway, GRBartlett, JHenley, SMLehmann, MHobbs, N, et al.Head size, age and gender adjustment in MRI studies: a necessary nuisance?. NeuroImage 2010;53:1244–1255.CrossRefGoogle ScholarPubMed
Tzourio-Mazoyer, NLandeau, BPapathanassiou, DCrivello, FEtard, ODelcroix, N, et al.Automated anatomical labeling of activations in SPM using a macroscopic anatomical parcellation of the MNI MRI single-subject brain. NeuroImage 2002;15:273–289.CrossRefGoogle ScholarPubMed
Duff, EPCunnington, REgan, GFREX: response exploration for neuroimaging datasets. Neuroinformatics 2007;5:223–234.CrossRefGoogle ScholarPubMed
Rudebeck, PHBannerman, DMRushworth, MFThe contribution of distinct subregions of the ventromedial frontal cortex to emotion, social behavior, and decision making. Cogn Affect Behav Neurosci 2008;8:485–497.CrossRefGoogle ScholarPubMed
Muhlert, NLawrence, ADBrain structure correlates of emotion-based rash impulsivity. NeuroImage 2015;115:138–146.CrossRefGoogle ScholarPubMed
Jackson, DCMueller, CJDolski, IDalton, KMNitschke, JBUrry, HL, et al.Now you feel it, now you don’t: frontal brain electrical asymmetry and individual differences in emotion regulation. Psychol Sci 2003;14:612–617.CrossRefGoogle ScholarPubMed
Izquierdo, ASuda, RKMurray, EAComparison of the effects of bilateral orbital prefrontal cortex lesions and amygdala lesions on emotional responses in rhesus monkeys. J Neurosci 2005;25:8534–8542.CrossRefGoogle ScholarPubMed
Rudebeck, PHWalton, MEMillette, BHShirley, ERushworth, MFBannerman, DMDistinct contributions of frontal areas to emotion and social behaviour in the rat. Eur J Neurosci 2007;26:2315–2326.CrossRefGoogle ScholarPubMed
Beer, JSJohn, OPScabini, DKnight, RTOrbitofrontal cortex and social behavior: integrating self-monitoring and emotion-cognition interactions. J Cogn Neurosci 2006;18:871–879.CrossRefGoogle ScholarPubMed
Oscar-Berman, MBowirrat, AGenetic influences in emotional dysfunction and alcoholism-related brain damage. Neuropsychiatr Dis Treat 2005;1:211–229.Google ScholarPubMed
Seo, DLacadie, CMTuit, KHong, KIConstable, RTSinha, RDisrupted ventromedial prefrontal function, alcohol craving, and subsequent relapse risk. JAMA Psychiatry 2013;70:727–739.CrossRefGoogle ScholarPubMed
Fromme, KMarlatt, GABaer, JSKivlahan, DRThe Alcohol Skills Training Program: a group intervention for young adult drinkers. J Subst Abuse Treat 1994;11:143–154.CrossRefGoogle ScholarPubMed
Tang, YYTang, RPosner, MIMindfulness meditation improves emotion regulation and reduces drug abuse. Drug Alcohol Depend 2016;163(Suppl. 1):S13–S18.CrossRefGoogle ScholarPubMed
Berking, MMargraf, MEbert, DWupperman, PHofmann, SGJunghanns, KDeficits in emotion-regulation skills predict alcohol use during and after cognitive-behavioral therapy for alcohol dependence. J Consult Clin Psychol 2011;79:307–318.CrossRefGoogle ScholarPubMed
Charlet, KHeinz, A Harm reduction — a systematic review on effects of alcohol reduction on physical and mental symptoms. Addict Biol 2016. http://dx.doi.org/10.1111/adb.12414 [Epub ahead of print].CrossRefGoogle Scholar
Hariri, ARBookheimer, SYMazziotta, JCModulating emotional responses: effects of a neocortical network on the limbic system. Neuroreport 2000;11:43–48.CrossRefGoogle ScholarPubMed
Stephens, DNRipley, TLBorlikova, GSchubert, MAlbrecht, DHogarth, L, et al.Repeated ethanol exposure and withdrawal impairs human fear conditioning and depresses long-term potentiation in rat amygdala and hippocampus. Biol Psychiatry 2005;58:392–400.CrossRefGoogle ScholarPubMed
Volkow, NDWang, GJTomasi, DBaler, RDUnbalanced neuronal circuits in addiction. Curr Opinion Neurobiol 2013;23:639–648.CrossRefGoogle ScholarPubMed
Makris, NOscar-Berman, MJaffin, SKHodge, SMKennedy, DNCaviness, VS, et al.Decreased volume of the brain reward system in alcoholism. Biol Psychiatry 2008;64:192–202.CrossRefGoogle ScholarPubMed
Wrase, JMakris, NBraus, DFMann, KSmolka, MNKennedy, DN, et al.Amygdala volume associated with alcohol abuse relapse and craving. Am J Psychiatry 2008;165:1179–1184.CrossRefGoogle ScholarPubMed
Sullivan, EVDeshmukh, ADe Rosa, ERosenbloom, MJPfefferbaum, AStriatal and forebrain nuclei volumes: contribution to motor function and working memory deficits in alcoholism. Biol Psychiatry 2005;57:768–776.CrossRefGoogle ScholarPubMed
Bechara, ADecision making, impulse control and loss of willpower to resist drugs: a neurocognitive perspective. Nat Neurosci 2005;8:1458–1463.CrossRefGoogle ScholarPubMed
Bush, GLuu, PPosner, MICognitive and emotional influences in anterior cingulate cortex. Trends Cogn Sci 2000;4:215–222.CrossRefGoogle ScholarPubMed
Naqvi, NHBechara, AThe insula and drug addiction: an interoceptive view of pleasure, urges, and decision-making. Brain Struct Funct 2010;214:435–450.CrossRefGoogle ScholarPubMed
Spanagel, RDurstewitz, DHansson, AHeinz, AKiefer, FKohr, G, et al.A systems medicine research approach for studying alcohol addiction. Addict Biol 2013;18:883–896.CrossRefGoogle ScholarPubMed
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