Integrating electrical field maps and alcohol cue-reactivity patterns to improve TMS treatment outcome in Alcohol Use Disorder: a retrospective analysis

AbstractPharmacological treatment in alcohol use disorder suffers from modest effect sizes. Efforts have been undertaken to identify patient characteristics that help to select individuals that benefit from pharmacological treatment. Previous studies indicated that neural alcohol cue-reactivity (CR) might provide a marker that identifies patients, which benefit from naltrexone treatment.We investigated the reproducibility of the association between ventral striatum (VS) activation and naltrexone (NTX) treatment response by analyzing data from a recent longitudinal clinical trial in N = 44 abstinent treatment-seeking alcohol-dependent patients. A follow-up was conducted over 3 months. We computed the percentage of significant voxels in VS and tested main effects and interactions with NTX treatment on relapse risk using Cox Regression models.We found a significant interaction effect between pre-treatment cue reactivity in the VS and NTX treatment on time to first heavy relapse (Hazard Ratio = 7.406, 95% CI 1.17–46.56, p = 0.033), such that the patient group with high VS activation (defined by a mean split) showed a significant medication effect (Hazard Ratio = 0.140, 95% CI 0.02–0.75, p = 0.022) with a number needed to treat of 3.4 [95% CI 2.413.5], while there was no significant effect in the group with low VS activation (Hazard Ratio = 0.726, p = 0.454).Thus, using an independent sample we replicated the previously described positive association between VS activation and NTX efficacy. Although our results should be considered cautiously in light of the small sample size, our results support the potential of neural alcohol CR as a tool for precision medicine approaches in alcohol dependence.

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Goal commitment predicts treatment outcome for adolescents with alcohol use disorder

Addictive Behaviors ◽

10.1016/j.addbeh.2017.07.035 ◽

2018 ◽

Vol 76 ◽

pp. 122-128 ◽

Cited By ~ 8

Author(s):

Yifrah Kaminer ◽

Christine McCauley Ohannessian ◽

James R. McKay ◽

Rebecca H. Burke ◽

Kaitlin Flannery

Keyword(s):

Treatment Outcome ◽

Alcohol Use ◽

Alcohol Use Disorder ◽

Goal Commitment

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Behavioural cue reactivity to alcohol and non-alcohol-related stimuli among individuals with severe alcohol use disorder: an fMRI study with a visual task

10.1101/2020.02.03.932889 ◽

2020 ◽

Author(s):

Shou Fukushima ◽

Hironori Kuga ◽

Naoya Oribe ◽

Takeo Mutou ◽

Takefumi Yuzuriha ◽

...

Keyword(s):

Alcohol Use ◽

Alcohol Use Disorder ◽

Brain Activity ◽

Cue Reactivity ◽

Drinking Behavior ◽

Significant Negative Correlation ◽

Blood Oxygen Level Dependent ◽

Posterior Cingulate Cortex ◽

Alcoholic Beverages ◽

Bold Responses

AbstractPatients with alcohol use disorder (AUD) have difficulties controlling alcohol cravings and thus exhibit increased use and earlier relapse. Although patients tend to respond more strongly to alcohol-related images compared with non-alcohol-related images, few researchers examined the factors that modulate cravings. Here, we examined whole-brain blood oxygen level-dependent (BOLD) responses to behavioural cues in individuals with AUD and healthy controls (HCs). The participants included 24 patients with severe AUD and 15 HCs. We presented four beverage images (juice, drinking juice, sake, and drinking sake) and compared participant BOLD responses between the two groups. Multiple comparisons revealed that the AUD group had lower BOLD responses compared with the HC group to images of drinking juice in the left precuneus (p = 0.036) and the left posterior cingulate cortex (PCC) (p = 0.044) and higher BOLD responses to images of drinking sake in the left PCC (p = 0.044). Furthermore, compared to the HCs, the AUD patients had decreased BOLD responses associated with cue reactivity to drinking juice in the left precuneus during the period from 15 to 18 s (p = 0.004, df = 37) and 18 to 21 s (p = 0.002, df = 37). Using the Spearman correlation, we found a significant negative correlation between BOLD responses in the left PCC of the AUD patients and Mini–Mental State Examination (MMSE) scores (r = −0.619, p = 0.001). Our findings suggest that HCs and severe AUD patients differ in their responses not to images of alcoholic beverages but those related to alcohol drinking behavior. Thus, these patients appear to have different patterns of brain activity. This information may aid clinicians in developing treatments for patients with AUD.

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Interaction between behavioral inhibition and neural alcohol cue-reactivity in ADHD and alcohol use disorder

Psychopharmacology ◽

10.1007/s00213-020-05492-1 ◽

2020 ◽

Vol 237 (6) ◽

pp. 1691-1707

Author(s):

S Vollstädt-Klein ◽

S Gerhardt ◽

A Lee ◽

A Strosche ◽

G Sharafi ◽

...

Keyword(s):

Alcohol Use ◽

Behavioral Inhibition ◽

Alcohol Use Disorder ◽

Cue Reactivity

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Behavioural cue reactivity to alcohol-related and non-alcohol-related stimuli among individuals with alcohol use disorder: An fMRI study with a visual task

PLoS ONE ◽

10.1371/journal.pone.0229187 ◽

2020 ◽

Vol 15 (7) ◽

pp. e0229187 ◽

Cited By ~ 2

Author(s):

Shou Fukushima ◽

Hironori Kuga ◽

Naoya Oribe ◽

Takeo Mutou ◽

Takefumi Yuzuriha ◽

...

Keyword(s):

Alcohol Use ◽

Alcohol Use Disorder ◽

Cue Reactivity ◽

Visual Task ◽

Fmri Study

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Correction: Behavioural cue reactivity to alcohol-related and non-alcohol-related stimuli among individuals with alcohol use disorder: An fMRI study with a visual task

PLoS ONE ◽

10.1371/journal.pone.0242531 ◽

2020 ◽

Vol 15 (11) ◽

pp. e0242531

Author(s):

Shou Fukushima ◽

Hironori Kuga ◽

Naoya Oribe ◽

Takeo Mutou ◽

Takefumi Yuzuriha ◽

...

Keyword(s):

Alcohol Use ◽

Alcohol Use Disorder ◽

Cue Reactivity ◽

Visual Task ◽

Fmri Study

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The Identification of Pretreatment Trajectories of Alcohol Use and Their Relationship to Treatment Outcome in Men and Women With Alcohol Use Disorder

Alcoholism Clinical and Experimental Research ◽

10.1111/acer.14216 ◽

2019 ◽

Vol 43 (12) ◽

pp. 2637-2648 ◽

Cited By ~ 1

Author(s):

Paul R. Stasiewicz ◽

Clara M. Bradizza ◽

Melanie U. Ruszczyk ◽

Joseph F. Lucke ◽

Junru Zhao ◽

...

Keyword(s):

Treatment Outcome ◽

Alcohol Use ◽

Alcohol Use Disorder ◽

Men And Women

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Effects of topiramate on neural responses to alcohol cues in treatment-seeking individuals with alcohol use disorder: preliminary findings from a randomized, placebo-controlled trial

Neuropsychopharmacology ◽

10.1038/s41386-021-00968-w ◽

2021 ◽

Author(s):

Reagan R. Wetherill ◽

Nathaniel Spilka ◽

Kanchana Jagannathan ◽

Paige Morris ◽

Danielle Romer ◽

...

Keyword(s):

Alcohol Use ◽

Alcohol Use Disorder ◽

Controlled Trial ◽

Cue Reactivity ◽

A Priori ◽

Heavy Drinking ◽

Double Blind ◽

Alcohol Cues ◽

Brain Responses ◽

The Right

AbstractTopiramate, a GABA/glutamate modulator, is efficacious in reducing alcohol consumption, though the mechanisms underlying this effect are not well characterized. This study analyzed functional magnetic resonance imaging (fMRI) data from 22 heavy drinkers enrolled in a 12-week placebo-controlled, randomized clinical trial of topiramate to examine the effects of topiramate on alcohol cue-elicited brain responses, craving, and heavy drinking in individuals with DSM-5 alcohol use disorder. Patients were randomized to receive either topiramate (maximal daily dosage of 200 mg/day) or placebo and were administered an fMRI alcohol cue-reactivity task at baseline (before starting medication) and after 6 weeks of double-blind treatment. Analyses compared the topiramate (n = 12) and placebo (n = 8) groups on (1) the change in brain responses during alcohol cue exposure (vs non-alcohol cues) within five a priori regions of interest related to reward—the bilateral and medial orbitofrontal cortex (OFC) and bilateral ventral striatum (VS) and (2) change in craving and heavy drinking days (HDDs) from baseline and scan 2. Topiramate, relative to placebo, reduced alcohol cue-elicited activation of the left VS, bilateral OFC, and medial OFC, alcohol cue-elicited craving, and HDDs between baseline and 6 weeks of treatment. The reduction in alcohol cue-elicited activation in the medial OFC correlated with reductions in craving, and reduced activation in the right VS, right OFC, and medial OFC correlated with the reduction in HDD. This preliminary study provides evidence that topiramate’s attenuation of alcohol cue-elicited brain activation and craving are key elements of the drug’s neurobiological mechanism of action in reducing heavy drinking.

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