A preliminary study of longitudinal neuroadaptation associated with recovery from addiction

Abstract

Background Few studies have explored longitudinal change in event-related brain responses during early recovery from addiction. Moreover, existing findings yield evidence of both increased and decreased signaling within reward and control centers over time. The current study explored reward- and control-related signals in a risky decision-making task and specifically investigated parametric modulations of the BOLD signal, rather than signal magnitude alone. It was hypothesized that risk-related signals during decision-making and outcome evaluation would reflect recovery and that change in specific signals would correspond with improved treatment outcomes. Methods Twenty-one substance dependent individuals were recruited upon enrollment in community-based substance use treatment programs, wherein they received treatment-as-usual. Participants completed functional neuroimaging assessments at baseline and 3-month follow-up while performing the Balloon Analogue Risk Task (BART). Risk- and reward-sensitive signals were identified using parametric modulators. Substance use was tracked throughout the 3-month study interval using the timeline follow-back procedure. Results Longitudinal contrasts of parametric modulators suggested improved formation of risk-informed outcome expectations at follow-up. Specifically, a greater response to high risk (low-likelihood) positive feedback was identified in caudal anterior cingulate cortex (ACC) and a greater response to low risk (low-likelihood) negative feedback was identified in caudal ACC and inferior frontal gyrus. In addition, attenuation of a ventromedial prefrontal cortex (vmPFC) “reward-seeking” signal (i.e., increasing response with greater reward) during risky decisions at follow-up was associated with less substance use during the study interval. Conclusions Changes in risk- and reward-related signaling in ACC/vmPFC appear to reflect recovery and may support sobriety.

History of Suicide Attempt Is Associated with Reduced Medial Prefrontal Cortex Activity during Emotional Decision-Making among Men with Schizophrenia: An Exploratory fMRI Study

“…To our knowledge, this is the first fMRI study seeking to determine if brain reward alterations are associated with a history of suicidal attempt in schizophrenia, using a risky decision-making task. In healthy men, activations were observed in the medial prefrontal cortex, the anterior cingulate cortex, and the right putamen during the Success event and in the bilateral anterior insula during both Inflation and Success events, as shown in previous fMRI studies using the BART [ 24 , 29 , 32 , 33 ]. The most important finding of this study is that SCZ + S patients had reduced activations of the mPFC during the Success event (with parametric modulation), relative to both SCZ − S patients and controls, as illustrated by the spatial conjunction analyses.…”

“…The most important finding of this study is that SCZ + S patients had reduced activations of the mPFC during the Success event (with parametric modulation), relative to both SCZ − S patients and controls, as illustrated by the spatial conjunction analyses. In the past, two fMRI studies performed in nonpsychotic individuals using the BART have shown that the mPFC activations increase parametrically with risk level during the Success event [ 32 , 33 ]. Given the fact that mPFC is a key region of the brain reward circuitry [ 10 ], the parametric increase in mPFC activity has been proposed to reflect a risk-related increase in the rewarding value of the Success outcome.…”

Neural responses to negative outcomes predict success in community‐based substance use treatment

“…Imaging data were acquired at baseline and 3‐month follow‐up using a 32‐channel head coil‐equipped, Siemens Magnetom Trio 3‐Tesla MRI scanner; follow‐up data are reported elsewhere . Echo‐planar gradient‐echo T2 * ‐weighted sequences of 240 whole‐brain volumes measured the functional blood‐oxygen‐level‐dependent (BOLD) response during two 8‐minute blocks of BART (see Fig.…”

The necessary paradigm shift in the study of addiction: Inconsistencies and fallacies of the brain disease model of addiction

“…However, this is not true either: drastic changes in the direction to normality are observed from very early phases of abstinence, which should not be attributed solely to the withdrawal of the toxic effects of drugs, but perhaps mainly to the recovery of healthy eating habits, improved rest, reduction of stress, etc. ; these changes being both structural and functional (Bartsch et al, 2007;Forster et al, 2016;Pfefferbaum et al, 2006;Chanraud et al, 2007). Almost all of the structural alterations observed in people with addictive behaviors remit very rapidly when consumption is interrupted and healthy habits are recovered (Agartz et al, 2003;Ende et al, 2005;Wallace et al, 2020;Wang et al, 2013).…”