Executive Control and Striatal Resting-State Network Interact with Risk Factors to Influence Treatment Outcomes in Alcohol-Use Disorder

Abstract

Alterations within mesocorticolimbic terminal regions commonly occur with alcohol use disorder (AUD). As pathological drug-seeking behavior may arise as a consequence of alcohol-induced neuroadaptations, it is critical to understand how such changes increase the likelihood of relapse. This report examined resting-state functional connectivity (RSFC) using both a seed-based and model-free approach in individuals in treatment for AUD and how dysregulation of network connectivity contributes to treatment outcomes. In order to provide a mechanism by which neural networks promote relapse, interactive effects of mesocorticolimbic connectivity and AUD risk factors in treatment completers and non-completers were examined. AUD group showed stronger RSFC between striatum, insula, and anterior cingulate cortex than controls. Within the AUD group, non-completers compared to completers showed enhanced RSFC between (1) striatum–insula, (2) executive control network (ECN)–amygdala, and (3) basal ganglia/salience network and striatum, precuneus, and insula. Completers showed enhanced RSFC between striatum-right dorsolateral prefrontal cortex. Furthermore, completers and non-completers differed in relationships between RSFC and relapse risk factors, where non-completers exhibited positive associations between craving intensity and RSFC of striatum–insula and ECN–amygdala. These findings provide evidence for interactions between corticolimbic connectivity in AUD and craving and establish an important link between network connectivity and dynamic risk factors that contribute to relapse. Results demonstrate that relapse vulnerability is attributed to craving dysregulation manifested by enhanced connectivity in striato-limbic regions and diminished corticostriatal connectivity.

A preliminary randomized clinical trial of naltrexone reduces striatal resting state functional connectivity in people with methamphetamine use disorder

“…These results are in line with studies of alcohol use disorder, where individuals who abstain from alcohol exhibit less RSFC in the reward/salience networks (Kohno et al, 2017). The reduction in striatolimbic RSFC extends findings of heightened RSFC between amygdala and hippocampus (Dean et al, 2014) and among regions of the mesocorticolimbic system (Kohno et al, 2014; Kohno et al, 2016) in MA use disorder and show that antagonizing mu-opioid receptors can reduce striatolimbic functional connectivity.…”

Executive Impairment in Alcohol Use Disorder Reflects Structural Changes in Large-Scale Brain Networks: A Joint Independent Component Analysis on Gray-Matter and White-Matter Features

“…networks (Kohno et al, 2017), with these changes paralleling an improvement of executive skills (Le Berre et al, 2017).…”

Sex differences in tobacco smokers: Executive control network and frontostriatal connectivity

“…Smokers also have weaker resting state DLPFC-DS connectivity, which is linked to more cognitive control errors (Yuan et al, 2016). Furthermore, reduced DLPFC-DS coupling has been associated with more treatment dropout in individuals with alcohol use disorder (Kohno et al, 2017), suggesting that the reduced DLPFC-DS coupling currently noted among female smokers may contribute to diminished ability or motivation to persist in treatment.…”