DOCSLIB.ORG

Neural Substrates of Cue Reactivity: Association with Treatment Outcomes and Relapse

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Neural Substrates of Cue Reactivity: Association with Treatment Outcomes and Relapse bs_bs_banner INVITED REVIEW doi:10.1111/adb.12314 Neural substrates of cue reactivity: association with treatment outcomes and relapse Kelly E. Courtney1, Joseph P. Schacht2, Kent Hutchison3, Daniel J. O. Roche1 & Lara A. Ray1,4 Department of Psychology, University of California, Los Angeles, CA, USA1, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA2, Department of Psychology and Neuroscience, University of Colorado at Boulder, Boulder, CO, USA3 and Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA4 ABSTRACT Given the strong evidence for neurological alterations at the basis of drug dependence, functional magnetic resonance imaging (fMRI) represents an important tool in the clinical neuroscience of addiction. fMRI cue-reactivity paradigms represent an ideal platform to probe the involvement of neurobiological pathways subserving the reward/motivation system in addiction and potentially offer a translational mechanism by which interventions and behavioral predictions can be tested. Thus, this review summarizes the research that has applied fMRI cue-reactivity paradigms to the study of adult substance use disorder treatment responses. Studies utilizing fMRI cue-reactivity paradigms for the prediction of relapse and as a means to investigate psychosocial and pharmacological treatment effects on cue-elicited brain activa- tion are presented within four primary categories of substances: alcohol, nicotine, cocaine and opioids. Lastly, sugges- tions for how to leverage fMRI technology to advance addiction science and treatment development are provided. Keywords Addiction, cue reactivity, fMRI, medication development, substance use disorder, treatment. Correspondence to: Lara A. Ray, Department of Psychology, University of California, 1285 Franz Hall, Box 951563, Los Angeles, CA 90095-1563, USA. E-mail: [email protected] INTRODUCTION and, after repeated drug use, the development of incen- tive salience to stimuli associated with these substances The clinical neuroscience of substance use disorders (Berridge & Robinson 1998; Berridge & Kringelbach (SUDs) is predicated on knowledge gained from animal 2008). Chronic drug use is known to alter various neuro- models of addiction, which suggest that dysfunction of transmitter systems and synaptic structure within these the brain systems underling motivated, goal-directed networks, leading to impairments in motivational drive behavior, as well as networks responsible for the inhibi- and sensitized conditioned responses to drug-related cues tory control of such behaviors, is a fundamental compo- (Kalivas & Volkow 2005), including cue-induced craving nent of the neurological alterations subserving the for the substance (Wise 1988; Berridge & Robinson development of SUDs (Kalivas & Volkow 2005). These 1998; Kauer & Malenka 2007). Furthermore, dysfunc- models suggest that motivated, goal-directed behavior is tion of higher cortical areas responsible for the regulation represented in the brain by an interconnected network of motivational drives, including the lateral orbitofrontal of areas, such as the ventral tegmental area (VTA), ven- cortex (OFC), inferior frontal gyrus (IFG), dorsolateral tral striatum (VS), ventromedial prefrontal cortex prefrontal cortex (dlPFC) and dorsal anterior cingulate (vmPFC), amygdala, lateral hypothalamus and hippo- cortex (ACC) (Bechara 2005; Koob & Volkow 2010), campus, that rely primarily on dopamine, GABA, opioid may aid in the progression to compulsive substance use and glutamate signaling (Kalivas & Volkow 2005; Nestler in later stages of addiction potentially by synergizing defi- 2005; Kauer & Malenka 2007). This network is thought ciencies in the function of the reward/motivation system to be responsible for the acute rewarding effects of drugs (Lubman, Yücel & Pantelis 2004; Kalivas 2009). of abuse (Berridge & Kringelbach 2008; Le Merrer et al. Given the strong evidence for neurological alterations 2009), the goal-directed behavior and exertion of effort at the basis of drug dependence (e.g., Goldstein & Volkow in attaining these drugs (Salamone & Correa 2012) 2011; Parvaz et al. 2011; Volkow et al. 2012), functional © 2015 Society for the Study of Addiction Addiction Biology 2 Kelly E. Courtney et al. magnetic resonance imaging (fMRI) represents an impor- (Drummond et al. 2000; Perkins 2009). Thus, fMRI-based tant tool in translating these preclinical insights to brain cue-reactivity paradigms are well positioned to advance function in humans affected by addictive disorders. While our understanding of the involvement of neurobiological there has been a focus on developing fMRI-based bio- pathways subserving the reward/motivation system in markers for psychiatric disorders in general (Fu & addiction and offer a translational platform by which inter- Costafreda 2013), the field of addictions has yet to identify ventions and behavioral predictions can be tested. reliable biomarkers, fMRI based or otherwise. Importantly, This review focuses on research that has applied fMRI diagnostic and prognostic biomarkers are only as useful as cue-reactivity paradigms to the study of adult SUD treat- their ability to add value to existing clinical and behav- ment responses. Based on the conceptual framework that ioral systems. With that in mind, one promising notion has evolved over the last two decades, pharmacological is that understanding addiction neurobiology at the level and psychosocial treatments are hypothesized to influ- of individual brain function will allow the development ence brain activation within the reward/motivation and of more efficacious psychosocial and pharmacological inhibitory networks (via bottom–up and/or top–down interventions. In particular, it has been argued that neu- control over these regions), which, in turn, is thought ropsychological and pharmacological therapies for addic- to predict treatment success and relapse propensity. As tion must target affected brain circuits, particularly the such, research utilizing fMRI cue-reactivity paradigms reward/motivation network (Konova, Moeller & Goldstein for the prediction of relapse is reviewed, and psychosocial 2013). Thus, fMRI represents a promising avenue to not and pharmacological treatment effects on cue-elicited only enable identification of these dysfunctional neurolog- brain activation are presented within four primary ical mechanisms underlying addiction but also to poten- categories of substances: alcohol, nicotine, cocaine and tially serve as an objective and quantifiable measure for opioids. Lastly, future directions for how to leverage fMRI evaluating changes associated with treatment beyond technology to advance addiction science and treatment what can be gathered from self-report or behavior alone development are proposed. (Menossi et al. 2013). Cue reactivity is one of the longest-studied phenotypes in substance use research, and several recent meta- PREDICTION OF RELAPSE FROM analyses (Chase et al. 2011; Engelmann et al.2012; CUE-ELICITED ACTIVATION Schacht, Anton & Myrick 2013a) and reviews (Yalachkov, Kaiser & Naumer 2012; Jasinska et al. 2014) summarize To date, 11 studies have examined prospective associa- the neuroimaging literature on this phenotype, including tions between brain activation and relapse among indi- a variety of individual difference variables that affect it. viduals dependent on alcohol, nicotine and cocaine; Because addiction neurobiology, and cue reactivity in par- nine of which employed drug-cue reactivity paradigms ticular, has a strong learning and memory component (see Table 1). However, several issues cloud interpreta- (Robinson & Berridge 1993; Kalivas & Volkow 2005), the tion of these findings and hinder efforts to synthesize this presentation of drug cues appears to reliably produce acti- literature. First, quantifications of relapse have varied vation of neural circuits involved in learning and memory, widely across studies. In general, breath tests for exhaled as well as brain regions associated with the aforementioned carbon monoxide and urine drug screens conducted reward/motivation network, such as the VS, amygdala, with varying frequency have been used to define nico- PFC, cingulate, precuneus and the insula (Camara et al. tine and cocaine relapse, while alcohol relapse is fre- 2009; Engelmann et al. 2012; Schacht et al.2013a).In quently captured only by patient self-report; however, a theory, greater cue-induced craving in the laboratory recent study in non-treatment-seeking alcohol drinkers should predict greater risk for relapse when similar cues suggests self-report data are highly consistent with bio- are faced in the natural environment, and in turn, a markers of alcohol intake (Simons et al. 2015). Second, therapy’s ability to blunt cue-induced craving in the labo- most studies have implicitly endorsed an abstinence- ratory should be a proxy marker of that treatment’sreal based treatment model, defining relapse as any subse- world efficacy (Marlatt 1990; Drummond 2000; Monti, quent substance use; re-initiation of heavy use has not Rohsenow & Hutchison 2000). These ideas are consistent been well studied. Third, many studies have compared with the notion of craving as a translational phenotype in baseline neuroimaging data between dichotomized addiction, which is exemplified by the recent addition of groups of patients who either relapsed to any use or craving as a symptom in the fifth edition of the Diagnostic remained abstinent;
Load more

Recommended publications
  • Gabab Regulation of Methamphetamine-Induced Associative Learning
    Loyola University Chicago Loyola eCommons Dissertations Theses and Dissertations 2010 Gabab Regulation of Methamphetamine-Induced Associative Learning Robin Michelle Voigt Loyola University Chicago Follow this and additional works at: https://ecommons.luc.edu/luc_diss Part of the Pharmacology Commons Recommended Citation Voigt, Robin Michelle, "Gabab Regulation of Methamphetamine-Induced Associative Learning" (2010). Dissertations. 38. https://ecommons.luc.edu/luc_diss/38 This Dissertation is brought to you for free and open access by the Theses and Dissertations at Loyola eCommons. It has been accepted for inclusion in Dissertations by an authorized administrator of Loyola eCommons. For more information, please contact [email protected]. This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License. Copyright © 2010 Robin Michelle Voigt LOYOLA UNIVERSITY CHICAGO GABAB REGULATION OF METHAMPHETAMINE-INDUCED ASSOCIATIVE LEARNING A DISSERTATION SUBMITTED TO THE FACULTY OF THE GRADUATE SCHOOL IN CANDIDACY FOR THE DEGREE OF DOCTOR OF PHILOSOPHY PROGRAM IN MOLECULAR PHARMACOLOGY & THERAPEUTICS BY ROBIN MICHELLE VOIGT CHICAGO, IL DECEMBER 2010 Copyright by Robin Michelle Voigt, 2010 All rights reserved ACKNOWLEDGEMENTS Without the support of so many generous and wonderful individuals I would not have been able to be where I am today. First, I would like to thank my Mother for her belief that I could accomplish anything that I set my mind to. I would also like to thank my dissertation advisor, Dr. Celeste Napier, for encouraging and challenging me to be better than I thought possible. I extend gratitude to my committee members, Drs. Julie Kauer, Adriano Marchese, Micky Marinelli, and Karie Scrogin for their guidance and insightful input.
    [Show full text]
  • Effect of a Brief Memory Updating Intervention On
    1 1 2 PI Name: Michael E. Saladin, PhD 3 4 Study Title: Reducing Smoking Cue Reactivity and Behavior via Retrieval-Extinction Mechanism 5 A. Specific Aims 6 The goal of the study will be to adopt many of the procedures and parameters of retrieval- 7 extinction training in an attempt to demonstrate enduring reductions in craving and cue-reactivity 8 among cigarette smokers. The study will conduct an exploratory analysis of the intervention’s effects on 9 substance use (i.e., smoking behavior). This exploratory study will investigate a novel behavioral 10 strategy for altering important memory processes that underlie human smoking-related nicotine 11 addiction. This strategy represents a paradigm shift in that it employs established cue exposure 12 procedures to putatively update1 smoking–related memory with information that will suppress 13 responding to smoking cues. The goal here is to alter existing nicotine-related memory directly rather 14 than rely exclusively on the establishment of an inhibitory extinction process2-6 via traditional cue 15 exposure therapy, which is known to be vulnerable to spontaneous recovery, renewal, and 16 reinstatement7,8. The proposed study will also be innovative and novel because, unlike the Xue et al. 17 2012 study, we will preliminarily assess, over the course of a 1-month follow-up period, the effects of 18 retrieval-extinction training on the smoking behavior of smokers who have made a cessation attempt. 19 20 B. Background and Significance 21 Smoking occurs in approximately 21% of the US population, is responsible for an annual 22 mortality rate of approximately 438,000 citizens, and has an associated healthcare economic burden of 23 $167 billion9.
    [Show full text]
  • The Effect of Naltrexone and Acamprosate on Cue-Induced
    European Neuropsychopharmacology (2007) 17, 558–566 www.elsevier.com/locate/euroneuro The effect of naltrexone and acamprosate on cue-induced craving, autonomic nervous system and neuroendocrine reactions to alcohol-related cues in alcoholics☆ Wendy Ooteman a,b,⁎, Maarten W.J. Koeter a,b, Roel Verheul c,d, Gerard M. Schippers a,b, Wim van den Brink a,b a Amsterdam Institute for Addiction Research, Amsterdam, The Netherlands b Department of Psychiatry, Academic Medical Center University of Amsterdam, Amsterdam, The Netherlands c Viersprong Institute for Studies on Personality Disorders (VISPD), Halsteren, The Netherlands d Department of Clinical Psychology, University of Amsterdam, Amsterdam, The Netherlands Received 22 March 2006; received in revised form 1 February 2007; accepted 13 February 2007 KEYWORDS Abstract Alcoholism; Naltrexone; Introduction: Acamprosate and naltrexone have been shown to be effective in relapse prevention of Acamprosate; alcoholism. It is hypothesized that naltrexone exerts its effects primarily on cue-induced craving Efficacy; and neuroendocrine cue reactivity, whereas acamprosate exerts its effect primarily on autonomic Craving; nervous system reactions to alcohol-related cues. Cue reactivity Experimental procedures: In a randomized double-blind experiment, 131 abstinent alcoholics received either acamprosate (n=56), naltrexone (n=52) or placebo (n=23) for three weeks and participated in two cue-exposure sessions: the first the day before and the second at the last day of medication. Results: Consistent with the hypotheses, naltrexone reduced craving more than acamprosate, and acamprosate reduced heart rate more than naltrexone. No medication effect was found on cue- induced cortisol. Discussion: The findings provide some evidence for differential effects of naltrexone and acamprosate: naltrexone may exert its effect, at least partly, by the reduction of cue-induced craving, whereas acamprosate may exert its effect, at least partly, by the reduction of autonomic nervous system reactions to alcohol-related cues.
    [Show full text]
  • Food Cue Reactivity and Craving Predict Eating and Weight Gain: a Meta-Analytic Review
    obesity reviews doi: 10.1111/obr.12354 Etiology and Pathophysiology Food cue reactivity and craving predict eating and weight gain: a meta-analytic review Rebecca G. Boswell1 and Hedy Kober1,2 1Department of Psychology, Yale University, Summary New Haven, CT, USA, and 2Department of According to learning-based models of behavior, food cue reactivity and craving Psychiatry, Yale School of Medicine, Yale are conditioned responses that lead to increased eating and subsequent weight gain. University, New Haven, CT, USA However, evidence supporting this relationship has been mixed. We conducted a quantitative meta-analysis to assess the predictive effects of food cue reactivity Received 16 June 2015; revised 7 October and craving on eating and weight-related outcomes. Across 69 reported statistics 2015; accepted 9 October 2015 from 45 published reports representing 3,292 participants, we found an overall me- dium effect of food cue reactivity and craving on outcomes (r = 0.33, p < 0.001; ap- Address for correspondence: Hedy Kober, proximately 11% of variance), suggesting that cue exposure and the experience of Departments of Psychology and Psychiatry, craving significantly influence and contribute to eating behavior and weight gain. Yale University, 1 Church Street, Suite 701, Follow-up tests revealed a medium effect size for the effect of both tonic and cue- New Haven, CT 06510, USA. induced craving on eating behavior (r = 0.33). We did not find significant differ- E-mail: [email protected] ences in effect sizes based on body mass index, age, or dietary restraint. However, we did find that visual food cues (e.g.
    [Show full text]
  • Heart Rate Variability As Reactivity in Alcoholics an Index Of
    Heart Rate Variability as an Index of Cue Reactivity in Alcoholics I. Rajan, P.J. Naga Venkatesha Murthy, A.G. Ramakrishnan, B.N. Gangadhar, and N. Janakiramaiah Background: Autonomic responses follow exposure to control group on physiological parameters such as skin conditioned stimuli such as contextual factors associated conductance, salivation, heart rate, and peripheral hypo- with alcohol ingestion. Heart rate variabili O, is under auto- thermic response (Drummond et al 1990). nomic control and may be a measure of such response. Spectral analysis of heart rate variability (HRV) is a Methods: Twenty alcoholics and 23 matched social drink- recent noninvasive method of assessing cardiac autonomic ers (all male) were exposed to a neutral cue and then an tone (Malliani et al 1991; Castiglioni 1995). Sympathetic ah'ohol cue in identical settings, during which the elec- and parasympathetic nervous activity is shown to make trocardiogram of these subjects was recorded. Time and frequency-specific contributions to the HRV power spec- frequency domain parameters of heart rate variability trum. Two major components, the high-frequency (HF) (HRV) were computed by a blind rater. and low-frequency (LF) components of the HRV power Results: Coefficient of variation ~( R-R intervals and spectrum, seem to reflect parasympathetic and sympa- absolute powers" of HRV spectrum (in frequency bands thetic activities, respectively (Murata et al 1994). These 0.05-0.15 Hz and 0.01-0.05 Hz) Jbllowing alcohol cue were significantly higher in alcoholics than social drink- sensitive indices of autonomic nervous system filnctioning ers'. The mean heart rate (MHR).fililed to reflect this could be used to measure autonomic perturbations in d~[fl, rence.
    [Show full text]
  • Neurobiology of Craving: Current Findings and New Directions
    Current Addiction Reports https://doi.org/10.1007/s40429-018-0202-2 ADOLESCENT/YOUNG ADULT ADDICTION (T CHUNG, SECTION EDITOR) Neurobiology of Craving: Current Findings and New Directions Lara A. Ray1,2 & Daniel J. O. Roche2 # Springer International Publishing AG, part of Springer Nature 2018 Abstract Purpose of the Review This review seeks to provide an update on the current literature on craving and its underlying neurobi- ology, as it pertains to alcohol and drug addiction. Recent Findings Studies on craving neurobiology suggest that the brain networks activated by conditioned cues in alcohol- and drug-dependent populations extend far beyond the traditional mesolimbic dopamine system and suggest that the early neurobiolog- ical theories of addiction, which heavily relied on dopamine release into the nucleus accumbens as the primary mechanism driving cue-induced craving and drug-seeking behavior, are incomplete. Ongoing studies will advance our understanding of the neurobio- logical underpinnings of addiction and drug craving by identifying novel brain regions associated with responses to conditioned cues that may be specific to humans, or at least primates, due to these brain areas’ involvement in higher cognitive processes. Summary This review highlights recent advances and future directions in leveraging the neurobiology of craving as a transla- tional phenotype for understanding addiction etiology and informing treatment development. The complexity of craving and its underlying neurocircuitry is evident and divergent methods of eliciting craving (i.e., cues, stress, and alcohol administration) may produce divergent findings. Keywords Craving . Addiction . Neurobiology . fMRI . Cue reactivity . Alcohol . Drug Introduction relative risk of all other diagnostic criteria for alcoholism [4].
    [Show full text]
  • The Effect of Abstinence from Smoking on Stress Reactivity" (2019)
    University of Pennsylvania ScholarlyCommons Publicly Accessible Penn Dissertations 2019 The ffecE t Of Abstinence From Smoking On Stress Reactivity Cheyenne Allenby University of Pennsylvania, [email protected] Follow this and additional works at: https://repository.upenn.edu/edissertations Part of the Pharmacology Commons Recommended Citation Allenby, Cheyenne, "The Effect Of Abstinence From Smoking On Stress Reactivity" (2019). Publicly Accessible Penn Dissertations. 3295. https://repository.upenn.edu/edissertations/3295 This paper is posted at ScholarlyCommons. https://repository.upenn.edu/edissertations/3295 For more information, please contact [email protected]. The ffecE t Of Abstinence From Smoking On Stress Reactivity Abstract Subjective stress is a well-documented predictor of early smoking relapse, yet our understanding of stress and tobacco use is limited by the reliability of current available measures of stress. Functional magnetic reasoning imaging (fMRI) could provide a much-needed objective measure of stress reactivity. The og al of this dissertation is to contribute to the understanding of abstinence-induced changes in stress reactivity by examining neural, neuroendocrine (cortisol), and subjective measures of stress response during abstinence. In addition, this study investigated the influence of individual variation in nicotine metabolism rates on these measures of stress reactivity. Seventy-five treatment-seeking smokers underwent blood oxygen level dependent (BOLD) fMRI during the Montreal Imaging Stress Task (MIST) on two occasions: once during smoking satiety and once following biochemically confirmed 24-hour abstinence (order counter-balanced). The primary outcome measure was brain response during stress (vs. control) blocks of the MIST. Neural stress reactivity during abstinence (vs. satiety) was associated with significantly increased activation in the left inferior frontal gyrus (IFG), a brain region previously associated with inhibitory control.
    [Show full text]
  • Cue-Induced Ethanol Seeking in Drosophila Melanogaster Is Dose-Dependent
    fphys-09-00438 April 19, 2018 Time: 15:58 # 1 ORIGINAL RESEARCH published: 23 April 2018 doi: 10.3389/fphys.2018.00438 Cue-Induced Ethanol Seeking in Drosophila melanogaster Is Dose-Dependent Kavin M. Nunez1, Reza Azanchi2 and Karla R. Kaun2* 1 Molecular Pharmacology and Physiology Graduate Program, Brown University, Providence, RI, United States, 2 Department of Neuroscience, Brown University, Providence, RI, United States Alcohol use disorder generates devastating social, medical and economic burdens, making it a major global health issue. The persistent nature of memories associated with intoxication experiences often induces cravings and triggers relapse in recovering individuals. Despite recent advances, the neural and molecular mechanisms underlying these memories are complex and not well understood. This makes finding effective pharmacological targets challenging. The investigation of persistent alcohol-associated memories in the fruit fly, Drosophila melanogaster, presents a unique opportunity to gain a comprehensive understanding of the memories for ethanol reward at the level of genes, molecules, neurons and circuits. Here we characterize the dose-dependent Edited by: nature of ethanol on the expression of memory for an intoxication experience. We Robert Huber, Bowling Green State University, report that the concentration of ethanol, number of ethanol exposures, length of United States ethanol exposures, and timing between ethanol exposures are critical in determining Reviewed by: whether ethanol is perceived as aversive or appetitive, and in how long the memory for Jens Herberholz, University of Maryland, College Park, the intoxicating properties of ethanol last. Our study highlights that fruit flies display United States both acute and persistent memories for ethanol-conditioned odor cues, and that a Nathan C.
    [Show full text]
  • The Automatic Pull of Drug Cues in Addiction: Neural Correlates and Effects of Re-Training
    Fachbereich Erziehungswissenschaft und Psychologie der Freien Universität Berlin The automatic pull of drug cues in addiction: Neural correlates and effects of re-training Dissertation zur Erlangung des akademischen Grades Doktorin der Philosophie (Dr.Phil.) / Doctor of Philosophy (Ph.D.) Vorgelegt von M.Sc. Psychologie Corinde E. Wiers Berlin, 2013 Erstgutachter: Prof. Dr. Hauke Heekeren, Freie Universität Berlin Zweitgutachter: Prof. Dr. Felix Bermpohl, Charité – Universitätsmedizin Berlin Datum der Disputation: 25.02.2014 i. Abstract Addiction is a chronic, relapsing brain disorder, characterized by continuation of drug- use despite knowledge of the negative consequences. One important factor for relapse may be the degree to which drug cues automatically trigger motivational approach responses (i.e., ―drug cue reactivity‖). This phenomenon is hypothesized to be the result of neuroadaptations in mesocorticolimbic areas. Empirical studies indeed demonstrate that drug-addicted individuals have a tendency to faster approach than avoid drug cues compared to neutral cues (i.e., a drug approach bias), which has been associated with higher drug craving and relapse. Moreover, retraining the drug approach bias with Cognitive Bias Modification training (CBM) in alcohol-dependent patients has been shown to reduce relapse rates one year after training. These findings highlight the clinical importance of the drug approach bias. However, much remains unknown about the persistence of the approach bias after drug abstinence, the neural correlates underlying
    [Show full text]
  • NIH Public Access Author Manuscript Psychopharmacology (Berl)
    NIH Public Access Author Manuscript Psychopharmacology (Berl). Author manuscript; available in PMC 2013 July 01. NIH-PA Author ManuscriptPublished NIH-PA Author Manuscript in final edited NIH-PA Author Manuscript form as: Psychopharmacology (Berl). 2012 July ; 222(1): 17–26. doi:10.1007/s00213-011-2618-4. Cue-Elicited Heart Rate Variability and Attentional Bias Predict Alcohol Relapse Following Treatment Eric L. Garland, Florida State University, Tallahassee, FL 32306-2570 Ingmar H.A. Franken, and Erasmus University, 3000 DR Rotterdam Matthew O. Howard University of North Carolina, Chapel Hill, NC 27599-3550 Abstract Rationale—Identification of malleable neurocognitive predictors of relapse among alcohol dependent individuals is important for the optimization of health care delivery and clinical services. Objectives—Given that alcohol cue-reactivity can predict relapse, we evaluated cue-elicited high frequency heart rate variability (HFHRV) and alcohol attentional bias (AB) as potential relapse risk indices. Method—Alcohol dependent patients in long-term residential treatment who had participated in mindfulness-oriented therapy or an addiction support group completed a spatial cueing task as a measure of alcohol AB and an affect-modulated alcohol cue-reactivity protocol while HFHRV was assessed. Results—Post-treatment HFHRV cue-reactivity and alcohol AB significantly predicted the occurrence and timing of relapse by 6-month follow-up, independent of treatment condition and after controlling for alcohol dependence severity. Alcohol dependent patients who relapsed exhibited a significantly greater HFHRV reactivity to stress-primed alcohol cues than patients who did not relapse. Conclusions—Cue-elicited HFHRV and alcohol AB can presage relapse and may therefore hold promise as prognostic indicators in clinical settings.
    [Show full text]
  • And Drug-Induced Reinstatement of Extinguished Amphetamine- Induced Conditioned Place Preference" (2006)
    University of Missouri, St. Louis IRL @ UMSL Dissertations UMSL Graduate Works 5-11-2006 Female Hormonal Influences on Stress- and Drug- induced Reinstatement of Extinguished Amphetamine-induced Conditioned Place Preference Melissa Elaine Bleile University of Missouri-St. Louis, [email protected] Follow this and additional works at: https://irl.umsl.edu/dissertation Part of the Psychology Commons Recommended Citation Bleile, Melissa Elaine, "Female Hormonal Influences on Stress- and Drug-induced Reinstatement of Extinguished Amphetamine- induced Conditioned Place Preference" (2006). Dissertations. 606. https://irl.umsl.edu/dissertation/606 This Dissertation is brought to you for free and open access by the UMSL Graduate Works at IRL @ UMSL. It has been accepted for inclusion in Dissertations by an authorized administrator of IRL @ UMSL. For more information, please contact [email protected]. FEMALE HORMONAL INFLUENCES ON STRESS- AND DRUG-INDUCED REINSTATEMENT OF EXTINGUISHED AMPHETAMINE-INDUCED CONDITIONED PLACE PREFERENCE Melissa E. Bleile, M.A. May 2006 A Dissertation Submitted to the Graduate School of the University of Missouri-St. Louis in Partial Satisfaction of Requirements for the Doctor of Philosophy Degree in Psychology Advisory Committee: George T. Taylor, Ph.D. Chairperson Carl Bassi, Ph.D. Michael G. Griffin, Ph.D. Jennifer Siciliani, Ph.D. Bleile, Melissa, 2006, UMSL, p.2 ACKNOWLEDGEMENTS I thank God for giving me the strength, knowledge, and courage needed to complete this dissertation and Ph.D. degree. I thank my children, Jessica and Keith, my reasons for living, for giving me their love and support, and enduring my pursuit of the Ph.D., even at their own great sacrifice. I am grateful to my mentor and Chairperson, Dr.
    [Show full text]
  • Current Perspectives on Incentive Salience and Applications to Clinical
    Available online at www.sciencedirect.com ScienceDirect Current perspectives on incentive salience and applications to clinical disorders Jeffrey J Olney, Shelley M Warlow, Erin E Naffziger and Kent C Berridge Affective neuroscience research has revealed that reward mediated by separable neural substrates. Here, we con- contains separable components of ‘liking’, ‘wanting’, and sider these components, and their application to reward learning. Here we focus on current ‘liking’ and ‘wanting’ dysfunctions. findings and applications to clinical disorders. ‘Liking’ is the hedonic impact derived from a pleasant experience, and is amplified by opioid and related signals in discrete sites located ‘Liking’ and ‘wanting’ as separate aspects of in limbic-related brain areas. ‘Wanting’ refers to incentive reward salience, a motivation process for reward, and is mediated by In ordinary experience, ‘liking’ and ‘wanting’ seem con- larger systems involving mesocorticolimbic dopamine. Deficits joined. For example, we eat cake because we enjoy it, and in incentive salience may contribute to avolitional features of often eat more than intended if the cake tastes good. depression and related disorders, whereas deficits in hedonic However, brain processes underlying liking and wanting impact may produce true anhedonia. Excesses in incentive can sometimes cause these components to diverge in salience, on the other hand, can lead to addiction, especially certain circumstances. when narrowly focused on a particular target. Finally, a fearful form of motivational salience may even contribute to some ‘Liking’ (in quote marks) refers to the hedonic impact paranoia symptoms of schizophrenia and related disorders. derived from a stimulus (which can be conscious or unconscious) [1,2]. Consciously, it corresponds to subjec- Address tively experienced pleasure commonly denoted by liking Department of Psychology, University of Michigan, Ann Arbor, MI 48109, (without quote marks).
    [Show full text]