Journal
EUROPEAN ARCHIVES OF PSYCHIATRY AND CLINICAL NEUROSCIENCE
Volume 269, Issue 3, Pages 295-308Publisher
SPRINGER HEIDELBERG
DOI: 10.1007/s00406-017-0860-4
Keywords
Alcohol dependence; Human neuroimaging; Nucleus accumbens; Pavlovian-instrumental transfer; Relapse
Categories
Funding
- German Research Foundation (Deutsche Forschungsgemeinschaft, DFG) [FOR 1617, HE 2597/13-1, HE 2597/13-2, HE 2597/14-1, HE 2597/14-2, HE 2597/15-1, HE 2597/15-2, RA 1047/2-1, RA 1047/2-2, SCHA 1971/1-2, SCHL 1969/2-1, SCHL 1969/2-2, SM 80/7-1, SM 80/7-2, WI 709/10-1, WI 709/10-2, ZI 1119/3-1, ZI 1119/3-2]
- Charite-Universitatsmedizin
- Berlin Institute of Health
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The influence of Pavlovian conditioned stimuli on ongoing behavior may contribute to explaining how alcohol cues stimulate drug seeking and intake. Using a Pavlovian-instrumental transfer task, we investigated the effects of alcohol-related cues on approach behavior (i.e., instrumental response behavior) and its neural correlates, and related both to the relapse after detoxification in alcohol-dependent patients. Thirty-one recently detoxified alcohol-dependent patients and 24 healthy controls underwent instrumental training, where approach or non-approach towards initially neutral stimuli was reinforced by monetary incentives. Approach behavior was tested during extinction with either alcohol-related or neutral stimuli (as Pavlovian cues) presented in the background during functional magnetic resonance imaging (fMRI). Patients were subsequently followed up for 6 months. We observed that alcohol-related background stimuli inhibited the approach behavior in detoxified alcohol-dependent patients (t = -3.86, p < .001), but not in healthy controls (t = -0.92, p = .36). This behavioral inhibition was associated with neural activation in the nucleus accumbens (NAcc) (t((30)) = 2.06, p < .05). Interestingly, both the effects were only present in subsequent abstainers, but not relapsers and in those with mild but not severe dependence. Our data show that alcohol-related cues can acquire inhibitory behavioral features typical of aversive stimuli despite being accompanied by a stronger NAcc activation, suggesting salience attribution. The fact that these findings are restricted to abstinence and milder illness suggests that they may be potential resilience factors.
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