Data_Sheet_1_Right Inferior Frontal Activation During Alcohol-Specific Inhibition Increases With Craving and Predicts Drinking Outcome in Alcohol Use Disorder.PDF

Alcohol use disorder (AUD) is characterized by enhanced cue-reactivity and the opposing control processes being insufficient. The ability to inhibit reactions to alcohol-related cues, alcohol-specific inhibition, is thus crucial to AUD; and trainings strengthening this ability might increase treatment outcome. The present study investigated whether neurophysiological correlates of alcohol-specific inhibition (I) vary with craving, (II) predict drinking outcome in AUD and (III) are modulated by alcohol-specific inhibition training. A total of 45 recently abstinent patients with AUD and 25 controls participated in this study. All participants underwent functional magnetic resonance imaging (fMRI) during a Go-NoGo task with alcohol-related as well as neutral conditions. Patients with AUD additionally participated in a double-blind RCT, where they were randomized to either an alcohol-specific inhibition training or an active control condition (non-specific inhibition training). After the training, patients participated in a second fMRI measurement where the Go-NoGo task was repeated. Percentage of days abstinent was assessed as drinking outcome 3 months after discharge from residential treatment. Whole brain analyses indicated that in the right inferior frontal gyrus (rIFG), activation related to alcohol-specific inhibition varied with craving and predicted drinking outcome at 3-months follow-up. This neurophysiological correlate of alcohol-specific inhibition was however not modulated by the training version. Our results suggest that enhanced rIFG activation during alcohol-specific (compared to neutral) inhibition (I) is needed to inhibit responses when craving is high and (II) fosters sustained abstinence in patients with AUD. As alcohol-specific rIFG activation was not affected by the training, future research might investigate whether potential training effects on neurophysiology are better detectable with other methodological approaches.酒精使用障碍（Alcohol use disorder, AUD）以线索反应性增强、对立控制过程功能不足为核心特征。对酒精相关线索的反应抑制能力（即酒精特异性抑制）因此成为酒精使用障碍诊疗的关键靶点；强化该能力的训练或可改善治疗结局。本研究旨在探究酒精特异性抑制的神经生理学相关指标：（I）是否随渴求程度发生变化，（II）能否预测酒精使用障碍患者的饮酒转归，以及（III）是否可通过酒精特异性抑制训练进行调控。 本研究共纳入45名近期戒酒的酒精使用障碍患者与25名健康对照受试者。所有受试者在完成包含酒精相关与中性线索的Go/NoGo任务时，接受功能磁共振成像（functional magnetic resonance imaging, fMRI）扫描。酒精使用障碍患者额外参与一项双盲随机对照试验（randomized controlled trial, RCT），被随机分配至酒精特异性抑制训练组或主动对照条件组（非特异性抑制训练组）。训练结束后，患者再次接受功能磁共振成像扫描，重复完成Go/NoGo任务。以从住院康复治疗出院后3个月的戒酒天数百分比作为饮酒转归的评估指标。 全脑分析结果显示，在右侧额下回（right inferior frontal gyrus, rIFG）中，与酒精特异性抑制相关的脑激活程度随渴求程度变化，且可预测3个月随访时的饮酒转归。然而，该酒精特异性抑制的神经生理学相关指标并未受本次训练范式的调控。 本研究结果表明：在酒精特异性（相较于中性线索）抑制过程中，右侧额下回激活增强（I）是高渴求状态下实现反应抑制的必要条件，且（II）有助于酒精使用障碍患者维持长期戒断。由于酒精特异性右侧额下回激活并未受本次训练的影响，未来研究可探讨采用其他方法学手段是否更易检测到训练对神经生理学指标的潜在调控效应。