PDF(Pubmed)
Abstract：
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.
摘要：
酒精使用障碍（AUD）的特征是提示反应性增强，相反的控制过程不足。抑制对酒精相关线索的反应的能力，酒精特异性抑制，因此对AUD至关重要；加强这种能力的培训可能会增加治疗结果。本研究调查了酒精特异性抑制（I）的神经生理学相关性是否随渴望而变化，(II)以AUD预测饮酒结果和(III)通过酒精特异性抑制训练调节。共有45名最近戒断的AUD患者和25名对照者参加了这项研究。在Go-NoGo任务期间，所有参与者都接受了功能磁共振成像（fMRI），与酒精相关以及中性条件。AUD患者还参加了双盲RCT，其中他们被随机分配到酒精特异性抑制训练或主动控制条件（非特异性抑制训练）。培训结束后,患者参与了第二次fMRI测量,重复执行Go-NoGo任务.从住院治疗出院后3个月，戒酒天数的百分比被评估为饮酒结果。全脑分析表明，在右额下回（rIFG），与酒精特异性抑制相关的激活随着3个月随访时的渴求和预测的饮酒结局而变化.然而，这种酒精特异性抑制的神经生理学相关性不受训练形式的调节。我们的结果表明，当渴望很高时，需要在酒精特异性（与中性）抑制期间增强rIFG激活（I）以抑制反应，并且（II）促进AUD患者的持续禁欲。由于酒精特异性rIFG激活不受训练影响，未来的研究可能会调查是否可以用其他方法学方法更好地检测对神经生理学的潜在训练效果。
