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Orbitofrontal structural markers of negative affect in alcohol dependence and their associations with heavy relapse-risk at 6 months post-treatment

Published online by Cambridge University Press:  23 March 2020

E. Zois ,
S. Vollstädt-Klein ,
S. Hoffmann ,
I. Reinhard ,
K. Charlet ,
A. Beck ,
A. Jorde ,
M. Kirsch ,
H. Walter  and
A. Heinz
...Show all authors
E. Zois*
Affiliation:
Department of addictive behaviour and addiction medicine, central institute of mental health, Mannheim, university of Heidelberg, Mannheim, Germany
S. Vollstädt-Klein
Affiliation:
Department of addictive behaviour and addiction medicine, central institute of mental health, Mannheim, university of Heidelberg, Mannheim, Germany
S. Hoffmann
Affiliation:
Department of addictive behaviour and addiction medicine, central institute of mental health, Mannheim, university of Heidelberg, Mannheim, Germany
I. Reinhard
Affiliation:
Department of biostatistics, central institute of mental health, Mannheim, university of Heidelberg, Mannheim, Germany
K. Charlet
Affiliation:
Department of psychiatry and psychotherapy, Charité-Universitätsmedizin Berlin, Berlin, Germany
A. Beck
Affiliation:
Department of psychiatry and psychotherapy, Charité-Universitätsmedizin Berlin, Berlin, Germany
A. Jorde
Affiliation:
Department of addictive behaviour and addiction medicine, central institute of mental health, Mannheim, university of Heidelberg, Mannheim, Germany
M. Kirsch
Affiliation:
Department of addictive behaviour and addiction medicine, central institute of mental health, Mannheim, university of Heidelberg, Mannheim, Germany
H. Walter
Affiliation:
Department of psychiatry and psychotherapy, Charité-Universitätsmedizin Berlin, Berlin, Germany
A. Heinz
Affiliation:
Department of psychiatry and psychotherapy, Charité-Universitätsmedizin Berlin, Berlin, Germany
F. Kiefer
Affiliation:
Department of addictive behaviour and addiction medicine, central institute of mental health, Mannheim, university of Heidelberg, Mannheim, Germany
*
* Corresponding author. Department of addictive and addiction medicine, central institute of mental health, medical faculty Mannheim/Heidelberg university, square J5, 68159 Mannheim, Germany. E-mail addressevangelos.zois@zi-mannheim.de (E. Zois).
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Abstract

Background

Alcohol relapse is often occurring to regulate negative affect during withdrawal. On the neurobiological level, alcoholism is associated with gray matter (GM) abnormalities in regions that regulate emotional experience such as the orbitofrontal cortex (OFC). However, no study to our knowledge has investigated the neurobiological unpinning of affect in alcoholism at early withdrawal and the associations of OFC volume with long-term relapse risk.

Methods:

One hundred and eighty-two participants were included, 95 recently detoxified alcohol dependent patients (ADP) and 87 healthy controls (HC). We measured affective states using the positive and negative affect schedule (PANAS). We collected T1-weighted brain structural images and performed Voxel-based morphometry (VBM).

Results:

Findings revealed GM volume decrease in alcoholics in the prefrontal cortex (including medial OFC), anterior cingulate gyrus, and insula. GM volume in the medial OFC was positively associated with NA in the ADP group. Cox regression analysis predicted that risk to heavy relapse at 6 months increases with decreased GM volume in the medial OFC.

Conclusions:

Negative affect during alcohol withdrawal was positively associated with OFC volume. What is more, increased GM volume in the OFC also moderated risk to heavy relapse at 6 months. Reduced GM in the OFC poses as risk to recovery from alcohol dependence and provides valuable insights into transient negative affect states during withdrawal that can trigger relapse. Implications exist for therapeutic interventions signifying the OFC as a neurobiological marker to relapse and could explain the inability of ADP to regulate internal negative affective states.

Keywords

Alcohol dependenceMedial orbitofrontal cortexNegative affectRelapse riskGray matter
Type
Original article
Information
European Psychiatry , Volume 46 , October 2017 , pp. 16 - 22
Copyright
Copyright © European Psychiatric Association 2017

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Footnotes

Abbreviations: ADP, alcohol dependent patients AD, alcohol dependence HC, healthy controls OFC, orbitofrontal cortex PFC, prefrontal cortex PA, positive affect NA, negative affect PANAS, positive and negative affect schedule GM, gray matter VBM, Voxel-based morphometry MPRAGE, Magnetization-prepared Rapid Acquisition Gradient Echo

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