Pavlovian-to-instrumental transfer effects in the nucleus accumbens relate to relapse in alcohol dependence
Pavlovian-to-instrumental transfer effects in the nucleus accumbens relate to relapse in alcohol dependence
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DOI：
10.1111/adb.12243
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发表时间：
2016-05-01
影响因子：
3.4
通讯作者：
Heinz, Andreas
中科院分区：
文献类型：
--
作者：
Garbusow, Maria;Schad, Daniel J.;Heinz, Andreas
在戒毒的酒精依赖患者中，与酒精相关的刺激可以促进复发。然而，到目前为止，语境刺激促进复发的机制还没有被详细阐明。一种假设是，这种背景刺激通过腹侧纹状体等相关大脑区域直接刺激饮酒动机，从而促进酒精的寻求、摄入和复发。巴甫洛夫-工具性迁移(PIT)可能是导致复吸的行为现象之一，它捕捉了巴甫洛夫条件性(语境)线索如何决定工具性行为(如寻求酒精和摄入)。我们在功能磁共振成像中使用PIT范式来检查经典条件巴甫洛夫刺激对31名被诊断为酒精依赖的戒毒患者和24名年龄和性别匹配的健康对照的工具选择的影响。对患者进行3个月以上的随访。我们观察到：(1)所有参与者都有显著的行为PIT效应，在酒精依赖患者中明显更明显；(2)PIT仅与随后复发者的伏隔核(NAcc)中的血氧水平依赖(BOLD)信号显著相关；以及(3)Pit相关的NAcc激活与酒精依赖患者的关键结果(酒精摄入量和3个月随访期内的复发)相关，并对其进行预测。这些观察首次表明，与坑相关的大胆信号，作为巴甫洛夫线索对工具行为影响的衡量标准，可以预测酒精依赖的酒精摄入量和复发。
In detoxified alcohol-dependent patients, alcohol-related stimuli can promote relapse. However, to date, the mechanisms by which contextual stimuli promote relapse have not been elucidated in detail. One hypothesis is that such contextual stimuli directly stimulate the motivation to drink via associated brain regions like the ventral striatum and thus promote alcohol seeking, intake and relapse. Pavlovian-to-Instrumental-Transfer (PIT) may be one of those behavioral phenomena contributing to relapse, capturing how Pavlovian conditioned (contextual) cues determine instrumental behavior (e.g. alcohol seeking and intake). We used a PIT paradigm during functional magnetic resonance imaging to examine the effects of classically conditioned Pavlovian stimuli on instrumental choices in n=31 detoxified patients diagnosed with alcohol dependence and n=24 healthy controls matched for age and gender. Patients were followed up over a period of 3 months. We observed that (1) there was a significant behavioral PIT effect for all participants, which was significantly more pronounced in alcohol-dependent patients; (2) PIT was significantly associated with blood oxygen level-dependent (BOLD) signals in the nucleus accumbens (NAcc) in subsequent relapsers only; and (3) PIT-related NAcc activation was associated with, and predictive of, critical outcomes (amount of alcohol intake and relapse during a 3 months follow-up period) in alcohol-dependent patients. These observations show for the first time that PIT-related BOLD signals, as a measure of the influence of Pavlovian cues on instrumental behavior, predict alcohol intake and relapse in alcohol dependence.