Neural Correlates of Alcohol-Approach Bias in Alcohol Addiction: the Spirit is Willing but the Flesh is Weak for Spirits

作者：Wiers Corinde E^*; Stelzel Christine; Park Soyoung Q; Gawron Christiane K; Ludwig Vera U; Gutwinski Stefan; Heinz Andreas; Lindenmeyer Johannes; Wiers Reinout W; Walter Henrik; Bermpohl Felix

来源：Neuropsychopharmacology, 2014, 39(3): 688-697.

DOI：10.1038/npp.2013.252

• addiction
• approach bias
• alcoholism
• fMRI
• reward
• craving

Behavioral studies have shown an alcohol-approach bias in alcohol-dependent patients: the automatic tendency to faster approach than avoid alcohol compared with neutral cues, which has been associated with craving and relapse. Although this is a well-studied psychological phenomenon, little is known about the brain processes underlying automatic action tendencies in addiction. We examined 20 alcohol-dependent patients and 17 healthy controls with functional magnetic resonance imaging (fMRI), while performing an implicit approach-avoidance task. Participants pushed and pulled pictorial cues of alcohol and soft-drink beverages, according to a content-irrelevant feature of the cue (landscape/portrait). The critical fMRI contrast regarding the alcohol-approach bias was defined as (approach alcohol > avoid alcohol) > (approach soft drink > avoid soft drink). This was reversed for the avoid-alcohol contrast: (avoid alcohol > approach alcohol) > (avoid soft drink>approach soft drink). In comparison with healthy controls, alcohol-dependent patients had stronger behavioral approach tendencies for alcohol cues than for soft-drink cues. In the approach, alcohol fMRI contrast patients showed larger blood-oxygen-level-dependent responses in the nucleus accumbens and medial prefrontal cortex, regions involved in reward and motivational processing. In alcohol-dependent patients, alcohol-craving scores were positively correlated with activity in the amygdala for the approach-alcohol contrast. The dorsolateral prefrontal cortex was not activated in the avoid-alcohol contrast in patients vs controls. Our data suggest that brain regions that have a key role in reward and motivation are associated with the automatic alcohol-approach bias in alcohol-dependent patients.

• 出版日期2014-2