Striatal reward sensitivity predicts therapy-related neural changes in alcohol addiction
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Individual differences in reward sensitivity along with weakened executive control are characteristic for alcohol use disorder (AUD). Emerging translational models of psychotherapy propose the integration of such neurobiological risk profiles to elucidate the mechanisms underlying behavior change in order to improve intervention efficacy. The primary aim of the study was to investigate whether striatal baseline reward sensitivity can be used as a neurobiological predictor of intervention-specific changes in neural functioning during AUD therapy. Fifty-eight detoxified AUD patients were randomly assigned to either receive cue exposure training (CET + TAU, N = 40) or treatment as usual (TAU only, N = 18). Pre- and post-treatment sensitivity to reward was assessed by a functional magnetic resonance imaging monetary reward paradigm. A moderated multiple regression analysis revealed a positive relationship between striatal baseline reward sensitivity and activation changes in the superior frontal gyrus and anterior cingulate cortex (ACC) after CET + TAU in contrast to a negative relationship after TAU only. Over all subjects, a stronger signal change in the superior frontal gyrus and ACC was associated with increased self-efficacy to abstain alcohol. These results provide evidence that reward sensitivity at baseline predicts neural changes in inhibitory networks after receiving CET + TAU. Striatal reward sensitivity might be a promising neurobiological marker to inform therapeutic decisions.
KeywordsAlcohol dependence Reward processing Cue exposure training Striatum Prefrontal cortex Functional magnetic resonance imaging
The study was funded by the Deutsche Forschungsgemeinschaft (SFB 636/D6). The authors would like to thank Abdallah Abdelhadi, Katharina Boor, Silvia Gubay, Patrick Halli, Bettina Kirr, Birgül Sarun, Claudia Stief and Michael Wester-Ebbinghaus for recruiting participants and for data collection. We thank Anna M. Ehret for proofreading the manuscript.
FK, PK and MK were responsible for the study concept and design. AB and MK collected the data. AB, MG, SH and PK analyzed the data. AB, MG and PK assisted with interpretation and drafted the manuscript. FK and MK provided critical revision of the manuscript for important intellectual content. All authors critically reviewed content and approved the final version for publication.
Compliance with ethical standards
Conflict of interest
The authors declare that there is no conflict of interest.
The authors assert that all procedures contributing to this work comply with the ethical standards of the relevant national and institutional committees on human experimentation and with the Helsinki Declaration of 1975, as revised in 2008.
The study was funded by the Deutsche Forschungsgemeinschaft (SFB 636/D6).
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