Dataset Information

Alcohol Approach Bias Is Associated With Both Behavioral and Neural Pavlovian-to-Instrumental Transfer Effects in Alcohol-Dependent Patients.

ABSTRACT:

Background

Even after qualified detoxification, alcohol-dependent (AD) patients may relapse to drinking alcohol despite their decision to abstain. Two mechanisms may play important roles. First, the impact of environmental cues on instrumental behavior (i.e., Pavlovian-to-instrumental transfer [PIT] effect), which was found to be stronger in prospectively relapsing AD patients than in abstaining patients. Second, an automatic approach bias toward alcohol stimuli was observed in AD patients, and interventions targeting this bias reduced the relapse risk in some studies. Previous findings suggest a potential behavioral and neurobiological overlap between these two mechanisms.

Methods

In this study, we examined the association between alcohol approach bias and both behavioral and neural non-drug-related PIT effects in AD patients after detoxification. A total of 100 AD patients (17 females) performed a PIT task and an alcohol approach/avoidance task. Patients were followed for 6 months.

Results

A stronger alcohol approach bias was associated with both a more pronounced behavioral PIT effect and stronger PIT-related neural activity in the right nucleus accumbens. Moreover, the association between alcohol approach bias and behavioral PIT increased with the severity of alcohol dependence and trait impulsivity and was stronger in patients who relapsed during follow-up in the exploratory analysis.

Conclusions

These findings indicate partial behavioral and neurobiological overlap between alcohol approach bias and the PIT effect assessed with our tasks. The association was stronger in patients with more severe alcohol dependence.

SUBMITTER: Chen K

PROVIDER: S-EPMC10382691 | biostudies-literature | 2023 Jul

REPOSITORIES: biostudies-literature

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Publications

Alcohol Approach Bias Is Associated With Both Behavioral and Neural Pavlovian-to-Instrumental Transfer Effects in Alcohol-Dependent Patients.

Chen Ke K Garbusow Maria M Sebold Miriam M Kuitunen-Paul Sören S Smolka Michael N MN Huys Quentin J M QJM Zimmermann Ulrich S US Schlagenhauf Florian F Heinz Andreas A

Biological psychiatry global open science 20220414 3

<h4>Background</h4>Even after qualified detoxification, alcohol-dependent (AD) patients may relapse to drinking alcohol despite their decision to abstain. Two mechanisms may play important roles. First, the impact of environmental cues on instrumental behavior (i.e., Pavlovian-to-instrumental transfer [PIT] effect), which was found to be stronger in prospectively relapsing AD patients than in abstaining patients. Second, an automatic approach bias toward alcohol stimuli was observed in AD patien ...[more]

PMID: 37519476

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Project description:In animals and humans, behavior can be influenced by irrelevant stimuli, a phenomenon called Pavlovian-to-instrumental transfer (PIT). In subjects with substance use disorder, PIT is even enhanced with functional activation in the nucleus accumbens (NAcc) and amygdala. While we observed enhanced behavioral and neural PIT effects in alcohol-dependent subjects, we here aimed to determine whether behavioral PIT is enhanced in young men with high-risk compared to low-risk drinking and subsequently related functional activation in an a-priori region of interest encompassing the NAcc and amygdala and related to polygenic risk for alcohol consumption. A representative sample of 18-year old men (n = 1937) was contacted: 445 were screened, 209 assessed: resulting in 191 valid behavioral, 139 imaging and 157 genetic datasets. None of the subjects fulfilled criteria for alcohol dependence according to the Diagnostic and Statistical Manual of Mental Disorders-IV-TextRevision (DSM-IV-TR). We measured how instrumental responding for rewards was influenced by background Pavlovian conditioned stimuli predicting action-independent rewards and losses. Behavioral PIT was enhanced in high-compared to low-risk drinkers (b = 0.09, SE = 0.03, z = 2.7, p < 0.009). Across all subjects, we observed PIT-related neural blood oxygen level-dependent (BOLD) signal in the right amygdala (t = 3.25, pSVC = 0.04, x = 26, y = -6, z = -12), but not in NAcc. The strength of the behavioral PIT effect was positively correlated with polygenic risk for alcohol consumption (rs = 0.17, p = 0.032). We conclude that behavioral PIT and polygenic risk for alcohol consumption might be a biomarker for a subclinical phenotype of risky alcohol consumption, even if no drug-related stimulus is present. The association between behavioral PIT effects and the amygdala might point to habitual processes related to out PIT task. In non-dependent young social drinkers, the amygdala rather than the NAcc is activated during PIT; possible different involvement in association with disease trajectory should be investigated in future studies.

Project description:The acquired motivational impact of conditioned stimuli has been studied using the Pavlovian-to-instrumental transfer (PIT) task, where a cue paired with a reward is consistently shown to energize responses separately trained with that same reward ("specific" PIT). However, most alcohol studies have shown that alcohol-related cues elevate responses trained with either the same alcohol reward or with other non-alcoholic rewards ("general" PIT). The effects of extinction on this alcohol PIT effect have not been fully explored. We tested the hypothesis that cues signaling different-tasting alcohols might acquire specific craving reactions for those alcohols leading to specific PIT, but that these effects might be sensitive to extinction. Three experiments examined the specificity of PIT using alcohol and non-alcohol outcomes. Rats first consumed different-flavored alcohol solutions in their home cages. Then they were trained to perform two responses, each reinforced with distinctly flavored solutions, using a Polycose fading procedure. The outcomes were sweet (4% sucrose) or salty (0.9% NaCl) ethanol (10% v/v) solutions (Experiments 1 and 2) or one plain or salty alcohol vs. a non-alcoholic sweet solution (Experiment 3). Then, two cues were each differentially paired with these outcomes. In PIT tests, animals performed both responses in the presence and absence of these cues without any rewards. Experiments 1, 2, and 3 showed that a cue paired with a flavored alcohol produced a small but consistent bias toward the response trained with the same alcohol solution (specific PIT). Experiment 2 showed that extinction eliminated this effect. Experiment 3 demonstrated that specific PIT occurred when contrasting salty, or plain, alcohol to a non-alcoholic solution. These results provide evidence that alcohol-related stimuli can elicit craving for specific types of alcohol (as revealed by specific PIT), but that this effect is sensitive to extinction. This paradigm of contrasting two distinctly flavored alcohols may be an especially useful animal model of alcohol addiction.

Project description:Threat conditioning is a common associative learning model with translational relevance. How threat-conditioned cues impact on formally unrelated instrumental behavior in humans is not well known. Such an effect is known as Pavlovian-to-instrumental transfer (PIT). While PIT with aversive primary Pavlovian reinforcers is established in nonhuman animals, this is less clear in humans, where secondary reinforcers or instructed instrumental responses are most often investigated. We modified an existing human PIT procedure to include primary reinforcers. Participants first learned to obtain (or avoid losing) appetitive instrumental reinforcement (chocolate) by appropriate approach or avoidance actions. They either had to act (Go) or to withhold an action (NoGo), and in the Go condition either to approach a reward target to collect it or to withdraw from the reward target to avoid losing it. Then they learned to associate screen color (CS) with aversive Pavlovian reinforcement (electric shock US). In the transfer phase, we conducted the instrumental task during the presence of Pavlovian CS. In a first experiment, we show that the aversive Pavlovian CS+, compared to CS-, increased response rate in Go-Withdraw trials, i.e., induce conditioned facilitation of avoidance responses. This finding was confirmed in a second and independent experiment with an increased number of Go-Withdraw trials. Notably, we observed no appreciable conditioned suppression of approach responses. Effect size to distinguish CS+/CS- in Go-Withdraw trials was d = 0.42 in the confirmation sample. This would require n = 37 participants to demonstrate threat learning with 80% power. Thus, the effect size is on a practically useful scale although smaller than for model-based analysis of autonomic measures. In summary, our results indicate conditioned facilitation of formally unrelated instrumental avoidance behavior in humans and provide a novel behavioral threat learning measure that requires only key presses.

Dataset Information

Alcohol Approach Bias Is Associated With Both Behavioral and Neural Pavlovian-to-Instrumental Transfer Effects in Alcohol-Dependent Patients.

Background

Methods

Results

Conclusions

Publications

Alcohol Approach Bias Is Associated With Both Behavioral and Neural Pavlovian-to-Instrumental Transfer Effects in Alcohol-Dependent Patients.

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