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Interaction between behavioral inhibition and neural alcohol cue-reactivity in ADHD and alcohol use disorder.
Psychopharmacology (Berl). 2020 Jun; 237(6):1691-1707.P

Abstract

RATIONALE

Compared to the general population, adult Attention-Deficit / Hyperactivity Disorder (ADHD) is more prevalent in patients with Alcohol Use Disorder (AUD). Impaired behavioral inhibition is a common characteristic in both ADHD and AUD. Relapse risk is increased in patients with AUD and comorbid, untreated ADHD and in AUD patients with increased neural cue-reactivity.

OBJECTIVES

In this study, we examined the interaction between neural correlates of behavioral inhibition and alcohol cue-reactivity with a hybrid imaging task.

METHODS

Out of 69 adult study participants, we included n = 49 in our final analyses: Individuals had a diagnosis of either AUD (n = 13), ADHD (n = 14) or both (n = 5), or were healthy controls (HC; n = 17). The functional magnetic resonance imaging paradigm aimed to examine the combined effects of both an interference-inhibition task ("Simon-task") and an alcohol cue-reactivity task. Instead of segregating by diagnostic group, we pursued a dimensional approach in which we compared measures of AUD and ADHD severity, as well as the interaction of both, using multiple regression analyses.

RESULTS

The four groups did not differ on the behavioral level on either the inhibition task or the alcohol cue-reactivity task. However, brain activation in frontal control and reward-related regions during completion of the combined tasks were related to ADHD and AUD severity (symptom load). During presentation of both alcohol cues and the inhibition task, participants with higher AUD and ADHD symptom load exhibited greater BOLD (blood oxygen level dependent) responses in subcortical reward-related regions.

CONCLUSIONS

Our findings support the hypothesis that ADHD additionally diminishes inhibition ability in individuals with AUD. This may increase relapse risk when confronted with alcohol cues. Further, it is crucial for patients with comorbid AUD and ADHD to take into account not only reduced cognitive control over behavioral inhibition but also simultaneously heightened alcohol cue-reactivity.

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Authors+Show Affiliations

Vollstädt-Klein S
Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, Medical Faculty of Mannheim, University of Heidelberg, Mannheim, Germany. s.vollstaedt-klein@zi-mannheim.de.
Gerhardt S
Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, Medical Faculty of Mannheim, University of Heidelberg, Mannheim, Germany.
Lee A
Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, Medical Faculty of Mannheim, University of Heidelberg, Mannheim, Germany.
Strosche A
Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, Medical Faculty of Mannheim, University of Heidelberg, Mannheim, Germany.
Sharafi G
Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, Medical Faculty of Mannheim, University of Heidelberg, Mannheim, Germany. Children's Center, Klinikum Frankfurt Oder, Frankfurt (Oder), Germany.
Nuriyeva R
Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, Medical Faculty of Mannheim, University of Heidelberg, Mannheim, Germany. Department of Obstetrics and Gynecology, University Hospital, Goethe University, Frankfurt, Germany.
Seidt J
Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty of Mannheim, University of Heidelberg, Mannheim, Germany.
Hennig O
Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty of Mannheim, University of Heidelberg, Mannheim, Germany.
Alm B
Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty of Mannheim, University of Heidelberg, Mannheim, Germany.
Hermann D
Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, Medical Faculty of Mannheim, University of Heidelberg, Mannheim, Germany.
Sommer WH
Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, Medical Faculty of Mannheim, University of Heidelberg, Mannheim, Germany. Institute of Psychopharmacology, Central Institute of Mental Health, Medical Faculty of Mannheim, University of Heidelberg, Mannheim, Germany.
Kiefer F
Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, Medical Faculty of Mannheim, University of Heidelberg, Mannheim, Germany.
Luderer M
Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, Medical Faculty of Mannheim, University of Heidelberg, Mannheim, Germany. Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University, Frankfurt, Germany.
Sobanski E
Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty of Mannheim, University of Heidelberg, Mannheim, Germany. Department of Child and Adolescent Psychiatry, University Medical Center Mainz, Mainz, Germany.

MeSH

AdultAlcoholismAttention Deficit Disorder with HyperactivityBrainConditioning, PsychologicalCuesFemaleHumansInhibition, PsychologicalMagnetic Resonance ImagingMaleMiddle AgedNerve NetPhotic StimulationRewardYoung Adult

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32285159

Citation

Vollstädt-Klein, S, et al. "Interaction Between Behavioral Inhibition and Neural Alcohol Cue-reactivity in ADHD and Alcohol Use Disorder." Psychopharmacology, vol. 237, no. 6, 2020, pp. 1691-1707.
Vollstädt-Klein S, Gerhardt S, Lee A, et al. Interaction between behavioral inhibition and neural alcohol cue-reactivity in ADHD and alcohol use disorder. Psychopharmacology (Berl). 2020;237(6):1691-1707.
Vollstädt-Klein, S., Gerhardt, S., Lee, A., Strosche, A., Sharafi, G., Nuriyeva, R., Seidt, J., Hennig, O., Alm, B., Hermann, D., Sommer, W. H., Kiefer, F., Luderer, M., & Sobanski, E. (2020). Interaction between behavioral inhibition and neural alcohol cue-reactivity in ADHD and alcohol use disorder. Psychopharmacology, 237(6), 1691-1707. https://doi.org/10.1007/s00213-020-05492-1
Vollstädt-Klein S, et al. Interaction Between Behavioral Inhibition and Neural Alcohol Cue-reactivity in ADHD and Alcohol Use Disorder. Psychopharmacology (Berl). 2020;237(6):1691-1707. PubMed PMID: 32285159.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Interaction between behavioral inhibition and neural alcohol cue-reactivity in ADHD and alcohol use disorder. AU - Vollstädt-Klein,S, AU - Gerhardt,S, AU - Lee,A, AU - Strosche,A, AU - Sharafi,G, AU - Nuriyeva,R, AU - Seidt,J, AU - Hennig,O, AU - Alm,B, AU - Hermann,D, AU - Sommer,W H, AU - Kiefer,F, AU - Luderer,M, AU - Sobanski,E, Y1 - 2020/04/13/ PY - 2019/03/27/received PY - 2020/02/14/accepted PY - 2020/4/15/pubmed PY - 2020/10/7/medline PY - 2020/4/15/entrez KW - Alcohol use disorder KW - Attention-deficit / hyperactivity disorder KW - Comorbidity KW - Cue-reactivity KW - Functional magnetic resonance imaging KW - Impulsivity KW - Inhibitory control KW - Interference inhibition KW - Reward system SP - 1691 EP - 1707 JF - Psychopharmacology JO - Psychopharmacology (Berl) VL - 237 IS - 6 N2 - RATIONALE: Compared to the general population, adult Attention-Deficit / Hyperactivity Disorder (ADHD) is more prevalent in patients with Alcohol Use Disorder (AUD). Impaired behavioral inhibition is a common characteristic in both ADHD and AUD. Relapse risk is increased in patients with AUD and comorbid, untreated ADHD and in AUD patients with increased neural cue-reactivity. OBJECTIVES: In this study, we examined the interaction between neural correlates of behavioral inhibition and alcohol cue-reactivity with a hybrid imaging task. METHODS: Out of 69 adult study participants, we included n = 49 in our final analyses: Individuals had a diagnosis of either AUD (n = 13), ADHD (n = 14) or both (n = 5), or were healthy controls (HC; n = 17). The functional magnetic resonance imaging paradigm aimed to examine the combined effects of both an interference-inhibition task ("Simon-task") and an alcohol cue-reactivity task. Instead of segregating by diagnostic group, we pursued a dimensional approach in which we compared measures of AUD and ADHD severity, as well as the interaction of both, using multiple regression analyses. RESULTS: The four groups did not differ on the behavioral level on either the inhibition task or the alcohol cue-reactivity task. However, brain activation in frontal control and reward-related regions during completion of the combined tasks were related to ADHD and AUD severity (symptom load). During presentation of both alcohol cues and the inhibition task, participants with higher AUD and ADHD symptom load exhibited greater BOLD (blood oxygen level dependent) responses in subcortical reward-related regions. CONCLUSIONS: Our findings support the hypothesis that ADHD additionally diminishes inhibition ability in individuals with AUD. This may increase relapse risk when confronted with alcohol cues. Further, it is crucial for patients with comorbid AUD and ADHD to take into account not only reduced cognitive control over behavioral inhibition but also simultaneously heightened alcohol cue-reactivity. SN - 1432-2072 UR - https://www.unboundmedicine.com/medline/citation/32285159/Interaction_between_behavioral_inhibition_and_neural_alcohol_cue_reactivity_in_ADHD_and_alcohol_use_disorder_ DB - PRIME DP - Unbound Medicine ER -