title: Prefrontal correlates of approach preferences for alcohol stimuli in alcohol dependence.
abstract: An approach bias for alcohol stimuli (i.e. faster approach than avoidance reactions) might facilitate relapses in alcohol dependence. Neurobiological models suggest hypersensitivity in the reward system [inter alia nucleus accumbens and orbitofrontal cortex (OFC)] to cause pathologically enhanced approach impulses towards alcohol stimuli. At the same time, in alcohol dependence, these structures are only insufficiently controlled by a hypoactive dorsolateral prefrontal cortex (DLPFC). The present study investigated the cortical aspects of this model with functional near-infrared spectroscopy in 21 alcohol-dependent in-patients and 21 healthy controls (HC; comparable in age, gender and education) during performance of the Approach-Avoidance Task (AAT) for the first time. Complementing previous findings, in reaction times (RTs), patients showed stronger approach preferences for alcohol than non-alcohol stimuli. For non-alcohol stimuli, patients even displayed avoidance preferences. The reversed pattern was found in HC. Group differences in activity of the OFC were identical to those in RTs, revealing patients to assign higher subjective value to approaching alcohol stimuli. In both groups, regulatory activity in the right DLPFC was stronger during avoiding than approaching alcohol pictures. Probable awareness of the behavioural hypotheses due to explicit task instructions and patients' deficient prefrontal function might account for this equally aligned pattern. Results are discussed with regard to recent findings revealing a reduced behavioural approach bias and risk for relapse by applying a retraining version of the AAT. Functional measurements might serve as a method for monitoring the corresponding neurobiological changes and-possibly-predicting the success of such a training.
authors.affiliation: Psychophysiology and Optical Imaging, Department of Psychiatry and Psychotherapy, University of Tuebingen, Germany.
authors.forename: Lena H
authors.initials: LH
authors.lastname: Ernst
authors.forename: Michael M
authors.initials: MM
authors.lastname: Plichta
authors.forename: Thomas
authors.initials: T
authors.lastname: Dresler
authors.forename: Anna K
authors.initials: AK
authors.lastname: Zesewitz
authors.forename: Sara V
authors.initials: SV
authors.lastname: Tupak
authors.forename: Florian B
authors.initials: FB
authors.lastname: Haeussinger
authors.forename: Matthias
authors.initials: M
authors.lastname: Fischer
authors.forename: Thomas
authors.initials: T
authors.lastname: Polak
authors.forename: Andreas J
authors.initials: AJ
authors.lastname: Fallgatter
authors.forename: Ann-Christine
authors.initials: AC
authors.lastname: Ehlis
mesh_terms: D000328:Adult; D000437:Alcoholism / Q000503:physiopathology / Q000523:psychology*; D000704:Analysis of Variance; D001362:Avoidance Learning / Q000502:physiology; D016022:Case-Control Studies; D005260:Female; D059907:Functional Neuroimaging; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D008297:Male; D057240:Patient Preference / Q000523:psychology*; D010775:Photic Stimulation; D017397:Prefrontal Cortex / Q000502:physiology*; D011581:Psychological Tests; D011597:Psychomotor Performance / Q000502:physiology; D019265:Spectroscopy, Near-Infrared
chemical_list: D006454:Hemoglobins
keywords: alcohol dependence; approach; approach bias; avoidance; functional near-infrared spectroscopy (fNIRS); prefrontal cortex (PFC)