title: Impaired decision-making and brain shrinkage in alcoholism.
abstract: Alcohol-dependent individuals usually favor instant gratification of alcohol use and ignore its long-term negative consequences, reflecting impaired decision-making. According to the somatic marker hypothesis, decision-making abilities are subtended by an extended brain network. As chronic alcohol consumption is known to be associated with brain shrinkage in this network, the present study investigated relationships between brain shrinkage and decision-making impairments in alcohol-dependent individuals early in abstinence using voxel-based morphometry. Thirty patients performed the Iowa Gambling Task and underwent a magnetic resonance imaging investigation (1.5T). Decision-making performances and brain data were compared with those of age-matched healthy controls. In the alcoholic group, a multiple regression analysis was conducted with two predictors (gray matter [GM] volume and decision-making measure) and two covariates (number of withdrawals and duration of alcoholism). Compared with controls, alcoholics had impaired decision-making and widespread reduced gray matter volume, especially in regions involved in decision-making. The regression analysis revealed links between high GM volume in the ventromedial prefrontal cortex, dorsal anterior cingulate cortex and right hippocampal formation, and high decision-making scores (P<0.001, uncorrected). Decision-making deficits in alcoholism may result from impairment of both emotional and cognitive networks.
authors.affiliation: Inserm, U1077, Caen, France; Université de Caen Basse-Normandie, UMR-S1077, Caen, France; École Pratique des Hautes Études, UMR-S1077, Caen, France; CHU de Caen, U1077, Caen, France.
authors.forename: A-P
authors.initials: AP
authors.lastname: Le Berre
authors.affiliation: Inserm, U1077, Caen, France; Université de Caen Basse-Normandie, UMR-S1077, Caen, France; École Pratique des Hautes Études, UMR-S1077, Caen, France; CHU de Caen, U1077, Caen, France.
authors.forename: G
authors.initials: G
authors.lastname: Rauchs
authors.affiliation: Inserm, U1077, Caen, France; Université de Caen Basse-Normandie, UMR-S1077, Caen, France; École Pratique des Hautes Études, UMR-S1077, Caen, France; CHU de Caen, U1077, Caen, France.
authors.forename: R
authors.initials: R
authors.lastname: La Joie
authors.affiliation: Inserm, U1077, Caen, France; Université de Caen Basse-Normandie, UMR-S1077, Caen, France; École Pratique des Hautes Études, UMR-S1077, Caen, France; CHU de Caen, U1077, Caen, France.
authors.forename: F
authors.initials: F
authors.lastname: Mézenge
authors.affiliation: Inserm, U1077, Caen, France; Université de Caen Basse-Normandie, UMR-S1077, Caen, France; École Pratique des Hautes Études, UMR-S1077, Caen, France; CHU de Caen, Service d'addictologie, Caen, France.
authors.forename: C
authors.initials: C
authors.lastname: Boudehent
authors.affiliation: Inserm, U1077, Caen, France; Université de Caen Basse-Normandie, UMR-S1077, Caen, France; École Pratique des Hautes Études, UMR-S1077, Caen, France; CHU de Caen, Service d'addictologie, Caen, France.
authors.forename: F
authors.initials: F
authors.lastname: Vabret
authors.affiliation: Inserm, U1077, Caen, France; Université de Caen Basse-Normandie, UMR-S1077, Caen, France; École Pratique des Hautes Études, UMR-S1077, Caen, France; CHU de Caen, U1077, Caen, France.
authors.forename: S
authors.initials: S
authors.lastname: Segobin
authors.affiliation: Inserm, U1077, Caen, France; Université de Caen Basse-Normandie, UMR-S1077, Caen, France; École Pratique des Hautes Études, UMR-S1077, Caen, France; CHU de Caen, Service de neurologie, Caen, France.
authors.forename: F
authors.initials: F
authors.lastname: Viader
authors.affiliation: Université d'Angers, UPRES EA 2646, Angers, France.
authors.forename: P
authors.initials: P
authors.lastname: Allain
authors.affiliation: Inserm, U1077, Caen, France; Université de Caen Basse-Normandie, UMR-S1077, Caen, France; École Pratique des Hautes Études, UMR-S1077, Caen, France; CHU de Caen, U1077, Caen, France.
authors.forename: F
authors.initials: F
authors.lastname: Eustache
authors.affiliation: Inserm, U1077, Caen, France; Université de Caen Basse-Normandie, UMR-S1077, Caen, France; École Pratique des Hautes Études, UMR-S1077, Caen, France; CHU de Caen, U1077, Caen, France.
authors.forename: A-L
authors.initials: AL
authors.lastname: Pitel
authors.affiliation: Inserm, U1077, Caen, France; Université de Caen Basse-Normandie, UMR-S1077, Caen, France; École Pratique des Hautes Études, UMR-S1077, Caen, France; CHU de Caen, U1077, Caen, France. Electronic address: helene.beaunieux@unicaen.fr.
authors.forename: H
authors.initials: H
authors.lastname: Beaunieux
mesh_terms: D000328:Adult; D000437:Alcoholism / Q000473:pathology / Q000503:physiopathology; D003657:Decision Making / Q000502:physiology*; D005260:Female; D006624:Hippocampus / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000295:instrumentation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D017397:Prefrontal Cortex / Q000473:pathology / Q000503:physiopathology