Neural correlates of alcohol-approach bias in alcohol addiction: the spirit is willing but the flesh is weak for spirits.
Behavioral studies have shown an alcohol-approach bias in alcohol-dependent patients: the automatic tendency to faster approach than avoid alcohol compared with neutral cues, which has been associated with craving and relapse. Although this is a well-studied psychological phenomenon, little is known about the brain processes underlying automatic action tendencies in addiction. We examined 20 alcohol-dependent patients and 17 healthy controls with functional magnetic resonance imaging (fMRI), while performing an implicit approach-avoidance task. Participants pushed and pulled pictorial cues of alcohol and soft-drink beverages, according to a content-irrelevant feature of the cue (landscape/portrait). The critical fMRI contrast regarding the alcohol-approach bias was defined as (approach alcohol>avoid alcohol)>(approach soft drink>avoid soft drink). This was reversed for the avoid-alcohol contrast: (avoid alcohol>approach alcohol)>(avoid soft drink>approach soft drink). In comparison with healthy controls, alcohol-dependent patients had stronger behavioral approach tendencies for alcohol cues than for soft-drink cues. In the approach, alcohol fMRI contrast patients showed larger blood-oxygen-level-dependent responses in the nucleus accumbens and medial prefrontal cortex, regions involved in reward and motivational processing. In alcohol-dependent patients, alcohol-craving scores were positively correlated with activity in the amygdala for the approach-alcohol contrast. The dorsolateral prefrontal cortex was not activated in the avoid-alcohol contrast in patients vs controls. Our data suggest that brain regions that have a key role in reward and motivation are associated with the automatic alcohol-approach bias in alcohol-dependent patients.
1] Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Berlin, Germany [2] Berlin School of Mind and Brain, Humboldt University Berlin, Berlin, Germany [3] Department of Education and Psychology, Free University Berlin, Berlin, Germany.
Corinde E
CE
Wiers
1] Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Berlin, Germany [2] Berlin School of Mind and Brain, Humboldt University Berlin, Berlin, Germany [3] Department of Psychology, Humboldt University Berlin, Berlin, Germany.
Christine
C
Stelzel
Department of Economics, University of Zürich, Zürich, Switzerland.
Soyoung Q
SQ
Park
Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Berlin, Germany.
Christiane K
CK
Gawron
1] Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Berlin, Germany [2] Berlin School of Mind and Brain, Humboldt University Berlin, Berlin, Germany [3] Department of Psychology, Humboldt University Berlin, Berlin, Germany.
Vera U
VU
Ludwig
1] Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Berlin, Germany [2] Berlin School of Mind and Brain, Humboldt University Berlin, Berlin, Germany.
Stefan
S
Gutwinski
1] Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Berlin, Germany [2] Berlin School of Mind and Brain, Humboldt University Berlin, Berlin, Germany [3] Berlin Center for Advanced Neuroimaging, Charité - Universitätsmedizin Berlin, Berlin, Germany.
Andreas
A
Heinz
1] Salus Klinik, Lindow, Germany [2] Department of Clinical Psychology, Chemnitz University of Technology, Chemnitz, Germany.
Johannes
J
Lindenmeyer
Addiction, Development and Psychopathology (ADAPT) Lab, Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands.
Reinout W
RW
Wiers
1] Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Berlin, Germany [2] Berlin School of Mind and Brain, Humboldt University Berlin, Berlin, Germany [3] Berlin Center for Advanced Neuroimaging, Charité - Universitätsmedizin Berlin, Berlin, Germany.
Henrik
H
Walter
1] Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Berlin, Germany [2] Berlin School of Mind and Brain, Humboldt University Berlin, Berlin, Germany [3] Berlin Center for Advanced Neuroimaging, Charité - Universitätsmedizin Berlin, Berlin, Germany.
Felix
F
Bermpohl
D000328:Adult; D000437:Alcoholism / Q000473:pathology* / Q000523:psychology*; D000704:Analysis of Variance; D016739:Behavior, Addictive / Q000523:psychology*; D015982:Bias; D001921:Brain / Q000098:blood supply / Q000503:physiopathology*; D001931:Brain Mapping; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010100:Oxygen; D011930:Reaction Time / Q000502:physiology; D029181:Spirituality
D010100:Oxygen