Gray-matter relationships to diagnostic and transdiagnostic features of drug and behavioral addictions.
Alterations in neural structure have been reported in both cocaine-use disorder and gambling disorder, separately, suggesting similarities across addiction diagnoses. Individual variation in neural structure has also been associated with impulsivity, a dimensional construct implicated in addictions. This study combines categorical (diagnosis-based) and dimensional (transdiagnostic) approaches to identify neural structural alterations linked to addiction subtypes and trait impulsivity, respectively, across individuals with gambling disorder (n = 35), individuals with cocaine-use disorder (n = 37) and healthy comparison individuals (n = 37). High-resolution T1-weighted data were analyzed using modulated voxel-based morphometry (VBM). Statistical analyses were conducted using whole-brain general-linear models, corrected for family-wise error (pFWE < .05). Categorical analyses indicated a main effect of diagnostic group on prefrontal (dorsal anterior cingulate and ventromedial prefrontal cortex) gray matter volumes (GMVs), involving decreased GMVs among cocaine-use disorder participants only. Dimensional analyses indicated a negative association between trait impulsivity and cortical (insula) and subcortical (amygdala and hippocampus) GMVs across all participants. Conjunction analysis indicated little anatomical overlap between regions identified as differentiating diagnostic groups and regions covarying with impulsivity. These data provide first evidence of neural structural differences between gambling disorder and an illicit substance-use disorder. They further indicate dissociable effects of diagnostic groupings and trait impulsivity on neural structure among individuals with behavioral and drug addictions. Study findings highlight the importance of considering both categorical and dimensional (e.g. Research Domain Criteria; RDoC) analysis approaches within the context of addictions research.
The National Center on Addiction and Substance Abuse, Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA.|Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA.
Sarah W
SW
Yip
Department of Diagnostic Radiology, Yale University School of Medicine, New Haven, CT, USA.
Patrick D
PD
Worhunsky
Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA.
Jiansong
J
Xu
Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA.
Kristen P
KP
Morie
Department of Diagnostic Radiology, Yale University School of Medicine, New Haven, CT, USA.
R Todd
RT
Constable
Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA.|Connecticut Mental Health Center, New Haven, CT, USA.
Robert T
RT
Malison
Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA.
Kathleen M
KM
Carroll
The National Center on Addiction and Substance Abuse, Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA.|Connecticut Mental Health Center, New Haven, CT, USA.|Department of Neurobiology, Yale University School of Medicine, New Haven, CT, USA.|Yale Child Study Center, Yale University School of Medicine, New Haven, CT, USA.
Marc N
MN
Potenza
D000328:Adult; D000679:Amygdala / Q000000981:diagnostic imaging; D001921:Brain / Q000000981:diagnostic imaging; D016022:Case-Control Studies; D002540:Cerebral Cortex / Q000000981:diagnostic imaging; D019970:Cocaine-Related Disorders / Q000000981:diagnostic imaging* / Q000523:psychology; D005260:Female; D005715:Gambling / Q000000981:diagnostic imaging* / Q000523:psychology; D066128:Gray Matter / Q000000981:diagnostic imaging* / Q000473:pathology; D006179:Gyrus Cinguli / Q000000981:diagnostic imaging; D006624:Hippocampus / Q000000981:diagnostic imaging; D006801:Humans; D007175:Impulsive Behavior; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D017397:Prefrontal Cortex / Q000000981:diagnostic imaging
cocaine; pathological gambling; voxel-based morphometry