1
|
Blaine SK, Ridner C, Campbell B, Crone L, Macatee R, Ansell EB, Robinson JL, Claus ED. People who binge drink show neuroendocrine tolerance to alcohol cues that is associated with immediate and future drinking- results from a randomized clinical experiment. Neuropsychopharmacology 2023; 48:1968-1974. [PMID: 37717082 PMCID: PMC10584838 DOI: 10.1038/s41386-023-01735-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 08/28/2023] [Accepted: 09/03/2023] [Indexed: 09/18/2023]
Abstract
Neuroendocrine tolerance to alcohol, i.e., a blunted cortisol response to alcohol, has been linked to Ventromedial Prefrontal Cortex (VmPFC) alcohol cue reactivity and relapse risk in severe Alcohol Use Disorders (AUDs), but its role in the development of AUDs is not clear. Recent work suggests that blunted cortisol responses to alcohol cues in individuals who engage in binge drinking (BD) may play a role in motivation to consume larger amounts of alcohol, but the link between this dysregulated endocrine response and BD's neural responses to alcohol cues remains unclear. To examine this, two groups of participants were recruited based on their recent drinking history. Thirty-three BD and 31 non-binging, social drinkers (SD) were exposed to alcohol cues and water cues in two separate 7 T functional magnetic resonance imaging (fMRI) scans. Each scan was followed by the Alcohol Taste Test (ATT) of implicit motivation for alcohol and a post-experiment, one-month prospective measurement of their "real world" drinking behavior. During each scan session, blood plasma was collected repeatedly to examine the separate effects of alcohol cues and alcohol consumption on cortisol levels. Relative to water cues and SD, BD demonstrated blunted cortisol cue reactivity that was negatively associated with VmPFC cue reactivity. In BD, both blunted cortisol and greater VmPFC cue reactivity were related to immediate and future alcohol consumption in the month following the scans. Thus, neuroendocrine tolerance in BD may be associated with increased incentive salience of cues and contribute mechanistically to increased alcohol consumption seen in the development of AUDs.
Collapse
Affiliation(s)
- Sara K Blaine
- Department of Psychological Sciences, Auburn University, Auburn, AL, USA.
| | - Clayton Ridner
- Department of Psychological Sciences, Auburn University, Auburn, AL, USA
| | - Benjamin Campbell
- Department of Psychological Sciences, Auburn University, Auburn, AL, USA
| | - Lily Crone
- Department of Psychological Sciences, Auburn University, Auburn, AL, USA
| | - Richard Macatee
- Department of Psychological Sciences, Auburn University, Auburn, AL, USA
| | - Emily B Ansell
- Department of Biobehavioral Health, Penn State University, State College, PA, USA
| | | | - Eric D Claus
- Department of Biobehavioral Health, Penn State University, State College, PA, USA
| |
Collapse
|
2
|
Blaine SK, Ridner CM, Campbell BR, Crone L, Claus ED, Wilson JR, West SN, McClanahan AJ, Siddiq AS, Layman IM, Macatee R, Ansell EB, Robinson JL, Beck DT. IL-6, but not TNF-α, response to alcohol cues and acute consumption associated with neural cue reactivity, craving, and future drinking in binge drinkers. Brain Behav Immun Health 2023; 31:100645. [PMID: 37484196 PMCID: PMC10362517 DOI: 10.1016/j.bbih.2023.100645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 05/26/2023] [Accepted: 06/03/2023] [Indexed: 07/25/2023] Open
Abstract
Objective and design Preclinical studies suggest learned immune system responses to alcohol cues and consumption may contribute to alcohol's pharmacodynamic properties and/or Alcohol Use Disorder (AUD) pathogenesis. Mechanistically, these immune alterations may be associated with increased craving and alcohol consumption, both acutely and over time. We sought to characterize this relationship in a randomized, counter-balanced, crossover neuroimaging experiment which took place between June 2020-November 2021. Methods Thirty-three binge drinkers (BD) and 31 non-binge, social drinkers (SD), matched for demographic and psychological variables, were exposed to alcohol cues and water cues in two separate 7 T functional magnetic resonance imaging (fMRI) scans. Each scan was followed by the Alcohol Taste Test (ATT) of implicit motivation for acute alcohol. Craving measures and blood cytokine levels were collected repeatedly during and after scanning to examine the effects of alcohol cues and alcohol consumption on craving levels, Tumor necrosis factor alpha (TNF-α), and Interleukin 6 (IL-6) levels. A post-experiment one-month prospective measurement of participants' "real world" drinking behavior was performed to approximate chronic effects. Results BD demonstrated significantly higher peak craving and IL-6 levels than SD in response to alcohol cues and relative to water cues. Ventromedial Prefrontal Cortex (VmPFC) signal change in the alcohol-water contrast positively related to alcohol cue condition craving and IL-6 levels, relative to water cue condition craving and IL-6 levels, in BD only. Additionally, peak craving and IL-6 levels were each independently related to ATT alcohol consumption and the number of drinks consumed in the next month for BD, again after controlling for craving and IL-6 repones to water cues. However, TNF-α release in the alcohol cue condition was not related to craving, neural activation, IL-6 levels, immediate and future alcohol consumption in either group after controlling for water cue condition responses. Conclusions In sum, BD show greater craving and IL-6 release in the alcohol cue condition than SD, both of which were associated with prefrontal cue reactivity, immediate alcohol consumption, and future alcohol consumption over the subsequent 30 days. Alcohol associated immune changes and craving effects on drinking behavior may be independent of one another or may be indicative of a common pathway by which immune changes in BD could influence motivation to consume alcohol. Trial registration Clinical Trials NCT04412824.
Collapse
Affiliation(s)
- Sara K. Blaine
- Department of Psychological Sciences, Auburn University, Auburn, AL, USA
| | - Clayton M. Ridner
- Department of Psychological Sciences, Auburn University, Auburn, AL, USA
| | | | - Lily Crone
- College of Sciences and Mathematics, Auburn University, Auburn, AL, USA
| | - Eric D. Claus
- Department of Biobehavioral Health, The Pennsylvania State University, University Park, PA, USA
| | - Juliet R. Wilson
- Edward Via College of Osteopathic Medicine, Auburn University, Auburn, AL, USA
| | - Summer N. West
- Edward Via College of Osteopathic Medicine, Auburn University, Auburn, AL, USA
| | | | - Anna S. Siddiq
- Edward Via College of Osteopathic Medicine, Auburn University, Auburn, AL, USA
| | - Isaak M.P. Layman
- Edward Via College of Osteopathic Medicine, Auburn University, Auburn, AL, USA
| | - Richard Macatee
- Department of Psychological Sciences, Auburn University, Auburn, AL, USA
| | - Emily B. Ansell
- Department of Biobehavioral Health, The Pennsylvania State University, University Park, PA, USA
| | | | - Darren T. Beck
- Edward Via College of Osteopathic Medicine, Auburn University, Auburn, AL, USA
| |
Collapse
|
3
|
Hennessy G, Boland M, Bambrick M, Crone L, Lloyd A, Abdelwahab S, Downey E, Staunton M, Hambly N, Mhuircheartaigh NN, Kerr J, Power C, Duke D, Hill ADK. Value of long-term follow-up in surgically excised lesions of uncertain malignant potential in the breast – Is 5 years necessary? Clin Breast Cancer 2022; 22:699-704. [DOI: 10.1016/j.clbc.2022.05.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 04/30/2022] [Accepted: 05/29/2022] [Indexed: 11/29/2022]
|
4
|
Ashraf Z, Crone L, Higgins MF. Factors affecting confidence and competence of doctors in performing operative vaginal births: A qualitative study. Eur J Obstet Gynecol Reprod Biol 2021; 258:348-352. [PMID: 33550214 DOI: 10.1016/j.ejogrb.2021.01.045] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Revised: 01/21/2021] [Accepted: 01/23/2021] [Indexed: 10/22/2022]
Abstract
OBJECTIVES Operative vaginal birth (OVB) is an important skill for obstetricians. It is the most common emergency intervention in obstetrics and requires a high degree of skill. While there is a lot of data available on technical and non-technical factors affecting the outcome of OVBs little work has been done to investigate the factors that make obstetricians feel confident and competent when performing such a procedure. The objective of this study was therefore to identify the common factors that affect confidence and competence of obstetricians in operative vaginal births (OVB). Our hypothesis was that a qualitative research method would provide a rich approach where themes would be developed that the participants themselves identify as important. STUDY DESIGN Qualitative research within two University Hospitals and one District Hospital in Ireland. Participants interviewed ranged from first year trainees to consultant obstetricians. Interviews using open ended questions. Interviews were recorded on audio and later transcribed. Thematic analysis was performed until saturation. RESULTS 35 obstetricians were interviewed. The median number of years of experience was 5 years (range 3-20 years). The median number of OVB was 200 (range 20-1000+). Vacuum was the preferred choice amongst junior trainees. Preference shifted to forceps with increasing clinical experience. Seven clear themes emerged. Three themes were common to all participants: firstly, that all clinicians reported respect for the primiparous OVB in anticipation of possible complications, secondly the wish for senior midwifery support and finally the importance of clinical experience and exposure. Four themes were common to trainees only. Female clinicians in training reported significant self-doubt in their ability to perform an OVB and had concerns about causing harm. Clinicians in training wished to be trained by consultants during their first year on the labour ward. Experience was important. The final theme was a wish for more training in forceps OVB by clinicians in training. CONCLUSION This qualitative study identified factors that can be used to design education and training in OVB in order to support trainees and ultimately improve care for the woman and baby.
Collapse
Affiliation(s)
- Z Ashraf
- Obstetrics and Gynaecology, National Maternity Hospital, Dublin, Ireland
| | - L Crone
- UCD School of Medicine, University College Dublin, Ireland
| | - M F Higgins
- UCD Perinatal Research Centre, National Maternity Hospital, University College Dublin, Holles Street, Dublin 2, Dublin, Ireland.
| |
Collapse
|