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Lohner V, Schneider S, Andreas M, Szafran D, Grundinger N, Vollstädt-Klein S, Fong GT, McNeill A, Mons U. Understanding addiction in e-cigarette users – the EVAPE project. Eur J Public Health 2022. [DOI: 10.1093/eurpub/ckac130.078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Electronic cigarettes (e-cigarettes) are often advertised as a healthier option to combustible cigarettes and as smoking cessation aid. However, e-cigarettes are a growing health concern and their addictive potential remains to be fully understood. Within the EValuation of the Addictive Potential of E-cigarettes (EVAPE) project, we studied subjective and objective measures of addiction in relation to e-cigarette use.
Methods
This cross-sectional analysis was based on 832 participants of the first wave (2016) of England from the ITC Four Country Smoking and Vaping (4CV) Survey, who were using e-cigarettes daily or weekly for at least four months. Perceived addiction to e-cigarettes was categorised as very vs. not/somewhat addicted, and perceived addictiveness of e-cigarettes relative to combustible cigarettes as equally/more addictive vs. less addictive. Objective measures of addiction included urge to vape, time to first vape after waking, frequency of use, and used nicotine strength. We examined associations between these objective and subjective measures of addiction using multivariate logistic regression, adjusted for age, gender, education, and cigarette smoking.
Results
17.8% of participants reported feeling very addicted to e-cigarettes and 42.3% considered e-cigarettes equally/more addictive than combustible cigarettes. Those who felt very addicted had higher odds of regarding e-cigarettes as more addictive (OR 3.43 (95%-CI 2.29-5.19)). All objective measures of addiction were associated with higher perceived addiction, whereas only a shorter time to first vape was associated with perceived product addictiveness.
Conclusions
Subjective measures of addiction to e-cigarettes, in particular perceived addiction, correspond with objective measures. Understanding the addictive potential of e-cigarettes is the cornerstone for developing new strategies for prevention and treatment, and ultimately understanding their role from a public health perspective.
Key messages
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Affiliation(s)
- V Lohner
- Department of Cardiology, University of Cologne , Cologne, Germany
| | - S Schneider
- Medical Faculty Mannheim, University of Heidelberg , Mannheim, Germany
| | - M Andreas
- Medical Faculty Mannheim, University of Heidelberg , Mannheim, Germany
| | - D Szafran
- Medical Faculty Mannheim, University of Heidelberg , Mannheim, Germany
| | - N Grundinger
- Medical Faculty Mannheim, University of Heidelberg , Mannheim, Germany
| | - S Vollstädt-Klein
- Medical Faculty Mannheim, University of Heidelberg , Mannheim, Germany
| | - GT Fong
- Department of Psychology, University of Waterloo , Waterloo, Canada
- School of Public Health Sciences, University of Waterloo , Waterloo, Canada
- Ontario Institute for Cancer Research , Toronto, Canada
| | - A McNeill
- Psychology and Neuroscience, King’s College London , London, UK
- SPECTRUM , London, UK
| | - U Mons
- Department of Cardiology, University of Cologne , Cologne, Germany
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Andreas M, Szafran D, Vollstädt-Klein S, Grundinger N, Mons U, Lohner V, Görig T, Schneider S. „Dauernuckler“ oder „Genussdampfer“?
Eine netnographische Analyse selbstberichteter Anzeichen möglicher
Abhängigkeitssymptome in E-Zigaretten-Online-Foren. Das Gesundheitswesen 2022. [DOI: 10.1055/s-0042-1753571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- M Andreas
- Medical Faculty of Mannheim, University of Heidelberg, Center for
Preventive Medicine and Digital Health Baden-Württemberg (CPD-BW),
Mannheim, Deutschland
| | - D Szafran
- Medical Faculty of Mannheim, University of Heidelberg, Center for
Preventive Medicine and Digital Health Baden-Württemberg (CPD-BW),
Mannheim, Deutschland
| | - S Vollstädt-Klein
- Medical Faculty of Mannheim, University of Heidelberg, Department of
Addictive Behavior and Addiction Medicine, Central Institute of Mental Health,
Mannheim, Deutschland
- Medical Faculty of Mannheim, University of Heidelberg, Mannheim Center
for Translational Neurosciences (MCTN), Mannheim, Deutschland
| | - N Grundinger
- Medical Faculty of Mannheim, University of Heidelberg, Department of
Addictive Behavior and Addiction Medicine, Central Institute of Mental Health,
Mannheim, Deutschland
| | - U Mons
- University of Cologne, Medical Faculty and University Hospital Cologne,
Köln, Deutschland
| | - V Lohner
- University of Cologne, Medical Faculty and University Hospital Cologne,
Köln, Deutschland
| | - T Görig
- Friedrich-Alexander-University Erlangen-Nürnberg, Institute for
Medical Informatics, Biometry and Epidemiology, Erlangen,
Deutschland
| | - S Schneider
- Medical Faculty of Mannheim, University of Heidelberg, Center for
Preventive Medicine and Digital Health Baden-Württemberg (CPD-BW),
Mannheim, Deutschland
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Tan H, Nakovics H, Zeng H, Copello A, Akhtar S, Lee AM, Kiefer F, Vollstädt-Klein S. Assessment of automated craving across substances and across cultures: stability-analysis of the Craving Automated Scale (CAS). J Addict Dis 2021; 40:405-414. [PMID: 34967698 DOI: 10.1080/10550887.2021.2015053] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND The transition from hedonic to compulsive use in Substance Use Disorders (SUD) is a critical point in SUD progression and hence relevant for assessment and treatment. To measure the habitual patterns of substance consumption, the Craving Automated Scales (CAS) for alcohol (CAS-A), substances (CAS-S) and cigarette smoking (CAS-CS) were developed and introduced to different countries. In this study, we aimed to investigate the structural stability of CAS across substances and cultures. METHODS This study analyzed the CAS-scores of a sample of 370 participants in Germany, China and the UK, including 262 opioid-users, 65 smokers and 43 alcohol-users. We performed stability analyses to check the stability (i. e. factorial invariance) of factor solutions. Based on confirmed stability of the general factor (gfactor) solution and the calculations rule obtained in the previous validation of CAS-alcohol (CAS-A), the factor structures of CAS-A, CAS-S and CAS-CS were compared. RESULTS The gfactor solutions based on calculations rule shows good stability, with the mean stability coefficients of 0.990 and 0.977 for CAS-S and CAS-CS respectively. The gfactor patterns were similar for CAS-A, CAS-S and CAS-CS, as well as across samples (Germany, China and the UK), with most factor-loadings larger than 0.7. Based on these findings, CAS-S and CAS-CS were also associated with established clinical measures of SUD. CONCLUSIONS Our findings suggest the two-gfactor solution based on a proposed calculation rule has a high stability across substances and cultures. This could be in line with common neurobiological mechanisms underlying habitual substance use. Moreover, comparing CAS with established clinical tools suggests that CAS might assess the automated behavior in substance consumption in a more sophisticated way.
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Affiliation(s)
- H Tan
- Department of Addictive Behaviour and Addiction Medicine, Central Institute of Mental Health, Medical, Faculty of Mannheim, University of Heidelberg, Mannheim, Germany
| | - H Nakovics
- Department of Addictive Behaviour and Addiction Medicine, Central Institute of Mental Health, Medical, Faculty of Mannheim, University of Heidelberg, Mannheim, Germany
| | - H Zeng
- Department of Psychology, Guangzhou University, Guangzhou, China
| | - A Copello
- School of Psychology, University of Birmingham, Birmingham, UK
| | - S Akhtar
- Birmingham and Solihull Mental Health Foundation Trust, Birmingham, UK
| | - A M Lee
- Department of Addictive Behaviour and Addiction Medicine, Central Institute of Mental Health, Medical, Faculty of Mannheim, University of Heidelberg, Mannheim, Germany
| | - F Kiefer
- Department of Addictive Behaviour and Addiction Medicine, Central Institute of Mental Health, Medical, Faculty of Mannheim, University of Heidelberg, Mannheim, Germany.,Feuerlein Center on Translational Addiction Medicine, University of Heidelberg, Heidelberg, Germany
| | - S Vollstädt-Klein
- Department of Addictive Behaviour and Addiction Medicine, Central Institute of Mental Health, Medical, Faculty of Mannheim, University of Heidelberg, Mannheim, Germany.,Mannheim Center for Translational Neurosciences (MCTN), Medical Faculty of Mannheim, University of Heidelberg, Mannheim, Germany
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Bach P, Reinhard I, Bühler S, Vollstädt-Klein S, Kiefer F, Koopmann A. Oxytocin attenuates nucleus accumbens-connectivity during alcohol cue presentation: Evidence from a recent randomized cross-over study. PHARMACOPSYCHIATRY 2020. [DOI: 10.1055/s-0039-3403029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- P Bach
- Zentralinstitut für Seelische Gesundheit Mannheim, Germany
| | - I Reinhard
- Zentralinstitut für Seelische Gesundheit Mannheim, Germany
| | - S Bühler
- Zentralinstitut für Seelische Gesundheit Mannheim, Germany
| | | | - F Kiefer
- Zentralinstitut für Seelische Gesundheit Mannheim, Germany
| | - A Koopmann
- Zentralinstitut für Seelische Gesundheit Mannheim, Germany
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Zois E, Vollstädt-Klein S, Hoffmann S, Reinhard I, Charlet K, Beck A, Jorde A, Kirsch M, Walter H, Heinz A, Kiefer F. Orbitofrontal structural markers of negative affect in alcohol dependence and their associations with heavy relapse-risk at 6 months post-treatment. Eur Psychiatry 2017; 46:16-22. [PMID: 28992531 DOI: 10.1016/j.eurpsy.2017.07.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Revised: 07/25/2017] [Accepted: 07/30/2017] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Alcohol relapse is often occurring to regulate negative affect during withdrawal. On the neurobiological level, alcoholism is associated with gray matter (GM) abnormalities in regions that regulate emotional experience such as the orbitofrontal cortex (OFC). However, no study to our knowledge has investigated the neurobiological unpinning of affect in alcoholism at early withdrawal and the associations of OFC volume with long-term relapse risk. METHODS One hundred and eighty-two participants were included, 95 recently detoxified alcohol dependent patients (ADP) and 87 healthy controls (HC). We measured affective states using the positive and negative affect schedule (PANAS). We collected T1-weighted brain structural images and performed Voxel-based morphometry (VBM). RESULTS Findings revealed GM volume decrease in alcoholics in the prefrontal cortex (including medial OFC), anterior cingulate gyrus, and insula. GM volume in the medial OFC was positively associated with NA in the ADP group. Cox regression analysis predicted that risk to heavy relapse at 6 months increases with decreased GM volume in the medial OFC. CONCLUSIONS Negative affect during alcohol withdrawal was positively associated with OFC volume. What is more, increased GM volume in the OFC also moderated risk to heavy relapse at 6 months. Reduced GM in the OFC poses as risk to recovery from alcohol dependence and provides valuable insights into transient negative affect states during withdrawal that can trigger relapse. Implications exist for therapeutic interventions signifying the OFC as a neurobiological marker to relapse and could explain the inability of ADP to regulate internal negative affective states.
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Affiliation(s)
- E Zois
- Department of addictive behaviour and addiction medicine, central institute of mental health, Mannheim, university of Heidelberg, Mannheim, Germany.
| | - S Vollstädt-Klein
- Department of addictive behaviour and addiction medicine, central institute of mental health, Mannheim, university of Heidelberg, Mannheim, Germany
| | - S Hoffmann
- Department of addictive behaviour and addiction medicine, central institute of mental health, Mannheim, university of Heidelberg, Mannheim, Germany
| | - I Reinhard
- Department of biostatistics, central institute of mental health, Mannheim, university of Heidelberg, Mannheim, Germany
| | - K Charlet
- Department of psychiatry and psychotherapy, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - A Beck
- Department of psychiatry and psychotherapy, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - A Jorde
- Department of addictive behaviour and addiction medicine, central institute of mental health, Mannheim, university of Heidelberg, Mannheim, Germany
| | - M Kirsch
- Department of addictive behaviour and addiction medicine, central institute of mental health, Mannheim, university of Heidelberg, Mannheim, Germany
| | - H Walter
- Department of psychiatry and psychotherapy, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - A Heinz
- Department of psychiatry and psychotherapy, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - F Kiefer
- Department of addictive behaviour and addiction medicine, central institute of mental health, Mannheim, university of Heidelberg, Mannheim, Germany
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Sommer WH, Pfarr S, Vollstädt-Klein S, Hermann D, Weil G, Mann K, Brown M, Hyytiä P, Canals S, Cosa-Linan A, Weber-Fahr W. SY27-2RELAPSE VULNERABILITY AS A BRAIN NETWORK STATE: STUDIES IN HUMANS AND RATS. Alcohol Alcohol 2015. [DOI: 10.1093/alcalc/agv076.110] [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] [Indexed: 11/14/2022] Open
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Weil G, Vollstädt-Klein S, Hermann D, Sommer WH. Funktionale Konnektivität bei Alkoholabhängigkeit: Einfluss von Abstinenz und Naltrexonbehandlung. Suchttherapie 2015. [DOI: 10.1055/s-0035-1557703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Nees F, Witt SH, Dinu-Biringer R, Lourdusamy A, Tzschoppe J, Vollstädt-Klein S, Millenet S, Bach C, Poustka L, Banaschewski T, Barker GJ, Bokde ALW, Bromberg U, Büchel C, Conrod PJ, Frank J, Frouin V, Gallinat J, Garavan H, Gowland P, Heinz A, Ittermann B, Mann K, Martinot JL, Paus T, Pausova Z, Robbins TW, Smolka MN, Rietschel M, Schumann G, Flor H. BDNF Val66Met and reward-related brain function in adolescents: role for early alcohol consumption. Alcohol 2015; 49:103-10. [PMID: 25650137 DOI: 10.1016/j.alcohol.2014.12.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2014] [Revised: 12/22/2014] [Accepted: 12/22/2014] [Indexed: 11/28/2022]
Abstract
Changes in reward processing have been identified as one important pathogenetic mechanism in alcohol addiction. The nonsynonymous single nucleotide polymorphism in the brain-derived neurotrophic factor (BDNF) gene (rs6265/Val66Met) modulates the central nervous system activity of neurotransmitters involved in reward processing such as serotonin, dopamine, and glutamate. It was identified as crucial for alcohol consumption in healthy adults and, in rats, specifically related to the function in the striatum, a region that is commonly involved in reward processing. However, studies in humans on the association of BDNF Val66Met and reward-related brain functions and its role for alcohol consumption, a significant predictor of later alcohol addiction, are missing. Based on an intermediate phenotype approach, we assessed the early orientation toward alcohol and alcohol consumption in 530 healthy adolescents that underwent a monetary incentive delay task during functional magnetic resonance imaging. We found a significantly lower response in the putamen to reward anticipation in adolescent Met carriers with high versus low levels of alcohol consumption. During reward feedback, Met carriers with low putamen reactivity were significantly more likely to orient toward alcohol and to drink alcohol 2 years later. This study indicates a possible effect of BDNF Val66Met on alcohol addiction-related phenotypes in adolescence.
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Affiliation(s)
- F Nees
- Department of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
| | - S H Witt
- Division of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - R Dinu-Biringer
- Department of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany; Department of Clinical Psychology and Psychotherapy, Ruprecht-Karls University Heidelberg, Heidelberg, Germany
| | - A Lourdusamy
- Institute of Psychiatry, King's College London, United Kingdom; MRC Social, Genetic and Developmental Psychiatry (SGDP) Centre, London, United Kingdom
| | - J Tzschoppe
- Department of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - S Vollstädt-Klein
- Department of Addictive Behaviour and Addiction Medicine, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - S Millenet
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - C Bach
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - L Poustka
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - T Banaschewski
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - G J Barker
- Institute of Psychiatry, King's College London, United Kingdom
| | - A L W Bokde
- Institute of Neuroscience and Discipline of Psychiatry, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - U Bromberg
- NeuroImage Nord, Department of Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Germany
| | - C Büchel
- NeuroImage Nord, Department of Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Germany
| | - P J Conrod
- Institute of Psychiatry, King's College London, United Kingdom; Department of Psychiatry, Universite de Montreal, CHU Ste Justine Hospital, Canada
| | - J Frank
- Division of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - V Frouin
- Neurospin, Commissariat à l'Energie Atomique et aux Energies Alternatives, Paris, France
| | - J Gallinat
- Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - H Garavan
- Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland; Department of Psychiatry, University of Vermont, USA; Department of Psychology, University of Vermont, USA
| | - P Gowland
- School of Physics and Astronomy, University of Nottingham, United Kingdom
| | - A Heinz
- Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - B Ittermann
- Physikalisch-Technische Bundesanstalt, Berlin, Germany
| | - K Mann
- Department of Addictive Behaviour and Addiction Medicine, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - J-L Martinot
- INSERM CEA Unit 1000 "Imaging & Psychiatry", Institut National de la Santé et de la Recherche Médicale, University Paris Sud, Orsay, France; AP-HP Department of Adolescent Psychopathology and Medicine, Maison de Solenn, University Paris Descartes, Paris, France
| | - T Paus
- Rotman Research Institute, University of Toronto, Toronto, Canada; Montreal Neurological Institute, McGill University, QC, Canada
| | - Z Pausova
- The Hospital for Sick Children, Department of Physiology and Nutritional Sciences, University of Toronto, Toronto, Canada
| | - T W Robbins
- Behavioural and Clinical Neurosciences Institute, Department of Experimental Psychology, University of Cambridge, United Kingdom
| | - M N Smolka
- Department of Psychiatry and Psychotherapy, Neuroimaging Center, Technische Universitaet Dresden, Dresden, Germany
| | - M Rietschel
- Division of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - G Schumann
- Institute of Psychiatry, King's College London, United Kingdom; MRC Social, Genetic and Developmental Psychiatry (SGDP) Centre, London, United Kingdom
| | - H Flor
- Department of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
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Reinhard I, Leménager T, Fauth-Bühler M, Hermann D, Hoffmann S, Heinz A, Kiefer F, Smolka MN, Wellek S, Mann K, Vollstädt-Klein S. A comparison of region-of-interest measures for extracting whole brain data using survival analysis in alcoholism as an example. J Neurosci Methods 2015; 242:58-64. [PMID: 25593047 DOI: 10.1016/j.jneumeth.2015.01.001] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2014] [Revised: 01/01/2015] [Accepted: 01/03/2015] [Indexed: 12/20/2022]
Abstract
BACKGROUND Aggregation of functional magnetic resonance imaging (fMRI) data in regions-of-interest (ROIs) is required for complex statistical analyses not implemented in standard fMRI software. Different data-aggregation measures assess various aspects of neural activation, including spatial extent and intensity. NEW METHOD In this study, conducted within the framework of the PREDICT study, we compared different aggregation measures for voxel-wise fMRI activations to be used as prognostic factors for relapse in 49 abstinent alcohol-dependent individuals in an outpatient setting using a cue-reactivity task. We compared the importance of the data-aggregation measures as prognostic factors for treatment outcomes by calculating the proportion of explained variation. RESULTS AND COMPARISON WITH EXISTING METHOD(S) Relapse risk was associated with cue-induced brain activation during abstinence in the ventral striatum (VS) and in the orbitofrontal cortex (OFC). While various ROI measures proved appropriate for using fMRI cue-reactivity to predict relapse, on the descriptive level the most "important" prognostic factor was a measure defined as the sum of t-values exceeding an individually defined threshold. Data collected in the VS was superior to that from other regions. CONCLUSIONS In conclusion, it seems that fMRI cue-reactivity, especially in the VS, can be used as prognostic factor for relapse in abstinent alcohol-dependent patients. Our findings suggest that data-aggregation measures that take both spatial extent and intensity of cue-induced brain activation into account make better biomarkers for predicting relapse than measures that consider an activation's spatial extent or intensity alone.
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Affiliation(s)
- I Reinhard
- Department of Biostatistics, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, 68159 Mannheim, Germany
| | - T Leménager
- Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, 68159 Mannheim, Germany
| | - M Fauth-Bühler
- Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, 68159 Mannheim, Germany
| | - D Hermann
- Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, 68159 Mannheim, Germany
| | - S Hoffmann
- Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, 68159 Mannheim, Germany
| | - A Heinz
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Charité Mitte, 10117 Berlin, Germany
| | - F Kiefer
- Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, 68159 Mannheim, Germany
| | - M N Smolka
- Section of Systems Neuroscience, Department of Psychiatry and Psychotherapy, Technische Universität Dresden, 01187 Dresden, Germany
| | - S Wellek
- Department of Biostatistics, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, 68159 Mannheim, Germany
| | - K Mann
- Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, 68159 Mannheim, Germany
| | - S Vollstädt-Klein
- Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, 68159 Mannheim, Germany.
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10
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Nees F, Witt SH, Lourdusamy A, Vollstädt-Klein S, Steiner S, Poustka L, Banaschewski T, Barker GJ, Büchel C, Conrod PJ, Frank J, Gallinat J, Garavan H, Heinz A, Ittermann B, Loth E, Mann K, Artiges E, Paus T, Pausova Z, Smolka MN, Struve M, Schumann G, Rietschel M, Flor H. Genetic risk for nicotine dependence in the cholinergic system and activation of the brain reward system in healthy adolescents. Neuropsychopharmacology 2013; 38:2081-9. [PMID: 23689675 PMCID: PMC3773681 DOI: 10.1038/npp.2013.131] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2012] [Revised: 04/23/2013] [Accepted: 04/25/2013] [Indexed: 01/30/2023]
Abstract
Genetic variation in a genomic region on chromosome 15q25.1, which encodes the alpha5, alpha3, and beta4 subunits of the cholinergic nicotinic receptor genes, confers risk to smoking and nicotine dependence (ND). Neural reward-related responses have previously been identified as important factors in the development of drug dependence involving ND. Applying an imaging genetics approach in two cohorts (N=487; N=478) of healthy non-smoking adolescents, we aimed to elucidate the impact of genome-wide significant smoking-associated variants in the CHRNA5-CHRNA3-CHRNB4 gene cluster on reward-related neural responses in central regions such as the striatum, orbitofrontal and anterior cingulate cortex (ACC), and personality traits related to addiction. In both samples, carriers of the rs578776 GG compared with AG/AA genotype showed a significantly lower neural response to reward outcomes in the right ventral and dorsal ACC but not the striatum or the orbitofrontal cortex. Rs578776 was unrelated to neural reward anticipation or reward magnitude. Significantly higher scores of anxiety sensitivity in GG compared with AG/AA carriers were found only in sample 1. Associations with other personality traits were not observed. Our findings suggest that the rs578776 risk variant influences susceptibility to ND by dampening the response of the ACC to reward feedback, without recruiting the striatum or orbitofrontal cortex during feedback or anticipation. Thus, it seems to have a major role in the processing of and behavioral adaptation to changing reward outcomes.
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Affiliation(s)
- F Nees
- Department of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany,Department of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, J 5, D-68159 Mannheim, Germany, Tel: +49 621 1703 6306, Fax: +49 621 1703 6305, E-mail:
| | - S H Witt
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - A Lourdusamy
- Institute of Psychiatry, King's College, London, UK
| | - S Vollstädt-Klein
- Department of Addictive Behaviour and Addiction Medicine, Central Institute of Mental Health, Mannheim, Germany
| | - S Steiner
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty, Heidelberg University, Mannheim, Germany
| | - L Poustka
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty, Heidelberg University, Mannheim, Germany
| | - T Banaschewski
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty, Heidelberg University, Mannheim, Germany
| | - G J Barker
- Institute of Psychiatry, King's College, London, UK
| | - C Büchel
- NeuroImage Nord, Department of Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - P J Conrod
- Institute of Psychiatry, King's College, London, UK,Department of Psychiatry, Université de Montreal, CHU Ste Justine Hospital, Montréal, QC, Canada
| | - J Frank
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - J Gallinat
- Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité—Universitätsmedizin Berlin, Berlin, Germany
| | - H Garavan
- Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland,Departments of Psychiatry and Psychology, University of Vermont, Burlington, VT, USA
| | - A Heinz
- Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité—Universitätsmedizin Berlin, Berlin, Germany
| | - B Ittermann
- Physikalisch-Technische Bundesanstalt, Berlin, Germany
| | - E Loth
- Institute of Psychiatry, King's College, London, UK
| | - K Mann
- Department of Addictive Behaviour and Addiction Medicine, Central Institute of Mental Health, Mannheim, Germany
| | - E Artiges
- INSERM CEA Unit 1000 ‘Imaging & Psychiatry', Institut National de la Santé et de la Recherche Médicale, University Paris Sud, Orsay, and AP-HP Department of Adolescent Psychopathology and Medicine, Maison de Solenn, University Paris Descartes, Paris, France
| | - T Paus
- Rotman Research Institute, University of Toronto, Toronto, ON, Canada,School of Psychology, University of Nottingham, Nottingham, UK,Montreal Neurological Institute, McGill University, Montreal, QC, Canada
| | - Z Pausova
- The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - M N Smolka
- Neuroimaging Center and Department of Psychiatry, Technische Universität Dresden, Dresden, Germany
| | - M Struve
- Department of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - G Schumann
- Institute of Psychiatry, King's College, London, UK
| | - M Rietschel
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - H Flor
- Department of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
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Grimm O, Jacob MJ, Kroemer NB, Krebs L, Vollstädt-Klein S, Kobiella A, Wolfensteller U, Smolka MN. The personality trait self-directedness predicts the amygdala's reaction to appetizing cues in fMRI. Appetite 2012; 58:1023-9. [PMID: 22381514 DOI: 10.1016/j.appet.2012.02.007] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2011] [Revised: 01/25/2012] [Accepted: 02/08/2012] [Indexed: 12/01/2022]
Abstract
Personality and neural response to food cues in various mesolimbic brain structures have been linked to eating disorders. We investigated the question of whether personality traits in healthy individuals correlate with the brain activation induced on confrontation with appetizing visual stimuli. Personality was assessed in 27 normal-weight participants (14 women, mean age=26.0, SD=3.3 years) with the Temperament and Character Inventory (TCI). After an overnight fast, participants viewed blocks of pictures, half containing appetizing food and the other half showing scrambled pictures as control. After each block, participants rated their appetite. Brain activation was measured using a 3T MR scanner. Food compared to control stimuli elicited a significantly higher appetite rating, as well as strong activation in the ventral and dorsal visual stream, the fusiform gyrus and consecutive limbic centres such as the parahippocampal gyrus, the amygdala, the thalamus, the insula, the ventral striatum and the orbitofrontal cortex. In a region-of-interest analysis, the TCI trait self-directedness was negatively correlated with mean blood oxygenation level dependent (BOLD) signal change in the right amygdala (r=-.43, p=.025). Ultimately, amygdala reactivity might provide a risk factor for the development of eating disorders.
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Affiliation(s)
- O Grimm
- Department of Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim/University Heidelberg, Mannheim, Germany
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12
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Grimm O, Vollstädt-Klein S, Krebs L, Zink M, Smolka MN. Reduced striatal activation during reward anticipation due to appetite-provoking cues in chronic schizophrenia: a fMRI study. Schizophr Res 2012; 134:151-7. [PMID: 22209236 DOI: 10.1016/j.schres.2011.11.027] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2011] [Revised: 11/21/2011] [Accepted: 11/27/2011] [Indexed: 11/26/2022]
Abstract
The occurrence of weight gain in schizophrenia (SZ) has profound clinical impact and interacts with antipsychotic medication, life style and disease severity. The functional neuroanatomy underlying altered nutritional behavior is unraveled, but dysregulated reward anticipation might be one of the involved neuronal mechanisms. The striatum, a core region of the reward network and salience attribution, was previously shown to regulate appetite perception and eating behavior. We studied patients suffering from chronic schizophrenia with a stable medication in comparison to age and gender matched healthy adults. Every subject had to undergo a 6h fasting period before a newly developed, appetite-provoking fMRI task was applied. Subjects saw visual stimuli of appetitive food items in a 3Tesla scanner. In healthy controls food images elicited stronger activation in the striatum compared to SZ patients. When adjusting a ROI-based striatal activation for medication and weight, the group difference remained still significant. This points an effect of illness independent of antipsychotic medication. These data underscore the involvement of the striatum into salience attribution, reward anticipation and the neuronal pathways leading to altered eating behavior and weight gain in schizophrenia.
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Affiliation(s)
- O Grimm
- Department of Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim/University Heidelberg, Mannheim, Germany
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13
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Loeber S, Grosshans M, Korucuoglu O, Vollmert C, Vollstädt-Klein S, Schneider S, Wiers RW, Mann K, Kiefer F. Impairment of inhibitory control in response to food-associated cues and attentional bias of obese participants and normal-weight controls. Int J Obes (Lond) 2011; 36:1334-9. [PMID: 21986703 DOI: 10.1038/ijo.2011.184] [Citation(s) in RCA: 111] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Starting from a model of impaired response inhibition and salience attribution for addictive behaviour we investigated whether obese participants show a greater impairment of inhibitory control in response to food-associated cues compared with neutral stimuli and whether this is seen in normal-weight control subjects. In addition, we questioned whether an attentional bias towards food-associated cues can be observed in an early stage of information processing. DESIGN Control-group study including the administration of behavioural tasks (that is, go/no-go task with food-associated and neutral words, visual dot probe task with food-associated and neutral pictures) and self-reported measures of eating behaviour and impulsivity. RESULTS Although self-reported measures indicated disinhibition of eating behaviour of obese patients, we found that food-associated stimuli induced an impairment of inhibitory control in both obese participants as well as normal-weight controls. Results from the visual dot-probe task indicated that food-associated cues did not modulate attention allocation in a very early stage of information processing, which suggests that the incentive salience of food-associated stimuli might be lower than that of drug-associated cues. CONCLUSION These findings are not in line with hypotheses derived from models of addictive behaviour and call into question that an impairment of inhibitory control in response to food-associated cues and salience attribution might be at the core of obesity. Future studies using larger sample sizes and refined experimental procedures are warranted to further investigate mechanisms controlling food intake in obesity.
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Affiliation(s)
- S Loeber
- Department of Addictive Behaviour and Addiction Medicine, Central Institute of Mental Health, Heidelberg University, Mannheim, Germany.
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Smolka MN, Kobiella A, Ulshöfer DE, Vollmert C, Vollstädt-Klein S. Nicotine enhances processing of aversive stimuli in non-smokers. Neuroimage 2009. [DOI: 10.1016/s1053-8119(09)71997-4] [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] [Indexed: 10/20/2022] Open
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