‘Just say no’ was the slogan of the US anti-drug campaign in the 1980s that still resonates with many people today. We now know that the ‘War on Drugs’ has failed, not at least because drug-addicted individuals simply cannot stop using, even if they want to, nor are they deterred from using by the devastating consequences of continued drug use. ‘Just say no’ places all responsibility on the individual without acknowledging the available neuroscientific evidence that points towards impairments in regulatory control in addiction. A panel of four European researchers will present latest neuroscientific advances in addiction research, elucidating the neurobiological underpinning of addictive behaviours and outlining the potential avenues for novel treatment approaches. Maartje Luijten will present data collected at the first time point of a longitudinal study in adolescent smokers to identify brain markers that predict the development of addiction and may help to define neurobiological vulnerability factors that characterise at-risk individuals. Karen Ersche will highlight in adults with cocaine addiction, how regular cocaine use interacts with vulnerability factors, thereby facilitating the breakdown of regulatory control, which makes cocaine addiction particularly difficult to treat. Anne Beck will examine neurobiological risk factors from a neurodevelopmental perspective, which lay the foundation for an increased susceptibility for the effects of alcohol, paving the way for later relapse during adulthood. Using computational modelling and neuroimaging, she aims to predict treatment outcome in alcohol-addicted adults. Sabine Vollstädt-Klein will report the role of stress in sustained alcohol drinking from pilot data acquired in a bar lab experiment after exposing patients to an acute psychosocial stress. Both stress- and alcohol cue-related physiological markers (cortisol, body-sensor measures and fMRI) and measures of craving were assessed.
Identifying risk markers for the transition of experimental tobacco use into addiction
Maartje Luijten, Nijmegen (Netherlands)
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Maartje Luijten, Nijmegen (Netherlands)
It is well known that addicted individuals are characterized by reduced inhibitory control and strong responses to substance related cues. The developmental pathways of these characteristics are less well understood. In this talk I will present data from a large sample of adolescents (N=100) in the early stages of experimenting with smoking, and non-smoking controls (N=51). All participants performed a Go-NoGo inhibitory control task and viewed smoking cues during fMRI scanning. Besides comparing these two groups, low-and high risk groups for the development of nicotine dependence were identified by means of a cluster analysis based on psychosocial risk factors independent of smoking behaviour. By doing so we were able to compare the, theoretically, most at-risk individuals with those at lower risk to develop nicotine dependence, as not all adolescents who try smoking will progress into dependence. Also, some of the non-smoking adolescents may be at risk to develop nicotine dependence based on psychosocial risk factors, but have not yet initiated smoking. All analyses were pre-registered using open science framework https://osf.io/wz6ve/. Results showed reduced brain activation in experimentally smoking adolescents in the right inferior frontal gyrus and the right superior parietal lobe during inhibitory control. No group differences were found for smoking cue-reactivity. Importantly, no differences were found between high- and low-risk groups on any of the inhibitory control and smoking cue-reactivity measures. It can therefore be suggested that experimenting with smoking, independently of risk profiles for the development of dependence, is associated with reduced brain activation in the inhibitory control network. Longitudinal analyses based on follow-up data collected in the current project will be performed to find out whether these effects will be predictive of the development of nicotine dependence.
Brain markers for predicting addiction trajectories in adolescence and adulthood
Anne Beck, Berlin (Germany)
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Anne Beck, Berlin (Germany)
Addiction is characterized by a gradual shit from initially goal-directed drug use mediated by the reinforcing effects of the drug to an increasing loss of control over drug intake, which becomes habitual and even compulsive. This habitual drug intake is e.g. triggered by drug-associated cues. In chronic drug users, conditioned drug cues gain incentive salience, whereas alternative reinforcers become less important. Here, neurobiological as well as neuropsychological factors for the development of addictive disorders as well as for relapse risk in addiction are crucial with respect to prediction of treatment outcome and possible prevention strategies.
Computational models based on longitudinal and cross-sectional structural and functional brain images to predict future relapse of alcohol-dependent patients and to predict heavy drinking during adolescence/ development of alcohol use disorders later in life are in focus.
Heavy drinking seems to be associated with reduced gray matter volume in various brain regions in young adults, especially in females. Moreover, in both genders, impulsivity and facets of novelty seeking at adolescence and early adulthood, are risk factors for heavy drinking at the age of 19. This knowledge may help to better target counseling and prevention programs for adolescents and young adults as well as to reduce the risk of developing alcohol use disorders later in adulthood.
In the prediction of relapse in alcohol-dependent patients, important individual predictors seem to be functional brain activation features derived from alcohol-associated cue reactivity pardigm in midbrain and striatum, as well as gray matter volume features in prefrontal cortex. This approach may help to identify different risk groups to finally provide specific interventions.
Multimodal approaches to investigate the role of stress in sustained alcohol use
Sabine Vollstädt-Klein, Mannheim (Germany)
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Sabine Vollstädt-Klein, Mannheim (Germany)
Multimodal approaches to investigate the role of stress in sustained alcohol use
S Vollstädt-Klein, F Kiefer
Klinik für Abhängiges Verhalten und Suchtmedizin, Zentralinstitut für Seelische Gesundheit, Medizinische Fakultät Mannheim / Universität Heidelberg, Mannheim
Einleitung:
In alcohol use disorder (AUD) both alcohol cues and stress represent potential triggers for craving and subsequent relapse. In this ongoing study a setup of stress-related body sensors as well as psychological and neurobiological measures are used to assess interactions between acute psychological stress exposure and alcohol cue-exposure regarding their effects on alcohol craving and related markers.
Methode:
A lab experiment imitating a naturalistic setting of relapse in non-treatment seeking AUD participants is conducted. After a psychosocial stress situation participants of the experimental group undergo an alcohol exposure in a bar environment (Bar Lab). The control group also conducts the Bar Lab alcohol exposure but without preceding stress exposure. During the laboratory assessment physiological parameters (electrodermal activity, heart rate) are acquired with portable sensors. Further craving, blood pressure, voice stress analysis (VSA) parameters and cortisol in saliva are measured at distinct time points. Right after this assessment, neuropsychobiological examinations are conducted to assess attentional bias to alcohol-cues and neural cue-reactivity using functional magnetic resonance imaging.
Ergebnisse:
In this ongoing study, data of 9 non-treatment seeking AUD participants are already acquired. Results of a larger sample will be presented in this talk. We hypothesize that psychosocial stress affects alcohol cue-induced craving, attentional bias and neural cue-reactivity compared to the control condition. Further, we expect data acquired with portable sensors and with VSA to correlate with reference measurements (e.g. cortisol in saliva, heart-rate variability, and systolic blo