Cognitive Control Network Function in Alcohol Use Disorder Before and During Treatment With Lorazepam

Abstract

Individuals with alcohol use disorders (AUDs) have deficits in cognitive control, but how they change with treatment is unclear. Seven patients with AUD and anxiety from an open-label trial of disulfiram plus lorazepam performed a multisensory Stroop task during fMRI (both pre and post initiation of treatment), and were compared to nine healthy controls (HCs) (n = 16; Albuquerque, NM; years 2009–2012). Evoked BOLD signal and resting state functional connectivity were compared (HC vs. AUD; Scan 1 vs. Scan 2). AUD demonstrated hyperactivity and altered connectivity in the cognitive control network compared to HC, but treatment did not normalize function.

Keywords :

• alcohol use disorder
• alcohol dependence
• fMRI
• connectivity
• cognitive control
• Stroop
• lorazepam
• benzodiazepine
• treatment

THE AUTHORS

Claire E. Wilcox, MD, is an Assistant Professor at the University of New Mexico in the Department of Psychiatry. She is board certified in both general psychiatry and addiction psychiatry, and is an attending in the dual diagnosis clinic. Her main research interests are the neural circuitry of decision making in substance use disorders, behavioral and pharmacological treatments for substance use disorders, and the use of functional MRI to predict treatment outcomes and to define mechanisms of effect during treatment of substance use disorders.

Andrew R. Mayer, PhD, is an Associate Professor of Translational Neuroscience, The Mind Research Network and an Adjunct Assistant Professor of Neurology and Psychology, University of New Mexico Health Science Center. Dr. Mayer's research systematically examines how the brain uses auditory and visual information dependent on task demands. For example, auditory signals excel at producing rapid bottom-up shifts of attention (orienting responses) whereas the visual modality is superior for making fine-grain discriminations about object location and type. He also examines how the brain processes complementary versus conflicting (selective attention) auditory and visual information. Our work suggests that unisensory cortex can be up- (increased signal) or down- (decreased signal) regulated during bimodal stimulation during demanding attentional tasks.

Michael Bogenschutz, MD, is a Professor at the University of New Mexico in the Department of Psychiatry. He is board certified in both general psychiatry and addiction psychiatry, and is an attending in the dual diagnosis clinic. He is also the Vice Chair for Addictions and Clinical Research in Psychiatry. His main research interests are behavioral and pharmacologic treatments for drug and alcohol dependence, clinical trials, co-occurring psychiatric disorders, mutual help, and development of clinical and educational programs in addiction psychiatry.

Josef Ling, B.A., has worked for 10 years as an imaging analyst and bioinformatics software engineer at the MIND Research Network (MRN). Mr. Ling worked for a decade as software engineer before joining the Mind Research Network.

Charlene Dekonenko, BA, is a fourth-year medical student at the University of New Mexico School of Medicine. She received her undergraduate degree in Biology at St. Mary's University in San Antonio, Texas in 2004. As an undergraduate, she worked as a laboratory technician in an HIV/AIDS epidemiology lab at the University of Texas at San Antonio Health Science Center. She then moved to New Mexico in 2004 where she continued research as a research assistant in the Department of Infectious Disease at the University of New Mexico until entering medical school in 2010. Her current research involves work within the Department of Psychiatry and the Department of Neurology at the University of New Mexico.

Heather Cumbo, MD, is a resident in psychiatry at the University of New Mexico.

Notice of Correction:

Middle initials have been added to the first two authors on the paper and the correspondence e-mail has been updated since the original online publication of October 7, 2014.