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Neuropsychopharmacology. 2014 Feb;39(3):688-97. doi: 10.1038/npp.2013.252. Epub 2013 Sep 20.

Neural correlates of alcohol-approach bias in alcohol addiction: the spirit is willing but the flesh is weak for spirits.

Author information

  • 11] Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Berlin, Germany [2] Berlin School of Mind and Brain, Humboldt University Berlin, Berlin, Germany [3] Department of Education and Psychology, Free University Berlin, Berlin, Germany.
  • 21] Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Berlin, Germany [2] Berlin School of Mind and Brain, Humboldt University Berlin, Berlin, Germany [3] Department of Psychology, Humboldt University Berlin, Berlin, Germany.
  • 3Department of Economics, University of Zürich, Zürich, Switzerland.
  • 4Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Berlin, Germany.
  • 51] Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Berlin, Germany [2] Berlin School of Mind and Brain, Humboldt University Berlin, Berlin, Germany.
  • 61] Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Berlin, Germany [2] Berlin School of Mind and Brain, Humboldt University Berlin, Berlin, Germany [3] Berlin Center for Advanced Neuroimaging, Charité - Universitätsmedizin Berlin, Berlin, Germany.
  • 71] Salus Klinik, Lindow, Germany [2] Department of Clinical Psychology, Chemnitz University of Technology, Chemnitz, Germany.
  • 8Addiction, Development and Psychopathology (ADAPT) Lab, Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands.

Abstract

Behavioral studies have shown an alcohol-approach bias in alcohol-dependent patients: the automatic tendency to faster approach than avoid alcohol compared with neutral cues, which has been associated with craving and relapse. Although this is a well-studied psychological phenomenon, little is known about the brain processes underlying automatic action tendencies in addiction. We examined 20 alcohol-dependent patients and 17 healthy controls with functional magnetic resonance imaging (fMRI), while performing an implicit approach-avoidance task. Participants pushed and pulled pictorial cues of alcohol and soft-drink beverages, according to a content-irrelevant feature of the cue (landscape/portrait). The critical fMRI contrast regarding the alcohol-approach bias was defined as (approach alcohol>avoid alcohol)>(approach soft drink>avoid soft drink). This was reversed for the avoid-alcohol contrast: (avoid alcohol>approach alcohol)>(avoid soft drink>approach soft drink). In comparison with healthy controls, alcohol-dependent patients had stronger behavioral approach tendencies for alcohol cues than for soft-drink cues. In the approach, alcohol fMRI contrast patients showed larger blood-oxygen-level-dependent responses in the nucleus accumbens and medial prefrontal cortex, regions involved in reward and motivational processing. In alcohol-dependent patients, alcohol-craving scores were positively correlated with activity in the amygdala for the approach-alcohol contrast. The dorsolateral prefrontal cortex was not activated in the avoid-alcohol contrast in patients vs controls. Our data suggest that brain regions that have a key role in reward and motivation are associated with the automatic alcohol-approach bias in alcohol-dependent patients.

PMID:
24060832
[PubMed - indexed for MEDLINE]
PMCID:
PMC3895246
[Available on 2015/2/1]
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