Neural Correlates of Alcohol Use Disorder Severity among Non-Treatment Seeking Heavy Drinkers: An Examination of the Incentive Salience and Negative Emotionality Domains of the Alcohol and Addiction Research Domain Criteria.

Abstract

BACKGROUND\nThe Alcohol and Addiction Research Domain Criteria (AARDoC) proposes that alcohol use disorder is associated with neural dysfunction in three primary domains: incentive salience, negative emotionality, and executive function. Prior studies in heavy drinking samples have examined brain activation changes associated with alcohol and negative affect cues, representing the incentive salience and negative emotionality domains, respectively; yet studies examining such cue-induced changes in functional connectivity are relatively sparse.\n\n\nMETHODS\nNon-treatment seeking heavy drinking adults (N=149, 56.0% male, 48.6% non-white, average age 34.8 years (SD=10.0)) underwent functional magnetic resonance imaging during presentation of alcohol, negative, and neutral pictures. We focused on functional connectivity (FC) changes involving the nucleus accumbens and amygdala in addition to activation and FC correlations with self-reported AUD severity.\n\n\nRESULTS\nFor alcohol cues versus neutral cues, we observed accumbens FC changes in the cerebellum and prefrontal cortex, and amygdala FC changes with occipital, parietal, and hippocampal regions. AUD severity positively correlated with activation in the cerebellum (p<0.05), accumbens FC in the cingulate gyri, somatosensory gyri, and cerebellum (p<0.05), and with amygdala FC in the prefrontal cortex and inferior parietal lobule (p<0.05) during alcohol cues. For negative cues versus neutral cues, we observed accumbens FC changes in the lateral temporal, occipital, and parietal regions, and amygdala FC changes in the fusiform and lingual gyri (p<0.05).\n\n\nCONCLUSIONS\nThe present findings provide empirical support for the AARDoC domains of incentive salience and negative emotionality and indicate that AUD severity is associated with salience and response control for reward cues. When co-varying for differences in non-alcohol substance use and mood disorder diagnoses, AUD severity was also found to be associated with emotional reactivity for negative cues.