Computational Psychiatry & Decision-making

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  • Neural correlates of instrumental responding in the context of alcohol-related cues index disorder severity and risk
  • Schad DJ*, Garbusow M*, Friedel E, Sommer C, Sebold M, Hägele M, Bernhardt N, Nebe S, Kuitunen-Paul S, Liu S, Eichmann U, Beck A, Wittchen H-U, Walter H, Sterzer P, Zimmermann US, Smolka MN, Schlagenhauf F*, Huys QJ*, Heinz A*, Rapp MA*
  • Eur. Arch. Psychiatry Clin. Neurosci. (2017). In Press.
  • The influence of Pavlovian conditioned stimuli on ongoing behavior may contribute to explaining how alcohol cues stimulate drug seeking and intake. Using a Pavlovian-instrumental transfer (PIT) task, we investigated the effects of alcohol-related cues on approach behavior (i.e., instrumental response behavior) and its neural correlates, and related both to relapse after detoxification in alcohol-dependent patients. Thirty-one recently detoxified alcohol-dependent patients and 24 healthy controls underwent instrumental training where approach or non-approach towards initially neutral stimuli was reinforced by monetary incentives. Approach behavior was tested during extinction with either alcohol-related or neutral stimuli (as Pavlovian cues) presented in the background during functional magnetic resonance imaging (fMRI). Patients were subsequently followed up for six months. We observed that alcohol-related background stimuli inhibited approach behavior in detoxified alcohol-dependent patients (t=-3.86, p<.001) but not in healthy controls (t=-0.92, p=.36). This behavioral inhibition was associated with neural activation in the nucleus accumbens (NAcc) (t(30)=2.06, p<.05). Interestingly, both effects were only present in subsequent abstainers but not relapsers and in those with mild but not severe dependence. Our data show that alcohol-related cues can acquire inhibitory behavioral features typical of aversive stimuli despite being accompanied by a stronger NAcc activation, suggesting salience attribution. The fact that these findings are restricted to abstinence and milder illness suggests that they may be potential resilience factors. Clinical trial: LeAD study,, NCT01679145