Affiliation:
1. Department of Psychiatry Columbia University Irving Medical Center/New York State Psychiatric Institute New York New York USA
2. Department of Psychology Columbia University New York New York USA
3. Department of Psychiatry Donald and Barbara Zucker School of Medicine at Hofstra University/Northwell Health Hempstead New York USA
Abstract
AbstractBackgroundCognitive behavioral therapy (CBT) is an effective treatment for alcohol use disorder (AUD). We hypothesized that the dorsolateral prefrontal cortex (DLPFC), a region implicated in cognitive control and goal‐directed behavior, plays a role in behavior change during CBT by facilitating the regulation of craving (ROC).MethodsTreatment‐seeking participants with AUD (N = 22) underwent functional magnetic resonance imaging (fMRI) scanning both before and after a 12‐week, single‐arm trial of CBT, using an ROC task that was previously shown to engage the DLPFC.ResultsWe found that both the percentage of heavy drinking days (PHDD) and the overall self‐reported alcohol craving measured during the ROC task were significantly reduced from pre‐ to post‐CBT. However, we did not find significant changes over time in either the ability to regulate craving or regulation‐related activity in any brain region. We found a significant 3‐way interaction between the effects of cue‐induced craving, cue‐induced brain activity and timepoint of assessment (pre‐ or post‐CBT) on PHDD in the left DLPFC. Follow‐up analysis showed that cue‐induced craving was associated with cue‐induced activity in the left DLPFC among participants who ceased heavy drinking during CBT, both at pre‐CBT and post‐CBT timepoints. No such associations were present at either timepoint among participants who continued to drink heavily.ConclusionsThese results suggest that patients in whom DLPFC functioning is more strongly related to cue‐induced craving may preferentially respond to CBT.
Funder
National Institute on Alcohol Abuse and Alcoholism
National Institute on Drug Abuse
National Institute of Mental Health
National Institutes of Health
Cited by
2 articles.
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