Anxiety during abstinence from alcohol: A systematic review of rodent and human evidence for the anterior insula's role in the abstinence network.

Autor: Flook EA; Vanderbilt Center for Addiction Research, Vanderbilt University School of Medicine, Nashville, TN, USA.; Vanderbilt Brain Institute, Vanderbilt University School of Medicine, Nashville, TN, USA.; Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA., Luchsinger JR; Vanderbilt Center for Addiction Research, Vanderbilt University School of Medicine, Nashville, TN, USA.; Vanderbilt Brain Institute, Vanderbilt University School of Medicine, Nashville, TN, USA.; Vanderbilt J.F. Kennedy Center for Research on Human Development, Vanderbilt University School of Medicine, Nashville, TN, USA., Silveri MM; Neurodevelopmental Laboratory on Addictions and Mental Health, Brain Imaging Center, McLean Hospital, Belmont, MA, USA.; Department of Psychiatry, Harvard Medical School, Boston, MA, USA., Winder DG; Vanderbilt Center for Addiction Research, Vanderbilt University School of Medicine, Nashville, TN, USA.; Vanderbilt Brain Institute, Vanderbilt University School of Medicine, Nashville, TN, USA.; Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA.; Vanderbilt J.F. Kennedy Center for Research on Human Development, Vanderbilt University School of Medicine, Nashville, TN, USA.; Department of Molecular Physiology and Biophysics, Vanderbilt University School of Medicine, Nashville, TN, USA., Benningfield MM; Vanderbilt Center for Addiction Research, Vanderbilt University School of Medicine, Nashville, TN, USA.; Vanderbilt Brain Institute, Vanderbilt University School of Medicine, Nashville, TN, USA.; Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA., Blackford JU; Vanderbilt Center for Addiction Research, Vanderbilt University School of Medicine, Nashville, TN, USA.; Vanderbilt Brain Institute, Vanderbilt University School of Medicine, Nashville, TN, USA.; Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA.; Vanderbilt J.F. Kennedy Center for Research on Human Development, Vanderbilt University School of Medicine, Nashville, TN, USA.; Research Health Scientist, Research and Development, Department of Veterans Affairs Medical Center, Nashville, TN, USA.
Jazyk: angličtina
Zdroj: Addiction biology [Addict Biol] 2021 Mar; Vol. 26 (2), pp. e12861. Date of Electronic Publication: 2020 Jan 28.
DOI: 10.1111/adb.12861
Abstrakt: Alcohol Use Disorder (AUD) is a chronic, relapsing disease that impacts almost a third of Americans. Despite effective treatments for attaining sobriety, the majority of patients relapse within a year, making relapse a substantial barrier to long-term treatment success. A major factor contributing to relapse is heightened negative affect that results from the combination of abstinence-related increases in stress-reactivity and decreases in reward sensitivity. Substantial research has contributed to the understanding of reward-related changes in AUD. However, less is known about anxiety during abstinence, a critical component of understanding addiction as anxiety during abstinence can trigger relapse. Most of what we know about abstinence-related negative affect comes from rodent studies which have identified key brain regions responsible for abstinence-related behaviors. This abstinence network is composed of brain regions that make up the extended amygdala: the nucleus accumbens (NAcc), the central nucleus of the amygdala (CeA), and the bed nucleus of the stria terminalis (BNST). More recently, emerging evidence from rodent and human studies suggests a fourth brain region, the anterior insula, might be part of the abstinence network. Here, we review current rodent and human literature on the extended amygdala's role in alcohol abstinence and anxiety, present evidence for the anterior insula's role in the abstinence network, and provide future directions for research to further elucidate the neural underpinnings of abstinence in humans. A better understanding of the abstinence network is critical toward understanding and possibly preventing relapse in AUD.
(© 2020 Society for the Study of Addiction.)
Databáze: MEDLINE