Clinical Trial Details
— Status: Recruiting
Administrative data
| NCT number |
NCT05843435 |
| Other study ID # |
2023-00736 |
| Secondary ID |
|
| Status |
Recruiting |
| Phase |
|
| First received |
|
| Last updated |
|
| Start date |
May 1, 2024 |
| Est. completion date |
December 2024 |
Study information
| Verified date |
May 2024 |
| Source |
University of Bern |
| Contact |
Matthias Grieder, PhD |
| Phone |
+41319328351 |
| Email |
matthias.grieder[@]upd.unibe.ch |
| Is FDA regulated |
No |
| Health authority |
|
| Study type |
Observational
|
Clinical Trial Summary
Research about patients with alcohol use disorder has shown that task-related brain
activation patterns as well as resting-state connectivity (measured with functional magnetic
resonance imaging) change with clinical parameters such as the extent of craving and duration
of abstinence during treatment. These brain activation alterations are related to treatment
success. Although an imbalance between increased cue-reactivity and impaired counteracting
inhibitory control processes are at the core of most neuropsychological conceptualizations of
alcohol use disorder, the direct interaction between these two processes has not yet been
investigated. Therefore, the investigators aim to study patients with alcohol use disorder in
an ultra-high-field 7 Tesla magnetic resonance imaging scanner to identify fine-grained
activation and connectivity patterns. The investigators would like to improve the knowledge
of the interplay between the brain networks for inhibition and cue-reactivity, as well as to
explore its influence on craving and treatment success. The investigators hypothesize that a
more pronounced negative relationship between increased cue-reactivity and reduced inhibitory
control processes in the brain is linked to higher craving and worse relapse probability.
Description:
Even if an imbalance between enhanced cue-reactivity and impaired opposing control processes
is at the center of most neuroscientific conceptualizations of alcohol use disorder (AUD),
these two processes are still rarely investigated in direct interaction.
Attempting to target both processes in one design, initial studies reported enhanced brain
activation in anterior cingulate cortex (ACC) and ventrolateral prefrontal cortex (vlPFC),
when control processes had to be carried out in the context of alcohol-related cues, and
linked this altered brain activation to relapse risk. Hence, the proposed study will take
advantage of the higher spatial resolution and signal-to-noise ratio of a 7 Tesla fMRI
scanner to investigate more subtle effects and the involvement of subregions of vlPFC and ACC
during alcohol-related inhibition.
Of special interest, particularly when it comes to explaining an imbalance between brain
systems related to cue-reactivity and inhibitory control, are concurrent measures of
functional brain connectivity. Aberrant resting-state functional connectivity in networks
involved in reward prediction, motivation, salience attribution and executive control have
been reported in AUD. Also, altered task-related connectivity was observed during
cue-reactivity as well as during executive control. However, functional connectivity measures
during a task combining both aspects are still missing. Therefore, this study examines the
mutual interplay between cue-responsive regions and opposing inhibitory control networks. To
this aim, task-related functional connectivity are measured in a specifically tailored
experimental design allowing for the assessment of effects related to cue-reactivity,
inhibition, as well as their interaction.
Besides, this study assesses whether possible interaction effects of task-related functional
connectivity between cue-reactivity and inhibitory control vary with craving, change with
prolonged abstinence or predicts drinking outcome.
Taken together, this study will deepen the understanding of the interplay between neuronal
networks central to AUD, cue-reactivity and inhibitory control. The (im)balance between these
processes is crucial for recently abstinent patients striving to control drinking habits and
urges in an environment infused with alcohol-related cues. As such, markers capturing the
interaction between these processes are of high conceptual and clinical relevance and might
pave the way towards a potential biomarker indicating enhanced relapse risk.
