Alterations in connectivity of the bed nucleus of the stria terminalis during early abstinence in individuals with alcohol use disorder. (8th April 2021)

• Record Type: Journal Article
• Authors: Flook, Elizabeth A.; Feola, Brandee; Benningfield, Margaret M.; Silveri, Marisa M.; Winder, Danny G.; Blackford, Jennifer Urbano
• Is Part Of: Alcoholism. Volume 45:Number 5(2021)
• Page Start: 1028
• Page End: 1038
• Publication Date: 2021-04-08
• Subjects: abstinence -- alcohol use disorder -- bed nucleus of the stria terminalis -- diffusion tensor imaging -- structural connectivity; Alcoholism -- Periodicals; Alcoholism -- Periodicals; Alcoolisme; Electronic journals; Périodique électronique (Descripteur de forme); Ressource Internet (Descripteur de forme); 616.861005
• DOI: 10.1111/acer.14596
• Languages: English
• ISSNs: 0145-6008

Abstract

Abstract: Background: For individuals with Alcohol Use Disorder (AUD), long‐term recovery is difficult in part due to symptoms of anxiety that occur during early abstinence and can trigger relapse. Research in rodent models of AUD has identified the bed nucleus of the stria terminalis (BNST), a small, sexually dimorphic, subcortical region, as critical for regulating anxiety‐like behaviors during abstinence, particularly in female mice. Furthermore, prolonged alcohol use and subsequent abstinence alter BNST afferent and efferent connections to other brain regions. To our knowledge, however, no studies of early abstinence have investigated BNST structural connectivity in humans during abstinence; this study addresses that gap. Methods: Nineteen participants with AUD currently in early abstinence and 20 healthy controls completed a diffusion tensor imaging (DTI) scan. BNST structural connectivity was evaluated using probabilistic tractography. A linear mixed model was used to test between‐groups differences in BNST network connectivity. Exploratory analyses were conducted to test for correlations between BNST connectivity and alcohol use severity and anxiety within the abstinence group. Sex was included as a factor for all analyses. Results: The BNST showed stronger structural connectivity with the BNST network in early abstinence women than in control women, which was not seen in men. Women also showed region‐specific differences, with stronger BNST‐hypothalamus structural connectivity but weaker vmPFC‐BNST structural connectivity than men. Exploratory analyses also demonstrated a relationship between alcohol use severity and vmPFC‐BNST structural connectivity that was moderated by sex. Conclusions: This study is the first to demonstrate BNST structural connectivity differences in early abstinence and revealed key sex differences. The sex‐specific differences in BNST structural connectivity during early abstinence could underlie known sex differences in abstinence symptoms and relapse risk and help to inform potential sex‐specific treatments. Abstract : Rodent studies have shown the BNST is critical for regulating negative emotions, such as anxiety, during abstinence from alcohol use disorder; however, little is known in humans. To address this gap, we tested for group and sex differences in BNST structural connectivity within a BNST network. Abstinent women had significantly stronger BNST network connectivity compared to controls. Furthermore, greater alcohol use severity was associated with stronger BNST‐vmPFC structural connectivity in abstinent but weaker BNST‐vmPFC structural connectivity in abstinent women.