Depicting People in Visual Cues Affects Alcohol Cue Reactivity in Male Alcohol-Dependent Patients

Abstract

Cue reactivity is often used to study alcohol cues brain responses. Standardized image sets are used, but the effect of viewing people interacting with the alcohol drink remains unclear, which is associated with the factors of alcohol cues that influence the degree of response to alcohol stimuli. The present study used fMRI to investigate the reactivity of alcohol dependence (AD) inpatients to alcohol cues with or without human drinking behavior. Cues with a human interacting with a drink were hypothesized to increase sensorimotor activation. In total, 30 AD inpatients were asked to view pictures with a factorial design of beverage types (alcoholic vs. non-alcoholic beverages) and cue types (with or without drink action). Whole-brain analyses were performed. A correlation analysis was conducted to confirm whether the whole-brain analysis revealed cue-related brain activations correlated with problem drinking duration. The left lingual gyrus showed significant beverage types through cue type interaction, and the bilateral temporal cortex showed significant activation in response to alcohol cues depicting human drinking behavior. The right and left lingual gyrus regions and left temporal cortex were positively correlated with problem drinking duration. Sensorimotor activations in the temporal cortex may reflect self-referential and memory-based scene processing. Thus, our findings indicate these regions are associated with alcohol use and suggest them for cue exposure treatment of alcohol addiction.

Keywords: alcohol; craving; cue reactivity; fMRI; sensorimotor.

Figure 1

Experimental structure and design: (A) each experiment has two types of beverage cues (alcohol and matched non-alcohol with different scenarios) and animal cues. The design of the task was single trial, in which each trial contains a fixation cross presented for 1–5 s before the stimulus image of an alcohol or non-alcohol cue was presented for 2 s. The animal picture was used to require pressing a button to keep the subject’s attention on the task. (B) sample task stimuli. The top six images show examples of alcohol/non-alcohol cues as a function of the action scenario. The bottom two images show examples of alcohol/non-alcohol cues as a function of the no-action scenario.

Figure 2

Brain activations of cue type main effect (i.e., action versus no-action). Alc_NoAct = alcohol cues without drinking actions, Alc_Act = alcohol cues with drinking actions; Neu_NoAct = non-alcohol cues without drinking actions, Neu_Act = non-alcohol cues with drinking actions.

Figure 3

Neural interaction among cue category and cue type. (A) the group’s significant BOLD activity means the interaction between beverage type and action context; (B) mean BOLD response in the left lingual gyrus for each condition. Error bars show the associated beta values of the conditions in the significant cluster of the lingual gyrus. ** p < 0.01, **** p < 0.0001 after Bonferroni multiple-comparisons correction. Alc_NoAct = alcohol cues without drinking actions, Alc_Act = alcohol cues with drinking actions, Neu_NoAct = non-alcohol cues without drinking actions, Neu_Act = non-alcohol cues with drinking actions.

Figure 4

Positive correlations between the duration of problem drinking (years) and activation clusters were revealed by the whole-brain analysis in the left middle temporal gyrus and left lingual gyrus, elicited by the contrast of alcohol versus non-alcohol cues. Lines indicate linear associations; r = Pearson correlation; Alc = alcohol cue; Non-Alc = non-alcohol cue.