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An insula‐driven network computes decision uncertainty and promotes abstinence in chronic cocaine users
European Journal of Neuroscience ( IF 2.7 ) Pub Date : 2020-07-27 , DOI: 10.1111/ejn.14917
Ju-Chi Yu 1 , Vincenzo G Fiore 2 , Richard W Briggs 3 , Jacquelyn Braud 4 , Katya Rubia 5 , Bryon Adinoff 4, 6, 7 , Xiaosi Gu 2, 8
Affiliation  

The anterior insular cortex (AIC) and its interconnected brain regions have been associated with both addiction and decision‐making under uncertainty. However, the causal interactions in this uncertainty‐encoding neurocircuitry and how these neural dynamics impact relapse remain elusive. Here, we used model‐based fMRI to measure choice uncertainty in a motor decision task in 61 individuals with cocaine use disorder (CUD) and 25 healthy controls. CUD participants were assessed before discharge from a residential treatment program and followed for up to 24 weeks. We found that choice uncertainty was tracked by the AIC, dorsal anterior cingulate cortex (dACC) and ventral striatum (VS), across participants. Stronger activations in these regions measured pre‐discharge predicted longer abstinence after discharge in individuals with CUD. Dynamic causal modeling revealed an AIC‐to‐dACC‐directed connectivity modulated by uncertainty in controls, but a dACC‐to‐AIC connectivity in CUD participants. This reversal was mostly driven by early relapsers (<30 days). Furthermore, CUD individuals who displayed a stronger AIC‐to‐dACC excitatory connection during uncertainty encoding remained abstinent for longer periods. These findings reveal a critical role of an AIC‐driven, uncertainty‐encoding neurocircuitry in protecting against relapse and promoting abstinence.

中文翻译:

脑岛驱动网络计算决策不确定性并促进慢性可卡因使用者的戒断

前岛叶皮层 (AIC) 及其相互连接的大脑区域与不确定性下的成瘾和决策有关。然而,这种不确定性编码神经回路中的因果相互作用以及这些神经动力​​学如何影响复发仍然难以捉摸。在这里,我们使用基于模型的 fMRI 来测量 61 名可卡因使用障碍 (CUD) 和 25 名健康对照者在运动决策任务中的选择不确定性。CUD 参与者在出院前接受了住院治疗计划的评估,并进行了长达 24 周的随访。我们发现,参与者的 AIC、背侧前扣带回皮层 (dACC) 和腹侧纹状体 (VS) 跟踪了选择的不确定性。出院前这些区域的更强激活预测了 CUD 患者出院后更长时间的禁欲。动态因果模型揭示了 AIC 到 dACC 导向的连接性受控制中的不确定性调节,但 CUD 参与者中的 dACC 到 AIC 连接性。这种逆转主要是由早期复发者(<30 天)驱动的。此外,在不确定性编码期间表现出更强的 AIC 到 dACC 兴奋性连接的 CUD 个体在更长的时间内保持禁欲。这些发现揭示了 AIC 驱动的、编码不确定性的神经回路在防止复发和促进戒断方面的关键作用。在不确定性编码期间表现出更强的 AIC 到 dACC 兴奋性连接的 CUD 个体仍然禁欲更长的时间。这些发现揭示了 AIC 驱动的、编码不确定性的神经回路在防止复发和促进戒断方面的关键作用。在不确定性编码期间表现出更强的 AIC 到 dACC 兴奋性连接的 CUD 个体仍然禁欲更长的时间。这些发现揭示了 AIC 驱动的、编码不确定性的神经回路在防止复发和促进戒断方面的关键作用。
更新日期:2020-07-27
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