Brain activation and subjective anxiety during an anticipatory anxiety task is related to clinical outcome during prazosin treatment for alcohol use disorder
Background: Higher levels of anxiety, negative affect, and impaired emotion regulation are associated with alcohol use disorder (AUD) and contribute to relapse and worse treatment outcomes. Prazosin, while typically used to treat post-traumatic stress disorder (PTSD) and other anxiety disorders, has...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2020-01-01
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| Series: | NeuroImage: Clinical |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2213158220300012 |
| _version_ | 1819029590978330624 |
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| author | Claire E. Wilcox Bryon Adinoff Joshua Clifford Josef Ling Katie Witkiewitz Andrew R. Mayer Kylar M. Boggs Matthew Eck Michael Bogenschutz |
| author_facet | Claire E. Wilcox Bryon Adinoff Joshua Clifford Josef Ling Katie Witkiewitz Andrew R. Mayer Kylar M. Boggs Matthew Eck Michael Bogenschutz |
| author_sort | Claire E. Wilcox |
| collection | DOAJ |
| description | Background: Higher levels of anxiety, negative affect, and impaired emotion regulation are associated with alcohol use disorder (AUD) and contribute to relapse and worse treatment outcomes. Prazosin, while typically used to treat post-traumatic stress disorder (PTSD) and other anxiety disorders, has shown promise for treating AUD. In order to better understand these underlying neural processes in individuals with AUD, our aims in this study were to measure brain activation during an anticipatory anxiety task before treatment to determine whether observed patterns supported previous work. We then aimed to measure the effects of prazosin on patients with AUD and explore whether greater baseline anticipatory anxiety (as measured by subjective and neural measures) predicts better treatment outcomes. Methods: Thirty-four individuals seeking treatment for AUD participated in a six-week placebo-controlled study of prazosin and underwent an anticipatory anxiety task during fMRI scans at baseline and three weeks. Alcohol use over six weeks was measured. Results: Greater levels of subjective anxiety and deactivation in posterior cingulate cortex (PCC) and ventromedial prefrontal cortex (vmPFC) were observed during high-threat stimuli compared to low-threat stimuli. Compared to placebo, prazosin reduced subjective anxiety to high-threat stimuli but there were no observed significant effects of prazosin on brain activation during the task. However, AUD patients with greater vmPFC deactivation during high threat relative to low threat and patients with low baseline anticipatory anxiety during the task had worse clinical outcomes on prazosin. Conclusions: Deactivation in PCC and vmPFC to high-threat stimuli replicated previous work and shows promise for further study as a marker for AUD. Although prazosin did not affect brain activation in the regions of interest during the anticipatory anxiety task, subjective levels of anxiety and brain activation in vmPFC predicted treatment outcomes in individuals with AUD undergoing treatment with prazosin, highlighting individuals more likely to benefit from prazosin than others. |
| first_indexed | 2024-12-21T06:16:41Z |
| format | Article |
| id | doaj.art-61ffd184faaa4e01a77183c0badd83d3 |
| institution | Directory Open Access Journal |
| issn | 2213-1582 |
| language | English |
| last_indexed | 2024-12-21T06:16:41Z |
| publishDate | 2020-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | NeuroImage: Clinical |
| spelling | doaj.art-61ffd184faaa4e01a77183c0badd83d32022-12-21T19:13:23ZengElsevierNeuroImage: Clinical2213-15822020-01-0126Brain activation and subjective anxiety during an anticipatory anxiety task is related to clinical outcome during prazosin treatment for alcohol use disorderClaire E. Wilcox0Bryon Adinoff1Joshua Clifford2Josef Ling3Katie Witkiewitz4Andrew R. Mayer5Kylar M. Boggs6Matthew Eck7Michael Bogenschutz8Mind Research Network, 1101 Yale Blvd. NE, Albuquerque, NM 87106, USA; Corresponding author.Department of Psychiatry, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX 75390, USA; VA North Texas Health Care System, 4500 S Lancaster Rd, Dallas, TX 75216, USA; Department of Psychiatry, School of Medicine, University of Colorado, 13001 E 17th Place, Aurora, CO 80045, USADepartment of Psychiatry, University of New Mexico, 2400 Tucker NE, Albuquerque, NM 87131, USAMind Research Network, 1101 Yale Blvd. NE, Albuquerque, NM 87106, USADepartment of Psychology, Center on Alcoholism, Substance Abuse & Addictions, University of New Mexico, 2650 Yale Blvd. SE, Albuquerque, NM 87106, USAMind Research Network, 1101 Yale Blvd. NE, Albuquerque, NM 87106, USAMind Research Network, 1101 Yale Blvd. NE, Albuquerque, NM 87106, USAMind Research Network, 1101 Yale Blvd. NE, Albuquerque, NM 87106, USA; University of Southern California, USADepartment of Psychiatry, New York University School of Medicine, New York, NY 10016, USABackground: Higher levels of anxiety, negative affect, and impaired emotion regulation are associated with alcohol use disorder (AUD) and contribute to relapse and worse treatment outcomes. Prazosin, while typically used to treat post-traumatic stress disorder (PTSD) and other anxiety disorders, has shown promise for treating AUD. In order to better understand these underlying neural processes in individuals with AUD, our aims in this study were to measure brain activation during an anticipatory anxiety task before treatment to determine whether observed patterns supported previous work. We then aimed to measure the effects of prazosin on patients with AUD and explore whether greater baseline anticipatory anxiety (as measured by subjective and neural measures) predicts better treatment outcomes. Methods: Thirty-four individuals seeking treatment for AUD participated in a six-week placebo-controlled study of prazosin and underwent an anticipatory anxiety task during fMRI scans at baseline and three weeks. Alcohol use over six weeks was measured. Results: Greater levels of subjective anxiety and deactivation in posterior cingulate cortex (PCC) and ventromedial prefrontal cortex (vmPFC) were observed during high-threat stimuli compared to low-threat stimuli. Compared to placebo, prazosin reduced subjective anxiety to high-threat stimuli but there were no observed significant effects of prazosin on brain activation during the task. However, AUD patients with greater vmPFC deactivation during high threat relative to low threat and patients with low baseline anticipatory anxiety during the task had worse clinical outcomes on prazosin. Conclusions: Deactivation in PCC and vmPFC to high-threat stimuli replicated previous work and shows promise for further study as a marker for AUD. Although prazosin did not affect brain activation in the regions of interest during the anticipatory anxiety task, subjective levels of anxiety and brain activation in vmPFC predicted treatment outcomes in individuals with AUD undergoing treatment with prazosin, highlighting individuals more likely to benefit from prazosin than others.http://www.sciencedirect.com/science/article/pii/S2213158220300012PrazosinAnticipatory anxiety taskAlcohol use disorderfMRIStressTreatment |
| spellingShingle | Claire E. Wilcox Bryon Adinoff Joshua Clifford Josef Ling Katie Witkiewitz Andrew R. Mayer Kylar M. Boggs Matthew Eck Michael Bogenschutz Brain activation and subjective anxiety during an anticipatory anxiety task is related to clinical outcome during prazosin treatment for alcohol use disorder NeuroImage: Clinical Prazosin Anticipatory anxiety task Alcohol use disorder fMRI Stress Treatment |
| title | Brain activation and subjective anxiety during an anticipatory anxiety task is related to clinical outcome during prazosin treatment for alcohol use disorder |
| title_full | Brain activation and subjective anxiety during an anticipatory anxiety task is related to clinical outcome during prazosin treatment for alcohol use disorder |
| title_fullStr | Brain activation and subjective anxiety during an anticipatory anxiety task is related to clinical outcome during prazosin treatment for alcohol use disorder |
| title_full_unstemmed | Brain activation and subjective anxiety during an anticipatory anxiety task is related to clinical outcome during prazosin treatment for alcohol use disorder |
| title_short | Brain activation and subjective anxiety during an anticipatory anxiety task is related to clinical outcome during prazosin treatment for alcohol use disorder |
| title_sort | brain activation and subjective anxiety during an anticipatory anxiety task is related to clinical outcome during prazosin treatment for alcohol use disorder |
| topic | Prazosin Anticipatory anxiety task Alcohol use disorder fMRI Stress Treatment |
| url | http://www.sciencedirect.com/science/article/pii/S2213158220300012 |
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