This article is more than 5 years old. Information may no longer be current.

Neurofunctional domains relevant for assessing alcohol use disorder

Three correlated neurofunctional domains — incentive salience, negative emotionality and executive function — were relevant for alcohol use disorder, study findings indicated.

Laura E. Kwako , PhD, of the National Institute on Alcohol Abuse and Alcoholism, and colleagues previously recommended the use of a neuroscience-based framework, known as the Addictions Neuroclinical Assessment (ANA), to better understand the heterogeneity of addiction. The framework implicates three domains — incentive salience, negative emotionality and executive function — in the development and maintenance of substance use disorders, according to the researchers.

In this study, published in the American Journal of Psychiatry, Kwako and colleagues tested whether these three domains could be identified via factor analysis of a deeply phenotyped clinical sample.

“We hypothesized, on the basis of developmental models of substance use disorders, that family history, adverse childhood experiences and age at first drink would predict the scores of individuals on factors emergent from this analysis,” they wrote.

The researchers examined data on clinical, behavioral and self-report measures of addiction as well as personality, cognition, behavior and exposure to early-life stress in 454 people across a spectrum of alcohol use and use disorders. They used the multiple indicators, multiple causes (MIMIC) approach to determine the association of both the latent factors and the indicators with the following: demographic variables, current alcohol use disorder diagnosis, family history of alcohol problems, age at first drink, and exposure to childhood adversity.

Kwako and researchers reported both the three- and four-factor models explained biobehavioral differences in this sample of individuals with alcohol use disorder and controls. However, the three-factor model had the best fit indices, according to results from the exploratory factor analysis. The three-factor model was also a good fit in the replication half of the data set examined in confirmatory factor analysis.

Overall, the three factors corresponded well to incentive salience, negative emotionality,

and executive function; however, there were a few nuances, such as the cross-correlation between the three factors, according to the results. Using the MIMIC approach, the investigators found that early-life stress exposure and sociodemographic variables predicted these factors.

“The neuroclinical assessment of addictions can capture important dimensions of neuropsychological functioning in individuals with varying levels of alcohol use and use disorders, and these domains are highly relevant to substance use disorders,” Kwako and colleagues concluded. “Future studies combining brain imaging and standardized measures for ANA will help refine our understanding of the relationship of these measures to neural circuits implicated in executive function, negative emotionality and incentive salience in substance use disorders and other addictive disorders.” – by Savannah Demko

Disclosure: Kwako reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.