{
    "abstract": "Connectivity between the anterior insula (AI) and the bed nucleus of the stria terminalis (BNST) may play a role in negative emotions that drive compulsive drinking in patients with alcohol use disorder (AUD). We hypothesized that reductions in drinking during cognitive behavioral therapy (CBT), an effective treatment that teaches regulation (coping) skills for managing negative emotions during abstinence, would be associated with reductions in resting-state functional connectivity (RSFC) between the AI and the BNST.\nWe included 18 patients with a Diagnostic and Statistical Manual of Mental Disorders, fifth edition diagnosis of AUD who were (1) seeking treatment and (2) drinking heavily at baseline. We measured RSFC as Pearson's correlation between the BNST and multiple regions of interest in the insula at baseline and after completion of 12\u00a0weeks of a single-arm clinical trial of outpatient CBT. We also assessed the number of heavy drinking days over the previous 28\u00a0days (NHDD) at both time points. We used 1-sample t-tests to evaluate AI-BNST RSFC at baseline, paired t-tests to evaluate changes in AI-BNST RSFC from pre-CBT to post-CBT, and linear regression to evaluate the relationship between changes in AI-BNST RSFC and NHDD.\nWe found a significant positive RSFC between the AI and the BNST at baseline (p\u00a0=\u00a00.0015). While there were no significant changes in AI-BNST RSFC from pre- to post-CBT at the group level (p\u00a0=\u00a00.42), we found that individual differences in reductions in AI-BNST RSFC from pre- to post-CBT were directly related to reductions in NHDD from pre- to post-CBT (r\u00a0=\u00a00.73, p\u00a0=\u00a00.0008).\nThese findings provide preliminary evidence that reduced AI-BNST RSFC may be a mechanism of drinking reduction in AUD and that AI-BNST RSFC may be a target for CBT and possibly other treatments.",
    "authors": [
        {
            "affiliation": "Division on Substance Use Disorders, Department of Psychiatry, Columbia University Irving Medical Center, New York State Psychiatric Institute, New York, New York, USA.",
            "firstname": "A Benjamin",
            "initials": "AB",
            "lastname": "Srivastava"
        },
        {
            "affiliation": "Division of Experimental Therapeutics, Department of Psychiatry, Columbia University Irving Medical Center, New York State Psychiatric Institute, New York, New York, USA.",
            "firstname": "Juan",
            "initials": "J",
            "lastname": "Sanchez-Pe\u00f1a"
        },
        {
            "affiliation": "Division on Substance Use Disorders, Department of Psychiatry, Columbia University Irving Medical Center, New York State Psychiatric Institute, New York, New York, USA.",
            "firstname": "Frances R",
            "initials": "FR",
            "lastname": "Levin"
        },
        {
            "affiliation": "Division on Substance Use Disorders, Department of Psychiatry, Columbia University Irving Medical Center, New York State Psychiatric Institute, New York, New York, USA.",
            "firstname": "John J",
            "initials": "JJ",
            "lastname": "Mariani"
        },
        {
            "affiliation": "Division of Experimental Therapeutics, Department of Psychiatry, Columbia University Irving Medical Center, New York State Psychiatric Institute, New York, New York, USA.",
            "firstname": "Gaurav H",
            "initials": "GH",
            "lastname": "Patel"
        },
        {
            "affiliation": "Division on Substance Use Disorders, Department of Psychiatry, Columbia University Irving Medical Center, New York State Psychiatric Institute, New York, New York, USA.",
            "firstname": "Nasir H",
            "initials": "NH",
            "lastname": "Naqvi"
        }
    ],
    "conclusions": null,
    "copyrights": "\u00a9 2021 Research Society on Alcoholism.",
    "doi": "10.1111/acer.14661",
    "journal": "Alcoholism, clinical and experimental research",
    "keywords": [
        "BNST",
        "CBT",
        "functional connectivity",
        "insula",
        "negative affect"
    ],
    "methods": null,
    "publication_date": "2021-08-04",
    "pubmed_id": "34342012\n26125154\n22279217\n8524021\n7573780\n30390064\n33470766\n22041256\n19693004\n32045624\n31091476\n30532080\n31133822\n31778819\n30865232\n22267308\n22689216\n31954845\n16183471\n23668970\n30946011\n28757305\n30640144\n32023486\n32339664\n26204262\n20679212\n27475769\n24525690\n30167705\n27591147\n10890800\n24565313\n24690001\n26259087\n25684053\n17255515\n32778224\n11900791\n24200213\n31711065\n23994314\n32286721\n16354934\n20934190\n26477807\n9881538\n9741477\n30153753\n15450349\n2597811\n31892465\n27876653\n27864080\n19595731\n31912524\n29953936\n31579824\n23580016",
    "results": "We found a significant positive RSFC between the AI and the BNST at baseline (p\u00a0=\u00a00.0015). While there were no significant changes in AI-BNST RSFC from pre- to post-CBT at the group level (p\u00a0=\u00a00.42), we found that individual differences in reductions in AI-BNST RSFC from pre- to post-CBT were directly related to reductions in NHDD from pre- to post-CBT (r\u00a0=\u00a00.73, p\u00a0=\u00a00.0008).",
    "title": "Drinking reduction during cognitive behavioral therapy for alcohol use disorder is associated with a reduction in anterior insula-bed nucleus of the stria terminalis resting-state functional connectivity.",
    "xml": "<Element 'PubmedArticle' at 0x7885049f49a0>"
}