Increased decision latency in alcohol use disorder reflects altered resting-state synchrony in the anterior salience network

Nicola Canessa,Gianpaolo Basso,Paolo Poggi,Irene Carne,Claudia Gianelli

doi:10.1038/s41598-021-99211-1

Abstract

Increased decision latency in alcohol use disorder (AUD) has been generally explained in terms of psychomotor slowing. Recent results suggest that AUD patients’ slowed decision-making might rather reflect alterations in the neural circuitry underlying the engagement of controlled processing by salient stimuli. We addressed this hypothesis by testing a relationship between decision latency at the Cambridge Gambling Task (CGT) and intrinsic brain activity in 22 individuals with AUD and 19 matched controls. CGT deliberation time was related to two complementary facets of resting-state fMRI activity, i.e. coherence and intensity, representing early biomarkers of functional changes in the intrinsic brain architecture. For both metrics, we assessed a multiple regression (to test a relationship with deliberation time in the whole sample), and an interaction analysis (to test a significantly different relationship with decision latency across groups). AUD patients’ slowed deliberation time (p < 0.025) reflected distinct facets of altered intrinsic activity in the cingulate node of the anterior salience network previously associated with the “output” motor stage of response selection. Its heightened activity in AUD patients compared with controls, tracking choice latency (p < 0.025 corrected), might represent a compensation mechanism counterbalancing the concurrent decrease of its internal coherent activity (p < 0.025 corrected). These findings provide novel insights into the intrinsic neural mechanisms underlying increased decision latency in AUD, involving decreased temporal synchronicity in networks promoting executive control by behaviourally relevant stimuli. These results pave the way to further studies assessing more subtle facets of decision-making in AUD, and their possible changes with rehabilitative treatment.

Highlights

Increased decision latency in alcohol use disorder (AUD) has been generally explained in terms of psychomotor slowing
AUD patients displayed a significantly longer deliberation time (U = 130, p = 0.019) (Table 2), which was not correlated with age, duration or amount of alcohol intake, nor with abstinence duration
We coupled the Cambridge Gambling Task (CGT) with resting-state fMRI to investigate decision-making performance, and its association with different metrics of intrinsic brain activity/connectivity, in early-abstinent AUD patients compared with age- and education-matched healthy controls

Summary

Introduction

Increased decision latency in alcohol use disorder (AUD) has been generally explained in terms of psychomotor slowing. The CGT provides distinct metrics of decision-making skills virtually unbiased by learning effects, while minimizing the loading on executive functions altered in AUD, such as working-memory[14] Despite such control on potential confounding variables, previous studies comparing different types of addictions have suggested that increased CGT decision latency is specific to AUD15,16. While this evidence was generally explained in terms of AUD patients’ psychomotor slowing[17,18,19], our recent data suggest that their longer deliberation time might reflect functional alterations in the neural circuitry underlying the engagement of controlled processes when behaviourally relevant, i.e. While this evidence was generally explained in terms of AUD patients’ psychomotor slowing[17,18,19], our recent data suggest that their longer deliberation time might reflect functional alterations in the neural circuitry underlying the engagement of controlled processes when behaviourally relevant, i.e. “salient”, stimuli are detected[20,21,22,23,24]

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