Cognitive Neuroscience Approaches to Understanding Behavior Change in Alcohol Use Disorder Treatments

Nasir H Naqvi, Jon Morgenstern, Nasir H Naqvi, Jon Morgenstern

Abstract

Researchers have begun to apply cognitive neuroscience concepts and methods to study behavior change mechanisms in alcohol use disorder (AUD) treatments. This review begins with an examination of the current state of treatment mechanisms research using clinical and social psychological approaches. It then summarizes what is currently understood about the pathophysiology of addiction from a cognitive neuroscience perspective. Finally, it reviews recent efforts to use cognitive neuroscience approaches to understand the neural mechanisms of behavior change in AUD, including studies that use neural functioning to predict relapse and abstinence; studies examining neural mechanisms that operate in current evidence-based behavioral interventions for AUD; as well as research on novel behavioral interventions that are being derived from our emerging understanding of the neural and cognitive mechanisms of behavior change in AUD. The article highlights how the regulation of subcortical regions involved in alcohol incentive motivation by prefrontal cortical regions involved in cognitive control may be a core mechanism that plays a role in these varied forms of behavior change in AUD. We also lay out a multilevel framework for integrating cognitive neuroscience approaches with more traditional methods for examining AUD treatment mechanisms.

Figures

Figure 1
Figure 1
A potential common mechanism for alcohol use disorder (AUD) treatments. A number of studies suggest that AUD treatments elicit behavior change by increasing the regulation of brain regions that mediate incentive motivation, such as the ventral striatum, by prefrontal cortical regions that mediate cognitive control. Arrows denote expected changes in specific neural, behavioral, psychophysiological and clinical outcome measures, given this hypothesized treatment mechanism. PFC = prefrontal cortex. VS = ventral striatum.
Figure 2
Figure 2
Predicted results from experiments directed at addressing the role of neural systems in alcohol use disorder (AUD) treatment mechanisms. (A) An active treatment should increase the neural parameters that index the functioning of these systems as it relates to a specific psychological process of interest (the experimental task). There should be no effect of the control treatment on these neural parameters. (B) The effects of a treatment on the neural parameter should mediate the effects of the treatment on clinical outcome. (C) Changes (Δ) in the neural parameters from pre- to posttreatment should correlate with corresponding changes in self-report measures that index psychological processes already known to drive behavior change.

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Source: PubMed

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