Stress-related Predictor Profiles in Human Addiction

Central Institute of Mental Health, Mannheim121 enrolled

Overview

Long-term aim is the definition of a setup of mobile sensors and their integration in a mobile infrastructure that allows the prediction of stress related alcohol intake in an ambulatory setting. Here, we aim to identify stress- and alcohol cue-related physiological markers in a lab experiment to assess interactions between acute psychological vs. physical stress exposure and alcohol cue-exposure regarding their effects on measures relevant for the development and maintenance of Alcohol Use Disorder (AUD). Further, we aim to identify neural correlates in brain circuits of motivational, cognitive, and affective processing. In addition to applying established stress-related markers, we will integrate innovative sensor-based measures.

In patients with Alcohol Use Disorder (AUD) stress exposure is known to affect craving, cue-reactivity and relapse risk. Here, we aim to identify stress- and alcohol cue-related physiological markers in a lab experiment to assess interactions between acute psychological vs. physical stress exposure and alcohol cue-exposure regarding their effects on (1) alcohol craving and related markers (attentional bias to alcohol-cues, implicit association task, neural cue-reactivity), (2) their predictive capacity for future alcohol intake, (3) the identification their neural correlates in brain circuits of motivational, cognitive, and affective processing. In addition to applying established stress-related markers (cortisol in saliva, heart-rate variability, systolic blood pressure and electrodermal activity), (4) we will integrate portable sensors (wearables) to allow a future integration in ambulatory assessments and to test innovative measures currently under investigation (e.g. voice stress analysis) to identify whether these additional parameters increase the predictive significance. Our long-term aim is the definition of a setup of mobile sensors and their integration in a mobile infrastructure that allows the prediction of stress related alcohol intake in an ambulatory setting.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

Interventions

Trier Social Stress TestBEHAVIORAL

Test to induce high levels of acute social stress, including actors and a faked exam situation

ErgometerBEHAVIORAL

Riding ergometer

Barlab-ExposureBEHAVIORAL

Participants are exposed to a bar situation with different sorts of alcohol available. They sniff at water and at one alcoholic drink.

Reading NewspaperBEHAVIORAL

Participants read newspaper

Eligibility

Sex: ALLMin age: 18 YearsMax age: 65 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Alcohol-use disorder according to 2 DSM-V criteria not requiring detoxification: AUD subjects with mild AUD will fulfill at least 2 and not more than 5 diagnostic criteria; a second group of AUD subjects will fulfill 4-5 criteria for moderate AUD * sufficient ability to communicate with the investigators, to answer questions in oral and written form * fully informed consent * written informed consent Exclusion Criteria: * withdrawal of the declaration of consent * Pregnancy * Using hormonal contraceptives * Perimenopausal/ postmenopausal * positive urin drug screening (cannabis, amphetamine, opiates, benzodiazepines, cocaine) * Lifetime history of DSM-5 bipolar disorder, schizophrenia or schizophrenia spectrum disorder, or substance dependence other than alcohol or nicotine or cannabis dependence. * Current threshold DSM-5 diagnosis of major depressive disorder, or presence of suicidal intention * History of severe head trauma or other severe central nervous system disorder (e.g., dementia, Parkinson's disease, multiple sclerosis) * Current use of medications or drugs known to interact with the CNS within at least four half-lives post last intake

Outcomes

Primary Outcomes

change in heart rate

heart rate acquired with ear clip (continuous time series)

Time frame: at examination day: continuous measurement throughout the whole experiment (except during MRI scanning); duration around 2 hours; starting 1 hour 50 minutes after arrival of the proband

change in heart rate variability

heart rate variability acquired with ear clip (continuous time series)

Time frame: at examination day: continuous measurement throughout the whole experiment (except during MRI scanning); duration around 2 hour; starting 1 hour 50 minutes after arrival of the proband

change in blood pressure (systolic and diastolic)

acquired with pressure sleeve

Time frame: at examination day: 6 time points measured throughout the whole experiment (except during MRI scanning); at hours:minutes 2:20, 2:50, 3:20, 3:50, 4:50, 5:05 after arrival of the proband

change in electrodermal activity

time series acquired with body sensor

Time frame: at examination day: continuous measurement throughout the whole experiment (except during MRI scanning); duration around 2 hour; starting 1h 50min after arrival of the proband

neural alcohol-related cue-reactivity

% signal change, measured with fMRI; paradigm Vollstädt-Klein et al. 2010; \[% signal change is not a change over time; it is measured during one experimental session\]