Análise da associação entre transtorno por uso de álcool e alterações no controle inibitório
Data
2023-05-23
Autores
Conte, Rafael 
Orientadores
Céspedes, Isabel Cristina
Tipo
Tese de doutorado
Título da Revista
ISSN da Revista
Título de Volume
Resumo
Objetivo: Avaliar os efeitos induzidos pelo álcool sobre o controle inibitório, por meio de testes comportamentais e neuroimagem estrutural (morfologia baseada em vóxel) e funcional (análise de conectividade). Assim como, analisar alterações neurotróficas e estruturais no cérebro e a presença de comorbidades através da avaliação dos sintomas de ansiedade e depressão. Métodos: Foram constituídos dois grupos de voluntários, grupo Controle (CO; n = 46) do Hospital São Paulo da UNIFESP e grupo transtorno por uso de álcool (TUA) (AL; n = 48) com pacientes do Centro de Tratamento Bezerra de Menezes. Foram aplicados um questionário sociodemográfico e o Teste de Triagem de Tabagismo e Envolvimento com Álcool e Substância (ASSIST). O teste de Stroop foi realizado para avaliar a capacidade de inibição comportamental. O Inventário de Traço e Estado de Ansiedade (IDATE) e o Inventário de Depressão de Beck (BDI) foram aplicados para avaliar os sintomas de ansiedade e depressão, respectivamente. Além disso, o fator neurotrófico derivado do cérebro (BDNF) foi avaliado a partir de amostras de plasma como um indicador de neuroplasticidade relacionada ao álcool. A ressonância magnética funcional de estado de repouso foi realizada para acessar os parâmetros de integridade morfométrica e conectividade cerebral. Resultados: Os resultados mostraram que o IDATE e o BDI indicaram uma maior prevalência de sintomas de ansiedade e depressão no grupo AL, e o desempenho geral no teste Stroop foi diminuído no grupo AL em comparação ao grupo CO. Não houve diferença na concentração de BDNF entre os grupos. A análise morfométrica indicou redução de volume da substância branca em regiões frontais e parietal do cérebro no grupo AL. Quanto à conectividade funcional, foram detectadas alterações entre a rede de saliência e regiões cerebrais relacionadas ao controle cognitivo e atencional (observando aumentada conectividade para com regiões parahipocampais e frontais, e diminuída para com regiões talâmicas, frontais, parietais e temporais; quando comparando controles e o grupo AL) controlando para o uso de medicação e idade. Conclusões: Pode-se concluir que o TUA ocorreu em conjunto a comportamentos relacionados à depressão e ansiedade e foi associado a alterações na estrutura e conectividade cerebral em regiões de controle cognitivo e atencional que também estão envolvidas em estados de ansiedade e depressão.
Objective: Evaluate the effects induced by alcohol on inhibitory control by means of behavioral tests, and analysis of structural (voxel-based morphometry) and functional neuroimaging (connectivity analysis). As well as analyze neurotrophic and structural alterations in the brain and the presence of comorbidities by evaluation of anxiety and depression symptoms. Methods: Two groups of volunteers were formed, Control group (CO; n = 46) from Hospital São Paulo of UNIFESP and alcohol use disorder group (AL; n = 48) of patients from the Bezerra de Menezes Treatment Center. A sociodemographic questionnaire and the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) were applied. The Stroop test was performed to assess behavioral inhibition ability. The State-Trait Anxiety Inventory (STAI) and the Beck Depression Inventory (BDI) were applied to assess anxiety and depression symptoms, respectively. In addition, brain-derived neurotrophic factor (BDNF) was assessed from plasma samples as an indicator of alcohol-related neuroplasticity. Resting-state functional magnetic resonance imaging (fMRI) was performed to access morphometric integrity and brain connectivity. Results: The results showed that STAI and BDI indicated a higher prevalence of anxiety and depression symptoms in the AL group, and overall performance on the Stroop test was decreased in the AL group compared to the CO group. There was no difference regarding BDNF concentrations between groups. Morphometric analysis indicated reduced white matter volume in frontal and parietal brain regions of AL group. As for functional connectivity, changes among the salience network and brain regions related to cognitive and attentional control (it was observed increased connectivity to parahipocampal and frontal regions, and decreased connectivity to thalamic, frontal, parietal, and temporal regions; when comparing controls with AL group) and controlling for medication use and age. Conclusions: It can be concluded that alcohol use disorder occurred together with behaviors associated with depression and anxiety and was also associated with changes in brain structure and connectivity in cognitive and attentional control regions that are also altered in anxiety and depressive states.
Objective: Evaluate the effects induced by alcohol on inhibitory control by means of behavioral tests, and analysis of structural (voxel-based morphometry) and functional neuroimaging (connectivity analysis). As well as analyze neurotrophic and structural alterations in the brain and the presence of comorbidities by evaluation of anxiety and depression symptoms. Methods: Two groups of volunteers were formed, Control group (CO; n = 46) from Hospital São Paulo of UNIFESP and alcohol use disorder group (AL; n = 48) of patients from the Bezerra de Menezes Treatment Center. A sociodemographic questionnaire and the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) were applied. The Stroop test was performed to assess behavioral inhibition ability. The State-Trait Anxiety Inventory (STAI) and the Beck Depression Inventory (BDI) were applied to assess anxiety and depression symptoms, respectively. In addition, brain-derived neurotrophic factor (BDNF) was assessed from plasma samples as an indicator of alcohol-related neuroplasticity. Resting-state functional magnetic resonance imaging (fMRI) was performed to access morphometric integrity and brain connectivity. Results: The results showed that STAI and BDI indicated a higher prevalence of anxiety and depression symptoms in the AL group, and overall performance on the Stroop test was decreased in the AL group compared to the CO group. There was no difference regarding BDNF concentrations between groups. Morphometric analysis indicated reduced white matter volume in frontal and parietal brain regions of AL group. As for functional connectivity, changes among the salience network and brain regions related to cognitive and attentional control (it was observed increased connectivity to parahipocampal and frontal regions, and decreased connectivity to thalamic, frontal, parietal, and temporal regions; when comparing controls with AL group) and controlling for medication use and age. Conclusions: It can be concluded that alcohol use disorder occurred together with behaviors associated with depression and anxiety and was also associated with changes in brain structure and connectivity in cognitive and attentional control regions that are also altered in anxiety and depressive states.