Alcohol use is associated with affective and interoceptive network alterations in bipolar disorder

• Published in: Brain and behavior Vol. 13; no. 1; pp. e2832 - n/a
• Main Authors: Martyn, Fiona M., McPhilemy, Genevieve, Nabulsi, Leila, Quirke, Jacqueline, Hallahan, Brian, McDonald, Colm, Cannon, Dara M.
• Format: Journal Article
• Language: English
• Published: United States John Wiley & Sons, Inc 01.01.2023; John Wiley and Sons Inc; Wiley
• Subjects: Alcohol use; Alcoholism - diagnostic imaging; Bipolar Disorder; Brain; Brain Mapping; Cognition; default mode network; Emotions; executive control network; functional connectivity; Humans; Magnetic Resonance Imaging - methods; Original; Questionnaires; bipolar disorder; functional connectivity; alcohol use; default mode network; executive control network
• ISSN: 2162-3279; 2162-3279
• DOI: 10.1002/brb3.2832

Introduction Alcohol use in bipolar disorder (BD) is associated with mood lability and negative illness trajectory, while also impacting functional networks related to emotion, cognition, and introspection. The adverse impact of alcohol use in BD may be explained by its additive effects on these networks, thereby contributing to a poorer clinical outcome. Methods Forty BD‐I (DSM‐IV‐TR) and 46 psychiatrically healthy controls underwent T1 and resting state functional MRI scanning and the Alcohol Use Disorders Identification Test‐Consumption (AUDIT‐C) to assess alcohol use. Functional images were decomposed using spatial independent component analysis into 14 resting state networks (RSN), which were examined for effect of alcohol use and diagnosis‐by‐alcohol use accounting for age, sex, and diagnosis. Results Despite the groups consuming similar amounts of alcohol (BD: mean score ± SD 3.63 ± 3; HC 4.72 ± 3, U = 713, p = .07), for BD participants, greater alcohol use was associated with increased connectivity of the paracingulate gyrus within a default mode network (DMN) and reduced connectivity within an executive control network (ECN) relative to controls. Independently, greater alcohol use was associated with increased connectivity within an ECN and reduced connectivity within a DMN. A diagnosis of BD was associated with increased connectivity of a DMN and reduced connectivity of an ECN. Conclusion Affective symptomatology in BD is suggested to arise from the aberrant functionality of networks subserving emotive, cognitive, and introspective processes. Taken together, our results suggest that during euthymic periods, alcohol can contribute to the weakening of emotional regulation and response, potentially explaining the increased lability of mood and vulnerability to relapse within the disorder. We find that having a diagnosis of BD, but moreover having a diagnosis of BD and consuming alcohol is significantly associated with increased connectivity within default mode networks and reduced spectral power at 0.05–0.1 Hz in an executive control network. These results suggest that introspective and cognitive networks are impacted by alcohol, over and above BD alone.