How do substance use disorders compare to other psychiatric conditions on structural brain abnormalities? A cross-disorder meta-analytic comparison using the ENIGMA consortium findings.

Journal: Human brain mapping

Volume: 43

Issue: 1

Year of Publication: 2022

Affiliated Institutions:  Department of Psychiatry, Université de Montreal, CHU Ste Justine Hospital, CHU Ste-Justine, Montreal, Canada. Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA. SAMRC Unit on Risk & Resilience in Mental Disorders, Department of Psychiatry and Neuroscience Institute, University of Cape Town, Cape Town, South Africa. National Institute of Alcohol Abuse and Alcoholism (NIAAA), Bethesda, Maryland, USA. Department of Psychiatry, Amsterdam UMC location VUMC, Amsterdam, The Netherlands. Addiction, Development and Psychopathology (ADAPT) Lab, Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands. Cognitive Psychology Unit & Leiden Institute for Brain & Cognition, Institute of Psychology, Leiden University, Leiden, The Netherlands. Amsterdam Institute for Addiction Research, Department of Psychiatry, Amsterdam UMC, Location AMC, University of Amsterdam, Amsterdam, The Netherlands. Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia. Department of Psychiatry, University of Vermont, Burlington, Vermont, USA. Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands. Monash Institute of Cognitive and Clinical Neurosciences, and School of Psychological Sciences, Monash University, Monash, Australia. Brain and Mental Health Research Hub, Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Monash University, Melbourne, Australia. Brain Research Institute, University of California, Los Angeles, California, USA. Imaging Genetics Center, Mark & Mary Stevens Institute for Neuroimaging and Infomatics, Keck School of Medicine, University of Southern California, Marina del Rey, California, USA.

Abstract summary 

Alcohol use disorder (AUD) and cannabis use disorder (CUD) are associated with brain alterations particularly involving fronto-cerebellar and meso-cortico-limbic circuitry. However, such abnormalities have additionally been reported in other psychiatric conditions, and until recently there has been few large-scale investigations to compare such findings. The current study uses the Enhancing Neuroimaging Genetics through Meta-Analysis (ENIGMA) consortium method of standardising structural brain measures to quantify case-control differences and to compare brain-correlates of substance use disorders with those published in relation to other psychiatric disorders. Using the ENIGMA protocols, we report effect sizes derived from a meta-analysis of alcohol (seven studies, N = 798, 54% are cases) and cannabis (seven studies, N = 447, 45% are cases) dependent cases and age- and sex-matched controls. We conduct linear analyses using harmonised methods to process and parcellate brain data identical to those reported in the literature for ENIGMA case-control studies of major depression disorder (MDD), schizophrenia (SCZ) and bipolar disorder so that effect sizes are optimally comparable across disorders. R elationships between substance use disorder diagnosis and subcortical grey matter volumes and cortical thickness were assessed with intracranial volume, age and sex as co-variates . After correcting for multiple comparisons, AUD case-control meta-analysis of subcortical regions indicated significant differences in the thalamus, hippocampus, amygdala and accumbens, with effect sizes (0.23) generally equivalent to, or larger than |0.23| those previously reported for other psychiatric disorders (except for the pallidum and putamen). On measures of cortical thickness, AUD was associated with significant differences bilaterally in the fusiform gyrus, inferior temporal gyrus, temporal pole, superior frontal gyrus, and rostral and caudal anterior cingulate gyri. Meta-analysis of CUD case-control studies indicated reliable reductions in amygdala, accumbens and hippocampus volumes, with the former effect size comparable to, and the latter effect size around half of that reported for alcohol and SCZ. CUD was associated with lower cortical thickness in the frontal regions, particularly the medial orbitofrontal region, but this effect was not significant after correcting for multiple testing. This study allowed for an unbiased cross-disorder comparison of brain correlates of substance use disorders and showed alcohol-related brain anomalies equivalent in effect size to that found in SCZ in several subcortical and cortical regions and significantly greater alterations than those found in MDD in several subcortical and cortical regions. Although modest, CUD results overlapped with findings reported for AUD and other psychiatric conditions, but appear to be most robustly related to reduce thickness of the medial orbitofrontal cortex.

Authors & Co-authors:  Navarri Xavier X Afzali Mohammad H MH Lavoie Jacob J Sinha Rajita R Stein Dan J DJ Momenan Reza R Veltman Dick J DJ Korucuoglu Ozlem O Sjoerds Zsuzsika Z van Holst Ruth J RJ Hester Rob R Orr Catherine C Cousijn Janna J Yucel Murat M Lorenzetti Valentina V Wiers Reinout R Jahanshad Neda N Glahn David C DC Thompson Paul M PM Mackey Scott S Conrod Patricia J PJ

Study Outcome 

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Statistics
Citations :  American Psychiatric Association . (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: American Psychiatric Association.
Authors :  21
Identifiers
Doi : 10.1002/hbm.25114
SSN : 1097-0193
Study Population
Male,Female
Mesh Terms
Bipolar Disorder
Other Terms
addiction;alcohol;cannabis;structural neuroimaging
Study Design
Cross Sectional Study
Study Approach
Country of Study
Mali
Publication Country
United States