Evidence map›Paper›PMID 32037283›Full record

Trial reportNeuroImage. Clinical2020

Brain activation and subjective anxiety during an anticipatory anxiety task is related to clinical outcome during prazosin treatment for alcohol use disorder.

Claire E Wilcox, Bryon Adinoff, Joshua Clifford, Josef Ling, Katie Witkiewitz, Andrew R Mayer, Kylar M Boggs, Matthew Eck, Michael Bogenschutz

Open access · goldAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in NeuroImage. Clinical, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
0.7field-weighted citation impact, top 27% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 1 synthesis or guideline pooled it, 10 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Review
  4. Review
  5. Review
  6. The role of anterior insula-brainstem projections and alpha-1 noradrenergic receptors for compulsion-like and alcohol-only drinking.Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology · 2021
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 5 institutions in 1 country.

Claire E WilcoxMind Research Network, 1101 Yale Blvd. NE, Albuquerque, NM 87106, USA. Electronic address: cwilcox@mrn.org.
Bryon AdinoffDepartment of Psychiatry, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX 75390, USA; VA North Texas Health Care System, 4500 S Lancaster Rd, Dallas, TX 75216, USA; Department of Psychiatry, School of Medicine, University of Colorado, 13001 E 17th Place, Aurora, CO 80045, USA.
Joshua CliffordDepartment of Psychiatry, University of New Mexico, 2400 Tucker NE, Albuquerque, NM 87131, USA.
Josef LingMind Research Network, 1101 Yale Blvd. NE, Albuquerque, NM 87106, USA.
Katie WitkiewitzDepartment of Psychology, Center on Alcoholism, Substance Abuse & Addictions, University of New Mexico, 2650 Yale Blvd. SE, Albuquerque, NM 87106, USA.
Andrew R MayerMind Research Network, 1101 Yale Blvd. NE, Albuquerque, NM 87106, USA.
Kylar M BoggsMind Research Network, 1101 Yale Blvd. NE, Albuquerque, NM 87106, USA.
Matthew EckMind Research Network, 1101 Yale Blvd. NE, Albuquerque, NM 87106, USA; University of Southern California, USA.
Michael BogenschutzDepartment of Psychiatry, New York University School of Medicine, New York, NY 10016, USA.
Mind Research Network · USUniversity of New Mexico · USNew York University · USUniversity of Southern California · USVA North Texas Health Care System · US

Funding

Neural Mechanisms of Change During Alcohol Use DisorderTreatment with PrazosinK23AA021156 · NIAAA · UNIVERSITY OF NEW MEXICO HEALTH SCIS CTR · PI WILCOX, CLAIRE · 2013 to 2017
$919k
NIAAA NIH HHS K23 AA021156
6 · The paper itself

Abstract

backgroundHigher levels of anxiety, negative affect, and impaired emotion regulation are associated with alcohol use disorder (AUD) and contribute to relapse and worse treatment outcomes. Prazosin, while typically used to treat post-traumatic stress disorder (PTSD) and other anxiety disorders, has shown promise for treating AUD. In order to better understand these underlying neural processes in individuals with AUD, our aims in this study were to measure brain activation during an anticipatory anxiety task before treatment to determine whether observed patterns supported previous work. We then aimed to measure the effects of prazosin on patients with AUD and explore whether greater baseline anticipatory anxiety (as measured by subjective and neural measures) predicts better treatment outcomes.

methodsThirty-four individuals seeking treatment for AUD participated in a six-week placebo-controlled study of prazosin and underwent an anticipatory anxiety task during fMRI scans at baseline and three weeks. Alcohol use over six weeks was measured.

resultsGreater levels of subjective anxiety and deactivation in posterior cingulate cortex (PCC) and ventromedial prefrontal cortex (vmPFC) were observed during high-threat stimuli compared to low-threat stimuli. Compared to placebo, prazosin reduced subjective anxiety to high-threat stimuli but there were no observed significant effects of prazosin on brain activation during the task. However, AUD patients with greater vmPFC deactivation during high threat relative to low threat and patients with low baseline anticipatory anxiety during the task had worse clinical outcomes on prazosin.

conclusionsDeactivation in PCC and vmPFC to high-threat stimuli replicated previous work and shows promise for further study as a marker for AUD. Although prazosin did not affect brain activation in the regions of interest during the anticipatory anxiety task, subjective levels of anxiety and brain activation in vmPFC predicted treatment outcomes in individuals with AUD undergoing treatment with prazosin, highlighting individuals more likely to benefit from prazosin than others.

Indexed as

Outcome Assessment, Health CareAdolescentAdrenergic alpha-1 Receptor AntagonistsAdultAlcoholismAnticipation, PsychologicalAnxietyFemaleGyrus CinguliHumansMagnetic Resonance ImagingMaleMiddle AgedPrazosinPrefrontal CortexYoung AdultAdrenergic alpha-1 Receptor AntagonistsPrazosinAlcohol use disorderAnticipatory anxiety taskfMRIPrazosinStressTreatment

Identifiers

PMID32037283
PMCPMC7229347
OpenAlexW2998928192

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.