Evidence map›Paper›PMID 34342012›Full record

Trial reportAlcoholism, clinical and experimental research2021

Drinking reduction during cognitive behavioral therapy for alcohol use disorder is associated with a reduction in anterior insula-bed nucleus of the stria terminalis resting-state functional connectivity.

A Benjamin Srivastava, Juan Sanchez-Peña, Frances R Levin, John J Mariani, Gaurav H Patel, Nasir H Naqvi

Erratum issued Registry-linked trialAbstract readClinical Trial
In one paragraph

Trial report in Alcoholism, clinical and experimental research, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. It is linked to trial NCT06793488 (Neural Mechanisms of Anxiety During Early and Protracted Abstinence in Alcohol Use Disorder), which is not on this map. Cited by 12 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
12citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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.

NCT06793488 early_phase1recruitingnot on this mapstarted 2025, after this paper: background citation

Neural Mechanisms of Anxiety During Early and Protracted Abstinence in Alcohol Use Disorder

TypeinterventionalSponsorColumbia UniversityRan2025 to 2029Enrolled60ConditionsAlcohol Use DisorderArmsDisulfiram 250 mg, functional MRI
3 · Its place in the literature

Who cites it

12 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Review
  4. Review
  5. Article
  6. Article
  7. Review
  8. Article
  9. Article
  10. Article
  11. Article
  12. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

6 authors.

A Benjamin SrivastavaDivision on Substance Use Disorders, Department of Psychiatry, Columbia University Irving Medical Center, New York State Psychiatric Institute, New York, New York, USA.ORCID 0000-0001-9358-7506
Juan Sanchez-PeñaDivision of Experimental Therapeutics, Department of Psychiatry, Columbia University Irving Medical Center, New York State Psychiatric Institute, New York, New York, USA.
Frances R LevinDivision on Substance Use Disorders, Department of Psychiatry, Columbia University Irving Medical Center, New York State Psychiatric Institute, New York, New York, USA.
John J MarianiDivision on Substance Use Disorders, Department of Psychiatry, Columbia University Irving Medical Center, New York State Psychiatric Institute, New York, New York, USA.
Gaurav H PatelDivision of Experimental Therapeutics, Department of Psychiatry, Columbia University Irving Medical Center, New York State Psychiatric Institute, New York, New York, USA.
Nasir H NaqviDivision on Substance Use Disorders, Department of Psychiatry, Columbia University Irving Medical Center, New York State Psychiatric Institute, New York, New York, USA.

Funding

Translational Clinical Research Fellowship on Substance Use DisordersT32DA007294 · NIDA · COLUMBIA UNIV NEW YORK MORNINGSIDE · PI Frances Rudnick Levin, Diana M Martinez · 1993 to 2026
$9.3M
The Role of Neural Systems for Emotion Regulation in Coping with Alcohol CravingK23AA022771 · NIAAA · NEW YORK STATE PSYCHIATRIC INSTITUTE DBA RESEARCH FOUNDATION FOR MENTAL HYGIENE, INC · PI NAQVI, NASIR HASNAIN · 2014 to 2018
$937k
NIAAA NIH HHS K23 AA022771NIDA NIH HHS T32 DA007294NIH HHS 1K23AA022771NIH HHS T32DA007294
6 · The paper itself

Abstract

backgroundConnectivity between the anterior insula (AI) and the bed nucleus of the stria terminalis (BNST) may play a role in negative emotions that drive compulsive drinking in patients with alcohol use disorder (AUD). We hypothesized that reductions in drinking during cognitive behavioral therapy (CBT), an effective treatment that teaches regulation (coping) skills for managing negative emotions during abstinence, would be associated with reductions in resting-state functional connectivity (RSFC) between the AI and the BNST.

methodsWe included 18 patients with a Diagnostic and Statistical Manual of Mental Disorders, fifth edition diagnosis of AUD who were (1) seeking treatment and (2) drinking heavily at baseline. We measured RSFC as Pearson's correlation between the BNST and multiple regions of interest in the insula at baseline and after completion of 12 weeks of a single-arm clinical trial of outpatient CBT. We also assessed the number of heavy drinking days over the previous 28 days (NHDD) at both time points. We used 1-sample t-tests to evaluate AI-BNST RSFC at baseline, paired t-tests to evaluate changes in AI-BNST RSFC from pre-CBT to post-CBT, and linear regression to evaluate the relationship between changes in AI-BNST RSFC and NHDD.

resultsWe found a significant positive RSFC between the AI and the BNST at baseline (p = 0.0015). While there were no significant changes in AI-BNST RSFC from pre- to post-CBT at the group level (p = 0.42), we found that individual differences in reductions in AI-BNST RSFC from pre- to post-CBT were directly related to reductions in NHDD from pre- to post-CBT (r = 0.73, p = 0.0008).

conclusionsThese findings provide preliminary evidence that reduced AI-BNST RSFC may be a mechanism of drinking reduction in AUD and that AI-BNST RSFC may be a target for CBT and possibly other treatments.

Indexed as

Cognitive Behavioral TherapyAdultAlcoholismFemaleHumansInsular CortexMagnetic Resonance ImagingMaleMiddle AgedSeptal NucleiBNSTCBTfunctional connectivityinsulanegative affect

Identifiers

PMID34342012
PMCPMC8429084

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

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.