Mega-Analysis of Gray Matter Volume in Substance Dependence: General and Substance-Specific Regional Effects.
- Authors
- Mackey, Scott; Allgaier, Nicholas; Chaarani, Bader; Spechler, Philip; Orr, Catherine; Bunn, Janice; Allen, Nicholas B; Alia-Klein, Nelly; Batalla, Albert; Blaine, Sara; Brooks, Samantha; Caparelli, Elisabeth; Chye, Yann Ying; Cousijn, Janna; Dagher, Alain; Desrivieres, Sylvane; Feldstein-Ewing, Sarah; Foxe, John J; Goldstein, Rita Z; Goudriaan, Anna E; Heitzeg, Mary M; Hester, Robert; Hutchison, Kent; Korucuoglu, Ozlem; Li, Chiang-Shan R; London, Edythe; Lorenzetti, Valentina; Luijten, Maartje; Martin-Santos, Rocio; May, April; Momenan, Reza; Morales, Angelica; Paulus, Martin P; Pearlson, Godfrey; Rousseau, Marc-Etienne; Salmeron, Betty Jo; Schluter, RenΓ©e; Schmaal, Lianne; Schumann, Gunter; Sjoerds, Zsuzsika; Stein, Dan J; Stein, Elliot A; Sinha, Rajita; Solowij, Nadia; Tapert, Susan; Uhlmann, Anne; Veltman, Dick; van Holst, Ruth; Whittle, Sarah; Wright, Margaret J; YΓΌcel, Murat; Zhang, Sheng; Yurgelun-Todd, Deborah; Hibar, Derrek P; Jahanshad, Neda; Evans, Alan; Thompson, Paul M; Glahn, David C; Conrod, Patricia; Garavan, Hugh; ENIGMA Addiction Working Group
- Year
- 2019
- Journal
- The American journal of psychiatry
- PMID
- 30336705
- DOI
- 10.1176/appi.ajp.2018.17040415
- PMCID
- PMC6427822
OBJECTIVE: Although lower brain volume has been routinely observed in individuals with substance dependence compared with nondependent control subjects, the brain regions exhibiting lower volume have not been consistent across studies. In addition, it is not clear whether a common set of regions are involved in substance dependence regardless of the substance used or whether some brain volume effects are substance specific. Resolution of these issues may contribute to the identification of clinically relevant imaging biomarkers. Using pooled data from 14 countries, the authors sought to identify general and substance-specific associations between dependence and regional brain volumes. METHOD: Brain structure was examined in a mega-analysis of previously published data pooled from 23 laboratories, including 3,240 individuals, 2,140 of whom had substance dependence on one of five substances: alcohol, nicotine, cocaine, methamphetamine, or cannabis. Subcortical volume and cortical thickness in regions defined by FreeSurfer were compared with nondependent control subjects when all sampled substance categories were combined, as well as separately, while controlling for age, sex, imaging site, and total intracranial volume. Because of extensive associations with alcohol dependence, a secondary contrast was also performed for dependence on all substances except alcohol. An optimized split-half strategy was used to assess the reliability of the findings. RESULTS: Lower volume or thickness was observed in many brain regions in individuals with substance dependence. The greatest effects were associated with alcohol use disorder. A set of affected regions related to dependence in general, regardless of the substance, included the insula and the medial orbitofrontal cortex. Furthermore, a support vector machine multivariate classification of regional brain volumes successfully classified individuals with substance dependence on alcohol or nicotine relative to nondependent control subjects. CONCLUSIONS: The results indicate that dependence on a range of different substances shares a common neural substrate and that differential patterns of regional volume could serve as useful biomarkers of dependence on alcohol and nicotine.
Cortical Regions of Interest Exhibiting Substance- Specific or Shared Substance-General Effects Displayed on the Surface of Partially Inflated Average Brainsaa Substance specific: alcohol alone (green), alcohol and cocaine (purple); substance general: pattern 2 (yellow), pattern 3 (orange).
Different Contributions of Dependence on the Five Substances Studied to the Association of Lower Volume or Thickness With Substance Dependenceaa For illustration purposes, both halves of the data (serving as the discovery and replication datasets) have been combined in the bar graphs. Three different patterns are illustrated. In pattern 1 (substance-specific effect), lower volume in the right nucleus accumbens was largely accounted for by dependence on alcohol alone. In pattern 2 (substance-general effect), volume in the left supramarginal gyrus was significantly lower in dependent compared with nondependent individuals (model 1) but was not significantly lower in any one particular substance group (model 2) compared with control subjects. In pattern 3 (substance-general effect), volume in the left insula was lower when either the alcohol-dependent group or the linear contrast of all substance groups except alcohol was compared with nondependent control subjects. Bars represent estimated marginal means expressed as percent difference from mean volume or thickness in nondependent control subjects. Error bars represent standard error. Meth=methamphetamine.
Plot of Receiver Operating Characteristic Curves for the Support Vector Machine Classification of Individuals Dependent on One of Five Substances Relative to Nondependent Control SubjectsaaThe area under the curve (AUC) is significant for alcohol or nicotine dependence when trained on the first half of the data and tested on the second half (left) as well as when trained on the second half and tested on the first half (right). Meth=methamphetamine.
| Name | Type |
|---|---|
| Addiction Working Group local | cohort |
| age | phenotype |
| alcohol | phenotype |
| Alcohol and cocaine dependence local | phenotype |
| alcohol- and nicotine-dependent individuals local | cohort |
| alcohol dependence | phenotype |
| Alcohol_dependence | phenotype |
| Alcohol dependence effects local | phenotype |
| alcohol-dependent group local | cohort |
| Alcohol Use | phenotype |
| amygdala | anatomy |
| anxiety | phenotype |
| behavioral phenotypes | phenotype |
| brain | anatomy |
| brain region thickness local | phenotype |
| brain region volume local | phenotype |
| brain volume | anatomy |
| cannabis dependence | phenotype |
| cannabis use | phenotype |
| cannabis use disorder | phenotype |
| cocaine | phenotype |
| cocaine-dependent participants local | cohort |
| control participants | cohort |
| control subjects | cohort |
| cortex | anatomy |
| cortical thinning local | phenotype |
| craving | phenotype |
| dependence | phenotype |
| dependent groups local | cohort |
| dependent individuals local | cohort |
| Dependent individuals (non-alcohol) local | cohort |
| depression | phenotype |
| Discovery Data Set local | cohort |
| ENIGMA | cohort |
| ENIGMA project local | cohort |
| ENIGMA Project local | cohort |
| hippocampus | anatomy |
| insula | anatomy |
| intracranial volume | anatomy |
| left inferior parietal lobule | anatomy |
| left middle temporal gyrus | anatomy |
| left supramarginal gyrus local | anatomy |
| Left supramarginal gyrus local | anatomy |
| mean age | phenotype |
| Medial orbital cortex local | anatomy |
| medial orbitofrontal cortex | anatomy |
| Medial orbitofrontal region local | anatomy |
| methamphetamine | drug |
| methamphetamine dependence | phenotype |
| methamphetamine-dependent participants local | cohort |
| Neuroimaging biomarker local | phenotype |
| nicotine | drug |
| nicotine dependence | phenotype |
| nicotine-dependent participants local | cohort |
| nicotine use | phenotype |
| nondependence local | phenotype |
| nondependent control subjects local | cohort |
| Nondependent control subjects local | cohort |
| Nondependent control subjects local | phenotype |
| nucleus accumbens | anatomy |
| other substances | phenotype |
| pallidum | anatomy |
| parietal cortex | anatomy |
| past-30-day alcohol use | phenotype |
| past-30-day nicotine use | phenotype |
| PhenX Toolkit | cohort |
| posterior cingulate cortex | anatomy |
| precentral gyrus | anatomy |
| putamen | anatomy |
| region of interest | anatomy |
| region-of-interest volume local | phenotype |
| relapse | phenotype |
| replication sample | cohort |
| right medial orbitofrontal cortex | anatomy |
| right middle temporal gyrus | anatomy |
| Right posterior cingulate local | anatomy |
| right thalamus | anatomy |
| sex | phenotype |
| sex distribution local | phenotype |
| smoking | phenotype |
| study cohort | cohort |
| subcortical regions | anatomy |
| Substance-dependent participants local | phenotype |
| substance use | phenotype |
| superior frontal cortex | anatomy |
| supramarginal gyrus | anatomy |
| thickness | phenotype |
| Total lifetime substance use local | phenotype |
| Urge to smoke local | phenotype |
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