Resting-State Functional Connectivity and Alcohol Use Disorder: A Case-Control Study.

OBJECTIVE: The authors examined differences in resting-state functional connectivity (rsFC) in the brain between nontreatment-seeking adults with alcohol use disorder (case group) and recreational drinkers without alcohol use disorder (control group) and explored behavioral and psychological mechanisms underlying these differences. METHODS: This case-control study included 140 adults (N=71 with alcohol use disorder and N=69 demographically matched control individuals) who completed a 9-minute resting-state functional MRI scan. About 45% were men, and the mean±SD age was 32.7±10.4 years. Seed-based rsFC analyses were conducted. Psychological mechanisms included alcohol-reinforcing value (assessed with the Alcohol Purchase Task), immediate reward orientation (delay-discounting task), and internalizing psychopathology (a composite of depression, anxiety, and posttraumatic stress measures). RESULTS: Significant rsFC differences were found between seed-target regions, including the inferior frontal gyrus and lingual gyrus, lingual gyrus and inferior occipital gyrus, nucleus accumbens and lingual gyrus, and supplementary motor cortex and temporal pole. Connectivity in these regions was significantly higher in the alcohol use disorder group, except for the supplementary motor cortex seed. Indirect effects of group differences in rsFC were found for alcohol-reinforcing value indicators and internalizing psychopathology but not delay discounting. CONCLUSIONS: This study provides initial evidence of diagnostically distinct rsFC patterns in alcohol use disorder, reflecting higher incentive salience for alcohol and elevated negative reinforcement motivation.