Craving dynamics and related cerebral substrates predict timing of use in alcohol, tobacco, and cannabis use disorders

Chirokoff V(1)(2), Dupuy M(1), Abdallah M(3)(4), Fatseas M(1)(5)(6), Serre F(7), Auriacombe M(5)(7), Misdrahi D(1)(5), Berthoz S(1)(8), Swendsen J(1)(2), Sullivan EV(9), Chanraud S(1)(2).

Author information:
(1)University of Bordeaux, CNRS-UMR 5287 – Institut de Neurosciences Cognitives et Intégratives d’Aquitaine (INCIA), Bordeaux, France.
(2)EPHE, PSL Research University, Paris, France.
(3)Bordeaux University, CNRS, Bordeaux Bioinformatics Center, IBGC UMR 5095, Bordeaux, France.
(4)Groupe d’Imagerie Neurofonctionnelle, Institut des Maladies
Neurodégénératives-UMR 5293, CNRS, Univeristy of Bordeaux, Bordeaux, France.
(5)CH Charles Perrens, Bordeaux, France.
(6)CHU Bordeaux, Bordeaux, France.
(7)University of Bordeaux, CNRS UMR 6033- Sleep, Addiction and Neuropsychiatry (SANPSY), Bordeaux, France.
(8)Institut Mutualiste Montsouris, Department of Psychiatry for Adolescents and Young Adults, Paris, France.
(9)Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, United States.

BACKGROUND: Patients treated for Substance Use Disorders exhibit highly
fluctuating patterns of craving that could reveal novel prognostic markers of
use. Accordingly, we 1) measured fluctuations within intensively repeated
measures of craving and 2) linked fluctuations of craving to connectivity
indices within resting-state (rs) brain regions to assess their relation to use
among patients undergoing treatment for Alcohol, Tobacco and Cannabis Use
Disorders.
METHOD: Participants -64 individuals with SUD for tobacco, alcohol, or cannabis
and 35 healthy controls-completed a week of Ecological Momentary Assessment
(EMA) during which they reported craving intensity and substance use five times
daily. Before EMA, a subsample of 50 patients, and 34 healthy controls also
completed resting-state (rs)-MRI acquisitions. Craving temporal dynamics within
each day were characterized using Standard Deviation (SD), Auto-Correlation
Factor (ACF), and Mean Successive Square Difference (MSSD). Absolute Difference
(AD) in craving between assessments was a prospective prediction measure.
RESULTS: Within-day, higher MSSD predicted greater substance use while
controlling for mean craving. Prospectively higher AD predicted later increased
substance use independently of previous use or craving level. Moreover, MSSD was
linked to strength in five functional neural connections, most involving
frontotemporal systems. Cerebello-thalamic and thalamo-frontal connectivity were
also linked to substance use and distinguished the SUD from the controls.
CONCLUSION: To the best of our knowledge, this is the first study to indicate
that instability in craving may be a trigger for use in several SUD types,
beyond the known effect of craving intensity.

DOI: 10.1016/j.addicn.2023.100138
PMCID: PMC10883348
PMID: 38389954

Conflict of interest statement: Declaration of Competing Interest The authors
declare that they have no known competing financial interests or personal
relationships that could have appeared to influence the work reported in this
paper.

Auteurs Bordeaux Neurocampus