Remission of alcohol use disorder following traumatic brain injury with focal orbitofrontal cortex hemorrhage: case report and network mapping
Notice bibliographique
Résumé
The orbitofrontal cortex (OFC) and its role in the regulation of urges/compulsion has been identified as a critical component of circuit-based addiction models. Building on such models, it was recently shown that brain lesions disrupting addictive behavior can be mapped to a common brain circuit. We present a case of a 42-year-old woman with chronic treatment-refractory alcohol use disorder who experienced early remission following a traumatic brain injury (TBI) with focal left OFC intracerebral hemorrhage. Using a network mapping approach (normative connectome, n = 1000), functional connectivity was computed from the traced OFC lesion across all brain voxels. The case lesion map topography converges on a brain lesion map previously described as disrupting addictive behavior, but with an inverse connectivity profile (spatial correlation r = −0.59). This spatial correlation is more negative than what would be expected by chance (permutation test 1-sided, p = 0.04) or by random lesion cases (1-sided, p < 0.001). Based on these results, we suggest that potentially just disrupting this brain network, regardless of the directionality, could facilitate remission. However, this case report cannot control for multiple psychosocial factors potentially impacting alcohol remission and caution is also needed for considering TBI as a mechanism for generating an isolated focal lesion. Overall, this case contributes to our understanding of circuit-based models of addictive behavior and could be useful in generating hypotheses for neuromodulatory treatment strategies. Cells in the brain connect together to perform specific functions. Recent research has proposed that disruption of some of these connections could help alleviate substance use disorders. We describe a patient with longstanding alcohol use disorder who reported reduced cravings and stopped drinking alcohol following a traumatic brain injury that damaged part of her left frontal lobe. We performed analyses on this damaged brain region and found that this area overlaps with previously identified brain connections involved in substance use disorders. Our findings provide additional understanding of the causes of substance use disorders and could be helpful for developing new treatment strategies. Haque et al. report a case of chronic alcohol use disorder that had early remission following a traumatic brain injury with left orbitofrontal cortex intracerebral hemorrhage. Mapping of this lesion converges on recently described addictive behavior network maps, but with inverse connectivity.
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Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,012 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,001 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».