Emotion regulation deficits in regular marijuana users

Zimmermann, Kaeli; Walz, Christina; Derckx, Raissa T; Kendrick, Keith M.; Weber, Bernd; Doré, Bruce; Ochsner, Kevin N.; Hurlemann, René; Becker, Benjamin

doi:10.1002/hbm.23671

Cited by 80 publications

(77 citation statements)

References 49 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The study had full ethi cal approval by the local ethics committee, adhered to the latest version of the Declaration of Helsinki and protocols were preregistered (NCT02692196, http://clinicaltrials.gov/show/NCT02692196). Please note that the registration refers to both sexes; however, in line with one of our recent ER studies [50] and the rationale above, we decided to focus on male subjects before the start of enrollment.…”

Section: Methodsmentioning

confidence: 99%

Real-Time Functional Connectivity-Informed Neurofeedback of Amygdala-Frontal Pathways Reduces Anxiety

Zhao

Yao

et al. 2019

Psychother Psychosom

Self Cite

View full text Add to dashboard Cite

Background: Deficient emotion regulation and exaggerated anxiety represent a major transdiagnostic psychopathological marker. On the neural level these deficits have been closely linked to impaired, yet treatment-sensitive, prefrontal regulatory control over the amygdala. Gaining direct control over these pathways could therefore provide an innovative and promising intervention to regulate exaggerated anxiety. To this end the current proof-of-concept study evaluated the feasibility, functional relevance and maintenance of a novel connectivity-informed real-time fMRI neurofeedback training. Methods: In a randomized crossover sham-controlled design, 26 healthy subjects with high anxiety underwent real-time fMRI-guided neurofeedback training to enhance connectivity between the ventrolateral prefrontal cortex (vlPFC) and the amygdala (target pathway) during threat exposure. Maintenance of regulatory control was assessed after 3 days and in the absence of feedback. Training-induced changes in functional connectivity of the target pathway and anxiety ratings served as primary outcomes. Results: Training of the target, yet not the sham control, pathway significantly increased amygdala-vlPFC connectivity and decreased levels of anxiety. Stronger connectivity increases were significantly associated with higher anxiety reduction on the group level. At the follow-up, volitional control over the target pathway was maintained in the absence of feedback. Conclusions: The present results demonstrate for the first time that successful self-regulation of amygdala-prefrontal top-down regulatory circuits may represent a novel intervention to control anxiety. As such, the present findings underscore both the critical contribution of amygdala-prefrontal circuits to emotion regulation and the therapeutic potential of connectivity-informed real-time neurofeedback.

show abstract

Section: Methodsmentioning

confidence: 99%

Real-Time Functional Connectivity-Informed Neurofeedback of Amygdala-Frontal Pathways Reduces Anxiety

Zhao

Yao

et al. 2019

Psychother Psychosom

Self Cite

View full text Add to dashboard Cite

show abstract

“…Stimuli and reappraisal task design 70 minutes after drug administration, participants underwent a distancing reappraisal paradigm with concomitant fMRI acquisition. The design of task is shown in Figure 1B and represents a modified version of prior evaluated event-related cognitive reappraisal paradigms (Koenigsberg et al, 2009;Ochsner et al, 2004;Zimmermann et al, 2017). Each trial began with a 2 s cue ('Distance' or 'Look'), followed by a 1.5-3.5 s anticipatory interval during which a fixation cross was presented.…”

Section: Psychometric Assessmentmentioning

confidence: 99%

Oxytocin differentially modulates amygdala responses during top-down and bottom-up aversive anticipation

Xin

Zhou

Dong

et al. 2020

Preprint

Self Cite

View full text Add to dashboard Cite

The ability to successfully regulate negative emotions such as fear and anxiety is vital for mental health.The neuropeptide oxytocin (OXT) acts as important modulator of emotion regulation, as reflected by reduced amygdala responses but increased amygdala-prefrontal cortex (PFC) functional connectivity in response to threatening stimuli. The present randomized, between-subject, placebo (PLC)controlled pharmacological study combined intranasal administration of OXT with functional MRI during an explicit (cognitive) emotion regulation (i.e. distancing reappraisal) paradigm in 65 healthy male participants to investigate the modulatory effects of OXT on both bottom-up and top-down emotion regulation. OXT attenuated the activation in posterior insular cortex and amygdala during anticipation of top-down regulation of predictable threat stimuli in participants with high trait anxiety, providing evidence to support the anxiolytic action of OXT. In contrast, OXT enhanced amygdala activity during bottom-up anticipation of an unpredictable threat stimulus in participants with low trait anxiety. OXT may thus facilitate top-down goal-directed attention by attenuating amygdala activity in high anxiety individuals, while promote bottom-up attention/vigilance to unexpected threat by enhancing anticipatory amygdala activity in low anxiety individuals. The opposite effects of OXT on anticipatory amygdala activation in high versus low anxiety individuals may suggest a baseline anxiety level dependent mechanism via which OXT promotes optimal levels of amygdala activation during the anticipation of an imminent threat. OXT may thus have the potential to promote an adaptive balance between bottom-up and top-down attention systems depending on individual levels of pre-treatment trait anxiety levels. 2017; Zilverstand et al., 2017). Behavioral interventions (Campbell-Sills and Barlow, 2007; Gross et al., 2006; Jazaieri et al., 2015), neurofeedback targeting the amygdala-prefrontal circuits (Cohen Kadosh et al., 2016; Zhao et al., 2019) and pharmacological agents primarily targeting serotonergic and GABAergic neurotransmission (Farach et al., 2012; Singewald et al., 2015) can facilitate the regulation of negative emotions, including anxiety and fear. However, not all patients respond adequately to the currently available treatment strategies and the pharmacological interventions may induce negative side-effects which often limit compliance with the treatment protocols, thus novel strategies to improve emotion regulation are urgently needed.Emotion generation and regulation involves the interaction of intrinsic/automatic bottom-up processes and controlled/deliberately top-down processes (Ochsner and Gross, 2005;Ochsner and Gross, 2007;Suri et al., 2013). Bottom-up processes are stimulus-driven and initiated by salient stimuli in the environment. In contrast, top-down processes are goal-driven and context-dependent (Beck and Kastner, 2009;Desimone and Duncan, 1995;Sussman et al., 2016a). During both the (pre-stimulus) anticipation and adven...

show abstract

“…To enhance statistical power for the present data-driven approach, the sample size was increased to n = 28 male cannabis-dependent subjects and n = 28 nonusing controls using identical inclusion and exclusion criteria. To control for potential confounding influences of menstrual cycle on striatal resting state activity as well as complex interactions between menstrual cycle and addiction-related alterations in frontostriatal functioning (Franklin et al, 2015;Wetherill, Jagannathan, Hager, Maron, & Franklin, 2016;Wiers et al, 2016), only male subjects were included (for a similar approach see Zimmermann, Walz, et al, 2017).…”

Section: Participantsmentioning

confidence: 99%

Shifted balance of dorsal versus ventral striatal communication with frontal reward and regulatory regions in cannabis‐dependent males

Zhou

Zimmermann

Xin

et al. 2018

Human Brain Mapping

Self Cite

View full text Add to dashboard Cite

The transition from voluntary to addictive behavior is characterized by a loss of regulatory control in favor of reward driven behavior. Animal models indicate that this process is neurally underpinned by a shift in ventral–dorsal striatal control of behavior; however, this shift has not been directly examined in humans. The present resting state functional magnetic resonance imaging (fMRI) study employed a two‐step approach to: (a) precisely map striatal alterations using a novel, data‐driven network classification strategy combining intrinsic connectivity contrast with multivoxel pattern analysis and, (b) to determine whether a ventral to dorsal striatal shift in connectivity with reward and regulatory control regions can be observed in abstinent (28 days) male cannabis‐dependent individuals (n = 24) relative to matched controls (n = 28). Network classification revealed that the groups can be reliably discriminated by global connectivity profiles of two striatal regions that mapped onto the ventral (nucleus accumbens) and dorsal striatum (caudate). Subsequent functional connectivity analysis demonstrated a relative shift between ventral and dorsal striatal communication with fronto‐limbic regions that have been consistently involved in reward processing (rostral anterior cingulate cortex [ACC]) and executive/regulatory functions (dorsomedial prefrontal cortex [PFC]). Specifically, in the cannabis‐dependent subjects, connectivity between the ventral striatum with the rostral ACC increased, whereas both striatal regions were uncoupled from the regulatory dorsomedial PFC. Together, these findings suggest a shift in the balance between dorsal and ventral striatal control in cannabis dependence. Similar changes have been observed in animal models and may promote the loss of control central to addictive behavior.

show abstract

Emotion regulation deficits in regular marijuana users

Cited by 80 publications

References 49 publications

Real-Time Functional Connectivity-Informed Neurofeedback of Amygdala-Frontal Pathways Reduces Anxiety

Real-Time Functional Connectivity-Informed Neurofeedback of Amygdala-Frontal Pathways Reduces Anxiety

Oxytocin differentially modulates amygdala responses during top-down and bottom-up aversive anticipation

Shifted balance of dorsal versus ventral striatal communication with frontal reward and regulatory regions in cannabis‐dependent males

Contact Info

Product

Resources

About