Delay discounting and alcohol consumption correlate with dorsal anterior insula activation during choice in nontreatment‐seeking heavy drinkers

• Published in: Alcoholism, clinical and experimental research clinical and experimental research, 2022-08, Vol.46 (8), p.1397-1407
• Main Authors: Halcomb, Meredith, Dzemidzic, Mario, Shen, Yitong I., Lin, Zikai, Butcher, Tarah J., Yoder, Karmen K., Oberlin, Brandon
• Format: Article
• Language: English
• Subjects: Adult; Alcohol; Alcohol Drinking - psychology; Alcohol use; alcohol use disorder; Alcoholic Intoxication; Alcoholics; Alcoholism; Alcoholism - psychology; Brain; Cortex (cingulate); Cortex (insular); Cortex (parietal); Decision making; Delay Discounting - physiology; Drinking behavior; Female; Functional magnetic resonance imaging; Humans; Impulsive behavior; Impulsive Behavior - physiology; Magnetic Resonance Imaging; monetary discounting; Neural networks; Precentral gyrus; psychophysiological interaction; Reward; task fMRI
• ISSN: 0145-6008; 1530-0277
• DOI: 10.1111/acer.14888

Background The anterior insular cortex (AIC), a prominent salience network node, integrates interoceptive information and emotional states into decision making. While AIC activation during delay discounting (DD) in alcohol use disorder (AUD) has been previously reported, the associations between AIC activation, impulsive choice, alcohol consumption, and connectivity remain unknown. We therefore tested AIC brain responses during DD in heavy drinkers and their association with DD performance, alcohol drinking, and task‐based connectivity. Methods Twenty‐nine heavy drinkers (12 females; mean (SD) age=31.5 ± 6.1 years; mean (SD)=40.8 ± 23.4 drinks/week) completed a DD task during functional MRI. Regions activated during DD decision making were tested for correlation with DD behavior and alcohol drinking. Psychophysiological interaction (PPI) models assessed the task‐dependent functional connectivity (FC) of activation during choice. Results Delay discounting choice activated bilateral anterior insular cortex, anterior cingulate cortex, and left precentral gyrus. Right dorsal (d) AIC activation during choice negatively correlated withdiscounting of delayed rewards and alcohol consumption. PPI analysis revealed FC of the right dAIC to both the anterior and posterior cingulate cortices—key nodes in the midline default mode network. Conclusions Greater dAIC involvement in intertemporal choice may confer more adaptive behavior (lower impulsivity and alcohol consumption). Moreover, salience network processes governing discounting may require midline default mode (precuneus/posterior cingulate cortex) recruitment. These findings supporta key adaptive role for right dAIC in decision making involving future rewards and risky drinking. Making choices across the time domain or about drinking decisions involves the anterior insular cortex (AIC). In our cohort of heavy drinkers, we detected AIC activation during temporal discounting that correlated with impulsive choice, drinking, and task‐related connectivity with default mode regions. More AIC activation corresponded with less drinking and greater preference for delayed rewards, suggesting that AIC involvement may be key for adaptive decision‐making in those engaging in hazardous drinking.