ABSTRACT
Alcohol use disorder (AUD) is a chronic, relapsing brain disorder. It is well established that stress
motivates alcohol use and triggers relapse in individuals with AUD; however, the neural mechanisms that
underlie this association are not clear. Preclinical studies have shown that chronic alcohol and chronic stress
impact the brain’s stress systems in a way that results in deficits in flexible, adaptive stress coping. These deficits
can perpetuate a cycle of enduring stress conditions, and ultimately drive progression of AUD. The vast majority
of the literature examining chronic stress and its effects on brain function in AUD has yet to be translated from
preclinical to human clinical samples. Furthermore, clinical studies examining chronic stress and its association
with brain function in AUD are limited by the nature and quality of chronic stress measures, which primarily rely
on self-report questionnaires. To advance the translational impact of the science of the stress neurocircuitry in
AUD, it is critical that clinical studies implement methods to objectively measure chronic stress. This F32 NRSA
will objectively assess chronic stress and examine dynamic functional connectivity within the brain’s stress
coping system, using fMRI, in a clinical sample with AUD (n=32) and matched controls (n=32). Additionally, this
F32 will foster the applicant’s development as independent clinical and translational neuroscientist with a focus
on the intersection of stress and AUD. This application will draw on resources from the Sponsors’ (Drs. Lara Ray
and Erica Grodin) R21 study investigating the effect of stress on decision-making in AUD by adding
complimentary, non-overlapping scientific aims and outcome measures. The UCLA Life Stress Interview will be
used to objectively assess the psychological experience of chronic stress. Resting state fMRI will be used to
examine dynamic functional connectivity within the brain’s stress coping network. The ventromedial prefrontal
cortex (vmPFC) is recognized as a key locus in a resilient stress coping network, and recent studies have
suggested that dynamic changes in vmPFC activation during acute stress signals resilient coping. The applicant
will extend this work by measuring dynamic vmPFC functional connectivity to characterize temporal variability
within the network. The applicant will integrate these psychological and neural levels of analysis to examine the
effects of chronic stress on temporal variability, or flexibility, within the brain’s stress coping system in AUD
versus controls. Aim 1 tests the hypothesis that individuals with AUD will exhibit greater chronic stress compared
with controls. Aim 2 tests the hypothesis that individuals with AUD will exhibit diminished temporal variability
(flexibility) in vmPFC resting state functional connectivity compared with controls. Aim 3 tests the hypothesis that
chronic stress will be associated with decreased flexibility in vmPFC resting state functional connectivity, and
that AUD will moderate this relationship. The proposed study represents important steps in: 1) translating
preclinical science on the stress neurocircuitry in AUD; and 2) the applicant’s scientific development and maturity
as an independent clinical alcohol researcher with an interest in the role of stress in AUD.