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

Zikai Lin

Abstract:

Abstract
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 with discounting 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