Brain Connectivity of the Cingulate Cortex in Alcohol Use Disorder: Exploring Its Association With Mindfulness

Alcohol use disorder (AUD) represents a significant challenge in mental health. Severe AUD is characterized by uncontrolled alcohol consumption and is associated with dysregulation in brain circuits responsible for reward, motivation, decision-making, affect, and stress response. Mindfulness is known to positively influence those dysregulations and may enhance abstinence-related self-efficacy (confidence in resisting alcohol consumption), which is one of the best predictors for abstinence following inpatient treatment. Large-scale networks underlie mindfulness, including the default mode and salience network. This study aims to investigate the role of the cingulum bundle (CB) in patients with AUD, which bridges these two networks in relation to mindfulness and abstinence-related self-efficacy. We conducted a study with 39 recently abstinent inpatients with AUD and 18 healthy controls. Mindfulness and self-efficacy were assessed using standardized and validated self-report questionnaires. Structural and resting state functional magnetic resonance imaging (MRI) data were acquired to examine structural and functional connectivity of the cingulate cortex. Our findings showed reduced structural and functional connectivity of the CB in AUD patients with a highly positive association between these metrics. Overall, mindfulness correlated strongly with abstinence-related self-efficacy. We found no association of trait mindfulness and structural and functional findings of the cingulate cortex. However, exploratory analyses suggest a positive association between CB number of streamlines and mindfulness factors 'acceptance' and 'decentring', and abstinence-related self-efficacy. This is the first study indicating that patients with AUD have structural and functional impairments of the CB. These alterations could be associated with reduced mindfulness and self-efficacy.