A, The ventromedial prefrontal cortex (vmPFC)/anterior cingulate cortex (ACC),
identified by Seo et al as a robust biomarker of alcohol relapse risk, modulates
and, in turn, is modulated by the activity of multiple other cortical and
subcortical regions whose combined output is used to orchestrate adaptive and
flexible goal-directed behaviors. Current evidence suggests that information
from cortical and subcortical structures converges toward a single common value
representation before passing on to the choice-related motor control circuitry.
Modulatory inputs play a critical role in establishing this final common
representation with those inputs carrying signals related to interoception,
salience attribution, conditioning, executive control, reward, habituation, and
stress and mood reactivity. B, In addition, each region has been numbered and
its general location tagged onto maps of the human brain (internal and external
views) overlaid with orange and yellow pseudocolors that represent the resting
state connectivity of the DMN. Regions (vmPFC/ACC and precuneus) that were
hyperactive during the neutral conditions and that predicted relapse show
significant overlap with the DMN. DLPFC indicates dorsolateral prefrontal
cortex; iPFC, inferior prefrontal cortex; lOFC, lateral orbitofrontal cortex;
mOFC, medial orbitofrontal cortex; Nac, nucleus accumbens; VTA, ventral
tegmental area.