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FC18-04 - Cue-induced brain activation mediates subsequent relapse in abstinent alcohol-dependent patients

Published online by Cambridge University Press:  16 April 2020

A. Beck
Affiliation:
Dept. of Psychiatry and Psychotherapy CCM, Charité - Universitätsmedizin Berlin, Berlin, Germany
T. Wüstenberg
Affiliation:
Dept. of Psychiatry and Psychotherapy CCM, Charité - Universitätsmedizin Berlin, Berlin, Germany
J. Wrase-Post
Affiliation:
Dept. of Psychiatry and Psychotherapy CCM, Charité - Universitätsmedizin Berlin, Berlin, Germany
F. Schlagenhauf
Affiliation:
Dept. of Psychiatry and Psychotherapy CCM, Charité - Universitätsmedizin Berlin, Berlin, Germany
S. Vollstädt-Klein
Affiliation:
Dept. of Addiction Research, Central Institute of Mental Health, Mannheim, Germany
D. Hermann
Affiliation:
Dept. of Addiction Research, Central Institute of Mental Health, Mannheim, Germany
M.N. Smolka
Affiliation:
Dept. of Psychiatry and Psychotherapy, Universitätsklinikum Carl Gustav Carus, TU Dresden, Dresden, Germany
M. Ruf
Affiliation:
Dept. of Addiction Research, Central Institute of Mental Health, Mannheim, Germany
W. Weber-Fahr
Affiliation:
Dept. of Addiction Research, Central Institute of Mental Health, Mannheim, Germany
H. Flor
Affiliation:
Dept. of Neuropsychology and Clinical Psychogy, Ruprecht-Karls-Universität Heidelberg, Central Institute of Mental Health, Mannheim, Germany
K. Mann
Affiliation:
Dept. of Addiction Research, Central Institute of Mental Health, Mannheim, Germany
D.F. Braus
Affiliation:
Dept. of Psychiatry and Psychotherapy, Dr. Horst Schmidt Klinken, Wiesbaden, Germany
A. Heinz
Affiliation:
Dept. of Psychiatry and Psychotherapy CCM, Charité - Universitätsmedizin Berlin, Berlin, Germany
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Abstract

Introduction

In alcoholism, one relevant mechanism contributing to relapse is the exposure to stimuli that are associated with alcohol intake. Such conditioned cues can elicit conditioned responses like alcohol craving and consumption. In the last decade, considerable progress has been made in identifying basic neuronal mechanisms that underlie cue-induced alcohol craving.

Objectives/ aims

We explored whether functional brain activation during exposure to alcohol-associated stimuli is related to the prospective relapse risk in detoxified alcohol-dependent patients.

Methods

46 alcohol-dependent and 46 healthy volunteers participated in a fMRI study using a cue reactivity paradigm, in which visual alcohol-related and control stimuli were presented. Patients were followed for 3 months. Afterwards data was analysed regarding the subsequent relapse, resulting in 16 abstainers and 30 relapsers.

Results

Alcohol-related versus neutral stimuli activated a frontocortical-limbic network including inferior, medial and middle frontal gyrus as well as putamen in the group of patients relative to healthy controls. Moreover, abstainers showed a stronger activation in orbitofrontal cortex as well as midbrain during the presentation of alcohol-related cues whereas relapsers revealed a stronger activation of cingulate gyrus.

Conclusions

This study suggests that cue-induced activation of orbitofrontal cortex and dopaminergic innervated midbrain is negatively associated with the prospective relapse risk in alcohol-dependent patients. This could indicate a more pronounced and conscious processing of alcohol cues which might serve as a warning signal and a behavioural controlling function. In contrast, prospective relapsers showed a stronger activation of cingulate gyrus, a region involved in the attribution of motivational value.

Type
Research Article
Copyright
Copyright © European Psychiatric Association 2011

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