Alcohol-associated stimuli activate the ventral striatum in abstinent alcoholics.
ABSTRACT Alcohol-associated cues may act as conditioned stimuli that activate the brain reward system and motivate alcohol intake in alcoholics. Alcohol-associated visual stimuli were presented during functional magnetic resonance imaging. An activation of the ventral putamen was observed in alcoholics but not in control subjects. Patients with a strong activation of the ventral putamen relapsed during the next three months. This observation supports the hypothesis that alcohol use affects areas involved in brain reward circuits and that their stimulus-induced activation may be associated with an increased risk for relapse.
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ABSTRACT: There is a considerable body of literature demonstrating that adolescence is a unique age period, which includes rapid and dramatic maturation of behavioral, cognitive, hormonal and neurobiological systems. Most notably, adolescence is also a period of unique responsiveness to alcohol effects, with both hyposensitivity and hypersensitivity observed to the various effects of alcohol. Multiple neurotransmitter systems are undergoing fine-tuning during this critical period of brain development, including those that contribute to the rewarding effects of drugs of abuse. The role of developmental maturation of the γ-amino-butyric acid (GABA) system, however, has received less attention in contributing to age-specific alcohol sensitivities. This review integrates GABA findings from human magnetic resonance spectroscopy studies as they may translate to understanding adolescent-specific responsiveness to alcohol effects. Better understanding of the vulnerability of the GABA system both during adolescent development, and in psychiatric conditions that include alcohol dependence, could point to a putative mechanism, boosting brain GABA, that may have increased effectiveness for treating alcohol abuse disorders.Pharmacology [?] Therapeutics 08/2014; DOI:10.1016/j.pharmthera.2014.03.001 · 7.75 Impact Factor
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ABSTRACT: Behavioral studies have shown an alcohol approach bias in alcohol-dependent patients: the automatic tendency to faster approach than avoid alcohol compared to neutral cues, which has been associated with craving and relapse. Although this is a well-studied psychological phenomenon, little is known about the brain processes underlying automatic action tendencies in addiction. We examined 20 alcohol-dependent patients and 17 healthy controls with functional magnetic resonance imaging (fMRI), while performing an implicit approach avoidance task (AAT). Participants pushed and pulled pictorial cues of alcohol and softdrink beverages, according to a content-irrelevant feature of the cue (landscape/portrait). The critical fMRI contrast regarding the alcohol approach bias was defined as (approach alcohol>avoid alcohol)>(approach softdrink>avoid softdrink). This was reversed for the avoid alcohol contrast: (avoid alcohol>approach alcohol)>(avoid softdrink>approach softdrink). In comparison with healthy controls, alcohol-dependent patients had stronger behavioral approach tendencies for alcohol cues than for softdrink cues. In the approach alcohol fMRI contrast patients showed larger blood-oxygen-level dependent (BOLD) responses in the nucleus accumbens (NAcc) and medial prefrontal cortex (mPFC), regions involved in reward and motivational processing. In alcohol-dependent patients alcohol craving scores were positively correlated with activity in the amygdala for the approach alcohol contrast. The dlPFC was not activated in the avoid alcohol contrast in patients versus controls. Our data suggest that brain regions that play a key role in reward and motivation are associated with the automatic alcohol approach bias in alcohol-dependent patients.Neuropsychopharmacology accepted article preview online, 20 September 2013. doi:10.1038/npp.2013.252.Neuropsychopharmacology: official publication of the American College of Neuropsychopharmacology 09/2013; DOI:10.1038/npp.2013.252 · 7.83 Impact Factor
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ABSTRACT: Craving is a major motivator underlying drug use and relapse but the neural correlates of cannabis craving are not well understood. This study sought to determine whether visual cannabis cues increase cannabis craving and whether cue-induced craving is associated with regional brain activation in cannabis-dependent individuals. Cannabis craving was assessed in 16 cannabis-dependent adult volunteers while they viewed cannabis cues during a functional MRI (fMRI) scan. The Marijuana Craving Questionnaire was administered immediately before and after each of three cannabis cue-exposure fMRI runs. FMRI blood-oxygenation-level-dependent (BOLD) signal intensity was determined in regions activated by cannabis cues to examine the relationship of regional brain activation to cannabis craving. Craving scores increased significantly following exposure to visual cannabis cues. Visual cues activated multiple brain regions, including inferior orbital frontal cortex, posterior cingulate gyrus, parahippocampal gyrus, hippocampus, amygdala, superior temporal pole, and occipital cortex. Craving scores at baseline and at the end of all three runs were significantly correlated with brain activation during the first fMRI run only, in the limbic system (including amygdala and hippocampus) and paralimbic system (superior temporal pole), and visual regions (occipital cortex). Cannabis cues increased craving in cannabis-dependent individuals and this increase was associated with activation in the limbic, paralimbic, and visual systems during the first fMRI run, but not subsequent fMRI runs. These results suggest that these regions may mediate visually cued aspects of drug craving. This study provides preliminary evidence for the neural basis of cue-induced cannabis craving and suggests possible neural targets for interventions targeted at treating cannabis dependence.09/2013; 214(2). DOI:10.1016/j.pscychresns.2013.06.005