Sun Mi Kim1, Doug Hyun Han2, Kyung Joon Min3, Bung-Nyun Kim4, Jae Hoon Cheong5. 1. Department of Psychiatry, Chung-Ang University, College of Medicine, 102 Heukseok-ro, Dongjak-gu, Seoul 156-755, Republic of Korea. Electronic address: sunmikim706@gmail.com. 2. Department of Psychiatry, Chung-Ang University, College of Medicine, 102 Heukseok-ro, Dongjak-gu, Seoul 156-755, Republic of Korea. Electronic address: hduk@yahoo.com. 3. Department of Psychiatry, Chung-Ang University, College of Medicine, 102 Heukseok-ro, Dongjak-gu, Seoul 156-755, Republic of Korea. Electronic address: kjoonmin@gmail.com. 4. Department of Psychiatry, Seoul National University, College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul 110-744, Republic of Korea. Electronic address: kbn1@snu.ac.kr. 5. Uimyung Research Institute for Neuroscience, Samyook University, Gongneung 2-dong, Nowon-gu, Seoul 139-742, Republic of Korea. Electronic address: cheongjh@syu.ac.kr.
Abstract
BACKGROUND: Episodes of alcohol consumption produce use-limiting aversive effects as well as use-promoting euphoric effects. The brain regions associated with the reward circuit in patients with alcohol dependence (PAD) show signs of conditioning for alcohol craving. Alternatively, brain structures in the medial temporal region are known to be crucial for aversive conditioning. In this study, we compare differences in patterns of brain activation in response to cues that induce cravings versus aversion in PAD. METHODS: Thirty-eight PAD and 26 healthy volunteers were administered cue reactivity tasks while undergoing functional magnetic resonance imaging (fMRI) to examine brain response to craving-inducing cues (CIC) and aversion-inducing cues (AIC). RESULTS: Activation of the right medial frontal gyrus (right orbitofrontal cortex) during CIC was greater in PAD than in healthy volunteers. Participants in the PAD group displayed less activation in the right amygdala and the right middle temporal gyrus during AIC than did the healthy volunteers. Brain reactivity within the right medial frontal gyrus in response to CIC was positively correlated with the scores of PAD on the Korean Alcohol Urge Questionnaire (AUQ-K) and the Michigan Alcohol Screening Test (MAST). Reactivity within the amygdala in response to AIC was negatively correlated with AUQ-K scores among PAD. CONCLUSION: The dysfunction of the orbitofrontal cortex that results from repeated exposure to alcohol accounts for craving and relapse in PAD. Additionally, PAD seem to be less sensitive to cues related to aversive consequences of alcohol overuse in comparison with healthy individuals.
BACKGROUND: Episodes of alcohol consumption produce use-limiting aversive effects as well as use-promoting euphoric effects. The brain regions associated with the reward circuit in patients with alcohol dependence (PAD) show signs of conditioning for alcohol craving. Alternatively, brain structures in the medial temporal region are known to be crucial for aversive conditioning. In this study, we compare differences in patterns of brain activation in response to cues that induce cravings versus aversion in PAD. METHODS: Thirty-eight PAD and 26 healthy volunteers were administered cue reactivity tasks while undergoing functional magnetic resonance imaging (fMRI) to examine brain response to craving-inducing cues (CIC) and aversion-inducing cues (AIC). RESULTS: Activation of the right medial frontal gyrus (right orbitofrontal cortex) during CIC was greater in PAD than in healthy volunteers. Participants in the PAD group displayed less activation in the right amygdala and the right middle temporal gyrus during AIC than did the healthy volunteers. Brain reactivity within the right medial frontal gyrus in response to CIC was positively correlated with the scores of PAD on the Korean Alcohol Urge Questionnaire (AUQ-K) and the Michigan Alcohol Screening Test (MAST). Reactivity within the amygdala in response to AIC was negatively correlated with AUQ-K scores among PAD. CONCLUSION: The dysfunction of the orbitofrontal cortex that results from repeated exposure to alcohol accounts for craving and relapse in PAD. Additionally, PAD seem to be less sensitive to cues related to aversive consequences of alcohol overuse in comparison with healthy individuals.
Authors: Clark W Bird; Felicha T Candelaria-Cook; Christy M Magcalas; Suzy Davies; C Fernando Valenzuela; Daniel D Savage; Derek A Hamilton Journal: PLoS One Date: 2015-03-06 Impact factor: 3.240
Authors: E H Limbrick-Oldfield; I Mick; R E Cocks; J McGonigle; S P Sharman; A P Goldstone; P R A Stokes; A Waldman; D Erritzoe; H Bowden-Jones; D Nutt; A Lingford-Hughes; L Clark Journal: Transl Psychiatry Date: 2017-01-03 Impact factor: 6.222
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