Disrupted Ventromedial Prefrontal Function, Alcohol Craving, and Subsequent Relapse Risk

IntroductionIn 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/ aimsWe explored whether functional brain activation during exposure to alcohol-associated stimuli is related to the prospective relapse risk in detoxified alcohol-dependent patients.Methods46 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.ResultsAlcohol-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.ConclusionsThis 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.

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EBV, CMV, and HSV IgG Titers Are Not Predictive of Subsequent Relapse Risk in Pediatric Multiple Sclerosis (P02.096)

Neurology ◽

10.1212/wnl.78.1_meetingabstracts.p02.096 ◽

2012 ◽

Vol 78 (Meeting Abstracts 1) ◽

pp. P02.096-P02.096

Author(s):

J. Graves ◽

L. Krupp ◽

B. Weinstock-Guttman ◽

J. Strober ◽

A. Belman ◽

...

Keyword(s):

Multiple Sclerosis ◽

Relapse Risk ◽

Pediatric Multiple Sclerosis ◽

Subsequent Relapse

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Stress, alcohol craving, and relapse risk: mechanisms and viable treatment targets

Alcohol ◽

10.1016/j.alcohol.2009.09.024 ◽

2009 ◽

Vol 43 (7) ◽

pp. 541-543 ◽

Cited By ~ 5

Author(s):

Barbara J. Mason ◽

Yavin Shaham ◽

Friedbert Weiss ◽

A.D. Le

Keyword(s):

Alcohol Craving ◽

Relapse Risk ◽

Treatment Targets ◽

Viable Treatment

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Association of the alcohol dehydrogenase gene polymorphism rs1789891 with gray matter brain volume, alcohol consumption, alcohol craving and relapse risk

Addiction Biology ◽

10.1111/adb.12571 ◽

2017 ◽

Vol 24 (1) ◽

pp. 110-120 ◽

Cited By ~ 4

Author(s):

Patrick Bach ◽

Evangelos Zois ◽

Sabine Vollstädt-Klein ◽

Martina Kirsch ◽

Sabine Hoffmann ◽

...

Keyword(s):

Alcohol Consumption ◽

Gene Polymorphism ◽

Alcohol Dehydrogenase ◽

Gray Matter ◽

Brain Volume ◽

Alcohol Craving ◽

Relapse Risk ◽

Dehydrogenase Gene

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Breast size, local relapse risk and prognosis after organ preserving therapy for early stage cancer

European Journal of Cancer ◽

10.1016/s0959-8049(02)80522-6 ◽

2002 ◽

Vol 38 (11) ◽

pp. S155

Author(s):

F Ampil

Keyword(s):

Early Stage ◽

Local Relapse ◽

Breast Size ◽

Early Stage Cancer ◽

Relapse Risk

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Verlangen nach Alkohol, Depressivität und Ängstlichkeit während stationärer Entzugsbehandlung:

Zeitschrift für Klinische Psychologie und Psychotherapie ◽

10.1026/0084-5345.32.4.303 ◽

2003 ◽

Vol 32 (4) ◽

pp. 303-306 ◽

Cited By ~ 2

Author(s):

Ralf Demmel ◽

Martina Schröder

Keyword(s):

Obsessive Compulsive ◽

Alcohol Craving ◽

Deutschsprachige Version

Zusammenfassung. Hintergrund: Alkoholabhängige Patienten berichten häufig von einem starken Verlangen nach Alkohol (alcohol craving). Die Ergebnisse experimenteller Untersuchungen lassen vermuten, dass Ängstlichkeit und Depressivität mit stärkerem Craving einhergehen. Darüber hinaus kann vorausgesetzt werden, dass Intensität und Häufigkeit des Verlangens nach Alkohol im Verlauf einer stationären Behandlung deutlich abnehmen. Fragestellung: Lässt sich die Konstruktvalidität einer deutschsprachigen Version der Obsessive Compulsive Drinking Scale (OCDS) empirisch belegen? Methode: Am ersten, siebten und 14. Tag nach Beginn einer stationäreren Behandlung wurde alkoholabhängigen Patienten (N = 41) jeweils eine deutschsprachige Version der OCDS sowie der Symptom-Checkliste von Derogatis vorgelegt. Ergebnisse: Das von den Patienten berichtete Verlangen nach Alkohol nahm im Verlauf der stationären Behandlung deutlich ab, Ängstlichkeit und Depressivität gingen jedoch nicht mit stärkerem Verlangen einher. Schlussfolgerungen: Möglicherweise bildet eine wöchentliche Erfassung die starken Schwankungen des Verlangens während des akuten Entzugs nicht adäquat ab.

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