Brain-Related Predictors of Alcohol Relapse
OVERVIEW:
Chronic alcohol abuse is a leading health problem in Western societies. The issue has individual and societal ramifications that include costly health expenditures, disability, and mortality (Oscar-Berman & Marinkovic, 2007). Accordingly, empirical efforts to better understand the impact of chronic alcohol abuse on brain functioning and treatment outcomes have emerged (e.g., Brokate, Hildenbrandt, Eling, Fichtner, & Runge, 2003; Harper, 2007; Oscar-Berman & Marinkovic, 2007). Despite these efforts, alcohol abuse and rates of relapse continue to be problematic. Furthermore, despite much of the alcohol-related treatments being devoted to relapse prevention, the literature on the brain mechanisms involved in chronic abuse and relapse are sparse. Therefore, there is a need for increased research investigating brain-related changes that may increase the risk of relapse, as well as neural mechanisms that help to predict persons most at risk for alcohol abuse. The highlighted article illustrates how gray matter volume deficits in specific brain regions (i.e., medial frontal, lateral prefrontal, and posterior parietal-occipital) may contribute to increased risk of relapse to alcohol.
ABSTRACT:
Association of Frontal and Posterior Cortical Gray Matter Volume with Time to Alcohol Relapse: A Prospective Study (2014)
Objective: Alcoholism is associated with gray matter volume deficits in frontal and other brain regions. Whether persistent brain volume deficits in abstinence are predictive of subsequent time to alcohol relapse has not been established. The authors measured gray matter volumes in healthy volunteers and in a sample of treatment-engaged, alcohol dependent patients after 1 month of abstinence and assessed whether smaller frontal gray matter volume was predictive of subsequent alcohol relapse outcomes.
Method: Forty-five abstinent alcohol dependent patients in treatment and 50 healthy comparison subjects were scanned once using high-resolution (T1-weighted) structural MRI, and voxel-based morphometry was used to assess regional brain volume differences between the groups. A prospective study design was used to assess alcohol relapse in the alcohol-dependent group for 90 days after discharge from 6 weeks of inpatient treatment.
Results: Significantly smaller gray matter volume in alcohol-dependent patients relative to comparison subjects was seen in three regions: the medial frontal cortex, the right lateral prefrontal cortex, and a posterior region surrounding the parietal-occipital sulcus. Smaller medial frontal and parietal-occipital gray matter volumes were each predictive of shorter time to any alcohol use and to heavy drinking relapse.
Conclusions: These findings are the first to demonstrate that gray matter volume deficits in specific medial frontal and posterior parietal-occipital brain regions are predictive of an earlier return to alcohol use and relapse risk, suggesting a significant role for gray matter atrophy in poor clinical outcomes in alcoholism. Extent of gray matter volume deficits in these regions could serve as useful neural markers of relapse risk and alcoholism treatment outcome.
Rando, K., Hong, K.-I., Bhagwagar, Z., Li, C.-S. R., Bergquist, K., Guarnaccia, J., & Sinha, R. (2014). Association of frontal and posterior cortical gray matter volume with time to alcohol relapse: a prospective study. American Journal of Psychiatry, 168(2), 183–192.
Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3668974/
WEBINAR:
In this video, researchers at the University of California, San Diego discuss how neuroimaging techniques may have predictive utility in anticipating what individuals are more inclined to abuse alcohol.
Link: https://www.youtube.com/watch?v=IGaGqaRpj30
FURTHER READING:
Chronic alcohol abuse is a leading health problem in Western societies. The issue has individual and societal ramifications that include costly health expenditures, disability, and mortality (Oscar-Berman & Marinkovic, 2007). Accordingly, empirical efforts to better understand the impact of chronic alcohol abuse on brain functioning and treatment outcomes have emerged (e.g., Brokate, Hildenbrandt, Eling, Fichtner, & Runge, 2003; Harper, 2007; Oscar-Berman & Marinkovic, 2007). Despite these efforts, alcohol abuse and rates of relapse continue to be problematic. Furthermore, despite much of the alcohol-related treatments being devoted to relapse prevention, the literature on the brain mechanisms involved in chronic abuse and relapse are sparse. Therefore, there is a need for increased research investigating brain-related changes that may increase the risk of relapse, as well as neural mechanisms that help to predict persons most at risk for alcohol abuse. The highlighted article illustrates how gray matter volume deficits in specific brain regions (i.e., medial frontal, lateral prefrontal, and posterior parietal-occipital) may contribute to increased risk of relapse to alcohol.
ABSTRACT:
Association of Frontal and Posterior Cortical Gray Matter Volume with Time to Alcohol Relapse: A Prospective Study (2014)
Objective: Alcoholism is associated with gray matter volume deficits in frontal and other brain regions. Whether persistent brain volume deficits in abstinence are predictive of subsequent time to alcohol relapse has not been established. The authors measured gray matter volumes in healthy volunteers and in a sample of treatment-engaged, alcohol dependent patients after 1 month of abstinence and assessed whether smaller frontal gray matter volume was predictive of subsequent alcohol relapse outcomes.
Method: Forty-five abstinent alcohol dependent patients in treatment and 50 healthy comparison subjects were scanned once using high-resolution (T1-weighted) structural MRI, and voxel-based morphometry was used to assess regional brain volume differences between the groups. A prospective study design was used to assess alcohol relapse in the alcohol-dependent group for 90 days after discharge from 6 weeks of inpatient treatment.
Results: Significantly smaller gray matter volume in alcohol-dependent patients relative to comparison subjects was seen in three regions: the medial frontal cortex, the right lateral prefrontal cortex, and a posterior region surrounding the parietal-occipital sulcus. Smaller medial frontal and parietal-occipital gray matter volumes were each predictive of shorter time to any alcohol use and to heavy drinking relapse.
Conclusions: These findings are the first to demonstrate that gray matter volume deficits in specific medial frontal and posterior parietal-occipital brain regions are predictive of an earlier return to alcohol use and relapse risk, suggesting a significant role for gray matter atrophy in poor clinical outcomes in alcoholism. Extent of gray matter volume deficits in these regions could serve as useful neural markers of relapse risk and alcoholism treatment outcome.
Rando, K., Hong, K.-I., Bhagwagar, Z., Li, C.-S. R., Bergquist, K., Guarnaccia, J., & Sinha, R. (2014). Association of frontal and posterior cortical gray matter volume with time to alcohol relapse: a prospective study. American Journal of Psychiatry, 168(2), 183–192.
Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3668974/
WEBINAR:
In this video, researchers at the University of California, San Diego discuss how neuroimaging techniques may have predictive utility in anticipating what individuals are more inclined to abuse alcohol.
Link: https://www.youtube.com/watch?v=IGaGqaRpj30
FURTHER READING:
- Brokate, B., Hildebrandt, H., Eling, P., Fichtner, H., Runge, K., & Timm, C. (2003). Frontal lobe dysfunctions in Korsakoff’s syndrome and chronic alcoholism: Continuity or discontinuity? Neuropsychology, 17(3), 420-428. http://www.ncbi.nlm.nih.gov/pubmed/12959508
- Cardenas, V. A., Durazzo, T. C., Gazdzinski, S., Mon, A., Studholme, C., & Meyerhoff, D. J. (2011). Brain morphology at entry into treatment for alcohol dependence is related to relapse propensity. Biological psychiatry, 70(6), 561-567. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3162109/
- Cardenas V. A., Studholme C., Gazdzinski, S., Durazzo, T. C., Meyerhoff, D. J. (2007). Deformation-based morphometry of brain changes in alcohol dependence and abstinence. NeuroImage, 34, 879–887. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1865510/pdf/nihms16930.pdf
- Demirakca, T., Ende, G., Kämmerer, N., Welzel‐Marquez, H., Hermann, D., Heinz, A., & Mann, K. (2011). Effects of alcoholism and continued abstinence on brain volumes in both genders. Alcoholism: Clinical and Experimental Research, 35(9), 1678–1685. http://www.ncbi.nlm.nih.gov/pubmed/21599718
- Harper, C. (2007). The neurotoxicity of alcohol. Human & experimental toxicology, 26(3), 251–257.
- http://www.sagepub.com/jungstudy/articles/05/Harper.pdf
- Mechtcheriakov, S., Brenneis, C., Eggar, K., Koppelstaetter, F., Schocke, M., Marksteiner, J. (2007). A widespread distinct pattern of cerebral atrophy in patients with alcohol addiction revealed by voxel-based morphometry. Journal of Neurology, Neurosurgery, & Psychiatry, 78, 610–614. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2077939/
- Oscar-Berman, M., & Marinković, K. (2007). Alcohol: Effects on neurobehavioral functions and the brain. Neuropsychology Review, 17(3), 239–257. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4040959/
- Tanabe, J., Tregellas, J. R., Dalwani, M., Thompson, L., Owens, E., Crowley, T., & Banich, M. (2009). Medial orbitofrontal cortex gray matter is reduced in abstinent substance-dependent individuals. Biolological Psychiatry, 65, 160–164. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2640220/
Contributors:
Elaine Lacson, M.A., and Joseph Babione, M.A. – Illinois School of Professional Psychology at Argosy University, Chicago
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