Cue reactivity is associated with duration and severity of alcohol dependence: an FMRI study

Zsuzsika Sjoerds; Wim van den Brink; Aartjan T F Beekman; Brenda W J H Penninx; Dick J Veltman

doi:10.1371/journal.pone.0084560

Cue reactivity is associated with duration and severity of alcohol dependence: an FMRI study

PLoS One. 2014 Jan 6;9(1):e84560. doi: 10.1371/journal.pone.0084560. eCollection 2014.

Authors

Zsuzsika Sjoerds¹, Wim van den Brink², Aartjan T F Beekman³, Brenda W J H Penninx⁴, Dick J Veltman³

Affiliations

¹ Department of Psychiatry, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands ; Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
² Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
³ Department of Psychiatry, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands.
⁴ Department of Psychiatry, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands ; Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands ; Department of Psychiatry, University Medical Center of Groningen, Groningen, The Netherlands.

Abstract

Introduction: With the progression of substance dependence, drug cue-related brain activation is thought to shift from motivational towards habit pathways. However, a direct association between cue-induced brain activation and dependence duration has not yet been shown. We therefore examined the relationship between alcohol cue-reactivity in the brain, cue-induced subjective craving and alcohol dependence duration and severity. Since alcohol dependence is highly comorbid with depression/anxiety, which may modulate brain responses to alcohol cues, we also examined the relation between comorbid depression/anxiety and cue-reactivity.

Methods: We compared 30 alcohol dependent patients with 15 healthy controls and 15 depression/anxiety patients during a visual alcohol cue-reactivity task using functional magnetic resonance imaging blood oxygenated level-dependent responses and subjective craving as outcomes. Within the alcohol dependent group we correlated cue-reactivity with alcohol dependence severity and duration, with cue-induced craving and with depression/anxiety levels.

Results: Alcohol dependent patients showed greater cue-reactivity in motivational brain pathways and stronger subjective craving than depression/anxiety patients and healthy controls. Depression/anxiety was not associated with cue-reactivity, but depression severity in alcohol dependent patients was positively associated with craving. Within alcohol dependence, longer duration of alcohol dependence was associated with stronger cue-related activation of the posterior putamen, a structure involved in habits, whereas higher alcohol dependence severity was associated with lower cue-reactivity in the anterior putamen, an area implicated in goal-directed behavior preceding habit formation.

Conclusion: Cue-reactivity in alcohol dependence is not modulated by comorbid depression or anxiety. More importantly, the current data confirm the hypothesis of a ventral to dorsal striatal shift of learning processes with longer dependence duration, which could underlie increasingly habitual substance use with progressing substance dependence.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Alcoholism / physiopathology*
Brain / physiopathology*
Brain Mapping*
Cues*
Female
Humans
Magnetic Resonance Imaging*
Male
Middle Aged

Grants and funding

Funding for this study was provided by grant 31160004 from the Netherlands Organization for Health Research and Development (Zon-Mw), commissioned by the Netherlands Organization for Scientific Research (NWO). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.