Brain patterns may help predict relapse risk for alcoholism

(Medical Xpress)—Distinct patterns of brain activity are linked to greater rates of relapse among alcohol dependent patients in early recovery, a study has found. The research, supported by the National Institutes of Health, may give clues about which people in recovery from alcoholism are most likely to return to drinking.

"Reducing the high rate of relapse among people treated for alcohol dependence is a fundamental research issue," said Kenneth R. Warren, Ph.D., acting director of the National Institute on Alcohol Abuse and Alcoholism (NIAAA), part of NIH. "Improving our understanding of the that underlie relapse will help us identify susceptible individuals and could inform the development of other prevention strategies."

Using , researchers found that people in recovery from alcoholism who showed hyperactivity in areas of the during a relaxing scenario were eight times as likely to relapse as those showing normal or healthy controls.

The prefrontal brain plays a role in regulating emotion, the ability to suppress urges, and decision-making. Chronic drinking may damage regions involved in self-control, affecting the ability to regulate cravings and resist relapse.

Findings from the study, which was funded by NIAAA, appear online at the JAMA Psychiatry website.

Relapse is common among those trying to overcome and is often triggered by stress and exposure to events or places that the individual associates with alcohol. Studies suggest that most people in recovery from alcoholism relapse at least once before they successfully quit drinking.

Using functional , a technique that allows researchers to measure localized changes in , scientists at Yale University compared the patterns of 45 patients who were about to successfully complete an inpatient treatment program for alcoholism to those of 30 people with no history of alcoholism. While undergoing brain scans, participants were asked to imagine relaxing situations such as sunning on a beach, as well as recent stressful situations. The patients in recovery were then followed for 90 days after leaving treatment to determine how many had returned to drinking.

The investigators found that individuals in recovery who showed patterns of heightened activity in the prefrontal region during the relaxing situation were much more likely to experience cravings for alcohol and subsequent relapse. These patterns of craving-related activity increased the likelihood of early relapse by 8.5 times and relapse to heavy drinking by 8.7 times. Abnormally low activity during the stressful scenario was also linked to greater number of days drinking after relapse.

Among the alcohol-dependent patients in this study, 30 percent had relapsed two weeks after leaving treatment, 46 percent had relapsed at the end of one month, and 71 percent had returned to drinking at the final three-month follow-up.

"The patterns of brain activity we observed may one day serve as a neural marker that could help clinicians identify alcohol-dependent patients in recovery who are most at risk of relapse," said Rajita Sinha, Ph.D., the study's senior author, who is Foundations Fund Professor of Psychiatry and Professor in the Child Study Center and of Neurobiology at Yale University.

"Our findings may also have implications for the use of medications and behavioral treatments that restore prefrontal function, as they could potentially benefit people at high risk of relapse," Dr. Sinha said.

More information: Seo, D. et al. Disrupted ventromedial prefrontal function, alcohol craving, and subsequent relapse risk. JAMA Psychiatry, 2013 May 1.

add to favorites email to friend print save as pdf

Related Stories

Brain stress system presents possible treatment

Feb 26, 2008

A brain circuit that underlies feelings of stress and anxiety shows promise as a new therapeutic target for alcoholism, according to new studies by researchers at the National Institute on Alcohol Abuse and Alcoholism (NIAAA), ...

For depression, relapsers go to the front of the brain

Aug 22, 2011

Depression is increasingly recognized as an illness that strikes repeatedly over the lifespan, creating cycles of relapse and recovery. This sobering knowledge has prompted researchers to search for markers of relapse risk ...

Recommended for you

Mothers don't speak so clearly to their babies

Jan 23, 2015

People have a distinctive way of talking to babies and small children: We speak more slowly, using a sing-song voice, and tend to use cutesy words like "tummy". While we might be inclined to think that we ...

Explainer: What is sexual fluidity?

Jan 23, 2015

Sexual preferences are not set in stone and can change over time, often depending on the immediate situation the individual is in. This has been described as sexual fluidity. For example, if someone identifies as heterosexual but th ...

Lucky charms: When are superstitions used most?

Jan 23, 2015

It might be a lucky pair of socks, or a piece of jewelry; whatever the item, many people turn to a superstition or lucky charm to help achieve a goal. For instance, you used a specific avatar to win a game and now you see ...

Low-income boys fare worse in wealth's shadow

Jan 22, 2015

Low-income boys fare worse, not better, when they grow up alongside more affluent neighbors, according to new findings from Duke University. In fact, the greater the economic gap between the boys and their neighbors, the ...

User comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.