title: Cue-induced activation of the striatum and medial prefrontal cortex is associated with subsequent relapse in abstinent alcoholics.
abstract: BACKGROUND
  Animal experiments have provided evidence that the striatum and medial prefrontal cortex play a predominant role in the acquisition and maintenance of drug-seeking behavior.
  
  
  OBJECTIVE
  Alcohol-associated stimuli that were regularly paired with alcohol intake may become conditioned cues and elicit a motivational response that triggers relapse in alcohol-dependent patients.
  
  
  METHODS
  We used functional magnetic resonance imaging and visual alcohol-associated and control cues to assess brain activation in ten abstinent alcoholics and control subjects. Patients were followed for 3 months, and alcohol intake was recorded.
  
  
  RESULTS
  Alcohol-related versus neutral visual stimuli activated the putamen, anterior cingulate and adjacent medial prefrontal cortex in alcoholics compared with healthy controls. Cue-induced activation of these brain areas was pronounced in the five alcoholics who subsequently relapsed during the observation period. A multiple regression analysis showed that, in alcoholics, the amount of subsequent alcohol intake was associated with the intensity of cue-induced brain activation but not the severity of alcohol craving, amount of previous alcohol intake or duration of abstinence before scanning.
  
  
  CONCLUSIONS
  This pilot study showed that cue-induced activation of the anterior cingulate, medial prefrontal cortex and striatum may play a role in the attribution of incentive salience to alcohol-associated stimuli, thus increasing the motivational value and attentional processing of alcohol cues. Functional brain imaging may help to identify a group of alcoholics with an otherwise undetected high risk of relapse.
authors.affiliation: Department of Medical Psychology, Campus Charité Mitte, Charité--University Medicine Berlin, Berlin, Germany.
authors.forename: Sabine M
authors.initials: SM
authors.lastname: Grüsser
authors.forename: Jana
authors.initials: J
authors.lastname: Wrase
authors.forename: Sabine
authors.initials: S
authors.lastname: Klein
authors.forename: Derik
authors.initials: D
authors.lastname: Hermann
authors.forename: Michael N
authors.initials: MN
authors.lastname: Smolka
authors.forename: Matthias
authors.initials: M
authors.lastname: Ruf
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Weber-Fahr
authors.forename: Herta
authors.initials: H
authors.lastname: Flor
authors.forename: Karl
authors.initials: K
authors.lastname: Mann
authors.forename: Dieter F
authors.initials: DF
authors.lastname: Braus
authors.forename: Andreas
authors.initials: A
authors.lastname: Heinz
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000503:physiopathology / Q000523:psychology*; D000437:Alcoholism / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000523:psychology*; D016739:Behavior, Addictive / Q000523:psychology; D001931:Brain Mapping; D003342:Corpus Striatum / Q000000981:diagnostic imaging / Q000503:physiopathology*; D003463:Cues; D005260:Female; D006179:Gyrus Cinguli / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D017397:Prefrontal Cortex / Q000000981:diagnostic imaging / Q000503:physiopathology*; D011859:Radiography; D012008:Recurrence; D013695:Temperance