title: Blockade of cue-induced brain activation of abstinent alcoholics by a single administration of amisulpride as measured with fMRI.
abstract: BACKGROUND
  Once alcohol dependence is established, alcohol-associated cues may induce dopamine release in the reward system, which is accompanied by alcohol craving and may lead to relapse. In cocaine addicts, dopamine release in the thalamus was positively correlated with cocaine craving. We tested the effects of the atypical dopamine D(2/3) blocker amisulpride on cue-induced brain activation in a functional magnetic resonance imaging (fMRI) paradigm.
  
  
  METHODS
  Alcohol-associated and neutral pictures were presented in a block design to 10 male abstinent alcoholics (1-3 weeks after detoxification) and 10 healthy men during fMRI. The fMRI scans were acquired before and 2 hours after the oral application of 400 mg amisulpride. Before and after each scan, alcohol craving was measured with visual analogue scales.
  
  
  RESULTS
  Before the application of amisulpride, alcohol versus control cues elicited a higher blood oxygen level-dependent (BOLD) signal in the left frontal and orbitofrontal lobe, left cingulate gyrus, bilateral parietal lobe, and bilateral hippocampus in alcoholics compared with healthy controls. After amisulpride, alcoholics showed a reduced activation in the right thalamus compared with the first scan. Alcoholics no longer showed significant differences in their cue-elicited BOLD response after amisulpride medication compared with medication-free controls. Self-reported craving was not affected by amisulpride medication.
  
  
  CONCLUSIONS
  Amisulpride medication was associated with reduced cue-induced activation of the thalamus, a brain region closely connected with frontostriatal circuits that regulate behavior and may influence relapse risk.
authors.affiliation: Central Institute of Mental Health, Mannheim, Germany.
authors.forename: Derik
authors.initials: D
authors.lastname: Hermann
authors.forename: Michael N
authors.initials: MN
authors.lastname: Smolka
authors.forename: Jana
authors.initials: J
authors.lastname: Wrase
authors.forename: Sabine
authors.initials: S
authors.lastname: Klein
authors.forename: Jörg
authors.initials: J
authors.lastname: Nikitopoulos
authors.forename: Alexander
authors.initials: A
authors.lastname: Georgi
authors.forename: Dieter F
authors.initials: DF
authors.lastname: Braus
authors.forename: Herta
authors.initials: H
authors.lastname: Flor
authors.forename: Karl
authors.initials: K
authors.lastname: Mann
authors.forename: Andreas
authors.initials: A
authors.lastname: Heinz
mesh_terms: D000328:Adult; D000437:Alcoholism / Q000188:drug therapy* / Q000378:metabolism / Q000523:psychology; D000077582:Amisulpride; D001921:Brain / Q000187:drug effects* / Q000378:metabolism; D003463:Cues; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D013469:Sulpiride / Q000008:administration & dosage / Q000031:analogs & derivatives*; D013695:Temperance / Q000523:psychology
chemical_list: D013469:Sulpiride; D000077582:Amisulpride