title: Association of frontal and posterior cortical gray matter volume with time to alcohol relapse: a prospective study.
abstract: 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.
  
  
  METHODS
  Forty-five abstinent alcohol-dependent patients in treatment and 50 healthy comparison subjects were scanned once using high-resolution (T(1)-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.
authors.affiliation: Departments of Psychiatry and Neurology, Yale University School of Medicine, New Haven, CT 06519, USA.
authors.forename: Kenneth
authors.initials: K
authors.lastname: Rando
authors.forename: Kwang-Ik
authors.initials: KI
authors.lastname: Hong
authors.forename: Zubin
authors.initials: Z
authors.lastname: Bhagwagar
authors.forename: Chiang-Shan Ray
authors.initials: CS
authors.lastname: Li
authors.forename: Keri
authors.initials: K
authors.lastname: Bergquist
authors.forename: Joseph
authors.initials: J
authors.lastname: Guarnaccia
authors.forename: Rajita
authors.initials: R
authors.lastname: Sinha
mesh_terms: D000293:Adolescent; D000328:Adult; D000437:Alcoholism / Q000473:pathology* / Q000523:psychology / Q000534:rehabilitation*; D001931:Brain Mapping; D005260:Female; D005625:Frontal Lobe / Q000473:pathology*; D006179:Gyrus Cinguli / Q000473:pathology*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009778:Occipital Lobe / Q000473:pathology*; D009929:Organ Size; D010296:Parietal Lobe / Q000473:pathology*; D011446:Prospective Studies; D012008:Recurrence; D012016:Reference Values; D013695:Temperance / Q000523:psychology; D055815:Young Adult