title: Genetic influences on craving for alcohol.
abstract: BACKGROUND
  Craving is being considered for inclusion in the Diagnostic and Statistical Manual (DSM) DSM-5. However, little is known of its genetic underpinnings - specifically, whether genetic influences on craving are distinct from those influencing DSM-IV alcohol dependence.
  
  
  METHODS
  Analyses were conducted in a sample of unrelated adults ascertained for alcohol dependence (N=3976). Factor analysis was performed to examine how alcohol craving loaded with the existing DSM-IV alcohol dependence criteria. For genetic analyses, we first examined whether genes in the dopamine pathway, including dopamine receptor genes (DRD1, DRD2, DRD3, DRD4) and the dopamine transporter gene (SLC6A3), which have been implicated in neurobiological studies of craving, as well as alpha-synuclein (SNCA), which has been previously found to be associated with craving, were associated with alcohol craving in this sample. Second, in an effort to identify novel genetic variants associated with craving, we conducted a genomewide association study (GWAS). For variants that were implicated in the primary analysis of craving, we conducted additional comparisons - to determine if these variants were uniquely associated with alcohol craving as compared with alcohol dependence. We contrasted our results to those obtained for DSM-IV alcohol dependence, and also compared alcohol dependent individuals without craving to non-dependent individuals who also did not crave alcohol.
  
  
  RESULTS
  Twenty-one percent of the full sample reported craving alcohol. Of those reporting craving, 97.3% met criteria for DSM-IV alcohol dependence with 48% endorsing all 7 dependence criteria. Factor analysis found a high factor loading (0.89) for alcohol craving. When examining genes in the dopamine pathway, single nucleotide polymorphisms (SNPs) in DRD3 and SNCA were associated with craving (p<0.05). There was evidence for association of these SNPs with DSM-IV alcohol dependence (p<0.05) but less evidence for dependence without craving (p>0.05), suggesting that the association was due in part to craving. In the GWAS, the greatest evidence of association with craving was for a SNP in the integrin alpha D (ITGAD) gene on chromosome 7 (rs2454908; p=1.8×10(-6)). The corresponding p-value for this SNP with DSM-IV alcohol dependence was similar (p=4.0×10(-5)) but was far less with dependence without craving (p=0.02), again suggesting the association was due to alcohol craving. Adjusting for dependence severity (number of endorsed criteria) attenuated p-values but did not eliminate association.
  
  
  CONCLUSIONS
  Craving is frequently reported by those who report multiple other alcohol dependence symptoms. We found that genes providing evidence of association with craving were also associated with alcohol dependence; however, these same SNPs were not associated with alcohol dependence in the absence of alcohol craving. These results suggest that there may be unique genetic factors affecting craving among those with alcohol dependence.
authors.affiliation: Washington University School of Medicine, USA. Electronic address: arpana@wustl.edu.
authors.forename: Arpana
authors.initials: A
authors.lastname: Agrawal
authors.affiliation: Indiana University School of Medicine, USA.
authors.forename: Leah
authors.initials: L
authors.lastname: Wetherill
authors.affiliation: Washington University School of Medicine, USA.
authors.forename: Kathleen K
authors.initials: KK
authors.lastname: Bucholz
authors.affiliation: University of Iowa School of Medicine, USA.
authors.forename: John
authors.initials: J
authors.lastname: Kramer
authors.affiliation: University of Iowa Hospitals and Clinics, USA.
authors.forename: Samuel
authors.initials: S
authors.lastname: Kuperman
authors.affiliation: Washington University School of Medicine, USA.
authors.forename: Michael T
authors.initials: MT
authors.lastname: Lynskey
authors.affiliation: Indiana University School of Medicine, USA.
authors.forename: John I
authors.initials: JI
authors.lastname: Nurnberger
authors.affiliation: University of California at San Diego, USA.
authors.forename: Marc
authors.initials: M
authors.lastname: Schuckit
authors.affiliation: Rutgers University, USA.
authors.forename: Jay A
authors.initials: JA
authors.lastname: Tischfield
authors.affiliation: Indiana University School of Medicine, USA.
authors.forename: Howard J
authors.initials: HJ
authors.lastname: Edenberg
authors.affiliation: Indiana University School of Medicine, USA.
authors.forename: Tatiana
authors.initials: T
authors.lastname: Foroud
authors.affiliation: Washington University School of Medicine, USA.
authors.forename: Laura J
authors.initials: LJ
authors.lastname: Bierut
mesh_terms: D000328:Adult; D000437:Alcoholism / Q000175:diagnosis / Q000235:genetics* / Q000523:psychology*; D018845:CD11 Antigens / Q000235:genetics; D003463:Cues; D039721:Diagnostic and Statistical Manual of Mental Disorders; D050483:Dopamine Plasma Membrane Transport Proteins / Q000235:genetics*; D005163:Factor Analysis, Statistical; D005260:Female; D020022:Genetic Predisposition to Disease; D055106:Genome-Wide Association Study; D005838:Genotype; D006801:Humans; D039001:Integrin alpha Chains / Q000235:genetics; D016015:Logistic Models; D008297:Male; D020641:Polymorphism, Single Nucleotide; D011594:Psychometrics; D011954:Receptors, Dopamine / Q000235:genetics*; D012720:Severity of Illness Index; D051844:alpha-Synuclein / Q000235:genetics
chemical_list: D018845:CD11 Antigens; D050483:Dopamine Plasma Membrane Transport Proteins; C406812:ITGAD protein, human; D039001:Integrin alpha Chains; D011954:Receptors, Dopamine; D051844:alpha-Synuclein