title: Extended-release naltrexone (XR-NTX) attenuates brain responses to alcohol cues in alcohol-dependent volunteers: a bold FMRI study.
abstract: Oral naltrexone reduces heavy drinking, but is less consistent as an abstinence promoter, whereas once-monthly extended-release naltrexone (XR-NTX) also maintains abstinence. The present study sought to determine if alcohol cue reactivity is attenuated by XR-NTX. Twenty-eight detoxified alcohol-dependent adult male and female volunteers received a single i.m. injection of either XR-NTX or placebo under double-blind conditions. An fMRI/cue reactivity procedure was conducted immediately before and two weeks after injection. At baseline, alcohol-related visual and olfactory cues elicited significant increases in orbital and cingulate gyri, inferior frontal and middle frontal gyri. Subsequently, brain activation was significantly altered in XR-NTX-treated individuals. These affected brain regions are associated with the integration of emotion, cognition, reward, punishment, and learning/memory, suggesting that XR-NTX attenuates the salience of alcohol-related cues. Such an effect on brain function may interrupt the processes associated with "slips" and relapse, which may account for XR-NTX's ability to maintain abstinence.
authors.affiliation: Behavioral Psychopharmacology Research Laboratory, McLean Hospital, Belmont, MA 02478, USA. slukas@mclean.harvard.edu
authors.forename: Scott E
authors.initials: SE
authors.lastname: Lukas
authors.forename: Steven B
authors.initials: SB
authors.lastname: Lowen
authors.forename: Kimberly P
authors.initials: KP
authors.lastname: Lindsey
authors.forename: Nina
authors.initials: N
authors.lastname: Conn
authors.forename: Wendy
authors.initials: W
authors.lastname: Tartarini
authors.forename: John
authors.initials: J
authors.lastname: Rodolico
authors.forename: Gopi
authors.initials: G
authors.lastname: Mallya
authors.forename: Christopher
authors.initials: C
authors.lastname: Palmer
authors.forename: David M
authors.initials: DM
authors.lastname: Penetar
mesh_terms: D000328:Adult; D000437:Alcoholism / Q000188:drug therapy* / Q000503:physiopathology; D001921:Brain / Q000187:drug effects* / Q000503:physiopathology; D001931:Brain Mapping; D003463:Cues; D003692:Delayed-Action Preparations; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009271:Naltrexone / Q000008:administration & dosage*; D009292:Narcotic Antagonists / Q000008:administration & dosage*; D014838:Volunteers
chemical_list: D003692:Delayed-Action Preparations; D009292:Narcotic Antagonists; D009271:Naltrexone