title: Brain activation in response to craving- and aversion-inducing cues related to alcohol in patients with alcohol dependence.
abstract: BACKGROUND
  Episodes of alcohol consumption produce use-limiting aversive effects as well as use-promoting euphoric effects. The brain regions associated with the reward circuit in patients with alcohol dependence (PAD) show signs of conditioning for alcohol craving. Alternatively, brain structures in the medial temporal region are known to be crucial for aversive conditioning. In this study, we compare differences in patterns of brain activation in response to cues that induce cravings versus aversion in PAD.
  
  
  METHODS
  Thirty-eight PAD and 26 healthy volunteers were administered cue reactivity tasks while undergoing functional magnetic resonance imaging (fMRI) to examine brain response to craving-inducing cues (CIC) and aversion-inducing cues (AIC).
  
  
  RESULTS
  Activation of the right medial frontal gyrus (right orbitofrontal cortex) during CIC was greater in PAD than in healthy volunteers. Participants in the PAD group displayed less activation in the right amygdala and the right middle temporal gyrus during AIC than did the healthy volunteers. Brain reactivity within the right medial frontal gyrus in response to CIC was positively correlated with the scores of PAD on the Korean Alcohol Urge Questionnaire (AUQ-K) and the Michigan Alcohol Screening Test (MAST). Reactivity within the amygdala in response to AIC was negatively correlated with AUQ-K scores among PAD.
  
  
  CONCLUSIONS
  The dysfunction of the orbitofrontal cortex that results from repeated exposure to alcohol accounts for craving and relapse in PAD. Additionally, PAD seem to be less sensitive to cues related to aversive consequences of alcohol overuse in comparison with healthy individuals.
authors.affiliation: Department of Psychiatry, Chung-Ang University, College of Medicine, 102 Heukseok-ro, Dongjak-gu, Seoul 156-755, Republic of Korea. Electronic address: sunmikim706@gmail.com.
authors.forename: Sun Mi
authors.initials: SM
authors.lastname: Kim
authors.affiliation: Department of Psychiatry, Chung-Ang University, College of Medicine, 102 Heukseok-ro, Dongjak-gu, Seoul 156-755, Republic of Korea. Electronic address: hduk@yahoo.com.
authors.forename: Doug Hyun
authors.initials: DH
authors.lastname: Han
authors.affiliation: Department of Psychiatry, Chung-Ang University, College of Medicine, 102 Heukseok-ro, Dongjak-gu, Seoul 156-755, Republic of Korea. Electronic address: kjoonmin@gmail.com.
authors.forename: Kyung Joon
authors.initials: KJ
authors.lastname: Min
authors.affiliation: Department of Psychiatry, Seoul National University, College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul 110-744, Republic of Korea. Electronic address: kbn1@snu.ac.kr.
authors.forename: Bung-Nyun
authors.initials: BN
authors.lastname: Kim
authors.affiliation: Uimyung Research Institute for Neuroscience, Samyook University, Gongneung 2-dong, Nowon-gu, Seoul 139-742, Republic of Korea. Electronic address: cheongjh@syu.ac.kr.
authors.forename: Jae Hoon
authors.initials: JH
authors.lastname: Cheong
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000503:physiopathology* / Q000523:psychology; D000434:Alcoholic Beverages; D000437:Alcoholism / Q000503:physiopathology* / Q000523:psychology; D001921:Brain / Q000503:physiopathology*; D001931:Brain Mapping; D066249:Craving; D003463:Cues; D000431:Ethanol; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012201:Reward
chemical_list: D000431:Ethanol
keywords: Alcohol dependence; Amygdala; Aversive conditioning; Functional magnetic resonance imaging; Orbitofrontal cortex