Abstract
We previously reported that at 1-and-4 weeks of sobriety, those who relapsed after treatment demonstrated significantly smaller total frontal cortical volume than individuals who maintained abstinence for at least 12 months post treatment. The segmentation method employed did not permit examination of frontal subregions that serve as nodes of the executive, salience and emotional regulation networks; structural abnormalities in these circuits are associated with relapse in those seeking treatment for alcohol use disorders (AUD). The primary goal of this study was to determine if frontal cortical subregion volume recovery during early abstinence is associated with long-term abstinence from alcohol. We compared bilateral components of the dorsal prefrontal cortex, orbitofrontal cortex, anterior cingulate cortex and insula volumes, at 1 and 4 weeks of abstinence, between individuals who resumed drinking within 12 months of treatment (Relapsers) those who showed sustained abstinence over 12 months following treatment (Abstainers) and healthy Controls. At 1 and 4 weeks of sobriety, Relapsers demonstrated significantly smaller volumes than Controls in 15 of 20 regions of interest, while Abstainers only had smaller volumes than Controls in 5 of 20 regions. In Relapsers, increasing volumes over 1 month in multiple frontal subregions and the insula were associated with longer duration of abstinence after treatment. The persistent bilateral frontal and insula volume deficits in Relapsers over 4 weeks from last alcohol use may have implications for neurostimulation methods targeting anterior frontal/insula regions, and represent an endophenotype that differentiates those who respond more favorably to available psychosocial and pharmacological interventions.
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Acknowledgments
This study was supported by National Institutes of Health (AA10788 to DJM and DA24136 to TCD) and Department of Veterans Affairs (RX002303 to TCD) with resources and use of facilities at the San Francisco VA Medical Center and the VA Palo Alto Health Care System. We thank Dr. Ellen Herbst, Ricky Chen and colleagues of the San Francisco Veterans Administration Substance Abuse Day Hospital and Dr. David Pating and colleagues at the Kaiser Permanente Chemical Dependency Recovery Program in San Francisco for their valuable assistance in participant recruitment. We thank Drs. Stefan Gazdzinski and Anderson Mon for MRI data acquisition, Dr. Xiaowei Zou for longitudinal FreeSurfer data processing, and Mr. Thomas Schmidt for assistance with psychiatric assessments and cohort maintenance. We also extend our gratitude to our participants, who made this research possible.
Funding
National Institutes of Health (AA10788 to Dieter J. Meyerhoff and DA24136 to Timothy C. Durazzo) and Department of Veterans Affairs (RX002303 to Timothy C. Durazzo) with resources and use of facilities at the San Francisco VA Medical Center and the VA Palo Alto Health Care System.
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Durazzo, T.C., Meyerhoff, D.J. Changes of frontal cortical subregion volumes in alcohol dependent individuals during early abstinence: associations with treatment outcome. Brain Imaging and Behavior 14, 1588–1599 (2020). https://doi.org/10.1007/s11682-019-00089-5
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DOI: https://doi.org/10.1007/s11682-019-00089-5