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. 2020 Jan;25(1):e12717.
doi: 10.1111/adb.12717. Epub 2019 Feb 12.

Incubation of neural alcohol cue reactivity after withdrawal and its blockade by naltrexone

Patrick Bach  1   2 , Georg Weil  1 , Enrico Pompili  1 , Sabine Hoffmann  1   2 , Derik Hermann  1   2 , Sabine Vollstädt-Klein  1 , Karl Mann  1 , Ursula Perez-Ramirez  3 , David Moratal  3 , Santiago Canals  4 , Serdar M Dursun  5 , Andrew J Greenshaw  5 , Peter Kirsch  6 , Falk Kiefer  1   2 , Wolfgang H Sommer  1   7
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Incubation of neural alcohol cue reactivity after withdrawal and its blockade by naltrexone

Patrick Bach et al. Addict Biol. 2020 Jan.

Abstract

During the first weeks of abstinence, alcohol craving in patients may increase or "incubate." We hypothesize that Naltrexone (NTX) blocks this incubation effect. Here, we compared NTX effects on neural alcohol cue reactivity (CR) over the first weeks of abstinence and on long-term clinical outcomes to standard treatment. Male alcohol-dependent patients (n = 55) and healthy controls (n = 35) were enrolled. Participants underwent baseline psychometric testing and functional magnetic resonance imaging (fMRI) assessment of mesolimbic alcohol CR. Patients participated in a standard treatment program with the option of adjuvant NTX. They received another scan after 2 weeks of treatment. We found higher CR in several brain regions in patients versus healthy controls. CR significantly increased over 2 weeks in the standard treatment group (n = 13) but not in the NTX group (n = 22). NTX significantly attenuated CR in the left putamen and reduced relapse risk to heavy drinking within 3 months of treatment. Additionally, increased CR in the left putamen and its course over time predicted both NTX response and relapse risk. Carrier status for the functional OPRM1 variant rs1799971:A > G was considered but had no effect on NTX efficacy. In conclusion, NTX was most effective in patients with high CR in the left putamen. While the results from our naturalistic study await further confirmation from prospective randomized trials, they support a potential role of neural CR as a biomarker in the development of precision medicine approaches with NTX.

Keywords: alcohol addiction; cue reactivity; fMRI; naltrexone; relapse.

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References

REFERENCES

    1. World Health Organization (2018) Global Status Report on Alcohol and Health.
    1. Jonas DE, Amick HR, Feltner C, Bobashev G, Thomas K, Wines R, Kim MM, Shanahan E, Gass CE, Rowe CJ, Garbutt JC (2014) In: Pharmacotherapy for Adults With Alcohol-Use Disorders in Outpatient Settings: Rockville (MD).
    1. Heilig M, Sommer WH, Spanagel R. The need for treatment responsive translational biomarkers in alcoholism research. Curr Top Behav Neurosci. 2016;28:151-171.
    1. Mann K, Roos CR, Hoffmann S, Nakovics H, Leménager T, Heinz A. Witkiewitz K (2018) precision medicine in alcohol dependence: a controlled trial testing pharmacotherapy response among reward and relief drinking phenotypes. Neuropsychopharmacology. 2018;43(4):891-899.
    1. Hansson AC, Gründer G, Hirth N, Noori HR, Spanagel R, Sommer WH. Dopamine and Opioid Systems Adaptation in Alcoholism Revisited: Convergent Evidence from Positron Emission Tomography and Postmortem Studies. Neuroscience and Biobehavioral Reviews InPress; 2018.

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