Tags

Type your tag names separated by a space and hit enter

Effects of a GABA-ergic medication combination and initial alcohol withdrawal severity on cue-elicited brain activation among treatment-seeking alcoholics.
Psychopharmacology (Berl). 2013 Jun; 227(4):627-37.P

Abstract

RATIONALE

Many studies have reported medication effects on alcohol cue-elicited brain activation or associations between such activation and subsequent drinking. However, few have combined the methodological rigor of a randomized clinical trial (RCT) with follow-up assessments to determine whether cue-elicited activation predicts relapse during treatment, the crux of alcoholism.

OBJECTIVES

This study analyzed functional magnetic resonance imaging (fMRI) data from 48 alcohol-dependent subjects enrolled in a 6-week RCT of an investigational pharmacotherapy.

METHODS

Subjects were randomized, based on their level of alcohol withdrawal (AW) at study entry, to receive either a combination of gabapentin (GBP; up to 1,200 mg for 39 days) and flumazenil (FMZ) infusions (2 days) or two placebos. Midway through the RCT, subjects were administered an fMRI alcohol cue reactivity task.

RESULTS

There were no main effects of medication or initial AW status on cue-elicited activation, but these factors interacted, such that the GBP/FMZ/higher AW and placebo/lower AW groups, which had previously been shown to have relatively reduced drinking, demonstrated greater dorsal anterior cingulate cortex (dACC) activation to alcohol cues. Further analysis suggested that this finding represented differences in task-related deactivation and was associated with greater control over alcohol-related thoughts. Among study completers, regardless of medication or AW status, greater left dorsolateral prefrontal cortex (DLPFC) activation predicted more post-scan heavy drinking.

CONCLUSIONS

These data suggest that alterations in task-related deactivation of dACC, a component of the default mode network, may predict better alcohol treatment response, while activation of DLPFC, an area associated with selective attention, may predict relapse drinking.

Authors+Show Affiliations

Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC 29425, USA. schacht@musc.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

23389755

Citation

Schacht, Joseph P., et al. "Effects of a GABA-ergic Medication Combination and Initial Alcohol Withdrawal Severity On Cue-elicited Brain Activation Among Treatment-seeking Alcoholics." Psychopharmacology, vol. 227, no. 4, 2013, pp. 627-37.
Schacht JP, Anton RF, Randall PK, et al. Effects of a GABA-ergic medication combination and initial alcohol withdrawal severity on cue-elicited brain activation among treatment-seeking alcoholics. Psychopharmacology (Berl). 2013;227(4):627-37.
Schacht, J. P., Anton, R. F., Randall, P. K., Li, X., Henderson, S., & Myrick, H. (2013). Effects of a GABA-ergic medication combination and initial alcohol withdrawal severity on cue-elicited brain activation among treatment-seeking alcoholics. Psychopharmacology, 227(4), 627-37. https://doi.org/10.1007/s00213-013-2996-x
Schacht JP, et al. Effects of a GABA-ergic Medication Combination and Initial Alcohol Withdrawal Severity On Cue-elicited Brain Activation Among Treatment-seeking Alcoholics. Psychopharmacology (Berl). 2013;227(4):627-37. PubMed PMID: 23389755.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effects of a GABA-ergic medication combination and initial alcohol withdrawal severity on cue-elicited brain activation among treatment-seeking alcoholics. AU - Schacht,Joseph P, AU - Anton,Raymond F, AU - Randall,Patrick K, AU - Li,Xingbao, AU - Henderson,Scott, AU - Myrick,Hugh, Y1 - 2013/02/07/ PY - 2012/09/19/received PY - 2013/01/14/accepted PY - 2013/2/8/entrez PY - 2013/2/8/pubmed PY - 2013/12/19/medline SP - 627 EP - 37 JF - Psychopharmacology JO - Psychopharmacology (Berl) VL - 227 IS - 4 N2 - RATIONALE: Many studies have reported medication effects on alcohol cue-elicited brain activation or associations between such activation and subsequent drinking. However, few have combined the methodological rigor of a randomized clinical trial (RCT) with follow-up assessments to determine whether cue-elicited activation predicts relapse during treatment, the crux of alcoholism. OBJECTIVES: This study analyzed functional magnetic resonance imaging (fMRI) data from 48 alcohol-dependent subjects enrolled in a 6-week RCT of an investigational pharmacotherapy. METHODS: Subjects were randomized, based on their level of alcohol withdrawal (AW) at study entry, to receive either a combination of gabapentin (GBP; up to 1,200 mg for 39 days) and flumazenil (FMZ) infusions (2 days) or two placebos. Midway through the RCT, subjects were administered an fMRI alcohol cue reactivity task. RESULTS: There were no main effects of medication or initial AW status on cue-elicited activation, but these factors interacted, such that the GBP/FMZ/higher AW and placebo/lower AW groups, which had previously been shown to have relatively reduced drinking, demonstrated greater dorsal anterior cingulate cortex (dACC) activation to alcohol cues. Further analysis suggested that this finding represented differences in task-related deactivation and was associated with greater control over alcohol-related thoughts. Among study completers, regardless of medication or AW status, greater left dorsolateral prefrontal cortex (DLPFC) activation predicted more post-scan heavy drinking. CONCLUSIONS: These data suggest that alterations in task-related deactivation of dACC, a component of the default mode network, may predict better alcohol treatment response, while activation of DLPFC, an area associated with selective attention, may predict relapse drinking. SN - 1432-2072 UR - https://www.unboundmedicine.com/medline/citation/23389755/Effects_of_a_GABA_ergic_medication_combination_and_initial_alcohol_withdrawal_severity_on_cue_elicited_brain_activation_among_treatment_seeking_alcoholics_ L2 - https://dx.doi.org/10.1007/s00213-013-2996-x DB - PRIME DP - Unbound Medicine ER -