Changes of frontal cortical subregion volumes in alcohol dependent individuals during early abstinence: associations wit
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ORIGINAL RESEARCH
Changes of frontal cortical subregion volumes in alcohol dependent individuals during early abstinence: associations with treatment outcome Timothy C. Durazzo 1,2 & Dieter J. Meyerhoff 3,4
# Springer Science+Business Media, LLC, part of Springer Nature 2019
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. Keywords Alcohol use disorder . Brain volumes . Relapse . Magnetic resonance imaging . Neurostimulation
Introduction Approximately 60% of individuals with an alcohol use disorder (AUD) will relapse to hazardous alcohol consumption within 6 months of treatment with currently available
* Timothy C. Durazzo [email protected] 1
Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
2
Mental Illness Research and Education Clinical Centers (151Y) and Sierra-Pacific War Related Illness and Injury Study Centers, VA Palo Alto Health Care System, 3801 Miranda Ave, Palo Alto, CA 94304, USA
3
Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA
4
Center for Imaging of Neurodegenerative Diseases, San Francisco VA Medical Center, San Francisco, CA, USA
psychosocial and pharmacological interventions (Witkiewitz 2011). Non-invasive neurostimulation techniques, such as repetitive transcranial magne
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