Prognostic factors for low-risk drinking and relapse in alcohol use disorder: A multimodal analysis.

Addict Biol

Normandie Univ, UNICAEN, PSL Université Paris, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, Neuropsychologie et Imagerie de la Mémoire Humaine, Caen, France.

Published: November 2022

AI Article Synopsis

  • This study investigates factors influencing low-risk alcohol drinking and relapse among patients with severe alcohol use disorder (AUD) after detoxification.
  • The research involved 54 AUD patients and 36 healthy controls, assessing their clinical and neuropsychological profiles early in abstinence and categorizing them as low-risk drinkers or relapsers after 6 and 12 months.
  • Key findings reveal that relapsers exhibit specific brain abnormalities, memory deficits, and greater nicotine dependence compared to low-risk drinkers, suggesting these factors as significant contributors to relapse within a year.

Article Abstract

This study aims to specify the determinants of low-risk alcohol drinking and relapse at different time points after detoxification in patients with severe alcohol use disorder (AUD). Fifty-four patients with AUD and 36 healthy controls (HC) were evaluated early in abstinence (T1). They underwent clinical, neuropsychological and neuroimaging (structural MRI and FDG-PET) investigations. Patients with AUD were subsequently classified as "low-risk drinkers" (LR) or "relapsers" (R) based on their alcohol drinking at 6 months (T2) and 1 year (T3) after discharge, using their medical record or self-reported drinking estimation at follow-up. Based on the alcohol status at T2 and compared with HC, only R had alexithymia, lower grey matter volume in the midbrain and hypermetabolism in the cerebellum and hippocampi. Based on the alcohol status at T3 and compared with HC, only R had more severe nicotinic dependence, lower episodic and working memory performance, lower grey matter volume in the amygdala, ventromedial prefrontal cortex and anterior cingulate gyrus and hypermetabolism in cerebellum, hippocampi and anterior cingulate gyrus. Moreover, R had bilateral frontal hypometabolism, whereas LR only presented right frontal hypometabolism. Nicotine dependence, memory impairments and structural brain abnormalities in regions involved in impulsivity and decision-making might contribute to a 1-year relapse. Treatment outcome at 1 year may also be associated with an imbalance between a hypermetabolism of the limbic system and a hypometabolism of the frontal executive system. Finally, cerebellar hypermetabolism and alexithymia may be determinants of relapse at both 6 months and 1 year.

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http://dx.doi.org/10.1111/adb.13243DOI Listing

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