Prognostic factors for low-risk drinking and relapse in alcohol use disorder: A multimodal analysis
- PMID: 36301210
- DOI: 10.1111/adb.13243
Prognostic factors for low-risk drinking and relapse in alcohol use disorder: A multimodal analysis
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 18 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.
Keywords: alcohol use disorder; cognition; low-risk drinking; neuroimaging; relapse; treatment outcomes.
© 2022 Society for the Study of Addiction.
Similar articles
-
Cerebellar Hypermetabolism in Alcohol Use Disorder: Compensatory Mechanism or Maladaptive Plasticity?Alcohol Clin Exp Res. 2019 Oct;43(10):2212-2221. doi: 10.1111/acer.14158. Epub 2019 Sep 5. Alcohol Clin Exp Res. 2019. PMID: 31373706
-
Combining gray matter volume in the cuneus and the cuneus-prefrontal connectivity may predict early relapse in abstinent alcohol-dependent patients.PLoS One. 2018 May 7;13(5):e0196860. doi: 10.1371/journal.pone.0196860. eCollection 2018. PLoS One. 2018. PMID: 29734343 Free PMC article.
-
Regional brain volume changes in alcohol-dependent individuals during early abstinence: associations with relapse following treatment.Addict Biol. 2017 Sep;22(5):1416-1425. doi: 10.1111/adb.12420. Epub 2016 Jun 22. Addict Biol. 2017. PMID: 27329647 Free PMC article.
-
Neurobiological correlates of cue-reactivity in alcohol-use disorders: A voxel-wise meta-analysis of fMRI studies.Neurosci Biobehav Rev. 2021 Sep;128:294-310. doi: 10.1016/j.neubiorev.2021.06.031. Epub 2021 Jun 23. Neurosci Biobehav Rev. 2021. PMID: 34171325 Review.
-
Cortical and subcortical gray matter shrinkage in alcohol-use disorders: a voxel-based meta-analysis.Neurosci Biobehav Rev. 2016 Jul;66:92-103. doi: 10.1016/j.neubiorev.2016.03.034. Epub 2016 Apr 21. Neurosci Biobehav Rev. 2016. PMID: 27108216 Review.
Cited by
-
Chronic Ethanol Exposure Produces Persistent Impairment in Cognitive Flexibility and Decision Signals in the Striatum.bioRxiv [Preprint]. 2024 Mar 29:2024.03.10.584332. doi: 10.1101/2024.03.10.584332. bioRxiv. 2024. PMID: 38585868 Free PMC article. Preprint.
-
Regional cortical brain volumes at treatment entry relates to post treatment WHO risk drinking levels in those with alcohol use disorder.Drug Alcohol Depend. 2024 Feb 1;255:111082. doi: 10.1016/j.drugalcdep.2024.111082. Epub 2024 Jan 5. Drug Alcohol Depend. 2024. PMID: 38219355
References
REFERENCES
-
- Moos RH, Moos BS. Rates and predictors of relapse after natural and treated remission from alcohol use disorders. Addiction. 2006;101(2):212-222. doi:10.1111/j.1360-0443.2006.01310.x
-
- Stohs ME, Schneekloth TD, Geske JR, Biernacka JM, Karpyak VM. Alcohol craving predicts relapse after residential addiction treatment. Alcohol Alcohol. 2019;54(2):167-172. doi:10.1093/alcalc/agy093
-
- Rupp CI, Derntl B, Osthaus F, Kemmler G, Fleischhacker W. Impact of social cognition on alcohol dependence treatment outcome: poorer facial emotion recognition predicts relapse/dropout. Alcohol Clin Exp Res. 2017;41(12):2197-2206. doi:10.1111/acer.13522
-
- Barreno EM, Domínguez-Salas S, Díaz-Batanero C, Lozano ÓM, Marín JAL, Verdejo-García A. Specific aspects of cognitive impulsivity are longitudinally associated with lower treatment retention and greater relapse in therapeutic community treatment. J Subst Abuse Treat. 2019;96:33-38. doi:10.1016/j.jsat.2018.10.004
-
- Witkiewitz K, Villarroel NA. Dynamic association between negative affect and alcohol lapses following alcohol treatment. J Consult Clin Psychol. 2009;77(4):633-644. doi:10.1037/a0015647
Publication types
MeSH terms
Substances
LinkOut - more resources
Full Text Sources
Medical