Relapse and gender specific activation of the striatum in alcohol dependent patients

The striatum is important for drug seeking behavior. We measured differences between subsequent relapseres and abstainers and both genders in respect to central processing of alcohol-associated stimuli.

We assessed the BOLD-response elicited by alcohol-associated pictures compared to control stimuli in 40 abstinent alcohol-dependent patients and in control-subjects. We used a block-paradigm. After discharge patients were followed for 6 month and alcohol intake was recorded.

Alcoholics showed a stronger BOLD-response to alcohol-associated cues in the bilateral striatum compared to controls. Comparing subsequent relapsers with abstainers, relapsers exhibited a stronger BOLD-response in the bilateral putamen. This finding indicates that the overall differences between alcohol-dependent and control subjects may be due to increased cue-induced striatal activation in subsequent relapsers. Patients with a strong striatal cue-induced BOLD-response could be therefore more prone to relapse.

Concerning sex differences alcohol-dependent women demonstrated stronger brain activation in the right nucleus caudatus to alcohol cues compared to controls and alcohol-dependent men. Male alcoholics displayed bilateral activation of the striatum. These gender specific lateralization differences may affect the assessment of group differences. We therefore recommend considering gender differences when analyzing central processing of drug-associated cues.