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Alcohol-specific cues affect areas of alcoholics' brains MUSC researchers have found a significant difference in brain activity between alcoholics and non-alcoholics when they are exposed to alcohol cues such as photographs of alcoholic beverages. The findings will be published in the April issue of the Archives of General Psychiatry scheduled for publication on April 14.  “This is an important discovery, said Mark George, M.D., principal investigator for the study. “It confirms that there is a significant biological and brain component to alcoholism. It gives us important information necessary to understand the differences in the brains of alcoholics and social drinkers and to test new therapies.”  In the trial, 10 alcoholic patients and 10 social drinkers were tested, using functional MRI brain scanning.  They were given a sip of alcohol prior to the brain scan, and during the course of the scan they were shown a series of images related to the consumption of alcoholic beverages (alcohol stimuli or cues). For the control task, they were shown images not related to consuming alcohol, for example, a cup of coffee or a glass of juice.   The researchers were able to determine what part of the brain was activated as the subject was shown an alcoholic cue or a non-alcoholic picture. When an area of the brain is activated, the blood flow increases to that area. The resulting increase in oxygen to this section of the brain becomes a marker that can be observed during the functional MRI scan. This enables the researchers to observe on the scan exactly what part of the brain is activated as a result of an alcohol picture.  The MUSC investigators found that when exposed to the alcohol cues (sip of alcohol and pictures), the alcoholic subjects demonstrated increased brain activity in the prefrontal cortex and anterior thalamus regions of the brain. During the exact same task, there was no activation of these regions in the non-alcoholic subjects. The prefrontal cortex and anterior thalamus are brain regions associated with emotion regulation and attention. George said this work suggests, but does not prove, that these brain regions may be involved with an increased attention being directed to alcohol stimuli and/or craving in alcoholics. However, further research is required in which subjective feelings of craving in the subjects are directly measured during activation of the particular areas of the brain. George and his team are currently engaging in these studies.  “We don't know if the brain differences found in alcoholics are causal or consequential,” said George. “Is it that alcoholics have brain activity that is different because they drink a lot and see alcohol stimuli more frequently, or do they develop alcoholism because their brain behaves differently when confronted with these stimuli? Our data are consistent with either of these.”  In the latter case, if the imaging shows that a particular person's brain is going to become alcoholic, this opens up the possibility for imaging to be used as a screening tool to determine who might be at risk of becoming an alcoholic. Those people identified could then be given preventive counseling and advice. It is particularly noteworthy that the individuals participating in this study were early stage alcoholics who were not very severely affected and who were not seeking treatment at the time of the study.  Another important potential use of the work is to evaluate promising new treatments for alcoholism. Alcoholics maintain their addiction because something in their environment triggers a craving response.  “Now we think we are able to identify on a brain image an indicator for that craving,” said George.  “This will be an extremely useful tool in evaluating in humans promising new medications that have shown to be effective in suppressing craving in animal models,” said Raymond F. Anton, M.D., a collaborator on the study and scientific director of the federally funded (NIH-NIAAA) Alcohol Research Center that funded this research. Brain scanning could be a powerful preliminary tool to determine the likelihood of success in humans before beginning an expensive and time consuming clinical trial. Authors of the study are Mark George, M.D.; Raymond F. Anton, M.D.; Courtnay Bloomer, Charlotte Teneback; David J. Drobes, Ph.D; Jeffrey P. Lorberbaum, M.D.; Ziad Nahas, M.D.; and Diana J. Vincent, Ph.D., all of MUSC.