Identifies Brain Regions Possibly Involved in Alcohol Craving
alcoholics experience an intense desire or "drug
hunger" for alcohol known as craving. Craving can be
conceptualized as a biopsychosocial process that involves social
cues that activate craving related brain responses. These
brain responses can be intensified or dampened by habitual ways
of thinking, feeling, and behaving that are used to deal with
the initial craving.
researchers agree that craving involves a process of
neuroadaptation. The frequent, heavy, and long-term use of
alcohol causes changes in brain cell function. Neuroadaptation
produces an imbalance in brain activity that may make alcoholics
more vulnerable to cues that activate craving.
experiments suggest that craving is associated with certain
brain regions and neurotransmitters. Such experiments are
limited by the animals' inability to report how they feel.
In humans, craving is experienced differently at different
stages of alcohol addiction and differently among drinkers at
any single stage. As a result it is difficult to measure
it accurately. To improve both measurement and understanding of
the craving phenomenon, researchers are looking to new
technologies in neuroimaging such as the fMRI technique.
at the Medical University of South Carolina (MUSC) used fMRI
(functional magnetic resonance imaging) to examine whether
alcohol cues stimulate specific brain regions. There were
two goals to their research: first, to learn whether certain
brain areas would be activated for the alcohol cues but not the
neutral cues; and second to determine whether brain areas in
alcoholics would be activated differently than those of moderate
researchers recruited eight male and two female alcoholics and
an equal number of moderate-drinking (no more than 14 drinks per
week) controls matched according to age and gender. The
alcoholics met DSM-IV criteria for alcohol dependence, drank an
average of seven drinks per drinking day, and drank on about 70
percent of days in the month before testing. They were not
severe alcoholics or in treatment at the time of study.
subjects viewed pictures on a screen while lying on their backs
in a 1.5-Tesla MRI scanner. For nine minutes, they were shown a
series of photographs of alcoholic beverages followed by a
series of nonalcoholic beverages (e.g., coffee, juice, soda) in
random order. To heighten their responses to alcohol cues, the
subjects were given a sip of an alcoholic beverage before
viewing the images. The researchers then compared the mean group
images of brain activity during the alcohol and nonalcohol
results showed two things.
1. When alcoholics view pictures of
alcoholic beverages, their prefrontal cortex and the
anterior thalamus become active (These brain regions are
associated with attention and emotional regulation
and have been associated with craving in other studies).
The same brain activation does not occur when alcoholics view
2. When moderate drinkers view pictures
of alcoholic beverages the same effect does not
that alcoholics have significantly different brain responses to
alcohol-related pictures than moderate drinkers. In other
words, cues associated with alcohol use cause a specific brain
response in alcoholics that is not activated by the same cues in
research reinforces the concept of alcoholism as a brain disease
by demonstrating that craving is a biopsychosocial process
associated with specific brain processes that are different in
alcoholics and non-alcoholics and confirming that there is a
significant biological and brain component to
author and Scientific Director of the NIAAA-funded MUSC Alcohol
Research Center is Raymond F. Anton, M.D. The findings are
reported in the April Archives of General Psychiatry.
interviews with Drs. George and Anton, please telephone Ellen
Bank (843/792-2626). For interviews with Dr. Gordis, please
telephone NIAAA Press (301/443-0595). For additional alcohol
or telephone 301/443-3860.