Frontal white matter integrity predictors of adult alcohol treatment outcome

Biol Psychiatry. 2012 Feb 1;71(3):262-8. doi: 10.1016/j.biopsych.2011.09.022. Epub 2011 Nov 1.

Abstract

Background: Previous research has associated abnormalities in frontal lobe functioning with alcohol relapse. In this study, we used diffusion tensor imaging to investigate whether frontal white matter integrity measured at the start of treatment differs between persons with alcohol use disorders (AUD) who sustain treatment gains and those who return to heavy use after treatment.

Methods: Forty-five treatment-seeking AUD inpatients and 30 healthy control subjects were included in the study. Six months after completing treatment, 16 of the AUD participants had resumed heavy use (RHU) and 29 others remained abstinent or drank minimally (treatment sustainers [TS]). Voxel-wise group comparisons (TS vs. RHU) were performed on fractional anisotropy (FA), radial diffusivity (RD), and axial diffusivity maps generated from each subject's diffusion tensor imaging scan at the start of treatment.

Results: We found significantly lower FA and significantly higher RD in the frontal lobes of the RHU group, relative to the TS group. The RHU group data are consistent with previous reports of abnormal frontal white matter tract abnormalities in persons with AUD.

Conclusions: It is possible that the lower FA and higher RD in the RHU group reflect microstructural injury to frontal circuitries, and these may underlie the reduced cognitive control amid heightened reward sensitivity associated with resumption of heavy drinking.

Publication types

  • Controlled Clinical Trial
  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adult
  • Alcoholism / pathology*
  • Alcoholism / prevention & control*
  • Alcoholism / psychology
  • Alcoholism / therapy
  • Anisotropy
  • Case-Control Studies
  • Cognitive Behavioral Therapy / methods
  • Cognitive Behavioral Therapy / statistics & numerical data
  • Diffusion Tensor Imaging / methods
  • Diffusion Tensor Imaging / psychology
  • Diffusion Tensor Imaging / statistics & numerical data
  • Female
  • Frontal Lobe / pathology*
  • Humans
  • Male
  • Middle Aged
  • Nerve Fibers, Myelinated / pathology*
  • Predictive Value of Tests
  • Secondary Prevention
  • Temperance / statistics & numerical data
  • Treatment Outcome
  • United States