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Activation of Prefrontal Cortex and Anterior Thalamus in Alcoholic Subjects on Exposure to Alcohol-Specific Cues
Mark S. George, MD;
Raymond F. Anton, MD;
Courtnay Bloomer, BA;
Charlotte Teneback, BS;
David J. Drobes, PhD;
Jeffrey P. Lorberbaum, MD;
Ziad Nahas, MD;
Diana J. Vincent, PhD
Arch Gen Psychiatry. 2001;58:345-352.
Background Functional imaging studies have recently demonstrated that specific
brain regions become active in cocaine addicts when they are exposed to cocaine
stimuli. To test whether there are regional brain activity differences during
alcohol cue exposure between alcoholic subjects and social drinkers, we designed
a functional magnetic resonance imaging (fMRI) protocol involving alcohol-specific
cues.
Methods Ten non–treatment-seeking adult alcoholic subjects (2 women) (mean
[SD] age, 29.9 [9.9] years) as well as 10 healthy social drinking controls
of similar age (2 women) (mean [SD] age, 29.4 [8.9] years) were recruited,
screened, and scanned. In the 1.5-T magnetic resonance imaging scanner, subjects
were serially rated for alcohol craving before and after a sip of alcohol,
and after a 9-minute randomized presentation of pictures of alcoholic beverages,
control nonalcoholic beverages, and 2 different visual control tasks. During
picture presentation, changes in regional brain activity were measured with
the blood oxygen level–dependent technique.
Results Alcoholic subjects, compared with the social drinking subjects, reported
higher overall craving ratings for alcohol. After a sip of alcohol, while
viewing alcohol cues compared with viewing other beverage cues, only the alcoholic
subjects had increased activity in the left dorsolateral prefrontal cortex
and the anterior thalamus. The social drinkers exhibited specific activation
only while viewing the control beverage pictures.
Conclusions When exposed to alcohol cues, alcoholic subjects have increased brain
activity in the prefrontal cortex and anterior thalamus—brain regions
associated with emotion regulation, attention, and appetitive behavior.
From the Departments of Radiology
(Drs George and Vincent), Psychiatry (Drs George, Anton, Drobes,
Lorberbaum, and Nahas and Mss Bloomer and Teneback), and Neurology (Dr
George), Medical University of South Carolina, Charleston; and the
Ralph H. Johnson Veterans Hospital, Charleston, SC
(Dr George).
Corresponding author and reprints: Mark S. George, MD, Radiology
Department, Medical University of South Carolina, 171 Ashley Ave, Charleston,
SC 29425 (e-mail: georgem{at}musc.edu).
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