The following is a summary of “Neural Correlates of Stress and Alcohol Cue-Induced Alcohol Craving and of Future Heavy Drinking: Evidence of Sex Differences,” published in the May 2024 issue of Psychiatry by Radoman et al.
Stress and alcohol cues often lead to poor treatment results in alcohol use disorder (AUD). However, we haven’t looked at how these triggers and their neural effects differ between sexes or how they relate to heavy drinking outcomes.
Researchers conducted a prospective study aimed to explore how stress and alcohol cues impact cravings and heavy drinking in men and women with AUD.
They studied 77 adults (46 men, 31 women) with AUD. Participants did a functional MRI task with stress, alcohol, and neutral cues, measuring alcohol craving levels. Then, 72 participants (43 men, 29 women) joined an 8-week AUD treatment program, tracking their heavy drinking days.
The results showed that stress and alcohol cues caused more cravings than neutral cues. Men had a more significant alcohol-neutral craving contrast, while women had similar stress and alcohol contrasts. Whole-brain scans showed craving-related hyperactivation for neutral cues but hypoactivity in prefrontal and striatal regions during stress and alcohol cues, with significant sex differences. More heavy drinking days linked to specific brain regions’ activity changes hypoactivation in women’s subgenual anterior cingulate cortex and the bed nucleus of the stria terminalis in the stress-neutral contrast, hyperactivation in men’s hypothalamus, and hippocampus hyperactivation during alcohol cues in men.
Investigators concluded that variations in brain responses to stress and alcohol cues suggest unique pathways for alcohol use outcomes in men and women, especially in their cortico-striatal-limbic network. The necessity for gender-specific treatments to target these neural differences effectively was emphasized.
Source: ajp.psychiatryonline.org/doi/10.1176/appi.ajp.20230849