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Repeated detoxification of alcohol-dependent patients impairs brain mechanisms of behavioural control important in resisting relapse
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posted on 2023-06-08, 21:30 authored by Dora Duka, Dai StephensAlcohol abuse is frequently characterised by cycles of heavy drinking, detoxification, and relapse. We review evidence that multiple detoxifications are associated with impaired ability to control reward seeking, and with exaggerated responses to negative emotional stimuli. Under conditions of incentive conflict and in intra-extra dimensional shift and reversal tasks, deficits are found that are consistent with impaired executive control of behaviour by prefrontal cortical mechanisms. Correspondingly, alcoholics who have undergone multiple detoxifications show loss of grey matter in prefrontal regions associated with accurate performance of these tasks, the extent correlating with numbers of detoxifications. The ability to respond appropriately to certain emotional stimuli (e.g., fearful faces) is also impaired following multiple detoxifications. Such impairments are associated with reduced connectivity between insula and prefrontal areas but increased connectivity between insula and subcortical regions (colliculus), and between amygdala and other subcortical regions (bed nucleus of stria terminalis, BNST). Such changes may increase vulnerability to stress-induced relapse, and disrupt social abilities, contributing to social isolation.
History
Publication status
- Published
Journal
Current Addiction ReportsISSN
2196-2952Publisher
Springer VerlagExternal DOI
Issue
1Volume
1Page range
1-9Department affiliated with
- Psychology Publications
Full text available
- No
Peer reviewed?
- Yes
Legacy Posted Date
2015-07-09Usage metrics
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