The brain regions involved in craving for alcohol are poorly understood, although several recent studies have demonstrated specific brain regions activated in craving for cocaine. We wondered if it was possible to invoke craving for alcohol in the MRI scanner, and whether one could also image changes in regional brain activity.
To date we have screened and scanned 6 non-treatment seeking adult alcoholics (1 woman, age 29.5, 9.5SD) as well as 7 age matched healthy non-alcoholic social drinking controls (3 women, 32.6, 10.9 SD). In the MRI scanner, subjects were serially rated for craving before and after a sip of alcohol, and after a 6 minute randomized presentation of 26 second epochs, each composed of 6 pictures of an alcoholic beverage, or 6 control pictures of non-alcoholic beverages, or 2 types of image controls. During stimulus presentation, changes in regional perfusion were measured in 15 T2*-weighted BOLD slices using a Picker 1.5 Tesla MRI scanner.
Alcoholics reported higher craving ratings for the alcohol cues than at baseline and compared to controls (who interestingly craved more for the control beverages). 50% of alcoholics (and only one control who reported alcohol craving) had significantly increased regional brain activity during the alcohol cues compared to the beverage match controls. This alcohol cue-induced activation in alcoholics was in the dorsolateral prefrontal, anterior temporal, insula, and orbitofrontal cortex.
These results suggest that cue-induced alcohol craving in alcoholics is possible in the high field MRI environment. Further, alcoholics, compared to controls, show more brain activity during presentation of alcohol cues in brain regions that have been seen in imaging studies of cocaine craving. Producing craving for alcohol while also using fMRI to image changes in regional brain function holds promise for understanding the brain regions associated with craving, as well as for potentially examining changes in that circuit as a function of treatment.
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