Alcohol-dependent Patients Research Articles

Disrupted diurnal oscillations of the gut microbiota in patients with alcohol dependence.

Patients with alcohol dependence (AD) can exhibit gut dysbacteria. Dysbacteria may co-occur with disruptions of circadian rhythmicity of the gut flora, which can aggravate AD. Herein, this study aimed to investigate diurnal oscillations of the gut microbiota in AD patients. Thirty-two patients with AD, based on the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, and 20 healthy subjects were enrolled in this study. Demographic and clinical data were collected by self-report questionnaires. Fecal samples at 7:00 AM, 11:00 AM, 3:00 PM, and 7:00 PM were collected from each subject. 16S rDNA sequencing was conducted. Wilcoxon and Kruskal-Wallis tests were performed to characterize alterations and oscillations of the gut microbiota. We found that β-diversity of the gut microbiota in AD patients oscillated diurnally compared with healthy subjects (p = 0.01). Additionally, 0.66% of operational taxonomic units oscillated diurnally in AD patients versus 1.68% in healthy subjects. At different taxonomic levels, bacterial abundance oscillated diurnally in both groups, such as Pseudomonas and Prevotella pallens (all p < 0.05). β-diversity of the gut microbiota in AD patients with high daily alcohol consumption, high-level cravings, short AD durations, and mild withdrawal symptoms oscillated diurnally compared with other AD patients (all p < 0.05). The gut microbiota in AD patients exhibits disruptions of diurnal oscillation, which may provide novel insights into mechanisms of AD and the development of therapeutic strategies.

Caudate gray matter volumes and risk of relapse in Type A alcohol-dependent patients: A 7-year MRI follow-up study.

Whether alteration in regional brain volumes can be detected in Type A alcoholics both at baseline and after a long follow-up remains to be confirmed. Therefore, we examined volume alterations at baseline, and longitudinal changes in a small follow-up subsample. In total of 26 patients and 24 healthy controls were assessed at baseline using magnetic resonance imaging and voxel-based morphometry, among which 17 patients and 6 controls were re-evaluated 7 years later. At baseline, regional cerebral volumes of patients were compared to controls. At follow-up, three groups were compared: abstainers (n = 11, more than 2 years of abstinence), relapsers (n = 6, <2 years of abstinence), and controls (n = 6). The cross-sectional analyses detected, at both times, higher caudate nuclei volumes bilaterally in relapsers compared to abstainers. In abstainers, the longitudinal analysis indicated recovery of normal gray matter volumes in the middle and inferior frontal gyrus, and in the middle cingulate, while white matter volumes recovery was detected in the corpus callosum and in anterior and superior white matter specific regions. Overall, the present investigation revealed larger caudate nuclei in the relapser AUD patient group both at baseline and at follow-up in the cross-sectional analyses. This finding suggest that a higher caudate volume could be a candidate risk factor of relapse. In patients with specific type A alcohol-dependence, we showed that long-term recovery in fronto-striato-limbic GM and WM volumes occurs during long-term abstinence. These results support the crucial role of frontal circuitry in AUD.

Association of Functional Polymorphism in TPH2 Gene with Alcohol Dependence and Personality Traits: Study in Cloninger's Type I and Type II Alcohol-Dependent Inpatients.

Alcohol dependence (AD) is a complex disorder with a poorly understood etiology. In this study, we investigated the relationship between genetic variation in the TPH2 gene, which encodes the enzyme responsible for serotonin synthesis in the brain, and both AD and personality traits, with attention to Cloninger's types of AD. The study included 373 healthy control subjects, 206 inpatients with type I AD, and 110 inpatients with type II AD. All subjects were genotyped for the functional polymorphism rs4290270 in the TPH2 gene, and AD patients completed the Tridimensional Personality Questionnaire (TPQ). The AA genotype and the A allele of the rs4290270 polymorphism were more frequent in both patient groups compared with the control group. In addition, a negative association was found between the number of A alleles and TPQ scores for harm avoidance in patients with type II, but not type I, AD. These results support the involvement of genetic variations of the serotonergic system in the pathogenesis of AD, especially type II AD. They also suggest that in a subset of patients, genetic variation of TPH2 could potentially influence the development of AD by affecting the personality trait of harm avoidance.

Borders of problem alcohol use from the point of view of practically healthy respondents and the epidemiological meaning of these borders

The primary goal of the work is to determine the borders of problematic alcohol use from the point of view of apparently healthy respondents, and the secondary goal is to determine the epidemiological meaning of these borders. In four regions of Ukraine (Kharkiv, Luhansk and Zaporizhzhia regions, as well as the city of Kyiv), 1742 people were examined during 2018—2021, who belonged to four comparison groups: pa- tients with alcohol dependence (AD) (393 people); healthy relatives of AD patients (274 people); representatives of the general population comparable with the representatives of the first two age groups (334 people) and students of 3, 4 courses of medical universities (741 people). The main research instruments were the questionnaire of the international research consortium GENAHTO (Gender, Alcohol, and Harms to Others), as well as the Hamilton Depression Rating Scale (HDRS) and the Alcohol Use Disorders Identification Test (AUDIT). The obtained data were processed by methods of mathematical statistics (variance and correlation analysis) on a computer using Excel 2016 computational tables (with the Data Analysis package). It has been established that, from the point of view of the surveyed respondents, the border between practically healthy persons and drinkers is a dose of 3 000 grams of absolute alcohol per year, and the border between drinkers and patients with AD is 15 000 grams of absolute alcohol per year. It was shown that in the group of examined healthy respondents there were 19.04 % of persons with alcohol problems of varying severity, including 16.06 % of drinkers (persons with risky or dangerous levels of alcohol consumption) and 2.98 % of patients with AD. Extrapolation of the proportion of people with alcohol problems of varying severity (19.04 %) among the sur- veyed respondents to the entire pre-war population of Ukraine (about 42 million people) allows us to state that the total number of such people in our country is about eight million people.

A novel technology of structural distance feature of Raman spectra and convolutional neural network for alcohol dependence diagnosis

Alcohol dependence is an addictive disease, which can lead to cancer, depression, and other problems. The current diagnostic methods of alcohol dependence are easily disturbed by patients' subjective consciousness, which could lead to wrong diagnoses. To solve this problem, this paper applies serum Raman spectra and a deep learning algorithm to the diagnosis of alcohol dependence and constructs an innovative diagnostic framework. We collected 228 serum samples for spectral analysis, including 119 alcohol-dependent patients and 109 controls. In this framework, spectra are firstly converted to two-dimensional spectrograms by clipping and stitching. Then, a calculating box extracts the distance features between spectral nonadjacent peaks on the spectrogram. Finally, the eigenvalues of each peak are used as pixels of artificial images and input into the ConvNeXt-T neural network model for classification. The sensitivity and specificity of the method are 81.82% and 100%. The results show that it is feasible to use Raman spectroscopy combined with a deep learning algorithm to diagnose alcohol dependence. Compared with directly using the ConvNeXt-T model, the distance feature performs better.

The Lack of Influence of Homozygous Long Allele of the 5-HTTLPR Gene on the Severity of Alcohol Craving During 6 Weeks of Rehab Hospitalisation in Comparison to Not Homozygous and Homozygous Short Alleles - Preliminary Report.

The aim of this study was to assess changes in the severity of alcohol craving according to allelic variants of the 5-HTTLPR gene polymorphism during hospitalisation and their association with selected clinical variables in alcohol-dependent patients. The study is exploratory. Participants were investigated at the 2nd and 6th week of alcohol-dependence therapy in the addiction treatment unit. Recruitment was conducted among alcohol-dependent patients from several Polish drug treatment centres. The total sample size was 130 persons (12 females and 118 males). Study subjects' mean age was 43.0 years. Patients were investigated twice by using the Penn Alcohol Craving Scale (PACS) and Beck Depression Inventory (BDI), and once by using Short Alcohol Dependence Data Questionnaire (SADD) and taking a swab for genetic testing. The polymorphism of the gene encoding the serotonin transporter 5-HTTLPR (SLC6A4) was determined from isolated DNA and its homozygous variants of short/short or long/long alleles and heterozygous short/long alleles were analysed. At 6th week of the follow-up, there was a decrease in the severity of alcohol craving in half of subjects with the short/short allele (p = 0.033) and in one-fifth of subjects with the long/short allele (p = 0.002) of the 5-HTTLPR gene. In subjects with long/long allele of the 5-HTTLPR gene, there was no change in the severity of alcohol craving between 2nd and 6th weeks of the study (p = 0.242). There was no statistical influence of the homozygous long allele of the 5-HTTLPR gene on severity of alcohol craving during 6 weeks of rehab hospitalisation in comparison to not homozygous and homozygous short alleles. The s-allele was associated with decrease of alcohol craving. It may point on the potential need for differentiated rehabilitation methods depending on the genetic diversity of addicted patients and its role in the severity of alcohol craving.

Confusion of Alcohol Craving With Food Hunger in Alcohol-Dependent Individuals Entering In-Patient Drug Treatment.

To identify the distinguishing characteristics of alcohol dependent patients who confuse alcohol cravings with pre-meal hunger. Data were collected at interview on sociodemographic status, clinical status and anthropometry in 179 patients (163 men and 16 women) undergoing in-patient treatment for alcohol dependence. A comparison of the patient subgroups studied showed that patients who did not confuse, and those who did confuse, alcohol craving with pre-meal hunger differed significantly in terms of alcohol craving scale scores (9 vs. 4 points). Patients confusing alcohol cravings with pre-meal hunger were more likely to recognize that experiencing severe pre-meal hunger can cause relapse (67.9 vs. 22.8%) and that not being able to distinguish between the sensations under study also increases the risk of breaking abstinence (75.0% vs. 50.4%). This was independent of severity of dependence and intensity of recent alcohol consumption. Alcohol-dependent persons who confuse alcohol craving with pre-meal hunger differ from those who do not confuse these hunger pangs in terms of feeling stronger alcohol craving and more frequent occurrence of symptoms accompanying the feeling of alcohol craving during pre-meal hunger. At the start of treatment for alcohol withdrawal, alcohol-dependent individuals who report confusing alcohol cravings with pre-meal hunger are less confident of maintaining abstinence. This is relevant to treatment. The role of possible confounders (depressive symptoms, cognitive and educational deficiency) could not be elucidated definitively.

Sodium Oxybate for Alcohol Dependence: A Network Meta-Regression Analysis Considering Population Severity at Baseline and Treatment Duration.

The estimated effect of sodium oxybate (SMO) in the treatment of alcohol dependence is heterogeneous. Population severity and treatment duration have been identified as potential effect modifiers. Population severity distinguishes heavy drinking patients with <14days of abstinence before treatment initiation (high-severity population) from other patients (mild-severity population). Treatment duration reflects the planned treatment duration. This study aimed to systematically investigate the effect of these potential effect moderators on SMO efficacy in alcohol-dependent patients. Network meta-regression allows for testing potential effect modifiers. It was selected to investigate the effect of the above factors on SMO efficacy defined as continuous abstinence (abstinence rate) and the percentage of days abstinent (PDA). Randomized controlled trials for alcohol dependence with at least one SMO group conducted in high-severity and mild-severity populations were assigned to a high-severity and mild-severity group of studies, respectively. Eight studies (1082 patients) were retained: four in the high-severity group and four in the mild-severity group. The high-severity group was associated with larger SMO effect sizes than the mild-severity group: abstinence rate risk ratio (RR) 3.16, P = 0.004; PDA +26.9%, P < 0.001. For PDA, longer treatment duration was associated with larger SMO effect size: +11.3% per extra month, P < 0.001. In the high-severity group, SMO showed benefit: abstinence rate RR 2.91, P = 0.03; PDA +16.9%, P < 0.001. In the mild-severity group, SMO showed benefit only in PDA for longer treatment duration: +23.9%, P < 0.001. In the retained studies with alcohol-dependent patients, high-severity population and longer treatment duration were associated with larger SMO effect sizes.

Serum Carbohydrate Deficient Transferrin: A Sensitive Marker in Diagnosing Alcohol Abuse

Introduction: Alcohol is a psychoactive substance with dependence producing properties and the burden of disease and death related to alcohol consumption remains significant in most countries. Early detection and proper medication with counselling can restore the alcoholics to normalcy. There is a need for a specific assay procedure to detect alcoholics early, so that proper therapy can be instituted. The traditional biomarkers in liver function test (LFT) are more frequently used for diagnosing alcohol abuse but they have variable and limited sensitivity and specificity. Carbohydrate Deficient Transferrin (CDT) can be considered as a more sensitive and specific marker for diagnosing alcohol abuse. The aim of this study is to determine % CDT in alcoholics and compare it with other alcohol markers in respect with sensitivity and specificity. The results of the study will be helpful in assessment of the alcohol dependence patients and therefore in their early detection and management. Materials and Methods: This is a hospital based comparative cross-sectional study carried out in Dharan. A total of 40 cases of alcohol abuse with ≥2 score in CAGE questionnaire and matched 40 subjects with no history of alcohol intake were enrolled in the study. Informed written consent and ethical approval were taken. Result: Serum %CDT has the highest diagnostic efficacy followed by serum gamma glutamyl transferase (GGT), Aspartate Transaminase (AST), Alanine Transaminase (ALT), AST/AL, and ALP as a biomarker for diagnosing alcohol abuse. Serum %CDT has the highest sensitivity with 97.5% and specificity of 73% at a cut off value of 3.5% compared to serum GGT with the sensitivity and specificity of 87% and 73%, respectively at a cut off value of 33.5 U/L. Conclusion: Serum %CDT is a better marker both in terms of sensitivity and specificity compared to other conventional markers and thus can be used as a tool to early diagnose the alcoholic cases and monitor the therapy and for early identification of the relapses in alcoholics during treatment.

Effect of psychic sleep on controlling withdrawal symptoms, balance and gait among alcohol dependent patients of selected hospital of Bhubaneswar and Cuttack

Background: In worldwide alcoholism is the major issues for affecting individual’s life and for socioeconomic development. Various treatment modalities have been developed for alcoholism, yoga nidra is one of them. yoga Nidra is an easy tool and very cost effective to practice for manage these symptoms. A wide range of gastrointestinal, cardiovascular, autonomic, neurological and psychological symptoms are all a part of the acute alcohol withdrawal syndrome. Objectives 1.To assess the level of alcohol dependents with demographic variables. 2. To assess the effect of psychic sleep on controlling withdrawal symptoms, balance and gait among alcohol dependent patients. 3. To find out the association between withdrawal symptoms, balance and gait among alcohol dependent patients with selected sociodemographic variables. Methods: A Quasi-Experimental research approach with purposive sampling technique was used at IMS & SUM Hospital, Bhubaneswar and SCB, Cuttack among 72 alcohol dependent patients. Psychic sleep module of 10 sessions were given to the experimental group for 10 days following the pretest. Posttest were conducted after 10 days of psychic sleep practice. Results: The results showed a substantial difference between the levels of the pretest and posttest withdrawal symptoms, balance and gait after giving psychic sleep as evidenced by Mann- Whitney U value at p= 0.000 which is extremely significant. There was a strong significant association between intensity of withdrawal symptoms and educational status and type of family and in level of balance and gait with duration of consumption of alcohol (by using SPSS Version20 software). The psychic sleep was an effective to reducing withdrawal symptoms, balance and gait. What is already Known . The severity of the alcohol dependence syndrome was observed in psychiatric co-morbidities as mood disorders which is the most common diagnosis. . In general alcohol usage is more common among college students. . The research shows that yoga nidra was effective among college students in reducing anxiety and depression. What this paper adds . The findings of the psychic sleep study show that Yoga nidra intervention was successful in lowering withdrawal symptoms in patients who were alcohol dependent. . Those patients who are consuming alcohol and are admitted to a DE addiction center can retain balance and gait with the help of psychic sleep. . Further study can be conducted with other substance abuse cases and with larger sample.

Does a ban on liquor sales benefit alcohol dependence patients? A study on usage and procurement of alcohol during the COVID-19 lockdown

BACKGROUND: Restricting the availability of alcohol in “dry states” and during the COVID-19 lockdown reveal illegal trading and consumption of illicit liquor leading to deaths and use of alternate harmful substances. The current study aims to fill the gaps in the literature to study alcohol usage and its procurement during its complete ban of sale.MATERIALS AND METHODS: A cross-sectional study of purposively sampled alcohol-dependent patients (n = 62) was conducted in an OPD setting, comparing two time periods: before and during total lockdown 2020. After reinforcing confidentiality and privacy, data were collected and analyzed.RESULTS: Alcohol usage during the lockdown was positively related to severity of alcohol dependence syndrome (r = 0.67, P = 0.00), quantity of alcohol consumed (r = 0.59, P = 0.00), and its cost of procurement (r = 0.43, P = 0.00) before lockdown. During the lockdown, the proportion of consuming alcohol more than or equal to 90 units weekly significantly decreased (Pearson Chi-square = 4.12, P = 0.04) and their predicting factors are rural residential location, moderate-income bracket, low socioeconomic class, and severe alcohol dependence. Furthermore, a significant increase in the proportion of procuring alcohol from the black market or used illicit liquor was observed (Fisher's exact test P = 0.00) with higher odds being associated with illegal procurement before lockdown (odds ratio = 22.00; 95% confidence interval = 3.93–123.28; P = 0.00). Increased use of alternate substances such as nicotine (37.1%) and cannabis (9.7%) during the lockdown was also observed.CONCLUSION: Although alcohol consumed did not significantly differ, illegal sources and money spent on procurement increased during the lockdown. Thus, a legal ban of liquor sales did not benefit alcohol dependence patients, and such restriction availability strategies may benefit from health awareness, treatment, and psychosocial support.

Serum metabolomics analysis in patients with alcohol dependence.

Alcohol dependence (AD) is a chronic recurrent mental disease caused by long-term drinking. It is one of the most prevalent public health problems. However, AD diagnosis lacks objective biomarkers. This study was aimed to shed some light on potential biomarkers of AD patients by investigating the serum metabolomics profiles of AD patients and the controls. Liquid chromatography-mass spectrometry (LC-MS) was used to detect the serum metabolites of 29 AD patients (AD) and 28 controls. Six samples were set aside as the validation set (Control: n = 3; AD group: n = 3), and the remaining were used as the training set (Control: n = 26; AD group: n = 25). Principal component analysis (PCA) and partial least squares discriminant analysis (PCA-DA) were performed to analyze the training set samples. The metabolic pathways were analyzed using the MetPA database. The signal pathways with pathway impact >0.2, value of p <0.05, and FDR < 0.05 were selected. From the screened pathways, the metabolites whose levels changed by at least 3-fold were screened. The metabolites with no numerical overlap in their concentrations in the AD and the control groups were screened out and verified with the validation set. The serum metabolomic profiles of the control and the AD groups were significantly different. We identified six significantly altered metabolic signal pathways, including protein digestion and absorption; alanine, aspartate, and glutamate metabolism; arginine biosynthesis; linoleic acid metabolism; butanoate metabolism; and GABAergic synapse. In these six signal pathways, the levels of 28 metabolites were found to be significantly altered. Of these, the alterations of 11 metabolites changed by at least 3-fold compared to the control group. Of these 11 metabolites, those with no numerical overlap in their concentrations between the AD and the control groups were GABA, 4-hydroxybutanoic acid, L-glutamic acid, citric acid and L-glutamine. The metabolite profile of the AD group was significantly different from that of the control group. GABA, 4-hydroxybutanoic acid, L-glutamic acid, citric acid, and L-glutamine could be used as potential diagnostic markers for AD.

Patterns of Use and Cessation Services Received for Other Substances in Patients with Alcohol Dependence Syndrome: A Hospital-Based Cross-Sectional Study

Abstract Background: Alcohol is one of the common substances used in India. Although majority of people with alcohol dependence syndrome (ADS) use other substances, this is underidentified. Thus, a valuable opportunity to offer cessation services for other substances goes unutilized. Extant Indian studies exploring this are scanty. Aim: The aim of the study is to analyze the pattern of use and cessation services received for other substances in patients with a primary diagnosis of ADS, admitted to a tertiary care center, in a state with a high per capita consumption of alcohol. Methods: After ethical clearance, 100 consecutive consenting male patients with ADS, aged 18–60 years, admitted to a psychiatry ward in a tertiary care center, were selected. Their pattern of use of other substances and cessation services received were studied. Results: Majority of the participants had moderate ADS (39%). About 46% of them smoked tobacco, 17% used smokeless form of tobacco, and 6% used both forms. Almost 64% of the participants were dependent on tobacco and the majority had severe dependence. Other substances used were cannabis (6%), benzodiazepines (2%), and opioids (1%). All of them used tobacco in addition. A significant association was noted between the severity of ADS and nicotine use (P = 0.016). Although 77% of participants with ADS used tobacco, only 20% received cessation services for tobacco use. Conclusion: Tobacco use in patients with ADS was not adequately identified, losing a golden opportunity to address a substance use with harmful health consequences. Psychiatrists need to be aware of this hidden problem and adopt routine screening for tobacco use in alcohol-dependent patients.

A new method for predicting alcohol relapse in patients undergoing liver transplantation for alcohol-related liver failure: Barratt scale.

Alcohol-induced liver disease has become one of the major causes of chronic liver disease worldwide with the increasing use of alcohol in society. The most important step in treatment is cessation of alcohol consumption. In patients with advanced liver disease, the most effective treatment is liver transplantation. Careful evaluation of patients with alcoholic liver disease before transplantation can help identify those at high risk of relapsing. Of a total of 42 patients who underwent liver transplantation for alcohol-related liver failure in our hospital between 2011 and 2022, 26 surviving patients were included in the study. Patient data were analyzed retrospectively. Demographic data, MELD score, history of alcohol consumption, alcohol treatment, post-transplant prognosis and survival were analyzed. The Barratt Impulsivity Scale-11 Short Form (BIS-11 SF) was applied to the surviving patients for impulsivity analysis to predict the possibility of relapse. Of the 26 patients who were included in the study, all were male. The mean age at transplantation was 53 (31-71) years. Mean MELD score was 22.31 (9-36). 12 patients (46.2%) received living donor liver transplantation and 14 patients (53.8%) received cadaveric liver transplantation. 25 patients (96.2%) had no post-transplant dependence, while 1 patient (3.8%) had post-transplant dependence. 5 patients (19.2%) continued to consume alcohol after transplantation. In our study, we observed that patients with high motor impulsivity tendency according to BSI-11 SF had alcohol relapse. We believe that revising this scale with more detailed questions for alcohol-dependent liver patients and applying it to patients before transplantation will be effective in better selection for transplantation and guiding patients to appropriate therapy and thus preventing relapse after transplantation.

Cognitive deficits in alcohol dependence—A case–control analytical study

Background: Use and abuse of alcohol is well known. Its abuse, predominantly its dependence, can cause medical, psychological, and social issues. Excessive alcohol intake over time is linked to cognitive problems, including memory loss. Excessive alcohol use has been linked to significant cognitive deficits that can last even after the person stops drinking. Executive functioning impairments are most likely to impact rehabilitation outcomes in people with cognitive impairment. Aim: To study the cognitive impairments in alcohol dependence and comparing with healthy individuals. Methods: An observational, analytical case–control study was done on 30 alcohol-dependent patients after stabilization and 25 healthy individuals from July 2019 to July 2021 in a tertiary care center in Pune; all subjects after diagnosis were assessed with Mini-Mental State Examination (MMSE), Frontal Assessment Battery (FAB), Barratt Impulsiveness Scale, Stroop Test, and the Wisconsin card sorting test (WCST). Results: The mean score on MMSE of the case group was 28.60 and the controls—29.72. The mean score on FAB of the case group was 16.45 and the controls—17.4. The mean score on BIS of the case group was 16.45 and in control 17.4. Stroop Effect score of the case group was 187.16 seconds and in control it was 146.92 seconds, all being statically significant in comparison. On the WCST, all the findings were statistically significant. Conclusion: Long-term alcohol consumption affects executive functions considerably. The current study showed significant cognitive deficits in individuals with alcohol dependence mainly in executive functions, working memory, and high impulsiveness.

Neurobiogical and biochemical mechanisms of the influence of alcohol on the central nervous system and cognitive personal activity

Topicality. The problem of alcohol addiction remains an acute medical and social problem. The intense stressful biochemical background of today greatly burdens alcohol abuse with all the consequences that follow. Given the availability of alcohol in our country, the negative multi-organ effects, including on the nervous and mental systems and cognitive functions, as well as the attractiveness of its rapid anxiolytic, hypnotic and other effects, the problem of alcohol addiction requires close attention of specialists. The purpose of this work was to determine the neurobiological and biochemical mechanisms of the formation of cognitive disorders due to alcohol consumption. Materials and methods: Modern scientific publications on neurobiological and biochemical mechanisms of the effect of ethanol on the central nervous system and, as a result, on human cognitive activity were analyzed. Results: The analysis of literature data showed that with alcohol addiction, the frontal lobes of the cerebral hemispheres are more prone to damage, which is manifested by a violation of executive functions (ability to abstract and plan, inhibition of perseverative processes, switching between different cognitive processes, speed of cognitive processes, etc.). The neurotransmitter systems of the brain are also negatively affected. The disease progresses as the compensatory capabilities of the body are exhausted, the role of which is performed by the increased synthesis of catecholamines in the central nervous system. Hypotheses explaining the phenomenology of the neuropsychological defect in alcoholism are considered. Conclusions: Thus, timely detection of brain dysfunctions associated with alcohol dependence in patients is of great importance at all stages of work - both in diagnostic and therapeutic processes. Also, theses from the given analytical data can be used when conducting psychoeducation as a stage of CBT intervention in alcohol addiction for all participants of the therapeutic process.

Effects of baclofen on insular gain anticipation in alcohol-dependent patients — a randomized, placebo-controlled, pharmaco-fMRI pilot trial

RationaleOne hallmark of addiction is an altered neuronal reward processing. In healthy individuals (HC), reduced activity in fronto-striatal regions including the insula has been observed when a reward anticipation task was performed repeatedly. This effect could indicate a desensitization of the neural reward system due to repetition. Here, we investigated this hypothesis in a cohort of patients with alcohol use disorder (AUD), who have been treated with baclofen or a placebo. The efficacy of baclofen in AUD patients has been shown to have positive clinical effects, possibly via indirectly affecting structures within the neuronal reward system.ObjectivesTwenty-eight recently detoxified patients (13 receiving baclofen (BAC), 15 receiving placebo (PLA)) were investigated within a longitudinal, double-blind, and randomized pharmaco-fMRI design with an individually adjusted daily dosage of 30–270 mg.MethodsBrain responses were captured by functional magnetic resonance imaging (fMRI) during reward anticipation while participating in a slot machine paradigm before (t1) and after 2 weeks of individual high-dose medication (t2).ResultsAbstinence rates were significantly higher in the BAC compared to the PLA group during the 12-week high-dose medication phase. At t1, all patients showed significant bilateral striatal activation. At t2, the BAC group showed a significant decrease in insular activation compared to the PLA group.ConclusionsBy affecting insular information processing, baclofen might enable a more flexible neuronal adaptation during recurrent reward anticipation, which could resemble a desensitization as previously observed in HC. This result strengthens the modulation of the reward system as a potential mechanism of action of baclofen.Trial registrationIdentifier of the main trial (the BACLAD study) at clinical.gov: NCT0126665.

Association between abnormal plasma metabolism and brain atrophy in alcohol-dependent patients.

In this study, we aimed to characterize the plasma metabolic profiles of brain atrophy and alcohol dependence (s) and to identify the underlying pathogenesis of brain atrophy related to alcohol dependence. We acquired the plasma samples of alcohol-dependent patients and performed non-targeted metabolomic profiling analysis to identify alterations of key metabolites in the plasma of BA-ADPs. Machine learning algorithms and bioinformatic analysis were also used to identify predictive biomarkers and investigate their possible roles in brain atrophy related to alcohol dependence. A total of 26 plasma metabolites were significantly altered in the BA-ADPs group when compared with a group featuring alcohol-dependent patients without brain atrophy (NBA-ADPs). Nine of these differential metabolites were further identified as potential biomarkers for BA-ADPs. Receiver operating characteristic curves demonstrated that these potential biomarkers exhibited good sensitivity and specificity for distinguishing BA-ADPs from NBA-ADPs. Moreover, metabolic pathway analysis suggested that glycerophospholipid metabolism may be highly involved in the pathogenesis of alcohol-induced brain atrophy. This plasma metabolomic study provides a valuable resource for enhancing our understanding of alcohol-induced brain atrophy and offers potential targets for therapeutic intervention.

Diurnal changes of the oral microbiome in patients with alcohol dependence.

Saliva secretion and oral microbiota change in rhythm with our biological clock. Dysbiosis of the oral microbiome and alcohol consumption have a two-way interactive impact, but little is known about whether the oral microbiome undergoes diurnal changes in composition and function during the daytime in patients with alcohol dependence (AD). The impact of alcohol consumption on the diurnal salivary microbiome was examined in a case-control study of 32 AD patients and 21 healthy control (HC) subjects. We tested the changes in microbial composition and individual taxon abundance by 16S rRNA gene sequencing. The present study is the first report showing that alcohol consumption enhanced the richness of the salivary microbiome and lowered the evenness. The composition of the oral microbiota changed significantly in alcohol-dependent patients. Additionally, certain genera were enriched in the AD group, including Actinomyces, Leptotrichia, Sphaerochaeta and Cyanobacteria, all of which have pathogenic effects on the host. There is a correlation between liver enzymes and oral microbiota. KEGG function analysis also showed obvious alterations during the daytime. Alcohol drinking influences diurnal changes in the oral microbiota, leading to flora disturbance and related functional impairment. In particular, the diurnal changes of the oral microbiota may open avenues for potential interventions that can relieve the detrimental consequences of AD.

Automatic Approach Behaviors in Alcohol Dependence: Does a Cognitive Bias Modification Training Affect Pavlovian-to-Instrumental Transfer Effects?

Introduction: Positively conditioned Pavlovian cues tend to promote approach and negative cues promote withdrawal in a Pavlovian-to-instrumental transfer (PIT) paradigm, and the strength of this PIT effect was associated with the subsequent relapse risk in alcohol-dependent (AD) patients. When investigating the effect of alcohol-related background cues, instrumental approach behavior was inhibited in subsequent abstainers but not relapsers. An automatic approach bias towards alcohol can be modified using a cognitive bias modification (CBM) intervention, which has previously been shown to reduce the relapse risk in AD patients. Here we examined the effects of such CBM training on PIT effects and explored its effect on the relapse risk in detoxified AD patients. Methods: N = 81 recently detoxified AD patients performed non-drug-related and drug-related PIT tasks before and after CBM versus placebo training. In addition, an alcohol approach/avoidance task (aAAT) was performed before and after the training to assess the alcohol approach bias. Patients were followed up for 6 months. Results: A stronger alcohol approach bias as well as a stronger non-drug-related PIT effect predicted relapse status in AD patients. No significant difference regarding relapse status or the number of heavy drinking days was found when comparing the CBM training group versus the placebo group. Moreover, there was no significant modulation effect of CBM training on any PIT effect or the aAAT. Conclusion: A higher alcohol approach bias in the aAAT and a stronger non-drug-related PIT effect both predicted relapse in AD patients, while treatment outcome was not associated with the drug-related PIT effect. Unlike expected, CBM training did not significantly interact with the non-drug-related or the drug-related PIT effects or the alcohol approach bias.