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Reilly MT, Noronha A, Goldman D, Koob GF. Genetic studies of alcohol dependence in the context of the addiction cycle. Neuropharmacology 2017; 122:3-21. [PMID: 28118990 DOI: 10.1016/j.neuropharm.2017.01.017] [Citation(s) in RCA: 67] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2016] [Revised: 01/13/2017] [Accepted: 01/19/2017] [Indexed: 12/16/2022]
Abstract
Family, twin and adoption studies demonstrate clearly that alcohol dependence and alcohol use disorders are phenotypically complex and heritable. The heritability of alcohol use disorders is estimated at approximately 50-60% of the total phenotypic variability. Vulnerability to alcohol use disorders can be due to multiple genetic or environmental factors or their interaction which gives rise to extensive and daunting heterogeneity. This heterogeneity makes it a significant challenge in mapping and identifying the specific genes that influence alcohol use disorders. Genetic linkage and (candidate gene) association studies have been used now for decades to map and characterize genomic loci and genes that underlie the genetic vulnerability to alcohol use disorders. These approaches have been moderately successful in identifying several genes that contribute to the complexity of alcohol use disorders. Recently, genome-wide association studies have become one of the major tools for identifying genes for alcohol use disorders by examining correlations between millions of common single-nucleotide polymorphisms with diagnosis status. Genome-wide association studies are just beginning to uncover novel biology; however, the functional significance of results remains a matter of extensive debate and uncertainty. In this review, we present a select group of genome-wide association studies of alcohol dependence, as one example of a way to generate functional hypotheses, within the addiction cycle framework. This analysis may provide novel directions for validating the functional significance of alcohol dependence candidate genes. This article is part of the Special Issue entitled "Alcoholism".
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Affiliation(s)
- Matthew T Reilly
- National Institutes of Health (NIH), National Institute on Alcohol Abuse and Alcoholism (NIAAA), Division of Neuroscience and Behavior, 5635 Fishers Lane, Bethesda, MD 20852, USA.
| | - Antonio Noronha
- National Institutes of Health (NIH), National Institute on Alcohol Abuse and Alcoholism (NIAAA), Division of Neuroscience and Behavior, 5635 Fishers Lane, Bethesda, MD 20852, USA
| | - David Goldman
- National Institutes of Health (NIH), National Institute on Alcohol Abuse and Alcoholism (NIAAA), Chief, Laboratory of Neurogenetics, 5635 Fishers Lane, Bethesda, MD 20852, USA
| | - George F Koob
- National Institutes of Health (NIH), National Institute on Alcohol Abuse and Alcoholism (NIAAA), Director NIAAA, 5635 Fishers Lane, Bethesda, MD 20852, USA
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Nakamura-Palacios EM, Souza RSM, Zago-Gomes MP, de Melo AMF, Braga FS, Kubo TTA, Gasparetto EL. Gray matter volume in left rostral middle frontal and left cerebellar cortices predicts frontal executive performance in alcoholic subjects. Alcohol Clin Exp Res 2013; 38:1126-33. [PMID: 24256621 DOI: 10.1111/acer.12308] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2013] [Accepted: 09/28/2013] [Indexed: 11/27/2022]
Abstract
BACKGROUND Alcoholic subjects manifest important deficits in frontal executive function, yet maintain cognitive mental status within normal range. METHODS This study searched for volumetric measurements of segmented brain structures obtained from magnetic resonance imaging (MRI) that would predict executive functions and cognitive mental status in alcoholic subjects. The frontal assessment battery (FAB) and the Mini-Mental State Examination (MMSE) were applied to alcoholic subjects who underwent MRI. Cortical and subcortical segmentation and corrections were performed using FreeSurfer. Multiple linear regressions analyses having volumetric measures of segmented brain structures as predictors for FAB or MMSE scores as dependent measures were conducted. Sixty alcoholic subjects, 52 males, mean age of 47.2 ± SD 10.4 years, with heavy use of alcohol (mean 284.4 ± SD 275.9 g of alcohol/d) over a long time (mean 32.4 ± SD 11.1 years), showed FAB 11.1 ± SD 3.2 and MMSE of 25.2 ± SD 4.1. RESULTS Multiple regression analyses having left and right side of each segment as predictors showed that gray matter volumes of rostral middle frontal cortex and cerebellar cortex (p < 0.001), in which only the left side of these structures showed significant partial effects in the full model (p < 0.05), showed to predict FAB performance. They were even more predictive when considered together (p < 0.001), in which both left rostral middle frontal cortex (p < 0.05) and left cerebellar cortex (p < 0.01) predictors had significant partial effects in the full model. None of brain structures was predictive of MMSE performance. CONCLUSIONS We have concluded that volumetric measurements of left rostral middle frontal and cerebellar cortices seem to be able to predict the frontal executive performance but not the cognitive mental status in alcoholic subjects.
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Affiliation(s)
- Ester M Nakamura-Palacios
- Laboratory of Cognitive Sciences and Neuropsychopharmacology, Department of Physiological Sciences, Health Science Center, Federal University of Espírito Santo, Vitória, Brazil
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Effects of abstinence on brain morphology in alcoholism: a MRI study. Eur Arch Psychiatry Clin Neurosci 2009; 259:143-50. [PMID: 19165528 PMCID: PMC3085767 DOI: 10.1007/s00406-008-0846-3] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2008] [Accepted: 08/28/2008] [Indexed: 10/26/2022]
Abstract
Chronic alcohol abuse leads to morphological changes of the brain. We investigated if these volumetric changes are reversible after a period of abstinence. For this reason 41 male and 15 female alcohol patients underwent MRI-scanning after in-patient detoxification (baseline) entering alcoholism treatment programs, and between 6 and 9 months later (follow-up), in a phase of convalescence. Additionally, 29 male and 16 female control subjects were examined. The MRI-scans were delineated and the resulting regions of interest, volumes of lateral ventricles and prefrontal lobes were expressed relatively to total brain volume. Compared to control subjects alcohol patients showed bilaterally decreased prefrontal lobes (11% reduction) and increased lateral ventricles (up to 42% enlargement). The extent of the ventricular increase was depending on patient's additional psychiatric diagnosis, showing smaller lateral ventricles in patients with additional personality disorder. While at follow-up the size of prefrontal lobes remained unchanged, volumes of the lateral ventricles decreased (5-6% reduction) in alcohol patients with abstinence and improved drinking behavior, especially in patients that underwent only one detoxification. The extent of the ventricular enlargement correlated with the elevation of alcohol related laboratory measures (mean corpuscular volume, gamma-glutamyl transpeptidase). In conclusion this study confirms the hypothesis that alcoholism causes brain damages that are partially reversible. It should be analyzed in further studies with larger sample sizes, if complete brain regeneration is possible maintaining abstinence over a longer period.
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Riikonen RS. Difference in susceptibility to teratogenic effects of alcohol in discordant twins exposed to alcohol during the second half of gestation. Pediatr Neurol 1994; 11:332-6. [PMID: 7702696 DOI: 10.1016/0887-8994(94)90012-4] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
A pair of discordant twins exposed to heavy maternal alcohol consumption only during the second half of pregnancy is reported. Apparently, differences in susceptibility to the dysmorphogenic influence of ethanol caused 1 twin to be more severely affected than the other. One twin had prenatal growth retardation, neonatal withdrawal symptoms, delay in both motor and cognitive function during the first year of life, slowing of background activity on electroencephalography, and cortical and central brain atrophy on computed tomography. Catch-up growth occurred during the postnatal period for the affected twin. The other twin was normal at the end of the follow-up at age 17 months. It seems that exposure to alcohol during the second half of pregnancy greatly increases the risk for brain damage but not lasting postnatal growth retardation. Minor abnormalities can also be caused during the second half of pregnancy. Genetic factors may have been important in determining the differences in fetal susceptibility to alcohol exposure.
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Affiliation(s)
- R S Riikonen
- Department of Child Neurology, University of Helsinki, Finland
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Gurling HM, Curtis D, Murray RM. Psychological deficit from excessive alcohol consumption: evidence from a co-twin control study. BRITISH JOURNAL OF ADDICTION 1991; 86:151-5. [PMID: 2021698 DOI: 10.1111/j.1360-0443.1991.tb01765.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Twenty-five pairs of monozygotic twins discordant for either the alcohol dependence syndrome or heavy drinking were studied to determine the adverse cognitive effects of alcohol. The twins and their co-twins were well-matched for premorbid history and personality but twins with high alcohol consumption performed significantly less well overall on cognitive testing than their co-twins. Impaired performance in parts of the following tests was found: visual spatial ability, visual spatial recognition, Mill Hill vocabulary, Bexley Maudsley category sorting, tactual performance. The number of years of problem drinking correlated with inferior scores on subtests of the tactual performance test. This study provides further evidence that alcohol abuse produces long-term cognitive sequelae which may not be grossly evident in clinical practice, and which may occur even at relatively low levels of intake.
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Affiliation(s)
- H M Gurling
- Academic Department of Psychiatry, University College and Middlesex School of Medicine, Middlesex Hospital, London, United Kingdom
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Strang J, Gurling H. Computerized tomography and neuropsychological assessment in long-term high-dose heroin addicts. BRITISH JOURNAL OF ADDICTION 1989; 84:1011-9. [PMID: 2790264 DOI: 10.1111/j.1360-0443.1989.tb00784.x] [Citation(s) in RCA: 53] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
A clinico-radiological assessment of seven high-dose long-term heroin addicts was undertaken to look for the presence of neuropsychological and CT scan pathology. Definite abnormalities were found in both neuropsychological and CT scan assessments in some individuals but the pattern of CT scan and neuropsychological deficit in relation to heroin addiction was not constant.
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MacDonald HL, Best JJ. The Scottish First Episode Schizophrenia Study. VI. Computerised tomography brain scans in patients and controls. Br J Psychiatry 1989; 154:492-8. [PMID: 2590780 DOI: 10.1192/bjp.154.4.492] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
This is the initial report of a prospective study by computerised tomography brain scan of first episode schizophrenia. Twenty-seven patients who met Research Diagnostic Criteria for schizophrenia were compared with volunteer controls on ventricular:brain ratio, sulcal:brain volume ratio, and the widths of third ventricle and Sylvian and interhemispheric fissures. The results provide evidence that sulcal enlargement, but not ventricular abnormalities, may be detected at first admission for schizophrenic illness, and are discussed in relation to findings from other studies.
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Marchesi C, Campanini T, Govi A, Tampieri E, Gnudi A, Chiodera P, Coiro V. Abnormal thyroid stimulating hormone, prolactin, and growth hormone responses to thyrotropin releasing hormone in abstinent alcoholic men with cerebral atrophy. Psychiatry Res 1989; 28:89-96. [PMID: 2500677 DOI: 10.1016/0165-1781(89)90200-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
The thyroid stimulating hormone (TSH), prolactin (PRL), and growth hormone (GH) responses to thyrotropin releasing hormone (TRH), the Wechsler Adult Intelligence Scale (WAIS) for cognitive impairment, and computed tomographic scans were evaluated in 15 nondepressed alcoholic men after 4 weeks of abstinence and in 10 normal controls. Both cognitive impairment and cerebral atrophy were found in 13 of the alcoholics. Eight alcoholics (seven with cerebral atrophy) had blunted TSH and PRL responses to TRH and a TRH-induced paradoxical increase of GH. This study demonstrates that besides affecting the TSH response to TRH, alcoholism often induces alterations of the PRL and GH secretory patterns in response to TRH. The severe brain damage caused by long-term alcoholism might be involved in the pathogenesis of these neuroendocrine alterations.
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Affiliation(s)
- C Marchesi
- Postgraduate School of Psychiatry, University Hospital, Parma, Italy
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Glass IB. Alcoholic hallucinosis: a psychiatric enigma--1. The development of an idea. BRITISH JOURNAL OF ADDICTION 1989; 84:29-41. [PMID: 2644996 DOI: 10.1111/j.1360-0443.1989.tb00549.x] [Citation(s) in RCA: 69] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
This paper outlines the evolution of ideas on the topic of alcoholic hallucinosis. From 1847 to 1987 numerous descriptive case-histories appeared in the literature. Analysis of these demonstrates that there were some phenomenological features of the illness about which authors were agreed. These were the acute onset of the illness, the predominance of auditory hallucinations and a history of heavy drinking. Protagonists of the delirium tremens school of though drew attention to the slight clouding of consciousness, the presence of the physical symptoms which may accompany an acute confusional state and the possibility of other kinds of hallucinations. Those who favoured the idea that it was a schizophrenic-like illness emphasized the chronicity, the predominance of auditory hallucinations and clear consciousness. Enlightening as these case-histories were, it was impossible to conclude the debate on these unsystematic observations alone.
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Hübner CVK, Gattaz WF. Tomografia cerebral computadorizada e esquizofrenia: revisão crítica da literatura. ARQUIVOS DE NEURO-PSIQUIATRIA 1988. [DOI: 10.1590/s0004-282x1988000300015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Vários estudos sobre tomografia cerebral computadorizada (CT) relatam alteração da estrutura cerebral em esquizofrenia. A grande variação da prevalência e da localização das anomalias pode estar relacionada à heterogenidade da amostra estudada, à escolha das medidas de CT ou ao uso de diferentes critérios diagnósticos. Apesar de alguns achados contraditórios, parece estabelecido que um subgrupo de pacientes esquizofrênicos apresenta atrofia cerebral discreta ou moderada; esse subgrupo se caracterizaria por apresentar cronicidade da doença, pior resposta ao tratamento neuroléptico e pela presença de outros sinais de disfunção cerebral difusa, como distúrbios neuropsicológicos, anormalidades no EEG e «soft signs» neurológicos. Sinais de atrofia na CT foram observados em pacientes esquizofrênicos jovens, no primeiro surto psicótico, indicando que o desenvolvimento das anomalias estruturais não é conseqüência do tratamento ou da cronicidade da doença. Nos diferentes estudos, pacientes com atrofia apresentaram menor carga genética (história familiar para a esquizofrenia) e se observou com maior freqüência história de complicações na gestação, no parto e trauma craniano nos primeiros anos do desenvolvimento. Em face da possibilidade de que doentes esquizofrênicos com atrofia cerebral formem um subgrupo homogêneo quanto à clínica e à etiopatologia da doença, é importante identificar e estudar as alterações da CT e caracterizar esse subgrupo de pacientes.
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Abstract
All patients aged 16-50 years who had been discharged from the Maudsley Hospital over a 4-year period with a diagnosis of schizophrenia were ascertained retrospectively. Case records were rated blindly for a history of obstetric complications (OCs). Sixty-one patients who satisfied the RDC for schizophrenia had undergone CT scanning. Those with a definite history of OCs presented at an earlier age. In this group widening of cortical sulci and fissures was more strongly correlated with VBR than in subjects without OCs. Moreover, large VBRs when accompanied by widened cortical sulci and fissures occurred more commonly in subjects with OCs than in those without. These results support the hypothesis that OCs, or a factor associated with them, lead to brain damage of aetiological significance in some cases of schizophrenia.
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Affiliation(s)
- M J Owen
- Genetics Section, Institute of Psychiatry, London
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Chitkara B, Macdonald A, Reveley AM. Twin birth and adult psychiatric disorder. An examination of the case records of the Maudsley Hospital. Br J Psychiatry 1988; 152:391-8. [PMID: 3167376 DOI: 10.1192/bjp.152.3.391] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
We compared the general distribution of diagnoses in 20,895 patients at the Maudsley Hospital with that of 504 patients born twins, including 117 twins where the co-twin had died before the age of 15. Significant differences in diagnostic distribution were found in the co-twin-dead compared with the co-twin-alive group; the former received diagnoses of schizophrenia, personality disorder, or substance abuse more often than the latter. While there were no overall differences between twins and non-twins, there were relatively more twins in the above three diagnostic groups. We suggest that the factors leading to the death of one twin are implicated in the later psychiatric morbidity of the survivor.
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Affiliation(s)
- B Chitkara
- Genetics Section, Institute of Psychiatry (Maudsley Hospital), London
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Murray RM, Lewis SW. Is schizophrenia a neurodevelopmental disorder? BMJ : BRITISH MEDICAL JOURNAL 1987; 295:681-2. [PMID: 3117295 PMCID: PMC1247717 DOI: 10.1136/bmj.295.6600.681] [Citation(s) in RCA: 662] [Impact Index Per Article: 17.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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Mullan MJ, Gurling HM, Oppenheim BE, Murray RM. The relationship between alcoholism and neurosis: evidence from a twin study. Br J Psychiatry 1986; 148:435-41. [PMID: 3730710 DOI: 10.1192/bjp.148.4.435] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
The twin register of the Maudsley Hospital was used to select a series of monozygotic (MZ) and same-sexed dizygotic (DZ) twins who had been given an ICD8 diagnosis related to alcoholism. They and their co-twins were traced. Medical and drinking histories were compiled (from records and by interview) for 56 twin-pairs, to permit current and retrospective diagnosis of any neurotic disorders. RDC diagnoses of panic disorder, generalised anxiety disorder, obsessive-compulsive disorder and phobias were more common in the alcoholic probands and the co-twins who were also alcoholics than in the normal-drinking co-twins. The Eysenck Personality Questionnaire (EPQ) and the Severity of Alcohol Dependence Questionnaire (SADQ) were completed by 54 individuals. Neuroticism scores were significantly higher for both male and female alcoholics than for their normal-drinking co-twins; and intra-pair differences in neuroticism were significantly correlated with intra-pair differences in severity of dependence. These results suggest that both clinically diagnosed neurotic illness and high neuroticism scores are more often a consequence than a cause of alcoholism.
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Glass IB. Alcohol and alcohol problems research 9. England, Wales and Northern Ireland. BRITISH JOURNAL OF ADDICTION 1986; 81:197-215. [PMID: 3518769 DOI: 10.1111/j.1360-0443.1986.tb00318.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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Meyer JS, Tanahashi N, Ishikawa Y, Hata T, Velez M, Fann WE, Kandula P, Mortel KF, Rogers RL. Cerebral atrophy and hypoperfusion improve during treatment of Wernicke-Korsakoff syndrome. J Cereb Blood Flow Metab 1985; 5:376-85. [PMID: 4030916 DOI: 10.1038/jcbfm.1985.52] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Nineteen patients with sudden onset of impaired recent memory, cerebellar ataxia, peripheral neuropathy, and other signs of Wernicke-Korsakoff syndrome (WKS) were treated and examined prospectively for 3 months. Serial studies included histories, neurological examinations, cognitive capacity screening examinations (CCSE), computed tomography (CT) scans, and measurements of regional CBF. Patients were detoxified and withdrawn from sedatives before CBF measurements were examined. Treatment included alcohol withdrawal, nutritious diet, and 300 mg thiamine daily. Before treatment CCSE scores and blood flow values of both white and gray matter were reduced, particularly within both temporoparietal regions. After treatment of compliant patients (n = 10), white and gray matter blood flow increased concurrently with improved CCSE scores. Abnormal eye signs, ataxia, peripheral neuropathy, and performance of activities of daily living also improved. Cerebral atrophy and ventricular enlargement measured by CT decreased. Early recognition and treatment of WKS in compliant patients permit rapid reversals of cognitive and neurological impairments associated with increased blood flow of gray and white matter and improvements of brain atrophy measured by CT scanning.
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Abstract
The term ‘dementia praecox’ was used by Kraepelin to emphasise the tendency towards deterioration to a state of impairment resembling a dementia. Early studies looked for structural brain lesions post mortem, and later using pneumoencephalography; there were positive findings (Haug, 1962), but they were not always replicated (Storey, 1966). The risks and limitations of pneumoencephalography gradually led to its being abandoned. However, studies showing minor neurological abnormalities (Rochford et al, 1970) and cognitive impairment (Malec, 1978) continued to suggest an organic component to schizophrenia.
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