Association of the alcohol dehydrogenase gene polymorphism rs1789891 with gray matter brain volume, alcohol consumption, alcohol craving and relapse risk

Neural evidence of implicit emotion regulation deficits: An explorative study of comparing PTSD with and without alcohol dependence

BACKGROUND

Previous studies have identified psychiatric comorbidity, including alcohol dependence (AD), as a significant factor in treating posttraumatic stress disorder (PTSD), there is a lack of evidence on how best to treat comorbid PTSD and AD. Poor emotion regulation may be a key potential mechanism of PTSD and AD comorbidity.

METHODS

Seventy-four participants (48 women and 26 men) include three groups: a healthy control group (HC group, N = 20), a PTSD without alcohol dependence group (PTSD without AD group, N = 36), and a PTSD with alcohol dependence group (PTSD with AD group, N = 18). They completed the Shifted Attention Emotion Evaluation Task (SEAT) paradigm while undergoing fMRI.

RESULTS

Gender and hyperarousal symptoms were found to predict the risk of AD. In the whole-brain fMRI data, compared to PTSD without AD, the PTSD with AD group showed significant deactivations in the left middle Occipital Gyri (BA19_L), the right Rolandic Operculum (BA48_R), and the right Lingual Gyri (BA37_R). Furthermore, AD showed a significant correlation with the right Lingual Gyri (BA37_R) in individuals with PTSD.

CONCLUSION

These findings reveal possible neural mechanisms underlying the difference between PTSD patients with and without AD. These regions are involved in visual pathways, memory processing, and spatial cognition within the context of implicit emotion regulation. The observed alterations in these areas may serve as neural diagnostic markers for PTSD comorbid with AD and could be potential targets for developing novel treatments.

Functional Connectivity Differences in the Resting-state of the Amygdala in Alcohol-dependent Patients with Depression

RATIONALE AND OBJECTIVES

The mechanism of comorbidity between alcohol dependence and depressive disorders are not well understood. This study investigated differences in the brain function of alcohol-dependent patients with and without depression by performing functional connectivity analysis using resting-state functional magnetic resonance imaging.

MATERIALS AND METHODS

A total of 29 alcohol-dependent patients with depression, 31 alcohol-dependent patients without depression and 31 healthy control subjects were included in this study. The resting-state functional connectivity between the amygdala and the whole brain was compared among the three groups. Additionally, we examined the correlation between functional connectivity values in significantly different brain regions and levels of alcohol dependence and depression.

RESULTS

The resting-state functional connectivity between the left amygdala and the right caudate nucleus was decreased in alcohol-dependent patients. Additionally, the resting-state functional connectivity of the right amygdala with the right caudate nucleus, right transverse temporal gyrus, right temporal pole: superior temporal gyrus were also decreased. In alcohol-dependent patients with depression, not only was functional connectivity between the above brain regions significantly decreased, but so was functional connectivity between the right amygdala and the left middle temporal gyrus. Also, there was no significant correlation between the resting-state functional connectivity values in statistically significant brain regions and the levels of alcohol dependence and depression.

CONCLUSION

The impairment of the functional connectivity of the amygdala with caudate nucleus and partial temporal lobe may be involved in the neural mechanism of alcohol dependence comorbidity depressive disorders.

NMR-based metabolomic investigation of dogs with acute flaccid paralysis due to tick paralysis

BACKGROUND

Acute flaccid paralysis (AFP) is a complex clinical syndrome with various aetiologies. If untreated, AFP may lead to death due to failure of respiratory muscles. Tick paralysis, which is a noninfectious neurologic syndrome of AFP, occurs following tick attachment, engorgement, and injection of tick saliva toxins. There is no specific diagnostic test for tick paralysis, and mortality increases as definitive diagnosis is delayed. Although metabolomic investigation of tick saliva was conducted, there is a lack of research on metabolomic evaluation of hosts affected by tick paralysis.

OBJECTIVES

Thus, the aim of this study is to investigate metabolomic changes in serum samples of dogs with tick paralysis due to Rhipicephalus sanguineus using NMR-based metabolomics and to identify potential diagnostic/prognostic markers.

MATERIALS AND METHODS

Forty dogs infested with R. sanguineus, with clinical findings compatible with AFP and with a confirmed tick paralysis diagnosis ex juvantibus, constituted the Paralysis Group. Ten healthy dogs, which were admitted either for vaccination and/or check-up purposes, constituted the Control Group. After the confirmation tick paralysis, medical history, vaccination and nutritional status, body surface area and estimated tick numbers of all the dogs were noted. Physical examination included body temperature, heart and respiratory rate, capillary refill time evaluation and Modified Glasgow Coma Scale calculation. Serum samples were extracted from venous blood samples of all the dogs and were prepared for NMR analysis, and NMR-based metabolomics identification and quantification were performed.

RESULTS

NMR-based serum metabolomics of the present study revealed distinct up/down-regulated expressions, presenting a promising avenue. Moreover, it was observed that energy metabolism and especially liver functions were impaired in dogs with tick paralysis, and not only the respiratory system but also the kidneys were affected.

CONCLUSION

It was concluded that the present approach may help to better understand the pathological mechanisms developing in cases of AFP due to tick paralysis.

A critical review of ethanol effects on neuronal firing: A metabolic perspective

Ethanol metabolism is relatively understudied in neurons, even though changes in neuronal metabolism are known to affect their activity. Recent work demonstrates that ethanol is preferentially metabolized over glucose as a source of carbon and energy, and it reprograms neurons to a state of reduced energy potential and diminished capacity to utilize glucose once ethanol is exhausted. Ethanol intake has been associated with changes in neuronal firing and specific brain activity (EEG) patterns have been linked with risk for alcohol use disorder (AUD). Furthermore, a haplotype of the inwardly rectifying potassium channel subunit, GIRK2, which plays a critical role in regulating excitability of neurons, has been linked with AUD and shown to be directly regulated by ethanol. At the same time, overexpression of GIRK2 prevents ethanol-induced metabolic changes. Based on the available evidence, we conclude that the mechanisms underlying the effects of ethanol on neuronal metabolism are a novel target for developing therapies for AUD.

Alterations of brain activity in patients with alcohol use disorder: a resting-state fMRI study

BACKGROUND

Alcohol use disorder (AUD) has a negative impact on one's health and wastes a lot of societal resources since it damages one's brain tissue. Yet the knowledge of the neural mechanisms underlying alcohol addiction still remains limited. This study aims to investigate the neural mechanisms underlying alcohol addiction by using voxel-wise binarized degree centrality (DC), weighted DC and functional connectivity (FC) methods to analyze brain network activity in individuals with AUD.

METHODS

Thirty-three AUD patients and 29 healthy controls (HC) participated in this study. Binarized and weighted DC approach coupled with a second seed-based FC algorithm was used to assess the abnormal intrinsic hub features in AUD. We also examined the correlation between changes in functional network nodes and the severity of alcohol dependence.

RESULTS

Thirty AUD patients and 26 HC were retained after head motion correction. The spatial distribution maps of the binarized DC and weighted DC for the AUD and HC groups were roughly similar. In comparison to HC, the AUD group had decreased binarized DC and decreased weighted DC in the left precentral gyrus (PreCG) and the left inferior parietal lobule (IPL). Significantly different brain regions in the DC analysis were defined as seed points in the FC analysis. Compared with HC, changes in FC within the right inferior temporal gyrus (ITG), right middle temporal gyrus (MTG), left dorsolateral superior frontal gyrus (SFGdor), bilateral IPL, left precuneus (PCUN), left lingual gyrus (LING), right cerebellum_crus1/ITG/inferior occipital gyrus (IOG) and right superior parietal gyrus (SPG) were observed. The correlation analysis revealed that FC of right MTG-right PreCG was negatively correlated with MAST scores, and FC of right IPL-left IPL was positively correlated with ADS scores.

CONCLUSIONS

Alcohol use disorder is associated with aberrant regional activities in multiple brain areas. Binarized DC, weighted DC and FC analyses may be useful biological indicators for the detection of regional brain activities in patients with AUD. Intergroup differences in FC have also been observed in AUD patients, and these variations were connected to the severity of the symptoms. The AUD patients with lower FC value of the right IPL - left IPL has a lighter dependence on alcohol. This difference in symptom severity may be a compensation for cognitive impairment, indicating a difference in pathological pathways. Future AUD research will now have a fresh path thanks to these discoveries.

ADH1B, ADH1B/C and CYP2E1 Gene Polymorphism and the Risk of Fetal Alcohol Spectrum Disorder

Increasing alcohol consumption by women of childbearing age contributes to more frequent cases of fetal alcohol spectrum disorder. The cause of the syndrome is fetal alcohol exposure, particularly what is referred to as high prenatal alcohol exposure. Low metabolic activity of fetal enzymes shifts the burden of ethanol removal to maternal metabolism. One of the factors influencing the pathogenesis of FASD is the genetic background. It can determine the rate of elimination of ethanol, thus increasing or decreasing the time of fetal exposure to ethanol and also decreasing its concentration. Genetic polymorphisms could potentially play a significant role in these processes. In the present study, we considered three polymorphisms of genes implicated in the synthesis of enzymes involved in ethanol metabolism, i.e., ADH1b (rs1229984), ADH1b/c (rs1789891), and CYP2E1 (rs3813867). The studied group consisted of 303 children and 251 mothers. Both mothers' and children's genotypes were considered in our analysis. There were no statistically significant differences between the respective groups of genotypes of the studied polymorphisms. However, the genetic background of FASD is still elusive.

Association between iron accumulation in the dorsal striatum and compulsive drinking in alcohol use disorder

RATIONALE

Brain iron accumulation has been observed in neuropsychiatric disorders and shown to be related to neurodegeneration.

OBJECTIVES

In this study, we used quantitative susceptibility mapping (QSM), an emerging MRI technique developed for quantifying tissue magnetic susceptibility, to examine brain iron accumulation in individuals with alcohol use disorder (AUD) and its relation to compulsive drinking.

METHODS

Based on our previous projects, QSM was performed as a secondary analysis with gradient echo sequence images, in 186 individuals with AUD and 274 healthy participants. Whole-brain susceptibility values were calculated with morphology-enabled dipole inversion and referenced to the cerebrospinal fluid. Then, the susceptibility maps were compared between AUD individuals and healthy participants. The relationship between drinking patterns and susceptibility was explored.

RESULTS

Whole-brain analyses showed that the susceptibility in the dorsal striatum (putamen and caudate) among AUD individuals was higher than healthy participants and was positively related to the Obsessive Compulsive Drinking Scale (OCDS) scores and the amount of drinking in the past three months.

CONCLUSIONS

Increased susceptibility suggests higher iron accumulation in the dorsal striatum in AUD. This surrogate for the brain iron level was linearly associated with the compulsive drinking pattern and the recent amount of drinking, which provides us a new clinical perspective in relation to brain iron accumulation, and also might indicate an association of AUD with neuroinflammation as a consequence of brain iron accumulation. The iron accumulation in the striatum is further relevant for functional imaging studies in AUD by potentially producing signal dropout and artefacts in fMRI images.

Factors modulating the incubation of drug and non-drug craving and their clinical implications

It was suggested in 1986 that cue-induced cocaine craving increases progressively during early abstinence and remains high during extended periods of time. Clinical evidence now supports this hypothesis and that this increase is not specific to cocaine but rather generalize across several drugs of abuse. Investigators have identified an analogous incubation phenomenon in rodents, in which time-dependent increases in cue-induced drug seeking are observed after abstinence from intravenous drug or palatable food self-administration. Incubation of craving is susceptible to variation in magnitude as a function of biological and/or the environmental circumstances surrounding the individual. During the last decade, the neurobiological correlates of the modulatory role of biological (sex, age, genetic factors) and environmental factors (environmental enrichment and physical exercise, sleep architecture, acute and chronic stress, abstinence reinforcement procedures) on incubation of drug craving has been investigated. In this review, we summarized the behavioral procedures adopted, the key underlying neurobiological correlates and clinical implications of these studies.

Meta-analysis of grey matter changes and their behavioral characterization in patients with alcohol use disorder

Alcohol Use Disorder (AUD) is associated with reductions in grey matter (GM) volume which can lead to changes in numerous brain functions. The results of previous studies on altered GM in AUD differ considerably in the regions identified. Three meta-analyses carried out between 2014 and 2017 yielded different results. The present study includes the considerable amount of newer research and delivers a state-of-the art meta-analysis in line with recently published guidelines. Additionally, we behaviorally characterized affected regions using fMRI metadata and identified related brain networks by determining their meta-analytic connectivity patterns. Twenty-seven studies with 1,045 AUD patients and 1,054 healthy controls were included in the analysis and analyzed by means of Anatomical Likelihood Estimation (ALE). GM alterations were identified in eight clusters covering different parts of the cingulate and medial frontal gyri, paracentral lobes, left post- and precentral gyri, left anterior and right posterior insulae and left superior frontal gyrus. The behavioral characterization associated these regions with specific cognitive, emotional, somatosensory and motor functions. Moreover, the clusters represent nodes within behaviorally relevant brain networks. Our results suggest that GM reduction in AUD could disrupt network communication responsible for the neurocognitive impairments associated with high chronic alcohol consumption.

Exploration of the Role of Serine Proteinase Inhibitor A3 in Alcohol Dependence Using Gene Expression Omnibus Database

Background: Alcohol dependence is an overall health-related challenge; however, the specific mechanisms underlying alcohol dependence remain unclear. Serine proteinase inhibitor A3 (SERPINA3) plays crucial roles in multiple human diseases; however, its role in alcohol dependence clinical practice has not been confirmed. Methods: We screened Gene Expression Omnibus (GEO) expression profiles, and identified differentially expressed genes (DEGs). Protein-protein interaction (PPI) networks were generated using STRING and Cytoscape, and the key clustering module was identified using the MCODE plugin. SERPINA3-based target microRNA prediction was performed using online databases. Functional enrichment analysis was performed. Fifty-eight patients with alcohol dependence and 20 healthy controls were recruited. Clinical variables were collected and follow-up was conducted for 8 months for relapse. Results: SERPINA3 was identified as a DEG. ELANE and miR-137 were identified after PPI analysis. The enriched functions and pathways included acute inflammatory response, response to stress, immune response, and terpenoid backbone biosynthesis. SERPINA3 concentrations were significantly elevated in the alcohol dependence group than in healthy controls (P < 0.001). According to the median value of SERPINA3 expression level in alcohol dependence group, patients were divided into high SERPINA3 (≥2677.33 pg/ml, n = 29) and low SERPINA3 groups (<2677.33 pg/ml, n = 29). Binary logistic analysis indicated that IL-6 was statistically significant (P = 0.015) Kaplan-Meier survival analysis did not indicate any difference in event-free survival between patients with low and high SERPINA3 levels (P = 0.489) after 8 months of follow-up. Receiver characteristic curve analysis revealed that SERPINA3 had an area under the curve of 0.921 (P < 0.0001), with a sensitivity and specificity of 93.1 and 80.0%, respectively. Cox regression analysis revealed that aspartate transaminase level was a negative predictor of relapse (β = 0.003; hazard ratio = 1.003; P = 0.03). Conclusions: SERPINA3 level was remarkably elevated in patients with alcohol dependence than healthy controls, indicating that SERPINA3 is correlated with alcohol dependence. However, SERPINA3 may not be a potential predictive marker of relapse with patients in alcohol dependence.

Ethanol metabolism: The good, the bad, and the ugly

Throughout the world, ethanol is both an important commercial commodity and a source of major medical and social problems. Ethanol readily passes through biological membranes and distributes throughout the body. It is oxidized, first to acetaldehyde and then to acetate, and finally by the citric acid cycle in virtually all tissues. The oxidation of ethanol is irreversible and unregulated, making the rate dependent only on local concentration and enzyme activity. This unregulated input of reducing equivalents increases reduction of both cytoplasmic and intramitochondrial NAD and, through the latter, cellular energy state {[ATP]/([ADP][Pi])}. In brain, this increase in energy state stimulates dopaminergic neural activity signalling reward and a sense of well being, while suppressing glutamatergic neural activity signalling anxiety and unease. These positive responses to ethanol ingestion are important to social alcohol consumption. Importantly, decreased free [AMP] decreases AMP-dependent protein kinase (AMPK) activity, an important regulator of cellular energy metabolism. Oxidation of substrates used for energy metabolism in the absence of ethanol is down regulated to accommodate the input from ethanol. In liver, chronic ethanol metabolism results in fatty liver and general metabolic dysfunction. In brain, transport of other oxidizable metabolites through the blood-brain barrier and the enzymes for their oxidation are both down regulated. For exposures of short duration, ethanol induced regulatory changes are rapid and reversible, recovering completely when the concentrations of ethanol and acetate fall again. Longer periods of ethanol exposure and associated chronic suppression of AMPK activity activates regulatory mechanisms, including gene expression, that operate over longer time scales, both in onset and reversal. If chronic alcohol consumption is abruptly ended, metabolism is no longer able to respond rapidly enough to compensate. Glutamatergic neural activity adapts to chronic dysregulation of glutamate metabolism and suppression of glutamatergic neural activity by increasing excitatory and decreasing inhibitory amino acid receptors. A point is reached (ethanol dependence) where withdrawal of ethanol results in significant metabolic energy depletion in neurons and other brain cells as well as hyperexcitation of the glutamatergic system. The extent and regional specificity of energy depletion in the brain, combined with hyperactivity of the glutamatergic neuronal system, largely determines the severity of withdrawal symptoms.

Alcohol use disorder relapse factors: A systematic review

A relapsing-remitting course is very common in patients with an Alcohol Use Disorder (AUD). Understanding the determinants associated with alcohol resumption remains a formidable task. This paper examines relapse determinants based on a systematic review of recent alcohol literature (2000-2019). Relevant databases were consulted for articles that contained information about specific relapse determinants and reported statistical significance of each relapse determinant in predicting relapse. Relapse was broadly defined based on the characterization in the included articles. From the initial identified 4613 papers, a total of 321 articles were included. Results encompass multiple relapse determinants, which were ordered according to biopsychosocial and spiritual categories, and presented, using a descriptive methodology. Psychiatric co-morbidity, AUD severity, craving, use of other substances, health and social factors were consistently significantly associated with AUD relapse. Conversely, supportive social network factors, self efficacy, and factors related to purpose and meaning in life, were protective against AUD relapse. Despite heterogeneity in different methods, measures, and sample characteristics, these findings may contribute to a better therapeutic understanding in which specific factors are associated with relapse and those that prevent relapse. Such factors may have a role in a personalized medicine framework to improve patient outcomes.

Intergenerational Effects of Alcohol: A Review of Paternal Preconception Ethanol Exposure Studies and Epigenetic Mechanisms in the Male Germline

While alcohol use disorder (AUD) is a highly heritable psychiatric disease, efforts to elucidate that heritability by examining genetic variation (e.g., single nucleotide polymorphisms) have been insufficient to fully account for familial AUD risk. Perhaps not coincidently, there has been a burgeoning interest in novel nongenomic mechanisms of inheritance (i.e., epigenetics) that are shaped in the male or female germ cells by significant lifetime experiences such as exposure to chronic stress, malnutrition, or drugs of abuse. While many epidemiological and preclinical studies have long pointed to a role for the parental preconception environment in offspring behavior, over the last decade many studies have implicated a causal relationship between the environmentally sensitive sperm epigenome and intergenerational phenotypes. This critical review will detail the heritable effects of alcohol and the potential role for epigenetics.