Dados do Trabalho

Título

SYSTEMATIC REVIEW ON NEURAL CORRELATES OF THE PHARMACOLOGICAL TREATMENT OF ALCOHOL DEPENDENCE

Introdução

Alcohol use disorder (AUD) is prevalent, has multifactorial causes and a chronic course, and generates a high global burden. Pharmacological treatment plays an essential role in AUD clinical care. However, medications’ neural effects are not entirely clear.

Objetivo

To summarize the neural effects of the medications approved for AUD treatment through functional neuroimaging studies. This review could guide AUD neural subtypes treatment and support the investigation of other drugs.

Método

We searched the following keywords on PubMed, Scielo and PsycINFO database: (naltrexone OR disulfiram OR topiramate OR acamprosate OR Gabapentin) and (alcoho*) and (neuroimage OR neuroimaging OR magnetic resonance OR smri OR structural magnetic resonance OR SPECT OR fmri OR functional magnetic resonance OR pet OR positron emission tomography). Original articles published in any language, investigating AUD pharmacological treatment through functional neuroimaging were included in this review.

Resultados

Naltrexone was the most investigated drug, particularly deactivating ventral striatum, amygdala, prefrontal cortex, and anterior cingulate cortex. It also deactivated dorsal striatum, supplementary motor area, olfactory bulb, hippocampus, thalamus, and regions of the frontal, parietal, temporal, and occipital lobe. Acamprosate and Gabapentin deactivated anterior cingulate cortex only. Disulfiram modulated the frontal cortex, cerebellar hemispheres, temporal lobe, and parietal lobe. No studies using Topiramate were found.

Conclusão

Naltrexone modulated regions that were previously related to the addiction neurobiological cycle. It also modulated several other brain areas, indicating promising target areas for future studies. Similar to Acamprosate, Gabapentin also modulates the anterior cingulate cortex, leading to the hypothesis that it might work better on "relief drinkers" just like acamprosate. Disulfiram did not modulate brain regions associated with the addiction cycle. However, it modulated areas connected with decision making, impulsivity, memory formation, and craving. Naltrexone also modulated some of these areas in the frontal, parietal and temporal lobes. These are candidate regions for being neurobiologically involved with the addiction cycle.

Palavras-chave

Pharmacological, neuroimaging, disorder, treatment, alcohol