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Theodora Duka

Brain Mechanisms of Behavioral Changes Promoting Relapse in Alcohol Dependent Individuals with Repeated Detoxifications

Theodora Duka University of Sussex, Falmer, Brighton

Repeated detoxifications from alcohol lead to an increased severity of withdrawal often accompanied by seizures. Evidence has now accumulated that other aspects of brain function can also deteriorate, resulting in altered motivation, disturbed emotional processing as well as impaired executive functions. This presentation describes how alcoholic patients, as they experience more detoxifications and their alcohol dependence increases, become increasingly impaired in performing a task that captures two of the basic features of addictive behavior – cue-induced motivation to seek a reward, and failure to inhibit such motivation when reward seeking is inappropriate. Performance deficits in this task reflect withdrawal‐induced impairments in prefrontal subfields essential for regulating emotional conflict and subsequently for remaining in abstinence. Furthermore, under emotional challenge, multiple detoxified alcoholics show decrease in integration of neural networks in cortical regions responsible for a top-down emotional regulation, whilst integration of neural networks in sub-cortical regions, underlying a bottom up emotional input, is increased. Such behavioural and brain functional changes may confer inability in conflict resolution, increased sensitivity to emotional stress and impaired social competence, all of which may contribute to relapse. The data in this presentation will add to our understanding of alcoholism and may have implications for how alcoholic detoxification is carried out.