Summary: fMRI reveals that early alcohol abstinence causes significant brain changes, with differences influenced by sex and anxiety levels, which may contribute to an increased risk of relapse.

Key Takeaways

  • fMRI reveals that early alcohol abstinence leads to significant changes in brain regions associated with anxiety, which may contribute to increased relapse rates.
  • The brain’s response to early abstinence varies by sex and anxiety severity, with men and women showing different patterns of brain activation and connectivity.
  • Altered bed nucleus of the stria terminalis (BNST)-functional connectivity during unpredictable threat cues, particularly in women, may explain higher stress-induced relapse rates, highlighting the need for further research on hormonal influences.

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Certain regions of the brain show changes during the early stages after quitting drinking that may contribute to increased anxiety and relapse rates in people attempting recovery from alcohol use disorder, according to a study published in Alcohol: Clinical and Experimental Research.

Using functional MRI, researchers found that an individual’s sex and severity of anxiety significantly influence the brain’s response during early abstinence, with men and women responding differently. Nearly half of people with alcohol use disorder who try to quit drinking relapse within the first year, often due to heightened anxiety during early abstinence. 

Brain Changes in Early Alcohol Abstinence

The study examined brain activation and functional connectivity in a network associated with anxiety, the bed nucleus of the stria terminalis (BNST), involving 40 participants aged 21 to 40, half of whom had stopped drinking for one to six months (the early abstinent group), with the other half as healthy controls. Results indicated that BNST network activation and connectivity are altered during early abstinence, with anxiety severity and sex influencing these changes. 

In particular, men in early abstinence showed less activation in the posterior cingulate compared to anxious men in the control group. Anxiety was negatively associated with BNST activation in the healthy group but positively associated in the early abstinent group. Early abstinent men with higher anxiety showed increased activation in the insula and dorsal anterior cingulate cortex compared to controls. These consistent changes suggest both brain alterations due to heavy alcohol use and a potential biological risk factor for alcohol use disorder. 

The study also found that BNST-functional connectivity during unpredictable threat cues differed by sex and anxiety levels. In women, connectivity between the BNST and ventromedial prefrontal cortex was weaker during unpredictable threat cues, potentially explaining the higher stress-induced relapse rates in women. The authors suggest further research into how hormones might affect these neural changes.