RT Journal
A1 Heinz A, Reimold M, Wrase J, et al
T1 Correlation of stable elevations in striatal μ-opioid receptor availability in detoxified alcoholic patients with alcohol craving: A positron emission tomography study using carbon 11–labeled carfentanil
JF Archives of General Psychiatry
JO Archives of General Psychiatry
YR 2005
FD January 1
VO 62
IS 1
SP 57
OP 64
DO 10.1001/archpsyc.62.1.57
UL http://dx.doi.org/10.1001/archpsyc.62.1.57
AB Background 
    The pleasant effects of food and alcohol intake are partially mediated by μ-opiate receptors in the ventral striatum, a central area of the brain reward system. Blockade of μ-opiate receptors with naltrexone reduces the relapse risk among some but not all alcoholic individuals.Objective 
    To test the hypothesis that alcohol craving is pronounced among alcoholic individuals with a high availability of μ-opiate receptors in the brain reward system.Design 
    Patients and comparison sample. The availability of central μ-opiate receptors was measured in vivo with positron emission tomography (PET) and the radioligand carbon 11–labeled carfentanil in the ventral striatum and compared with the severity of alcohol craving as assessed by the Obsessive Compulsive Drinking Scale (OCDS).Setting 
    Hospitalized care.Participants 
    Volunteer sample of 25 male alcohol-dependent inpatients assessed after detoxification of whom 12 underwent PET again 5 weeks later. Control group of 10 healthy men.Main Outcome Measures 
    After 1 to 3 weeks of abstinence, the availability of μ-opiate receptors in the ventral striatum, including the nucleus accumbens, was significantly elevated in alcoholic patients compared with healthy controls and remained elevated when 12 alcoholic patients had these levels measured 5 weeks later (P<.05 corrected for multiple testing). Higher availability of μ-opiate receptors in this brain area correlated significantly with the intensity of alcohol craving as assessed by the OCDS.Conclusions 
    Abstinent alcoholic patients displayed an increase in μ-opiate receptors in the ventral striatum, including the nucleus accumbens, which correlated with the severity of alcohol craving. These findings point to a neuronal correlate of alcohol urges.