The relapsing nature of alcohol use disorder (AUD) is a major obstacle to successful treatment. Future treatments need to integrate relevant brain biomarkers for subtyping patients to guide individualized treatment for relapse prevention. These researchers have cross-sectional data showing higher functional connectivity (FC) of nucleus accumbens (NAcc) and prefrontal regions in long-term abstinent AUD when compared to controls, with intermediate FC in short-term abstinence. We found that lower FC in NAcc during short-term abstinence can predict relapse in the subsequent 6 months (75% accuracy). Cross-sectional results suggest that FC between NAcc and executive control regions may be a brain biomarker of vulnerability to relapse.
In a pilot longitudinal FC study, the researchers examined resting NAcc FC at 5 and 13 weeks of abstinence in individuals with stimulant use disorder with relapse information 6 months later to define subsequent relapsers and abstainers. They found that NAcc FC (frontal/parietal regions) decreased from 5 to 13 weeks of abstinence in subsequent relapsers, while it increased in subsequent abstainers. This time-varying factor may be a brain biomarker of relapse vulnerability. To disentangle this interaction effect, finer temporal resolution of both brain FC changes and relapse course is essential. The researchers are collecting data in a larger sample size of individuals with AUD, at three time points during abstinence (5, 9, 13 weeks), with monthly follow-up interviews querying relapse status for 12 months. The overall objective is to identify the dynamic changes in neural circuitry during early abstinence (first 13 weeks) as potential brain biomarkers of relapse in AUD. The central hypothesis is that those that subsequently relapse will show a reduction in FC from 5-13 weeks of abstinence and that this change can accurately predict relapse. Findings from this research will provide insight into the neurobiology of relapse vulnerability that will inform new treatment strategies needed to improve treatment outcome.