Alcohol Cues Elicit Differences in Brain Activation Patterns of Abstinent Men and Women with Alcohol Use Disorders

Introduction: Cognitive, emotional, and behavioral abnormalities have been associated with alcohol use disorders (AUD). Because of their reward salience, photographs of alcoholic beverages can influence brain activation in individuals with AUD. Methods: We employed fMRI to measure gender differences in brain activation elicited by alcohol cues in 84 men and women with and without a history of alcohol use disorders (ALC and NC, respectively). Brain activity was measured during performance on a delayed matching-to-sample (DMTS) working memory task; emotional faces served as the sample and match cues. During the delay period, intervening distractors were either reward-salient cues (alcoholic beverages) or neutral cues (nonalcoholic beverages or scrambled pictures). Results: Region of interest analyses showed that the ALC group had significantly higher levels of activation throughout reward-related circuitry during alcohol distractor interference than during scrambled picture interference. Significant Group-by-Gender interactions were also observed: Compared to NC men (NCm), ALC men (ALCm) evidenced lower activation contrast between reward-salient cues and neutral cues in default mode network regions (including superior prefrontal and precuneus areas), while ALC women (ALCw) had more activation than NC women (NCw). Similar significant interactions were observed for task-regions (including superior parietal, lateral occipital, and prefrontal areas). Additionally, ALCw had higher DMTS accuracy scores than ALCm. Discussion: The findings suggest that abstinent ALCm and ALCw differ in processing reward-salient cues, which can impact treatment and recovery. Plain Language Summary: Brain reward regions activate highly when individuals with a history of alcohol use disorder view alcoholic beverages. The brain regions identified subserve vision, memory, and judgment. Opposite abnormalities in activation patterns appeared for men and women.