ABSTRACT
After detoxification, patients suffering from a drug addiction show high relapse risks. For example, among alcoholics up to 85% of all patients relapse, independent of whether they have been treated as inpatients until complete remission of physical withdrawal symptoms (Boothby and Doering 2005). Current brain-imaging studies have tried to identify the neuronal correlates of learning processes involved in relapse such as behavioral mechanisms including classical Pavlovian and instrumental
4.1 Introduction and Scope ................................................................................. 137 4.2 Methodical Approaches to Study Neuronal Systems Relevant for
Alcohol Addiction ......................................................................................... 138 4.3 Neurotransmitter Systems Implicated in Craving for Alcohol and Other
Drugs of Abuse ............................................................................................. 140 4.3.1 Neurotransmitter Dysfunction Associated with Altered Cue
Reactivity .......................................................................................... 144 4.4 Behavioral Design of Studies that Measure Neuronal Systems Activated
by Alcohol-Associated Cues ......................................................................... 144 4.4.1 Important Behavioral Parameters in Imaging Studies ..................... 145 4.4.2 Cue-Induced Brain Activation and the Prospective Relapse Risk ... 146
4.5 Alcohol Craving: A Learned Response? How to Assess the Impact of Learning ....................................................................................................... 148 4.5.1 Clinical Studies Trying to Link Craving and Relapse:
Identifying Craving ........................................................................... 150 4.5.2 Computational Models of Phasic Dopamine Release ....................... 152
4.6 Using Imaging to Make Clinical Diagnoses ................................................ 154 4.7 Summary and Outlook ................................................................................. 155 Acknowledgment ................................................................................................... 155 References .............................................................................................................. 155
conditioning. The goal of such studies is to provide insight into the neurobiology of drug addiction as well as to provide new options for specific behavioral intervention or pharmacological modification of alcohol craving and the risk of relapse. In this chapter, we will discuss the theoretical background and the results of neuro imaging studies that identified alterations and relevant neurotransmitter systems that are associated with cue-induced brain activation and alcohol craving, and their impact on neuronal networks that are activated by drug-specific cues.
