Tuesday, May 28, 2024

Yale Study Reveals Gender Differences in Brain Activity Related to Alcohol Craving and Heavy Drinking

A recent study from Yale University suggests that brain activity associated with alcohol craving and heavy drinking differs significantly between men and women, shedding light on the need for sex-specific therapeutic approaches in treating alcohol use disorder.

Using functional magnetic resonance imaging (fMRI), researchers at Yale found that the brain circuits involved in alcohol craving and heavy drinking exhibit similarities between men and women but also significant differences. Published in the American Journal of Psychiatry on May 6, the study indicates that these differences in brain activity could impact the effectiveness of alcohol use disorder treatments.

Previous research has shown that individuals with alcohol use disorder who experience intense cravings for alcohol are more likely to relapse into heavy drinking. Stressful life events and alcohol-related cues often trigger these cravings. However, whether these patterns are the same in men and women has been unclear until now.

Rajita Sinha, the Foundations Fund Professor of Psychiatry at Yale School of Medicine and senior author of the study, noted, “In the last two decades, there has been a very steep increase in binge drinking among women in the United States, much more so than in men. That has led to a lot more concern for the comorbidities associated with alcohol use disorder, such as liver disease, cardiovascular issues, and cancer risk. So we set out to see if stress- and cue-related craving is different in men and women.”

The study involved 77 treatment-seeking adults with alcohol use disorder, including 46 men and 31 women. During fMRI scanning, participants viewed images depicting stressful scenes, alcohol-related scenes, or neutral images. They then rated their stress levels and alcohol cravings after viewing each image.

Results revealed that women reported higher stress levels after viewing stress cues compared to men. Additionally, while alcohol cues triggered stronger cravings in men than stress cues did, women experienced the same level of craving from both stress and alcohol-related cues.

Brain imaging showed that the circuits associated with emotion, reward, stress regulation, and impulse control responded differently in men and women. Sinha explained, “In women, those circuits were clearly blunted, but in men, they were hyperactive. So the disruption is there in both but in different ways.”

Although there were no differences in the frequency of heavy drinking between men and women, brain regions associated with future heavy drinking differed between the sexes. Disruptions in brain regions linked to anxiety were correlated with future heavy drinking in women, while disruptions in areas associated with high stress arousal were correlated with heavy drinking in men.

These findings suggest that men and women may benefit from targeted therapeutic approaches, including both pharmacological and behavioral treatments, tailored to their specific neural responses. Understanding these gender differences in craving and its neural correlates could lead to more effective treatments for alcohol use disorder and better outcomes for patients.

Rajita Sinha emphasized the importance of considering experiential, biological, and demographic variability across individuals for developing better treatments not only for alcohol use disorder but also for many other illnesses. She stated, “We want these types of studies to get clues on processes that drive heavy drinking and what type of interventions might work. It can be a very critical component of novel treatment development and better outcomes.”

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