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Neurobiology of Alcohol Addiction

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Neuroscience in the 21st Century

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Abstract

Consumption of alcohol is the third leading cause of preventable deaths worldwide making it a major public health issue. After a brief account of the history and current situation of alcohol use and abuse, we describe the clinical pictures of the most severe neuropsychiatric consequences of pathological alcohol consumption, namely, alcohol addiction, Wernicke’s encephalopathy, and fetal alcohol syndrome. We then explain the neurobiological and pharmacological mechanisms of alcohol’s action in the brain that underlie its rewarding effects in humans and other animals. We point out how genetic factors in interaction with the environment influence the risk for heavy drinking, which ultimately may lead to alcohol addiction, a chronic relapsing disorder where relapse is characterized by compulsive alcohol seeking, and the loss of control in limiting alcohol intake. We account for some influential theories that try to explain the dysregulation in brain circuits along the development into an addicted state, and based on these concepts we point to pharmacological strategies that can reduce the risk for relapse and thus will be helpful in managing alcohol-addicted patients.

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Abbreviations

5-HT3 :

Serotonin type 3 receptor

AA:

Alko alcohol (alcohol-preferring rat line)

ACTH:

Adrenocorticotropic hormone

ADE:

Alcohol deprivation effect

ADH:

Alcohol dehydrogenase

ALDH:

Aldehyde dehydrogenase

AMPA:

α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (specific agonist for the AMPA receptor mimicking the effects of the neurotransmitter glutamate)

ANA:

Alko nonalcohol (alcohol-nonpreferring rat line)

ANP:

Atrial natriuretic peptide

ARND:

Alcohol-related neurodevelopmental disorder

ATP:

Adenosintriphosphate

BAC:

Blood alcohol concentration

CRH:

Corticotropin-releasing hormone

CRHR1:

Corticotropin-releasing hormone receptor 1

DA:

Dopamine

DALs:

Disability-adjusted life-years

DBS:

Deep brain stimulation

DSM-IV:

Diagnostic and Statistical Manual of Mental Disorders – Version IV

EPSC:

Excitatory postsynaptic current

FAS:

Fetal alcohol syndrome

fMRI:

Functional magnetic resonance imaging

GABA:

Gamma-aminobutyric acid

GATA4:

GATA-binding protein 4

GHSR-1A:

Growth hormone secretagogue receptor

GluA1:

Glutamate receptor 1

GWAS:

Genome-wide association studies

hCRHR1:

Human CRH1 receptor gene

HPA axis:

Hypothalamic-pituitary-adrenocortical axis

htSNP:

Haplotype SNP

ICD-10:

WHO’s International Classification of Diseases – Version 10

LTP:

Long-term potentiation

LY686017:

Neurokinin 1 receptor antagonist

MPEP:

2-Methyl-6-(phenylethynyl)pyridine hydrochloride (a selective mGluR5 receptor antagonist)

MRI:

Magnetic resonance imaging

MRS:

Magnetic resonance spectroscopy

NAC:

Nucleus accumbens

nAch:

Neuronal acetylcholine

NIAAA:

National Institute on Alcohol Abuse and Alcoholism

NMDA:

N-methyl-d-aspartate (specific agonist at the NMDA receptor mimicking the action of glutamate)

PET:

Positron emission tomography

PFC:

Prefrontal cortex

QTL:

Quantitative trait loci

RCT:

Randomized clinical trial

SNPs:

Single nucleotide polymorphisms

VTA:

Ventral tegmental area

WHO:

World Health Organization

Further Reading

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Authors and Affiliations

  1. Institute of Psychopharmacology, Central Institute of Mental Health, University of Heidelberg, J5, 68159, Mannheim, Germany

    Prof. Rainer Spanagel & Dr. Wolfgang H. Sommer

  2. Department of Psychiatry, Central Institute of Mental Health, University of Heidelberg, J5, 68159, Mannheim, Germany

    Dr. Mathias Zink

Authors
  1. Prof. Rainer Spanagel
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  2. Dr. Mathias Zink
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  3. Dr. Wolfgang H. Sommer
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Corresponding author

Correspondence to Rainer Spanagel .

Editor information

Editors and Affiliations

  1. Laboratory of Neurobiology and Behavior, The Rockefeller University, New York, NY, USA

    Donald W. Pfaff

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Spanagel, R., Zink, M., Sommer, W.H. (2013). Neurobiology of Alcohol Addiction. In: Pfaff, D.W. (eds) Neuroscience in the 21st Century. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-1997-6_107

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