Anterior Cingulate Glutamate Is Reduced by Acamprosate Treatment in Patients With Alcohol Dependence.
Anterior Cingulate Glutamate Is Reduced by Acamprosate Treatment in Patients With Alcohol Dependence.
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DOI：
10.1097/jcp.0000000000000590
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发表时间：
2016-12
影响因子：
2.9
通讯作者：
Port JD
中科院分区：
文献类型：
--
作者：
Frye MA;Hinton DJ;Karpyak VM;Biernacka JM;Gunderson LJ;Feeder SE;Choi DS;Port JD
Although the precise drug mechanism of action of acamprosate remains unclear, its antidipsotropic effect is mediated in part through glutamatergic neurotransmission. We evaluated the effect of 4 weeks of acamprosate treatment in a cohort of 13 subjects with alcohol dependence (confirmed by structured interview DSM-IV-TR) on 1H-MRS glutamate levels in the midline anterior cingulate cortex (MACC). We compared levels of metabolites to a group of 16 healthy controls. The Pennsylvania Alcohol Craving Scale (PACS) was used to assess craving intensity. At baseline, before treatment, the mean cerebrospinal fluid (CSF)-corrected MACC glutamate [Glu] level was significantly elevated in subjects with alcohol dependence compared to controls (P = 0.004). Four weeks of acamprosate treatment reduced glutamate levels (P = 0.025), an effect that was not observed in subjects that did not take acamprosate. At baseline, there was a significant positive correlation between cravings, measured by PACS, and MACC [Glu] levels (P = 0.019). Overall, these data would suggest a normalizing effect of acamprosate on a hyper-glutamatergic state observed in recently withdrawn patients with alcohol dependence and a positive association between MACC glutamate levels and craving intensity in early abstinence. Further research is needed to evaluate utility of these findings for clinical practice, including monitoring of craving intensity and individualized selection of treatment with antidipsotropic medications in subjects with alcohol dependence.
