Effects of cue-exposure treatment on neural cue reactivity in XXXX dependence: a randomized trial.

@entity167 @entity1 @entity1297 @entity988
BACKGROUND: In @entity167 -dependent @entity1 , @entity167 -associated cues elicit brain activation in mesocorticolimbic networks involved in relapse mechanisms. @entity1297 ( @entity1297 ) has been shown to be efficacious in the treatment of @entity988 ; however, it has remained unexplored whether @entity1297 mediates its therapeutic effects via changes of activity in mesolimbic networks in response to @entity167 cues. In this study, we assessed @entity1297 treatment effects on cue-induced responses using functional magnetic resonance imaging (fMRI). METHODS: In a randomized controlled trial, abstinent @entity167 -dependent @entity1 were randomly assigned to a @entity1297 group (n = 15) or a control group (n = 15). All @entity1 underwent an extended detoxification treatment comprising medically supervised detoxification, health education, and supportive therapy. The @entity1297 @entity1 additionally received nine @entity1297 sessions over 3 weeks, exposing the @entity1 to his/her preferred alcoholic beverage. Cue-induced fMRI activation to @entity167 cues was measured at pretreatment and posttreatment. RESULTS: Compared with pretreatment, fMRI cue-reactivity reduction was greater in the @entity1297 relative to the control group, especially in the anterior cingulate gyrus and the insula, as well as limbic and frontal regions. Before treatment, increased cue-induced fMRI activation was found in limbic and reward-related brain regions and in visual areas. After treatment, the @entity1297 group showed less activation than the control group in the left ventral striatum. CONCLUSIONS: The study provides first evidence that an exposure-based psychotherapeutic intervention in the treatment of @entity988 impacts on brain areas relevant for addiction memory and attentional focus to @entity167 -associated cues and affects mesocorticolimbic reward pathways suggested to be pathophysiologically involved in addiction.
