Brain Structure and Function in Recovery

Abstract

Alcohol use disorder (AUD) commonly is associated with compromise in neurobiological and/or neurobehavioral processes. The severity of this compromise varies across individuals and outcomes, as does the degree to which recovery of function is achieved. This narrative review first summarizes neurobehavioral, neurophysiological, structural, and neurochemical aberrations/deficits that are frequently observed in people with AUD after detoxification. Subsequent sections review improvements across these domains during recovery, taking into account modulators of recovery to the extent permitted. Where appropriate, the discussion includes work integrating outcomes across domains, leveraging the strengths of diverse experimental methods. Interventions to ameliorate neurobiological or neurobehavioral deficits do not constitute a primary objective of this review. However, their consideration is a logical inclusion. Therefore, a limited introduction to existing methods is also presented.

Preliminary evidence for changes in frontoparietal network connectivity in the early abstinence period in alcohol use disorder: a longitudinal resting-state functional magnetic resonance imaging study

“…Alcohol use disorder (AUD) is characterized by dysregulation across various neurobiological and neuropsychological domains (1)(2)(3)(4). Although empirical studies suggest that both neurobiological and behavioral measures improve substantially after stopping alcohol use, the trajectories over which recovery takes place are still poorly understood (1). While drinking leads to adaptations to alcohol in AUD, a new equilibrium has to be found after stopping drinking (2,5,6).…”

“…While drinking leads to adaptations to alcohol in AUD, a new equilibrium has to be found after stopping drinking (2,5,6). The initial weeks of abstinence mark a crucial period in which dynamic adaptations may help to start and subsequently sustain recovery, while failure to adapt may presage relapse (1). The importance of the early abstinence period is highlighted by studies showing that AUD patients are most likely to relapse in the first weeks following attempted abstinence (7,8).…”

From the Editors

“…7 The positive neurophysiological, somatic, psychological, and behavioral effects of, and the milestones involved in, AUD recovery are of great interest to affected parties, as well as to the public and the clinical and research fields. These effects are covered in detail across domains of brain (Nixon and Lewis, 2020) 8 and other organ systems (Thomes, Rasineni, Saraswathi, et al, 2021). 9 Several articles describe the therapeutic and dynamic mobilizers of recovery-related change across various clinical, nonclinical, and selfmanagement pathways, including articles about the recovery journey (Davidson, Rowe, DiLeo, et al, 2021; Stout, 2021) 11,12 among individuals and their families (McCrady and Flanagan, 2021).…”