Neural cue reactivity and intrinsic functional connectivity in individuals with alcohol use disorder following treatment with topiramate or naltrexone

• DOI: 10.1007/s00213-025-06745-7
• Publication Date: 2025-01-24T05:09:10Z
• Authors: Warren B. Logge; Paul S. Haber; Tristan Hurzeler; Hugh Gallagher; Henry Kranzler; Kirsten C. Morley
• Keywords: Cue reactivity; Alcohol use disorder; Alcohol Dependence; Reactivity

Abstract Rationale Both topiramate and naltrexone have been shown to affect neural alcohol cue reactivity in use disorder (AUD). However, their comparative effects on are unknown. Moreover, while has found normalize hyperactive localized network connectivity implicated AUD, no studies examined the effect of intrinsic functional or compared between these two widely used medications. Objective This study versus cue-elicited brain activation patients with disorder. Methods Forty-seven participants received daily (titrating dose up 200 mg/day n = 21) (50 mg/day, 26) for at least 6 weeks. Using magnetic resonance imaging (fMRI), we during rest a visual task 120 min following treatment administration. Functional percentage heavy drinking days (% HDD) associations were assessed. Results No differences either activity seen naltrexone-treated groups. Overall, showed increased three clusters spanning occipital regions involved recognition stimuli, hypoactivation both control cues salience attribution processing emotional valence external stimuli. observed measure post-scan % HDD. Conclusions Topiramate enacted comparable patterns. Some overall responses coupled reduced evidenced treatments. These patterns expected show attenuation resulting from treatment. may thus enact through similar modulation individuals AUD. Trial registration ClinicalTrials.gov, NCT03479086 https://www.clinicaltrials.gov/study/NCT03479086 .