The effect of a forced oral Glucose intake on alcohol craving and mesolimbic cue reactivity in patients suffering from an alcohol use disorder

• Applicant: Dr. Anne Koopmann
• Subject Area: Clinical Psychiatry, Psychotherapy, Child and Adolescent Psychiatry
• Term: from 2020 to 2023
• Project identifier: Deutsche Forschungsgemeinschaft (DFG) - Project number 438291497

Alcohol craving is the most important risk factor for relapses in patients suffering from an alcohol use disorder. Recently, association studies could show various associations between the plasma levels of appetite regulating peptides ghrelin, leptin and insulin and alcohol craving in these patients. Additionally, preclinical studies found, that these peptides have specific receptors on the dopaminergic neurons of the mesolimbic reward system. So one can build the hypothesis, that these peptides can influence alcohol craving via their effects on mesolimbic dopaminergic neurons. Therefor they are interesting targets for the development of new skills in relapse prevention of alcohol use disorders. In this randomized clinical cross-over study we want to test, if a forced oral glucose intake (80 g glucose in 200 ml water in 10 min) changes plasma levels of acetylated and total ghrelin as well as insulin and reduce craving in patients suffering from an alcohol use disorder, who take part in an alcohol exposure session Additionally, we want to test if this intervention causes changes in mesolimbic dopaminergic cue reactivity (using functional magnetresonance tomography, fMRT). Using these data, we want to test, if there are associations between changes in plasma levels of appetite regulating peptides and mesolimbic cue reactivity. In the control condition, the participants undergo the same experimental trail after receiving a placebo, which is as sweet as glucose solution (Natriumcyclamat 1,5 g in 200 ml water). In this study project we want to elucidate the interaction between the mesolimbic dopaminergic system and ghrelin as well as insulin and based on this improve the therapeutic approaches in relapse prevention in alcohol use disorder (e.g. by the integration of a training of forced glucose in intake in group therapy programs in in- and out-patient units). In combination with former research data of our department these data can help to develop individualized, phenotype-based therapy programs for patients suffering from an alcohol use disorder. Besides improving the prognosis of an individual patient, the results of this study can reduce treatment costs for alcohol use disorder in general.

• DFG Programme: Research Grants