Learning and Relapse Risk in Alcohol Dependence
Condition: Alcohol Use Disorders
MeSH terms: Alcoholism
Study type: Observational [Patient Registry]

Summary: 
      The aim of this project is to assess which behavioral and neuroimaging alterations associated
      with reward- based learning predict relapse in alcohol- dependent patients within a follow-
      up period of 12 months.

      The investigators will explore how these alterations interact with clinical and psychosocial
      factors which can modify the relapse risk. Functional magnetic resonance imaging (fMRI) and
      positron emission tomography (PET) will be used to identify neurofunctional abnormalities in
      neurotransmitter systems. The investigators will also provide data for genetic analysis and
      modeling.

      Patients will be detoxified in an inpatient setting and followed for 12 months using the
      Time-Line Follow- Back Procedure. Clinical assessments, behavioral paradigms of learning and
      brain imaging will be carried out within at least 4 half- lives after any psychotropic
      medication.

      The investigators will implement and apply functional imaging paradigms assessing
      Pavlovian-to-instrumental transfer and reversal learning tasks and associate model parameters
      of learning with alcohol craving, intake and prospective relapse risk.
    

Detailed description: 
      This project will examine 150 detoxified alcohol-dependent patients and 100 age- and gender
      matched controls. The main aim of this project is to assess 1) which behavioural and
      neuroimaging alterations (fMRI) associated with reward-based learning (see Projects 1 & 3)
      predict relapse within the follow-up period of 6 months, 2) how these interact with clinical
      and psychosocial factors which can modify the relapse risk, and 3) to provide data for
      genetic and imaging analyses and modelling. Furthermore, we will explore gender effects on
      functional imaging parameters of learning. Patients will be detoxified in an inpatient
      setting and followed for 6 months using the Form 90 and Time-Line Follow-Back Procedure.
      Clinical assessments, behavioral paradigms of learning, and brain imaging will be carried out
      within at least 4 half-lives after any psychotropic medication. Subjects will undergo medical
      management with bimonthly follow-ups and predefined in- and exclusion criteria as described
      previously. We will implement and apply functional imaging paradigms assessing
      Pavlovian-to-instrumental transfer and reversal learning as described in Projects 1 and 3. We
      will associate model parameters of learning with alcohol craving, intake and prospective
      relapse risk. Independent of these central questions, we will also assess comorbidity,
      psychosocial and neurobiological disease severity markers to control for specificity of
      findings.
    

Observational model: Case-Control
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        Detoxified alcohol- dependent patients and age- and gender matched healthy controls living
        in Germany
      
Biospecimen description: 
      liver encymes
    
Keywords: Reward- based learning; Pavlovian-to-instrumental transfer; Functional imaging; Relapse risk