Loss of Control of Alcohol Use and Severity of Alcohol Dependence in Non-Treatment-Seeking Heavy Drinkers Are Related to Lower Glutamate in Frontal White Matter

Background The development and maintenance of alcohol use disorders (AUD) have been hypothesized to be associated with an imbalance of glutamate (GLU) homeostasis. White matter (WM) loss, especially in anterior brain regions, has been reported in alcohol dependence, which may involve disturbances in both myelin and axonal integrity. Frontal lobe dysfunction plays an important role in addiction, because it is suggested to be associated with the loss of control over substance use. This study investigated magnetic resonance spectroscopy (MRS)‐detectable Glu levels in frontal WM of non‐treatment‐seeking heavy drinkers and its associations with AUD symptoms. Methods Single‐voxel MR spectra optimized for Glu assessment (TE 80 ms) were acquired at 3T from a frontal WM voxel in a group of heavy drinking, non‐treatment‐seeking subjects in comparison with a group of subjects with only light alcohol consumption. Results The results corroborate previous findings of increased total choline in heavy drinking subjects. A negative association of Glu levels with severity of alcohol dependence and especially loss of control over time and amount of alcohol intake was observed. Conclusions In contrast to the rather unspecific rise in choline‐containing compounds, low Glu in frontal WM may be specific for the shift from nondependent heavy drinking to dependence and does not reflect a simple effect of the amount of alcohol consumption alone.