Behavioral Health Immediate Care Program seeks to fill gaps in access to care
Researchers at The Ohio State University Wexner Medical Center are studying the neurological changes that occur in the brains of individuals with alcohol use disorder and/or intermittent explosive disorder to support development of new treatment.
Severe problem drinking is a diagnosed disease known as alcohol use disorder (AUD). It afflicted 14.1 million adults in 2019, and the National Institute on Alcohol Abuse and Alcoholism anticipates this number will continue to increase.
Aggressive behavior is often associated with alcohol abuse and, when this behavior is extreme, it may be clinically diagnosed as intermittent explosive disorder (IED), a disease that the National Institutes of Health reports affects around 7% of the population.
Treating alcohol-induced aggression
Today, a comprehensive treatment program for patients with AUD-IED might include:
- medical detoxification
- drug therapy
- psychological counseling
- behavior modification therapies, such as anger management and stress reduction techniques like massage therapy, physical exercise or meditation
While studies testing behavioral therapies have shown their positive physical and mental health benefits, there is no clear understanding of how biomechanical and neurological processes in the brain affect aggressive behaviors. However, recent advances in technologies, such as MRI, are now making it possible for scientists to look beyond just the behavioral aspects of AUD-IED and explore the neurological changes that occur in the brain.
Important new information
Emil Coccaro, MD, the George T. Harding III, MD, Jr. Endowed Professor of Psychiatry and Behavioral Health at The Ohio State University College of Medicine, and research partner, Andrea King, PhD at the University of Chicago are now measuring and recording the neurological changes that occur in the brains of patients with AUD and/or IED.
“This work will be critical to identifying targets for intervention to reduce alcohol-related aggressive behavior,” he says. “Thus, understanding the underlying neuroscience of social-emotional information processing (SEIP) under the influence of alcohol will be critical to identifying targets for intervention to reduce alcohol-related aggressive behavior.”
Previous research has shown that in healthy subjects, acute alcohol intoxication alters cortico-limbic functioning – the area of the brain that facilitates aggressive behavior. There are similar anomalies the brains of individuals diagnosed with AUD or AUD-AGG. This new study – “Aggression and SEIP: Neural Correlates During Alcohol Intoxication, Aggression and SEIP,” which is being conducted in collaboration with Andrea King, PhD, in the Department of Psychiatry and Behavioral Neuroscience at The University of Chicago – will more closely examine the brain’s response to SEIP and aggression during acute alcohol consumption. The responses in individuals both with and without AUG and/or IED will be compared to the responses in healthy individuals.
Specific brain responses may guide development of more effective treatment
The study aims to demonstrate that alcohol dulls orbitofrontal (decision-making) and amygdala activity (aggression and fear) in response to explicit cues of threat, as well as cortico-limbic activity in response to ambiguous social cues of threat, and increases ventral striatal activity (the brain’s reward center) in both threat conditions.
Researchers hope that understanding these varied brain responses will lead to the development of new pharmacologic and cognitive behavioral-based interventions that could involve the rehabilitation of aberrant neuronal circuits underlying social cognitive function through neuroplasticity-based remediation exercises.