Common Gray Matter Reductions in Alcohol Use and Obsessive-Compulsive Disorders: A Meta-analysis

Gender Differences in Alcohol Use: a Nationwide Study in a Multiethnic Population

“…The alterations in the insula could lead to enhanced cravings for alcohol, and with reduced grey matter in the ACC, there would be less control over regulating the cravings, when faced with the decision to drink (Stevens et al, 2021). However, Stevens et al (2021) did not examine potential sex or gender differences in their meta-analysis; hence, we are unable to explain the higher prevalence of AUD and OCD comorbidity in females in this study. A recent meta-analysis found that women were 1.6 times more at risk experiencing OCD than men (Fawcett et al, 2020).…”

“…There is a possibility that women with OCD in Singapore tend to use maladaptive drinking patterns as their coping mechanism. In view of Stevens et al (2021) study, it is plausible that they also lack the self-regulation to buffer their cravings for alcohol. However, a previous study by Gentil et al (2009) reported that males were more likely to have an AUD or substance use disorder and comorbid OCD than females.…”

“…In addition, Lee et al (2020) also found that although binge drinking rates were low and were infrequent in Singapore, there was an exclusive association with anxiety disorders in females, and a stronger association between AUD and anxiety disorder in female binge drinkers. A recent meta-analysis found decreased grey matter in the anterior cingulate cortex (ACC) and insula brain regions in both OCD and AUD (Stevens et al, 2021). The alterations in the insula could lead to enhanced cravings for alcohol, and with reduced grey matter in the ACC, there would be less control over regulating the cravings, when faced with the decision to drink (Stevens et al, 2021).…”

“…A recent meta-analysis found decreased grey matter in the anterior cingulate cortex (ACC) and insula brain regions in both OCD and AUD (Stevens et al, 2021). The alterations in the insula could lead to enhanced cravings for alcohol, and with reduced grey matter in the ACC, there would be less control over regulating the cravings, when faced with the decision to drink (Stevens et al, 2021). However, Stevens et al (2021) did not examine potential sex or gender differences in their meta-analysis; hence, we are unable to explain the higher prevalence of AUD and OCD comorbidity in females in this study.…”

Early-onset smoking theory of compulsivity development: a neurocognitive model for the development of compulsive tobacco smoking

“…A review conducted by the same authors showed that the compulsive behavior manifested by individuals affected by addictions and by those affected by OCD is characterized by (a) impaired reward processing associated with blunted responses in the ventral striatum to non-drug-related rewards (for individuals with drug addiction) and non-symptom provoking stimuli (for individuals affected by OCD), (b) negative reinforcement (compulsive behavior to avoid anxiety and stress) associated with abnormalities in brain anti-reward and anxiety circuits involving the bed nucleus of the stria terminalis (BST), amygdala, and habenula, (c) cognitive inflexibility associated with structural and functional abnormalities in the orbitofrontal cortex (OFC), and (d) insensitivity toward punishment associated with decreased neuronal activity in the medial-prefrontal cortex (mPFC)–ventrolateral striatum circuitry and insular cortex. In support of this paradigm, a recent meta-analysis conducted by Stevens et al ( 15 ) on 44 VBM studies reported that 736 individuals affected by alcohol use disorder and 995 individuals affected by obsessive–compulsive disorder (OCD) share a low GM volume in the right insular cortex, while an activation likelihood estimation (ALE) meta-analysis conducted by Klugah-Brown et al ( 16 ) on 144 fMRI studies reported shared neurofunctional alterations in the anterior insular cortex between 2,428 individuals affected by SUDs (e.g., cocaine, alcohol, and tobacco), 361 individuals affected by internet gaming disorder (IGD), and 715 individuals affected by OCD.…”