[Neuroimaging diagnosis of alcohol dependence]

Neuroimaging provides insight into the main biological mechanisms underlying alcohol dependence. This article discusses results from brain imaging studies on neurobiological correlates of alcohol dependence. Cardinal symptoms of alcohol dependence are the development of tolerance, withdrawal symptoms, drug craving, loss of control on alcohol intake, and harmful consequences of alcohol consumption. Brain imaging studies support the hypothesis that tolerance can be understood as a neuroadaptive mechanism to ensure homeostasis during chronic alcohol intake. When alcohol consumption is suddenly interrupted during detoxification, the loss of homeostasis typically manifests as withdrawal syndrome. While tolerance reduces the effects of chronic alcohol intake, sensitization is a neuroadaptive process that increases the effects of alcohol and raises incentive salience. Brain imaging studies indicate that sensitization and drug craving are associated with neuroadaptive processes in the brain reward system. Harmful consequences of alcohol intake also include neurotoxic effects on the central nervous system characterized by local and global atrophy. These findings can be best diagnosed with neuroimaging.