Alpha band oscillations in the limbic pallidum track future alcohol use

Alcohol use disorder (AUD) is difficult to treat, with high relapse rates even after prolonged abstinence. The limbic pallidum (LP) is a key structure involved in reward and motivated behavior and has been proposed as a potential target for neuromodulatory interventions for AUD like deep brain stimulation (DBS). In this study, a sensing-enabled DBS system was implanted in the LP of a patient with severe, treatment-resistant AUD. Local field potentials (LFPs) were recorded during regular clinic visits and cue reactivity sessions to examine whether neural activity in the LP is related to alcohol use or alcohol craving. We identified prominent neural oscillations in the canonical alpha to low beta frequency range (7-15 Hz) that peaked in the alpha band (11-12Hz) and was localized to the right ventral LP. Relative power across this frequency range was strongly correlated with the number of drinks consumed in the days following the recording session, with the strongest correlation observed with drinking behavior in the first three days after the recording session. Furthermore, the heavy vs. light or no drinking behavior could be distinguished based on the power of the LP alpha oscillation using unbiased clustering. The correlation was specific to the right ventral LP and was only significant for drinking behavior following, rather than preceding, recording sessions. These results suggest that LP oscillations in the alpha band may serve as a biomarker of future heavy alcohol use and highlight the possibility of identifying a neural biomarker of drinking behavior that could be used to guide AUD treatment.