Abnormal Spontaneous Brain Activity in Alcohol Use Disorder Patients: A Meta-Analysis Based on Resting-State fMRI

Previous neuroimaging studies have revealed abnormal functional activity in multiple brain regions among individuals with alcohol use disorder (AUD). However, due to the heterogeneity in study designs, these findings lack consistency, leaving the core neuropathological mechanisms of AUD unclear to date. To address this, we conducted a quantitative whole-brain meta-analysis of relevant resting-state functional imaging data to identify persistent brain region characteristics in individuals with AUD. A systematic literature search was conducted across six databases from their inception to August 8, 2025. Subsequently, a meta-analysis employing the anomaly effect size-marked difference mapping (AES-SDM) method was performed to identify abnormal brain activity patterns in patients with AUD. This was supplemented by jackknife sensitivity analysis, heterogeneity testing, publication bias assessment, subgroup analysis, and meta-regression analysis. The results showed that a total of 16 articles (20 datasets) were included, involving 520 patients with AUD and 523 healthy controls (HCs). SDM meta-analysis revealed enhanced functional activity in the right pars opercularis of the inferior frontal gyrus of AUD patients compared to healthy controls, while reduced functional activity was observed in the bilateral postcentral gyrus and left precuneus. Sensitivity analyses and subgroup analyses demonstrated high robustness across all regions. Meta-regression analysis indicated that reduced activity in the left posterior central gyrus was significantly correlated with AUD severity and moderated by age. This study shows AUD patients have abnormal activity in brain regions linked to sensory processing, emotional regulation, and self-awareness, offering comprehensive insights into AUD's neuropathology.