fNIRS identifies right prefrontal hemodynamic signatures for subclassifying Alcohol Use Disorder

Alcohol use disorder (AUD) is a globally prevalent mental health condition, yet its classification remains largely reliant on subjective reports, lacking objective neurobiological biomarkers. This study employed functional near-infrared spectroscopy (fNIRS) to monitor prefrontal cortex hemodynamic activity in 80 male AUD patients, categorized into acute-onset (n = 29) and poly-symptomatic (n = 51) groups. During an alcohol cue exposure task, we measured oxygenated (HbO) and deoxygenated hemoglobin (HbR) concentrations across 24 prefrontal channels. Significant group differences were observed in HbO levels at channels 4, 5, 7, 10, 11, 14, and 15, with channel 4 showing the most pronounced variation. Channel 13 exhibited significant differences in HbR. Linear and logistic regression analyses identified HbO in channels 4 and 5, along with HbR in channel 13, as effective predictors of AUD subtype classification under alcohol cue stimulation. These findings underscore the critical role of the right prefrontal cortex, particularly the right middle frontal gyrus, in AUD pathophysiology. Our results support the utility of fNIRS-derived hemodynamic biomarkers for objective AUD classification and suggest potential avenues for targeted intervention strategies.