The Charleston Alcohol Research Center (ARC) at MUSC has received notification from the National Institute on Alcohol Abuse and Alcoholism (NIAAA) at the National Institutes of Health (NIH) that it will receive funding ($7 million) for another five-year period beginning January 2016. The Charleston ARC, which is housed in the Addiction Sciences Division of the Department of Psychiatry and Behavioral Sciences at MUSC, has continually sustained this NIH support as a Center of Excellence for 21 years (since 1995). The renewed funding will sustain support for this important research for years 21-25.
The Charleston ARC, one of only a few NIH/NIAAA-funded “specialized” alcohol research centers, boasts a uniquely strong relationship between basic scientists and clinicians that places it at the leading edge among alcohol research facilities. The ARC combines basic research and clinical investigation in a comprehensive program that informs a robust outpatient treatment program – all under one roof. Howard C. Becker, Ph.D., Professor in the MUSC Department of Psychiatry and Behavioral Sciences and Director of the Charleston ARC, praises this arrangement as highly advantageous to discovering new and better treatments for alcohol use disorders.
“I can’t tell you how many times we meet around the coffee pot and discuss issues facing our patients, and then discuss how to bring that down to the laboratory level,” says Becker. “Bringing everyone together and focusing on a common research problem from all these different perspectives really elevates the science we do at the ARC.”
That common research problem is a serious one – more than half of all adults in the U.S. have a family history of alcoholism or problem drinking. The economic, medical, and health care burden, not to mention personal tragedy, of alcohol use disorders in our society is enormous. Yet, while the negative health consequences of alcoholism are as familiar to us as those from hypertension or diabetes, less than 10% of people with alcohol dependency undergo treatment for the disorder. The mission of the ARC – to discover how alcohol affects health, with an emphasis on pharmacological intervention—relies on changing that statistic. It’s a matter of changing perception about alcohol abuse. “The main thing the ARC allows us to do is bring information to medical professionals and the public that this is a brain disease, not an individual personal weakness,” says Becker.
The renewed NIAAA funding provides support to continue basic and clinical research efforts that focus on complementary aspects of how alcohol alters normal functioning of the brain and how those changes in turn lead to heavy uncontrolled drinking and alcohol dependence. The basic research teams develop preclinical models to determine which brain regions and circuits change when exposed to alcohol and how those changes influence motivation to drink. The clinical research teams use neuroimaging (e.g., magnetic resonance imaging) approaches to see changes in the human brain. Working in a coordinated fashion, both groups use these results to learn which medications they should test that might best halt or reverse those changes.
As leaders in the field, ARC researchers are discovering how heavy alcohol drinking results in specific changes in the brain. Over time, the striatum, an inner region of the brain responsible for motivation and the pleasure response, becomes sensitized and highly reactive to visual and olfactory cues of alcohol. At the same time, long-term heavy alcohol use compromises the function of sub-regions of the cerebral cortex, reducing a person’s ability to make responsible decisions about drinking. In particular, alcohol abuse can result in adaptations in the striatum and parts of the frontal cortex that increase impulsivity, enhance craving and vulnerability to relapse, and promote excessive and compulsive drinking. Changes in these regions and in the circuits connecting them appear to drive the transition from drinking for pleasure to drinking out of habit.
Understanding how changes in the brain underlie this transition from moderate, controlled drinking to uncontrolled, compulsive drinking is a major research focus within the ARC. For example, work in the research laboratories of ARC basic researchers John J. Woodward, Ph.D., and L. Judson Chandler, Ph.D., have shown that heavy alcohol exposure alters activity of brain cells and specific circuits in the cortex that are critical for executive (decision-making) function. Another project, led by Raymond F. Anton, M.D., is testing whether people with a specific genetic makeup are more or less likely to respond to a medication that enhances behavioral control over drinking. The Center has also recruited a new clinical investigator to study a novel and exciting potential treatment option. Specifically, Colleen A. Hanlon, Ph.D., is testing whether a new technique called transcranial magnetic stimulation (TMS)—a noninvasive tool to excite precise brain regions—can rescue “normal” communication between the cortex and striatum, thereby blunting brain activation to alcohol cues and strengthening behavioral control over drinking in alcohol-dependent study patients.
Becker hopes that teasing apart the circuitry underlying drinking for pleasure and drinking out of habit will enable ARC researchers to develop pharmacotherapies and nonpharmacological approaches that may more effectively treat alcohol dependence. The five-year plan is to have a much better picture of which medications and therapies work in people with differing genetic and environmental backgrounds.
All of the effort within the ARC is helping define alcoholism as a true brain disease. “The more we learn about the neuroscience of alcohol addiction, the more we legitimize the fact that this is a medical problem that needs to be addressed and treated,” says Becker.
Charleston ARC researchers collaborate with departments across MUSC and in the local and national community. To enhance the mission of the Center, encourage collaboration, and draw other investigators into the alcohol field, the ARC offers pilot funding to MUSC researchers and clinicians with pertinent questions about alcohol use disorders. Visit MUSC.edu/arc to learn more about alcohol use problems or for information about ARC research projects, collaborations, and community outreach activities.