Papers by Marlene Oscar-Berman
Substance use & misuse, Jan 19, 2017
Buprenorphine and naloxone (bup/nal), a combination partial mu receptor agonist and low-dose delt... more Buprenorphine and naloxone (bup/nal), a combination partial mu receptor agonist and low-dose delta mu antagonist, is presently recommended and used to treat opioid-use disorder. However, a literature review revealed a paucity of research involving data from urine drug tests that looked at compliance and abstinence in one sample. Statistical analysis of data from the Comprehensive Analysis of Reported Drugs (CARD) was used to assess compliance and abstinence during treatment in a large cohort of bup/nal patients attending chemical-dependency programs from eastern USA in 2010 and 2011. Part 1: Bup/nal was present in 93.4% of first (n = 1,282; p <.0001) and 92.4% of last (n = 1,268; p <.0001) urine samples. Concomitantly, unreported illicit drugs were present in 47.7% (n = 655, p =.0261) of samples. Patients who were compliant to the bup/nal prescription were more likely than noncompliant patients to be abstinent during treatment (p =.0012; odds ratio = 1.69 with 95% confidence i...
Men and women may use alcohol to regulate their emotions differently, with corresponding differen... more Men and women may use alcohol to regulate their emotions differently, with corresponding differences in neural responses. We examined how photographs of emotional stimuli impacted brain activity obtained through functional magnetic resonance imaging (fMRI) from 42 alcoholic (25 women) and 46 nonalcoholic (24 women) participants. Brain responsivity was blunted in alcoholic compared to nonalcoholic groups. Further analyses indicated significant gender differences in the impact of alcoholism. Brain activation of the alcoholic men (ALC M) was significantly lower than that of the alcoholic women (ALC W) and nonalcoholic men (NC M) in regions including the inferior parietal gyrus, anterior cingulate gyrus, and postcentral gyrus, whereas activation was higher in the ALC W than in the nonalcoholic women (NC W) in superior frontal and supramarginal cortical regions. The reduced brain reactivity of ALC M and increases for ALC W highlighted divergent brain regions and gender effects, suggesting possible differences in the underlying basis for development of alcohol use disorders.
PLOS ONE, Jun 9, 2021
Inclusion of women in research on Alcohol Use Disorder (AUD) has shown that gender differences co... more Inclusion of women in research on Alcohol Use Disorder (AUD) has shown that gender differences contribute to unique profiles of cognitive, emotional, and neuropsychological dysfunction. We employed functional magnetic resonance imaging (fMRI) of abstinent individuals with a history of AUD (21 women [AUDw], 21 men [AUDm]) and demographically similar non-AUD control (NC) participants without AUD (21 women [NCw], 21 men [NCm]) to explore how gender and AUD interact to influence brain responses during emotional processing and memory. Participants completed a delayed match-to-sample emotional face memory fMRI task, and brain activation contrasts between a fixation stimulus and pictures of emotional face elicited a similar overall pattern of activation for all four groups. Significant Group by Gender interactions revealed two activation clusters. A cluster in an anterior portion of the middle and superior temporal gyrus, elicited lower activation to the fixation stimulus than to faces for the AUDw as compared to the NCw; that abnormality was more pronounced than the one observed for men. Another cluster in the medial portion of the superior frontal cortex elicited higher activation to the faces by AUDm than NCm, a difference that was more evident than the one observed for women. Together, these findings have added new evidence of AUD-related gender differences in neural responses to facial expressions of emotion.
ABSTRACTAimsAlcohol use disorder (AUD), has been shown to have harmful cognitive and physiologica... more ABSTRACTAimsAlcohol use disorder (AUD), has been shown to have harmful cognitive and physiological effects, including altered brain chemistry. Further, although men and women may differ in vulnerability to the neurobiological effects of AUD, results of existing studies have been conflicting. Brain metabolite levels and cognitive functions were examined in a cross section of men with AUD (AUDm) and women with AUD (AUDw) to determine degree of abnormalities after extended periods of abstinence (mean, six years), and to evaluate gender differences in cognitive and metabolite measures.MethodsParticipants were 40 abstinent individuals with AUD (22 AUDw, 18 AUDm) and 50 age-equivalent non-AUD comparison participants (26 NCw, 24 NCm). Proton magnetic resonance spectroscopy (MRS) was employed at 3 Tesla to acquire metabolite spectra from the dorsal anterior cingulate cortex (dACC). Brain metabolites N-acetylaspartate (NAA), choline (Cho), myo-Inositol (mI), and glutamate & glutamine (Glx) w...
We employed fMRI in 84 men and women with and without a history of alcohol use disorders (ALC and... more We employed fMRI in 84 men and women with and without a history of alcohol use disorders (ALC and NC, respectively), to explore how gender interacts with alcoholism as reflected in brain activity elicited by alcohol cues. Brain activation was measured in a working memory task (delayed matching-to-sample) with emotional faces as the sample and match cues. During the delay period, intervening distractors were either reward-salient cues (alcoholic beverages) or neutral cues (nonalcoholic beverages or scrambled pictures). ALC women (ALCw) had higher accuracy than ALC men (ALCm). Analyses of scans during the viewing of distractor images revealed significant group-by-gender interactions. Compared to NC men, ALCm evidenced lower activation contrast between reward-salient cues and neutral cues in default mode network regions (including superior prefrontal and precuneus areas), while ALCw had more activation than NC women. Similar interactions were observed for task-regions (including superi...
Aims. Alcohol use disorder (AUD), also often referred to as alcoholism, has been associated with ... more Aims. Alcohol use disorder (AUD), also often referred to as alcoholism, has been associated with abnormalities in hippocampal volumes, but these relationships have not been fully explored with respect to gender or sub-regional volumes. Methods. Using Magnetic Resonance Imaging at 3 Tesla, we obtained brain images from 67 alcoholic (ALC) participants (31 women) and 63 nonalcoholic control (NC) participants (30 women). We used Freesurfer 6.0 to segment the hippocampus into 12 regions. These were imputed into mixed models to examine the relationships of brain volume with alcoholism group, gender, age, drinking history, and memory. Results. The ALC group had approximately 5% smaller CA1, hippocampal tail, and molecular layer regions than the NC group. Age was negatively associated with volumes for the ALC group in the hippocampal tail, subiculum, and presubiculum. The relationships for delayed and immediate memory with hippocampal tail volume differed for ALC and NC groups: Higher score...
eLife, 2019
Men and women may use alcohol to regulate emotions differently, with corresponding differences in... more Men and women may use alcohol to regulate emotions differently, with corresponding differences in neural responses. We explored how the viewing of different types of emotionally salient stimuli impacted brain activity observed through functional magnetic resonance imaging (fMRI) from 42 long-term abstinent alcoholic (25 women) and 46 nonalcoholic (24 women) participants. Analyses revealed blunted brain responsivity in alcoholic compared to nonalcoholic groups, as well as gender differences in those activation patterns. Brain activation in alcoholic men (ALCM) was significantly lower than in nonalcoholic men (NCM) in regions including rostral middle and superior frontal cortex, precentral gyrus, and inferior parietal cortex, whereas activation was higher in alcoholic women (ALCW) than in nonalcoholic women (NCW) in superior frontal and supramarginal cortical regions. The reduced brain reactivity of ALCM, and increases for ALCW, highlighted divergent brain regions and gender effects, ...
Alcohol research & health : the journal of the National Institute on Alcohol Abuse and Alcoholism, 2003
Alcoholism can affect the brain and behavior in a variety of ways, and multiple factors can influ... more Alcoholism can affect the brain and behavior in a variety of ways, and multiple factors can influence these effects. A person's susceptibility to alcoholism-related brain damage may be associated with his or her age, gender, drinking history, and nutrition, as well as with the vulnerability of specific brain regions. Investigators use a variety of methods to study alcoholism-related brain damage, including examining brains of deceased patients as well as neuroimaging, a technique that enables researchers to test and observe the living brain and to evaluate structural damage in the brain.
Inclusion of women in alcoholism research has shown that gender differences contribute to unique ... more Inclusion of women in alcoholism research has shown that gender differences contribute to unique profiles of cognitive, emotional, and neuropsychological dysfunction. We employed functional magnetic resonance imaging (fMRI) of abstinent long-term alcoholics (21 women [ALCw] and 21 men [ALCm]) and demographically-similar nonalcoholic controls (21 women [NCw] and 21 men [NCm]) to explore how gender and alcoholism interact to influence emotional processing and memory. Participants completed a delayed match-to-sample emotional face memory fMRI task. While the results corroborated reports implicating amygdalar, superior temporal, and cerebellar involvement in emotional processing overall, the alcoholic participants showed hypoactivation of the left intraparietal sulcus to encoding the identity of the emotional face stimuli. The nonalcoholic participants demonstrated more reliable gender differences in neural responses to encoding the identity of the emotional faces than did the alcoholic...
Alcoholism: Clinical and Experimental Research, 2008
Background-Alcoholism-related deficits in cognition and emotion point toward frontal and limbic d... more Background-Alcoholism-related deficits in cognition and emotion point toward frontal and limbic dysfunction, particularly in the right hemisphere. Prefrontal and anterior cingulate cortices are involved in cognitive and emotional functions and play critical roles in the oversight of the limbic reward system. In the present study, we examined the integrity of white matter tracts that are critical to frontal and limbic connectivity. Methods-Diffusion tensor magnetic resonance imaging (DT-MRI) was used to assess functional anisotropy (FA), a measure of white matter integrity, in 15 abstinent long-term chronic alcoholic and 15 demographically equivalent control men. Voxel-based and region-based analyses of group FA differences were applied to these scans. Results-Alcoholic subjects had diminished frontal lobe FA in the right superior longitudinal fascicles II and III, orbitofrontal cortex white matter, and cingulum bundle, but not in corresponding left hemisphere regions. These right frontal and cingulum white matter regional FA
Journal of systems and integrative neuroscience, Jul 16, 2017
This multi-center study of dual diagnosis (DD) programs involved 804 residential patients with co... more This multi-center study of dual diagnosis (DD) programs involved 804 residential patients with co-occurring alcohol and mental health disorders. The Addiction Severity Index was administered at admission and at one, six, and 12 months after discharge. Repeated measures analysis showed the intoxication rate per month stabilized between months six and 12 with 68% still in remission and an 88% mean reduction from baseline (F = 519, p < .005). A comparison between patients with and without weekly relapse produced significant differences in hospitalization (odds ratio 11.3:1; 95% C.I., 5.5 to 23.2). Eight ANCOVAs used mean intoxication days per month after discharge as the outcome variable, pre-admission intoxication days per month as a covariate, and eight variables associated with relapse (e.g. depression) as factors. Patients with these factors at admission did not have significantly higher intoxication rates after discharge than patients without them. This suggests that these DD p...
Journal of reward deficiency syndrome
The connection between religion/spirituality and deviance, like substance abuse, was first made b... more The connection between religion/spirituality and deviance, like substance abuse, was first made by Durkheim who defined socially expected behaviors as norms. He explained that deviance is due in large part to their absence (called anomie), and concluded that spirituality lowers deviance by preserving norms and social bonds. Impairments in brain reward circuitry, as observed in Reward Deficiency Syndrome (RDS), may also result in deviance and as such we wondered if stronger belief in spirituality practice and religious belief could lower relapse from drugs of abuse. The NIDA Drug Addiction Treatment Outcome Study data set was used to examine post hoc relapse rates among 2,947 clients who were interviewed at 12 months after intake broken down by five spirituality measures. Our main findings strongly indicate, that those with low spirituality have higher relapse rates and those with high spirituality have higher remission rates with crack use being the sole exception. We found signific...
Journal of Reward Deficiency Syndrome, 2015
Conflict of Interest Kenneth Blum, Ph.D., holds U.S. and foreign patents issued and pending on KB... more Conflict of Interest Kenneth Blum, Ph.D., holds U.S. and foreign patents issued and pending on KB220 and KB220Z™ variants. He is licensed through his company Synaptamine, Inc., and a number of retail companies including RD Solutions, LLC, Victory Nutrition, LLC, Natures Plus, Inc., Nupathways, Inc. There are no more conflicts of interest.
Journal of Sleep Disorders & Therapy, 2014
The issue of insomnia is a global phenomenon which requires additional in-depth research. Insomni... more The issue of insomnia is a global phenomenon which requires additional in-depth research. Insomnia especially in alcohol-dependent patients, for example, may lead to suicide. It is noteworthy that childhood sleep problems predict the onset of drinking in boys. We now know that while there are multi-faceted reasons for sleep problems and disturbances (e.g. sleep drive homeostasis, circadian rhythm physiology, and genetic influences), the scientific community has not been able to deliver an appropriate solution. Some benefit has been noted with cognitive behavioral therapy, but it has minimal effects in patients relapsing from drugs especially alcohol, cocaine and opiates. While there are a number of pharmaceutical drugs developed to treat insomnia, most have associated side effects and even addiction liability. We do know that benzodiazepines hijack the midbrain dopamine system leading to addiction. Finally, it has been proposed that dopamine D2 receptors are involved in rapid eye movement sleep, suggesting as proposed herein that dopaminergic activation is a worthwhile mechanism to explore in the future. The concepts presented herein on potential nutrigenomic therapy warrants further in-depth analysis. In this regard we hypothesize based on both literature review and empirical data that a putative dopaminergic, melatonin, benzodiazepine reward circuitry receptor(s) activator provides sleep induction benefits.
Journal of sleep disorders & therapy, Jan 18, 2014
It is well-known that sleep has a vital function especially as it relates to prevention of substa... more It is well-known that sleep has a vital function especially as it relates to prevention of substance-related disorders as discussed in the DSM-V. We are cognizant that certain dopaminergic gene polymorphisms have been associated with various sleep disorders. The importance of "normal dopamine homeostasis" is tantamount for quality of life especially for the recovering addict. Since it is now know that sleep per se has been linked with metabolic clearance of neurotoxins in the brain, it is parsonomiuos to encourage continued research in sleep science, which should ultimately result in attenuation of sleep deprivation especially associated with substance related disorders.
Journal of genetic syndromes & gene therapy, Jan 3, 2013
This article co-authored by a number of scientists, ASAM physicians, clinicians, treatment center... more This article co-authored by a number of scientists, ASAM physicians, clinicians, treatment center owners, geneticists, neurobiologists, psychologists, social workers, criminologists, nurses, nutritionist, and students, is dedicated to all the people who have lost loved ones in substance-abuse and "reward deficiency syndrome" related tragedies. Why are we failing at reducing the incidence of 'Bad Behaviors'? Are we aiming at the wrong treatment targets for behavioral disorders? We are proposing a paradigm shift and calling it "Reward Deficiency Solution System" providing evidence for its adoption.
Journal of genetic syndromes & gene therapy, Jan 10, 2013
Having entered the genomics era with confidence in the future of medicine, including psychiatry, ... more Having entered the genomics era with confidence in the future of medicine, including psychiatry, identifying the role of DNA and polymorphic associations with brain reward circuitry has led to a new understanding of all addictive behaviors. It is noteworthy that this strategy may provide treatment for the millions who are the victims of "Reward Deficiency Syndrome" (RDS) a genetic disorder of brain reward circuitry. This article will focus on drugs and food being mutuality addictive, and the role of dopamine genetics and function in addictions, including the interaction of the dopamine transporter, and sodium food. We will briefly review our concept that concerns the genetic antecedents of multiple-addictions (RDS). Studies have also shown that evaluating a panel of established reward genes and polymorphisms enables the stratification of genetic risk to RDS. The panel is called the "Genetic Addiction Risk Score (GARS)", and is a tool for the diagnosis of a geneti...
Journal of genetic syndromes & gene therapy, Jan 17, 2012
Work from our laboratory in both in-patient and outpatient facilities utilizing the Comprehensive... more Work from our laboratory in both in-patient and outpatient facilities utilizing the Comprehensive Analysis of Reported Drugs (CARD)(™) found a significant lack of compliance to prescribed treatment medications and a lack of abstinence from drugs of abuse during active recovery. This unpublished, ongoing research provides an impetus to develop accurate genetic diagnosis and holistic approaches that will safely activate brain reward circuitry in the mesolimbic dopamine system. This editorial focuses on the neurogenetics of brain reward systems with particular reference to genes related to dopaminergic function. The terminology "Reward Deficiency Syndrome" (RDS), used to describe behaviors found to have an association with gene-based hypodopaminergic function, is a useful concept to help expand our understanding of Substance Use Disorder (SUD), process addictions, and other obsessive, compulsive and impulsive behaviors. This editorial covers the neurological basis of pleasure...
Uploads
Papers by Marlene Oscar-Berman