Centre for Alcohol and Drug Research

Pupillary reactivity to alcohol cues as a predictive biomarker of alcohol relapse following treatment in a pilot study

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Rationale Identifying the predictors of relapse in detoxified alcohol-dependent patients is crucial for effective surveillance
procedures and the optimization of treatment. Physiological measures such as functional MRI activity and heart rate variability
have been shown as potential markers of relapse prediction.
Objectives Our aim was to assess differential pupillary reactions to alcohol-related cues as an objective physiological candidate
predictor of relapse.
Methods We examined the relationship between cue-elicited pupillary reactions to alcohol stimuli and luminance-controlled
neutral stimuli in 21 detoxified alcohol-dependent patients and subsequent relapse outcome at a 4-month follow-up.
Results Differential pupillary dilation to alcohol stimuli as compared to neutral stimuli at 150 to 250 ms after stimulus onset
substantially improved the model prediction of relapse outcome (additional 27% of variance) beyond that achieved from five
standardized questionnaires on alcohol craving, alcohol use, problematic use severity, depressive tendencies, and duration of
abstinence (47% of variance). In contrast, alcohol craving did not improve relapse model prediction.
Conclusions This pilot study shows that alcohol-dependent patients with greater pupillary dilation to alcohol stimuli are more
vulnerable to relapse, and that pupillometry presents as an important tool for addiction science.
Original languageEnglish
Publication statusE-pub ahead of print - 3 Jan 2019

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