The mesolimbic dopamine system plays a central role in the development of addiction. Some of its areas enable quick (impulsive) desires for preferred or conditioned stimuli. On the other hand, pre-frontal areas, which are disturbed in addictive patients, suppress impulsive behavior in favor of a long-term goal.

A functional magnetic resonance imaging with a DRD-Paradigm was used to investigate potential dysfunctions of neurofunctional systems of impulse control in patients with longstanding alcohol dependence.

17 patients and 15 controls were included in the clinical prospective study.

As expected, the abstinent alcoholics activated the areas of the mesolimbic dopamine system during presentation of alcoholic stimuli. In the Desire context, however, the patients showed a reduced activation of these areas. Together, these findings point to a higher salience of alcohol-associated stimuli. Moreover, it also took the patients longer to refuse alcoholic stimuli. Finally, in Reason-context the abstinent alcoholics showed a top-down suppression effect to alcoholic stimuli in favor of a long-term goal. We interpret this finding as a successful therapeutic effect after inpatient treatment.