Abstract
Tobacco smoking is highly comorbid with heavy alcohol drinking, yet the interaction of tobacco smoking and alcohol drinking on brain catecholaminergic synaptic markers is unexplored. Here we evaluate the effects of alcohol drinking alone from comorbid alcohol drinking and tobacco smoking on dopamine (DA) and serotonin (5-HT) transporter availability. A total of 14 heavy alcohol drinking smokers (n=6) and nonsmokers (n=8) and 14 age-matched control smokers (n=6) and nonsmokers (n=8) were imaged with [123]β-CIT single photon emission computed tomography. Alcohol drinking smokers and nonsmokers consumed 134.3±100.3 and 196.5±139.9 drinks, respectively, over the previous month and were imaged during acute withdrawal, eg within 5 days of their last drink. Striatal DA transporter availability was significantly higher (16%, P=0.04) in alcohol drinkers compared to controls. 5-HT transporter availability was also significantly higher in alcohol drinkers vs controls in the brainstem (25%, P=0.001) and the diencephalon (8%, P=0.01). This elevation was restricted to alcohol drinking nonsmokers with higher DA transporter availability in the striatum (26%, P=0.006), and higher 5-HT transporter availability in the diencephalon (26%, P=0.04) and brainstem (42%, P<0.0002). There was a significant positive correlation between days since last drink and 5-HT transporter availability in the diencephalon (r=0.60, P=0.023) and brainstem (r=0.54, P=0.047), in the total group of alcohol drinkers and in the nonsmokers, but not the smokers. During the first week of abstinence, DA and 5-HT transporter availability is higher in alcohol drinking nonsmokers but not in alcohol drinking smokers. Smoking appears to suppress neuroadaptive changes in DA and 5-HT transporters during acute withdrawal from alcohol.
Similar content being viewed by others
Log in or create a free account to read this content
Gain free access to this article, as well as selected content from this journal and more on nature.com
or
References
Backstrom I, Bergstrom M, Marcusson J (1989). High affinity [3H]paroxetine binding to serotonin uptake sites in human brain tissue. Brain Res 486: 261–268.
Baldwin R, Zea-Ponce Y, Zoghbi S, Laurelle M, Al-Tikriti M, Sybirska E et al. (1993). Evaluation of the monoamine uptake site ligand [123I]methyl 3β-(4-iodophenyl)-tropane-2β-carboxylate ([123I]β-CIT) in non-human primates: pharmacokinetics, biodistribution and SPECT brain imaging coregistered with MRI. Nucl Med Biol 20: 597–606.
Beck S, Ward C, Mendelsohn M, Erbaugh J (1961). An inventory for measuring depression. Arch Gen Psychiatry 4: 561–571.
Brown AK, George DT, Fujita M, Liow JS, Ichise M, Hibbeln J et al. (2007). PET [11C]DASB imaging of serotonin transporters in patients with alcoholism. Alcohol Clin Exp Res 31: 28–32.
Brown S, Vessey M, Stratton I (1988). The influence of method of contraception and cigarette smoking on menstrual patterns. Br J Obstet Gynecol 95: 905–910.
Carmody T, Brischetto C, Matarazzo J, O'Donnell R, Connor W (1985). Co-occurrent use of cigarettes, alcohol, and coffee in healthy, community-living men and women. Health Psychol 4: 323–335.
Chastain G (2006). Alcohol, neurotransmitter systems, and behavior. J Gen Psychol 133: 329–335.
Dawson D (2000). Drinking as a risk factor for sustained smoking. Drug Alcohol Depen 59: 235–249.
Di Chiara G, Imperato A (1988). Drugs abused by humans preferentially increase synaptic dopamine concentrations in the mesolimbic system of freely moving rats. Proc Natl Acad Sci USA 85: 5274–5278.
Emanuele MA, Wezeman F, Emanuele NV (2002). Alcohol's effects on female reproductive function. Alcohol Res Health 26: 274–281.
Funk D, Marinelli PW, Le AD (2006). Biological processes underlying co-use of alcohol and nicotine: neuronal mechanisms, cross-tolerance, and genetic factors. Alcohol Res Health 29: 186–192.
Grant BF, Hasin DS, Chou SP, Stinson FS, Dawson DA (2004). Nicotine dependence and psychiatric disorders in the United States: results from the national epidemiologic survey on alcohol and related conditions. Arch Gen Psychiatry 61: 1107–1115.
Hallman J, von Knorring L, Edman G, Oreland L (1991). Personality traits and platelet monoamine oxidase activity in alcoholic women. Addict Behav 16: 533–541.
Heinz A, Goldman D, Jones DW, Palmour R, Hommer D, Gorey JG et al. (2000a). Genotype influences in vivo dopamine transporter availability in human striatum. Neuropsychopharmacology 22: 133–139.
Heinz A, Higley JD, Gorey JG, Saunders RC, Jones DW, Hommer D et al. (1998a). In vivo association between alcohol intoxication, aggression, and serotonin transporter availability in nonhuman primates. Am J Psychiatry 155: 1023–1028.
Heinz A, Jones DW, Gorey JG, Bennet A, Suomi SJ, Weinberger DR et al. (2003). Serotonin transporter availability correlates with alcohol intake in non-human primates. Mol Psychiatry 8: 231–234.
Heinz A, Jones DW, Mazzanti C, Goldman D, Ragan P, Hommer D et al. (2000b). A relationship between serotonin transporter genotype and in vivo protein expression and alcohol neurotoxicity. Biol Psychiatry 47: 643–649.
Heinz A, Jones DW, Zajicek K, Gorey JG, Juckel G, Higley JD et al. (2004). Depletion and restoration of endogenous monoamines affects beta-CIT binding to serotonin but not dopamine transporters in non-human primates. J Neural Transm Suppl 68: 29–38.
Heinz A, Mann K, Weinberger DR, Goldman D (2001). Serotonergic dysfunction, negative mood states, and response to alcohol. Alcohol Clin Exp Res 25: 487–495.
Heinz A, Ragan P, Jones DW, Hommer D, Williams W, Knable MB et al. (1998b). Reduced central serotonin transporters in alcoholism. Am J Psychiatry 155: 1544–1549.
Ilani T, Lamensdorf I, Finberg JP (2000). Selective monoamine oxidase subtype inhibition and striatal extracellular dopamine in the guinea-pig. Br J Pharmacol 130: 1992–1998.
Janhunen S, Ahtee L (2007). Differential nicotinic regulation of the nigrostriatal and mesolimbic dopaminergic pathways: implications for drug development. Neurosci Biobehav Rev 31: 287–314.
Koob GF (2003). Alcoholism: allostasis and beyond. Alcohol Clin Exp Res 27: 232–243.
Kuikka J, Tihonen J, Bergstrom K, Karhu J, Hartikainen P, Viinamaki H et al. (1995). Imaging of serotonin and dopamine transporters in the living human brain. Eur J Nucl Med 22: 346–350.
Laine TP, Ahonen A, Torniainen P, Heikkila J, Pyhtinen J, Rasanen P et al. (1999). Dopamine transporters increase in human brain after alcohol withdrawal. Mol Psychiatry 4: 189–191, 104–5.
Lamensdorf I, Youdim MB, Finberg JP (1996). Effect of long-term treatment with selective monoamine oxidase A and B inhibitors on dopamine release from rat striatum in vivo. J Neurochem 67: 1532–1539.
Laruelle M, Baldwin R, Malison R, Zea-Ponce Y, Zoghbi S, Al-Tikriti M et al. (1993). SPECT imaging of dopamine and serotonin transporters with [123I]β−CIT: pharmacological characterization of brain uptake in nonhuman primates. Synapse 13: 295–309.
Laruelle M, Vanisberg M, Maloteaux J (1988). Regional and subcellular localization in human brain of [3H]paroxetine binding, a marker of serotonin uptake sites. Biol Psychiatry 24: 299–309.
Lavalaye J, Booij J, Reneman L, Habraken J, Royen Ev (2000). Effect of age and gender on dopamine transporter imaging with [123I]FP-CIT SPET in healthy volunteers. Eur J Nucl Med 27: 867–869.
Mash DC, Staley JK, Doepel FM, Young SN, Ervin FR, Palmour RM (1996). Altered dopamine transporter densities in alcohol-preferring vervet monkeys. Neuroreport 7: 457–462.
McKee SA, Falba T, O'Malley SS, Sindelar J, O'Connor PG (2007). Smoking status as a clinical indicator for alcohol misuse in US adults. Arch Intern Med 167: 716–721.
Meyerhoff DJ, Tizabi Y, Staley JK, Durazzo TC, Glass JM, Nixon SJ (2006). Smoking comorbidity in alcoholism: neurobiological and neurocognitive consequences. Alcohol Clin Exp Res 30: 253–264.
Miller N, Gold M (1998). Comorbid cigarette and alcohol addiction: epidemiology and treatment. J Addict Dis 17: 55–66.
Mozley LH, Gur RC, Mozley PD, Gur RE (2001). Striatal dopamine transporters and cognitive functioning in healthy men and women. Am J Psychiatry 158: 1492–1499.
Radloff L (1977). The CES-D scale: a self-report depression scale for research in the general population. Applied Psychol Meas 1: 385–401.
Repo E, Kuikka JT, Bergstrom KA, Karhu J, Hiltunen J, Tiihonen J (1999). Dopamine transporter and D2-receptor density in late-onset alcoholism. Psychopharmacology (Berl) 147: 314–318.
Seibyl JP, Laruelle M, van Dyck CH, Wallace E, Baldwin RM, Zoghbi S et al. (1996). Reproducibility of iodine-123-beta-CIT SPECT brain measurement of dopamine transporters. J Nucl Med 37: 222–228.
Seibyl JP, Marek K, Sheff K, Baldwin RM, Zoghbi S, Zea-Ponce Y et al. (1997). Test/retest reproducibility of iodine-123-betaCIT SPECT brain measurement of dopamine transporters in Parkinson's patients. J Nucl Med 38: 1453–1459.
Seth P, Cheeta S, Tucci S, File SE (2002). Nicotinic–serotonergic interactions in brain and behaviour. Pharmacol Biochem Behav 71: 795–805.
Skinner H, Hom J (1984). Alcohol Dependence Scale (ADS) User's Guide. Addiction Research Foundation: Toronto.
Sobell L, Sobell M (1993). Timeline Followback: a technique for assessing self-reported ethanol consumption. In: Allen J, Litten R (eds) Techniques to Assess Alcohol Consumption. Humana Press: New Jersey.
Staley J, Krishnan-Sarin S, Zoghbi S, Tamagnan G, Fujita M, Seibyl J et al. (2001). Sex differences in [123I]beta-CIT SPECT measures of dopamine and serotonin transporter availability in healthy smokers and nonsmokers. Synapse 41: 275–284.
Staley JK, Gottschalk C, Petrakis IL, Gueorguieva R, O'Malley S, Baldwin R et al. (2005). Cortical gamma-aminobutyric acid type A-benzodiazepine receptors in recovery from alcohol dependence: relationship to features of alcohol dependence and cigarette smoking. Arch Gen Psychiatry 62: 877–888.
Staley JK, Sanacora G, Tamagnan G, Maciejewski PK, Malison RT, Berman RM et al. (2006). Sex differences in diencephalon serotonin transporter availability in major depression. Biol Psychiatry 59: 40–47.
Sullivan J, Sykora K, Schneiderman J, Naranjo C, Sellers E (1989). Assessment of alcohol withdrawal: the revised Clinical Institute Withdrawal Assessment for Alcohol Scale (CIWA-Ar). Br J Addiction 84: 1353–1357.
Szabo Z, Owonikoko T, Peyrot M, Varga J, Mathews WB, Ravert HT et al. (2004). Positron emission tomography imaging of the serotonin transporter in subjects with a history of alcoholism. Biol Psychiatry 55: 766–771.
Tiihonen J, Kuikka J, Bergstrom K, Hakola P, Karhu J, Ryynanen OP et al. (1995). Altered striatal dopamine re-uptake site densities in habitually violent and non-violent alcoholics. Nat Med 1: 654–657.
True WR, Xian H, Scherrer JF, Madden PA, Bucholz KK, Heath AC et al. (1999). Common genetic vulnerability for nicotine and alcohol dependence in men. Arch Gen Psychiatry 56: 655–661.
Tupala E, Halonen P, Tiihonen J (2006). Visualization of the cortical dopamine transporter in type 1 and 2 alcoholics with human whole hemisphere autoradiography. Eur Neuropsychopharmacol 16: 552–560.
Tupala E, Kuikka JT, Hall H, Bergstrom K, Sarkioja T, Rasanen P et al. (2001). Measurement of the striatal dopamine transporter density and heterogeneity in type 1 alcoholics using human whole hemisphere autoradiography. Neuroimage 14: 87–94.
Tupala E, Tiihonen J (2004). Dopamine and alcoholism: neurobiological basis of ethanol abuse. Prog Neuropsychopharmacol Biol Psychiatry 28: 1221–1247.
van Dyck C, Malison R, Seibyl J, Laruelle M, Klumpp H, Zoghbi S et al. (2000). Age-related decline in central serotonin transporter availability with [123I]β-CIT SPECT. Neurobiol Aging 21: 497–501.
Vengeliene V, Bilbao A, Molander A, Spanagel R (2008). Neuropharmacology of alcohol addiction. Br J Pharmacol 154: 299–315.
Volkow ND, Wang GJ, Fowler JS, Logan J, Hitzemann R, Ding YS et al. (1996). Decreases in dopamine receptors but not in dopamine transporters in alcoholics. Alcohol Clin Exp Res 20: 1594–1598.
von Knorring AL, Bohman M, von Knorring L, Oreland L (1985). Platelet MAO activity as a biological marker in subgroups of alcoholism. Acta Psychiatr Scand 72: 51–58.
Von Knorring L, Oreland L (1985). Personality traits and platelet monoamine oxidase in tobacco smokers. Psychol Med 15: 327–334.
von Knorring L, Oreland L, von Knorring AL (1987). Personality traits and platelet MAO activity in alcohol and drug abusing teenage boys. Acta Psychiatr Scand 75: 307–314.
Windham G, Elkin E, Swan S, Waller K, Fenster L (1999). Cigarette smoking and effects on menstrual function. Obstet Gynecol 93: 59–65.
Acknowledgements
This work was supported by the Department of Veterans Affairs (via support for the Alcohol Research Center), US Veterans Affairs VISN 1 Mental Illness Research Education and Clinical Center (MIRECC), National Institute of Alcohol and Alcoholism (KO1AA00288; RO1 AA-11321; K05 AA-14906-01; I-P50 AA-12870-03), and National Institute of Drug Abuse (KO1DA02065; KO2DA21863).
Author information
Authors and Affiliations
Corresponding author
Additional information
Disclosures/Conflict of Interest
Dr Krystal serves as a consultant to AstraZeneca, Bristol-Myers Squibb, Cypress Bioscience Inc., Eli Lilly and Co., Forest Laboratories, GlaxoSmithKline, Houston Pharma, Janssen Research Foundation, Lohocla Research Corporation, Merz Pharmaceuticals, Organon Pharmaceuticals/Division of Schering-Plough Research Institute, Pfizer Pharmaceuticals, Schering Corporation acting through Schering-Plough Research Institute Division, Shire Pharmaceuticals, Takeda Industries, Tetragenex Pharmaceuticals, Transcept Pharmaceuticals, UCB Pharma, and US Micron. Dr Krystal has patents pending for glutamatergic agents for psychiatric disorders and oral ketamine for depression. No other authors report any conflicts of interest.
Rights and permissions
About this article
Cite this article
Cosgrove, K., Krantzler, E., Frohlich, E. et al. Dopamine and Serotonin Transporter Availability During Acute Alcohol Withdrawal: Effects of Comorbid Tobacco Smoking. Neuropsychopharmacol 34, 2218–2226 (2009). https://doi.org/10.1038/npp.2009.49
Received:
Revised:
Accepted:
Published:
Issue date:
DOI: https://doi.org/10.1038/npp.2009.49
Keywords
This article is cited by
-
A systematic review of the potential effects of medications and drugs of abuse on dopamine transporter imaging using [123I]I-FP-CIT SPECT in routine practice
European Journal of Nuclear Medicine and Molecular Imaging (2023)
-
Effects of sedative drug use on the dopamine system: a systematic review and meta-analysis of in vivo neuroimaging studies
Neuropsychopharmacology (2019)
-
Tobacco smoking and dopaminergic function in humans: a meta-analysis of molecular imaging studies
Psychopharmacology (2019)
-
Cognitive and neurobiological mechanisms of alcohol-related aggression
Nature Reviews Neuroscience (2011)
-
How the serotonin transporter 5-HTTLPR polymorphism influences amygdala function: the roles of in vivo serotonin transporter expression and amygdala structure
Translational Psychiatry (2011)