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Chunk #51 — Future Considerations to Address Sex/Gender Disparities — Consideration of Stress-Related Brain Regions

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Sex/gender differences in brain function and structure in alcohol use: A narrative review of neuroimaging findings over the last 10 years.
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Findings presented in the current review suggest that alcohol-related disturbances in brain function and structure in women and men may overlap with stress pathophysiology. Brain regions such as the PFC, amygdala, insula, ACC, and hippocampus demonstrate alterations in volume and activation by SG as a function of alcohol use (e.g., AUD vs. healthy controls), and these structures are also heavily implicated in stress-related drinking behavior (Logrip, Milivojevic, Bertholomey, & Torregrossa, 2018; Peltier et al., 2019; Zakiniaeiz, Scheinost, Seo, Sinha, & Constable, 2017). For example, alcohol and stress both induce disturbances in PFC activity in both women and men (Peltier et al., 2019; D. Seo et al., 2011; D. Seo et al., 2013). Alcohol-related cues activated the mPFC and dlPFC in individuals with AUD (George et al., 2001; Grüsser et al., 2004), and lesions of the ventromedial PFC enhance hypothalamic-pituitary-adrenal (HPA) axis reactivity in response to stress (Sinha, 2008). AUD individuals had lower activation in the ventromedial PFC in response to stress, and lower ventromedial PFC activity was predictive of greater days of alcohol use after relapse (D. Seo et al.,