Research has also focused on AUD disruption of brain reward pathways (Koob, 1999; Koob and Kreek, 2007; Kreek and Koob, 1998; Makris et al., 2008; Wise, 1998), including prefrontal cortex and the subcortical striatopallidal and extended amygdala systems. Repeated chronic abuse and withdrawal of alcohol and drugs can change one's hedonic set point (e.g., raising thresholds), increasing substance dependence. Alcoholics have shown smaller volumes of reward-related structures (nucleus accumbens and amygdala, along with dorsolateral prefrontal cortex and anterior insula) compared to non-alcoholic controls (Makris et al., 2008), with these smaller volumes associated with impaired memory.
