There is MRS data in keeping with the predications of the “glutamate model of withdrawal”: within 24 hours of the last drink, a trend for higher Glx (Yeo et al., 2013) and higher Glu (relative to tCr)(Hermann et al., 2012; Streit et al., 2018) has been reported in the anterior cingulate cortex of alcohol-dependent relative to control participants. A trend for higher Glu/tCr ratios was observed in the anterior cingulate of alcohol dependent participants scanned at 4 days and 4 weeks abstinence (Umhau et al., 2010). Another study similarly found higher Glu levels in nucleus accumbens (but not cingulate) of alcohol dependent participants (1–10 days into abstinence) compared to controls which was associated with higher craving for alcohol (Bauer et al., 2013). Normalization of acutely elevated Glu has been reported with two weeks of abstinence (Hermann et al., 2012): lower than control levels of Glu have been reported in alcoholdependent subjects during prolonged abstinence (2–50 days since last drink) in anterior cingulate (Mon, Durazzo, & Meyerhoff, 2012), medial frontal cortex (Thoma et al., 2011), and occipital cortex (Glu/Gln, Bagga, Khushu, et al., 2014).
