Structural findings in adults suggest that moderate to chronic alcohol use may be associated with deficits in frontal areas, and that alterations in frontal regions may be greater in heavy drinking men. In young adults, associations between reduced cortical thickness in frontal regions (e.g., dlPFC, anterior cingulate cortex [ACC], orbitofrontal cortex [OFC]) and drinking were driven by men; an effect not observed in women (V. Morris et al., 2019). In a longitudinal cohort study of over 30 years, moderate-to-high alcohol consumption was also associated with greater hippocampal shrinkage in men compared to women (Topiwala et al., 2017). This is consistent with findings of reduced cortical thickness, reduced gray matter volumes, and smaller reward system volumes, including dlPFC, in men with AUD compared to same-sex controls (Momenan et al., 2012; Sawyer et al., 2017), and findings of reduced white matter volume in corpus callosum in heavy drinking older men or abstinent men with AUD compared to same-sex controls but not in women (Kapogiannis et al., 2012; Ruiz et al., 2013). Lastly, three studies found that men with AUD had smaller reward
