We initially hypothesized that alcohol would potentiate the frontal response to its cues, as we had previously found in a smaller sample of individuals who varied in their family history of alcoholism (Bragulat et al., 2008). The picture emerging from this study was more complex, as alcohol dampened the mPFC response to AO in HD-FHP, while potentiating it in HD-FHN. This could suggest that a genetic predisposition to alcoholism biases the medial frontal response to rewarding stimuli in general (Acheson et al., 2009) or to alcohol’s cues specifically. Once alcohol has been obtained, this response may diminish. By contrast, heavy drinkers without any obvious genetic component may be less cue-responsive until acute intoxication, when the medial frontal coding of reward value strengthens. Thus, genetic history (as inferred from family history) may differentially influence the state in which reward cue processing is most active. Support for such a concept comes from rodent studies that distinguish between approach and consumption (Czachowski & Samson, 1999), and where dopaminergic manipulation affects approach more than consumption (Czachowski et al., 2002; Czachowski, Chappell, & Samson, 2001).
