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. 2019 Sep 18;10:580. doi: 10.3389/fpsyt.2019.00580

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Copyright © 2019 Béracochéa, Mons and David

This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

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Parallel evolution of alcohol withdrawal–induced symptoms and plasmatic or brain regional glucocorticoid (GC) levels over time. Acute withdrawal is associated with a release of catecholamines, CRF, and high plasmatic GCs, which mediate physiological and behavioral symptoms initially through non-genomic effects. The early abstinence period is associated with a decrease in plasmatic GC concentration as opposed to a brain regional GC increase, particularly in the PFC, likely involving genomic effects of GC. Although brain GC concentration and affective/cognitive symptoms will be normalized in many dependent subjects, persistence of elevated brain GC levels and cognitive impairments in others is predictive of high risk of relapse (see text for details).