{"doi":"10.1111/adb.70010","title":"Neural responses to stress and alcohol cues in individuals with pain with and without alcohol use disorder","abstract":"Pain and alcohol use disorder (AUD) frequently co-occur, but the underlying neurobiology is not well-understood. Although many studies have reported disruptions in stress and reward cue-elicited neural reactivity and heightened alcohol craving in individuals with AUD, little is known about these constructs among patients who experience pain. Here, individuals with pain (Pain+, n = 31) and without pain (Pain-, n = 37) completed a well-validated functional magnetic resonance imaging (fMRI) paradigm involving stress (S), alcohol (A) and neutral (N) cue exposure with repeated alcohol craving assessments. Using whole-brain, voxel-based analyses (p < 0.001, whole-brain cluster correction at α < .05), the Pain+ versus Pain- group evidenced greater dorsal anterior cingulate cortex and left amygdala hyperactivation during N, but hypoactivation during the S-N contrast. Additionally, Pain+ exhibited blunted right anterior insular cortex (AIC) during S-N and blunted anteromedial thalamus and left AIC with hyperactive orbitofrontal cortex (OFC) during A-N. Exploratory analyses further revealed that individuals with pain and AUD (n = 17) relative to pain alone (n = 14) showed hyperactive bilateral AIC and hypoactive right dorsal caudate during A-N. Alcohol cue-induced craving, significantly higher in Pain+ (p = 0.03), correlated with blunted right AIC and OFC responses during A-N. In sum, these results provide first evidence of heightened alcohol cue-elicited craving and disrupted stress- and alcohol cue-reactivity within corticostriatal-limbic regions implicated in negative affect and preoccupation/anticipation stages of AUD in those with pain and with comorbid pain and AUD. Future investigations of pain-AUD interaction are needed that include systematic pain assessment and longitudinal designs with larger sample sizes.","journal":"Addiction Biology","year":2024,"id":452054,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":3,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9544,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2024-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1274347,"name":"Colleen McGowan","orcid":null,"position":1,"is_corresponding":false},{"id":1274348,"name":"Emily Heilner","orcid":null,"position":2,"is_corresponding":false},{"id":514565,"name":"Cheryl Lacadie","orcid":"0009-0006-3130-4156","position":3,"is_corresponding":false},{"id":235364,"name":"Rajita Sinha","orcid":"0000-0003-3012-4349","position":4,"is_corresponding":false},{"id":392546,"name":"Milena Radoman","orcid":"0000-0002-3980-591X","position":0,"is_corresponding":true}],"reference_count":49,"raw_metadata":null,"created_at":"2026-07-19T02:02:50.407779Z","pmid":"39660770","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}