Evidence map›Paper›PMID 39853353›Full record

Trial reportPsychopharmacology2025

Neural cue reactivity and intrinsic functional connectivity in individuals with alcohol use disorder following treatment with topiramate or naltrexone.

Warren B Logge, Paul S Haber, Tristan Hurzeler, Hugh Gallagher, Henry Kranzler, Kirsten C Morley

Registry-linked trialAbstract readRandomized Controlled TrialComparative Study
In one paragraph

Trial report in Psychopharmacology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03479086 (Defining the Clinical Role of Topiramate in the Treatment of Alcohol Dependence in Australia), which is not on this map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03479086 phase3unknown statusnot on this map

Defining the Clinical Role of Topiramate in the Treatment of Alcohol Dependence in Australia

TypeinterventionalSponsorSouth West Sydney Local Health DistrictRan2017 to 2020Enrolled180ConditionsAlcohol DependenceArmsTopiramate, Naltrexone
3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Trial
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Warren B LoggeEdith Collins Centre for Translational Research in Alcohol, Drugs and Toxicology, Royal Prince Alfred Hospital, Sydney Local Health District, Sydney, NSW, Australia. warren.logge@sydney.edu.au.ORCID http://orcid.org/0000-0003-0777-3033
Paul S HaberEdith Collins Centre for Translational Research in Alcohol, Drugs and Toxicology, Royal Prince Alfred Hospital, Sydney Local Health District, Sydney, NSW, Australia.
Tristan HurzelerEdith Collins Centre for Translational Research in Alcohol, Drugs and Toxicology, Royal Prince Alfred Hospital, Sydney Local Health District, Sydney, NSW, Australia.
Hugh GallagherEdith Collins Centre for Translational Research in Alcohol, Drugs and Toxicology, Royal Prince Alfred Hospital, Sydney Local Health District, Sydney, NSW, Australia.
Henry KranzlerCenter for Studies of Addiction, Perelman School of Medicine, Education, and Clinical Center, University of Pennsylvania and Mental Illness Research, Crescenz VAMC, Philadelphia, PA, USA.
Kirsten C MorleyEdith Collins Centre for Translational Research in Alcohol, Drugs and Toxicology, Royal Prince Alfred Hospital, Sydney Local Health District, Sydney, NSW, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

rationaleBoth topiramate and naltrexone have been shown to affect neural alcohol cue reactivity in alcohol use disorder (AUD). However, their comparative effects on alcohol cue reactivity are unknown. Moreover, while naltrexone has been found to normalize hyperactive localized network connectivity implicated in AUD, no studies have examined the effect of topiramate on intrinsic functional connectivity or compared functional connectivity between these two widely used medications.

objectiveThis study compared topiramate versus naltrexone on alcohol cue-elicited brain activation and intrinsic functional connectivity in patients with alcohol use disorder.

methodsForty-seven participants with alcohol use disorder received daily topiramate (titrating the dose up to 200 mg/day n = 21) or naltrexone (50 mg/day, n = 26) for at least 6 weeks. Using functional magnetic resonance imaging (fMRI), we examined intrinsic functional connectivity during rest and alcohol cue-elicited neural activation during a visual alcohol cue reactivity task 120 min following treatment administration. Functional connectivity and alcohol cue reactivity and percentage of heavy drinking days (% HDD) associations were assessed.

resultsNo differences in either intrinsic functional connectivity or alcohol cue-elicited neural activity were seen between topiramate and naltrexone-treated groups. Overall, participants showed increased alcohol cue-elicited activation in three clusters spanning occipital regions involved in visual recognition of stimuli, and hypoactivation to both alcohol and control cues in three clusters involved in salience attribution and processing of emotional valence of external stimuli. No differences between topiramate versus naltrexone were observed for either functional measure or associations with post-scan % HDD.

conclusionsTopiramate and naltrexone enacted comparable alcohol cue reactivity and intrinsic functional connectivity patterns. Some overall responses of increased brain activation to alcohol cues in visual processing regions coupled with reduced activation to alcohol and control cues were evidenced for both treatments. These activation patterns were in regions expected to show attenuation of brain activity resulting from treatment. Topiramate and naltrexone may thus enact functional effects through similar modulation of functional neural activity in individuals with AUD.

trial registrationClinicalTrials.gov, NCT03479086 https://www. CLINICALTRIALS: gov/study/NCT03479086 .

Indexed as

AlcoholismBrainNaltrexoneTopiramateAdultCuesFemaleHumansMagnetic Resonance ImagingMaleMiddle AgedNaltrexoneTopiramateAlcohol use disorderCue reactivityFunctional magnetic resonance imagingNaltrexoneRandomized controlled trialTopiramate

Identifiers

PMID39853353
PMCPMC12226611

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.