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ArticleEuropean archives of psychiatry and clinical neuroscience2026

2D:4D digit ratio and brain volumes in alcohol use disorder.

Matthias Reichl, Bernd Lenz, Rafat Boroumand-Jazi, Patrick Bach, Tobias Banaschewski, Michael A Rapp, Henrik Walter, Michael Marxen, Michael N Smolka, Andreas Heinz and 4 more

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Article in European archives of psychiatry and clinical neuroscience, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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4 · The record

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5 · Who and what money

Authors and funding

14 authors.

Matthias Reichl *Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health (CIMH), Medical Faculty Mannheim, Heidelberg University, J 5, 68159, Mannheim, Germany. Matthias.Reichl@zi-mannheim.de.ORCID http://orcid.org/0009-0006-9585-2741
Bernd Lenz *Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health (CIMH), Medical Faculty Mannheim, Heidelberg University, J 5, 68159, Mannheim, Germany.ORCID http://orcid.org/0000-0001-6086-0924
Rafat Boroumand-JaziDepartment of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health (CIMH), Medical Faculty Mannheim, Heidelberg University, J 5, 68159, Mannheim, Germany.ORCID http://orcid.org/0000-0001-7085-881X
Patrick BachDepartment of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health (CIMH), Medical Faculty Mannheim, Heidelberg University, J 5, 68159, Mannheim, Germany.
Tobias BanaschewskiGerman Center for Mental Health, Partner Site Mannheim-Heidelberg-Ulm, Mannheim, Germany.
Michael A RappDepartment of Social and Preventive Medicine, University of Potsdam, Potsdam, Germany.
Henrik WalterCenter for Mental Health, University of Tübingen, and German Center for Mental Health (DZPG), Site Tübingen, Germany.
Michael MarxenDepartment of Psychiatry and Psychotherapy, Technische Universität Dresden, Dresden, Germany.
Michael N SmolkaDepartment of Psychiatry and Psychotherapy, Technische Universität Dresden, Dresden, Germany.
Andreas HeinzCenter for Mental Health, University of Tübingen, and German Center for Mental Health (DZPG), Site Tübingen, Germany.
Falk KieferDepartment of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health (CIMH), Medical Faculty Mannheim, Heidelberg University, J 5, 68159, Mannheim, Germany.
Roshan RaneDepartment of Psychiatry and Neurosciences (CCM), Charité - Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität Zu Berlin, Berlin, Germany.
Kerstin RitterDepartment of Psychiatry and Neurosciences (CCM), Charité - Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität Zu Berlin, Berlin, Germany.
ReCoDe-Consortium

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPrenatal androgen exposure organizes the development of the brain with permanent effects on brain structure and function. The second-to-fourth digit length ratio (2D:4D) has been associated with mental illnesses, including addictive disorders, with some studies reporting sex-dependent associations. Preliminary evidence suggests that in healthy male adolescents lower 2D:4D (indicating higher prenatal androgenization) is related to lower volumes of the right anterior cingulate cortex (ACC) which has previously been linked to a higher risk of alcohol use disorder (AUD). We aimed at transferring this association into an older cohort with AUD. Further, we explored relationships between 2D:4D and brain volumes on a whole brain level.

methodsWe investigated 253 men and 155 women with AUD (mean age 37.31 ± 12.54 years) and associated mean of the right and left hand 2D:4D (M2D:4D = primary predictor) with brain volumes from 3 T MRI using FreeSurfer.

resultsWe found that lower M2D:4D was associated with smaller right ACC volume in men using a pre-specified directional one-tailed test. Secondary subsegment analyses indicated this association may primarily be observed in the right caudal ACC. Exploratory analyses suggested sex- and hemisphere-stratified associations with other brain volumes, unaffected by age moderation and largely robust after adjustment for education and AUD criteria count across models examined. DISCUSSION: In line with previous findings, the results indicate that in men with AUD, lower 2D:4D ratios are associated with smaller right ACC volumes. The findings contribute to understanding brain variability in AUD.

Indexed as

2D:4DAlcohol use disorderBrain volumesCortical volumesDigit ratioNeuroimagingPrenatal androgen exposureSexual dimorphism

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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.