Korean Journal of Biological Psychiatry (생물정신의학)

The Korean Society of Biological Psychiatry (대한생물정신의학회)
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Neurobiological and Clinical Characteristics According to Lesch's Typology in Alcohol Dependence

알코올의존의 Lesch의 유형학에 따른 신경생물학적 특성 및 임상적 특성

  • Choi, Mi-Ran (Division of Molecular & Life Sciences, Hanyang University) ;
  • Choi, Young-Gyu (Division of Molecular & Life Sciences, Hanyang University) ;
  • Lee, Bun-Hee (KARF Hospital, The Korean Alcohol Research Foundation) ;
  • Lee, Jun-Seok (KARF Hospital, The Korean Alcohol Research Foundation)
  • 최미란 (한양대학교 분자생명과학부) ;
  • 채영규 (한양대학교 분자생명과학부) ;
  • 이분희 (한국음주문화연구재단, 카프병원) ;
  • 이준석 (한국음주문화연구재단, 카프병원)
  • Received : 2010.12.10
  • Accepted : 2011.06.07
  • Published : 2011.08.31
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Abstract

Objectives Many studies have suggested different neurobiological findings and clinical courses in alcoholism. Recently, subtyping in alcohol dependence has become essential to overcome the heterogeneity of patients. Among several criteria of subtypes, Lesch's typology is proposed to integrate biological, social, and psychological factors. This review provides neurobiological findings and treatment-responses of alcohol dependence according to Lesch's typology. Method We searched the international published medical literature using the search terms 'Lesch's typology' and 'alcohol dependence' and using the limits 'human'. Results We identified 17 studies with subjects of alcohol dependence according to Lesch's typology. Conclusion They indicated that each subtype of Lesch's typology can have specific neurobiological factors and different clinical responses as follows. Lesch's subtype 1 is characterized by severe withdrawal symptoms and associated with elevated glutamate and homocysteine. Lesch's subtype 2 is defined by individuals who drink alcohol as self-medication for anxiety. Their craving has significant positive correlations with prolactin, leptin level, or intake-volume (vasopressin). Lesch's subtype 4 is related to cerebral dysfunction and associated with increased glutamate and left-handedness. Clinical trials showed that naltrexone was effective in Lesch's subtype 3 and 4 patients, while acamprosate was effective in the subtypes 1 and 2.

Keywords

References

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