Browse > Article

Neurobiological and Clinical Characteristics According to Lesch's Typology in Alcohol Dependence  

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)
Publication Information
Korean Journal of Biological Psychiatry / v.18, no.3, 2011 , pp. 109-118 More about this Journal
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
Alcohol dependence; Lesch's typology; Neurobiological finding; Treatment responsen;
Citations & Related Records
연도 인용수 순위
  • Reference
1 Cloninger CR, Bohman M, Sigvardsson S. Inheritance of alcohol abuse. Cross-fostering analysis of adopted men. Arch Gen Psychiatry 1981;38:861-868.   DOI   ScienceOn
2 Addolorato G, Abenavoli L, Leggio L, Gasbarrini G. How many cravings? Pharmacological aspects of craving treatment in alcohol addiction: a review. Neuropsychobiology 2005;51:59-66.   DOI   ScienceOn
3 Potgieter AS, Deckers F, Geerlings P. Craving and relapse measurement in alcoholism. Alcohol Alcohol 1999;34:254-260.   DOI
4 Tabakoff B, Hoffmann PL. Biological Aspects of Alcoholism. Toronto: Hogrefe & Huber Publishers;1995.
5 Silkworth WD. Alcoholism as a manifestation of allergy. Medical Record 1937;145:249-251.
6 Lemere F, Voegtlin WL, Broz WR, O'Hollaren P, Tupper WE. Heredity as an etiologic factor in chronic alcoholism. Northwestern Medicine 1943;42:110-111.
7 Jellinek EM. The disease concept of alcoholism. New Brunswick: Hill-house Press;1960.
8 Babor TF, Hofmann M, DelBoca FK, Hesselbrock V, Meyer RE, Dolinsky ZS, et al. Types of alcoholics, I. Evidence for an empirically derived typology based on indicators of vulnerability and severity. Arch Gen Psychiatry 1992;49:599-608.   DOI   ScienceOn
9 Yoshino A, Kato M, Takeuchi M, Ono Y, Kitamura T. Examination of the tridimensional personality hypothesis of alcoholism using empirically multivariate typology. Alcohol Clin Exp Res 1994;18:1121-1124.   DOI   ScienceOn
10 Sannibale C, Hall W. An evaluation of Cloninger's typology of alcohol abuse. Addiction 1998;93:1241-1249.   DOI   ScienceOn
11 Epstein EE, Labouvie E, McCrady BS, Jensen NK, Hayaki J. A multisite study of alcohol subtypes: classification and overlap of unidimensional and multi-dimensional typologies. Addiction 2002;97:1041-1053.   DOI   ScienceOn
12 Hill SY. Absence of paternal sociopathy in the etiology of severe alcoholism: is there a type III alcoholism? J Stud Alcohol 1992;53:161-169.   DOI
13 Hauser J, Rybakowski J. Three clusters of male alcoholics. Drug Alcohol Depend 1997;48:243-250.   DOI   ScienceOn
14 Lee DK, Shin JK, Chung YI. A Study on the Types of Alcohol Dependence by Alcohol Use Inventory and Their Characteristics. J Korean Neuropsychiatr Assoc 2000;39:1132-1142.
15 Del Boca FK, Hesselbrock MN. Gender and alcoholic subtypes. Alcohol Health Res World 1996;20:56-62.
16 Driessen M, Lange W, Junghanns K, Wetterling T. Proposal of a comprehensive clinical typology of alcohol withdrawal--a cluster analysis approach. Alcohol Alcohol 2005;40:308-313.   DOI   ScienceOn
17 Lesch OM, Kefer J, Lentner S, Mader R, Marx B, Musalek M, et al. Diagnosis of chronic alcoholism--classificatory problems. Psychopathology 1990;23:88-96.   DOI   ScienceOn
18 De Witte P. Imbalance between neuroexcitatory and neuroinhibitory amino acids causes craving for ethanol. Addict Behav 2004;29:1325-1339.   DOI   ScienceOn
19 Breese GR, Overstreet DH, Knapp DJ. Conceptual framework for the etiology of alcoholism: a "kindling"/stress hypothesis. Psychopharmacology (Berl) 2005;178:367-380.   DOI
20 Walter H, Ramskogler-Skala K, Dvorak A, Gutierrez-Lobos K, Hartl D, Hertling I, et al. Glutamic acid in withdrawal and weaning in patients classified according to Cloninger's and Lesch's typologies. Alcohol Alcohol 2006;41:505-511.   DOI   ScienceOn
21 Hillemacher T, Bayerlein K, Wilhelm J, Bonsch D, Poleo D, Sperling W, et al. Recurrent detoxifications are associated with craving in patients classified as type 1 according to Lesch's typology. Alcohol Alcohol 2006;41:66-69.   DOI   ScienceOn
22 Bleich S, Bleich K, Kropp S, Bittermann HJ, Degner D, Sperling W, et al. Moderate alcohol consumption in social drinkers raises plasma homocysteine levels: a contradiction to the 'French Paradox'? Alcohol Alcohol 2001;36:189-192.   DOI
23 Cravo ML, GlOria LM, Selhub J, Nadeau MR, Camilo ME, Resende MP, et al. Hyperhomocysteinemia in chronic alcoholism: correlation with folate, vitamin B-12, and vitamin B-6 status. Am J Clin Nutr 1996;63:220-224.   DOI
24 Saffroy R, Benyamina A, Pham P, Marill C, Karila L, Reffas M, et al. Protective effect against alcohol dependence of the thermolabile variant of MTHFR. Drug Alcohol Depend 2008;96:30-36.   DOI
25 Bleich S, Degner D, Sperling W, BÖnsch D, Thürauf N, Kornhuber J. Homocysteine as a neurotoxin in chronic alcoholism. Prog Neuropsychopharmacol Biol Psychiatry 2004;28:453-464.   DOI   ScienceOn
26 Bleich S, Degner D, Bandelow B, von Ahsen N, Rüther E, Kornhuber J. Plasma homocysteine is a predictor of alcohol withdrawal seizures. Neuroreport 2000;11:2749-2752.   DOI   ScienceOn
27 Bleich S, Bayerlein K, Reulbach U, Hillemacher T, Bonsch D, Mugele B, et al. Homocysteine levels in patients classified according to Lesch's typology. Alcohol Alcohol 2004;39:493-498.   DOI
28 Frosst P, Blom HJ, Milos R, Goyette P, Sheppard CA, Matthews RG, et al. A candidate genetic risk factor for vascular disease: a common mutation in methylenetetrahydrofolate reductase. Nat Genet 1995;10:111-113.   DOI   ScienceOn
29 Kiefer F, Jahn H, Jaschinski M, Holzbach R, Wolf K, Naber D, et al. Leptin: a modulator of alcohol craving? Biol Psychiatry 2001;49:782-787.   DOI   ScienceOn
30 Wurst FM, Rasmussen DD, Hillemacher T, Kraus T, Ramskogler K, Lesch O, et al. Alcoholism, craving, and hormones: the role of leptin, ghrelin, prolactin, and the pro-opiomelanocortin system in modulating ethanol intake. Alcohol Clin Exp Res 2007;31:1963-1967.   DOI   ScienceOn
31 Hillemacher T, Bleich S, Frieling H, Schanze A, Wilhelm J, Sperling W, et al. Evidence of an association of leptin serum levels and craving in alcohol dependence. Psychoneuroendocrinology 2007;32:87-90.   DOI   ScienceOn
32 Kim DJ, Yoon SJ, Choi B, Kim TS, Woo YS, Kim W, et al. Increased fasting plasma ghrelin levels during alcohol abstinence. Alcohol Alcohol 2005;40:76-79.   DOI
33 Addolorato G, Capristo E, Leggio L, Ferrulli A, Abenavoli L, Malandrino N, et al. Relationship between ghrelin levels, alcohol craving, and nutritional status in current alcoholic patients. Alcohol Clin Exp Res 2006;30:1933-1937.   DOI   ScienceOn
34 Hillemacher T, Kraus T, Rauh J, Weiss J, Schanze A, Frieling H, et al. Role of appetite-regulating peptides in alcohol craving: an analysis in respect to subtypes and different consumption patterns in alcoholism. Alcohol Clin Exp Res 2007;31:950-954.   DOI   ScienceOn
35 Chick J, Howlett H, Morgan MY, Ritson B. United Kingdom Multicentre Acamprosate Study (UKMAS): a 6-month prospective study of acamprosate versus placebo in preventing relapse after withdrawal from alcohol. Alcohol Alcohol 2000;35:176-187.   DOI
36 Lesch OM, Riegler A, Gutierrez K, Hertling I, Ramskogler K, Semler B, et al. The European acamprosate trials: conclusions for research and therapy. J Biomed Sci 2001;8:89-95.   DOI   ScienceOn
37 Wiesbeck GA, Weijers HG, Lesch OM, Glaser T, Toennes PJ, Boening J. Flupenthixol decanoate and relapse prevention in alcoholics: results from a placebo-controlled study. Alcohol Alcohol 2001;36:329-334.   DOI
38 Wiesbeck GA, Weijers HG, Lesch OM, Glaser T, Toennes PJ, Boening J. Flupenthixol decanoate and relapse prevention in alcoholics: results from a placebo-controlled study. Alcohol Alcohol 2001;36:329-334.   DOI
39 Hillemacher T, Bayerlein K, Wilhelm J, Frieling H, Sperling W, Kornhuber J, et al. Prolactin serum levels and alcohol craving-an analysis using Lesch's typology. Neuropsychobiology 2006;53:133-136.   DOI   ScienceOn
40 Biermann T, Reulbach U, Lenz B, Muschler M, Sperling W, Hillemacher T, et al. Herp mRNA expression in patients classified according to Lesch's typology. Alcohol 2009;43:91-95.   DOI   ScienceOn
41 Apostolopoulos M, Judd FK, Burrows GD, Norman TR. Prolactin response to dl-fenfluramine in panic disorder. Psychoneuroendocrinology 1993;18:337-342.   DOI   ScienceOn
42 Trabert W, Caspari D, Bernhard P, Biro G. Inappropriate vasopressin secretion in severe alcohol withdrawal. Acta Psychiatr Scand 1992;85:376-379.   DOI   ScienceOn
43 Taivainen H, Laitinen K, Tahtela R, Kilanmaa K, Valimaki MJ. Role of plasma vasopressin in changes of water balance accompanying acute alcohol intoxication. Alcohol Clin Exp Res 1995;19:759-762.   DOI   ScienceOn
44 Doring WK, Herzenstiel MN, Krampe H, Jahn H, Pralle L, Sieg S, et al. Persistent alterations of vasopressin and N-terminal proatrial natriuretic peptide plasma levels in long-term abstinent alcoholics. Alcohol Clin Exp Res 2003;27:849-861.   DOI   ScienceOn
45 Jahn H, Doring WK, Krampe H, Sieg S, Werner C, Poser W, et al. Preserved vasopressin response to osmostimulation despite decreased basal vasopressin levels in long-term abstinent alcoholics. Alcohol Clin Exp Res 2004;28:1925-1930.   DOI   ScienceOn
46 Hillemacher T, Bayerlein K, Wilhelm J, Poleo D, Frieling H, Ziegenbein M, et al. Volume intake and craving in alcohol withdrawal. Alcohol Alcohol 2006;41:61-65.   DOI   ScienceOn
47 Benyamina A, Saffroy R, Blecha L, Pham P, Karila L, Debuire B, et al. Association between MTHFR 677C-T polymorphism and alcohol dependence according to Lesch and Babor typology. Addict Biol 2009;14:503-505.   DOI   ScienceOn
48 Bonsch D, Bayerlein K, Reulbach U, Fiszer R, Hillemacher T, Sperling W, et al. Different allele-distribution of mthfr 677 C -> T and mthfr -393 C -> a in patients classified according to subtypes of Lesch's typology. Alcohol Alcohol 2006;41:364-367.   DOI   ScienceOn
49 Sperling W, Biermann T, Bleich S, Galvin R, Maihofner C, Kornhuber J, et al. Non-right-handedness and free serum testosterone levels in detoxified patients with alcohol dependence. Alcohol Alcohol 2010;45:237-240.   DOI   ScienceOn
50 Sperling W, Frank H, Martus P, Mader R, Barocka A, Walter H, et al. The concept of abnormal hemispheric organization in addiction research. Alcohol Alcohol 2000;35:394-399.   DOI
51 Babor TF, Caetano R. Subtypes of substance dependence and abuse: implications for diagnostic classification and empirical research. Addiction 2006;101 Suppl 1:104-110.   DOI
52 Hesselbrock VM, Hesselbrock MN. Are there empirically supported and clinically useful subtypes of alcohol dependence? Addiction 2006;101 Suppl 1:97-103.   DOI
53 Samochowiec J, Kucharska-Mazur J, Grzywacz A, Pelka-Wysiecka J, Mak M, Samochowiec A, et al. Genetics of Lesch's typology of alcoholism. Prog Neuropsychopharmacol Biol Psychiatry 2008;32:423-427.   DOI   ScienceOn
54 Walter H, Ramskogler K, Semler B, Lesch OM, Platz W. Dopamine and alcohol relapse: D1 and D2 antagonists increase relapse rates in animal studies and in clinical trials. J Biomed Sci 2001;8:83-88.   DOI