Examining alcohol use disorder recovery definitions and demographic reporting in studies of structural brain recovery: an updated systematic review and extension.

INTRODUCTION

The National Institute on Alcohol Abuse and Alcoholism's (NIAAA) definition of recovery from alcohol use disorder (AUD) expanded from an abstinence-based model to encompass remission from AUD symptoms and cessation from heavy drinking. However, many neuroimaging studies continue to use abstinence-based definitions of recovery. Many neuroimaging studies also report limited sample demographic information and diverse participants remain underrepresented in neuroimaging research. The aims of this systematic review were to: (i) update a review by Parvaz et al. (2022) on the topic of structural changes in the prefrontal cortex, (ii) apply the NIAAA's updated definition of recovery to studies in the original review and newly identified studies, and (iii) report demographic information from all included studies.

MATERIALS AND

METHODS

The original review was extended by searching PubMed and PsycInfo for articles published between May 2021 and June 2025. Demographic reporting practices were reviewed and the Newcastle-Ottawa Quality Assessment Scale was used to assess bias in all included articles.

RESULTS

There was one newly identified study which reported cessation from heavy drinking. However, the 19 original studies were abstinence-based and did not use the updated NIAAA definition of recovery. Demographic information in the 20 included studies was largely limited to age, sex assigned at birth, and educational attainment. Reporting on additional demographic information was scarce.

CONCLUSIONS

Future neuroimaging studies should examine duration of alcohol use disorder symptom remission and cessation of heavy drinking as outcomes. Moreover, studies should include additional demographic information. These efforts would align with national guidelines and advance clinical science.