Central role of amygdala and hypothalamus neural circuits in alcohol withdrawal symptom

Alcohol withdrawal symptom is the most well characterized risk factor for relapsing to unhealthy alcohol use. Although alcohol withdrawal is typified with both physical symptoms and emotional instabilities, the emotional instabilities persist much longer and are more often associated with relapse. While the specific mechanisms underlying alcohol withdrawal are not fully understood, chronic alcohol use is known to disrupt the signaling and circuit of many brain regions with long-term consequences and adaptations shifting the allostatic state and contributing to many of the symptoms observed in alcohol withdrawal. In particular, alterations in signaling within the extended amygdala and hypothalamus, typically associated with emotional state and the stress response, may contribute to the emotional instabilities observed in alcohol withdrawal. Thus, in this chapter we will summarize current knowledge of the extended amygdala-hypothalamic circuits and the possible cellular and molecular mechanisms within these regions contributing to the emotional instabilities observed in alcohol withdrawal.