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Research in rodent models of AUD has identified the bed nucleus of the stria terminalis (BNST), a small, sexually dimorphic, subcortical region, as critical for regulating anxiety\u2010like behaviors during abstinence, particularly in female mice. Furthermore, prolonged alcohol use and subsequent abstinence alter BNST afferent and efferent connections to other brain regions. To our knowledge, however, no studies of early abstinence have investigated BNST structural connectivity in humans during abstinence; this study addresses that gap.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Nineteen participants with AUD currently in early abstinence and 20 healthy controls completed a diffusion tensor imaging (DTI) scan. BNST structural connectivity was evaluated using probabilistic tractography. A linear mixed model was used to test between\u2010groups differences in BNST network connectivity. Exploratory analyses were conducted to test for correlations between BNST connectivity and alcohol use severity and anxiety within the abstinence group. Sex was included as a factor for all analyses.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The BNST showed stronger structural connectivity with the BNST network in early abstinence women than in control women, which was not seen in men. Women also showed region\u2010specific differences, with stronger BNST\u2010hypothalamus structural connectivity but weaker vmPFC\u2010BNST structural connectivity than men. Exploratory analyses also demonstrated a relationship between alcohol use severity and vmPFC\u2010BNST structural connectivity that was moderated by sex.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This study is the first to demonstrate BNST structural connectivity differences in early abstinence and revealed key sex differences. The sex\u2010specific differences in BNST structural connectivity during early abstinence could underlie known sex differences in abstinence symptoms and relapse risk and help to inform potential sex\u2010specific treatments.<\/jats:p><\/jats:sec>","DOI":"10.1111\/acer.14596","type":"journal-article","created":{"date-parts":[[2021,4,8]],"date-time":"2021-04-08T16:40:29Z","timestamp":1617900029000},"page":"1028-1038","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Alterations in connectivity of the bed nucleus of the stria terminalis during early abstinence in individuals with alcohol use disorder"],"prefix":"10.1111","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0192-0496","authenticated-orcid":false,"given":"Elizabeth A.","family":"Flook","sequence":"first","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences Vanderbilt University Medical Center Nashville TN 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