Brumback Ty, Squeglia Lindsay M, Jacobus Joanna, Pulido Carmen, Tapert Susan F, Brown Sandra A
University of California San Diego, Department of Psychiatry, La Jolla, CA, USA.
Medical University of South Carolina, Department of Psychiatry and Behavioral Sciences, Charleston, SC, USA.
Addict Behav. 2015 Jul;46:45-52. doi: 10.1016/j.addbeh.2015.03.001. Epub 2015 Mar 8.
Heavy drinking during adolescence is associated with increased reactivity to alcohol related stimuli and to differential neural development. Alcohol cue reactivity has been widely studied among adults with alcohol use disorders, but little is known about the neural substrates of cue reactivity in adolescent drinkers. The current study aimed to identify changes in blood-oxygen level dependent (BOLD) signal during a cue reactivity task pre- and post-monitored abstinence from alcohol.
Demographically matched adolescents (16.0-18.9 years, 54% female) with histories of heavy episodic drinking (HD; n=22) and light or non-drinking control teens (CON; n=16) were recruited to participate in a month-long study. All participants completed a functional Magnetic Resonance Imaging (fMRI) scan with an alcohol cue reactivity task and substance use assessments at baseline and after 28 days of monitored abstinence from alcohol and drugs (i.e., urine toxicology testing every 48-72 h). Repeated-measure analysis of variance (ANOVA) examined main effects of group, time, and group×time interactions on BOLD signal response in regions of interest defined by functional differences at baseline.
The HD group exhibited greater (p<.01) BOLD activation than CON to alcohol cues relative to neutral cues in all regions of interest (ROIs; bilateral striatum/globus pallidus, left anterior cingulate, bilateral cerebellum, and parahippocampal gyrus extending to the thalamus/substantia nigra) across time points. Group×time effects showed that HD exhibited greater BOLD activation to alcohol cues than CON at baseline in left anterior cingulate cortex and in the right cerebellar region, but these decreased to non-significance after one month of monitored abstinence.
In all ROIs examined, HD exhibited greater BOLD response than CON to alcohol relative to neutral beverage picture cues at baseline, indicating heightened cue reactivity to alcohol cues in heavy drinking adolescents prior to the onset of any alcohol use diagnosis. Across the majority of these brain regions, differences in BOLD response were no longer apparent following a month of abstinence, suggesting a decrease in alcohol cue reactivity among adolescent non-dependent heavy drinkers as a consequence of abstaining from alcohol. These results highlight the malleability of adolescent brain function despite no formal intervention targeting cue reactivity. Increased understanding of the neural underpinnings of cue reactivity could have implications for prevention and intervention strategies in adolescent heavy alcohol users.
青少年时期大量饮酒与对酒精相关刺激的反应性增加以及神经发育差异有关。酒精线索反应性在患有酒精使用障碍的成年人中已得到广泛研究，但对于青少年饮酒者线索反应性的神经基础知之甚少。本研究旨在确定在监测戒酒前后的线索反应任务期间血氧水平依赖（BOLD）信号的变化。
招募了人口统计学特征匹配的青少年（16.0 - 18.9岁，54%为女性），其中有重度间歇性饮酒史（HD组；n = 22）和轻度或不饮酒的对照青少年（CON组；n = 16）参与为期一个月的研究。所有参与者在基线时以及在监测戒酒和戒毒28天后（即每48 - 72小时进行尿液毒理学检测）完成了一项带有酒精线索反应任务的功能磁共振成像（fMRI）扫描以及物质使用评估。重复测量方差分析（ANOVA）检验了组、时间以及组×时间交互作用对由基线时功能差异定义的感兴趣区域的BOLD信号反应的主要影响。
在所有时间点，相对于中性线索，HD组在所有感兴趣区域（ROIs；双侧纹状体/苍白球、左侧前扣带回、双侧小脑以及延伸至丘脑/黑质的海马旁回）对酒精线索的BOLD激活均显著高于CON组（p < .01）。组×时间效应表明，在基线时，HD组在左侧前扣带回皮质和右侧小脑区域对酒精线索的BOLD激活高于CON组，但在监测戒酒一个月后这些差异不再显著。
在所有检测的ROIs中，相对于中性饮料图片线索，HD组在基线时对酒精的BOLD反应高于CON组，这表明在任何酒精使用诊断开始之前，重度饮酒青少年对酒精线索的线索反应性增强。在这些大脑区域中的大多数，经过一个月的戒酒，BOLD反应的差异不再明显，这表明青少年非依赖性重度饮酒者因戒酒而导致酒精线索反应性降低。这些结果凸显了青少年脑功能的可塑性，尽管没有针对线索反应性的正式干预。对线索反应性神经基础的进一步了解可能对青少年重度酒精使用者的预防和干预策略具有启示意义。
