To BOLDly Go (or No-go): Brain imaging predicts frequent binge drinking in adolescents

A study published in the journal Alcoholism: Clinical and Experimental Research could inform efforts to prevent adolescents from escalating to harmful patterns of drinking. Binge drinking in adolescence has many short- and long-term heath consequences, including risk of future alcohol use disorder and potential for harm to the developing brain. The risks are greatest for those who binge frequently – at least once a week. A hallmark of binge drinking is a reduced capacity to control one’s alcohol intake, related to a neurological process of  ‘inhibitory control’ involving several regions of the brain. In adolescents who have not yet started drinking, specific alterations in these brain responses have been linked to an increased risk of future alcohol and drug use; however, it was not known if there are changes that could predict escalation of alcohol use among those already drinking. Therefore, researchers from the University of California investigated whether abnormal brain patterns could predict a future change to high-risk frequent binge drinking among adolescents with moderate alcohol use.

Data were analyzed from twenty-nine people who had enrolled in a larger study when aged 12-14, and had transitioned within 15 years from minimal alcohol use to frequent binge drinking. At around age 18 (after starting to drink moderately but before onset of frequent binging), participants had undergone a brain scan while completing a task often used to assess inhibitory control. Participants were told they would see a series of different shapes on-screen, and instructed to press a button (‘go’) when any shape appeared except for a small square, for which they were told to withhold their response (‘no go’). Researchers were interested in the brain activity that occurred during correct (did not press button) versus incorrect (pressed button) ‘no go’ responses. Brain activity was measured using a type of MRI called BOLD, which detects changes in blood flow in the brain that occur when brain cells (neurons) are activated.

Overall, participants correctly withheld their response (did not press the button) in 87% of instances when a small square appeared. As anticipated, a correct ‘no go’ response was associated with BOLD activity in parts of the brain that have been previously implicated in inhibitory control. Further, the researchers found that the magnitude of the BOLD signal across a particular cluster of brain locations correlated with the time to transition to high-risk frequent drinking – such that adolescents with a smaller BOLD response during successful inhibitory control escalated to impulsive binge drinking behavior sooner than those with a larger response.

The findings support the notion that frequent binge drinking is driven in part by deficiencies in inhibitory control, and provide a potential neural ‘marker’ of future difficulties in regulating alcohol use. Although larger studies are needed to confirm these results, the researchers hope the work will inform interventions aimed at delaying the onset of high-risk drinking patterns beyond the critical neurodevelopmental stage of adolescence.   

Prospective Associations between BOLD Markers of Response Inhibition and the Transition to Frequent Binge Drinking. K.E. Courtney, M.A. Infante, M. Bordyug, A.N. Simmons, S.F. Tapert (pages xxx).

ACER-19-4113.R2

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