The effect of alcohol use on human adolescent brain structures and systems

Adolescent binge ethanol impacts H3K9me3-occupancy at synaptic genes and the regulation of oligodendrocyte development

Introduction

Binge drinking in adolescence can disrupt myelination and cause brain structural changes that persist into adulthood. Alcohol consumption at a younger age increases the susceptibility of these changes. Animal models to understand ethanol's actions on myelin and white matter show that adolescent binge ethanol can alter the developmental trajectory of oligodendrocytes, myelin structure, and myelin fiber density. Oligodendrocyte differentiation is epigenetically regulated by H3K9 trimethylation (H3K9me3). Prior studies have shown that adolescent binge ethanol dysregulates H3K9 methylation and decreases H3K9-related gene expression in the PFC.

Methods

Here, we assessed ethanol-induced changes to H3K9me3 occupancy at genomic loci in the developing adolescent PFC. We further assessed ethanol-induced changes at the transcription level with qPCR time course approaches in oligodendrocyte-enriched cells to assess changes in oligodendrocyte progenitor and oligodendrocytes specifically.

Results

Adolescent binge ethanol altered H3K9me3 regulation of synaptic-related genes and genes specific for glutamate and potassium channels in a sex-specific manner. In PFC tissue, we found an early change in gene expression in transcription factors associated with oligodendrocyte differentiation that may lead to the later significant decrease in myelin-related gene expression. This effect appeared stronger in males.

Conclusion

Further exploration in oligodendrocyte cell enrichment time course and dose response studies could suggest lasting dysregulation of oligodendrocyte maturation at the transcriptional level. Overall, these studies suggest that binge ethanol may impede oligodendrocyte differentiation required for ongoing myelin development in the PFC by altering H3K9me3 occupancy at synaptic-related genes. We identify potential genes that may be contributing to adolescent binge ethanol-related myelin loss.

Longitudinal Relations Among Parental Substance Use Disorder and Adolescent Drinking Behavior: The Role of Temperament, Negative Urgency, and Maternal Parenting

Research suggests that parental substance use disorder is associated with adolescent drinking indirectly through negative urgency, a form of impulsivity that is particularly associated with high-risk drinking. Moreover, childhood mechanisms of risk may play a role in this developmental chain such that childhood temperament and parenting may be mechanisms through which parental substance use disorder is associated with adolescent negative urgency and drinking behavior. Therefore, the current study tested whether parental substance use disorder was indirectly associated with adolescent drinking frequency through childhood temperament (i.e., "dysregulated irritability") and adolescent negative urgency, and whether relations differed by levels of maternal support and consistency of discipline. Data come from a multigenerational, longitudinal study of familial substance use disorder (N = 276, Mage in childhood = 6.28 (SD = 1.16), Mage in adolescence = 15.86 (SD = 1.56), 45.3% female). Findings indicated that parental substance use disorder indirectly predicted adolescent drinking through both childhood dysregulated irritability and adolescent negative urgency (mediated pathways). This indirect relation was stronger at higher vs. lower levels of maternal support but did not vary by maternal consistency of discipline. Parental substance use disorder also indirectly predicted adolescent drinking separately through childhood dysregulated irritability and negative urgency. Findings thus suggest that childhood dysregulated irritability may be an early marker of risk toward high-risk personality traits and behavior in adolescence that are associated with having a parental history of substance use disorder. Findings also suggest that increased maternal support may only be helpful in buffering risk for those with low levels of dysregulated irritability. Prevention efforts focused on childhood emotion regulation and emotion-based action may be useful in preventing adolescent risk behavior.

Epigenetic regulation of microglia and neurons by proinflammatory signaling following adolescent intermittent ethanol (AIE) exposure and in human AUD

Adolescent alcohol drinking is linked to high rates of adult alcohol problems and alcohol use disorder (AUD). The Neurobiology of Alcohol Drinking in Adulthood (NADIA) consortium adolescent intermittent ethanol (AIE) models adolescent binge drinking, followed by abstinent maturation to adulthood to determine the persistent AIE changes in neurobiology and behavior. AIE increases adult alcohol drinking and preference, increases anxiety and reward seeking, and disrupts sleep and cognition, all risks for AUD. In addition, AIE induces changes in neuroimmune gene expression in neurons and glia that alter neurocircuitry and behavior. HMGB1 is a unique neuroimmune signal released from neurons and glia by ethanol that activates multiple proinflammatory receptors, including Toll-like receptors (TLRs), that spread proinflammatory gene induction. HMGB1 expression is increased by AIE in rat brain and in post-mortem human AUD brain, where it correlates with lifetime alcohol consumption. HMGB1 activation of TLR increase TLR expression. Human AUD brain and rat brain following AIE show increases in multiple TLRs. Brain regional differences in neurotransmitters and cell types impact ethanol responses and neuroimmune gene induction. Microglia are monocyte-like cells that provide trophic and synaptic functions, that ethanol proinflammatory signals sensitize or "prime" during repeated drinking cycles, impacting neurocircuitry. Neurocircuits are differently impacted dependent upon neuronal-glial signaling. Acetylcholine is an anti-inflammatory neurotransmitter. AIE increases HMGB1-TLR4 signaling in forebrain, reducing cholinergic neurons by silencing multiple cholinergic defining genes through upregulation of RE-1 silencing factor (REST), a transcription inhibitor known to regulate neuronal differentiation. HMGB1 REST induction reduces cholinergic neurons in basal forebrain and cholinergic innervation of hippocampus. Adult brain hippocampal neurogenesis is regulated by a neurogenic niche formed from multiple cells. In vivo AIE and in vitro studies find ethanol increases HMGB1-TLR4 signaling and other proinflammatory signaling as well as reducing trophic factors, NGF, and BDNF, coincident with loss of the cholinergic synapse marker vChAT. These changes in gene expression-transcriptomes result in reduced adult neurogenesis. Excitingly, HMGB1 antagonists, anti-inflammatories, and epigenetic modifiers like histone deacetylase inhibitors restore trophic the neurogenesis. These findings suggest anti-inflammatory and epigenetic drugs should be considered for AUD therapy and may provide long-lasting reversal of psychopathology.

Parental Deprivation- and Threat-Based Factors Associated with Youth Emotion-Based Neurocircuitry and Externalizing Behavior: A Systematic Review

Parental factors, including negative parenting practices (e.g., family conflict, low monitoring), parental depression, and parental substance use, are associated with externalizing behaviors among youth. However, the ways in which these parental factors are associated with youth brain function and consequent externalizing behavior has been less studied. Both the dimensional and stress acceleration models provide frameworks for understanding how parental factors may be associated with frontolimbic and frontoparietal networks implicated in emotional attention and regulation processes. The current review builds upon this work by examining how deprivation- and threat-based parental factors are associated with youth neurocircuitry involved in emotional functioning and externalizing behaviors. A systematic review using PRISMA guidelines was completed and included five studies assessing parenting behaviors, six studies assessing parental depressive symptoms and/or diagnosis, and 12 studies assessing parental history of substance use. Synthesis of reviewed studies discusses support for the dimensional and stress acceleration models within the context of deprivation and threat. Further, a limited number of studies tested (i.e., six studies) and supported (i.e., three studies) youth neural structure and function as a mediator of the association between parental factors and youth externalizing behavior. Specific recommendations for future work include more deliberate planning related to sample composition, improved clarity related to parental constructs, consistency in methodology, and longitudinal study design in order to better understand associations between contextual parental influences and youth neural and behavioral functioning.

Ethanol changes Nestin-promoter induced neural stem cells to disturb newborn dendritic spine remodeling in the hippocampus of mice

Adolescent binge drinking leads to long-lasting disorders of the adult central nervous system, particularly aberrant hippocampal neurogenesis. In this study, we applied in vivo fluorescent tracing using NestinCreERT2::Rosa26-tdTomato mice and analyzed the endogenous neurogenesis lineage progression of neural stem cells (NSCs) and dendritic spine formation of newborn neurons in the subgranular zone of the dentate gyrus. We found abnormal orientation of tamoxifen-induced tdTomato+ (tdTom+) NSCs in adult mice 2 months after treatment with EtOH (5.0 g/kg, i.p.) for 7 consecutive days. EtOH markedly inhibited tdTom+ NSCs activation and hippocampal neurogenesis in mouse dentate gyrus from adolescence to adulthood. EtOH (100 mM) also significantly inhibited the proliferation to 39.2% and differentiation of primary NSCs in vitro. Adult mice exposed to EtOH also exhibited marked inhibitions in dendritic spine growth and newborn neuron maturation in the dentate gyrus, which was partially reversed by voluntary running or inhibition of the mammalian target of rapamycin-enhancer of zeste homolog 2 pathway. In vivo tracing revealed that EtOH induced abnormal orientation of tdTom+ NSCs and spatial misposition defects of newborn neurons, thus causing the disturbance of hippocampal neurogenesis and dendritic spine remodeling in mice.

Neuropsychological functioning of patients with major depression or bipolar disorder comorbid to substance use disorders: A systematic review

Major depression disorder (MDD) and bipolar disorder (BD) are usual comorbidities in patients with substance use disorders (SUD), a condition known as dual disorder (DD). MDD, BD and SUD are associated with cognitive impairment, potentially leading to a greater functional impairment in the context of DD.

OBJECTIVES

To review the existing data on the cognitive impairment in DD patients with comorbid MDD or BD, considering the influence of the depressive symptomatology.

METHODS

Following the PRISMA protocol 19 studies were selected from the last 17 years, 13 of which focused on BD, five on MDD and one included both diagnoses.

RESULTS

Studies based in BD+SUD showed that the most affected cognitive domains were attention and executive functions, but not all of them found a greater impairment due to the comorbidity. While fewer studies were found for depression, MDD+SUD works point to a similar impairment cognitive pattern. Furthermore, depression improvement could be associated to better cognitive performance.

LIMITATIONS

More standardized research is needed regarding the influence of depression on cognitive performance of DD patients, especially on those with comorbid MDD. Factors such as main substance, abstinence, or MDD/BD-related variables should be considered. Unstudied factors, like gender or circadian rhythms, are proposed to improve knowledge in this area.

CONCLUSIONS

Current studies suggest that DD could potentiate cognitive impairment in BD, MDD and SUD. However, additional research is needed to improve the understanding of comorbidity to apply more individualized therapies in the treatment of these patients, considering the interference of their neurocognitive functioning.

Neuroanatomical predictors of problematic alcohol consumption in adolescents: a systematic review of longitudinal studies

AIMS

This study aimed to systematically review the literature on neuroanatomical predictors of future problematic drinking in adolescents.

METHODS

Using PRISMA guidelines, a systematic review was conducted to evaluate neuroanatomical predictors of problematic alcohol consumption in adolescents. EMBASE, MEDLINE, and PsycINFO databases were searched from inception to 6 January 2023. Studies were included if they were original, had a prospective design, had a sample size of at least 12, had a follow-up period of at least 1 year, had at least one structural neuroimaging scan before 18 with no prior alcohol use, and had alcohol use as the primary outcome. Studies were excluded if they had animals only and were not in English. Risk of bias was conducted using the CASP tool.

RESULTS

Out of 1412 studies identified, 19 studies met the criteria, consisting of 11 gray matter (n = 4040), 5 white matter (n = 319), and 3 assessing both (n = 3608). Neuroanatomical predictors of future problematic drinking in adolescents were reported to be distributed across various brain regions such as the orbitofrontal cortex and paralimbic regions. However, the findings were largely heterogeneous.

CONCLUSIONS

This is the first systematic review to map out the existing literature on neuroanatomical predictors of problematic drinking in adolescents. Future research should focus on the aforementioned regions to determine their role in predicting future problematic drinking with more certainty.

Intermittent Exposure to a Single Bottle of Ethanol Modulates Stress Sensitivity: Impact of Age at Exposure Initiation

Alcohol use during adolescence is a serious public health problem, with binge drinking and high-intensity drinking being particularly harmful to the developing adolescent brain. To investigate the adverse consequences of binge drinking and high-intensity adolescent drinking, adolescent rodents were intermittently exposed to ethanol through intragastric gavage, intraperitoneal injection, or vapor inhalation. These models revealed the long-lasting behavioral and neural consequences of adolescent intermittent ethanol (AIE) exposure. The present study was designed to characterize a different AIE model, namely, intermittent exposure to a single bottle of 10% ethanol as the only source of fluids on a 2 days on/2 days off (water days) schedule, and to determine whether this AIE exposure model would produce changes in hormonal and neuroimmune responsiveness to challenges of differing modalities. Assessments of ethanol intake as well as blood and brain ethanol concentrations (BECs and BrECs, respectively) in adult male and female rats (Experiment 1) revealed that BECs and BrECs peaked following access to ethanol for a 2 h period when assessed 1 h into the dark cycle. Experiment 2 revealed age differences in ethanol intake, BECs, and BrECs following a 2 h access to ethanol (1 h into the dark cycle), with adolescents ingesting more ethanol and reaching higher BECs as well as BrECs than adults. In Experiment 3, intermittent exposure to a single bottle of 10% ethanol for 10 cycles of 2 days on/2 days off was initiated either in early or late adolescence, followed by an acute systemic immune challenge with lipopolysaccharide (LPS) in adulthood. LPS increased corticosterone and progesterone levels regardless of sex and prior ethanol history, whereas an LPS-induced increase in cytokine gene expression in the hippocampus was evident only in ethanol-exposed males and females, with females who underwent early exposure to ethanol being more affected than their later-exposed counterparts. In Experiment 4, intermittent ethanol exposure in females was initiated either in adolescence or adulthood and lasted for 12 ethanol exposure cycles. Then, behavioral (freezing behavior), hormonal (corticosterone and progesterone levels), and neuroimmune (cytokine gene expression in the PVN, amygdala, and hippocampus) responses to novel environments (mild stressors) and shock (intense stressors) were assessed. More pronounced behavioral and hormonal changes, as well as changes in cytokine gene expression, were evident in the shock condition than following placement in the novel environment, with prior history of ethanol exposure not playing a substantial role. Interleukin (IL)-1β gene expression was enhanced by shock in the PVN, whereas shock-induced increases in IL-6 gene expression were evident in the hippocampus. Together, these findings demonstrate that our intermittent adolescent exposure model enhances responsiveness to immune but not stress challenges, with females being more vulnerable to this AIE effect than males.

Reduced connectivity of the cognitive control neural network at rest in young adults who had their first drink of alcohol prior to age 18

The cognitive control network (CCN) is an important network responsible for performing and modulating executive functions. In adolescents, alcohol use has been associated with weaker cognitive control, higher reward sensitivity, and later-in-life alcohol problems. Given that the CCN continues to develop into young adulthood, it is important to understand relations between early alcohol use, the CCN, and reward networks. Participants included individuals 18-23 years without alcohol use disorder. Based upon self-reported age of first alcoholic drink, participants were split into two groups: Early (onset) Drinkers (first drink < age 18, N = 52) and Late (onset) Drinkers (first drink > age 18, N = 44). All participants underwent an 8-minute resting-state fMRI scan. Seed regions of interest included the anterior dorsolateral prefrontal cortex (DLPFC), amygdala, and ventral striatum. Early Drinkers demonstrated significant reduced connectivity of CCN regions, including bilateral anterior DLPFC, compared to Late Drinkers. There were no significant differences between Early and Late Drinkers in connectivity between reward and CCN regions. These results suggest that individuals who begin drinking alcohol earlier in life may have alterations in the development of the CCN; however, longitudinal research is necessary to determine whether lower connectivity precedes or follows early alcohol use, and any other relevant factors.

Holding your liquor: Comparison of alcohol-induced psychomotor impairment in drinkers with and without alcohol use disorder

BACKGROUND

Behavioral tolerance to alcohol underscores the widely accepted notion that individuals who regularly drink alcohol become less sensitive to its impairing effects. However, previous research assessing alcohol-induced impairment in humans has primarily focused on social drinkers. This has limited our understanding of the nature and extent of behavioral tolerance among heavier drinkers, such as those with alcohol use disorder (AUD).

METHODS

Data from three cohorts of the Chicago Social Drinking Project were evaluated to examine the acute effects of alcohol on psychomotor performance across the breath alcohol curve in light drinkers (LDs; n = 86), heavy drinkers (HDs; n = 208), and individuals with AUD (AUDs; n = 103). Before and at several intervals after ingesting either alcohol (0.8 g/kg, peak BrAC = 0.09 g/dL) or placebo in two random-order laboratory sessions, participants completed a test of fine motor coordination (Grooved Pegboard), a test of perceptual-motor processing (Digit Symbol Substitution Task), and a self-reported survey of perceived impairment. Sixty individuals with AUD completed a third session with a very high dose of alcohol (1.2 g/kg, peak BrAC = 0.13 g/dL).

RESULTS

The AUD and HD groups, relative to the LD group, perceived less impairment and demonstrated greater behavioral tolerance to an intoxicating dose of alcohol, exhibited by reduced peak impairment and a quicker return to baseline performance on psychomotor measures. Among individuals with AUD who consumed the very high dose, impairment was more than double that following the usual high dose, and it exceeded the impairment among LDs following the usual high dose.

CONCLUSIONS

In this sample of young adult drinkers, relative to the LD group, those with heavier drinking patterns (AUD and HD groups) showed greater behavioral tolerance to 0.8 g/kg alcohol, a dose typically associated with a binge drinking episode. However, when challenged with a very high alcohol dose commensurate with high-intensity drinking, individuals with AUD showed substantial psychomotor impairment.

Value-based decision-making network functional connectivity correlates with substance use and delay discounting behaviour among young adults

Substance use disorders are characterized by reduced control over the quantity and frequency of psychoactive substance use and impairments in social and occupational functioning. They are associated with poor treatment compliance and high rates of relapse. Identification of neural susceptibility biomarkers that index risk for developing a substance use disorder can facilitate earlier identification and treatment. Here, we aimed to identify the neurobiological correlates of substance use frequency and severity amongst a sample of 1,200 (652 females) participants aged 22-37 years from the Human Connectome Project. Substance use behaviour across eight classes (alcohol, tobacco, marijuana, sedatives, hallucinogens, cocaine, stimulants, opiates) was measured using the Semi-Structured Assessment for the Genetics of Alcoholism. We explored the latent organization of substance use behaviour using a combination of exploratory structural equation modelling, latent class analysis, and factor mixture modelling to reveal a unidimensional continuum of substance use behaviour. Participants could be rank ordered along a unitary severity spectrum encompassing frequency of use of all eight substance classes, with factor score estimates generated to represent each participant's substance use severity. Factor score estimates and delay discounting scores were compared with functional connectivity in 650 participants with imaging data using the Network-based Statistic. This neuroimaging cohort excludes participants aged 31 and over. We identified brain regions and connections correlated with impulsive decision-making and poly-substance use, with the medial orbitofrontal, lateral prefrontal and posterior parietal cortices emerging as key hubs. Functional connectivity of these networks could serve as susceptibility biomarkers for substance use disorders, informing earlier identification and treatment.

An innovative inpatient protocol for alcohol withdrawal prevention in a 16-year-old adolescent: a case report

BACKGROUND

Alcohol cessation in youth with daily drinking poses a risk of severe and life-threatening alcohol withdrawal. If unsupervised, alcohol withdrawal in heavy users can cause severe complications, such as seizures, delirium tremens, and death. We present the case of a teenager admitted at our pediatric center for the prevention of alcohol withdrawal using an innovative protocol, including a fixed-dosage benzodiazepine regimen.

CASE DESCRIPTION

A 16-year-old Caucasian male, known to have anxiety and an attention deficit disorder, was electively admitted for medical stabilization and surveillance of alcohol withdrawal. He had been previously diagnosed with alcohol use disorder and had a past history of withdrawal symptoms. He was prescribed a course of thiamine, folic acid, as well as a fixed-dosage benzodiazepine taper over 5 days. His withdrawal symptoms were evaluated using a standardized Clinical Institute Withdrawal Assessment for Alcohol scale. During his stay, he reported minimal symptoms, as well as a score on the Clinical Institute Withdrawal Assessment for Alcohol scale consistently lower than 5. His mood, motivation, eating habits and sleeping patterns significantly improved during his stay. He developed no medical complications and demonstrated pride in his successes. He was successfully transferred to a long-term rehabilitation center.

CONCLUSIONS

A withdrawal prevention protocol was developed on the basis of existing literature. It included a soothing environment, basic laboratory work evaluating the medical complications of alcohol use, as well as medication aiming to prevent and reduce potential withdrawal symptoms. The patient responded well to the fixed-dosage taper with minimal symptoms and discomfort. Although alcohol use in adolescents is frequent, alcohol withdrawal in this population is rarely seen in a pediatric hospital setting. Nonetheless, given the lack of existing guidelines regarding alcohol withdrawal in adolescents, standardized protocols could be greatly beneficial for the prevention of this condition in this population.

Multilevel Factors Associated With Lifetime, Current, and Binge Drinking Among Korean Adolescents Based on the Ecological Model

BACKGROUND

Drinking usually begins in adolescence and is a major public health concern. Few studies have identified multilevel factors considering the frequency and amount of drinking among adolescents. This study aimed to identify the multilevel factors associated with lifetime, current, and binge drinking among Korean adolescents based on the ecological model.

METHODS

This cross-sectional study used data from the 2018 Korea Youth Risk Behavior Survey (N = 60,040). Hierarchal multinomial logistic regression analyses were performed using complex sample data.

RESULTS

Overall, 15,030 (25.4%), 4,629 (8.0%), and 5,038 (8.9%) subjects were involved in lifetime, current, and binge drinking, respectively. The following multilevel factors revealed significant associations with lifetime, current, and binge drinking: boys, high school students, depression, suicidal ideation at individual level, family acceptance of alcohol use, poor household economic status at family level, poor academic achievement, not receiving education on alcohol use at school level, possible alcohol access, and harm caused by drinkers at social level (all ps < .01). The main risk factors were family acceptance of alcohol use (lifetime, current, and binge drinking vs. OR = 3.95, 6.88, and 5.46, respectively) and possible alcohol access (OR = 5.65, 19.78, and 93.62).

DISCUSSION

This study revealed multilevel factors associated with lifetime, current, and binge drinking. School nurses and community leaders are necessary to develop customized drinking prevention programs considering drinking frequency and amount, and individual, family, school, and social factors. Especially, the implementation of a drinking prevention program that reduces family acceptance of alcohol use and access to alcohol could be an effective strategy.

Do Australian adolescents with permission to drink at home engage in different alcohol use behaviours and experience more harms than those without such permission?

INTRODUCTION

Around half of Australian students aged 16-17 are estimated to have drunk alcohol in the past month, with 11% drinking at 'risky' levels. This study investigated: (i) how many Australian adolescents aged 16-17 had parental permission to drink at home in 2016/17 and whether prevalence differed by adolescent sex; (ii) whether adolescents allowed to drink at home had drunk more recently and were drinking greater quantities; (iii) if adolescents allowed to drink at home experienced more alcohol-related harms; and (iv) if parental drinking patterns were associated with permitting adolescents to drink at home.

METHODS

Data from Wave 7 of the Longitudinal Study of Australian Children were used. Descriptive and bivariate analyses addressed Aims i-iii. Nested multivariable logistic regression models addressed aim iv.

RESULTS

In 2016/17, 28% of Australian adolescents aged 16-17 were allowed to drink alcohol at home. More adolescents with permission had drunk alcohol in the past month (77% vs. 63% of those without permission). There was no difference in quantity of alcohol consumed in the past week between groups. More adolescents allowed to drink at home had experienced alcohol-related harm compared to those without permission (23% vs. 17%). In multivariable analyses, alcohol consumption by primary parents was associated with an increased likelihood of allowing adolescents to drink at home.

DISCUSSIONS AND CONCLUSIONS

In order to reduce adolescent alcohol use and associated harms, parents should avoid permitting alcohol use among adolescents at home. Frequent (twice or more/week) primary parental alcohol consumption was especially associated with greater odds of allowing adolescents to drink at home.

Adolescent binge ethanol impacts H3K36me3 regulation of synaptic genes

Adolescence is marked in part by the ongoing development of the prefrontal cortex (PFC). Binge ethanol use during this critical stage in neurodevelopment induces significant structural changes to the PFC, as well as cognitive and behavioral deficits that can last into adulthood. Previous studies showed that adolescent binge ethanol causes lasting deficits in working memory, decreases in the expression of chromatin remodeling genes responsible for the methylation of histone 3 lysine 36 (H3K36), and global decreases in H3K36 in the PFC. H3K36me3 is present within the coding region of actively-transcribed genes, and safeguards against aberrant, cryptic transcription by RNA Polymerase II. We hypothesize that altered methylation of H3K36 could play a role in adolescent binge ethanol-induced memory deficits. To investigate this at the molecular level, ethanol (4 g/kg, i.g.) or water was administered intermittently to adolescent mice. RNA-and ChIP-sequencing were then performed within the same tissue to determine gene expression changes and identify genes and loci where H3K36me3 was disrupted by ethanol. We further assessed ethanol-induced changes at the transcription level with differential exon-use and cryptic transcription analysis - a hallmark of decreased H3K36me3. Here, we found ethanol-induced changes to the gene expression and H3K36me3-regulation of synaptic-related genes in all our analyses. Notably, H3K36me3 was differentially trimethylated between ethanol and control conditions at synaptic-related genes, and Snap25 and Cplx1 showed evidence of cryptic transcription in males and females treated with ethanol during adolescence. Our results provide preliminary evidence that ethanol-induced changes to H3K36me3 during adolescent neurodevelopment may be linked to synaptic dysregulation at the transcriptional level, which may explain the reported ethanol-induced changes to PFC synaptic function.

Perception of Parental Attitudes and Self-Efficacy in Refusing Alcohol Drinking and Smoking by Spanish Adolescents: A Cross-Sectional Study

Adolescents are particularly vulnerable to initiation of the use of substances harmful to health, and its increase is cause for concern. The objective of this study was to analyze the relationship between self-efficacy in refusing alcohol and the attitude of adolescents toward drugs and their perception of their parents' attitude toward refusal. The study was carried out in 2019 in a sample of 1287 students from 11 public high schools in the province of Almería (Spain). Students were aged 14 to 18 in their 3rd and 4th year of compulsory secondary education. The Drinking Refusal Self-Efficacy Questionnaire-Revised Adolescent version (DRSEQ-RA), Attitudes Toward Taking Drugs-Basic BIP Scale and the Parents' attitudes Toward Drug Use were administered. The results showed that family relationships seem to have a direct impact on adolescent patterns in smoking and drinking alcohol. However, a favorable attitude toward drugs is a risk factor for drinking alcohol and smoking tobacco. The self-efficacy dimension also acts as a protective factor against the probability of using alcohol or tobacco. The conclusions emphasized that communication within the family core can increase or decrease the risk of adolescents using substances harmful to health.

Integrative Analysis of Proteome-wide Association Studies and Functional Enrichment Analysis to Identify Genes and Chemicals Associated with Alcohol Dependence

OBJECTIVES

Alcohol dependence accounts for a large proportion of the global burden of disease and disability. This study aims to investigate the candidate genes and chemicals associated with alcohol dependence.

METHODS

Using data from published alcohol dependence genome-wide association studies, we first conducted a proteome-wide association study of alcohol dependence by integrating alcohol dependence genome-wide association studies with 2 human brain reference proteomes of dorsolateral prefrontal cortex from the Religious Order Study and Rush Memory and Aging Project and the Banner Sun Health Research Institute. Then, based on the identified genes in proteome-wide association study, we conducted functional enrichment analysis and chemical-related functional enrichment analysis to detect the related Gene Ontology terms and chemicals.

RESULTS

Proteome-wide association study identified several potential candidate genes for alcohol dependence, such as GOT2 (P = 7.59 × 10-6) and C3orf33 (P = 5.00 × 10-3). Furthermore, functional enrichment analysis identified multiple candidate Gene Ontology terms associated with alcohol dependence, such as glyoxylate metabolic process (adjusted P = 2.99 × 10-6) and oxoglutarate metabolic process (adjusted P = 9.95 × 10-6). Chemical-related functional enrichment analysis detected several alcohol dependence-related candidate chemicals, such as pitavastatin (P = 2.00 × 10-4), cannabinoids (P = 4.00 × 10-4), 11-nor-Δ(9)-tetrahydrocannabinol-9-carboxylic acid (P = 4.00 × 10-4), and gabapentin (P = 2.00 × 10-3).

CONCLUSIONS

Our study reports multiple candidate genes and chemicals associated with alcohol dependence, providing novel clues for understanding the biological mechanism of alcohol dependence.

Blood Vessels as a Key Mediator for Ethanol Toxicity: Implication for Neuronal Damage

Excessive intake of ethanol is associated with severe brain dysfunction, and the subsequent neurological and behavioral abnormalities are well-established social risks. Many research studies have addressed how ethanol induces neurological toxicity. However, the underlying mechanisms with which ethanol induces neurological toxicity are still obscure, perhaps due to the variety and complexity of these mechanisms. Epithelial cells are in direct contact with blood and can thus mediate ethanol neurotoxicity. Ethanol activates the endothelial cells of blood vessels, as well as lymphatic vessels, in a concentration-dependent manner. Among various signaling mediators, nitric oxide plays important roles in response to ethanol. Endothelial and inducible nitric oxide synthases (eNOS and iNOS) are upregulated and activated by ethanol and enhance neuroinflammation. On the other hand, angiogenesis and blood vessel remodeling are both affected by ethanol intake, altering blood supply and releasing angiocrine factors to regulate neuronal functions. Thus, ethanol directly acts on endothelial cells, yet the molecular target(s) on endothelial cells remain unknown. Previous studies on neurons and glial cells have validated the potential contribution of membrane lipids and some specific proteins as ethanol targets, which may also be the case in endothelial cells. Future studies, based on current knowledge, will allow for a greater understanding of the contribution and underlying mechanisms of endothelial cells in ethanol-induced neurological toxicity, protecting neurological health against ethanol toxicity.

Associations between Adolescent Alcohol Use and Neurocognitive Functioning in Young Adulthood

This study examined the associations between excessive alcohol intake during adolescence and neurocognitive functioning in young adulthood and whether these relations varied by sex. Participants were working-class Chilean adolescents (N = 692; Mage 16.0 years; 54.5% female) who provided frequency of past 30-day bingeing and past-year intoxication. Neurocognitive measures were completed in young adulthood (Mage 21.2 years). Illicit substance users were excluded a priori and other substance use was controlled. When males and females were considered simultaneously, no main effects of intoxication or bingeing were found. However, several sex-specific effects emerged for intoxication, such that more frequent intoxication was associated with poorer visual memory, attention, processing speed, response inhibition, and cognitive flexibility in females, while frequent intoxication related to better attention and processing speed in males. In general, effect sizes were small. No relations emerged for verbal memory, working memory, or spatial learning. Possible factors that contribute to divergent sex effects are discussed.

Association between simultaneity of health-risk behaviours and self-rated health in Brazilian adolescents

Introduction

This study examined the association between simultaneity of four health-risk behaviours, namely, low levels of moderate-to-vigorous physical activity (insufficient MVPA: <420 min/week), tobacco use, alcohol consumption, and excessive television (TV)–(>2 h/d of TV viewing) and self-rated health (SRH) in Brazilian adolescents.

Methods

We used data of 100,551 adolescents from the National School Health Survey, a national cross-sectional study carried out in 2015. Association between simultaneity of health risk behaviours (i.e. the ratio between observed and expected prevalence rates) and SRH was examined using logistic regression models.

Results

The majority of the participants were female (51.9%) and 14 years of age (50.6%), and 26% of the participants’ SRH ranged from ’average’ to ’extremely poor’. Those who engaged in the following combinations of health-risk behaviours had higher odds of worse SRH than their healthier counterparts: insufficient MVPA and tobacco use (odds ratio—OR: 2.0, 95% confidence interval [CI]: 1.4 to 3.0); insufficient MVPA and alcohol consumption (OR: 1.6, 95%CI: 1.3 to 1.9); insufficient MVPA and >2 h/day of TV viewing (OR: 1.3, 95%CI: 1.1 to 1.6); insufficient MVPA, tobacco use and alcohol consumption (OR: 2.1, 95%CI: 1.7, to 2.7); and insufficient MVPA, alcohol consumption and >2 h/day of TV viewing (OR: 1.6, 95%CI: 1.4 to 2.0).

Conclusions

Insufficient MVPA, alcohol consumption, and other health-risk behaviours were associated with worse SRH in Brazilian adolescents.

Prospective associations between attitudes toward alcohol advertisements and alcohol use behaviors among adolescent boys

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Exposure to alcohol advertisements is associated with drinking among adolescents.

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Little is known about attitudes toward advertisements and drinking.

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Positive attitudes toward advertisements affect alcohol use prospectively.

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Media literacy programs should address attitudes toward alcohol advertisements.

Objectives

Earlier initiation of alcohol use and problematic drinking among adolescents are linked with adverse health outcomes. Exposure to alcohol advertisements is associated with drinking among adolescents, but the association between the attitudes toward alcohol advertisements and drinking behaviors is understudied. We evaluated the association between attitudes towards alcohol advertisements and initiation of alcohol use among adolescent boys.

Methods

Adolescent boys from urban and Appalachian Ohio enrolled in a prospective study and reported whether they had ever consumed alcohol or been drunk at baseline (N = 1220; ages 11–16 years) and at the 24-month follow up (N = 891). Attitudes toward alcohol advertisements were measured at baseline following a brief advertisement viewing activity. Adjusted logistic regression models were used to estimate associations between attitudes toward advertisements and initiating alcohol use or drunkenness at the 24-month follow-up.

Results

Adolescent boys reporting any positive attitudes toward alcohol advertisements had higher odds of initiating alcohol use (aOR = 2.00, 95% CI [1.16, 3.44]), and attitudes were marginally associated with incident drunkenness (aOR = 2.20, 95% CI [0.94, 5.12]). Increasing age, higher household income, ever use of tobacco, and frequency of visiting alcohol retailers were also associated with greater odds of incident alcohol use and/or drunkenness.

Conclusions

Attitudes toward alcohol advertisements at baseline were associated with alcohol drinking behaviors 24-months later among adolescent boys. Results highlight the importance of media literacy interventions targeted to adolescents.

Adolescent Binge Alcohol Enhances Early Alzheimer's Disease Pathology in Adulthood Through Proinflammatory Neuroimmune Activation

Epidemiological studies suggest that heavy alcohol use early in life is associated with increased risk for Alzheimer's disease (AD). However, mechanisms connecting AD with alcohol use have not been identified. Both heavy alcohol use and AD feature increased proinflammatory signaling. Therefore, we hypothesized that adolescent binge ethanol would increase AD molecular and behavioral pathology in adulthood through proinflammatory signaling. The 3xTg-AD mouse model (APPSwe, tauP301, Psen1^tm1Mpm) which features amyloid (Aβ) and tau pathology beginning at 6-12 months underwent adolescent intermittent ethanol (AIE, 5 g/kg/d, i.g., P25-55) with assessment of AD pathologic mediators at P200. A second group of mice received AIE +/- minocycline (30 mg/kg/d, IP) followed by behavioral testing in adulthood. Behavioral testing and age of testing included: locomotor activity and exploration (27-28 weeks), novel object recognition (NORT, 28-30 weeks), 3-chamber sociability and social memory (29-31 weeks), prepulse inhibition (PPI, 30-32 weeks), Morris Water Maze with reversal (MWM, 31-35 weeks), and Piezo sleep monitoring (35-37 weeks). We found that AIE increased levels of neurotoxic Aβ_1-42 in adult female hippocampus as well as intraneuronal Aβ_1-42 in amygdala and entorhinal cortex. Phosphorylated tau at residue Thr181 (p-tau-181) was also increased in female hippocampus by AIE. Several proinflammatory genes were persistently increased by AIE in the female hippocampus, including IL-1β, MCP-1, IL-6, and IFNα. Expression of these genes was strongly correlated with the levels of Aβ_1-42 and p-tau-181 in hippocampus. AIE caused persistent decreases in locomotor activity (open-field and NORT habituation) and increased anxiety-like behavior (thigmotaxis) while reducing memory retention. Treatment with the anti-inflammatory compound minocycline during AIE blocked persistent increases in Aβ_1-42 in amygdala and p-tau-181 in hippocampus, and prevented AIE-induced thigmotaxis and memory loss. Together, these data find that adolescent binge ethanol enhances AD molecular and behavioral pathology in adulthood through proinflammatory signaling. Blockade of proinflammatory signaling during ethanol exposure prevents ethanol-induced effects on pathologic accumulation of AD-associated proteins and persistent behavior changes relevant to human AD.

Alcohol Use and Prefrontal Cortex Volume Trajectories in Young Adults with Mood Disorders and Associated Clinical Outcomes

(1) Background: Alcohol use in the course of mood disorders is associated with worse clinical outcomes. The mechanisms by which alcohol use alters the course of illness are unclear but may relate to prefrontal cortical (PFC) sensitivity to alcohol. We investigated associations between alcohol use and PFC structural trajectories in young adults with a mood disorder compared to typically developing peers. (2) Methods: 41 young adults (24 with a mood disorder, agemean = 21 ± 2 years) completed clinical evaluations, assessment of alcohol use, and two structural MRI scans approximately one year apart. Freesurfer was used to segment PFC regions of interest (ROIs) (anterior cingulate, orbitofrontal cortex, and frontal pole). Effects of group, alcohol use, time, and interactions among these variables on PFC ROIs at baseline and follow-up were modeled. Associations were examined between alcohol use and longitudinal changes in PFC ROIs with prospective mood. (3) Results: Greater alcohol use was prospectively associated with decreased frontal pole volume in participants with a mood disorder, but not typically developing comparison participants (time-by-group-by-alcohol interaction; p = 0.007); however, this interaction became a statistical trend in a sensitivity analysis excluding one outlier in terms of alcohol use. Greater alcohol use and a decrease in frontal pole volume related to longer duration of major depression during follow-up (p’s < 0.05). (4) Conclusion: Preliminary findings support more research on alcohol use, PFC trajectories, and depression recurrence in young adults with a mood disorder including individuals with heavier drinking patterns.

The Role of Cyclooxygenase 2 in the Cognitive Impairment Induced by Alcohol or Stress in Rats

Background:

Cognitive impairment is an unpleasant and progressive mental disorder characterized by learning and memory disabilities. Stress and alcohol are two known environmental factors that increase cognitive impairment. This study was designed to evaluate the relative role of cyclooxygenase 2 in alcohol or stress-induced cognitive impairment.

Materials and Methods:

Male Wistar rats were randomly divided into groups with six rats in each. The groups included sham, control, alcohol (15% ethanol in drinking water), and restraint stress (restraint 6 h per day). Three separated groups received celecoxib at a dose of 20 mg/kg in addition to those listed above. The treatments continued daily for 28 days. The object recognition task (ORT) and Morris water maze (MWM) are used to evaluate the learning and memory.

Results:

Alcohol or restrain stress significantly increased the time and distance needed to find the hidden platform in MWM. Furthermore, they decreased the recognition index in ORT compared to the control group. Administration of celecoxib significantly decreased the required time and traveled distance to reach the platform in alcohol-treated animals but not in the stress-exposed rats. Celecoxib also significantly increased the recognition index both in alcohol- or restraint stress-exposed animals.

Conclusion:

We found that either alcohol or restraint stress impairs memory in rats. In MWM, celecoxib improved the alcohol-induced memory impairment but could not show a reduction in memory deterioration due to restraint stress. In ORT, celecoxib reversed memory impairment due to both alcohol and restraint stress.

Preparing for the COVID-19 paediatric mental health crisis: A focus on youth reactions to caretaker death

To promote clinician preparedness for working with children and adolescents who lost or will lose a parent or caretaker to COVID-19, findings from a review of the literature concerning youth reactions to parent and caretaker death and incapacitation were integrated with recent and emergent data concerning the COVID-19 pandemic. Children and adolescents who lose a parent or caretaker are at an increased risk of anxiety and depressive reactions and disorders, externalizing and health-risk behaviours, and substance use disorders. Particular aspects of the COVID-19 pandemic may influence these presentations and the risk of complicated grief. Youth with prior histories of adverse childhood experiences as well as boys and young men may require special considerations in formulation and planning. Tailored paediatric care based on the evidence advances accurate formulations and effective interventions for children and adolescents who suffer such a loss.

Intrinsic brain functional connectivity patterns in alcohol use disorder

Alcohol use disorder is associated with damaging effects to the brain. This study aimed to examine differences in static and dynamic intrinsic functional connectivity patterns in individuals with a history of alcohol use disorder in comparison to those with no history of alcohol abuse. A total of 55 participants consisting of 23 patients and 32 control individuals underwent neuropsychological assessments and resting-state functional magnetic resonance imaging on a 3 Tesla MRI scanner. Differences in functional connectivity between the two groups were determined using static and dynamic independent component analysis. Differences in static functional connectivity between the two groups were identified in the default mode network, attention network, frontoparietal network, frontal cortical network and cerebellar network. Furthermore, the analyses revealed specific differences in the dynamic temporal characteristics of functional connectivity between the two groups of participants, in a cluster involving key regions in reward, sensorimotor and frontal cortical functional networks, with some connections correlating with the length of sobriety and some others with the severity of drinking. The findings altogether suggest dysregulation in the intrinsic connectivity of cortico-basal ganglia-thalamo-cortical loops that may reflect persistent alcohol use disorder-related network abnormalities, compensatory recovery-related processes whereby additional neural resources are recruited to achieve normal levels of performance, or a predisposition toward developing alcohol use disorder.

Underage access to alcohol and its impact on teenage drinking and crime

Does underage access to alcohol increase teenage drinking and crime? To address this question, I leverage a discontinuity in legal access to alcohol at age 16 in Germany, a country with high consumption levels and a particularly early access regulation. Using detailed survey data and administrative crime records from 2005 to 2015, I detect considerable increases in drinking participation, frequency, and intensity at the legal cutoff along the middle and lower end of the distribution. These increases coincide with discrete jumps in criminal engagement under the influence of alcohol, mostly due to violent and property crimes. My findings suggest that changes in drinking intensity induce these crimes, implying a drinking-crime elasticity of 0.4 at age 16.

Anti-saccade as a Tool to Evaluate Neurocognitive Impairment in Alcohol Use Disorder

It has been widely shown that chronic alcohol use leads to cognitive dysfunctions, especially inhibitory control. In an extension of the traditional approach, this research field has benefited from the emergence of innovative measures, among which is an anti-saccade, allowing direct and sensitive measure of the eye movements indexing attention bias to alcohol-related cues and the capability of inhibiting the reflexive saccades to the cues. During the past decade, there are numerous reports showing that drinkers make more unwanted reflexive saccades and longer latency in the anti-saccade task. These increased errors are usually explained by the deficits in inhibitory control. It has been demonstrated that inhibitory control on eye movement may be one of the earliest biomarkers of the onset of alcohol-related cognitive impairments. This review summarizes how an anti-saccade task can be used as a tool to investigate and assess the cognitive dysfunctions and the early detection of relapsing risk of alcohol dependence.

Adolescent neuroimmune function and its interaction with alcohol

Adolescence is an evolutionarily conserved developmental period associated with behavioral change, including increased risk-taking and alcohol use. Experimentation with alcohol typically begins in adolescence and transitions to binge-like patterns of consumption. Alcohol exposure during adolescence can alter normative changes in brain structure and function. Understanding mechanisms by which ethanol impacts neurodevelopmental processes is important for preventing and ameliorating the deleterious consequences of adolescent alcohol abuse. This review focuses on the neuroimmune system as a key contributor to ethanol-induced changes in adolescent brain and behavior. After brief review of neuroimmune system development, acute and chronic effects of ethanol on adolescent neuroimmune functioning are addressed. Comparisons between stress/immunological challenges and ethanol on adolescent neuroimmunity are reviewed, as cross-sensitization is relevant during adolescence. The mechanisms by which ethanol alters neuroimmune functioning are then discussed, as they may portend development of neuropathological consequences and thus increase vulnerability to subsequent challenges and potentiate addictive behaviors.

Local and network-level dysregulation of error processing is associated with binge drinking

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Go/NoGo performance does not differ between binge (BDs) and light drinkers.

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BDs show greater BOLD activity to inhibition errors primarily in prefrontal areas.

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Greater functional connectivity in the frontal cortex correlates with drinking.

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Observed increase in error-related activity may serve a compensatory role.

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This is consistent with allostatic hyperexcitability reflecting neuroadaptation.

Binge drinking refers to the pattern of alcohol consumption that brings blood alcohol levels to or above legal intoxication levels. Commonly practiced by young adults, it is associated with neurofunctional alterations, raising health-related concerns. Executive deficits may contribute to the inability to refrain from excessive alcohol intake. As a facet of cognitive control, error processing allows for flexible modification of behavior to optimize future outcomes. It is highly relevant to addiction research, as a failure to inhibit excessive drinking results in relapses, which is a hallmark of alcohol use disorder. However, research on local and system-level neural underpinnings of inhibition failures as a function of binge drinking is limited. To address these gaps, functional magnetic resonance imaging (fMRI) was used to examine local changes and interregional functional connectivity during response inhibition errors on a Go/NoGo task. Young adult binge drinkers (BDs) performed equally well as light drinkers (LDs), a group of demographically matched individuals who drink regularly but in low-risk patterns. In contrast, BDs exhibited greater fMRI activity to inhibition errors contrasted with correct NoGo trials in the rostral anterior (rACC) and posterior cingulate cortices (PCC), as well as right middle frontal gyrus (R-MFG). Furthermore, BDs showed increased connectivity between the rACC and right lateral prefrontal cortex, in addition to greater connectivity between the R-MFG and the left ventrolateral and superior frontal cortices. Imaging indices were positively correlated only with alcohol-related measures, but not with those related to moods, disposition, or cognitive capacity. Taken together, greater error-related activity and expanded functional connectivity among prefrontal regions may serve a compensatory role to maintain efficiency of inhibitory control. Aligned with prominent models of addiction, these findings accentuate the importance of top-down control in maintaining low-risk drinking levels. They provide insight into potentially early signs of deteriorating cognitive control functions in BDs and may help guide intervention strategies aimed at preventing excessive drinking habits.

Effects of a web-based alcohol drinking prevention program linking school-to-home in elementary students

OBJECTIVES

We investigated the effects of a web-based alcohol drinking prevention program among early elementary school students in South Korea using the theory of planned behavior. This study utilized a combined family and school intervention approach.

DESIGN

This was a quasi-experimental study with a non-equivalent control group.

SAMPLE

A total of 251 third graders (experimental group: 170, control group: 81) from four public schools were included.

MEASUREMENTS

A web-based alcohol drinking prevention program was implemented in five weekly sessions. Students' attitudes, subjective norms, perceived behavioral control (PBC), and intentions toward alcohol drinking prevention behavior were evaluated through pre- and post-tests.

RESULTS

The average age of the participants was 9 years in both the experimental (82 male and 88 female students) and control (44 male and 37 female students) groups. A significant improvement in attitudes, PBC, and intentions toward alcohol drinking prevention behaviors was found in the experimental group.

CONCLUSIONS

A web-based alcohol drinking prevention program combining family and school interventions for lower elementary school students was effective at increasing intentions toward alcohol drinking prevention behavior. Alcohol drinking prevention programs should target lower elementary school students to effectively postpone the onset of alcohol drinking.

Adolescent alcohol use in Estonia compared with Latvia, Lithuania, Finland and Sweden: results from cross-sectional surveys, 2003-2015

OBJECTIVES

The aims of the study were (1) to describe trends in the prevalence of monthly alcohol use from 2003 to 2015 and (2) to analyse the associations between alcohol use and family-related and school-related factors, risk behaviours and perceived alcohol availability in Estonia compared with Latvia, Lithuania, Finland and Sweden.

METHODS

The study used nationally representative data of 15-16-year-old adolescents from the European School Survey Project on Alcohol and Other Drugs. Data from Estonia, Latvia, Lithuania, Finland and Sweden collected in 2003, 2007, 2011 and 2015 were utilised (n=57 779). The prevalence of monthly alcohol use including light and strong alcohol use was calculated for each study year. A χ² test for trend was used to evaluate statistically significant changes in alcohol use over the study period. A multilevel logistic regression analysis was used for assessing the association between alcohol use and explanatory factors. Marginal ORs with 95% CIs for each country were calculated.

RESULTS

Monthly alcohol use decreased significantly among boys and girls in all countries from 2003 to 2015. In 2015, the prevalence of monthly alcohol use among boys was 36.1% in Estonia, 44.3% in Latvia, 32.4% in Lithuania, 32.3% in Finland and 22.4% in Sweden. Among girls, it was 39.1%, 45.9%, 35.6%, 31.8% and 29.1%, respectively. In all countries, higher odds of monthly alcohol use were observed among adolescents who skipped school, smoked cigarettes, used cannabis, perceived alcohol to be easy to access and had parents who did not know always/often about their child's whereabouts on Saturday nights. Compared with Estonia, associations between alcohol use and explanatory factors were similar in Latvia and Lithuania but different in Finland and Sweden.

CONCLUSION

Results of cross-national comparison of alcohol use and explanatory factors could be effectively used to further decrease alcohol use among adolescents.

Alcohol use and brain morphology in adolescence: A longitudinal study in three different cohorts

Alcohol consumption is commonly initiated during adolescence, but the effects on human brain development remain unknown. In this multisite study, we investigated the longitudinal associations of adolescent alcohol use and brain morphology. Three longitudinal cohorts in the Netherlands (BrainScale n = 200, BrainTime n = 239 and a subsample of the Generation R study n = 318) of typically developing participants aged between 8 and 29 years were included. Adolescent alcohol use was self‐reported. Longitudinal neuroimaging data were collected for at least two time points. Processing pipelines and statistical analyses were harmonized across cohorts. Main outcomes were global and regional brain volumes, which were a priori selected. Linear mixed effect models were used to test main effects of alcohol use and interaction effects of alcohol use with age in each cohort separately. Alcohol use was associated with adolescent's brain morphology showing accelerated decrease in grey matter volumes, in particular in the frontal and cingulate cortex volumes, and decelerated increase in white matter volumes. No dose–response association was observed. The findings were most prominent and consistent in the older cohorts (BrainScale and BrainTime). In summary, this longitudinal study demonstrated differences in neurodevelopmental trajectories of grey and white matter volume in adolescents who consume alcohol compared with non‐users. These findings highlight the importance to further understand underlying neurobiological mechanisms when adolescents initiate alcohol consumption. Therefore, further studies need to determine to what extent this reflects the causal nature of this association, as this longitudinal observational study does not allow for causal inference.

Adolescent exposure to delta-9-tetrahydrocannabinol and ethanol heightens sensitivity to fear stimuli

Cannabis use disorder (CUD) has doubled in prevalence over the past decade as a nation-wide trend toward legalization allows for increased drug accessibility. As a result, marijuana has become the most commonly used illicit drug in the United States particularly among the adolescent population. This is especially concerning since there is greater risk for the harmful side effects of drug use during this developmental period due to ongoing brain maturation. Increasing evidence indicates that CUD often occurs along with other debilitating conditions including both alcohol use disorder (AUD) and anxiety disorders such post-traumatic stress disorder (PTSD). Additionally, exposure to cannabis, alcohol, and stress can induce alterations in glutamate regulation and homeostasis in the prefrontal cortex (PFC) that may lead to impairments in neuronal functioning and cognition. Therefore, in order to study the relationship between drug exposure and the development of PTSD, these studies utilized rodent models to determine the impact of adolescent exposure to delta-9-tetrahydrocannabinol (THC) and ethanol on responses to fear stimuli during fear conditioning and used calcium imaging to measure glutamate activity in the prelimbic cortex during this behavioral paradigm. The results from these experiments indicate that adolescent exposure to THC and ethanol leads to enhanced sensitivity to fear stimuli both behaviorally and neuronally. Additionally, these effects were attenuated when animals were treated with the glutamatergic modulator N-acetylcysteine (NAC). In summary, these studies support the hypothesis that adolescent exposure to THC and ethanol leads to alterations in fear stimuli processing through glutamatergic reliant modifications in PFC signaling.

Neuroepigenetic consequences of adolescent ethanol exposure

Adolescence is a critical developmental period characterized by ongoing brain maturation processes including myelination and synaptic pruning. Adolescents experience heightened reward sensitivity, sensation seeking, impulsivity, and diminished inhibitory self-control, which contribute to increased participation in risky behaviors, including the initiation of alcohol use. Ethanol exposure in adolescence alters memory and cognition, anxiety-like behavior, and ethanol sensitivity as well as brain myelination and dendritic spine morphology, with effects lasting into adulthood. Emerging evidence suggests that epigenetic modifications may explain these lasting effects. Focusing on the amygdala, prefrontal cortex and hippocampus, we review studies investigating the epigenetic consequences of adolescent ethanol exposure. Ethanol metabolism globally increases donor substrates for histone acetylation and histone and DNA methylation, and this chapter discusses how this can further impact epigenetic programming of the adolescent brain. Elucidation of the mechanisms through which ethanol can alter the epigenetic code at specific transcripts may provide therapeutic targets for intervention.

Characterising the number and type of presentations to a tertiary emergency department by young people affected by drugs and alcohol

Objective The aim of this study was to investigate the frequency and type of emergency department (ED) presentations involving drugs and/or alcohol (DA) among young people. Methods A retrospective chart review was conducted of patients aged 14-25 years who presented to the ED at a tertiary hospital between 7 October and 25 November 2013. Data were collected on standardised data sheets, including whether DA was a factor in the patient's presentation. Results In all, 713 ED presentations of patients aged 14-25 years were included in this review (mean age 20 years). Of these, 94 (13%) presentations involved DA (median blood alcohol level 0.12%; range 0.01-0.39%); among patients aged 14-17 years, 13 (8%) presentations involved DA. Patient presentations involving DA were more likely to occur overnight and at weekends, had higher Australasian Triage Scale scores and had longer ED lengths of stay. These patients were also more likely to present with aggression, because of an assault, or with mental health disorders. Conclusion DA are involved in a substantial number of presentations of young people to the ED and are associated with an increased risk of assault and aggression. Public health strategies should target the links between DA use and mental health in young people. What is known about the topic already? It is known that the use of alcohol and drugs in young people is an ongoing public health concern. Research suggests this cohort of the population is more likely to present to an ED with an injury than the comparative age group not intoxicated by drugs or alcohol, and is more likely to be reviewed after hours. Alcohol is the predominant drug that had been used by young people at the time of the present study. What does this paper add? This paper reviews the number and types of presentations to a tertiary ED. In so doing, many more areas were researched (rather than simply link to injury) and, as a result, it was found that young people present to the ED with an increased risk of mental health issues and an increased risk of aggression. The study also found that young people intoxicated with DA most commonly presented for different reasons than the same sober cohort. What are the implications for practitioners? We know that young people intoxicated with DA represent a different public health issue than the sample group, and, as a result, public health initiatives must concentrate on the confounding factors of the presenting complaint, notably education surrounding the risk of mental health disturbance and increased aggression rates. Furthermore, the study should benefit practitioners, showing that more mental health services should be available after hours for this cohort presenting with issues related to DA.

[Alcohol use before the age of 14: marker variable or independent risk factor?]

BACKGROUND

Even if the legal age for alcoholic beverages in Germany is 16 or 18, the majority of young people have tried alcohol before this age. Parents are a frequent source of supply, especially for small amounts of alcohol ("sipping").

AIM OF THE WORK

To investigate whether trying small amounts of alcohol is an independent predictor for binge drinking initiation.

MATERIAL AND METHODS

A longitudinal analysis was carried out with 2566 students from 6th to 8th grade from thirteen German federal states (survey period 2018 to 2020). Inclusion criteria were an age of 13 years or younger and had never drunk a full drink of alcohol. The main study parameter was the first binge drinking event within 12 months.

RESULTS

Of the respondents, 35.9% stated that they had already tried alcohol but had not yet drunk a whole drink, while 64.1% had not yet had any experience with alcohol. After 12 months, those who had tried alcohol stated more often that they had already practiced binge drinking. This relationship persisted even after all study variables associated with binge drinking were controlled including age, type of school, sensation seeking, smoking, consumption of energy drinks and coffee, media time, sleep duration, hyperactivity, and behavior problems (adjusted odds ratio = 2.33; 95% CI 1.64-3.31).

DISCUSSION

There was an independent association between prematurely trying alcohol and the onset of binge drinking. The findings are in line with those of other studies that question the practice of early alcohol exposure. However, further studies are necessary to establish a causal relationship.

Moderate adolescent chronic intermittent ethanol exposure sex-dependently disrupts synaptic transmission and kappa opioid receptor function in the basolateral amygdala of adult rats

Adolescent alcohol exposure is associated with many consequences in adulthood, including altered affective and reward-related behaviors. However, the long-term neurological disruptions underlying these behaviors are not fully understood. Shifts in the excitatory/inhibitory balance in the basolateral amygdala (BLA) relate to the expression of these behaviors and changes to BLA physiology are seen during withdrawal immediately following adolescent ethanol exposure, but no studies have examined whether these changes persist long-term. The kappa opioid receptor (KOR) neuromodulatory system mediates negative affective behaviors, and alterations of this system are implicated in behavioral changes following adult and adolescent chronic ethanol exposure. In the BLA, the KOR system undergoes functional changes across development, but whether BLA KOR function is disrupted by adolescent ethanol exposure is unknown. In this study, male and female Sprague-Dawley rats were exposed to a vapor model of moderate adolescent chronic intermittent ethanol (aCIE) and assessed for long-term effects on GABAergic and glutamatergic neurotransmission within the adult BLA and KOR modulation of these systems. aCIE exposure increased presynaptic glutamate transmission in females but had no effect in males or on GABA transmission in either sex. Additionally, aCIE exposure disrupted male KOR modulation of GABA release, with no effects in females or on glutamate transmission. These data suggest that aCIE produces sex-dependent and long-term changes to BLA physiology and KOR function. This is the first study to examine these persistent adaptations following adolescent alcohol exposure and opens a broad avenue for future investigation into other adolescent ethanol-induced disruptions of these systems.

How adolescents' working memory abilities relate to their alcohol craving in real-life contexts depends on biological sex

AIM

We sought to elucidate whether stress, peers, and in vivo (i.e., direct) alcohol cues elicit alcohol craving in daily life among adolescents and to test whether individual variation in working memory function and biological sex alters these associations.

METHODS

We leveraged ecological momentary assessment (EMA) to examine momentary associations between stress, peers, and direct alcohol cues with craving, assessed as "urge to drink alcohol," among 86 male (51.2 %) and female (48.8 %) frequent drinkers (i.e., two or more drinking days per week). Participants were ages 14-24 years (M = 20.7 years, SD = 2.1). Participants completed EMA throughout the day for about one week prior to randomization to a treatment condition for an AUD clinical trial. Pre-registered, secondary analyses focused on craving for assessments when adolescents were not drinking, and assessments occurring after drinking on drinking days were removed. Working memory performance was assessed in the laboratory via the Memory for Words subtest of the Woodcock-Johnson III Tests of Cognitive Abilities.

RESULTS

Craving was heightened at more stressful moments and when adolescents were with their peers and in the presence of direct alcohol cues. Working memory function was not related to craving but altered the relation of momentary stress, peers, and cues with craving once biological sex-related differences were considered. Females generally had lower craving than males, but working memory function served to buffer against stress-induced craving for males.

CONCLUSIONS

Higher working memory function buffered the in-the-moment relation of stress with alcohol craving for males but not females.

Determination of the Relationship Between Craving and 4-repeat Allele of DRD4 Gene Polymorphism in the Early Withdrawal Period of Alcohol Use Disorders

OBJECTIVE

Alcohol use disorder (AUD) is a disease with chronic relapses. Risk factors of craving, which is thought to be one of the predictors of relapse, have been studied for a long time. The DRD4 gene is located on chromosome 11p and has a 48-base pair variable number of tandem repeat (VNTR) polymorphisms in the 3rd exon. This study aimed to investigate if a relationship existed between craving and DRD4 VNTR polymorphism and to determine the predictors of craving.

METHODS

A total of 125 patients with AUD were included in the study. The sociodemographic data form, the Michigan Alcoholism Screening Test (MAST), the Obsessive Compulsive Drinking Scale (OCDS), and the Penn Alcohol Craving Scale (PACS) were applied to the patients. Polymerase chain reaction (PCR) was used to determine the DRD4 VNTR variant of all participants in the peripheral blood sample.

RESULTS

In the 4R/4R homozygous group, it was found that the age at first alcohol use was higher and the scores of the OCDS on the seventh day were lower, but this relationship could not be demonstrated in further statistical analyses. In the stepwise linear regression model, the age at first alcohol use, MAST score, duration of AUD, and delirium tremens history were found to be the predictors of craving.

CONCLUSION

DRD4 VNTR polymorphism does not play a role as a predictor of craving. A decrease in age at first alcohol use, an increase in the MAST score, and the presence of delirium tremens were found to be the predictors of craving among the participants of this study.

Visuoperceptive Impairments in Severe Alcohol Use Disorder: A Critical Review of Behavioral Studies

The present literature review is aimed at offering a comprehensive and critical view of behavioral data collected during the past seventy years concerning visuoperception in severe alcohol use disorders (AUD). To pave the way for a renewal of research and clinical approaches in this very little understood field, this paper (1) provides a critical review of previous behavioral studies exploring visuoperceptive processing in severe AUD, (2) identifies the alcohol-related parameters and demographic factors that influence the deficits, and (3) addresses the limitations of this literature and their implications for current clinical strategies. By doing so, this review highlights the presence of visuoperceptive deficits but also shows how the lack of in-depth studies exploring the visual system in this clinical population results in the current absence of integration of these deficits in the dominant models of vision. Given the predominance of vision in everyday life, we stress the need to better delineate the extent, the specificity, and the actual implications of the deficits for severe AUD.

Alcohol consumption in early adolescence: Associations with sociodemographic and psychosocial factors according to gender

Introduction

Early alcohol consumption can irreversible damage the adolescents’ brain and may affect their quality of life. In order to better prevent such a deleterious behaviour, knowing its determinants is needed. So far, only few studies among adolescents aged <15 years exist, of which the majority failed to include gender differences. Therefore, the aim of this study was to investigate whether gender differences in the association between alcohol use and sociodemographic and psychosocial characteristics among 10-14-year olds exist.

Methods

Data came from the 2018 Health Behaviour in School-Aged Children (HBSC) study conducted in French-speaking schools of Belgium. The sample analysed here comprised 4,364 10-14-year olds from the Walloon Region. Associations of the recent alcohol consumption (at least one glass during the past month) with sociodemographic and psychosocial characteristics were estimated using gender-stratified multivariable logistic regression modelling.

Results

Prevalence of early alcohol consumption was 14% (boys: 16%; girls: 12%). Migration status and family affluence scale (FAS) were associated with early alcohol consumption only in boys. Second-generation immigrant boys (vs. natives: OR = 0.66 [0.47–0.92]) and boys from “low” FAS families (vs. “high”: OR = 0.56 [0.32–0.98]) or “medium” FAS (vs. “high”: OR = 0.63 [0.43–0.92]) were less likely to have consumed alcohol in the past month. In both genders, alcohol consumption was positively associated with age and inversely associated with school satisfaction and family support. No association was observed with family structure, peer support and life satisfaction in the multivariable models.

Conclusion

Our findings showed that gender differences may exist in the determinants of alcohol consumption among young adolescents. They will contribute to the development of public health policies and actions for the most vulnerable adolescents, which should take gender differences into account.

Moderate Adolescent Ethanol Vapor Exposure and Acute Stress in Adulthood: Sex-Dependent Effects on Social Behavior and Ethanol Intake in Sprague-Dawley Rats

Adolescent alcohol use can lead to numerous consequences, including altered stress reactivity and higher risk for later anxiety and alcohol use disorders. Many studies have examined the consequences of heavy ethanol exposure in adolescence, but far less is understood about lower levels of intoxication. The present study examined moderate adolescent ethanol exposure as a possible factor in increasing stress reactivity in adulthood, measured through general and social anxiety-like behaviors, as well voluntary ethanol intake. Male and female Sprague-Dawley rats underwent an adolescent chronic intermittent ethanol (aCIE) vapor exposure during early adolescence, reaching moderate blood ethanol concentrations. Animals then underwent two days of forced swim stress in adulthood. We found that ethanol-exposed males consumed more ethanol than their air counterparts and an interesting stress and ethanol exposure interaction in males. There were no significant effects on voluntary drinking in females. However, the social interaction test revealed increased play-fighting behavior in ethanol-exposed females and reduced social preference in females after two days of stress exposure. Overall, this work provides evidence for sex-specific, long-term effects of moderate aCIE and susceptibility to acute stress in adulthood.

Constitutive Genetic Deletion of Hcn1 Increases Alcohol Preference during Adolescence

The hyperpolarization-activated cyclic nucleotide-gated channel (HCN), which underlies the hyperpolarization-activated cation current (I_h), has diverse roles in regulating neuronal excitability across cell types and brain regions. Recently, HCN channels have been implicated in preclinical models of substance abuse including alcohol. In the prefrontal cortex of rodents, HCN expression and I_h magnitude are developmentally regulated during adolescence and may be vulnerable to alcohol’s effects. In mice, binge alcohol consumption during the adolescent period results in a sustained reduction in I_h that coincides with increased alcohol consumption in adulthood, yet the direct role HCN channels have on alcohol consumption are unknown. Here, we show that the genetic deletion of Hcn1 causes an increase in alcohol preference on intermittent 2-bottle choice task in homozygous null (HCN1^−/−) male mice compared to wild-type littermates without affecting saccharine or quinine preference. The targeted viral deletion of HCN1 in pyramidal neurons of the medial prefrontal cortex resulted in a gradual loss of Hcn1 expression and a reduction in I_h magnitude during adolescence, however, this did not significantly affect alcohol consumption or preference. We conclude that while HCN1 regulates alcohol preference, the genetic deletion of Hcn1 in the medial prefrontal cortex does not appear to be the locus for this effect.

Factors related to heavy drinking between British Columbia Asian adolescents and South Korean adolescents

PURPOSE

The aim of this study is to compare the factors related to heavy drinking among British Columbia (BC) Asian adolescents and South Korean adolescents.

DESIGN AND METHODS

A cross-sectional descriptive design was used. Participants were 72,422 adolescents (12,382 BC Asian adolescents and 60,040 South Korean adolescents) from the 2018 BC Adolescent Health Survey and the 2018 Korean Youth Risk Behavior Web-Based Survey. Complex samples descriptive statistics, Rao-Scott χ² tests, and complex samples logistic regression analyses were performed.

RESULTS

Heavy drinking was reported by 8.6% of BC Asian adolescents and 7.7% of South Korean adolescents. Asian adolescents in BC and South Korea shared six risk factors and one protective factor linked to odds of heavy drinking. The strongest risk factor for heavy drinking in each region was current cigarette smoking. Other risk factors for heavy drinking included older age/higher grade (10/12th), early initiation of sexual intercourse (age 14 or younger), experiences of bullying, depression, and exercise. The only protective factor for heavy drinking, sufficient sleep, was similar in both regions.

PRACTICE IMPLICATIONS

This study suggests several nursing interventions and health promotion strategies to help us to prevent or reduce heavy drinking for BC Asian adolescents and South Korean adolescents.

Onset Age of Substance Use and Neuropsychological Performance in Hospital Patients

OBJECTIVE

Several studies have found neurocognitive deficits in adolescents following substance abuse. Predisposing risk factors may further impact vulnerability to neurocognitive deficits. Little is known about the cognitive performance of adult onset substance users compared to earlier onset users. This study aims to explore differences in neuropsychological functioning between early (EOAs) and late onset substance abusers (LOAs) when the effects of confounding factors are controlled.

METHOD

Data for this cross-sectional study was collected from hospital patients. A total of 164 patients with substance use disorder (SUD) aged 19 to 65, 76 with single-drug diagnosis and 88 with multidrug diagnosis, underwent neuropsychological tests for verbal capacity, attention, speed of processing, perceptual reasoning, memory and learning, executive functioning, and inhibitory capacity. Associations between regular onset age and neuropsychological measures were analysed using in multi-way ANCOVA, and the effect of age, multiple substance abuse, education level and learning difficulties were controlled.

RESULTS

Compared with LOAs, EOAs had weaker performance in the Digit Symbol test for mono-substance users. Meanwhile, compared with EOAs, LOAs had weaker performance in the Delayed Visual Memory test and the Raven test for mono-substance users, and the Block Design test for poly-substance users. From the confounding factors, early onset age of substance use is heightened among individuals with learning disabilities.

CONCLUSIONS

Onset age of substance use is related to the deterioration of performance in neuropsychological tests. Premorbid poor learning and inhibitory capacity may be important predisposing risk factors of SUD. Conversely, high level of education may be a protective factor for cognitive performance in patients with SUD.

Twenty-first birthday drinking: Extreme-drinking episodes and white matter microstructural changes in the fornix and corpus callosum

The 21st birthday celebration is characterized by extreme alcohol consumption. Accumulating evidence suggests that high-dose bingeing is related to structural brain changes and cognitive deficits. This is particularly problematic in the transition from adolescence to adulthood when the brain is still maturing, elevating the brain's sensitivity to the acute effects of alcohol intoxication. Heavy drinking is associated with reduced structural integrity in the hippocampus and corpus callosum and is accompanied by cognitive deficits. However, there is little research examining changes in the human brain related to discrete heavy-drinking episodes. The present study investigated whether alcohol exposure during a 21st birthday celebration would result in changes to white matter microstructure by utilizing diffusion tensor imaging measures and a quasi-experimental design. By examining structural changes in the brain from pre- to postcelebration within subjects (N = 49) prospectively, we were able to more directly observe brain changes following an extreme-drinking episode. Region of interest analyses demonstrated increased fractional anisotropy in the posterior fornix (p < .0001) and in the body of the corpus callosum (p = .0029) from pre- to postbirthday celebration. These results suggest acute white matter damage to the fornix and corpus callosum following an extreme-drinking episode, which is especially problematic during continued neurodevelopment. Therefore, 21st birthday drinking may be considered an important target event for preventing acute brain injury in young adults. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Role of mTOR-regulated autophagy in spine pruning defects and memory impairments induced by binge-like ethanol treatment in adolescent mice

Adolescence is a brain maturation developmental period during which remodeling and changes in synaptic plasticity and neural connectivity take place in some brain regions. Different mechanism participates in adolescent brain maturation, including autophagy that plays a role in synaptic development and plasticity. Alcohol is a neurotoxic compound and its abuse in adolescence induces neuroinflammation, synaptic and myelin alterations, neural damage and behavioral impairments. Changes in synaptic plasticity and its regulation by mTOR have also been suggested to play a role in the behavioral dysfunction of binge ethanol drinking in adolescence. Therefore, by considering the critical role of mTOR in both autophagy and synaptic plasticity in the developing brain, the present study aims to evaluate whether binge ethanol treatment in adolescence would induce dysfunctions in synaptic plasticity and cognitive functions and if mTOR inhibition with rapamycin is capable of restoring both effects. Using C57BL/6 adolescent female and male mice (PND30) treated with ethanol (3 g/kg) on two consecutive days at 48‐hour intervals over 2 weeks, we show that binge ethanol treatment alters the density and morphology of dendritic spines, effects that are associated with learning and memory impairments and changes in the levels of both transcription factor CREB phosphorylation and miRNAs. Rapamycin administration (3 mg/kg) prior to ethanol administration restores ethanol‐induced changes in both plasticity and behavior dysfunctions in adolescent mice. These results support the critical role of mTOR/autophagy dysfunctions in the dendritic spines alterations and cognitive alterations induced by binge alcohol in adolescence.