Direct and mediated associations between P300 amplitude in childhood and substance use disorders outcome in young adulthood

Parietal P3 and midfrontal theta prospectively predict the development of adolescent alcohol use

BACKGROUND

Subclinical adolescent alcohol use is highly prevalent and may have deleterious effects on important psychosocial and brain outcomes. Prior research has focused on identifying endophenotypes of pathological drinking, and the predictors of normative drinking remain understudied. This study investigated the incremental predictive value of two potential psychophysiological endophenotypes, P3 amplitude (an index of decision making) and midfrontal theta power (a correlate of attentional control), for prospectively predicting the expression and initiation of alcohol use emerging in adolescence.

METHODS

A large (N = 594) epidemiological sample was prospectively assessed at ages 11/14/17. Alcohol/substance use was assessed at all ages via a computerized self-report inventory. EEG was recorded at age-14 during a visual oddball task to elicit P3 and theta.

RESULTS

Reduced target-related P3 and theta at age-14 prospectively predicted drinking at age-17 independent of one another. Among alcohol-naive individuals at age-14, attenuated P3 and theta increased the odds of new-onset alcohol behaviors 3 years later. Importantly, the endophenotypes provided significant incremental predictive power of future non-clinical alcohol use beyond relevant risk factors (prior alcohol use; tobacco/illicit drug initiation; parental alcohol use disorder).

CONCLUSIONS

The current report is the first of our knowledge to demonstrate that deviations in parietal P3 and midfrontal theta prospectively predict the emergence of normative/non-pathological drinking. P3 and theta provide modest yet significant explanatory variance beyond prominent self-report and familial risk measures. Findings offer strong evidence supporting the predictive utility of P3 and theta as candidate endophenotypes for adolescent drinking.

The difference between trait disinhibition and impulsivity-and why it matters for clinical psychological science

In the psychological science field, there is substantial interest in quantifying individual differences in self-regulatory capacity because of its transdiagnostic relevance to various forms of psychopathology. Trait disinhibition and impulsiveness are popular conceptualizations of dispositions reflecting self-regulation of behavioral and emotional responding. In the literature, these constructs are often treated interchangeably because of their shared focus on general disconstraint and a lack of direct comparisons between measures of each. The current work used structural modeling to examine conceptual and empirical differences between 2 popular operationalizations of these traits in 2 samples (Ns = 400, 308), and employed regression and dominance analyses to compare their predictive relations with criterion measures of externalizing problems and negative affectivity (NA). Impulsigenic traits were related both to externalizing problems and NA, whereas trait disinhibition was selectively associated with externalizing. In a dominance analysis, trait disinhibition exhibited complete dominance over all impulsigenic traits in predicting externalizing problems. Conversely, multiple impulsigenic traits evidenced complete dominance over trait disinhibition in prediction of NA. The current work provides evidence that (a) disinhibition and impulsigenic traits are not interchangeable, (b) disinhibition specifically indexes propensity for externalizing problems, and (c) impulsigenic traits reflect a blend of externalizing and NA that appears relevant to diverse forms of psychopathology. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Target-related parietal P3 and medial frontal theta index the genetic risk for problematic substance use

Theoretical and empirical work suggests that problematic substance use (PSU) is associated with individual differences in prefrontal cortex activity. While research has strongly linked parietal P3 amplitude reduction (P3AR) to genetic risk for problematic substance use, few studies have tested whether prefrontal EEG measures are sensitive to this genetic liability. In addition to P3, oddball target detection tasks elicit medial frontal theta power, reflecting attentional allocation, and parietal delta, indexing decision making or stimulus-response link updating. Midfrontal theta and parietal delta may index neurocognitive processes relevant to PSU beyond P3AR. The present investigation examined the etiological relationship between PSU and P3, frontal theta, and parietal delta in a large twin sample (N = 754). EEG was recorded during a visual oddball task. Greater PSU was associated with reduced target P3 amplitude and midfrontal theta/parietal delta power, and increased mean reaction time and reaction time variability (RTV; indexing attentional fluctuations). P3, theta, and RTV, but not delta or mean RT, explained unique variance in PSU (R2  = 0.04). Twin biometric modeling indicated a genetic relationship between PSU and P3, theta, and RTV. Theta accounted for distinct genetic variance in PSU beyond P3 and RTV. Together, 23% of the total additive genetic variance in PSU was explained by the three endophenotypes. Results replicate P3AR as an endophenotype and provide support for additional behavioral (RTV) and neurophysiological (midfrontal theta) endophenotypes of PSU. Reduced theta and greater RTV may reflect variations in a prefrontal attentional network that confers genetic risk for substance use problems.

Sustained dysfunctional information processing in patients with Internet gaming disorder: 6-month follow-up ERP study

Internet gaming disorder (IGD), defined as an inability to control Internet-based game play, leads to serious impairment in psychological and social functioning, but few studies have identified the neurophysiological characteristics of patients with IGD. The aim of this study was to determine neurophysiological markers of P300 components associated with changes in symptoms after outpatient management with pharmacotherapy in patients with IGD. The present prospective longitudinal study included 18 patients with IGD and 29 healthy controls. The patients with IGD completed a 6-month outpatient management program including selective serotonin reuptake inhibitor-based pharmacotherapy. Event-related potentials (ERPs) were acquired during the auditory oddball task. ERPs of the patients with IGD were recorded before and after treatment. Between-group differences and the pre-to-post treatment differences in P300 components were investigated using repeated-measures analysis of variance. The primary treatment outcome was a change in score on Young Internet Addiction Test between before and after treatment. At baseline assessments, the IGD group showed significantly reduced P300 amplitudes and delayed latencies at the midline centro-parietal site compared with those in the healthy controls. No significant changes in the P300 indices were observed between pre and post-treatment in the patients with IGD after 6 months of treatment, even though the patients with IGD exhibited significant improvements in their IGD symptoms. Furthermore, no significant difference in ERPs was observed between responders and nonresponders to a 6-month treatment in patients with IGD. These results suggest that reduced P300 amplitudes and delayed latencies are candidate endophenotypes in the pathophysiology of IGD.

Less Efficient Neural Processing Related to Irregular Sleep and Less Sustained Attention in Toddlers

The current study used event-related potentials to examine a candidate process through which sleep difficulties affect attentional processing in toddlers. Fifteen toddlers participated in an auditory Oddball task while neurophysiological data were collected. Sleep deficits were assessed using actigraphs, and attention was examined with a sustained attention task. A P3-like component was elicited from the toddlers, and longer target P3 latencies were associated with poorer sustained attention and irregular sleep. Findings suggest that irregular sleep is associated with less efficient attentional processing as reflected by the P3 component, and that longer target P3 latencies are associated with poorer sustained attention.

Heritability and molecular-genetic basis of the P3 event-related brain potential: a genome-wide association study

P3 amplitude is a candidate endophenotype for disinhibitory psychopathology, psychosis, and other disorders. The present study is a comprehensive analysis of the behavioral- and molecular-genetic basis of P3 amplitude and a P3 genetic factor score in a large community sample (N = 4,211) of adolescent twins and their parents, genotyped for 527,829 single nucleotide polymorphisms (SNPs). Biometric models indicated that as much as 65% of the variance in each measure was due to additive genes. All SNPs in aggregate accounted for approximately 40% to 50% of the heritable variance. However, analyses of individual SNPs did not yield any significant associations. Analyses of individual genes did not confirm previous associations between P3 amplitude and candidate genes but did yield a novel association with myelin expression factor 2 (MYEF2). Main effects of individual variants may be too small to be detected by GWAS without larger samples.

Longitudinal stability and predictive utility of the visual P3 response in adults with externalizing psychopathology

We determined whether time-domain P3 amplitude and time-frequency principal component (TF-PC) reductions could serve as stable and predictive developmental endophenotypes of externalizing psychopathology. Participants from the Minnesota Twin Family Study were assessed at age 17 and again at age 29 for lifetime externalizing (EXT) disorders. Comparisons of P3 amplitude and TF-PCs at delta and theta frequencies were made between EXT and unaffected comparison subjects. P3 amplitude and all five extracted TF-PCs were significantly reduced in those presenting lifetime EXT disorders at both ages 17 and 29 and showed substantial 12-year rank-order stability. P3 amplitude and delta TF-PCs measured at age 17 also predicted subsequent development of EXT by age 29, with every 1-microvolt decrease in age 17 amplitude associated with an approximately 5% increase in risk for an EXT diagnosis by age 29. Overall, results from this study further confirm that these P3-derived brain measures maintain their potential as putative EXT endophenotypes through the third decade of life.

Psychological and Neurobiological Precursors of Alcohol Use Disorders in High Risk Youth

It has long been known that Alcohol Use Disorders (AUDs) run in families with substantial heritability. Determining the specific genetic underpinnings of these disorders has been challenging because of the clinical heterogeneity and variable expression across the lifespan. The search for endophenotypic biological variation associated with the AUD and related substance use disorder (SUD) phenotypes is based on the belief that an endophenotype is more proximal to the causative gene. Identification of genes conferring increased susceptibility has important implications for treatment through the potential development of medications that target specific genetic pathways. High risk family designs that contrast offspring with and without a familial/genetic background have provided valuable insights into the psychological characteristics (executive control, affective regulation, decision making and social cognition) that differentiate such individuals. The current chapter will review these with a focus on brain morphology of specific regions, the coordinated activity of neural networks, and developmental trajectories of electrophysiological activity.

Familial risk for alcohol dependence and developmental changes in BMI: the moderating influence of addiction and obesity genes

AIM

Familial loading for alcohol dependence (AD) and variation in genes reported to be associated with AD or BMI were tested in a longitudinal study.

MATERIALS & METHODS

Growth curve analyses of BMI data collected at approximately yearly intervals and obesity status (BMI > 30) were examined.

RESULTS

High-risk males were found to have higher BMI than low-risk males, beginning at age 15 years (2.0 kg/m(2) difference; p = 0.046), persisting through age 19 years (3.3 kg/m(2) difference; p = 0.005). CHRM2 genotypic variance predicted longitudinal BMI and obesity status. Interactions with risk status and sex were also observed for DRD2 and FTO gene variation.

CONCLUSION

Variation at loci implicated in addiction may be influential in determining susceptibility to increased BMI in childhood and adolescence.

The contributions of early adverse experiences and trajectories of respiratory sinus arrhythmia on the development of neurobehavioral disinhibition among children with prenatal substance exposure

Neurobehavioral disinhibition (ND) is a complex condition reflecting a wide range of problems involving difficulties with emotion regulation and behavior control. Respiratory sinus arrhythmia (RSA) is a physiological correlate of emotion regulation that has been studied in a variety of at-risk populations; however, there are no studies of RSA in children with ND. Data were drawn from a prospective longitudinal study of prenatal substance exposure that included 1,073 participants. Baseline RSA and RSA reactivity to an attention-demanding task were assessed at 3, 4, 5, and 6 years. ND was assessed at ages 8/9, 11, and 13/14 years via behavioral dysregulation and executive dysfunction composite measures. Greater exposure to early adversity was related to less RSA reactivity at 3 years, increases in RSA reactivity from ages 3 to 6 years, and increased behavioral dysregulation from ages 8/9 to 13/14. RSA reactivity was examined as a moderator of the association between early adversity and changes in ND. A significant Early Adversity × RSA Reactivity quadratic interaction revealed that children with decelerations in RSA reactivity exhibited increases in behavioral dysregulation, regardless of their exposure to early adversity. However, greater exposure to early adversity was related to greater increases in behavioral dysregulation, but only if children exhibited accelerations in RSA reactivity from ages 3 to 6 years. The results contribute to our understanding of how interactions across multiple levels of analysis contribute to the development of ND.

Cholinergic receptor gene (CHRM2) variation and familial loading for alcohol dependence predict childhood developmental trajectories of P300

P300 amplitude in childhood predicts substance use disorders by young adulthood. Trajectories of visual P300 amplitude show an association between low amplitude P300 and familial risk for alcohol dependence (AD). Variation in the cholinergic muscarinic receptor gene (CHRM2) has previously been associated with P300 amplitude and AD. The present study used group based trajectory modeling of auditory P300 data collected longitudinally from offspring in families with and without familial loading for AD to determine if specific trajectories would be associated with familial risk and CHRM2 variation. Trajectory modeling confirms previous reports of an association between the low visual P300 trajectory with high familial risk in male offspring. This association was detected in offspring in the 8-12 age range, but not in 13-18 or 19-29 year olds or in high-risk female offspring. CHRM2 association analysis with P300 finds 8-12 year olds who are homozygous for the T allele of rs1824024 are 2.6 times more likely to follow a P300 trajectory characterized by lower and slower change regardless of familial loading. Combining the odds for being male and having a TT genotype results in odds of 6.5 that individuals will follow the low P300 trajectory.

P300 amplitude reduction is associated with early-onset and late-onset pathological substance use in a prospectively studied cohort of 14-year-old adolescents

P3 amplitude reduction (P3AR) is associated with risk for adolescent-onset pathological substance use (PSU). In this longitudinal study, data from over 1,100 adolescent twins were used to examine P3AR in relation to early adolescent onset PSU (i.e., by age 14), late adolescent onset PSU (i.e., ages 14-18), misuse of different classes of substances (PSU-nicotine, PSU-alcohol, PSU-illicit), degree of PSU comorbidity, and gender differences. P3 amplitude was recorded at age 14 from two midline electrodes during a visual oddball paradigm. PSU was defined as meeting criteria for any symptom of a substance use disorder assessed using semistructured clinical interviews. P3AR was associated with degree of drug class comorbidity, early adolescent onset PSU for all three substance classes, and late adolescent onset PSU for alcohol and illicit PSU. Gender differences in P3AR were not statistically significant. These findings provide further evidence that P3AR indexes a nonspecific diathesis for adolescent-onset PSU.

Age of alcohol and cannabis use onset mediates the association of transmissible risk in childhood and development of alcohol and cannabis disorders: evidence for common liability

Age at the time of first alcohol and cannabis use was investigated in relation to a measure of transmissible (intergenerational) risk for addiction in childhood and development of alcohol use disorder (AUD) and cannabis use disorder (CUD). It was hypothesized that age at the time of first experience with either substance mediates the association between transmissible risk and subsequent diagnosis of both disorders. The Transmissible Liability Index (TLI; (Vanyukov et al., 2009) was administered to 339 10- to 12-year-old boys (n = 254) and girls (n = 85). Age at the time of first alcohol and cannabis use, and diagnosis of AUD and CUD, were prospectively tracked to age 22. Each standard deviation unit increase in TLI severity corresponded to a reduction in age of alcohol and cannabis use onset by 3.2 months and 4.6 months, respectively. Age at the time of first alcohol use mediated the association of TLI with both AUD and CUD. Parallel results were obtained for cannabis. Whereas transmissible risk is congenerous to both AUD and CUD, its magnitude was 7 times greater in youths who initiated substance use with cannabis. TLI predicts age of first use of alcohol and cannabis that is common to developing both AUD and CUD. The ramifications of these findings for prevention are discussed.

Functional brain imaging of development-related risk and vulnerability for substance use in adolescents

The adolescent period is characterized by substantial behavioral changes, including increases in novelty-seeking and risk-taking, which may facilitate substance use and experimentation. These behavioral changes co-occur with widespread structural and functional neural developments. Ontogenic changes affecting the neural circuitry subserving inhibitory control and reward-related processes are particularly relevant to adolescent risk-taking behavior. Impairment or immaturity of these processes are shown to contribute to enhanced risk for substance abuse. Additionally, the direct neural action of drugs of abuse in adolescents may have more severe consequences than in adults because of the additional potential effects on development. Functional neuroimaging research is beginning to examine the neural correlates of reward and inhibitory processes in adolescents. However, the study of the consequences of exposure to drugs of abuse on brain function in adolescents is lagging. This review summarizes the functional neuroimaging literature that can inform conceptualizations of risk and consequences of substance use in adolescence.

Review of risk and protective factors of substance use and problem use in emerging adulthood

This review examines the evidence for longitudinal predictors of substance use and abuse in emerging adulthood. Nationally representative data from the 2007 National Survey on Drug use and Health suggest that many substance use problems reach their peak prevalence during emerging adulthood (usually defined as the period from age 18 to age 26). This stage of development is characterized by rapid transitions into new social contexts that involve greater freedom and less social control than experienced during adolescence. Concurrent with this newfound independence is an increase in rates of substance use and abuse. Understanding the risk and protective factors associated with emerging adult substance use problems is an important step in developing interventions targeting those problems. While multiple reviews have examined risk and protective factors for substance use during adolescence, and many of these earlier predictors may predict emerging adult substance use, few studies have focused primarily on the emerging adult outcomes examining predictors from both adolescence and emerging adulthood. This review used the databases PubMed and PsycInfo to identify articles pertaining to longitudinal predictors of substance use problems in emerging adulthood, building from the conceptual framework presented in a review on risk and protective factors for adolescent substance abuse by Hawkins and colleagues (Hawkins, Catalano, & Miller, 1992). Predictors identified as predictors of substance use in adolescence, sometimes decreased in strength and in one case reversed direction. Unique predictors in emerging adulthood were also identified. Implications for prevention science during adolescence and emerging adulthood are discussed as well as suggestions for future research.

Developmental Endophenotypes: Indexing Genetic Risk for Substance Abuse with the P300 Brain Event-Related Potential

Although substance use disorders are heritable, their complexity has made identifying genes underlying their development challenging. Endophenotypes, biologically informed quantitative measures that index genetic risk for a disorder, are being recognized for their potential to assist the search for disorder relevant genes. After outlining criteria for an endophenotype that includes developmental considerations, we review how the brain P300 response serves as an index of genetic risk for substance abuse and related externalizing disorders. The P300 response is highly heritable and associated broadly with characteristics of externalizing disorder, including childhood disruptive disorders, antisociality, and precocious expression of deviant behavior. This association appears to be mediated by shared genetic influences. Prospective studies confirm that reduced P300 amplitude present in youth prior to significant exposure to addictive substances is associated with the subsequent development of substance use disorders. Despite pronounced change in mean level over the course of development, P300 amplitude shows strong rank order stability with repeated assessment through young adulthood. In addition, P300 developmental trajectories based on multiple assessments show very high heritability and may be especially informative as measures of genetic risk. Collectively, these findings provide strong support that P300 amplitude and its change through development reflect genetic vulnerability to substance abuse and related externalizing psychopathology.

The P300 event-related brain potential as a neurobiological endophenotype for substance use disorders: a meta-analytic investigation

Endophenotypes are intermediate phenotypes on the putative causal pathway from genotype to phenotype and can aid in discovering the genetic etiology of a disorder. There are currently very few suitable endophenotypes available for substance use disorders (SUD). The amplitude of the P300 event-related brain potential is a possible candidate. The present study determined whether the P300 amplitude fulfils two fundamental criteria for an endophenotype: (1) an association with the disorder (disease marker), and (2) presence in unaffected biological relatives of those who have the disorder (vulnerability marker). For this purpose, two separate meta-analyses were performed. Meta-analysis 1 investigated the P300 amplitude in relation to SUD in 39 studies and Meta-analysis 2 investigated P300 amplitude in relation to a family history (FH+) of SUD in 35 studies. The findings indicate that a reduced P300 amplitude is significantly associated with SUD (d=0.51) and, though to a lesser extent, with a FH+ of SUD (d=0.28). As a disease maker, the association between reduced P300 amplitude and SUD is significantly larger for participants that were exclusively recruited from treatment facilities (d=0.67) than by other methods (i.e., community samples and family studies; d=0.45 and 0.32, respectively), and larger for abstinent SUD patients (d=0.71) than for current substance users (d=0.37). Furthermore, in contrast to FH+ males, a P300 amplitude reduction seems not to be present in FH+ females (d=-0.07). Taken together, these results suggest that P300 amplitude reduction can be both a useful disease and vulnerability marker and is a promising neurobiological endophenotype for SUD, though only in males. Implications and future directions are discussed.

Adolescent ethanol exposure: does it produce long-lasting electrophysiological effects?

This review discusses evidence for long-lasting neurophysiological changes that may occur following exposure to ethanol during adolescent development in animal models. Adolescence is the time that most individuals first experience ethanol exposure, and binge drinking is not uncommon during adolescence. If alcohol exposure is neurotoxic to the developing brain during adolescence, not unlike it is during fetal development, then understanding how ethanol affects the developing adolescent brain becomes a major public health issue. Adolescence is a critical time period when cognitive, emotional, and social maturation occurs and it is likely that ethanol exposure may affect these complex processes. To study the effects of ethanol on adolescent brain, animal models where the dose and time of exposure can be carefully controlled that closely mimic the human condition are needed. The studies reviewed provide evidence that demonstrates that relatively brief exposure to high levels of ethanol, via ethanol vapors, during a period corresponding to parts of adolescence in the rat is sufficient to cause long-lasting changes in functional brain activity. Disturbances in waking electroencephalogram and a reduction in the P3 component of the event-related potential (ERP) have been demonstrated in adult rats that were exposed to ethanol vapor during adolescence. Adolescent ethanol exposure was also found to produce long-lasting reductions in the mean duration of slow-wave sleep (SWS) episodes and the total amount of time spent in SWS, a finding consistent with a premature aging of sleep. Further studies are necessary to confirm these findings, in a range of strains, and to link those findings to the neuroanatomical and neurochemical mechanisms potentially underlying the lasting effects of adolescent ethanol exposure.

The enrichment study of the Minnesota twin family study: increasing the yield of twin families at high risk for externalizing psychopathology

The Enrichment Study (ES) was designed to extend the Minnesota Twin Family Study (MTFS) by oversampling 11-year-old twins at especially high risk for substance use disorders by virtue of having a childhood disruptive disorder. The sample was ascertained from Minnesota birth records. To identify high-risk twins, we conducted telephone screening interviews for parent-reported symptoms of attention-deficit/hyperactivity disorder (ADHD) and conduct disorder (CD) as well as indications of academic disengagement. Twins who exceeded a predetermined threshold were invited to participate. To facilitate comparison with the previously ascertained MTFS participants, a random sample of 11-year-old twins was also recruited. As part of the ES study, 499 twin pairs, and their parents, visited the University of Minnesota, where each participant completed a clinical interview, psychophysiological evaluation, and thorough assessment of environmental risk. We were highly successful in recruiting at-risk twins; 52% of the screened male twins and 41% of the screened females met criteria for a diagnosis of ADHD, CD, or oppositional defiant disorder (ODD). At the pair level, 63% of the screened pairs had at least one member with a childhood disruptive disorder. This article provides an overview of the study design and includes a review of recent findings using this sample of twins.

The role of executive control in human drug addiction

Recent neurobiological models propose that executive control deficits play a critical role in the development and maintenance of drug addiction. In this review, we discuss recent advances in our understanding of executive control processes and their constituent neural network, and examine neuropsychological and neuroimaging evidence of executive control dysfunction in addicted drug users. We explore the link between attentional biases to drug-related stimuli and treatment outcome, and discuss recent work demonstrating that the hedonic balance between drug cues and natural reinforcers is abnormal in addiction. Finally, we consider the potential impact of early drug use on the developing adolescent brain, and discuss research examining premorbid executive control impairments in drug-naïve "at-risk" populations.

Childhood risk factors for young adult substance dependence outcome in offspring from multiplex alcohol dependence families: a prospective study

BACKGROUND

Age of onset to begin drinking is a known risk factor for alcohol dependence. Factors have been identified that contribute to age of onset to begin regular drinking. These include reduced P300, increased postural sway, and personality variation. A longitudinal study spanning childhood to young adulthood provided the opportunity to determine if these same factors would predict the presence and onset of substance use disorders (SUD).

METHODS

Multiplex families were identified through two or more alcohol-dependent brothers. Offspring from these multiplex or control families (n = 133) were followed annually during childhood. Using childhood predictors previously identified as risk factors for age of onset to begin drinking, SUD outcome by young adulthood was modeled.

RESULTS

Familial risk status was a significant predictor of young adult SUD outcome as a main effect and as an interaction with P300 amplitude recorded before the age of 13. In adolescence (age 15), increased postural sway and familial risk predicted the SUD outcome by age 22. Analysis comparing the presence of one or both risk factors showed that those above the median for sway and below the median for P300 amplitude had substantially increased odds of developing SUD (odds ratio = 8.08 [confidence interval = 1.52-42.83]).

CONCLUSIONS

Our findings indicate that among the factors predicting age of onset to begin regular drinking, P300 predicts SUD outcome across an 11-year span. The present findings provide the longest follow-up to date demonstrating that neurobiological factors in childhood are among the most salient predictors of young adult SUD outcome.

The P300 event-related potential and its possible role as an endophenotype for studying substance use disorders: a review

The concept of endophenotypes has gained popularity in recent years. This is because of the potential that endophenotypes provide of measuring objective trait markers that are simpler to access and assess than complex behavioral disease phenotypes themselves. The simplicity, ease of measurement and the putative links to the etiology of the disease in the study of an endophenotype has the potential promise of unraveling the genetic basis of the disease in question. Of the various proposed endophenotypes, the P300 component of the event-related potential has been used in studies on alcoholism, schizophrenia and externalizing disorders. The current state of knowledge regarding the concept of endophenotypes, P300 and the validity of P300 as an endophenotype with special reference to substance use disorders is discussed in this review. The implications of the above are discussed.

The heritability of P300 amplitude in 18-year-olds is robust to adolescent alcohol use

P3 amplitude reduction (P3AR) is associated with adolescent alcohol use (AAU) and highly heritable, suggesting that P3AR may index a genetic predisposition (e.g., an endophenotype) for AAU. However, because P3AR and AAU covary naturally in the population, these observations are also consistent with P3AR reflecting neurotoxic effects of AAU on the developing adolescent brain. In this report, we describe the use of recent advancements in biometric modeling to examine changes in the genetic and environmental contributions to variability in P3 amplitude related to cumulative AAU by late adolescence in a large community-based twin sample. We found that the genetic and environmental contributions to variability in P3 amplitude were unaffected by AAU. This suggests that P3AR indexes risk for alcoholism independent of any deleterious effect of AAU on adolescent brain development.

D2 dopamine receptor (DRD2) gene, P300, and personality in children of alcoholics

The D2 dopamine receptor (DRD2) gene has been associated with alcoholism and other drug use disorders. Reduced P300 amplitude has been noted in individuals with psychiatric disorders. Personality variables are also associated with reduced P300 amplitude. The current study was conducted to determine whether variants of the DRD2 would show differential relationships among P300 amplitude and personality traits. The study consisted of 101 adolescent children of alcoholics; 39 carried the A1(+) genotype (A1A1, A1A2) and 62 carried the A1(-) genotype (A2A2). The A1(+) genotype group had higher IQ and Self-Directedness scores than the A1(-) genotype group. As predicted, the negative relationship between Novelty Seeking and Harm Avoidance was present in A1(-) but not A1(+) participants. Additionally, in A1(+) but not in A1(-) participants, there was a negative relationship between Novelty Seeking and Self-Directedness and a positive relationship between P300 amplitude and Cooperativeness. The results suggest that in adolescent children of alcoholics, dopaminergic genetic determinants are critical modifiers of the relationship between neurocognitive and personality endophenotypes proposed as vulnerability markers for substance use disorders.

Deviant P300 amplitude development in males is associated with paternal externalizing psychopathology

Boys at risk for alcoholism show deviant P300 amplitude development. Genetic influences on P300, however, are related to a range of externalizing disorders. This study examined whether P300 development from adolescence to early adulthood differed between groups varying in severity of paternal externalizing. Parietal P300 was assessed during the "rotated heads" task on up to 3 times between the ages of 17 and 24 years. Participants were divided into 3 paternal externalizing groups: (a) severe (father has adult antisocial behavior), (b) intermediate (father has alcohol dependence but not a more severe disorder), and (c) low (father has no externalizing disorders or substance treatment and is not extreme in alcohol use). Mixed models were used to evaluate linear change in amplitude. P300 decreased with age. The severe-risk group had smaller P300 initially and changed less with time than did the low-risk group. The intermediate-risk group did not differ significantly from the low-risk group, but differed marginally from the severe-risk males. Externalizing and early-onset substance disorders in the sons were associated with smaller initial values of P300. Measures of deviant P300 development may be vulnerability markers for externalizing psychopathology.

Relation of individual differences in impulsivity to nonclinical emotional decision making

Impulsivity has been identified as a behavioral precursor to addiction, and may be the manifestation of a neurological vulnerability. The present study investigated whether individual differences in impulsivity were associated with performance on the Iowa Gambling Task (IGT, a test of emotional decision making thought to be associated in part with ventromedial prefrontal cortex function) and the Wisconsin Card Sorting Task (WCST, a set-shifting thought to be associated in part with dorsolateral prefrontal cortex function). Subjects were screened for impulsivity using the BIS-11 (self-report) and a delay discounting questionnaire (a behavioral measure of impulsivity). High impulsivity was associated with poorer performance on the final block of trials of the IGT but was not significantly related to WCST performance. Both measures were significantly correlated with scores on the BIS. These results provide support for hypothesis that, in a nonclinical sample, impulsivity may vary systematically with performance on neuropsychological indicators of prefrontal function.

Impulsivity as a vulnerability marker for substance-use disorders: review of findings from high-risk research, problem gamblers and genetic association studies

There is a longstanding association between substance-use disorders (SUDs) and the psychological construct of impulsivity. In the first section of this review, personality and neurocognitive data pertaining to impulsivity will be summarised in regular users of four classes of substance: stimulants, opiates, alcohol and 3,4-methylenedioxymethamphetamine (MDMA). Impulsivity in these groups may arise via two alternative mechanisms, which are not mutually exclusive. By one account, impulsivity may occur as a consequence of chronic exposure to substances causing harmful effects on the brain. By the alternative account, impulsivity pre-dates SUDs and is associated with the vulnerability to addiction. We will review the evidence that impulsivity is associated with addiction vulnerability by considering three lines of evidence: (i) studies of groups at high-risk for development of SUDs; (ii) studies of pathological gamblers, where the harmful consequences of the addiction on brain structure are minimised, and (iii) genetic association studies linking impulsivity to genetic risk factors for addiction. Within each of these three lines of enquiry, there is accumulating evidence that impulsivity is a pre-existing vulnerability marker for SUDs.

Neurobiological processes in adolescent addictive disorders

The purpose of this review is to summarize the neurobiological factors involved in the etiology of adolescent addiction and present evidence implicating various mechanisms in its development. Adolescents are at heightened risk for experimentation with substances, and early experimentation is associated with higher rates of SUD in adulthood. Both normative (e.g., immature frontal-limbic connections, immature frontal lobe development) and non-normative (e.g., lowered serotonergic function, abnormal hypothalamic-pituitary-adrenal axis function) neurobiological developmental factors can predispose adolescents to a heightened risk for SUD. In addition, a normative imbalance in the adolescent neurobiological motivational system may be caused by the relative underdevelopment of suppressive mechanisms when compared to stimulatory systems. These neurobiological liabilities may correspond to neurobehavioral impairments in decision-making, affiliation with deviant peers and externalizing behavior; these and other cognitive and behavioral traits converge with neurobiological factors to increase SUD risk. The progression to SUD acts as an amplifying feedback loop, where the development of SUD results in reciprocal impairments in neurobehavioral and neurobiological processes. A clearer understanding of adolescent neurobiology is a necessary step in the development of prevention and treatment interventions for adolescent SUD.

Lower P300 amplitude in eight-year-old offspring of alcoholic fathers with a delinquent history

The aim of the present study was to investigate the P300 amplitude as a possible vulnerability marker in children of alcoholic (COA) fathers with and without paternal delinquency. Event-related potentials (ERPs) of 122 children aged 8 years (63 boys, 59 girls) were compared depending on father's alcoholism subtype: 30 COAs without paternal delinquency, 10 COAs with paternal delinquency, and 82 children of non-alcoholic and non-delinquent fathers. ERPs were recorded from Fz, Cz, and Pz, using an auditory oddball paradigm. Sinus tones of 60 dB HL were presented binaurally at 1,000 Hz (standard stimulus) and 2,000 Hz (target stimulus), at a relative frequency ratio of 80:20. Two trial blocks of 250 stimuli each were collected. Results indicated that only COAs with paternal delinquency displayed significant differences from the control group, characterized by reduced P300 amplitude at frontal site and in the second trial block. Thus, the combination of fathers' alcoholism and delinquency was more likely to relate to attenuated P300 amplitude in the offspring than paternal alcoholism alone. Our results suggest that both alcoholic and delinquent family history appear to play a role in P300 amplitude reduction in the offspring.

Childhood neurobehavior disinhibition amplifies the risk of substance use disorder: interaction of parental history and prenatal alcohol exposure

OBJECTIVE

This investigation examined the influence of parental substance use disorder (SUD) and mother's alcohol consumption during pregnancy on neurobehavior disinhibition (ND) measured in 10- to 12-year-old children. The extent to which ND predicted SUD outcome 7 to 9 years later was also determined.

METHODS

SUD was documented in each parent and as the outcome variable in their 19-year-old sons. Average daily alcohol consumption during the mother's pregnancy was recorded using a structured interview. ND was assessed using indicators of behavior undercontrol, affect modulation and executive cognitive functions.

RESULTS

Paternal SUD and the interaction between maternal SUD and alcohol consumption during pregnancy predicted child's ND score. ND at 10 to 12 years of age was a significant predictor of SUD at age 19.

CONCLUSIONS

The disinhibitory disturbance associated with risk of SUD has both transmissible and teratogenic causes. The ramifications of this finding for pediatric practice are discussed.

P3 components and adolescent binge drinking in Southwest California Indians

In adolescence, consuming a large number of drinks over a short interval of time (e.g. binging) is not an uncommon occurrence. Since adolescence is an important neurodevelopmental period, the effect of binge drinking on brain and behavior has become a significant health concern. The present study evaluated event-related potentials (ERPs) in young adult Southwest California Indians who had a history of binge drinking during their adolescence. One hundred twenty five participants who were currently 18-25 yrs of age who were free of Axis I psychiatric diagnoses were categorized as: 1) reporting no binge drinking during adolescence (>5 drinks per occasion before age 18) or drug dependence diagnoses 2) reporting binge drinking during adolescence with no drug dependence diagnoses 3) reporting binge drinking during adolescence and drug dependence diagnoses. ERPs were collected using a facial discrimination task. Adolescent alcohol and drug exposure was found to be associated with decreases in the latency of an early P3 component (P350). Decreases in a later component amplitude (P450) were also found in young adults exposed to alcohol, and those exposed to alcohol and drugs. However, that finding appears to be a combined result of predisposing factors such as family history of alcoholism and presence of other externalizing diagnoses. Taken together these preliminary studies suggests that adolescent binge drinking may result in a decreases in P3 component latencies and amplitudes perhaps reflecting a loss or delay in the development of inhibitory brain systems.

Impulsivity, neural deficits, and the addictions: the "oops" factor in relapse

Impulsive behaviors are observed in a wide range of psychiatric disorders, including substance use, bipolar, attention-deficit hyperactivity, antisocial and borderline personality, gambling, and eating disorders. The shared phenotype of impulsivity is thought to significantly contribute to both the etiology and perpetuation of these disorders. In this review, we focus upon the relevance of impulsivity to the addictive disorders, particularly substance use disorders. First, the literature supporting the presence of impulsive behaviors prior to the onset of drug use and addiction is discussed. The relevance of impulsivity to relapse is then presented, with a focus on three distinct neurocognitive constructs: automaticity, response inhibition, and decision making. Automaticity is a quickly occurring relapse process resulting from the learned habits induced by persistent drug use. Addicted persons with response inhibition deficits are unable to suppress these previously reinforced behaviors. Decision-making deficits contribute to relapse through a poorly considered assessment of the consequences of drug use. The brain regions associated with each model of impulsive behavior are described, and relevant neurobiologic disruptions in addicted subjects are discussed in the context of their specific neurocognitive deficit(s). Descriptive confusions in the terminology and confounds inherent in the study of impulsivity are described. Empirical investigations documenting the hypothesized relationship between specific deficits in impulsive behaviors, coupled with their neurobiological correlates, and relapse should be the focus of future studies.

Heritability of P300 amplitude development from adolescence to adulthood

Early adulthood is a period of late brain development corresponding to the age of onset for psychopathology associated with P300 amplitude reductions. Although amplitude from a single occasion is heritable, little is known about genetic influences on change during this period. This is the first study of P300 change to combine latent growth and twin models. P300 at Pz was measured up to three times at approximately ages 17, 20, and 23 in monozygotic and dizygotic male twins using a visual task. P300 decreased with age. Correlations indexing the stability of amplitude over time were high (median r=.72) and almost 90% of the stable variance (i.e., the model intercept) was attributable to genetic influences. The rate of decrease was heritable, and the genes influencing intercept may be the same ones influencing change. Finally, intercept was more heritable than amplitude at any single time point. Intercept may be a more useful aid in the search for genes associated with relevant psychopathology than single measures of P300. Over a broader age range growth indices may be useful "developmental" endophenotypes.

Using the brain P300 response to identify novel phenotypes reflecting genetic vulnerability for adolescent substance misuse

We used a novel approach to identify candidate alternative phenotypes for investigating genetic influence underlying substance use disorders (SUDs) in adolescents. The existing literature suggests that P300 amplitude reduction (P3-AR) observed in brain event-related potentials is associated with risk for SUDs generally, not just alcoholism. Using data from a community-based sample of 17-year-old male and female twins, we fit biometric models to P3 amplitude data to show that it is strongly heritable, especially in boys. The extant evidence coupled with our findings strongly supports treating P3-AR as an endophenotype indexing SUD risk. We then examined a set of 15 potential alternative phenotypes (e.g., frequent use of cannabis) to determine whether they were associated with P3-AR. The results indicated that almost all of these alternative phenotypes were associated with P3-AR, with larger effect sizes observed for boys. Given the strong association of these use phenotypes with P3-AR, which is itself an index of genetic risk for SUDs, we conclude that these use phenotypes may provide tools for finding vulnerability genes in adolescents who have yet to pass through the age of risk for SUDs.

Association of DRD4 exon III polymorphism with auditory P300 amplitude in 8-year-old children

OBJECTIVES

The present study was designed to investigate the association between the DRD4 genotype and auditory P300 amplitudes in a high-risk community sample.

METHODS

ERPs were elicited in 197 eight-year-olds (98 boys, 99 girls) using a passive and an active oddball task. Auditory stimuli of 60 dB HL were presented binaurally at 1000 (standard stimulus) and 2000 Hz (target stimulus), at a relative frequency ratio of 80:20. Two trial blocks of 250 stimuli each were collected. P300 amplitudes were analyzed from Fz, Cz and Pz. DNA was genotyped for the DRD4 exon III polymorphism.

RESULTS

A pattern of significant interactions of the DRD4 genotype with gender and experimental conditions was obtained. In both the active and the passive task, boys with at least one copy of the DRD4 7-repeat allele displayed significantly lower P300 amplitudes during the second trial block than boys carrying other alleles.

CONCLUSIONS

This finding provides further evidence supporting a role of P300 amplitude reduction as an endophenotype for disinhibited psychopathology.

Individual differences in childhood neurobehavior disinhibition predict decision to desist substance use during adolescence and substance use disorder in young adulthood: a prospective study

Genetic, physiological and psychological investigations have demonstrated that deficient inhibitory regulation amplifies the risk for substance use disorder (SUD). This study extends this line of research by determining the association between childhood neurobehavior disinhibition and decision to desist substance use following prevention intervention during adolescence. The sample consisted of 302 boys who were evaluated at ages 10-12, 12-14, 16, and 19. Results indicated that childhood neurobehavior disinhibition negatively covaried with decision to desist substance use during adolescence. These two variables predicted acceleration of drug consumption frequency during adolescence and DSM-IV diagnosis of SUD by age 19. Decision to desist drug use did not mediate the association between neurobehavior disinhibition and substance use/SUD. The findings indicate that substance abuse prevention would be potentiated by ameliorating childhood neurobehavior disinhibition.

Detection of youth at high risk for substance use disorders: a longitudinal study

This study extends prior research (D. Clark, J. Cornelius, L. Kirisci, & R. Tarter, 2005) by determining whether variation in the developmental trajectories of liability to substance use disorder (SUD) is contributed by neurobehavioral disinhibition, parental substance use involvement, and demographic variables. The sample, participants in a long-term prospective investigation, consisted of 351 boys, evaluated at ages 10-12, 12-14, 16, 19, and 22, whose parents either had SUD or no adult psychiatric disorder. Neurobehavioral disinhibition in childhood, in conjunction with parental lifetime substance use/SUD, place the child at very high risk for SUD by age 22 if psychosocial maladjustment progresses in severity in early adolescence. These results indicate that monitoring social adjustment during the transition from childhood to mid-adolescence is important for identifying youth at very high risk for succumbing to SUD by young adulthood.

P300 development during adolescence: Effects of DRD2 genotype

OBJECTIVE

Young boys at high risk for alcoholism by having a family history of alcoholism (FH+) have lower amplitude of the visual P300 event-related scalp potential. They have also been reported to have a slowing in the rate of P300 amplitude change during adolescence. The present study examined whether the change in P300 amplitude during adolescence in sons of alcoholics and nonalcoholics is affected by D2 dopamine receptor (DRD2) polymorphism.

METHODS

P300 was elicited with a visual discrimination task from 71 adolescent sons of alcoholics and social drinkers (Time 1, T1). The task was readministered 2 years later (Time 2, T2). Comparisons were made between boys who had the DRD2 A1 allele (A1+) and boys who did not (A1-), and between boys with one or both parents being alcoholic (FH+) and boys having no alcoholic parents (FH-).

RESULTS

Discrimination task accuracy was lowest in the highest risk group (A1+, FH+) at T1, and highest in the lowest risk group (A1-, FH-) at T2, producing a significant interaction of allelic group x family history group x session. Reaction time was faster at T2 than T1, and this effect was larger in FH-boys (125 ms) than FH+boys (40 ms). Overall, the behavioral results suggest mild performance deficits on the discrimination task are associated with higher risk for alcoholism. In both testing sessions, P300 attained larger amplitudes in sons of nonalcoholics than sons of alcoholics. At T2 compared to T1, both the latency and amplitude of the P300 were decreased. However, while the developmental P300 latency effect was equivalent in both the A1+ and A1- allelic groups, the P300 amplitude reduction during adolescence, measured both in response to targets and in target minus non-target subtraction waveforms, was only found in boys with the A1- allele.

CONCLUSION

Differences in the developmental course of P300 amplitude over the course of adolescence are dependent on DRD2 polymorphism.

SIGNIFICANCE

These results suggest the importance of genetic determinants of the dopaminergic system in understanding the P300 as a risk marker for substance abuse using an integrative developmental perspective.