Alcohol and Neural Dynamics: A Meta-analysis of Acute Alcohol Effects on Event-Related Brain Potentials

Exploring Cortical Interneurons in Substance Use Disorder: From Mechanisms to Therapeutic Perspectives

Interneurons (INs) play a crucial role in the regulation of neural activity within the medial prefrontal cortex (mPFC), a brain region critically involved in executive functions and behavioral control. In recent preclinical studies, dysregulation of INs in the mPFC has been implicated in the pathophysiology of substance use disorder, characterized by vulnerability to chronic drug use. Here, we explore the diversity of mPFC INs and their connectivity and roles in vulnerability to addiction. We also discuss how these INs change over time with drug exposure. Finally, we focus on noninvasive brain stimulation as a therapeutic approach for targeting INs in substance use disorder, highlighting its potential to restore neural circuits.

A wearable alcohol biosensor: Exploring the accuracy of transdermal drinking detection

BACKGROUND

Trace amounts of consumed alcohol are detectable within sweat and insensible perspiration. However, the relationship between ingested and transdermally emitted alcohol is complex, varying across environmental conditions and involving a degree of lag. As such, the feasibility of real-time drinking detection across diverse environments has been unclear. In the current research we revisit sensor performance using new tools, exploring the accuracy of a new generation of rapid-sampling transdermal biosensor for contemporaneous drinking detection across diverse environments via machine learning.

METHODS

Regular drinkers (N = 100) attended three laboratory sessions involving the experimental manipulation of alcohol dose, rate of consumption, and environmental dosing conditions. Participants further supplied breath alcohol concentration (BAC) readings in the field over 14 days. Participants wore compact wrist sensors capable of rapid sampling (20sec intervals). Transdermal sensor data was translated into alcohol use estimates using machine learning, integrating only transdermal data collected prior to the point of BAC assessment.

RESULTS

A total of 5.39 million transdermal readings (28,615hours) and 12,699 BAC readings were collected for this research. Models indicated strong transdermal sensor accuracy for real-time drinking detection across both laboratory and field contexts (AUROC, 0.966, 95 % CI, 0.956-0.972; Sensitivity, 89.8 %; Specificity, 90.6 %). Models aimed at differentiating high-risk (≥0.08 %) drinking levels yielded intermediate (AUROC, 0.738; 95 % CI, 0.698-0.777; only drinking episodes) to strong (AUROC, 0.941, 95 % CI, 0.929-0.954; all data) accuracy levels.

CONCLUSIONS

Results indicate a range of useful future applications for transdermal alcohol sensors including long-term health tracking, medical monitoring, and just-in-time relapse prevention.

Examining social attention as a predictor of problem drinking behavior: A longitudinal study using eye-tracking

BACKGROUND

Researchers have long been interested in identifying objective markers for problem drinking susceptibility informed by the environments in which individuals drink. However, little is known of objective cognitive-behavioral indices relevant to the social contexts in which alcohol is typically consumed. Combining group-based alcohol administration, eye-tracking technology, and longitudinal follow-up over a 2-year span, the current study examined the role of social attention in predicting patterns of problem drinking over time.

METHODS

Young heavy drinkers (N = 246) were randomly assigned to consume either an alcoholic (target BAC 0.08%) or a control beverage in dyads comprising friends or strangers. Dyads completed a virtual video call in which half of the screen comprised a view of themselves ("self-view") and half a view of their interaction partner ("other-view"). Participants' gaze behaviors, operationalized as the proportion of time spent looking at "self-view" and "other-view," were tracked throughout the call. Problem drinking was assessed at the time of the laboratory visit and then every year subsequent for 2 years.

RESULTS

Significant interactions emerged between beverage condition and social attention in predicting binge drinking days. In cross-sectional analyses, among participants assigned to the control (but not alcohol) group, heightened self-focused attention was linked with increased binge days at baseline, B = 0.013, Exp(B) = 1.013, 95% CI = [0.004, 0.022], p = 0.005. In contrast, longitudinal models indicated that heightened self-focused attention among control participants while interacting with friends was linked with a more pronounced decline in binge drinking over time.

CONCLUSIONS

The relationship between social attention and problem drinking is complex and evolves over time. While dispositional self-consciousness may act as a risk factor at the cross-sectional level, it appears to serve a potentially protective function as participants mature into young adulthood. More broadly, results highlight potential utility for objective markers of self-consciousness in the understanding of problem drinking etiology.

Prefrontal electrophysiological biomarkers and mechanism-based drug effects in a rat model of alcohol addiction

Patients with alcohol use disorder (AUD) who seek treatment show highly variable outcomes. A precision medicine approach with biomarkers responsive to new treatments is warranted to overcome this limitation. Promising biomarkers relate to prefrontal control mechanisms that are severely disturbed in AUD. This results in reduced inhibitory control of compulsive behavior and, eventually, relapse. We reasoned here that prefrontal dysfunction, which underlies vulnerability to relapse, is evidenced by altered neuroelectric signatures and should be restored by pharmacological interventions that specifically target prefrontal dysfunction. To test this, we applied our recently developed biocompatible neuroprosthesis to measure prefrontal neural function in a well-established rat model of alcohol addiction and relapse. We monitored neural oscillations and event-related potentials in awake alcohol-dependent rats during abstinence and following treatment with psilocybin or LY379268, agonists of the serotonin 2A receptor (5-HT2AR), and the metabotropic glutamate receptor 2 (mGluR2), that are known to reduce prefrontal dysfunction and relapse. Electrophysiological impairments in alcohol-dependent rats are reduced amplitudes of P1N1 and N1P2 components and attenuated event-related oscillatory activity. Psilocybin and LY379268 were able to restore these impairments. Furthermore, alcohol-dependent animals displayed a dominance in higher beta frequencies indicative of a state of hyperarousal that is prone to relapse, which particularly psilocybin was able to counteract. In summary, we provide prefrontal markers indicative of relapse and treatment response, especially for psychedelic drugs.

Neuroimaging Biomarkers in Addiction

As a neurobiological process, addiction involves pathological patterns of engagement with substances and a range of behaviors with a chronic and relapsing course. Neuroimaging technologies assess brain activity, structure, physiology, and metabolism at scales ranging from neurotransmitter receptors to large-scale brain networks, providing unique windows into the core neural processes implicated in substance use disorders. Identified aberrations in the neural substrates of reward and salience processing, response inhibition, interoception, and executive functions with neuroimaging can inform the development of pharmacological, neuromodulatory, and psychotherapeutic interventions to modulate the disordered neurobiology. Based on our systematic search, 409 protocols registered on ClinicalTrials.gov include the use of one or more neuroimaging paradigms as an outcome measure in addiction, with the majority (N=268) employing functional magnetic resonance imaging (fMRI), followed by positron emission tomography (PET) (N=71), electroencephalography (EEG) (N=50), structural magnetic resonance imaging (MRI) (N=35) and magnetic resonance spectroscopy (MRS) (N=35). Furthermore, in a PubMed systematic review, we identified 61 meta-analyses including 30 fMRI, 22 structural MRI, 8 EEG, 7 PET, and 3 MRS meta-analyses suggesting potential biomarkers in addictions. These studies can facilitate the development of a range of biomarkers that may prove useful in the arsenal of addiction treatments in the coming years. There is evidence that these markers of large-scale brain structure and activity may indicate vulnerability or separate disease subtypes, predict response to treatment, or provide objective measures of treatment response or recovery. Neuroimaging biomarkers can also suggest novel targets for interventions. Closed or open loop interventions can integrate these biomarkers with neuromodulation in real-time or offline to personalize stimulation parameters and deliver the precise intervention. This review provides an overview of neuroimaging modalities in addiction, potential neuroimaging biomarkers, and their physiologic and clinical relevance. Future directions and challenges in bringing these putative biomarkers from the bench to the bedside are also discussed.

The extrastriate symmetry response is robust to alcohol intoxication

Visual symmetry activates a network of regions in the extrastriate cortex and generates an event-related potential (ERP) called the sustained posterior negativity (SPN). Previous work has found that the SPN is robust to experimental manipulations of task, spatial attention, and memory load. In the current study, we investigated whether the SPN is also robust to alcohol-induced changes in mental state. A pilot experiment (N = 13) found that alcohol unexpectedly increased SPN amplitude. We followed this unexpected result with two new experiments on separate groups, using an alcohol challenge paradigm. One group completed an Oddball discrimination task (N = 26). Another group completed a Regularity discrimination task (N = 26). In both groups, participants consumed a medium dose of alcohol (0.65 g/kg body weight) and a placebo drink, in separate sessions. Alcohol reduced SPN amplitude in the Oddball task (contrary to the pilot results) but had no effect on SPN amplitude in the Regularity task. In contrast, the N1 wave was consistently dampened by alcohol in all experiments. Exploratory analysis indicated that the inconsistent effect of alcohol on SPN amplitude may be partly explained by individual differences in alcohol use. Alcohol reduced the SPN in light drinkers and increased it in heavier drinkers. Despite remaining questions, the results highlight the automaticity of symmetry processing. Symmetry still produces a large SPN response, even when participants are intoxicated, and even when symmetry is not task relevant.

Where to Look? Alcohol, Affect, and Gaze Behavior During a Virtual Social Interaction

COVID-19 forced social interactions to move online. Yet researchers have little understanding of the mental health consequences of this shift. Given pandemic-related surges in emotional disorders and problematic drinking, it becomes imperative to understand the cognitive and affective processes involved in virtual interactions and the impact of alcohol in virtual social spaces. Participants (N=246) engaged in an online video call while their gaze behavior was tracked. Prior to the interaction, participants were randomly assigned to receive an alcoholic or control beverage. Participants' affect was repeatedly assessed. Results indicated that a proportionally larger amount of time spent gazing at oneself (vs. one's interaction partner) predicted significantly higher negative affect after the exchange. Further, alcohol independently increased self-directed attention, failing to demonstrate its typically potent social-affective enhancement in this virtual context. Results carry potential implications for understanding factors that increase risk for hazardous drinking and negative affect in our increasingly virtual world.

High-resolution imaging in studies of alcohol effect on prenatal development

Fetal alcohol syndrome represents the leading known preventable cause of mental retardation. FAS is on the most severe side of fetal alcohol spectrum disorders that stem from the deleterious effects of prenatal alcohol exposure. Affecting as many as 1 to 5 out of 100 children, FASD most often results in brain abnormalities that extend to structure, function, and cerebral hemodynamics. The present review provides an analysis of high-resolution imaging techniques that are used in animals and human subjects to characterize PAE-driven changes in the developing brain. Variants of magnetic resonance imaging such as magnetic resonance microscopy, magnetic resonance spectroscopy, diffusion tensor imaging, along with positron emission tomography, single-photon emission computed tomography, and photoacoustic imaging, are modalities that are used to study the influence of PAE on brain structure and function. This review briefly describes the aforementioned imaging modalities, the main findings that were obtained using each modality, and touches upon the advantages/disadvantages of each imaging approach.

The Dopamine System in Mediating Alcohol Effects in Humans

Brain-imaging studies show that the development and maintenance of alcohol use disorder (AUD) is determined by a complex interaction of different neurotransmitter systems and multiple psychological factors. In this context, the dopaminergic reinforcement system appears to be of fundamental importance. We focus on the excitatory and depressant effects of acute versus chronic alcohol intake and its impact on dopaminergic neurotransmission. Furthermore, we describe alterations in dopaminergic neurotransmission as associated with symptoms of alcohol dependence. We specifically focus on neuroadaptations to chronic alcohol consumption and their effect on central processing of alcohol-associated and reward-related stimuli. Altered reward processing, complex conditioning processes, impaired reinforcement learning, and increased salience attribution to alcohol-associated stimuli enable alcohol cues to drive alcohol seeking and consumption. Finally, we will discuss how the neurobiological and neurochemical mechanisms of alcohol-associated alterations in reward processing and learning can interact with stress, cognition, and emotion processing.

A scoping review of electroencephalographic (EEG) markers for tracking neurophysiological changes and predicting outcomes in substance use disorder treatment

Substance use disorders (SUDs) constitute a growing global health crisis, yet many limitations and challenges exist in SUD treatment research, including the lack of objective brain-based markers for tracking treatment outcomes. Electroencephalography (EEG) is a neurophysiological technique for measuring brain activity, and although much is known about EEG activity in acute and chronic substance use, knowledge regarding EEG in relation to abstinence and treatment outcomes is sparse. We performed a scoping review of longitudinal and pre-post treatment EEG studies that explored putative changes in brain function associated with abstinence and/or treatment in individuals with SUD. Following PRISMA guidelines, we identified studies published between January 2000 and March 2022 from online databases. Search keywords included EEG, addictive substances (e.g., alcohol, cocaine, methamphetamine), and treatment related terms (e.g., abstinence, relapse). Selected studies used EEG at least at one time point as a predictor of abstinence or other treatment-related outcomes; or examined pre- vs. post-SUD intervention (brain stimulation, pharmacological, behavioral) EEG effects. Studies were also rated on the risk of bias and quality using validated instruments. Forty-four studies met the inclusion criteria. More consistent findings included lower oddball P3 and higher resting beta at baseline predicting negative outcomes, and abstinence-mediated longitudinal decrease in cue-elicited P3 amplitude and resting beta power. Other findings included abstinence or treatment-related changes in late positive potential (LPP) and N2 amplitudes, as well as in delta and theta power. Existing studies were heterogeneous and limited in terms of specific substances of interest, brief times for follow-ups, and inconsistent or sparse results. Encouragingly, in this limited but maturing literature, many studies demonstrated partial associations of EEG markers with abstinence, treatment outcomes, or pre-post treatment-effects. Studies were generally of good quality in terms of risk of bias. More EEG studies are warranted to better understand abstinence- or treatment-mediated neural changes or to predict SUD treatment outcomes. Future research can benefit from prospective large-sample cohorts and the use of standardized methods such as task batteries. EEG markers elucidating the temporal dynamics of changes in brain function related to abstinence and/or treatment may enable evidence-based planning for more effective and targeted treatments, potentially pre-empting relapse or minimizing negative lifespan effects of SUD.

Design of an Artificial Opal/Photonic Crystal Interface for Alcohol Intoxication Assessment: Capillary Condensation in Pores and Photonic Materials Work Together

Alcohol intoxication has a dangerous effect on human health and is often associated with a risk of catastrophic injuries and alcohol-related crimes. A demand to address this problem adheres to the design of new sensor systems for the real-time monitoring of exhaled breath. We introduce a new sensor system based on a porous hydrophilic layer of submicron silica particles (SiO₂ SMPs) placed on a one-dimensional photonic crystal made of Ta₂O₅/SiO₂ dielectric layers whose operation relies on detecting changes in the position of surface wave resonance during capillary condensation in pores. To make the active layer of SiO₂ SMPs, we examine the influence of electrostatic interactions of media, particles, and the surface of the crystal influenced by buoyancy, gravity force, and Stokes drag force in the frame of the dip-coating preparation method. We evaluate the sensing performance toward biomarkers such as acetone, ammonia, ethanol, and isopropanol and test sensor system capabilities for alcohol intoxication assessment. We have found this sensor to respond to all tested analytes in a broad range of concentrations. By processing the sensor signals by principal component analysis, we selectively determined the analytes. We demonstrated the excellent performance of our device for alcohol intoxication assessment in real-time.

Acute effects of alcohol on social and personal decision making

Social drinking is common, but it is unclear how moderate levels of alcohol influence decision making. Most prior studies have focused on adverse long-term effects on cognitive and executive function in people with alcohol use disorders (AUD). Some studies have investigated the acute effects of alcohol on decision making in healthy people, but have predominantly used small samples and focused on a narrow selection of tasks related to personal decision making, e.g., delay or probability discounting. Here, we conducted a large (n = 264), preregistered randomized placebo-controlled study (RCT) using a parallel group design, to systematically assess the acute effects of alcohol on measures of decision making in both personal and social domains. We found a robust effect of a 0.6 g/kg dose of alcohol on both moral judgment and altruistic behavior, but no effects on several measures of risk taking or waiting impulsivity. These findings suggest that alcohol at low to moderate doses selectively moderates decision making in the social domain, and promotes utilitarian decisions over those dictated by rule-based ethical principles (deontological). This is consistent with existing theory that emphasizes the dual roles of shortsighted information processing and salient social cues in shaping decisions made under the influence of alcohol. A better understanding of these effects is important to understand altered social functioning during alcohol intoxication.

Alcohol consumption and MRI markers of brain structure and function: Cohort study of 25,378 UK Biobank participants

Moderate alcohol consumption is widespread but its impact on brain structure and function is contentious. The relationship between alcohol intake and structural and functional neuroimaging indices, the threshold intake for associations, and whether population subgroups are at higher risk of alcohol-related brain harm remain unclear. 25,378 UK Biobank participants (mean age 54.9 ± 7.4 years, 12,254 female) underwent multi-modal MRI 9.6 ± 1.1 years after study baseline. Alcohol use was self-reported at baseline (2006-10). T1-weighted, diffusion weighted and resting state images were examined. Lower total grey matter volumes were observed in those drinking as little as 7-14 units (56-112 g) weekly. Higher alcohol consumption was associated with multiple markers of white matter microstructure, including lower fractional anisotropy, higher mean and radial diffusivity in a spatially distributed pattern across the brain. Associations between functional connectivity and alcohol intake were observed in the default mode, central executive, attention, salience and visual resting state networks. Relationships between total grey matter and alcohol were stronger than other modifiable factors, including blood pressure and smoking, and robust to unobserved confounding. Frequent binging, higher blood pressure and BMI steepened the negative association between alcohol and total grey matter volume. In this large observational cohort study, alcohol consumption was associated with multiple structural and functional MRI markers in mid- to late-life.

Alcohol narrows physical distance between strangers

Pandemic management is likely to represent a global reality for years to come, but the roadmap for how to approach pandemic restrictions is as yet unclear. Of the restrictions enacted during COVID-19, among the more controversial surround alcohol. Like many infectious diseases, the principal mode of transmission for COVID-19 is direct respiration of droplets emitted during close social contact, and health officials warn that alcohol consumption may lead to decreased adherence to physical distancing guidelines. Governing bodies have acted to close bars before restaurants and have also specifically restricted alcohol sales, while at the same time those in the nightlife industry have labeled such actions unfounded and discriminatory. Complicating such debates is the lack of evidence on alcohol's effects on physical distance. In the current study we employed a randomized alcohol-administration design paired with computer-vision measures, analyzing over 20,000 proximity readings derived from video to examine the effect of alcohol consumption on physical distance during social interaction. Results indicated that alcohol caused individuals to draw significantly closer to an unfamiliar interaction partner during social exchange, reducing physical proximity at a rate with potentially important implications for public health. In contrast, alcohol had no effect on physical distance with a familiar interaction partner. Findings suggest that alcohol might act to overcome a natural caution people feel towards strangers and thus promote virus transmission between previously unconnected social groups.