Response Inhibition and Binge Drinking During Transition to University: An fMRI Study

Neural substrates of behavioral inhibitory control during the two-choice oddball task: functional neuroimaging evidence

Background

Behavioral inhibitory control (BIC) depicts a cognitive function of inhibiting inappropriate dominant responses to meet the context requirement. Despite abundant research into neural substrates of BIC during the go/no-go and stop signal tasks, these tasks were consistently shown hard to isolate neural processes of response inhibition, which is of primary interest, from those of response generation. Therefore, it is necessary to explore neural substrates of BIC using the two-choice oddball (TCO) task, whose design of dual responses is thought to produce an inhibition effect free of the confounds of response generation.

Objective

The current study aims at depicting neural substrates of performing behavioral inhibitory control in the two-choice oddball task, which designs dual responses to balance response generation. Also, neural substrates of performing BIC during this task are compared with those in the go/no-go task, which designs a motor response in a single condition.

Methods

The present study integrated go/no-go (GNG) and TCO tasks into a new Three-Choice BIC paradigm, which consists of standard (75%), deviant (12.5%), and no-go (12.5%) conditions simultaneously. Forty-eight college students participated in this experiment, which required them to respond to standard (frequent) and deviant stimuli by pressing different keys, while inhibiting motor response to no-go stimuli. Conjunction analysis and ROI (region of interest) analysis were adopted to identify the unique neural mechanisms that subserve the processes of BIC.

Results

Both tasks are effective in assessing BIC function, reflected by the significantly lower accuracy of no-go compared to standard condition in GNG, and the significantly lower accuracy and longer reaction time of deviant compared to standard condition in TCO. However, there were no significant differences between deviant and no-go conditions in accuracy. Moreover, functional neuroimaging has demonstrated that the anterior cingulate cortex (ACC) activation was observed for no-go vs. standard contrast in the GNG task, but not in deviant vs. standard contrast in the TCO task, suggesting that ACC involvement is not a necessary component of BIC. Second, ROI analysis of areas that were co-activated in TCO and GNG showed co-activations in the right inferior frontal cortex (triangle and orbital), with the signals in the TCO task significantly higher than those in the GNG task.

Conclusions

These findings show that the designed responses to both standard and deviant stimuli in the TCO task, compared to the GNG task, produced a more prominent prefrontal inhibitory processing and extinguished an unnecessary component of ACC activation during BIC. This implies that prefrontal involvement, but not that of ACC, is mandatory for the successful performance of inhibiting prepotent behaviors.

Longitudinal change of inhibitory control functional connectivity associated with the development of heavy alcohol drinking

Introduction

Heavy drinking (HD) prevalent pattern of alcohol consumption among adolescents, particularly concerning because of their critical vulnerability to the neurotoxic effects of ethanol. Adolescent neurodevelopment is characterized by critical neurobiological changes of the prefrontal, temporal and parietal regions, important for the development of executive control processes, such as inhibitory control (IC). In the present Magnetoencephalography (MEG) study, we aimed to describe the relationship between electrophysiological Functional Connectivity (FC) during an IC task and HD development, as well as its impact on functional neuromaturation.

Methods

We performed a two-year longitudinal protocol with two stages. In the first stage, before the onset of HD, we recorded brain electrophysiological activity from a sample of 67 adolescents (mean age = 14.6 ± 0.7) during an IC task. Alcohol consumption was measured using the AUDIT test and a semi-structured interview. Two years later, in the second stage, 32 of the 67 participants (mean age 16.7 ± 0.7) completed a similar protocol. As for the analysis in the first stage, the source-space FC matrix was calculated, and then, using a cluster-based permutation test (CBPT) based on Spearman's correlation, we calculated the correlation between the FC of each cortical source and the number of standard alcohol units consumed two years later. For the analysis of longitudinal change, we followed a similar approach. We calculated the symmetrized percentage change (SPC) between FC at both stages and performed a CBPT analysis, analyzing the correlation between FC change and the level of alcohol consumed in a regular session.

Results

The results revealed an association between higher beta-band FC in the prefrontal and temporal regions and higher consumption years later. Longitudinal results showed that greater future alcohol consumption was associated with an exacerbated reduction in the FC of the same areas.

Discussion

These results underline the existence of several brain functional differences prior to alcohol misuse and their impact on functional neuromaturation.

Adolescent brain maturation and the neuropathological effects of binge drinking: A critical review

Adolescence is a transitional stage marked by continued brain development. This period is accompanied by physical and neurochemical modifications in the shape and function of the hippocampus, prefrontal cortex, and other limbic system structures. Brain maturation during adolescence, which is typically governed by intrinsic factors, can be dramatically altered by environmental influences such as drugs and alcohol. Unlike many other addictive substances, binge drinking is very common and normative among teenagers and young adults. This repeated pattern of excessive alcohol consumption in adolescents has been shown to cause behavioral changes and neurocognitive impairments that include increased anxiety, risky decision-making, and learning deficits, which could lead to the development of alcohol use disorder (AUD). This manuscript highlights factors that lead to adolescent binge drinking, discusses maturational changes that occur in an adolescent's brain, and then evaluates the effect of adolescent alcohol consumption on brain structure, function, and neurocognitive abilities in both human studies and animal models. The impact of gender/sex and COVID-19 are briefly discussed. Understanding the factors that promote the onset of adolescent binge drinking and its undesirable consequences could serve as a catalyst for developing therapeutic agents that would decrease or eradicate the damaging effects of alcohol on an adolescent brain.

[Disorders of cognitive decision-making mechanisms related to reward in alcohol use disorders]

OBJECTIVE

To assess the relationship of disorders of cognitive decision-making mechanisms related to reward with clinical indicators of alcohol dependence.

MATERIAL AND METHODS

Forty-five patients with alcohol dependence were studied. A control group consisted of 30 age- and sex-matched healthy individuals. To quantify cognitive functions, the Go/NoGo task, the Balloon test (BART), the Cambridge Game Task (CGT) and the Iowa Game task (IGT) were used. The age of the first alcohol sample, the age of the beginning of systematic alcohol abuse, the average amount of alcohol consumption over the past month, the number of hospitalizations, the age of the first visit to a narcologist and the duration of the last remission were used as clinical indicators.

RESULTS

The indicators of executive functions are significantly reduced in patients with alcohol dependence compared with the control group. In the Go/NoGo task, patients have more errors, both on the Go signal (p=0.012) and on the NoGo signal (p=0.009). Significant differences in the group of patients with alcohol dependence from the control group were also revealed in CGT: patients had lower values of decision quality (QDM) (p=0.002), higher values of risk acceptance (OBR) (p=0.015), and they also needed more time to make decisions (DT) (p=0.012). It was also found that the age of the onset of systematic alcohol abuse directly correlates with the quality of decision-making in CGT (r_s=0.407, p=0.048).

CONCLUSION

The results emphasize the importance of studying cognitive impairment in patients with alcohol dependence, since the severity of these disorders is associated with the clinical course of the disease.

The role of left insula mediating impaired error processing in response inhibition in adult heavy drinkers

Identification of neurobiological mechanisms underlying development of alcohol use disorder is critical to ensuring the appropriate early-phase treatment and prevention of the disorder. To this aim, we tried to elucidate the disturbance of neural functions in heavy drinking, which can lead to alcohol use disorder. Because response inhibition is affected by alcohol use disorder, we examined neural activation and task performance for response inhibition using the Go/No-Go task in an fMRI paradigm in adult non-dependent heavy and light drinkers. We examined the neural activation for error processing and inhibitory control, components of response inhibition. We then investigated the mediating effect of the relevant neural substrate on the relationship between the level of alcohol drinking and task performance using mediation analysis. We found that heavy drinking significantly decreased activation in the left insula during error processing and increased the mean commission error rate for No-Go trials compared with light drinking. Mediation analysis demonstrated full mediation of the left insula activation during error processing for the relationship between drinking level and commission error rate. Our results suggested that left insula activation may be a neural marker pivotal for potential conversion to alcohol use disorder in individuals with high clinical risk such as heavy drinking.

Effects of binge drinking during adolescence and emerging adulthood on the brain: A systematic review of neuroimaging studies

Binge drinking (BD) is a common pattern of alcohol consumption which is generating great concern because of its deleterious consequences. We selected 33 neuroimaging studies of healthy young binge drinkers (BDs) by following PRISMA guidelines. This review provides a comprehensive overview of the relationship between BD and neurocognitive anomalies reported across magnetic resonance studies. Moreover, this work is the first in which results of relatively new imaging techniques, such as resting-state functional connectivity (RS-FC) and neurite orientation dispersion and density imaging (NODDI), have been reviewed using a systematic procedure. We established strict inclusion criteria in order to isolate the various potential effects of BD on the adolescent brain. Two authors independently evaluated the methodological quality, assessing different aspects related to sample size, and statistical correction methods, which are of particular importance in neuroimaging studies. BD is associated with structural and functional anomalies in several cortical and subcortical brain regions intimately involved in the control and regulation of impulsive or risky behaviours, as well as in the processing of reinforcing stimuli.

Alcohol-related stimuli modulate functional connectivity during response inhibition in young binge drinkers

Binge drinking is a pattern of intermittent excessive alcohol consumption that is highly prevalent in young people. Neurocognitive dual-process models have described substance abuse and adolescence risk behaviours as the result of an imbalance between an overactivated affective-automatic system (related to motivational processing) and damaged and/or immature reflective system (related to cognitive control abilities). Previous studies have evaluated the reflective system of binge drinkers (BDs) through neutral response inhibition tasks and have reported anomalies in theta (4-8 Hz) and beta (12-30 Hz) bands. The present study aimed to investigate the influence of the motivational value of alcohol-related stimuli on brain functional networks devoted to response inhibition in young BDs. Sixty eight BDs and 78 control participants performed a beverage Go/NoGo task while undergoing electrophysiological recording. Whole cortical brain functional connectivity (FC) was evaluated during successful response inhibition trials (NoGo). BDs exhibited fast-beta and theta hyperconnectivity in regions related to cognitive control. These responses were modulated differently depending on the motivational content of the stimuli. The increased salience of alcohol-related stimuli may lead to overactivation of the affective-automatic system in BDs, and compensatory neural resources of the reflective system will thus be required during response inhibition. In BDs, inhibition of the response to alcohol stimuli may require higher theta FC to facilitate integration of information related to the task goal (withholding a response), while during inhibition of the response to no-alcoholic stimuli, higher fast-beta FC would allow to apply top-down inhibitory control of the information related to the prepotent response.

Better living through understanding the insula: Why subregions can make all the difference

Insula function is considered critical for many motivated behaviors, with proposed functions ranging from attention, behavioral control, emotional regulation, goal-directed and aversion-resistant responding. Further, the insula is implicated in many neuropsychiatric conditions including substance abuse. More recently, multiple insula subregions have been distinguished based on anatomy, connectivity, and functional contributions. Generally, posterior insula is thought to encode more somatosensory inputs, which integrate with limbic/emotional information in middle insula, that in turn integrate with cognitive processes in anterior insula. Together, these regions provide rapid interoceptive information about the current or predicted situation, facilitating autonomic recruitment and quick, flexible action. Here, we seek to create a robust foundation from which to understand potential subregion differences, and provide direction for future studies. We address subregion differences across humans and rodents, so that the latter's mechanistic interventions can best mesh with clinical relevance of human conditions. We first consider the insula's suggested roles in humans, then compare subregional studies, and finally describe rodent work. One primary goal is to encourage precision in describing insula subregions, since imprecision (e.g. including both posterior and anterior studies when describing insula work) does a disservice to a larger understanding of insula contributions. Additionally, we note that specific task details can greatly impact recruitment of various subregions, requiring care and nuance in design and interpretation of studies. Nonetheless, the central ethological importance of the insula makes continued research to uncover mechanistic, mood, and behavioral contributions of paramount importance and interest. This article is part of the special Issue on 'Neurocircuitry Modulating Drug and Alcohol Abuse'.

Identifying Internet Addiction and Evaluating the Efficacy of Treatment Based on Functional Connectivity Density: A Machine Learning Study

Although mounting neuroimaging studies have greatly improved our understanding of the neurobiological mechanism underlying internet addiction (IA), the results based on traditional group-level comparisons are insufficient in guiding individual clinical practice directly. Specific neuroimaging biomarkers are urgently needed for IA diagnosis and the evaluation of therapy efficacy. Therefore, this study aimed to develop support vector machine (SVM) models to identify IA and assess the efficacy of cognitive behavior therapy (CBT) based on unbiased functional connectivity density (FCD). Resting-state fMRI data were acquired from 27 individuals with IA before and after 8-week CBT sessions and 30 demographically matched healthy controls (HCs). The discriminative FCDs were computed as the features of the support vector classification (SVC) model to identify individuals with IA from HCs, and the changes in these discriminative FCDs after treatment were further used as features of the support vector regression (SVR) model to evaluate the efficacy of CBT. Based on the informative FCDs, our SVC model successfully differentiated individuals with IA from HCs with an accuracy of 82.5% and an area under the curve (AUC) of 0.91. Our SVR model successfully evaluated the efficacy of CBT using the FCD change ratio with a correlation efficient of 0.59. The brain regions contributing to IA classification and CBT efficacy assessment were the left inferior frontal cortex (IFC), middle frontal cortex (MFC) and angular gyrus (AG), the right premotor cortex (PMC) and middle cingulate cortex (MCC), and the bilateral cerebellum, orbitofrontal cortex (OFC) and superior frontal cortex (SFC). These findings confirmed the FCDs of hyperactive impulsive habit system, hypoactive reflecting system and sensitive interoceptive reward awareness system as potential neuroimaging biomarkers for IA, which might provide objective indexes for the diagnosis and efficacy evaluation of IA.

Neural correlates of inhibitory control in relation to the degree of substance use and substance-related problems - A systematic review and perspective

Inhibitory control deficits are associated with substance use disorders (SUDs) and considered a risk factor. Most studies compare SUD groups with unaffected individuals, although the degree of substance use might relate to inhibitory control deficits and explain group differences. This raises the question to which extent these deficits are specifically linked to substance-related problems. We review studies reporting associations of inhibition-related neural activation (stop signal and go/nogo task) with continuous measures of the degree of substance use and substance-related problems, and with substance-related problems controlling for the degree of substance use. Results suggest negative associations between inhibition-related neural activation and the degree of substance use, but are inconclusive on the association with substance-related problems. Nonetheless, two studies reported significant associations of inhibition-related neural activation with substance-related problems controlling for the degree of substance use. Despite numerous studies showing alterations in inhibition-related neural activation in SUDs, the role of the degree of substance use needs further investigation and studies using dimensional approaches are necessary to uncover specific links to substance-related problems.

Electroencephalographic signatures of the binge drinking pattern during adolescence and young adulthood: A PRISMA-driven systematic review

•

Controls and binge drinkers (BDs) do not differ in their behavioral performance.

•

BDs show increased neural activity during attention, working memory and inhibition.

•

Augmented P3 amplitude in BDs was the most solid electrophysiological finding.

•

Evidence does not support specific gender vulnerabilities to the effects of BD.

•

Memory, emotional processing and decision-making processes need further exploration.

Research on neurophysiological impairments associated with binge drinking (BD), an excessive but episodic alcohol use pattern, has significantly increased over the last decade. This work is the first to systematically review –following PRISMA guidelines- the empirical evidence regarding the effects of BD on neural activity –assessed by electroencephalography- of adolescents and young adults. A systematic review was conducted in 34 studies (N = 1723). Results indicated that binge drinkers (BDs) showed similar behavioral performance as non/low drinkers. The most solid electrophysiological finding was an augmented P3 amplitude during attention, working memory and inhibition tasks. This increased neural activity suggests the recruitment of additional resources to perform the task at adequate/successful levels, which supports the neurocompensation hypothesis. Similar to alcoholics, BDs also displayed increased reactivity to alcohol-related cues, augmented resting-state electrophysiological signal and reduced activity during error detection –which gives support to the continuum hypothesis. Evidence does not seem to support greater vulnerability to BD in females. Replication and longitudinal studies are required to account for mixed results and to elucidate the extent/direction of the neural impairments associated with BD.