ALCOHOL AND ADOLESCENT BRAIN DEVELOPMENT

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ALCOHOL AND ADOLESCENT BRAIN DEVELOPMENT
Sandra A. Brown, Ph.D. University of California,
San Diego Veterans Health Service System
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Research support
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Adolescence in the Lifespan
Young Adult
escent
Adolescent
Adol
Middle Age
Child
Senior
Fetus
Adolescence is the period between the onset of
puberty and the attainment of adult roles
and responsibilities.
Dahl, 2002
Dahl,NYAS, 2002
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Adolescent AUDs/SUDs Occur in the Context of
Developmental Changes

• Biological (pubertal, neuroanatomical)
• Socioemotional (family/peer/intimate relations,
  emotional lability and management)
• Cognitive (information processing, executive
  functioning)
• Behavioral (risk taking, self-regulation)

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Alcohol is the Drug of Choice Among Adolescents
Source Monitoring the Future, 2003
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Youth Drink Less Frequently than Adults, but
Drink More Per Occasion
Source SAMHSA National Survey on Drug Use and
Health, 2002
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Alcohol and Youth

• Alcohol Causes or
• Contributes to
• Physical and sexual assault/high-risk sexual
  behavior
• Adverse effects on bones, liver, growth
  reproductive function
• Academic problems and early dropout
• Neurocognitive impairment and reduced hippocampal
  volume
• Source Brown, 2004

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Disentangling Multiple Reciprocal Relations

Neurocognitive Abilities
Alcohol/ Drugs
Other Aspects Of Functioning
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Neurobiological Studies of Alcohol Effects on
Animals

• Adolescent animals are
• Less sensitive to sedative effects of acute
  intoxication
• More sensitive to disruption of memory,
  impairment of neurotransmission in hippocampus
  and cortex, and social facilitation
• Binge exposure produces long-lasting memory
  effects and damage to frontal-anterior cortical
  regions.
• Prolonged ethanol exposure enhances withdrawal
  and produces changes in cortex and hippocampus.

Source Spear Varlinskaya, 2005
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Brain Development
RATE OF CHANGE
1st
2nd
3rd
1

2

7

30

16

T

T

T

Prenatal

Post
-
birth Age

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The Human Brain Continues to Develop into the
Early 20s

• gtIncreases in speed/efficiency
• gtMore regional specialization
• gtLimbic region (emotions) matures earlier
• than frontal lobes (planning, self-control,
  decision making)
• Source Geidd, 2004

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Neurocognitive Impact of Alcohol on Youth
Middle Adolescence -Fewer Learning
Strategies -Memory
Impairment Late Adolescence
-Attentional Decrement
-Visuospatial Impairment Withdrawal
May Impact Different Abilities than Use.
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Neurocognitive Functioning of AUD and Community
Teens
10
10

• Gender
• Age
• Grade
• SES
• FH
• 3 wks abstinent

• Brown, et al. (2000). Alcohol Clin
  Exp Res.

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Neurocognition, Coping Relapse

• Youth with poorer attention functioning who have
  poor coping skills are at very high relapse risk

Tapert et al. (1999). Journal of Studies on
Alcohol.
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Neuropsychological Functioning of Youth Four
Years After Treatment
Source Tapert Brown (1999). J Int Neuropsych
Soc.
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Alcohol and the Adolescent Brain

• Neuropsychological Findings

• Planning/Executive Functioning
• Memory
• Visuospatial Skills
• Attention

Neuroimaging Research

• Reduced size of hippocampus
• Less brain response on memory tests
• Greater reactivity to alcohol cues

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Neurodevelopmental Research Issues

• Development biological and social
• Gender differences
• Family history of alcohol/substance
• use disorder
• Psychiatric comorbidity
• Polysubstance use
• Abstinence duration

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fMRI Task
SPATIAL WORKING MEMORY
VIGILANCE
FIXATION
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Alcohol and Adolescents Functional Magnetic
Resonance Imaging (fMRI)

• Adolescents (15-17 years old) with a history of
  heavy drinking show less BOLD response to
  challenging cognitive tasks than nondrinking
  peers.

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GROUP T-TEST
side view
R
L
AUD teens had less BOLD response while doing the
spatial working memory in parietal and cingulate
regions (plt.025).
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Post-Drinking Effects Predict Activation
Drinks per Month Predict Activation
Regressions with N24 (ControlAUD)plt.01
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Alcohol and Adolescents Functional Magnetic
Resonance Imaging (fMRI)

• 18-22 year olds with a history of alcohol
  dependence also show reduced brain activation.
• These youth also have a 10 lower performance on
  visuospatial memory tests.

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Exposure to Alcohol Cues and Brain Reactivity
Adolescents

• Does the brain react differently to alcohol
  cues after youth have had alcohol experience?
• Does alcohol experience make a difference in
  likelihood to respond to alcohol advertisements?
• YES !!!!!!

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Cue Reactivity Alcohol Dependent Adolescents vs.
Controls
Non-Alcohol Pictures
Alcohol Pictures
Tapert et al. (2003). Arch Gen Psychiatry
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fMRI Results of AUD and Control Adolescents
During Alcohol Pictures Relative to Non-Alcohol
Beverage Trials
Tapert., Cheung, G. Brown, Frank, Paulus,
Schweinsburg, Meloy, S.A. Brown (2003).
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Teens Brain Response

• Alcohol picture trials relative to non-alcohol
  beverage trials

• Affect
• Interest
• Craving

LEFT HEMISPHERE

• Orange AUD teens had more response to alcohol
  pictures
• Tapert et al., 2003, Arch Gen Psychiatry

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Alcohol and the Adolescent Brain What Do We Know?

• Early involvement is associated with poorer
  behavioral measures of thinking abilities of
  youth.
• -Memory and Learning Strategies
• -Visuospatial Abilities and Attention
• 2. Continued heavy use leads to greater
  deterioration in cognitive functioning.
• 3. Early alcohol involvement is associated with
  under activation in several brain regions
  during cognitive tasks.
• - Frontal and Prefrontal
• - Parietal and Cingulate
• 4. Teens with alcohol experience are more
  reactive to alcohol cues/advertisements.

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What Do We Need to Learn?

• 1. Are these deficits/brain changes permanent?
• How long do they last?
• Can we speed recovery?
• 2. To what extent are neurocognitive and
  neuroanatomical differences present before
  alcohol use starts?
• 3. Which children are most vulnerable to these
  adverse alcohol consequences?

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The End