0
ALCOHOL AND ADOLESCENT BRAIN DEVELOPMENT Sandra A. Brown, Ph.D. University of California, San Diego Veterans Health Servic...
Research support
Adolescence in the Lifespan Dahl,NYAS, 2002 Adolescence is the period between the onset of puberty and the attainment of a...
Adolescent AUDs/SUDs Occur in the Context of Developmental Changes <ul><li>Biological  (pubertal, neuroanatomical) </li></...
Alcohol is the Drug of Choice Among Adolescents Source:  Monitoring the Future, 2003
Youth Drink Less Frequently than Adults, but Drink More Per Occasion Source:  SAMHSA National Survey on Drug Use and Healt...
Source: Grant BF  et al .  Drug Alcohol Depend.  2004. 74(3):223-34.
Alcohol  and Youth  <ul><li>Alcohol Causes or  </li></ul><ul><li>Contributes to: </li></ul><ul><ul><ul><li>Physical and se...
Disentangling Multiple Reciprocal Relations Alcohol/ Drugs Neurocognitive Abilities Other Aspects Of Functioning
Neurobiological Studies of Alcohol Effects on Animals <ul><li>Adolescent animals are: </li></ul><ul><ul><ul><li>Less sensi...
Brain Development 1st  T 2nd  T 3rd  T 1 2 7 16 30  Prenatal Post - birth Age RATE OF CHANGE Volume Myelination Synaptic R...
The Human Brain Continues to Develop into the Early 20s >Increases in speed/efficiency  >More regional specialization >Lim...
Neurocognitive Impact of Alcohol on Youth Middle Adolescence -Fewer Learning  Strategies -Memory  Impairment Late Adolesce...
Neurocognitive Functioning of AUD and Community Teens <ul><li>Brown, et al. (2000).  Alcohol: Clin & Exp Res . </li></ul><...
Tapert et al. (1999).  Journal of Studies on Alcohol . Neurocognition, Coping & Relapse <ul><li>Youth with poorer attentio...
Neuropsychological Functioning of   Youth Four Years After Treatment Source: Tapert & Brown (1999).  J Int Neuropsych Soc ...
Alcohol and the Adolescent Brain <ul><li>Neuropsychological Findings </li></ul>Neuroimaging Research <ul><li>Planning/Exec...
Neurodevelopmental Research Issues <ul><li>Development:  biological and social </li></ul><ul><li>Gender  differences </li>...
fMRI Task SPATIAL WORKING MEMORY VIGILANCE FIXATION FIXATION 7:48 VIGILANCE TARGET TRIAL TARGET TRIAL SPATIAL WORKING MEMO...
Alcohol and Adolescents: Functional Magnetic Resonance Imaging (fMRI)   <ul><li>Adolescents (15-17 years old) with a histo...
GROUP T-TEST AUD teens had less BOLD response while doing the spatial working memory in parietal and cingulate regions (p<...
Regressions  with N=24  (Control+AUD) p<.01 Post-Drinking Effects Predict Activation Drinks per Month Predict Activation P...
Alcohol and Adolescents: Functional Magnetic Resonance Imaging (fMRI) <ul><li>18-22 year olds with a history of alcohol de...
Exposure to Alcohol Cues and Brain Reactivity: Adolescents <ul><li>Does the  brain react differently to alcohol  cues afte...
Cue Reactivity: Alcohol Dependent Adolescents vs. Controls Non-Alcohol Pictures Alcohol Pictures Tapert et al. (2003).  Ar...
Tapert., Cheung,  G. Brown, Frank, Paulus, Schweinsburg,  Meloy, &  S.A. Brown (2003).  fMRI Results of AUD and Control Ad...
Teen’s Brain Response <ul><li>Alcohol picture trials relative to non-alcohol beverage trials: </li></ul><ul><li>Orange: AU...
Alcohol and the Adolescent Brain: What Do We Know? <ul><li>Early involvement is associated with poorer    behavioral measu...
What Do We Need to Learn? <ul><li>1. Are these deficits/brain changes permanent? </li></ul><ul><ul><ul><li>How long do the...
The End
Upcoming SlideShare
Loading in...5
×

Alcohol &amp; Adolescent Brain Development

2,015

Published on

0 Comments
1 Like
Statistics
Notes
  • Be the first to comment

No Downloads
Views
Total Views
2,015
On Slideshare
0
From Embeds
0
Number of Embeds
0
Actions
Shares
0
Downloads
43
Comments
0
Likes
1
Embeds 0
No embeds

No notes for slide
  • 10.7 million youth 12 to 20 were current drinkers. 7.2 million of current drinkers were binge drinkers . 2.3 million of binge drinkers were heavy drinkers who engaged in binge drinking on at least five different days during the past 30 days
  • Adol cog fx and treatment response: -few studies Adults: Alcoholics who resumed drinking (N = 41) performed significantly poorer on an overall neuropsychological performance index than abstainers (N = 62) (Parsons, Schaefer, Glenn) Time-dependent versus experience-dependent recovery (Goldman &amp; Roehrich) - Adults *some exercises and mental activity may assist in speeding cognitive recovery from heavy substance use Accumulating research has shown that some cognitive deficits in recently abstinent alcoholics (e.g., cognitive flexibility, acquisition of novel skills) improve only with remediation in contrast to the spontaneous, time-dependent rebound seen for other tasks. In principle, this facilitated or experience-dependent recovery should enhance acquisition of the content of alcoholism treatment programs, but this relationship has yet to be tested empirically; previous research assessed recovery using only neuropsychological tasks presented by an experimenter. The current investigation focused on treatment-relevant remediation (acquisition of the content of a relapse-prevention [RP] program) using tasks administered by self-guided workbooks. Four groups of male alcoholics received pre- and posttesting. Between the two testing sessions, the groups received neuropsychological remediation tasks (n = 15), ecologically relevant tasks (n = 15), attention-placebo tasks (n = 16), or no intervention (n = 15). Results showed that exposure to both types of remediation produced significant cognitive recovery, with skills transferring to posttest neuropsychological measures and RP acquisition. Hence, cognitive remediation may facilitate alcoholism treatment.
  • We were interested in brain response to alcohol-related cues in adolescents with AUD, and were especially interested in alcohol ads, which teens see every day. We assembled a collection of alcohol ads from magazines often read by teens, and gathered non-alc beverage ads with similar visual features (we are currently in the process of expanding the # of these images and norming them using the IAPS methodology) We administered the alcohol and non-alc bev pics to AUD and non-AUD teens during FMRI data collection.
  • Orange shows where AUD adolescent’s had significantly more brain response than light drinking youth to alcohol stimuli (specifically, alcohol advertisement pictures) relative to non-alcohol stimuli (non-alcohol beverage advertisement pictures). AUD teens showed significantly more brain (BOLD) response in prefrontal, nucleus accumbens, and visual attention cortex. Tapert , S. F. , Cheung, E . H., Brown, G . G., Frank, L . R., Paulus, M . P., Schweinsburg, A . D., Meloy, M. J., &amp; Brown, S . A. (2003). Neural r esponse to a lcohol s timuli in adolescents with a lcohol u se disorder. Archives of General Psychiatry , 60 , 727-735.
  • Putting it all together … 4. Parietal and frontal regions were under-activated in alcohol dependent young women relative to controls *Differential sensitivity: These regions may be particularly sensitive to ethanol effects *Developmental differences : Parietal and frontal regions may be affected earlier in the course of alcohol dependence -we know that these are the last regions to myelinate during human brain development – into adolescence and ages at which youth may well be drinking harmful amounts Consistent with adult studies in that decrements in functioning are apparent in group comparisons; not severe; not in all subjects Developmental differences: less impairment of cognitive flexibility; less severity; but drinking before myelination &amp; pruning are complete may cause more damage but may allow possibility for future recoverability with abstinence
  • Putting it all together … 4. Parietal and frontal regions were under-activated in alcohol dependent young women relative to controls *Differential sensitivity: These regions may be particularly sensitive to ethanol effects *Developmental differences : Parietal and frontal regions may be affected earlier in the course of alcohol dependence -we know that these are the last regions to myelinate during human brain development – into adolescence and ages at which youth may well be drinking harmful amounts Consistent with adult studies in that decrements in functioning are apparent in group comparisons; not severe; not in all subjects Developmental differences: less impairment of cognitive flexibility; less severity; but drinking before myelination &amp; pruning are complete may cause more damage but may allow possibility for future recoverability with abstinence
  • Transcript of "Alcohol &amp; Adolescent Brain Development"

    1. 1. ALCOHOL AND ADOLESCENT BRAIN DEVELOPMENT Sandra A. Brown, Ph.D. University of California, San Diego Veterans Health Service System
    2. 2. Research support
    3. 3. Adolescence in the Lifespan Dahl,NYAS, 2002 Adolescence is the period between the onset of puberty and the attainment of adult roles and responsibilities. Dahl, 2002 Fetus Child Adolescent Young Adult Middle Age Senior Adol escent
    4. 4. Adolescent AUDs/SUDs Occur in the Context of Developmental Changes <ul><li>Biological (pubertal, neuroanatomical) </li></ul><ul><li>Socioemotional (family/peer/intimate relations, emotional lability and management) </li></ul><ul><li>Cognitive (information processing, executive functioning) </li></ul><ul><li>Behavioral (risk taking, self-regulation) </li></ul>Exposure to New and More Diverse Environments
    5. 5. Alcohol is the Drug of Choice Among Adolescents Source: Monitoring the Future, 2003
    6. 6. Youth Drink Less Frequently than Adults, but Drink More Per Occasion Source: SAMHSA National Survey on Drug Use and Health, 2002 (12-17) (26 and older)
    7. 7. Source: Grant BF et al . Drug Alcohol Depend. 2004. 74(3):223-34.
    8. 8. Alcohol and Youth <ul><li>Alcohol Causes or </li></ul><ul><li>Contributes to: </li></ul><ul><ul><ul><li>Physical and sexual assault/high-risk sexual behavior </li></ul></ul></ul><ul><ul><ul><li>Adverse effects on bones, liver, growth & reproductive function </li></ul></ul></ul><ul><ul><ul><li>Academic problems and early dropout </li></ul></ul></ul><ul><ul><ul><li>Neurocognitive impairment and reduced hippocampal volume </li></ul></ul></ul><ul><li>Source: Brown, 2004 </li></ul>
    9. 9. Disentangling Multiple Reciprocal Relations Alcohol/ Drugs Neurocognitive Abilities Other Aspects Of Functioning
    10. 10. Neurobiological Studies of Alcohol Effects on Animals <ul><li>Adolescent animals are: </li></ul><ul><ul><ul><li>Less sensitive to sedative effects of acute intoxication </li></ul></ul></ul><ul><ul><ul><li>More sensitive to disruption of memory, impairment of neurotransmission in hippocampus and cortex, and social facilitation </li></ul></ul></ul><ul><li>Binge exposure produces long-lasting memory effects and damage to frontal-anterior cortical regions. </li></ul><ul><li>Prolonged ethanol exposure enhances withdrawal and produces changes in cortex and hippocampus. </li></ul>Source: Spear & Varlinskaya, 2005
    11. 11. Brain Development 1st T 2nd T 3rd T 1 2 7 16 30 Prenatal Post - birth Age RATE OF CHANGE Volume Myelination Synaptic Refinement Metabolism Blood Flow Receptors
    12. 12. The Human Brain Continues to Develop into the Early 20s >Increases in speed/efficiency >More regional specialization >Limbic region (emotions) matures earlier than frontal lobes (planning, self-control, decision making) Source: Geidd, 2004
    13. 13. 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 .
    14. 14. Neurocognitive Functioning of AUD and Community Teens <ul><li>Brown, et al. (2000). Alcohol: Clin & Exp Res . </li></ul><ul><li>Gender </li></ul><ul><li>Age </li></ul><ul><li>Grade </li></ul><ul><li>SES </li></ul><ul><li>FH </li></ul><ul><li>3 wks abstinent </li></ul>10% 10%
    15. 15. Tapert et al. (1999). Journal of Studies on Alcohol . Neurocognition, Coping & Relapse <ul><li>Youth with poorer attention functioning who have poor coping skills are at very high relapse risk </li></ul>
    16. 16. Neuropsychological Functioning of Youth Four Years After Treatment Source: Tapert & Brown (1999). J Int Neuropsych Soc .
    17. 17. Alcohol and the Adolescent Brain <ul><li>Neuropsychological Findings </li></ul>Neuroimaging Research <ul><li>Planning/Executive Functioning </li></ul><ul><li>Memory </li></ul><ul><li>Visuospatial Skills </li></ul><ul><li>Attention </li></ul><ul><li>Reduced size of hippocampus </li></ul><ul><li>Less brain response on memory tests </li></ul><ul><li>Greater reactivity to alcohol cues </li></ul>
    18. 18. Neurodevelopmental Research Issues <ul><li>Development: biological and social </li></ul><ul><li>Gender differences </li></ul><ul><li>Family history of alcohol/substance </li></ul><ul><ul><li>use disorder </li></ul></ul><ul><li>Psychiatric comorbidity </li></ul><ul><li>Polysubstance use </li></ul><ul><li>Abstinence duration </li></ul>
    19. 19. fMRI Task SPATIAL WORKING MEMORY VIGILANCE FIXATION FIXATION 7:48 VIGILANCE TARGET TRIAL TARGET TRIAL SPATIAL WORKING MEMORY TARGET TRIAL
    20. 20. Alcohol and Adolescents: Functional Magnetic Resonance Imaging (fMRI) <ul><li>Adolescents (15-17 years old) with a history of heavy drinking show less BOLD response to challenging cognitive tasks than nondrinking peers. </li></ul>
    21. 21. GROUP T-TEST AUD teens had less BOLD response while doing the spatial working memory in parietal and cingulate regions (p<.025). side view R L STRONG INTENSITY STRONG INTENSITY Controls more activated than AUD AUD more activated than Controls
    22. 22. Regressions with N=24 (Control+AUD) p<.01 Post-Drinking Effects Predict Activation Drinks per Month Predict Activation Post-drinking effects predict much less activation #Drinks predict more activation #Drinks predict less activation
    23. 23. Alcohol and Adolescents: Functional Magnetic Resonance Imaging (fMRI) <ul><li>18-22 year olds with a history of alcohol dependence also show reduced brain activation. </li></ul><ul><li>These youth also have a 10% lower performance on visuospatial memory tests. </li></ul>
    24. 24. Exposure to Alcohol Cues and Brain Reactivity: Adolescents <ul><li>Does the brain react differently to alcohol cues after youth have had alcohol experience? </li></ul><ul><li>Does alcohol experience make a difference in likelihood to respond to alcohol advertisements? </li></ul><ul><ul><li>YES !!!!!! </li></ul></ul>
    25. 25. Cue Reactivity: Alcohol Dependent Adolescents vs. Controls Non-Alcohol Pictures Alcohol Pictures Tapert et al. (2003). Arch Gen Psychiatry + + + + +
    26. 26. Tapert., Cheung, G. Brown, Frank, Paulus, Schweinsburg, Meloy, & S.A. Brown (2003). fMRI Results of AUD and Control Adolescents During Alcohol Pictures Relative to Non-Alcohol Beverage Trials -21 -13 -5 +3 +11 +19 Left Right +27 +35 +43 +51 +59 +67 Orange = AUD > Controls Blue = Controls > AUD Numbers = Axial Slice Position
    27. 27. Teen’s Brain Response <ul><li>Alcohol picture trials relative to non-alcohol beverage trials: </li></ul><ul><li>Orange: AUD teens had more response to alcohol pictures </li></ul><ul><li>Tapert et al., 2003, Arch Gen Psychiatry </li></ul>LEFT HEMISPHERE <ul><li>Affect </li></ul><ul><li>Interest </li></ul><ul><li>Craving </li></ul>Anterior cingulate & NAc Orbital/prefrontal (BA11)
    28. 28. Alcohol and the Adolescent Brain: What Do We Know? <ul><li>Early involvement is associated with poorer behavioral measures of thinking abilities of youth. </li></ul><ul><ul><ul><li>-Memory and Learning Strategies </li></ul></ul></ul><ul><ul><ul><li>-Visuospatial Abilities and Attention </li></ul></ul></ul><ul><li>2. Continued heavy use leads to greater deterioration in cognitive functioning. </li></ul><ul><li>3. Early alcohol involvement is associated with under activation in several brain regions during cognitive tasks. </li></ul><ul><li> - Frontal and Prefrontal </li></ul><ul><li> - Parietal and Cingulate </li></ul><ul><li>4. Teens with alcohol experience are more reactive to alcohol cues/advertisements. </li></ul>
    29. 29. What Do We Need to Learn? <ul><li>1. Are these deficits/brain changes permanent? </li></ul><ul><ul><ul><li>How long do they last? </li></ul></ul></ul><ul><ul><ul><li>Can we speed recovery? </li></ul></ul></ul><ul><li>2. To what extent are neurocognitive and neuroanatomical differences present before alcohol use starts? </li></ul><ul><li>3. Which children are most vulnerable to these adverse alcohol consequences? </li></ul>
    30. 30. The End
    1. A particular slide catching your eye?

      Clipping is a handy way to collect important slides you want to go back to later.

    ×