Effects of adolescent alcohol consumption on the brain and behaviour

Nitrate ameliorates alcohol-induced cognitive impairment via oral microbiota

Alcohol use is associated with cognitive impairment and dysregulated inflammation. Oral nitrate may benefit cognitive impairment in aging through altering the oral microbiota. Similarly, the beneficial effects of nitrate on alcohol-induced cognitive decline and the roles of the oral microbiota merit investigation. Here we found that nitrate supplementation effectively mitigated cognitive impairment induced by chronic alcohol exposure in mice, reducing both systemic and neuroinflammation. Furthermore, nitrate restored the dysbiosis of the oral microbiota caused by alcohol consumption. Notably, removing the oral microbiota led to a subsequent loss of the beneficial effects of nitrate. Oral microbiota from donor alcohol use disordered humans who had been taking the nitrate intervention were transplanted into germ-free mice which then showed increased cognitive function and reduced neuroinflammation. Finally, we examined 63 alcohol drinkers with varying levels of cognitive impairment and found that lower concentrations of nitrate metabolism-related bacteria were associated with higher cognitive impairment and lower nitrate levels in plasma. These findings highlight the protective role of nitrate against alcohol-induced cognition impairment and neuroinflammation and suggest that the oral microbiota associated with nitrate metabolism and brain function may form part of a "microbiota-mouth-brain axis".

Analysis of the synergy between prenatal ethanol and postnatal adolescent ethanol exposure

Prenatal ethanol exposure (PEE) is associated with long-lasting neurodevelopmental alterations that increase susceptibility to adverse behavioral outcomes, including greater likelihood of binge drinking during adolescence. However, the interactive effects of these two developmental risk factors remain underexplored. The present study investigated the synergistic impact of PEE and adolescent binge-like ethanol exposure on behavioral and ethanol consumption patterns in Wistar rats. Pregnant dams received ethanol (2.0 g/kg/day) or vehicle from gestational days 17-20. Offspring were subjected to intermittent ethanol exposure (4.0 g/kg/day, two days on-two days off) or vehicle from postnatal days 23-36. Behavioral assessments included tests for anxiety-like behaviors (light-dark box test), anhedonia (sucrose preference test), exploratory behavior (multivariate concentric square field test), and voluntary ethanol consumption in early adulthood. PEE was associated with increased overall fluid consumption (p = 0.001, η2p = 0.17) and a sex-dependent increase in ethanol intake (p = 0.001, η2p = 0.05). PEE rats displayed reduced sucrose preference (p = 0.02, η2p = 0.07), suggesting an anhedonic-like phenotype independent of adolescent ethanol exposure. The latter exposure induced an anxious phenotype, characterized by reduced time in the illuminated compartment of the light-dark box test, which was attenuated in PEE-exposed rats (p = 0.03, η2p = 0.06). These findings suggest that PEE (a) facilitates ethanol consumption in offspring, potentially through tolerance mechanisms or altered chemosensory processing; and (b) modulates anxiety-like behaviors induced by adolescent ethanol exposure. Understanding these interactions is critical for elucidating the mechanisms underlying alcohol use disorders and designing targeted interventions for at-risk populations.

Global, regional, and national burden of pancreatitis in children and adolescents

BACKGROUND

Pancreatitis poses a growing public health concern among children and adolescents, yet comprehensive data on its prevalence, incidence, mortality, and disability-adjusted life years (DALYs) remain scarce. This study aims to analyze global, regional, and national trends in pancreatitis burden over the past 3 decades.

METHODS

Using data from the Global Burden of Disease (GBD) 2019 database spanning 1990-2019, we assessed pancreatitis prevalence, incidence, mortality, and DALYs, reporting on numbers, rates, age-standardized prevalence rate (ASPR), age-standardized incidence rate (ASIR), age-standardized mortality rate (ASMR), age-standardized DALYs rate (ASDR), and average annual percentage changes (AAPCs). Trends were analyzed by age, sex, region, and socio-demographic index (SDI) using jointpoint analysis and predictive modeling.

RESULTS

Globally, pancreatitis prevalence and incidence rates have increased (AAPC prevalence = 0.13, 95% CI: 0.11-0.16; AAPC incidence = 0.30, 95% CI: 0.28-0.32), while mortality and DALYs rates have decreased (AAPC mortality = -1.30, 95% CI: -1.53, -1.07; AAPC DALYs = -1.21, 95% CI: -1.41, -1.01). Both genders showed similar trends. Children under 5 and adolescents 15-19 had higher mortality and DALYs rates. Low SDI regions experienced the greatest increase in ASIR. Eastern Europe exhibited high and rising ASIR, ASMR, and ASDR. Projections indicate continued rise in prevalence with declining mortality and DALYs.

CONCLUSION

Pancreatitis burden in children and adolescents has surged globally, especially in lower SDI regions. These findings underscore the urgent need for targeted interventions and healthcare resources in affected areas.

A network analysis of alcohol-related harms: An exploratory study in United Kingdom adolescents

BACKGROUND

This study applied a network analysis approach to the study of individual self-reported alcohol-related harms (ARHs) across four waves of data.

METHODS

Data were from a large clustered randomised control trial (N = 12,738) involving 105 schools. Data were collected at 4 time points over 4 academic years (mean age 12.5 [Time 0], 13.5 [T1], 14.5 [T2], and 15.3 years [Time 3]). Data were gathered on the experience of 16 separate ARHs experienced during the previous six months, and these were dichotomised (yes/no). We estimated cross-lagged panel networks for the 16 ARHs, capturing both the auto-regressive relationships (a harm predicting itself at follow up) and the cross-lagged relationships (a harm predicting another harm at follow-up) across the study (T0 → T1; T1 → T2; T2 →T3).

RESULTS

Exposure to all ARHs increased with age. However, the most serious ARHs (e.g., getting in trouble with the police because of your drinking) remained relatively rare, even at age 15. Actively planning to get drunk, coupled with an inability to control levels of intoxication (drinking more than planned) appeared central to each network, facilitating the emergence of all other ARHs. While the prevalence of ARHs increased with age, network complexity declined, and networks becoming more stable.

CONCLUSIONS

Interventions aimed at improving the capacity to self-regulate alcohol consumption, and actively challenging the planning of drunken episodes, may be pivotal in reducing the emergence of both acute and chronic ARHs in adolescence.

Relevance of Probabilistic Reversal Learning for Adolescent Drinking Trajectories

One of the many human capabilities acquired during adolescence is the adaptivity in changing environments. In this longitudinal study, we investigated this adaptivity, as measured by probabilistic reversal learning (PReL) tasks, in N = 143 adolescents at ages 14, 16 and 18. Computational modelling and functional magnetic resonance imaging were applied to identify the neurocognitive processes underlying reversal learning and its development. Previous studies have demonstrated a correlation between heavy alcohol use and impaired reversal learning. Our hypothesis was that PReL is negatively associated with current and future alcohol use and that alcohol use impairs PReL by altering neurocognitive processes. Behaviourally, PReL performance improved, which was associated with a lower probability of switching choices and was considered an adaptive process. Computationally, this was accounted for by higher learning rates, enhanced sensitivity to wins and reduced sensitivity to losses in older adolescents. Alcohol consumption increased but remained at a low level for most participants. More risky drinking was associated with less medial frontal activity elicited by reward prediction errors. These findings suggest that reversal learning may be more relevant for the maintenance or escalation of risky than for low-level drinking. Challenges and potential solutions for longitudinal studies such as reliability are discussed.

Longitudinal associations between childhood adversity and alcohol use behaviours in early adulthood: Examining the mediating roles of parental and peer relationships

BACKGROUND

Research has demonstrated positive associations between adverse childhood experiences (ACEs) and alcohol use behaviours in young adults. However, many of these are based on cross-sectional data. The pathway between ACEs and alcohol misuse among emerging adults is not fully understood and there is a lack of data on how parental and peer relationships may mediate this relationship.

OBJECTIVE

To examine ACE exposure relationships with alcohol use behaviours and determine if associations between ACEs and harmful alcohol use are mediated by parent and peer relationships and school engagement.

PARTICIPANTS AND SETTING

Participants (n = 4729) were a cohort of children recruited to the Growing Up in Ireland study, a nationally representative longitudinal sample of children.

METHODS

Linear and logistic regression analyses examined individual and cumulative ACE exposure relationships with alcohol use behaviours at age 20 years. Mediation analyses assessed whether parental and peer relationships and school engagement mediate ACE history associations with harmful alcohol use.

RESULTS

Exposure to ACEs in childhood was associated with higher Alcohol Use Disorders Identification Test (AUDIT) scores and alcohol dependence at age 20. Young adults who experienced 3+ ACEs had a three-fold (OR = 3.33, 95 % CI: 2.00, 5.55) increased odds of alcohol dependence when compared to participants who experienced no ACEs. Mediation analyses suggested that parent and peer relationships partially mediate associations between ACEs and harmful alcohol use behaviours.

CONCLUSIONS

Children who have experienced ACEs are at higher risk of harmful alcohol use. In supporting these children, identified mediators may help guide selection of prevention interventions.

Estrogen and alcohol use in women: a targeted literature review

PURPOSE

Alcohol is posited to affect sex steroid hormone concentrations, and a growing body of research has demonstrated menstrual cycle effects on women's use of alcohol. The present targeted review synthesizes the literature examining the relationship between alcohol use and estradiol in women and suggests directions for future research.

METHODS

Articles were identified using the PubMed database using the following criteria: published in English, presented original findings for women, were peerreviewed, and included measures of estradiol levels in the analyses. Twenty-nine articles were identified for inclusion.

RESULTS

Results from this review indicate acute alcohol use temporarily increases estradiol levels in women, and this may be strongest when gonadotropins are high. Regular alcohol use (≥1 drink per day) increases estradiol levels, but estradiol appears to be suppressed in women with alcohol use disorders and physiologic dependence. Alcohol use tends to be highest in women during ovulation, when estradiol is high, and progesterone is low.

CONCLUSION

Alcohol use increases estradiol levels in women, particularly in the presence of gonadotropins. More research is needed to assess the effect of estradiol on alcohol use in women. Research on the relationship of estrogen and alcohol use in women is needed to elucidate health outcomes through the lifespan.

Adolescent alcohol exposure promotes mechanical allodynia and alters synaptic function at inputs from the basolateral amygdala to the prelimbic cortex

Binge drinking is common among adolescents despite mounting evidence linking it to various adverse health outcomes that include heightened pain perception. The prelimbic (PrL) cortex is vulnerable to insult from adolescent alcohol exposure and receives input from the basolateral amygdala (BLA) while sending projections to the ventrolateral periaqueductal gray (vlPAG) - two brain regions implicated in nociception. In this study, adolescent intermittent ethanol (AIE) exposure was carried out in male and female rats using a vapor inhalation procedure. Assessments of mechanical and thermal sensitivity revealed that AIE exposure induced protracted mechanical allodynia. To investigate synaptic function at BLA inputs onto defined populations of PrL neurons, retrobeads and viral labelling were combined with optogenetics and slice electrophysiology. Recordings from retrobead labelled cells in the PrL revealed AIE reduced BLA driven feedforward inhibition of neurons projecting from the PrL to the vlPAG, resulting in augmented excitation/inhibition (E/I) balance and increased intrinsic excitability. Consistent with this finding, recordings from virally tagged PrL parvalbumin interneurons (PVINs) demonstrated that AIE exposure reduced both E/I balance at BLA inputs onto PVINs and PVIN intrinsic excitability. These findings provide compelling evidence that AIE alters synaptic function and intrinsic excitability within a prefrontal nociceptive circuit.

Recent Investigations Designed to Unravel the Interaction of Age and Alcohol on Behavior and Cognition: Potential Neurobiological Mechanisms

Understanding factors that alter the effect of alcohol in biological systems has been an area of active investigation for several decades. Recently, it has become clear that age is one of the most salient factors influencing how both acute and chronic alcohol exposure alters behavioral function. The following book chapter discusses how alcohol produces differential effects in adolescent animals in comparison to adult and aged (i.e., older) animals. Furthermore, where possible, relevant research identifying possible brain mechanisms mediating the differential effects of alcohol will be discussed. Finally, we highlight a small number of studies where sex and age of the subject interact to modify cognitive impairments produced by alcohol. We conclude that much work still needs to be done to fully understand how age, sex, and alcohol interact to produce the wide range of effects caused by consumption of the drug.

A randomized controlled trial testing the efficacy of the eCHECKUP TO GO on drinking games participation and behavior among high school seniors

BACKGROUND

Among high school students, seniors report the highest levels of hazardous drinking behavior, including playing drinking games. Technology-based interventions are a promising approach for reducing hazardous drinking behavior among this age group.

OBJECTIVES

This randomized controlled trial investigated the efficacy of the eCHECKUP TO GO, an online personalized feedback intervention, on reducing the frequency of playing drinking games, the number of drinks consumed while playing drinking games, and the number of drinks consumed on occasions when drinking games were played among high school seniors (ClinicalTrials.gov Identifier NCT03613818).

METHOD

Participants were recruited from two high schools. Class periods were randomized to the intervention condition or an assessment-only control condition. Participants completed online surveys at baseline, 30-day, and 6-month assessments. The subsample in this study (N = 109) consisted of high-risk drinkers (i.e., students reporting binge drinking in the past two weeks at baseline).

RESULTS

We did not find any significant differences in frequency of playing drinking games between the intervention and control conditions. For number of drinks consumed, students in the intervention condition reported a significant reduction in the number of drinks consumed while playing drinking games (p < 0.01) and total number of drinks consumed on drinking game occasions (p < 0.04) at the 30-day follow-up relative to students in the control condition. Reductions within the intervention group were sustained at the 6-month follow-up.

CONCLUSIONS

Results support the efficacy of the eCHECKUP TO GO for decreasing hazardous alcohol use among high school seniors.

The differential effects of parent-targeted alcohol harm-reduction campaigns with varying executional styles

INTRODUCTION

Parental provision of alcohol to children is associated with a range of negative outcomes. Public health campaigns discouraging this practice are required as part of a comprehensive approach to reduce alcohol-related harm among minors, however, limited research has examined the relative effectiveness of different messaging approaches. This study compared the effects of two campaigns with different executional styles on parents' intentions to provide alcohol to minors-one campaign used a fear-based approach and the other adopted a first-person narrative approach.

METHODS

The study used a repeated cross-sectional design. An independent samples t-test was used to compare the effects of two campaigns with alternative executional styles on parents' alcohol provision intentions. Two ordinal logistic generalised linear models were used to assess whether intentions effects differed according to parents' demographic and behavioural characteristics.

RESULTS

Both campaigns were effective at motivating parents to abstain from providing alcohol to minors. This outcome was particularly notable among female respondents and those who had never provided alcohol to their children. Older respondents and those who used less alcohol were more likely to intend to change their behaviours as a result of exposure to the fear-based campaign, while the campaign using a narrative approach was more effective with heavier drinkers.

DISCUSSION AND CONCLUSIONS

Overall strong performance of both campaigns combined with varying effectiveness by parent attributes highlights the utility of parent-focused campaigns targeting alcohol provision to minors. To best protect minors, continued investments are needed to develop suites of evidence-based campaigns that resonate with different parent subgroups.

Excessive Alcohol Use as a Risk Factor for Alzheimer's Disease: Epidemiological and Preclinical Evidence

Alcohol use has recently emerged as a modifiable risk factor for Alzheimer's disease (AD). However, the neurobiological mechanisms by which alcohol interacts with AD pathogenesis remain poorly understood. In this chapter, we review the epidemiological and preclinical support for the interaction between alcohol use and AD. We hypothesize that alcohol use increases the rate of accumulation of specific AD-relevant pathologies during the prodromal phase and exacerbates dementia onset and progression. We find that alcohol consumption rates are increasing in adolescence, middle age, and aging populations. In tandem, rates of AD are also on the rise, potentially as a result of this increased alcohol use throughout the lifespan. We then review the biological processes in common between alcohol use disorder and AD as a means to uncover potential mechanisms by which they interact; these include oxidative stress, neuroimmune function, metabolism, pathogenic tauopathy development and spread, and neuronal excitatory/inhibitory balance (EIB). Finally, we provide some forward-thinking suggestions we believe this field should consider. In particular, the inclusion of alcohol use assessments in longitudinal studies of AD and more preclinical studies on alcohol's impacts using better animal models of late-onset Alzheimer's disease (LOAD).

Adolescent Alcohol and the Spectrum of Cognitive Dysfunction in Aging

Among the many changes associated with aging, inflammation in the central nervous system (CNS) and throughout the body likely contributes to the constellation of health-related maladies associated with aging. Genetics, lifestyle factors, and environmental experiences shape the trajectory of aging-associated inflammation, including the developmental timing, frequency, and intensity of alcohol consumption. This chapter posits that neuroinflammatory processes form a critical link between alcohol exposure and the trajectory of healthy aging, at least in part through direct or indirect interactions with cholinergic circuits that are crucial to cognitive integrity. In this chapter, we begin with a discussion of how inflammation changes from early development through late aging; discuss the role of inflammation and alcohol in the emergence of mild cognitive impairment (MCI); elaborate on critical findings on the contribution of alcohol-related thiamine deficiency to the loss of cholinergic function and subsequent development of Wernicke-Korsakoff syndrome (WKS); and present emerging findings at the intersection of alcohol and Alzheimer's disease and related dementias (ADRD). In doing so, our analysis points toward inflammation-mediated compromise of basal forebrain cholinergic function as a key culprit in cognitive dysfunction associated with chronic alcohol exposure, effects that may be rescuable through either pharmacological or behavioral approaches. Furthermore, our chapter reveals an interesting dichotomy in the effects of alcohol on neuropathological markers of ADRD that depend upon both biological sex and genetic vulnerability.

Prelimbic cortex perineuronal net expression and social behavior: Impact of adolescent intermittent ethanol exposure

Adolescent intermittent ethanol (AIE) exposure in rats leads to social deficits. Parvalbumin (PV) expressing fast-spiking interneurons in the prelimbic cortex (PrL) contribute to social behavior, and perineuronal nets (PNNs) within the PrL preferentially encompass and regulate PV interneurons. AIE exposure increases PNNs, but it is unknown if this upregulation contributes to AIE-induced social impairments. The current study was designed to determine the effect of AIE exposure on PNN expression in the PrL and to assess whether PNN dysregulation contributes to social deficits elicited by AIE. cFos-LacZ male and female rats were exposed every other day to tap water or ethanol (4 g/kg, 25% w/v) via intragastric gavage between postnatal day (P) 25-45. We evaluated neuronal activation by β-galactosidase expression and PNN levels either at the end of the exposure regimen on P45 and/or in adulthood on P70. In addition, we used Chondroitinase ABC (ChABC) to deplete PNNs following adolescent exposure (P48) and allowed for PNN restoration before social testing in adulthhod. AIE exposure increased PNN expression in the PrL of adult males, but decreased PNNs immediately following AIE. Vesicular glutamate transporter 2 (vGlut2) and vesicular GABA transporter (vGat) near PNNs were downregulated only in AIE-exposed females. Gene expression of PNN components was largely unaffected by AIE exposure. Removal and reestablishment of PrL PNNs by ChABC led to upregulation of PNNs and social impairments in males, regardless of adolescent exposure. These data suggest that AIE exposure in males upregulates PrL PNNs that likely contribute to social impairments induced by AIE.

Gut microbiota dysbiosis induced by alcohol exposure in pubertal and adult mice

Alcohol intake causes many diseases including neuropsychiatric symptoms, nutritional deficiency, progressive pancreatitis, liver cirrhosis, and ischemic heart disease. The gut microbiota changes significantly after alcohol exposure. Alcohol consumption tends to increase in underage and young people, but the feature of the gut microbiota in puberty remains largely unexplored. In this study, we conducted alcohol-exposed pubertal and adult mice model to investigate the intestinal damage and gut microbiota change. Interestingly, the responses of pubertal mice and adult mice after alcohol exposure were different. We found that alcohol dehydrogenase decreased and aldehyde dehydrogenase increased in the liver of pubertal mice, thus reducing the accumulation of toxic acetaldehyde. Furthermore, alcohol exposure caused less intestinal injury in pubertal mice. Through the analysis of metagenome assembly genome, we obtained many unrecognized bacterial genomes. Limosillactobacillus reuteri (cluster_56) and Lactobacillus intestinalis (cluster_57) were assembled from the samples of pubertal mice, which were involved in the production of indole acetic acid and the transformation of bile acids in response to alcohol exposure. This study provided a new insight to investigate the gut microbiota change and explained the difference of the gut microbiota after alcohol exposure between pubertal mice and adult mice.

IMPORTANCE

This study elucidates the significant impact of alcohol exposure on the gut microbiota and metabolic pathways in mice, highlighting the differential responses between adolescent and adult stages. Alcohol exposure was found to damage the intestinal barrier, alter the microbial composition by decreasing beneficial bacteria like Lactobacillus, and increase harmful bacteria such as Alistipes. The study also discovered unique microbial changes and resilience in pubertal mice. Species-level metagenomic analysis revealed specific microbial taxa and metabolic functions affected by alcohol. Metagenome-assembled genomes (MAGs) found many species that could not be annotated by conventional methods including many members of Lachnospiraceae, greatly expanding our understanding of the gut microbiota composition. These findings underscore the need for further research on alcohol's effects on various organs and the implications of microbial metabolites on disease progression.

Across the multiverse: exploring a diverse set of specifications related to cross-sectional and prospective associations between adolescent alcohol use and emotional problems

BACKGROUND

The relationship between adolescent alcohol use and emotional problems remains unclear and contradictory. These inconsistencies may in part be due to differences in the measurement and operationalization of alcohol use and emotional problems across studies, as well as confounder selection and missing data decisions. This study explores the associations between common specifications of adolescent alcohol use and emotional problems in a large sample of adolescents.

METHODS

A multiverse analysis (also known as specification curve analysis or vibration of effects) was done with 7680 unique model specifications in a large longitudinal sample of 6639 Australian adolescents (aged ~14.7-15.7, 2021-2022).

RESULTS

While alcohol use and emotional problems nearly universally co-occurred in minimally adjusted cross-sectional models (98-99%), the operationalization of emotional problems, temporality of prospective relationships, and choice of confounders substantially impacted findings. Emotional problems appeared to predict later alcohol use more-so than the reverse, depression-focused measures yielded more consistent associations with alcohol use than anxiety-focused measures, and certain confounders (i.e. conduct, ADHD, smoking) explained most of the associations between adolescent alcohol use and emotional problems. Missing data decisions and whether outcomes were modelled continuously v. dichotomously had minimal impact on findings.

CONCLUSIONS

While adolescent alcohol use and emotional problems commonly co-occur, inconsistencies in the magnitude, direction, and significance of effects are closely tied to researcher decisions that are often made arbitrarily.

Adult and adolescent antipsychotic exposure increases delay discounting and diminishes behavioral flexibility in male C57BL/6 mice

Second-generation antipsychotics are frequently prescribed to adolescents, but the long-term consequences of their use remain understudied. These medications work via monoamine neurotransmitter systems, especially dopamine and serotonin, which undergo considerable development and pruning during adolescence. Dopamine and serotonin are linked to a wide host of behaviors, including impulsive choice and behavioral plasticity. In a murine model of adolescent antipsychotic use, male C57BL/6 mice were exposed to either 2.5 mg/kg/day risperidone or 5 mg/kg/day olanzapine via drinking water from postnatal days 22-60. To determine whether the adolescent period was uniquely sensitive to antipsychotic exposure, long-term effects on behavior were compared to an equivalently exposed group of adults where mice were exposed to 2.5 mg/kg risperidone from postnatal days 101-138. Motor activity and body weight in adolescent animals were assessed. Thirty days after exposure terminated animal's behavioral flexibility and impulsive choice were assessed using spatial discrimination reversal and delay discounting. Antipsychotic exposure produced a modest change in behavior flexibility during the second reversal. There was a robust and reproducible difference in impulsive choice: exposed animals devalued the delayed alternative reward substantially more than controls. This effect was observed both following adolescent and adult exposure, indicating that an irreversible change in impulsive choice occurs regardless of the age of exposure.

Neurostructural features predict binge drinking in emerging adulthood: Evidence from a 5-year follow-up study

BACKGROUND

Binge drinking (BD) involves consuming large amounts of alcohol within a short timeframe, leading to a blood alcohol concentration of 0.08g/dL or above. This pattern of alcohol consumption is prevalent among young adults and has significant implications for brain structure and subsequent drinking behaviors.

METHODS

In this prospective longitudinal study, we employed zero-inflated negative binomial regression models to examine whether various neurostructural features (i.e., volume, surface area, cortical thickness) of brain regions involved in executive and emotional/motivational processes at the age of 18-19 could predict number of BD episodes five years later, at ages 23-24, once participants were expected to complete their university degree. Specifically, we recorded magnetic resonance imaging (MRI) data from 68 students who completed both the baseline MRI and follow-up alcohol use assessment, with the aim of analyzing the predictive value of these neurostructural characteristics five years later.

RESULTS

The analysis revealed that a larger surface area in the caudal division of the right middle frontal gyrus was significantly associated with a higher incidence rate of BD episodes (IRR = 2.24, 95 % CI = 1.28-3.91, p = 0.005). Conversely, a smaller surface area in the right caudal anterior cingulate cortex was associated with a higher incidence rate of BD episodes (IRR = 0.61, 95 % CI = 0.44-0.85, p = 0.004).

CONCLUSIONS

These findings suggest that specific neurostructural characteristics during adolescence can predict BD behaviors in young adulthood. This highlights the potential of neuroimaging to identify individuals at risk for developing problematic alcohol use.

Theory of Planned Behavior and alcohol use in adolescents in Ecuador. Structural linear regression analysis

The general aim is to identify the explanatory potential of alcohol use intentions in drinking behaviors in a sample of adolescents in Ecuador. The method consists of a descriptive, explanatory, and cross-sectional study using SEM techniques. The participants were 384 adolescents (57% male and 43% female), aged 14-18 years (M = 16.51; SD = 2.64), who are students attending between the 1st and 3rd year of high school in a public educational institution in Ambato, Ecuador. Like principal results, the presence of alcohol use intention is moderate; the practice of alcohol use is low and mostly does not represent a risk, although 3.9% of the participants could report significant problems with consumption. Intentionality and drinking covary positively with low and moderate intensity. Drinking Intentionality explained 15.3% of the variance of drinking. We conclude that the Alcohol Use Intentions are a predictor of adolescent drinking behaviors.

Prevalence and psycho-social factors associated with alcohol use among primary school-going children aged 6 to 13 years in Mbale district, Uganda: a cross-sectional study

BACKGROUND

Alcohol use among children in low-resource settings has received limited attention. This study investigated the prevalence of and biopsychosocial factors associated with alcohol use among children aged 6 to 13 years enrolled in primary education in Uganda.

METHODS

This cross-sectional study conducted in primary schools within Mbale district, employed stratified random sampling to select 470 child-parent dyads. Screening for child alcohol consumption utilized the validated Ugandan (Lumasaaba) version of the Car, Relax, Alone, Forget, Family/Friends, Trouble (CRAFFT) tool. Alcohol Use Disorder (AUD) was diagnosed using the AUD module of the Mini International Neuropsychiatric Interview for children and adolescents (MINI KID). Logistic regression analysis explored associations between alcohol consumption (CRAFFT cut-off score: 1 or more) and biopsychosocial factors (age, sex, nutrition, family dynamics, socioeconomic indicators, and school environment). Data analysis utilized STATA-17 statistical software.

RESULTS

The median age of the participants was 11 years, with an interquartile range (IQR) of 9 to 12 years and a male to female ratio of 1:1.3. The screened prevalence of alcohol consumption among the children in the past 12 months was 25.2% (95% CI: 21.4-29.4) and 7.2% (95% CI: 5.1-10.0) were diagnosed with AUD. The study found a comparable prevalence of alcohol use between boys (25.0%, 95% CI: 19.4-31.5) and girls (25.4%, 95% CI: 20.0-31.1). Age-specific variations indicated that early adolescents (10 to 13 years), were more likely to consume alcohol 28.1% (95% CI: 23.5-33.3) compared to pre-adolescent children (6 to 9 years) 17.6% (95% CI: 11.9-25.1) in the past 12 months. Factors associated with alcohol use included single-parent households, lower caregiver education, low socioeconomic status, maternal drinking, food insecurity, under-weight, physical discipline by parents, peer influence, rural school attendance, and the school environment.

CONCLUSION

The prevalence of alcohol consumption among children in Mbale district, eastern Uganda was high with one-in-four primary-school-children aged 6 to 13 years consuming alcohol in the past year, and no significant gender differences. It highlights various interconnected factors associated with alcohol use among school-aged children. We recommend awareness campaigns at all levels, stricter implementation of alcohol policies, school prevention programs, and family-focused and socio-economic interventions. Nationwide school surveys should target pre-adolescent alcohol use.

Dysregulation of neurotrophin expression in prefrontal cortex and nucleus basalis magnocellularis during and after adolescent intermittent ethanol exposure

A preclinical model of human adolescent binge drinking, adolescent intermittent ethanol exposure (AIE) recreates the heavy binge withdrawal consummatory patterns of adolescents and has identified the loss of basal forebrain cholinergic neurons as a pathological hallmark of this model. Cholinergic neurons of the nucleus basalis magnocellularis (NbM) that innervate the prefrontal cortex (PFC) are particularly vulnerable to alcohol related neurodegeneration. Target derived neurotrophins (nerve growth factor [NGF] and brain-derived neurotrophic factor [BDNF]) regulate cholinergic phenotype expression and survival. Evidence from other disease models implicates the role of immature neurotrophin, or proneurotrophins, activity at neurotrophic receptors in promoting cholinergic degeneration; however, it has yet to be explored in adolescent binge drinking. We sought to characterize the pro- and mature neurotrophin expression, alongside their cognate receptors and cholinergic markers in an AIE model. Male and female Sprague Dawley rats underwent 5 g/kg 20% EtOH or water gavage on two-day-on, two-day-off cycles from post-natal day 25-57. Rats were sacrificed 2 h, 24 h, or 3 weeks following the last gavage, and tissue were collected for protein measurement. Western blot analyses revealed that ethanol intoxication reduced the expression of BDNF and vesicular acetylcholine transporter (vAChT) in the PFC, while NGF was lower in the NbM of AIE treated animals. During acute alcohol withdrawal, proNGF in the PFC was increased while proBDNF decreased, and in the NbM proBDNF increased while NGF decreased. During AIE abstinence, the expression of neurotrophins, their receptors, and vAChT did not differ from controls in the PFC. In contrast, in the NbM the expression of both NGF and choline acetyltransferase (ChAT) were reduced long-term following AIE. Taken together these findings suggest that AIE alters the expression of proneurotrophins and neurotrophins during intoxication and withdrawal that favor prodegenerative mechanisms by increasing the expression of proNGF and proBDNF, while also reducing NGF and BDNF.

Alcohol outlet density and adolescent drinking behaviors in Thailand, 2007-2017: A spatiotemporal mixed model analysis

This study aimed to explore the relationship between alcohol outlet density and the proportion of alcohol consumption among Thai adolescents. We utilized the alcohol consumption data from the 2007, 2011, and 2017 Tobacco and Alcohol Consumption Survey in Thailand. We analyzed the relationships between alcohol sales license figures and consumption behavior using a spatiotemporal mixed model. Our data had two levels. The upper (provincial) level featured alcohol sales license density (spatial effect), the years of survey (temporal effect), and the social deprivation index. The lower (individual) level included the demographic data of the adolescents. A total of 9,566 Thai adolescents participated in this study, based on surveys conducted in 2007 (n = 4,731), 2011 (n = 3,466), and 2017 (n = 1,369). The density of alcohol sales licenses increased the odds for the one-year current drinker category (odds ratio [OR] = 1.08, 95% confidence interval [CI], 1.04-1.45), especially in male adolescents (OR = 1.09, 95% CI, 1.04-1.14). Furthermore, it increased the odds for the heavy episodic drinker category for female adolescents (OR = 1.23, 95% CI, 1.05-1.44). Increased alcohol sales licenses are associated with higher alcohol consumption among Thai adolescents. This highlights the need for government organizations to develop and apply strategies to reduce the number of licenses for the sale of alcohol.

Adult mental health outcomes of adolescent depression and co-occurring alcohol use disorder: a longitudinal cohort study

Depression and alcohol use disorder (AUD) are frequently co-occurring in adolescence, which often goes undetected in routine care. While this may potentially compromise treatment effectiveness and lead to a less favourable long-term prognosis, few longitudinal studies have followed this group into adulthood. The aim of this study was to explore the risk for adult depression, anxiety disorders, suicidality, and AUD in adolescents with concurrent depression and AUD. The study was based on the Uppsala Longitudinal Adolescent Depression Study (ULADS), a Swedish prospective cohort study. Diagnostic interviews were conducted in adolescence (age 16-17) and adulthood (around age 30). Adolescents with concurrent depression and AUD (n = 38) were compared with peers having only depression (n = 189) or neither of the conditions (n = 144). Logistic regression was used to calculate adjusted odds ratios (aORs) with 95% confidence intervals (CIs). Adolescents with concurrent depression and AUD were more likely than their non-affected peers to experience adult depressive episodes (aOR, 5.33; 95% CI, 2.22-12.83), anxiety disorders (4.05; 1.77-9.27), suicidality (5.37; 2.28-12.66), and AUD (7.68; 2.59-22.81). Notably, 34% of adolescents with both depression and AUD subsequently experienced both these conditions as adults, compared to 7% of adolescents with only depression. Adolescents suffering only from depression were less likely than those with both conditions to experience suicidality (0.44; 0.21-0.95) and AUD in adulthood (0.18; 0.07-0.44). These findings underscore the clinical imperative to identify adolescents with this comorbidity. Recognition of the poor long-term prognosis can inform targeted interventions for this vulnerable group, ultimately improving health and well-being throughout the life course.

Prevalence of steatotic liver disease (MASLD, MetALD, ALD) and clinically significant fibrosis in US adolescents : Authors' name

We aim to evaluate the prevalence of steatotic liver disease (SLD) in United States (US) adolescents and explore whether metabolic dysfunction-associated steatotic liver disease (MASLD) can identify individuals with clinically significant fibrosis (CSF) in this study. The prevalence of SLD and its categories, including MASLD, metabolic dysfunction and alcohol associated liver disease (MetALD), alcohol related liver disease (ALD) and other SLD were determined. Weighted multivariable logistic regression analysis was conducted to evaluate the association between MASLD and CSF in adolescents with SLD. Among the total 1,446 US adolescents, SLD was present in 291 (20.1%) of individuals, including 260 (17.9%) for MASLD, 9 (0.6%) for MetALD and 5 (0.3%) for ALD. Only 58 (4%) had CSF. Patients with SLD showed a higher prevalence of CSF (9.6% vs. 2.6%, p < 0.001). Among patients with SLD, 89.3% met the MASLD criteria. The risk of CSF in patients with MASLD was not significantly different (odds ratio [OR] = 1.07, 95% confidence interval [CI] = 0.30-3.83, p = 0.9180) compared with those without MASLD. MASLD was met by most of the US adolescents with SLD. Moreover, MASLD was not associated with higher prevalence of CSF among adolescents with SLD.

Sex Differences in Contextual Extinction Learning After Single Binge-Like EtOH Exposure in Adolescent C57BL/6J Mice

The relationship between chronic heavy drinking and post-traumatic stress disorder (PTSD) is well-documented; however, the impact of more common drinking patterns, such as a single episode leading to a blood alcohol concentration (BAC) of 0.09 g/dL (moderate intoxication), remains underexplored. Given the frequent co-occurrence of PTSD and alcohol misuse, it is essential to understand the biological and behavioral factors driving this comorbidity. We hypothesize that alcohol's immediate sedative effects are coupled with the development of persistent molecular alcohol tolerance, which may disrupt fear extinction learning. To investigate this, we employed a S ingle E pisode E thanol (SEE) in-vivo exposure to mimic binge-like alcohol consumption over a 6-hour period, following contextual conditioning trials. Extinction trials were conducted 24 hours later to assess the effects on extinction learning. Our findings reveal a significant deficit in fear extinction learning in alcohol-treated adolescent male mice compared to saline-treated controls, with no such effects observed in female adolescent mice. These results suggest that even non-chronic alcohol exposure may contribute to the development of trauma- and stress-related disorders, such as PTSD, in males. Additionally, histological analysis revealed significant alterations in FKBP5, β-catenin, and GSK-3β levels in the hippocampus, striatum, and basolateral amygdala of alcohol-treated mice following extinction. The insights gained from this study could reshape our understanding of the risk factors for PTSD and open new avenues for prevention and treatment, targeting the molecular mechanisms that mediate alcohol tolerance.

Voluntary wheel running exercise rescues behaviorally-evoked acetylcholine efflux in the medial prefrontal cortex and epigenetic changes in ChAT genes following adolescent intermittent ethanol exposure

Adolescent intermittent ethanol (AIE) exposure, which models heavy binge ethanol intake in adolescence, leads to a variety of deficits that persist into adulthood-including suppression of the cholinergic neuron phenotype within the basal forebrain. This is accompanied by a reduction in acetylcholine (ACh) tone in the medial prefrontal cortex (mPFC). Voluntary wheel running exercise (VEx) has been shown to rescue AIE-induced suppression of the cholinergic phenotype. Therefore, the goal of the current study is to determine if VEx will also rescue ACh efflux in the mPFC during spontaneous alternation, attention set shifting performance, and epigenetic silencing of the cholinergic phenotype following AIE. Male and female rats were subjected to 16 intragastric gavages of 20% ethanol or tap water on a two-day on/two-day off schedule from postnatal day (PD) 25-54, before being assigned to either VEx or stationary control groups. In Experiment 1, rats were tested on a four-arm spontaneous alternation maze with concurrent in vivo microdialysis for ACh in the mPFC. An operant attention set-shifting task was used to measure changes in cognitive and behavioral flexibility. In Experiment 2, a ChIP analysis of choline acetyltransferase (ChAT) genes was performed on basal forebrain tissue. It was found that VEx increased ACh efflux in the mPFC in both AIE and control male and female rats, as well as rescued the AIE-induced epigenetic methylation changes selectively at the Chat promoter CpG island across sexes. Overall, these data support the restorative effects of exercise on damage to the cholinergic projections to the mPFC and demonstrate the plasticity of cholinergic system for recovery after alcohol induced brain damage.

Injury, substance abuse, verbal abuse, and emotional and behavioral issues among adolescents in Uttarakhand, India: A categorical principal component analysis of global school-based health survey

Background

Adolescents in low-middle-income countries face increasing physical and mental health challenges. The present study aimed to assess status of injury, verbal abuse, substance use, and emotional behavior of adolescents of Uttarakhand, India, and evaluate the importance of each component.

Methods

A cross-sectional study was conducted among adolescents in 13 government schools in Uttarakhand using the Global School-based Health Survey (GSHS). Categorical principal component analysis (CATPCA) using Varimax rotation was performed to analyze principal components among two domains of GSHS (substance abuse domain and verbal abuse and emotional behavior domain). Factorability was assessed using Kaiser-Meyer-Olkin and Bartlett's test. Variance Accounted For index was used to evaluate the importance of each component.

Results

A total of 634 adolescents completed the questionnaire. 41.3% students suffered from serious injury with a significant difference (P < 0.0001) between both genders. Girls were more likely to report having felt lonely most of the time or always in the past 12 months (11.0% vs 4.6%, P = 0.018). Boys were more likely to miss classes on 3 or more days (9.9% vs 4.9%, P = 0.043). Initiation of smoking cigarettes (9.6% vs 1.2%, P <0.0001) and tobacco chewing (3.4% vs 0.3%, P = 0.001) was more likely in 12-15-year-old boys. One-third of the students reported male guardians to use either alcohol or some form of tobacco. CATPCA yielded an 11-factor model accounting for 58.26% of variances with the most important principal component named "Tobacco (Smoking and Chewing): Initiation, Frequency and Attempt to Stop" (eigenvalue: 4.109).

Conclusion

Significant differences in various items of injury, verbal abuse, substance use, and emotional behavior were recorded between boys and girls. CATPCA revealed patterns among injury, verbal abuse, emotional behavior, and substance abuse domains of GSHS by categorizing them into 11 components. On the basis of these patterns, prioritizing and development of appropriate school-based interventions may be implemented by various stakeholders of Uttarakhand.

Sex-dependent effects of acute stress and alcohol exposure during adolescence on mRNA expression of brain signaling systems involved in reward and stress responses in young adult rats

BACKGROUND

Adolescent stress and alcohol exposure increase the risk of maladaptive behaviors and mental disorders in adulthood, with distinct sex-specific differences. Understanding the mechanisms underlying these early events is crucial for developing targeted prevention and treatment strategies.

METHODS

Male and female Wistar rats were exposed to acute restraint stress and intermittent alcohol during adolescence. We assessed lasting effects on plasma corticosterone (CORT) and adrenocorticotropic hormone (ACTH) levels, and mRNA expression of genes related to corticotropin releasing hormone (CRH), neuropeptide Y (NPY), corticoid, opioid, and arginine vasopressin systems in the amygdala and hypothalamus.

RESULTS

The main findings are as follows: (1) blood alcohol concentrations (BAC) increased after the final alcohol administration, but stressed males had lower BAC than non-stressed males; (2) Males gained significantly more weight than females; (3) Stressed females showed higher ACTH levels than non-stressed females, with no changes in males; (4) Stress increased CORT levels in males, while stressed, alcohol-treated females had lower CORT levels than non-stressed females; (5) CRH: Females had lower Crhr1 levels in the amygdala, while alcohol reduced Crhr2 levels in males but not females. Significant interactions among sex, stress, and alcohol were found in the hypothalamus, with distinct patterns between sexes; (6) NPY: In the amygdala, stress reduced Npy and Npy1r levels in males but increased them in females. Alcohol decreased Npy2r levels in males, with varied effects in females. Similar sex-specific patterns were observed in the hypothalamus; (7) Corticoid system: Stress and alcohol had complex, sex-dependent effects on Pomc, Nr3c1, and Nr3c2 in both brain regions; (8) Opioid receptors: Stress and alcohol blunted the elevated expression of Oprm1, Oprd1, and Oprk1 in the amygdala of males and the hypothalamus of females; (8) Vasopressin: Stress and alcohol interacted significantly to affect Avp and Avpr1a expression in the amygdala, with stronger effects in females. In the hypothalamus, alcohol increased Avp levels in females.

CONCLUSIONS

This study demonstrates that adolescent acute stress and alcohol exposure induce lasting, sex-specific alterations in systems involved in reward and stress responses. These findings emphasize the importance of considering sex differences in the prevention and management of HPA dysfunction and psychiatric disorders.

A robust brain network for sustained attention from adolescence to adulthood that predicts later substance use

Substance use, including cigarettes and cannabis, is associated with poorer sustained attention in late adolescence and early adulthood. Previous studies were predominantly cross-sectional or under-powered and could not indicate if impairment in sustained attention was a predictor of substance use or a marker of the inclination to engage in such behavior. This study explored the relationship between sustained attention and substance use across a longitudinal span from ages 14 to 23 in over 1000 participants. Behaviors and brain connectivity associated with diminished sustained attention at age 14 predicted subsequent increases in cannabis and cigarette smoking, establishing sustained attention as a robust biomarker for vulnerability to substance use. Individual differences in network strength relevant to sustained attention were preserved across developmental stages and sustained attention networks generalized to participants in an external dataset. In summary, brain networks of sustained attention are robust, consistent, and able to predict aspects of later substance use.

Expression of exploratory activity of rat offspring depends on the expression of exploratory activity of their parents at the moment of mating

The aim of this work was to study the, so far, unexplored possibility that non-genetic inheritance of animal behavioral characteristics could depend on the state of the parents at the time of conception. In this study, we measured the levels of motor and exploratory activity in rats at the ages of 2 and 5 months. Male and female rats were mated at the age of 5 months. The following groups were used: male and female rats with high motor activity at ages of 2 and 5 months (ACT+); male and female rats with high activity at the age of 2 months, but low activity at the age of 5 months (ACT-); male and female rats with low activity at the ages of 2 and 5 months (PAS-); male and female rats with low activity at the age of 2 months, but high activity at the age of 5 months (PAS+). It was found that both males and females ACT+ had significantly higher motor activity, which was observed in the first 10 minutes, in the next 20-60 minutes, in the center of the cage and more rearings as compared with PAS- rats. Significant differences in the severity of exploratory activity were found between the male offspring of ACT+ and ACT- rats. Differences between the offspring of PAS+ and PAS- rats were observed in both the male and female rats. The motor activity of animals in the period from 20 minutes after the start of registration did not differ between groups. Thus, it can be considered that individual characteristics of general motor activity are due to genetically inherited factors, while differences in the level of exploratory activity, apparently, are formed due to non-genetic influences from parents during mating.

Neuroimaging of the effects of drug exposure or self-administration in rodents: A systematic review

A systematic review of functional neuroimaging studies on drug (self-) administration in rodents is lacking. Here, we summarized effects of acute or chronic drug administration of various classes of drugs on brain function and determined consistency with human literature. We performed a systematic literature search and identified 125 studies on in vivo rodent resting-state functional magnetic resonance imaging (n = 84) or positron emission tomography (n = 41) spanning depressants (n = 27), opioids (n = 23), stimulants (n = 72), and cannabis (n = 3). Results primarily showed alterations in the striatum, consistent with the human literature. The anterior cingulate cortex and (nonspecific) prefrontal cortex were also frequently implicated. Upregulation was most often found after shorter administration and downregulation after long chronic administration, particularly in the striatum. Importantly, results were consistent across study design, administration models, imaging method, and animal states. Results provide evidence of altered resting-state brain function in rodents upon drug administration, implicating the brain's reward network analogous to human studies. However, alterations were more dynamic than previously known, with dynamic adaptation depending on the length of drug administration.

Cannabidiol or ketamine for preventing the impact of adolescent early drug initiation on voluntary ethanol consumption in adulthood

Background

Few studies have previously evaluated the long-term impact of initiating the combined use of alcohol and cocaine early-in-life during adolescence. Our preclinical study characterized changes in affective-like behavior and/or voluntary ethanol consumption emerging later on in adulthood induced by a prior adolescent drug exposure, as well as tested therapeutical interventions (i.e., cannabidiol or ketamine) to prevent the observed effects.

Methods

We performed three independent studies with male and female Sprague-Dawley rats, treated in adolescence (postnatal days, PND 29-38) with non-contingent paradigms of ethanol, cocaine, their combination or vehicle. Later on, adult rats were (1) scored for their affective-like state (forced-swim, elevated-plus maze, novelty-suppressed feeding, sucrose preference), (2) allowed to freely drink ethanol for 6 weeks (two-bottle choice), or (3) treated with cannabidiol or ketamine before given access to ethanol in adulthood.

Results

No signs of increased negative affect were observed in adulthood following the adolescent treatments. However, adolescent ethanol exposure was a risk-factor for later developing an increased voluntary ethanol consumption in adulthood, both for male and female rats. This risk was similar when ethanol was combined with adolescent cocaine exposure, since cocaine alone showed no effects on later ethanol intake. Finally, rats exposed to adolescent ethanol and pretreated in adulthood with cannabidiol (and/or ketamine, but just for females) reduced their ethanol voluntary consumption.

Conclusion

Our data provided two therapeutical options capable of preventing the impact of an early drug initiation during adolescence by decreasing voluntary ethanol consumption in adult rats.

Mixing energy drinks and alcohol during adolescence impairs brain function: A study of rat hippocampal plasticity

In the last decades, the consumption of energy drinks has risen dramatically, especially among young people, adolescents and athletes, driven by the constant search for ergogenic effects, such as the increase in physical and cognitive performance. In parallel, mixed consumption of energy drinks and ethanol, under a binge drinking modality, under a binge drinking modality, has similarly grown among adolescents. However, little is known whether the combined consumption of these drinks, during adolescence, may have long-term effects on central function, raising the question of the risks of this habit on brain maturation. Our study was designed to evaluate, by behavioral, electrophysiological and molecular approaches, the long-term effects on hippocampal plasticity of ethanol (EtOH), energy drinks (EDs), or alcohol mixed with energy drinks (AMED) in a rat model of binge-like drinking adolescent administration. The results show that AMED binge-like administration produces adaptive hippocampal changes at the molecular level, associated with electrophysiological and behavioral alterations, which develop during the adolescence and are still detectable in adult animals. Overall, the study indicates that binge-like drinking AMED adolescent exposure represents a habit that may affect permanently hippocampal plasticity.

Patterns of neuronal activation following ethanol-induced social facilitation and social inhibition in adolescent cFos-LacZ male and female rats

Alcohol-associated social facilitation together with attenuated sensitivity to adverse alcohol effects play a substantial role in adolescent alcohol use and misuse, with adolescent females being more susceptible to adverse consequences of binge drinking than adolescent males. Adolescent rodents also demonstrate individual and sex differences in sensitivity to ethanol-induced social facilitation and social inhibition, therefore the current study was designed to identify neuronal activation patterns associated with ethanol-induced social facilitation and ethanol-induced social inhibition in male and female adolescent cFos-LacZ rats. Experimental subjects were given social interaction tests on postnatal day (P) 34, 36, and 38 after an acute challenge with 0, 0.5 and 0.75 g/kg ethanol, respectively, and β-galactosidase (β-gal) expression was assessed in brain tissue of subjects socially facilitated and socially inhibited by 0.75 g/kg ethanol. In females, positive correlations were evident between overall social activity and neuronal activation of seven out of 13 ROIs, including the prefrontal cortex and nucleus accumbens, with negative correlations evident in males. Assessments of neuronal activation patterns revealed drastic sex differences between ethanol responding phenotypes. In socially inhibited males, strong correlations were evident among almost all ROIs (90 %), with markedly fewer correlations among ROIs (38 %) seen in socially facilitated males. In contrast, interconnectivity in females inhibited by ethanol was only 10 % compared to nearly 60 % in facilitated subjects. However, hub analyses revealed convergence of brain regions in males and females, with the nucleus accumbens being a hub region in socially inhibited subjects. Taken together, these findings demonstrate individual and sex-related differences in responsiveness to acute ethanol in adolescent rats, with sex differences more evident in socially inhibited by ethanol adolescents than their socially facilitated counterparts.

Perceived psychological control relates to coping-related drinking motives via social anxiety among adolescents: A cross-sectional mediation analysis

Accumulating evidence suggests that particular parenting behaviors (e.g., elevated psychological control) may increase risk for both problematic social anxiety and alcohol use among youth; however, no work has yet examined these factors together in a single model. Building developmentally sensitive models of problematic alcohol use trajectories is key to developing effective prevention and intervention strategies. The present study includes 94 adolescents (ages 14-17 years; 53.3% girls; 89.2% White) entering a treatment facility for a variety of internalizing and externalizing forms of psychological distress. Levels of perceived parental psychological control, social anxiety, and coping-related drinking motives were assessed. Higher levels of perceived psychological control were associated with a greater endorsement of coping-related drinking motives; however, a significant proportion of that association was accounted for by elevated social anxiety symptoms. These data extend the existing literature and lay groundwork for more sophisticated experimental and longitudinal designs to corroborate the findings. Moreover, personality-targeted drinking interventions for adolescents may benefit from identifying elevated perceived psychological control as a developmentally relevant risk factor for social anxiety and problematic drinking motives and administering relevant interventions (e.g., personality-targeted coping skills training, parent-involved care) before drinking patterns are established.

Associations of Content Domain-Specific Possible Selves with Adolescent Drinking Behaviors

Alcohol use ranks as one of the most prevalent health-risk behaviors among Taiwanese adolescents. Possible selves-personalized future-oriented cognitions about the self-are significant motivators of one's actions, which may potentially influence adolescent drinking behavior. This study aimed to estimate the content domain-specific possible selves and their associations with drinking behaviors among Taiwanese adolescents. A total of 225 Taiwanese seventh and eighth graders from a public junior high school were recruited. An anonymous self-reported questionnaire was used to collect data during two time-points at six-month intervals. Results showed that having a "physical appearance" related hoped-for possible self and a "friendship" related feared possible self was associated with adolescent alcohol use after six months. Whereas, having the "physical appearance" related hoped-for and feared possible selves were associated with alcohol problems, at both, baseline and six months later. Future studies could clarify the meaning behind "physical appearance" related possible selves.

Neurological Disorders Induced by Drug Use: Effects of Adolescent and Embryonic Drug Exposure on Behavioral Neurodevelopment

Clinical studies demonstrate that the risk of developing neurological disorders is increased by overconsumption of the commonly used drugs, alcohol, nicotine and cannabis. These drug-induced neurological disorders, which include substance use disorder (SUD) and its co-occurring emotional conditions such as anxiety and depression, are observed not only in adults but also with drug use during adolescence and after prenatal exposure to these drugs, and they are accompanied by long-lasting disturbances in brain development. This report provides overviews of clinical and preclinical studies, which confirm these adverse effects in adolescents and the offspring prenatally exposed to the drugs and include a more in-depth description of specific neuronal systems, their neurocircuitry and molecular mechanisms, affected by drug exposure and of specific techniques used to determine if these effects in the brain are causally related to the behavioral disturbances. With analysis of further studies, this review then addresses four specific questions that are important for fully understanding the impact that drug use in young individuals can have on future pregnancies and their offspring. Evidence demonstrates that the adverse effects on their brain and behavior can occur: (1) at low doses with short periods of drug exposure during pregnancy; (2) after pre-conception drug use by both females and males; (3) in subsequent generations following the initial drug exposure; and (4) in a sex-dependent manner, with drug use producing a greater risk in females than males of developing SUDs with emotional conditions and female offspring after prenatal drug exposure responding more adversely than male offspring. With the recent rise in drug use by adolescents and pregnant women that has occurred in association with the legalization of cannabis and increased availability of vaping tools, these conclusions from the clinical and preclinical literature are particularly alarming and underscore the urgent need to educate young women and men about the possible harmful effects of early drug use and to seek novel therapeutic strategies that might help to limit drug use in young individuals.

Adolescent alcohol exposure alters age-related progression of behavioral and neurotrophic dysfunction in the TgF344-AD model in a sex-specific manner

Alzheimer's Disease (AD) and heavy alcohol use are widely prevalent and lead to brain pathology. Both alcohol-related brain damage (ABRD) and AD result in cholinergic dysfunction, reductions in hippocampal neurogenesis, and the emergence of hippocampal-dependent cognitive impairments. It is still unknown how ARBD caused during a critical developmental timepoint, such as adolescence, interacts with AD-related pathologies to accelerate disease progression later in life. The current study utilized a longitudinal design to characterize behavioral and pathological changes in a transgenic rat model of AD (TgF344-AD) following adolescent intermittent ethanol (AIE) exposure. We found that AIE accelerates cognitive decline associated with AD transgenes in female rats at 6 months of age, and male AD-rats are impaired on spatial navigation by 3-months with no additional deficits due to AIE exposure. Protein levels of various AD-pathological markers were analyzed in the dorsal and ventral hippocampus of male and female rats. The data suggests that AIE-induced alterations of the tropomyosin-related kinase A receptor (TrkA) / p75 neurotrophin receptor (p75NTR) ratio creates a brain that is vulnerable to age- and AD-related pathologies, which leads to an acceleration of cognitive decline, particularly in female rats.

Beyond the Laws: Parental Monitoring, Perceived Acceptability of Underage Drinking and Alcohol Use Among Belgian Youth

Parental monitoring behaviors are negatively associated with adolescent substance use. Yet, the processes explaining these associations are still unclear. The current study examined adolescents' knowledge of minimum legal drinking age laws and their perceived acceptability of underage drinking as potential mediators of the links between parental monitoring behaviors and youth alcohol use. The sample included 1154 Belgian adolescents (Mage = 16.34, SD = 1.33; 71% girls), who were recruited in Wallonia (54.9%) and in Flanders (45.1%). Path analyses revealed that higher parental rule setting, but not solicitation, was related to lower alcohol use. Acceptability of underage drinking mediated this link, but not knowledge of the laws. Results suggest that beyond laws regulating the minimum legal drinking age, alcohol use prevention programs should consider the importance of parental rule setting and youth's perceived acceptability of underage drinking.

Development of the modified Highly Processed Food Withdrawal Scale (mProWS)

The Highly Processed Food Withdrawal Scale (ProWS) is a 29-item measure that operationalizes physical and psychological indicators of withdrawal symptoms associated with cutting down on the consumption of ultra-processed foods. The current study developed a briefer 7-item version of the ProWS (modified ProWS; mProWS) using the participant sample from the ProWS validation paper (n = 231). Then, in an independent sample recruited from Amazon Mechanical Turk, 244 participants (55.3% females) completed the mProWS, the ProWS, and measures of eating-related constructs in order to evaluate the psychometric properties of the mProWS, relative to the ProWS. The mProWS and the ProWS performed similarly on indexes of reliability, convergent validity with addictive-like eating behavior (e.g., Yale Food Addiction Scale 2.0 symptom count), discriminant validity with distinct measures (e.g., cognitive desire to restrict food consumption), and incremental validity evidenced by associations with weight cycling above and beyond body mass index (BMI) and YFAS 2.0 symptoms. The mProWS may be an appropriate choice for studies with higher participant burden (e.g., ecological momentary assessment) to assess withdrawal symptoms in real-time when they occur in response to cutting down on ultra-processed foods.

Divergent Roles of APOAI and APOM in the Identification of Alcohol Use Disorder and Their Association With Inflammation and Cognitive Decline: A Pilot Study

BACKGROUND

Alcohol use disorder (AUD) courses with inflammation and cognitive decline. Apolipoproteins have emerged as novel target compounds related to inflammatory processes and cognition.

METHODS

A cross-sectional study was performed on abstinent AUD patients with at least 1 month of abstinence (n  = 33; 72.7% men) and healthy controls (n  = 34; 47.1% men). A battery of plasma apolipoproteins (APOAI, APOAII, APOB, APOCII, APOE, APOJ, and APOM), plasma inflammatory markers (LPS, LBP), and their influence on cognition and presence of the disorder were investigated.

RESULTS

Higher levels of plasma APOAI, APOB, APOE, and APOJ, as well as the proinflammatory LPS, were observed in the AUD group, irrespective of sex, whereas APOM levels were lower vs controls. Hierarchical logistic regression analyses, adjusting for covariates (age, sex, education), associated APOM with the absence of cognitive impairment in AUD and identified APOAI and APOM as strong predictors of the presence or absence of the disorder, respectively. APOAI and APOM did not correlate with alcohol abuse variables or liver status markers, but they showed an opposite profile in their associations with LPS (positive for APOAI; negative for APOM) and cognition (negative for APOAI; positive for APOM) in the entire sample.

CONCLUSIONS

The HDL constituents APOAI and APOM were differentially regulated in the plasma of AUD patients compared with controls, playing divergent roles in the disorder identification and associations with inflammation and cognitive decline.

cGAS/STING signaling pathway-mediated microglial activation in the PFC underlies chronic ethanol exposure-induced anxiety-like behaviors in mice

Chronic ethanol consumption is a prevalent condition in contemporary society and exacerbates anxiety symptoms in healthy individuals. The activation of microglia, leading to neuroinflammatory responses, may serve as a significant precipitating factor; however, the precise molecular mechanisms underlying this phenomenon remain elusive. In this study, we initially confirmed that chronic ethanol exposure (CEE) induces anxiety-like behaviors in mice through open field test and elevated plus maze test. The cGAS/STING signaling pathway has been confirmed to exhibits a significant association with inflammatory signaling responses in both peripheral and central systems. Western blot analysis confirmed alterations in the cGAS/STING signaling pathway during CEE, including the upregulation of p-TBK1 and p-IRF3 proteins. Moreover, we observed microglial activation in the prefrontal cortex (PFC) of CEE mice, characterized by significant alterations in branching morphology and an increase in cell body size. Additionally, we observed that administration of CEE resulted in mitochondrial dysfunction within the PFC of mice, accompanied by a significant elevation in cytosolic mitochondrial DNA (mtDNA) levels. Furthermore, our findings revealed that the inhibition of STING by H-151 effectively alleviated anxiety-like behavior and suppressed microglial activation induced by CEE. Our study unveiled a significant association between anxiety-like behavior, microglial activation, inflammation, and mitochondria dysfunction during CEE.

Adolescent alcohol exposure persistently alters orbitofrontal cortical encoding of Pavlovian conditional stimulus components in female rats

Exposure to alcohol during adolescence impacts cortical and limbic brain regions undergoing maturation. In rodent models, long-term effects on behavior and neurophysiology have been described after adolescent intermittent ethanol (AIE), especially in males. We hypothesized that AIE in female rats increases conditional approach to a reward-predictive cue and corresponding neuronal activity in the orbitofrontal cortex (OFC) and nucleus accumbens (NAc). We evaluated behavior and neuronal firing after AIE (5 g/kg intragastric) or water (CON) in adult female rats. Both AIE and CON groups expressed a ST phenotype, and AIE marginally increased sign-tracking (ST) and decreased goal-tracking (GT) metrics. NAc neurons exhibited phasic firing patterns to the conditional stimulus (CS), with no differences between groups. In contrast, neuronal firing in the OFC of AIE animals was greater at CS onset and offset than in CON animals. During reward omission, OFC responses to CS offset normalized to CON levels, but enhanced OFC firing to CS onset persisted in AIE. We suggest that the enhanced OFC neural activity observed in AIE rats to the CS could contribute to behavioral inflexibility. Ultimately, AIE persistently impacts the neurocircuitry of reward-motivated behavior in female rats.

"Alcohol will never run out": Socio-ecological drivers of adolescent boys' alcohol use in Kilimanjaro Region, Tanzania

Heavy alcohol use amongst adolescent boys is a major public health concern in many countries. It is associated with a range of negative physical and mental health outcomes and predicts alcohol-related problems in adulthood. In Kilimanjaro Region, adolescent boys' alcohol use is widespread, and higher than other regions in Tanzania. An understanding of causal and contextual factors that influence the use of alcohol is needed to inform the development and implementation of effective alcohol prevention interventions. This study aimed to explore these socio-ecological factors in-depth amongst adolescent boys, young men and key stakeholders in Kilimanjaro Region, Tanzania. Between August 2022 and June 2023, multi-method, participatory, qualitative methods including: ethnographic observations (8 weeks), 37 in-depth interviews, 14 focus group discussions and participatory adolescent activities were used to elicit perceptions on factors driving adolescent boys' alcohol use in two (rural/urban) settings. Data were triangulated and deductively analysed, guided by Bronfenbrenner's socio-ecological framework. This study found many dynamic and inter-related factors linked to alcohol use within adolescents' social, cultural, economic, regulatory, and physical environments. In a context of widespread availability of alcohol, low enforcement of alcohol regulation and (mis)conceptions around the benefits of alcohol use (e.g. curative and/or nutritional properties), parental and cultural influences largely determined the initiation of use in childhood and younger adolescence; employment status, peers, lack of alternative recreational activity and social norms around independence appeared to drive continued and increased use in older adolescence. Factors and their impact varied between rural and urban settings. In conclusion, a wide range of determinants and drivers of alcohol use among ABYM work at multiple socio-ecological levels especially parental, cultural and socioeconomic factors. This suggests that effective prevention requires a systems approach intervening across these levels. For example, incorporating education/awareness raising, increased law enforcement, parent-child communication and problem-solving, and income generation activities.

Increased anxiolytic effect in aged female rats and increased motoric behavior in aged male rats to acute alcohol administration: Comparison to younger animals

The population of most countries in the world is increasing and understanding risk factors that can influence the health of the older population is critical. Older adults consume alcohol often in a risky, binge manner. Previous work has demonstrated that aged rats are more sensitive to many of the effects of acute ethanol. In the current project aged, adult, and adolescent female and male rats were tested on the elevated plus maze and open field following either a 1.0 g/kg alcohol injection or a saline injection. We report sex- and age-dependent effects whereas aged female rats, but not aged male rats, showed an increased anxiolytic effect of alcohol in the elevated plus maze while aged male rats, but not aged female rats, showed increased stimulatory movement in the open field. In addition, significant age effects were found for both female and male rats. It is proposed that the sex- and age-dependent effects reported in the current studies may be due to differential levels of alcohol-induced allopregnanolone for the anxiolytic effects and differential levels of alcohol-induced dopamine for the stimulatory effects. The current work provides insights into factors influencing alcohol consumption in older adults.

Alcohol Consumption During Adolescence Alters the Cognitive Function in Adult Male Mice by Persistently Increasing Levels of DUSP6

Binge alcohol drinking during adolescence has long-term effects on the adult brain that alter brain structure and behaviors, but the underlying mechanisms remain poorly understood. Extracellular signal-regulated kinase (ERK) is involved in the synaptic plasticity and pathological brain injury by regulating the expression of cyclic adenosine monophosphate response element binding protein (CREB) and brain-derived neurotrophic factor (BDNF). Dual-specificity phosphatase 6 (DUSP6) is a critical effector that dephosphorylates ERK1/2 to control the basal tone, amplitude, and duration of ERK signaling. To explore DUSP6 as a regulator of ERK signaling in the mPFC and its impact on long-term effects of alcohol, a male mouse model of adolescent intermittent alcohol (AIA) exposure was established. Behavioral experiments showed that AIA did not affect anxiety-like behavior or sociability in adulthood, but significantly damaged new object recognition and social recognition memory. Molecular studies further found that AIA reduced the levels of pERK-pCREB-BDNF-PSD95/NR2A involved in synaptic plasticity, while DUSP6 was significantly increased. Intra-mPFC infusion of AAV-DUSP6-shRNA restored the dendritic spine density and postsynaptic density thickness by reversing the level of p-ERK and its downstream molecular expression, and ultimately repaired adult cognitive impairment caused by chronic alcohol exposure during adolescence. These findings indicate that AIA exposure inhibits ERK-CREB-BDNF-PSD95/NR2A by increasing DUSP6 in the mPFC in adulthood that may be associated with long-lasting cognitive deficits.

Problematic substance use in depressed adolescents: Prevalence and clinical correlates

Background

Substance use among adolescents is common and associated with significant consequences, including depression. Adolescents can experience myriad problems related to early onset substance use and depression, making further understanding of this comorbidity necessary.

Method

Participants were a subset from a large-scale performance improvement project and consisted of adolescents aged 12-18 who screened positive for depression during their routine medical or psychiatric appointment and who then completed the substance use assessment Car, Relax, Alone, Forget, Friends, Trouble Version 2.1 (CRAFFT). Participants with problematic substance use had a CRAFFT score ≥2.

Results

A total of 621 participants were included in this study, and 105 (16.9%) reported problematic substance use. Compared with participants without problematic substance use, those with problematic use were more likely to have moderate to severe depression and anxiety, as well as significantly higher irritability, impulsivity, suicidal propensity, and suicidal thoughts scores. Controlling for age at screening, sex, race, and ethnicity, problematic substance use remained a significant predictor of depression severity, impulsivity, suicidal propensity, and suicidal thoughts.

Limitations

Participants were from a large, metropolitan area of the Southwest United States who must have screened positive for depression, so results may not generalize. Because all participants were underage, they may have been wary in responding to the substance use assessment accurately.

Conclusions

By using a large, diverse sample in a real-world clinical setting, findings strengthen the association between problematic substance use and depression and depression-associated symptoms among adolescents, highlighting the need for early detection and universal depression screening.

C57BL/6J offspring mice reared by a single-mother exhibit, compared to mice reared in a biparental parenting structure, distinct neural activation patterns and heightened ethanol-induced anxiolysis

RATIONALE

Parenting experiences with caregivers play a key role in neurodevelopment. We recently reported that adolescents reared by a single-mother (SM) display an anxiety-prone phenotype and drink more alcohol, compared to peers derived from a biparental (BP) rearing condition.

OBJECTIVES

To investigate if SM and BP offspring infant mice exhibit differential sensitivity to ethanol-induced locomotor activity and differential activity patterns in brain areas related to anxiety response. We also analyzed anxiety response and ethanol-induced anxiolysis in SM and BP adolescents.

METHODS

Mice reared in SM or BP conditions were assessed for (a) ethanol-induced locomotor activity at infancy, (b) central expression of Fos-like proteins (likely represented mostly by FosB, a transcription factor that accumulates after chronic stimuli exposure and serves as a molecular marker of neural plasticity) and cathecolaminergic activity, and (c) anxiety-like behavior and ethanol-induced anxiolysis in adolescence.

RESULTS

Infant mice were sensitive to the stimulating effects of 2.0 g/kg alcohol, regardless parenting structure. SM mice exhibited, relative to BP mice, a significantly greater number of Fos-like positive cells in the central amygdala and basolateral amygdala nuclei. Ethanol treatment, but not parenting condition, induced greater activation of dopaminergic neurons in ventral tegmental area. SM, but not BP, adolescent mice were sensitive to ethanol-induced anxiolysis.

CONCLUSIONS

These results highlight the complex relationship between parenting experiences and neurodevelopment. The SM parenting may result in greater neural activation patterns in brain areas associated with anxiety response, potentially contributing to increased basal anxiety and alcohol sensitivity.

Early-life inflammation increases ethanol consumption in adolescent male mice

Recent studies have demonstrated that stress during the critical windows of development can evoke a cascade of neurological changes that can result in neuropsychiatric disorders later in life. In this study, we examined the effect of early-life inflammation on ethanol consumption in adolescent mice. C57BL/6J mice were assigned to either the control or Lipopolysaccharide (LPS) group on postnatal day 14 (P14). In the latter group, LPS at a dose of 50 μg/kg was injected intraperitoneally. The mice were weaned at P21, and behavior tests were performed at P45. Ethanol consumption was assessed using a two-bottle choice drinking paradigm. Anxiety-like behaviors were assessed by marble burying test (MBT), open field (OF), and elevated plus maze (EPM). Ethanol-induced loss of righting reflex (LORR), hypothermia and ethanol metabolism were assessed to evaluate ethanol intoxication. P14 LPS-injected adolescent male mice exhibited significantly increased ethanol preference and consumption, with a similar taste preference for saccharin and avoidance of quinine. The adolescent male mice showed increased anxiety-like behaviors in the OF and EPM tests, and an increased duration of LORR, without affecting the hypothermic effects of ethanol and ethanol metabolism. Interestingly, these behavioral changes were not obvious in female mice. In conclusion, our data indicate that early-life inflammation may be a risk factor for ethanol consumption in adolescents with greater changes observed in male mice. SIGNIFICANCE STATEMENT: Our study is the first preclinical model to report the enhancement effect of early-life inflammation on ethanol consumption in adolescent male mice and our findings provide a valuable mouse model to examine the neurobiological mechanisms mediating the long-lasting effects of early-life inflammation on alcohol use disorders vulnerability.

Biologics Reduce Symptoms of Alcohol Intolerance Better than Aspirin Desensitization in Patients with N-ERD and Nasal Polyps

BACKGROUND

Non-steroidal anti-inflammatory drugs (NSAIDs) exacerbated respiratory disease (N-ERD) is associated with chronic rhinosinusitis with nasal polyps (CRSwNP), asthma, and NSAID hypersensitivity. An overproduction of leukotrienes characterizes the pathomechanism of the disease. N-ERD patients often report breathing difficulties after consuming alcohol. These symptoms have been observed in patients receiving either aspirin therapy after desensitization (ATAD), therapy with the biologics dupilumab (anti-IL-4Ra antibody) and omalizumab (anti-IgE antibody), or intranasal corticosteroid treatment (INCS).

METHODS

This retrospective, real-world study assessed the severity of alcohol-related and non-alcohol-related respiratory symptoms in CRSwNP/N-ERD patients 3-6 months after ATAD, biologic (dupilumab or omalizumab), or INCS therapy. A total of 171 patients (98 women and 73 men) were enrolled in the study. All groups received standard INCS therapy. Sixty-three patients were treated with ATAD; 48 received biologics (dupilumab n = 31; omalizumab n = 17); and 60 received INCS only and served as a control group. Alcohol-dependent symptoms and typical CRS symptoms (alcohol-independent) were quantified using visual analog scales (VAS).

RESULTS

ATAD and biological therapy significantly reduced VAS scores for alcohol dependence and CRS symptoms. In the control group receiving INCS, only non-alcohol dependent CRS symptoms improved significantly (p < 0.05). The most significant differences in pre/post scores were observed in patients receiving dupilumab, with the most significant improvement in alcohol-dependent and CRS symptoms (dupilumab > omalizumab > ATAD).

CONCLUSIONS

This real-world study shows that alcohol-related respiratory symptoms are a relevant parameter in CRSwNP/N-ERD patients. Patients benefit more from biologic therapy than from ATAD in terms of their alcohol-related symptoms and other CRS symptoms. Future studies should include placebo-controlled oral alcohol challenge.