Effects of heavy alcohol abuse on adolescent brain structure and function

描述（由申请人提供）：相对而言，我们对酒精对青春期的影响知之甚少，而青春期是人类发展的关键阶段。这是正确的，尽管事实是：1)大多数人在青少年时期就开始尝试饮酒；2)在青春期开始饮酒是后来酗酒的最有力的预测因素之一；3)在青春期，大脑调节药物强化的区域发生了变化。此外，大多数关于酒精依赖对大脑影响的研究都是针对接受治疗的个体进行的。这些样本代表了一般人群中一小部分酗酒者，我们已经表明，治疗的成年酗酒者并不是具有更强烈的早期饮酒轨迹、更大的共病精神病理和异常心理功能的成年酗酒者一般人群的代表性样本。在没有其他证据证明之前，一个合理的假设是，在接受酒精使用障碍治疗的青少年中，与未接受治疗的青少年相比，酗酒的青少年也有更多的合并症。因此，研究社区中的青少年酒精滥用者是至关重要的，以便了解酒精滥用对整个人群中青少年大脑的影响。此外，研究有AUDs但没有其他物质使用障碍（SUDs）的社区青少年是很重要的。否则，就不可能将aud与其他sud对大脑结构和功能的影响分开。这一目标在美国尚未实现，因为绝大多数患有aud的青少年也患有其他sud。在南非的开普敦地区，存在一个独特的机会来研究“纯”青少年aud（我们已经在一项试点研究中记录了这一点）。我们建议招募和研究100名患有AUDs的青少年（12 - 18岁，男女各占一半），以及100名年龄和性别匹配的轻度/非饮酒者对照，所有人都没有其他sud或当前可诊断的共病精神病理。受试者将在四个领域进行研究：心理功能、神经心理功能、脑结构和脑功能的电生理测量。我们将独特地分离出aud对青少年大脑结构和功能的影响。

DESCRIPTION (provided by applicant): Relatively little is known about alcohol's effects in adolescence, a critical stage of human development. This is true despite the facts that: 1) the majority of individuals began experimenting with alcohol as teenagers, 2) drinking beginning in adolescence is one of the most powerful predictors of later alcohol abuse, and 3) in adolescence, there are changes in the areas of the brain that modulate drug reinforcement. In addition, most studies of the impact of alcohol dependence on the brain have examined individuals in treatment. Such samples represent a small proportion of alcoholics in the general population, and we have shown that treated adult alcoholics are not a representative sample of the general population of adult alcoholics with more intense early trajectory of alcohol consumption and with greater comorbid psychopathology and abnormal psychological functioning. Until proven otherwise, a reasonable assumption is that adolescents in treatment for alcohol use disorders (AUDs) are also heavier drinkers with more comorbidities than untreated adolescents with AUDs in the general population. For this reason, it is crucially important to study adolescent alcohol abusers in the community in order to understand the effects of alcohol abuse on the adolescent brain in the population at large. Moreover, it is important to study community adolescents with AUDs, but without other substance use disorders (SUDs). To do otherwise, would make it impossible to disentangle the effects of AUDs from those of other SUDs on brain structure and function. This goal has not been achievable in the United States, because the vast majority of adolescents with AUDs also have other SUDs. In the Cape Town region of South Africa, a unique opportunity to study 'pure' adolescent AUDs exists (we have documented this in a pilot study). We propose to recruit and study 100 such adolescents with AUDs (12 - 18 years of age, half males and half females), and 100 light/non-drinker age and gender matched controls, all without other SUDs or current diagnosable comorbid psychopathology. Subjects will be studied in four domains: psychological functioning, neuropsychological functioning, brain structure, and electrophysiological measures of brain function. We will be uniquely able to isolate the effects of AUDs on brain structure and function in adolescence.