Effects of heavy alcohol abuse on adolescent brain structure and function

描述(申请人提供)：对酒精在青春期的影响知之甚少，青春期是人类发育的关键阶段。这是真的，尽管事实是：1)大多数人在青少年时期就开始尝试酒精，2)从青春期开始饮酒是未来酗酒的最有力的预测因素之一，3)在青春期，调节药物强化的大脑区域发生了变化。此外，大多数关于酒精依赖对大脑影响的研究都对接受治疗的个人进行了检查。这些样本代表了普通人群中的一小部分酗酒者，我们已经表明，接受治疗的成年酗酒者并不是成年酗酒者中具有代表性的样本，他们早期饮酒的轨迹更强烈，精神病理和心理功能异常的情况也更多。在被证明并非如此之前，一个合理的假设是，在普通人群中，接受酒精使用障碍(AUD)治疗的青少年也是更酗酒的人，与未治疗的AUDS青少年相比，他们的共病更多。因此，研究社区中的青少年酗酒者，以了解酒精滥用对整个人群青少年大脑的影响至关重要。此外，对患有AUDS但没有其他物质使用障碍(SUDS)的社区青少年进行研究也很重要。否则，将无法将AUDS与其他肥皂泡对大脑结构和功能的影响分开。这一目标在美国是不可能实现的，因为绝大多数患有AUDS的青少年也有其他肥皂水。在南非开普敦地区，有一个研究“纯”青少年AUD的独特机会(我们在一项初步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，一半男性和一半女性)，以及100名年龄和性别匹配的轻度/非饮酒者对照，所有人都没有其他肥皂泡或目前可诊断的共病精神病理学。受试者将在四个领域进行研究：心理功能、神经心理功能、大脑结构和大脑功能的电生理测量。我们将独一无二地分离出AUDS对青春期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.