Effects of heavy alcohol abuse on adolescent brain structure and function

描述（由申请人提供）：关于酒精对青春期的影响，人类发育的关键阶段，人们知之甚少。这是真的，尽管事实是：1）大多数人在青少年时期开始尝试酒精，2）从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，大脑中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对接受治疗的个体进行了检查。这样的样本代表了一般人群中的一小部分酗酒者，我们已经证明，治疗的成年酗酒者并不是一般人群中具有更强烈的早期饮酒轨迹和更大的共病精神病理学和异常心理功能的成年酗酒者的代表性样本。除非另有证明，否则一个合理的假设是，接受酒精使用障碍（AUD）治疗的青少年也是酗酒者，与一般人群中未经治疗的AUD青少年相比，合并症更多。出于这个原因，研究社区中的青少年酒精滥用者，以了解酒精滥用对整个人群中青少年大脑的影响至关重要。此外，重要的是要研究社区青少年与AUD，但没有其他物质使用障碍（SUD）。否则，就不可能将AUD与其他SUD对大脑结构和功能的影响区分开来。这一目标在美国还无法实现，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，存在一个研究“纯”青少年AUDs的独特机会（我们在一项试点研究中记录了这一点）。我们建议招募并研究100名患有AUDs的青少年（12 - 18岁，男女各半），以及100名年龄和性别匹配的轻度/非饮酒者对照组，所有患者均无其他SUDs或当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。我们将能够独特地分离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.