Neurobiological Markers of Alcohol Use Disorder: Implications for Prevention and Treatment

Alcohol use disorder (AUD) is a major global public health issue because of the financial costs and societal burden it imposes worldwide. This presentation aims to contribute to a better understanding of the causes that promote (or reduce) risk for AUD, alcohol relapse, and treatment failure. First, I will present novel findings from a recently published study in which nondependent young drinkers (N=160) viewed images of alcoholic beverages and of “natural” rewards (e.g., erotic; thrill-seeking) while EEG was recorded. Findings indicated that individuals at risk for problematic and heavy drinking show a specific pattern of brain reactivity characterized by enhanced brain responses to alcohol-related cues and blunted responses to cues depicting natural rewards. Second, I will present data from a genetically informed longitudinal study with adolescent twins (N=173) who were prospectively followed from age 12 through 18-20. The included sample consisted of 79 [46%] monozygotic [MZ] and 94 [54%] dizygotic [DZ] twins, who completed annual follow-up interviews and an EEG session at age 18 or 20, where they completed a picture-viewing task (pictures of alcohol, nonalcohol beverages, and neutral IAPS images). Findings show that brain reactivity to alcohol cues is an acquired marker of risk for AUD shaped by unique individual experiences with heavy episodic drinking. Next, I will present data from N=17 treatment-entering AUD patients who completed an fMRI task in which they viewed stress, alcohol, and neutral-relaxing images prior to initiating an 8-week outpatient treatment during which they were prospectively assessed for alcohol intake, craving and stress using a smartphone app. Participants completed a second fMRI after treatment with the same task using a similar set of images. Results indicated that altered neural circuits of stress and emotion regulation in AUD patients recovered with treatment. Finally, I will identify unanswered questions and propose promising directions for future research aimed at improving prevention strategies and treatment efforts for alcohol dependence.