Adolescent alcoholism treatment. Teen Drinking Linked to Brain Changes, Medpage Today

by Michael Smith Michael Smith, North American Correspondent, MedPage Today Teen alcoholism.

TORONTO -- Adolescent alcohol drinking affects the normal development of the brain, a researcher said here.

In a longitudinal study, heavy-drinking teens lost more gray matter and gained less white matter over time than their peers who did not drink, according to Lindsay Squeglia, PhD, of the Medical University of South Carolina in Charleston.

The differences -- seen on sequential magnetic resonance imaging -- were similar regardless of sex, Squeglia said in an oral scientific session at the annual meeting of the American Psychiatric Association.

Previous cross-sectional research has shown that the volume of cortical gray matter begins to fall even before adolescence and continues to decline into early adulthood, while white matter volume begins to increase over the teen years, Squeglia said.

But the magnitude of the changes is exaggerated in teens who engage in episodic heavy drinking, Squeglia said, even when the drinking does not reach the threshold associated with alcohol use disorder.

Her paper appeared online in the American Journal of Psychiatry. A second study presented here, also dealing with teen drinking, was published by the same journal.

In that study, researchers led by Gunter Schumann, MD, of King's College London in England, reported that environmentally induced changes in gene activity were associated with early and heavy teen drinking.

Both studies are "outstanding" and advance the understanding of teenage drinking, commented George Koob, PhD, director of the National Institute on Alcohol Abuse and Alcoholism in Bethesda, Md.

Adolescent alcoholism symptoms

While the studies seem to be miles apart, he said here, they "converge" to present a consistent picture of brain changes that increase impulsiveness and decrease control, making it easier to start drinking and harder to stop.

"If such changes are not reversible," Koob argued in an editorial accompanying the two papers, "then they could help explain the increased risk of enduring alcohol use disorders in adulthood following excessive drinking during adolescence."

Squeglia and colleagues reported on 134 adolescents, including 75 who transitioned to heavy drinking while 59 remained light drinkers or nondrinkers over roughly 3.5 years.

The drinking tended to take place in binges such as weekend parties, she said, with heavy drinking defined as four or more drinks over two hours for girls and five or more for boys.

All of the participants had an MRI scan two to six times between the ages of 12 and 24 and were followed for up to 8 years, the investigators reported.

Over time, neocortical gray matter decreased in all participants, they found, but was significantly greater in the drinkers, especially in the frontal, lateral frontal, and temporal cortices (at P=0.019, P=0.013, and P=0.001, respectively.)

Similarly, white matter regions grew in volume in both groups, but growth was attenuated in the heavy drinkers compared with the nondrinkers in the pons and the corpus callosum (at P=0.001 and P<,0.001, respectively.)

There was no apparent association with the use of other drugs, but Squeglia noted the sample size was small.

Youth alcoholism statistics

Participants had a mean grade-point average of 3.5 (out of 4) at baseline, she said, a level that was maintained by the nondrinkers. The impact of drinking, however, was marginal: The drinkers were still able to maintain an average GPA of 3.2, she reported.

She also noted that the participants were of relatively high socioeconomic status and had no comorbid pathologies, such as hyperactivity disorders. Their alcohol use remained subclinical throughout the study.

Those factors probably limit how widely the findings can be applied, she said.

On the other hand, she said, "if we find differences in these high-functioning kids who are really healthy, we might expect to find even more pronounced differences when they have other factors on board."

In the other study, Schumann and colleagues in the so-called IMAGEN consortium, which is studying mental health and risk-taking in European teens, found what they suggested is the first evidence of a so-called epigenetic change that influences alcohol use.

The analysis began with 18 pairs of identical twins in which one twin had an alcohol use disorder and the other did not. Using genome-wide analysis methods, the researchers looked for sites where genes were methylated differently between the twins.

The analysis turned up several genetic regions that were differently methylated, affecting some 62 genes, Schumann said. Analysis suggested that in the twins the most affected was a gene known as 3'-protein-phosphatase-1G, or PPM1G, that has been previously linked with alcohol dependence.

In the second stage of the study, the researchers investigated the PPM1G gene in 499 participants in the IMAGEN project.

Adolescent alcoholism treatment

In baseline blood samples, when the participants were 14, there was no evidence of hypermethylation of the gene, Schumann said. But among those who started drinking between that age and 16, they found a positive association between methylation of PPM1G and escalation of daily drinking.

They also found that escalation of daily drinking was associated with impulsiveness, which, in turn, was positively associated with methylation of PPM1G.

"So we have a triangular situation," he said, where a methylated gene is associated with increased drinking and the increase is mediated by increased impulsivity.

But, he added, exactly what causes the methylation remains an open question.

Reviewed by Henry A. Solomon, MD, FACP, FACC Clinical Associate Professor, Weill Cornell Medical College and Dorothy Caputo, MA, BSN, RN, Nurse Planner

Posted by at 08:10PM

Tags: adolescent alcoholism treatment, youth alcoholism on the rise, adolescent alcoholism symptoms, youth alcoholism statistics

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