The neural correlates of 'social-oriented' and 'drug-oriented' drinking behavior

Alcohol use increases dramatically during (late) adolescence and is related to
alcohol abuse later in life. By getting more insight in processes driving
adolescent drinking behaviour, we may eventually be able to identify
individuals at risk. The incentive sensitization theory (Robinson & Berridge,
1993) proposes that due to repeated drug use, neutral cues associated with drug
use (i.e., drug-related cues) become sensitized through conditioning and
thereby acquire rewarding properties themselves. As adolescent drinking occurs
mostly in social settings and people tend to imitate their drinking company, it
is useful to investigate social alcohol drinking cues. However, the
sensitization of social cues is hardly investigated. Therefore, this study will
investigate the rewarding effects of social alcohol-related cues. Increased
neural reactivity to these social alcohol-related cues may drive a
social-oriented drinking style.
In addition to the reactivity to social alcohol-related cues, we hypothesize
that heavy drinking patterns may be specifically associated with increased
anticipation for alcohol intake itself. Anticipation for reward is strongly
linked to activity in the ventral striatum. We suggest that ventral striatal
brain activation during anticipation of actual alcohol intake is associated
with drinking frequency, with heavy drinkers showing stronger anticipation
effects (i.e., they are more drug-oriented).

With this study we aim to predict drinking behaviour at follow-up based on
brain activation reflecting reactivity to social alcohol cues and brain
activation reflecting anticipation of alcohol intake. In addition, brain
activation in response to social alcohol related cues will be related to
real-life imitation of alcohol intake in a social setting. Brain activation
will be measured using fMRI during two different cognitive tasks; 1) a social
alcohol cue exposure task (SACE) which is an alcohol cue exposure task
including social relevant pictures, 2) a drug incentive delay task (DID) which
is a monetary incentive delay task with alcohol (i.e. sips of beer) incentives.

The study involves three evening test sessions as well as a follow-up
questionnaire battery. The first two sessions will be scheduled in a laboratory
specifically designed to look like a typical Dutch bar (Bar-Lab). The current
study includes a cover story (i.e. evaluation of alcohol advertisements), as
participants should be unaware of the purpose of the study while imitation of
alcohol intake is measured. In the third session, participants will perform the
SACE and DID task while brain activation will be measured using fMRI. 18 months
after study entry, participants are asked to report on their drinking behaviour
through questionnaires.

fMRI is a safe and non-invasive method for measuring brain activity.
Importantly, we will only study the effect of a low-to-moderate alcohol dose, a
dose that is relatively low in the context of the levels of alcohol intake
typical for the population from which our sample will be drawn. Additionally,
the session will be immediately terminated when participants consume more than
4 alcoholic drinks, and are only allowed to leave the university building once
their Blood Alcohol Concentration (BAC) falls below <0.05%.The total amount of
beer consumed in the fMRI scanner is approximately 10 ml, and therefore the BAC
values can be neglected. The study has no therapeutical goals; there are no
benefits for the participants.