Learning in Young Adults as Predictor for the Development of Alcohol Use Disorders (LeAD)

Overall goal of this study is to scrutinize the relation of learning behavior and related brain activity to the development of alcohol use disorder (AUD).

The researchers aim is to characterise a representative sample (200 men at age 18) with regard to learning parameters and their respective neural correlates which are thought to be indicators for the risk to develop an alcohol use disorder.

As part of a large multi-center study on alcohol dependency (in Dresden & Berlin, Germany) the researchers will characterize the sample and then prospectively assess alcohol consumption and development of AUDs over a period of three years plus additional follow-ups after that period, depending on future funding.

Among other hypotheses it is expected that increased activation of striatal and prefrontal brain regions by the Pavlovian-to-instrumental transfer process is related to increased risk of developing an AUD.

Study Overview

• Status: Completed
• Conditions: High-risk Alcohol Consumption Pattern; Low-risk Alcohol Consumption Pattern

Detailed Description

Hazardous alcohol use and alcohol use disorders (AUDs) are extremely prevalent in industrialized countries, affecting about 6 million individuals in Germany alone. The onset of most cases occurs during adolescence and early adulthood. Therefore, targeted prevention would be desirable especially in young people who are at high risk to develop AUDs. Since our knowledge about predisposing factors is limited, this project aims to identify mechanisms underlying liability for dysfunctional alcohol consumption (i.e. hazardous alcohol use, alcohol abuse and alcohol dependence). Based on the hypothesis that addiction is a disorder due to aberrant learning, the researchers expect that inter-individual differences in learning behavior should be associated with liability for as well as resiliency against AUD. To test the hypotheses, the researchers will characterize 200 men at age 18, and then prospectively assess alcohol consumption and development of AUDs over a period of three years. At baseline, the researchers will study three clusters of predictive variables: (i) individual learning parameters, estimated by computational modeling of behavioral performance in learning tasks such as Pavlovian-to-instrumental transfer, probabilistic reversal learning, and habitization-devaluation; (ii) individual neural correlates of learning, assessed by functional brain imaging during learning; and (iii) already established risk factors such as family history of alcoholism and impulsivity.

The specific aim is to test a set of related hypotheses. The researchers assume that high risk for AUD at baseline (cross-sectional design), increase of alcohol consumption after 3 years and incidence or progression of AUD during follow-up (prospective data) will be associated with decreased reward sensitivity, decreased punishment sensitivity, increased Pavlovian approach behavior ('sign tracking'), increased 'go' effect of conditioned appetitive stimuli, increased habitization, increased activation of striatal and prefrontal brain regions by the Pavlovian-to-instrumental transfer process, decreased correlation between striatal brain activity and prediction error during reversal learning.

• Study Type: Observational
• Enrollment (Actual): 201

Contacts and Locations

Study Locations

• Germany
  • Berlin, Germany, 10117
    • Charité - Universitätsmedizin Berlin
  • Saxony
    • Dresden, Saxony, Germany, 01307
      • Universitaetsklinikum Carl Gustav Carus at the Technische Universitaet Dresden
    • Dresden, Saxony, Germany, 01187
      • Technische Universitat Dresden

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 18 years (ADULT)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: Male

• Sampling Method: Probability Sample

Study Population

random, representative sample from the respective city area (100 in Dresden, 100 in Berlin; male; born between January 1 1994 and November 30 1994

Description

Inclusion Criteria:

• men at age 18
• ability to provide fully informed consent and to use self-rating scales
• habitual social drinking during the three months preceding participation, defined by at least two drinking days in any four weeks-interval
• being able to provide information concerning biological parents and grandparents

Exclusion Criteria:

• lifetime history of Diagnostic Statistical Manual-IV bipolar or psychotic disorder
• current diagnosis of one of the following disorders: major depressive disorder, generalized anxiety disorder, PTSD, borderline personality disorder, or obsessive-compulsive disorder
• prior treatment for any axis-I or axis-II disorder except for specific disorders of childhood and adolescence (i.e., oppositional defiant disorder, conduct disorder, ADHD)
• history of substance dependence other than nicotine dependence
• current substance use other than nicotine and alcohol as evinced by positive urine screen
• history of severe head trauma or other severe central neurological disorder (e.g. multiple sclerosis)
• any alcohol intake in the last 24 hours before test days
• use of medications or illicit substances known to interact with the central nervous system within the last 10 days or at least four half-lives post last intake

Study Plan

How is the study designed?

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort
18-year-old males; 18-year-old males, representative random sample of the Dresden/Berlin (Germany) area, categorized as high and as low-risk drinkers respectively

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
blood oxygenation level dependent (BOLD) response	investigation of neural activation of the mesolimbic system in a healthy random sample of male subjects categorized in high and low risk-for-AUD using 3 Tesla magnetic resonance imaging	time point 1: when subject is 18 years of age

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
alcohol consumption pattern after and during a 3-year follow-up period	time life follow-back assessment of alcohol consumption pattern will be assessed every 6 months, as well as standardized diagnostic interviewing for psychopathologies every 12 months	assessment every 6 months

Collaborators and Investigators

• Sponsor: Technische Universität Dresden
• Collaborators: Charite University, Berlin, Germany
• Investigators: Principal Investigator: Michael Smolka, Prof MD, Technische Universität Dresden, Dresden, Germany

Publications and helpful links

Helpful Links

• Official study group website
• English study description

Study record dates

Study Major Dates

• Study Start: December 1, 2012
• Primary Completion (ACTUAL): April 1, 2018
• Study Completion (ACTUAL): December 1, 2020

Study Registration Dates

• First Submitted: December 6, 2012
• First Submitted That Met QC Criteria: December 6, 2012
• First Posted (ESTIMATE): December 7, 2012

Study Record Updates

• Last Update Posted (ACTUAL): April 7, 2022
• Last Update Submitted That Met QC Criteria: March 30, 2022
• Last Verified: March 1, 2022

More Information

Terms related to this study

• Keywords: Functional imaging; Pavlovian-to-instrumental transfer; Reward-based learning; alcohol use disorder risk
• Additional Relevant MeSH Terms: Mental Disorders; Chemically-Induced Disorders; Drinking Behavior; Alcohol-Related Disorders; Substance-Related Disorders; Alcohol Drinking; Alcoholism
• Other Study ID Numbers: HE2597/13-1;SM80/71;WI709/10-1