Neuropsychophysiological Measures of Alcohol Dependence: Can We Use EEG in the Clinical Assessment?

Abstract

Addiction management is complex, and it requires a bio-psycho-social perspective, that ought to consider the multiple etiological and developmental factors. Because of this, a large amount of resources has been allocated to assess the vulnerability to dependence, i.e., to identify the processes underlying the transition from substance use to dependence, as well as its course, in order to determine the key points in its prevention, treatment, and recovery. Consequently, knowledge \from neuroscience must be taken into account, which is why different initiatives have emerged with this objective, such as the “Research Domain Criteria” (RDoC), and the “Addiction Neuroclinical Assessment” (ANA). Particularly, neuropsychophysiological measures could be used as markers of cognitive and behavioral attributes or traits in alcohol dependence, and even trace clinical change. In this way, the aim of this narrative review is to provide an overview following ANA clinical framework, to the most robust findings in neuropsychophysiological changes in alcohol dependence, that underlie the main cognitive domains implicated in addiction: incentive salience, negative emotionality, and executive functioning. The most consistent results have been found in event-related potential (ERP) analysis, especially in the P3 component, that could show a wide clinical utility, mainly for the executive functions. The review also shows the usefulness of other components, implicated in affective and substance-related processing (P1, N1, or the late positive potential LPP), as well as event-related oscillations, such as theta power, with a possible use as vulnerability or clinical marker in alcohol dependence. Finally, new tools emerging from psychophysiology research, based on functional connectivity or brain graph analysis could help toward a better understanding of altered circuits in alcohol dependence, as well as communication efficiency and effort during mental operations. This review concludes with an examination of these tools as possible markers in the clinical field and discusses methodological differences, the need for more replicability studies and incipient lines of work. It also uses consistent findings in psychophysiology to draw possible treatment targets and cognitive profiles in alcohol dependence.

Electroencephalographic signatures of the binge drinking pattern during adolescence and young adulthood: A PRISMA-driven systematic review

“…Importantly, as ERPs have revealed a high sensitivity to change –e.g. along the treatment process ( Campanella et al, 2020 , Houston and Schlienz, 2018 ), they also constitute a valuable tool for monitoring interindividual alterations ( Jurado-Barba et al, 2020 ). EEG assessment may also help to detect specific neurocognitive deficits associated with BD and to assist with cognitive stimulation (e.g., via cognitive training or by transcranial electrical stimulation), which might in turn facilitate early recovery before progression of these abnormalities, even in the absence of behavioral alterations ( Di Lemma et al, 2020 , Dormal et al, 2020 ).…”

Targeting Unmet Clinical Needs in the Treatment of Alcohol Use Disorder

“…The incentive salience construct refers to the psychological “wanting” that is driven by both physiological factors and learned associations about a reward cue, prompting compulsive habits ( 51 ). Cue exposure is related to increased craving and changes in the neural reward system, facilitating chemical dependence ( 52 ). In AUD, factors like depression, trait anxiety scores, and items from the Obsessive Compulsive Drinking Scale load onto the incentive salience domain ( 50 ).…”

“…As in the incentive salience factor, craving also maps onto negative emotionality; the desire to avoid withdrawal is mediated by the associated negative affect. More specifically, it is believed that individuals with AUD drink for the sole purpose of avoiding the negative emotionality states associated with withdrawal shifting from pleasant feelings following consumption to feelings of relief instead ( 52 ).…”

Sex differences in the alcohol-mediated modulation of BLA network states

“…This indicates that alcohol can modulate specific oscillatory frequencies within the BLA that are implicated both in addiction and mood disorders (Jurado-Barba et al, 2020).…”