Sex Differences in Risk for Alcohol Abuse

Mark Fillmore

Status: Completed

Conditions: Alcohol Abuse

Treatments: Drug: Saline; Drug: Alcohol

Study type: Interventional

Funder types: Other; NIH

Identifiers

NCT04543942

50301

K01AA024519-06 (U.S. NIH Grant/Contract)

Details and patient eligibility

About

This study will determine the neural and hormonal mechanisms underlying sex differences in sensitivity to the disinhibiting effects of alcohol in heavy drinkers.

Full description

Alcohol abuse inflicts enormous physical, emotional, and financial burdens on the individual and society at large. Knowing who is at risk for alcohol abuse, and why, is crucial for the development of effective prevention and treatment strategies. Alcohol abuse has been traditionally considered a male-oriented problem and as a consequence research on risk factors specific to women has been minimal. However, the sex gap in substance abuse is closing rapidly, and findings from both animal and human studies suggest that females are actually more vulnerable to drug use than males. As such, there is an urgent need to identify sex differences in risk factors for alcohol abuse in order to develop sex-specific prevention and treatment efforts. One clear candidate risk factor is poor inhibitory control, both in terms of baseline levels of inhibition and sensitivity to the disinhibiting effects of alcohol. Recent studies suggest that sex hormones affect inhibitory control in drug-free individuals, potentially contributing to sex differences in baseline levels of inhibition. However, the degree to which fluctuations in sex hormones influence sex differences in inhibition-related brain function in sober and intoxicated individuals is not known. The proposed project will determine the neural and hormonal mechanisms underlying sex differences in sensitivity to the disinhibiting effects of alcohol in heavy drinkers.

The overall objective of the research is to identify hormonal determinants of alcohol effects on brain activation during response inhibition (BARI) in young adult female and male drinkers. BARI will be assessed using functional magnetic resonance imaging (fMRI) during performance of the stop signal task. This task reliably activates right-lateralized prefrontal regions implicated in inhibitory control. This study will assess BARI during IV alcohol (60mg%) and saline infusion in women during the early follicular and mid-luteal phases and in men at matched intervals.

Enrollment: 28 patients

Sex: All

Ages: 21 to 29 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• heavy drinking
• Alcohol Use Disorder Identification Test score above 7
• right-handed
• BMI between 19 and 26
• high school education
• fluent in English
• women must have regular menstrual cycles
• not using hormonal contraceptives

Exclusion criteria

• drug use disorder (SCID, DSM-5), other than nicotine or caffeine
• meets withdrawal criteria
• history of physical or psychiatric disease
• contraindication for fMRI
• pregnant or breastfeeding
• smoking more than 5 cigarettes per day

Trial design

Primary purpose: Basic Science

Allocation: Randomized

Interventional model: Crossover Assignment

Masking: Single Blind

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28 participants in 2 patient groups

Alcohol, then saline, then alcohol, then saline

Experimental group

Description:

Participants first received alcohol (60mg%) intravenously and then 24-48 hours later they received saline intravenously. Two weeks later, they again received alcohol (60mg%) intravenously and then 24 - 48 hours later they received saline intravenously.

Treatment:

Drug: Alcohol

Drug: Saline

Saline, then alcohol, then saline, then alcohol

Experimental group

Description:

Participants first received saline intravenously and then 24-48 hours later they received alcohol (60mg%) intravenously. Two weeks later, they again received saline intravenously and then 24 - 48 hours later they received alcohol (60mg%) intravenously.

Treatment:

Drug: Alcohol

Drug: Saline