Tackling addictive behaviors through memory suppression: A scoping review and perspective.

Forgetting is often viewed as a human frailty. However, over the years, it has been considered an adaptive process that allows people to avoid retrieval of undesirable memories, preventing them from suffering and discomfort. Evidence shows that the ability to suppress memories is affected by several psychopathological conditions characterized by persistent unwanted thoughts, including anxiety and posttraumatic stress disorders. Nevertheless, memory suppression (MS) mechanisms in addiction-a clinical condition characterized by recurrent drug-related thoughts that contribute to repeated drug use-have received little attention so far. Addiction theories reveal that drugs change behavior by working on memory systems, particularly on declarative memory, which is related to the retrieval and encoding of drug-related memories. In this review, the main behavioral and neurofunctional findings concerning the Think/No-Think task-an adaptation of the classical Go/No-Go tasks typically used to evaluate the suppression of motor response-are presented. We then show how the memory system can be involved in the craving or anticipation/preoccupation stage of the addiction cycle. Subsequently, the study of MS in the context of addictive behaviors is highlighted as a promising approach for gaining knowledge about the mechanisms contributing to the continuation of addiction. Finally, we discuss how interventions aiming to strengthen this ability could impact the anticipation/preoccupation stage by (i) reducing the accessibility of drug-related memories, (ii) decreasing craving and attention toward drug-related stimuli, and (iii) improving overall inhibition abilities. In conclusion, this review aims to illustrate how the study of MS may be a valuable approach to enhance our understanding of substance use disorders by unveiling the underlying cognitive and neural mechanisms involved, which could have important implications for addiction treatment.

Forgetting Alcohol: A Double-Blind, Randomized Controlled Trial Investigating Memory Inhibition Training in Young Binge Drinkers.

Background: Binge Drinking (BD) has been associated with altered inhibitory control and augmented alcohol-cue reactivity. Memory inhibition (MI), the ability to voluntarily suppress unwanted thoughts/memories, may lead to forgetting of memories in several psychiatric conditions. However, despite its potential clinical implications, no study to date has explored the MI abilities in populations with substance misuse, such as binge drinkers (BDs). Method: This study-registered in the NIH Clinical Trials Database (ClinicalTrials.gov identifier: NCT05237414)-aims firstly to examine the behavioral and electroencephalographic (EEG) correlates of MI among college BDs. For this purpose, 45 BDs and 45 age-matched non/low-drinkers (50% female) will be assessed by EEG while performing the Think/No-Think Alcohol task, a paradigm that evaluates alcohol-related MI. Additionally, this work aims to evaluate an alcohol-specific MI intervention protocol using cognitive training (CT) and transcranial direct current stimulation (tDCS) while its effects on behavioral and EEG outcomes are assessed. BDs will be randomly assigned to one MI training group: combined [CT and verum tDCS applied over the right dorsolateral prefrontal cortex (DLPFC)], cognitive (CT and sham tDCS), or control (sham CT and sham tDCS). Training will occur in three consecutive days, in three sessions. MI will be re-assessed in BDs through a post-training EEG assessment. Alcohol use and craving will be measured at the first EEG assessment, and both 10-days and 3-months post-training. In addition, behavioral and EEG data will be collected during the performance of an alcohol cue reactivity (ACR) task, which evaluates attentional bias toward alcoholic stimuli, before, and after the MI training sessions. Discussion: This study protocol will provide the first behavioral and neurofunctional MI assessment in BDs. Along with poor MI abilities, BDs are expected to show alterations in event-related potentials and functional connectivity patterns associated with MI. Results should also demonstrate the effectiveness of the protocol, with BDs exhibiting an improved capacity to suppress alcohol-related memories after both combined and cognitive training, along with a reduction in alcohol use and craving in the short/medium-term. Collectively, these findings might have major implications for the understanding and treatment of alcohol misuse. Clinical Trial Registration: [www.ClinicalTrials.gov], identifier [NCT05237414].

"It's a beer!": Brain functional hyperconnectivity during processing of alcohol-related images in young binge drinkers.

Alcohol attentional bias has been pointed as a major marker of alcohol misuse. Recent evidence has revealed that brain functional connectivity (FC) may be a valuable index of the brain networks' integrity in young binge drinkers (BDs). However, there is no study to date examining the FC networks linked to the processing of alcohol-related images in this population. The present study aimed to explore the FC signatures underlying alcohol attention bias in young BDs. Thus, electroencephalographic (EEG) activity was recorded in 54 college students (55.5% females; 27 non/low-drinkers and 27 BDs) while performing a visual alcohol cue-reactivity task. We evaluated whole-brain FC profiles during the processing of alcoholic and non-alcoholic cues, as well as their potential relationship with craving and severity of alcohol use. Results showed that, at the behavioural level, BDs rated alcohol-related images as more pleasant/attractive than non/low-drinkers. Furthermore, at the electrophysiological level, BDs exhibited increased beta-band FC-particularly in the fronto-parieto-occipital network-when processing alcoholic cues. Conversely, they displayed reduced theta-band FC relatively to non/low-drinkers for non-alcoholic images. These hyper-/hypo-connectivity patterns were associated with higher alcohol craving levels. Findings are congruent with previous neurofunctional studies reporting an attentional bias towards alcohol-related information in BDs. These results may have important clinical implications as this neural reactivity to alcoholic cues may contribute to the maintenance and/or escalation of the drinking pattern. Finally, the present study constitutes the first evidence showing that FC networks may be a sensitive indicator to alcohol attentional bias in BDs.

Effects of the COVID-19 Mitigation Measures on Alcohol Consumption and Binge Drinking in College Students: A Longitudinal Survey.

To "flatten the curve" of COVID-19 contagion, several countries ordered lockdowns amid the pandemic along with indications on social distancing. These social isolation measures could potentially bring alterations to healthy behavior, including to alcohol consumption. However, there is hardly any scientific evidence of the impact of such measures on alcohol consumption and binge drinking (BD) among young adults, and how they relate to alcohol craving, stress, anxiety, and depression levels. We addressed these questions by conducting a longitudinal study with 146 Portuguese college students-regular binge drinkers (regular BDs), infrequent binge drinkers (infrequent BDs) and non-binge drinkers (non-BDs)-in three moments: before the pandemic (Pre-Lockdown), during lockdown (Lockdown) and 6 months after (Post-Lockdown). Results revealed that regular BDs decreased alcohol use during Lockdown, a change in behavior that was even greater during Post-Lockdown, when regular BDs displayed similar levels of consumption to infrequent/non-BDs. Additionally, alcohol craving and living with friends were predictive of alcohol use during Lockdown, whereas stress, anxiety, and depression symptoms did not contribute to explain changes in drinking behavior. Collectively, the results suggest that BD in young Portuguese college students can be stopped when the contexts in which alcohol intake usually takes place are suppressed, which may have important implications for future prevention and intervention strategies.

Portuguese validation of the Alcohol Craving Questionnaire-Short Form-Revised.

Alcohol craving has been described as a strong subjective desire to drink, being considered highly valuable in the clinical practice, as it is recognized as a strong predictor of alcohol relapse in alcohol-dependent individuals. However, to date, there is not a multifactorial questionnaire available for assessing short-term acute craving experience in Portugal. The aim of the present study was to validate a swift and efficient tool for the assessment of acute alcohol craving in a sample of Portuguese citizens. For that purpose, the Alcohol Craving Questionnaire-Short Form-Revised (ACQ-SF-R) was translated into European Portuguese and administered to a sample of 591 college participants with ages between 18 and 30 years. Results suggested that a three-factor model (i.e., Emotionality, Purposefulness, and Compulsivity) proved to be most suitable for the Portuguese sample. Overall, the ACQ-SF-R exhibited good psychometric properties, having a good internal consistency both for the general craving index (Cronbach's α = 0.85) and each subscale (Cronbach's α = 0.66-0.83), as well as an appropriate convergent validity with the Penn Alcohol Craving Scale (r = 0.65, p<0.001), suggesting a good construct validity. In addition, the ACQ-SF-R also showed a good concurrent validity with the Alcohol Use Disorders Identification Test (r = 0.57, p<0.001), indicating that risky alcohol use patterns are associated with increased craving scores in the ACQ-SF-R. Collectively, these findings suggest that the Portuguese version of the ACQ-SF-R can accurately measure alcohol craving at a multifactorial level, being a valid and reliable tool to use in Portuguese samples in research settings.

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

Research on neurophysiological impairments associated with binge drinking (BD), an excessive but episodic alcohol use pattern, has significantly increased over the last decade. This work is the first to systematically review -following PRISMA guidelines- the empirical evidence regarding the effects of BD on neural activity -assessed by electroencephalography- of adolescents and young adults. A systematic review was conducted in 34 studies (N = 1723). Results indicated that binge drinkers (BDs) showed similar behavioral performance as non/low drinkers. The most solid electrophysiological finding was an augmented P3 amplitude during attention, working memory and inhibition tasks. This increased neural activity suggests the recruitment of additional resources to perform the task at adequate/successful levels, which supports the neurocompensation hypothesis. Similar to alcoholics, BDs also displayed increased reactivity to alcohol-related cues, augmented resting-state electrophysiological signal and reduced activity during error detection -which gives support to the continuum hypothesis. Evidence does not seem to support greater vulnerability to BD in females. Replication and longitudinal studies are required to account for mixed results and to elucidate the extent/direction of the neural impairments associated with BD.