(PS1-A7) P3 Event-related Potential Response to Alcohol Cues Predicts Ecologically Assessed Within-episode Indicators of Problem Drinking in Emerging Adults

The Addictions Neuroclinical Assessment (ANA) framework aims to inform the development of neuroscience-based clinical assessment batteries that may be useful for tailoring addiction treatments based on neurobehavioral risk processes, including incentive salience sensitization. Accordingly, neural indices of enhanced incentive salience have the potential to advance understanding of addiction-relevant biomarkers for risky alcohol use behavior and subjective response profiles.

The present study examined whether the P3 event-related potential (ERP)—an index of motivational significance—elicited by pictures of alcoholic vs. nonalcoholic beverages (ACR-P3) can forecast real-world alcohol use and craving reports during ecologically assessed drinking episodes. Participants (N = 265; Mage = 19.54; 56% assigned female at birth) completed a 21-day ecological momentary assessment (EMA) protocol in which they recorded their in-the-moment alcohol use and alcohol craving. Estimated blood alcohol concentration (eBAC) during drinking episodes was derived using drink reports and anthropomorphic data.

Prior to the EMA period, participants completed a picture-viewing task in the lab in which they viewed images of everyday objects (Neutral), non-alcoholic drinks (NonAlc), and alcoholic beverages (Alc) while EEG was recorded. ERPs were derived from artifact-free, image-locked EEG epochs. Surprisingly, generalized linear mixed models (GLMMs) using a nonzero-inflated gamma distribution showed positive associations between P3s elicited by all cue types and EMA measures of within-episode alcohol intake (e.g., eBAC: bs = .045-.049, ps = < .001-.034, cumulative drink total; bs = .031-.037, ps = < .001-.011).

To isolate alcohol cue reactivity from reactivity to other appetitive stimuli, we residualized Alc-P3 on NonAlc-P3 to create the ACR-P3. Both Alc-P3 and ACR-P3 were positively associated with measures of max eBAC per episode (Alc-P3: b = .026, p < .001; ACR-P3; b = .041, p < .01) and max drink total (Alc-P3: b = .020, p < .01; ACR-P3; b = .033, p < .01). NonAlc-P3 also was positively associated with max eBAC, but to a slightly lesser extent (b = .015, p < .05). Follow-up analyses controlling for the effect of NonAlc-P3 over time showed a moderate positive association between Alc-P3 and eBAC over time (b = .020, p < .05). None of the P3 variables predicted craving (ps = .21-.80).

Individual differences in neural measures of incentive salience attribution to cues for ingested rewards, particularly images of alcoholic beverages, may predict the speed and intensity of real-world alcohol use. These findings suggest support the clinical utility of neurophysiological indices of addiction-related function domains, which eventually might be used to identify alcohol-relevant biomarkers.