Radar des Essais Cliniques

Alcohol intoxication is responsible for a large proportion of violent crime/assault and personal injury in our society. While a number of variables have been associated with alcohol-related aggression, high trait aggression and impaired executive function have been identified as key factors. Both Alcohol Use Disorder (AUD) and Impulsive Aggression behavior (AGG) are related to impaired social-emotional information processing (SEIP) whereby social threat cues, especially ones that are ambiguous in nature, lead to hostile attribution and negative emotional response to the "other" and, then, aggression against the "other". Thus, understanding the underlying neuroscience of SEIP under the influence of alcohol will be critical to identifying targets for intervention to reduce alcohol-related aggressive behavior. In addition to potential pharmacologic and cognitive-behavioral based interventions, such interventions may also involve the rehabilitation of aberrant neuronal circuits underlying social cognitive function through neuroplasticity-based remediation exercises. This study is designed to see how brain activation of cortico-limbic circuits involving social-emotional information processing, analyzed by fMRI Imaging, are impacted by alcohol administration in those with and without aggressive disorders and with and without alcohol use disorder.

A critical issue related to aggression and to alcohol-related aggression is the role of social-emotional information processing (SEIP) including hostile attribution bias (HAB). SEIP can explain the development and maintenance of impulsive aggressive behaviors. SEIP involves a multi-stage set of processes involving (1) encoding of social information, (2) attribution of the intent of the behavior of the other participant, and (3) emotional response. Ultimately, deficits in SEIP lead to aggressive behavior because the misperception of emotional stimuli in social encounters leads to hostile attribution, anger, and then, an inappropriate aggressive response. Experimental studies consistently demonstrate that acute intake of alcohol facilitates aggressive behavior. These studies have typically measured aggression with the Taylor Aggression Paradigm (TAP) in which aggression occurs in the context of electric shocks to a fictitious opponent in response to electric shocks that this opponent gives to the subject during a reaction-time task. Generally, individuals who receive alcohol respond more aggressively (i.e., set higher shocks) than those who receive a non-alcoholic placebo beverage. Importantly, these studies report that provocation is a necessary component for aggressive behavior to occur during alcohol intoxication. Simply put, alcohol-induced aggression is elicited when participants are provoked. Other relevant factors in alcohol-related aggression include impairments in executive cognitive function (ECF) and disruption of cognitive processes critical for self-regulation (e.g., attention, inhibition, information processing, and decision making), all of which are important in social-emotional information processing (SEIP). In fMRI studies, during alcohol infusion, decreased responses were observed in cortical areas [anterior cingulate cortex (ACC) and in the dorsomedial PFC (dmPFC)], and increased responses in subcortical areas [AMYG and ventral striatum (VS)]. In addition, increases in responses in AMYG and in VS were both correlated with aggressive responding to provocation during the TAP test. Emerging data indicate that acute alcohol intoxication alters cortico-limbic circuits in healthy, non-alcoholic, individuals and that history of alcoholism or aggression also alters these circuits.