Predictive utility of the P3 event-related potential (ERP) response to alcohol cues for ecologically assessed alcohol craving and use

Abstract

Neural measures of alcohol cue incentive salience have been associated with retrospective reports of riskier alcohol use behaviour and subjective response profiles. This study tested whether the P3 event-related potential (ERP) elicited by alcohol-related cues (ACR-P3) can forecast alcohol use and craving during real-world drinking episodes. Participants (N = 262; M_age = 19.53; 56% female) completed a laboratory task in which they viewed images of everyday objects (Neutral), non-alcohol drinks (NonAlc) and alcohol beverages (Alc) while EEG was recorded and then completed a 21-day ecological momentary assessment (EMA) protocol in which they recorded alcohol craving and consumption. Anthropometrics were used to derive estimated blood alcohol concentration (eBAC) throughout drinking episodes. Multilevel modelling indicated positive associations between P3 amplitudes elicited by all stimuli and within-episode alcohol use measures (e.g., eBAC, cumulative drinks). Focal follow-up analyses indicated a positive association between AlcP3 amplitude and eBAC within episodes: Larger AlcP3 was associated with a steeper rise in eBAC. This association was robust to controlling for the association between NonAlcP3 and eBAC. AlcP3 also was positively associated with episode-level measures (e.g., max drinks, max eBAC). There were no associations between any P3 variables and EMA-based craving measures. Thus, individual differences in neural measures of alcohol cue incentive salience appear to predict the speed and intensity of alcohol consumption but not reports of craving during real-world alcohol use episodes.

Keywords: LPP; P300; alcohol craving; alcohol use; biomarkers; ecological momentary assessment.

FIGURE 1

ERP waveforms as a function of stimulus category. Cue onset and offset occurred at 0 and 1000 ms, respectively. Grand average ERP waveforms from the first half of the picture viewing task averaged over an occipitoparietal electrode cluster (PZ, P3, P4, P7, P8, PO7, PO8, O1 and O2) are shown for different cue types: alcohol beverage images (Alc; light orange ribbon with dashed line at its centre), nonalcohol beverage images (NonAlc; sky blue ribbon with densely dotted line at its centre) and neutral non‐beverage images (neutral; light grey ribbon with solid line at its centre). Also shown is a difference ERP waveform capturing alcohol cue‐specific reactivity (ACR: Alc − NonAlc; lilac ribbon with dashed‐dotted line at its centre). Line at the centre of each ribbon represents the M across participants. Ribbon thickness represents ±1 SD across participants. The time‐window (300–700 ms) used for P3 response mean amplitude measurement is indicated on the plot by the tall rectangular box (black outline, no fill) placed on the x‐axis. Data shown are from N = 262 persons who contributed to the P3‐EMA analyses

FIGURE 2

Model‐estimated eBAC during drinking episodes as a function of time and P3 score. eBAC = estimated blood alcohol concentration; low P3 = mean P3 score − 1 SD; high P3 = mean P3 score + 1 SD. Lines inside each plot depict back‐transformed, model‐estimated means; the grey area around each line shows ±1 SE. All graphs represent model‐estimated means of gamma GLMMs controlling for biological sex and the following moment‐level contextual factors: weekend versus weekday, bar/restaurant versus any other location, presence of peers, recent consumption of tobacco cigarettes and recent consumption of cannabis products. Models for cumulative drink total not pictured as they are very similar (see Figure S2). Horizontal line with asterisk along the x‐axis indicates the period of significant difference between eBAC time courses estimated for people with low versus high P3 scores, as identified using the Johnson‐Neyman technique. All models based on 1588 observations within 793 drinking episodes.

FIGURE 3

Model‐estimated eBAC during drinking episodes as a function of time and AlcP3 score, controlling for NonAlcP3 × Time. eBAC = estimated blood alcohol concentration; low P3 = mean P3 score − 1 SD; high P3 = mean P3 score + 1 SD. Lines inside plot depict back‐transformed, model‐estimated means; the grey area around the line shows ±1 SE. Graph represents model‐estimated means of gamma GLMM also controlling for biological sex and the following moment‐level contextual factors: weekend versus weekday, bar/restaurant versus any other location, presence of peers, recent consumption of tobacco cigarettes and recent consumption of cannabis products. Line with asterisk along the x‐axis indicates the period of significant difference between eBAC time courses estimated for people with low versus high P3 scores, as identified using the Johnson‐Neyman technique. Model based on 1588 observations within 793 drinking episodes.