Brain Changes in Drinking Teens

Robert Gerchalk

Robert is our health care professional reviewer of this website. He worked for many years in mental health and substance abuse facilities in Florida, as well as in home health (medical and psychiatric), and took care of people with medical and addictions problems at The Johns Hopkins Hospital in Baltimore. He has a nursing and business/technology degrees from The Johns Hopkins University.

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Finland is the eighth largest country in Europe, with an estimated population of nearly 5.5 million people. The Finnish people have a long and cultural history, and it shows in their country’s beautiful architecture. Finland also has a terrible alcohol problem. Medical treatments required due to alcohol have increased 30% recently, and a top health expert believes that alcohol abuse disorders affect one million Finns.

Now, this includes both alcoholics and those directly affected by them. Still almost 20% of the country feels the pain of substance abuse. Children always end up hurt most by addiction. This is surely why in the early 2000s Finland launched the Adolescents and Alcohol Study, or AAS, a country-wide series of studies aimed at reducing and preventing teen drinking.

One of the studies performed as part of AAS involved a research team from the University of Eastern Finland examining changes over time in the brains of heavy-drinking teenagers. We will refer to it as ‘the teenage brain study.’ After eighteen years research team recently published the results.

Alcohol dramatically alters the brains of teen drinkers.

We review the study itself: what they did and how they did it. Then we discuss what these brain changes are. Finally, we talk about the implications of this study’s results. Get ready for some “shocking” information.

The Teenage Brain Study

For ten years, starting in 2005, the team followed 27 participants, aged 13 to 18, all of whom consumed alcohol “approximately six to nine units roughly once a week…” reports Science Daily. None of these participants, however, had diagnosed alcoholism. (This is a very important factor, and will be brought up later on). The team also used 25 control subjects of the same age, gender, and education level. These participants consumed little to no alcohol.

Brain studies were performed on all fifty-two participants in 2005, in 2010, and in 2015. Two different tests were run each time, a TMS (transcranial magnetic stimulation), and an EEG (electroencephalography). Over the decade, the tests showed some alarming changes occurring in multiple areas of the heavy-drinking teens’ brains. Here’s what the tests consist of:

TMS

TMS-BRAINDuring this test, electromagnetism is used to stimulate certain parts of the brain. The results are measured, and are used to “…examine the integrity of the fast-conducting corticomotor pathways…,” as said by Clinical Neurophysiology. Essentially, a TMS shows how efficiently whichever part of your brain being tested is working. The magnetic coil produces small electromagnetic currents in the brain, able to be measured. Here’s a picture for clarification:

Most commonly, TMS is used as a diagnostic tool to measure brain damage caused by things like a stroke, multiple sclerosis, and plenty of other brain-related injuries and ailments. It is not common for TMS to be used in an alcohol-based study.

EEG

This measures and records the overall electrical activity in the brain. Electrodes are placed on the scalp, translating brain waves into visible waves. Think of it as an EKG but for the brain. On the left is a person set up for an EEG, and on the right is an example of what normal results would look like:

 

 

 

 

 

 

 

Using one test for brain function in exact locations and another test for overall brain function gave the research team a special distinction. This study was the first of its kind ever used to study the long-term effects of adolescent alcohol use. However, surely none of the scientists involved were happy with the results.

All 27 heavy-drinker participants displayed significant changes in the brain, and none of them for the better. None of the 25 non-drinker participants showed these changes. Five major alterations to normal brain behavior were discovered. Two of them involve specific regions of the brain, one of them involves a specific neurotransmitter, and the other two are more general effects.

Brain Changes in Drinking Teens

Before we discuss the five brain changes, there’s something important to recognize. As mentioned, the teenage brain study only used participants who did NOT have diagnosable alcohol dependence. This means two things. Number one is that for teen alcoholics, the following changes are more intense than for those in the study. That’s fairly obvious. Number two is more subtle, and more important to know.

Even light-drinking teenagers are at risk to these changes.

“The maturation of the brain is still ongoing in adolescence, and… until the twenties. Our findings strongly indicate that alcohol use may disrupt this maturation process,” said Noora Heikkinen, the lead researcher. What follows are the five ways this happens.

  1. Anterior Cingulate Cortex

‘Anterior’ simply means front. The cingulate cortex is a part of the limbic cortex, responsible for memory and navigation. The part of the brain that alcohol use damages in teens is the anterior cingulate cortex, or ACC. The grey matter actually wears down in the ACC in drinking teens. This is scary because most of the brain consists of grey matter. Therefore, alcohol abuse in teens literally eats away at this part of the brain.

The ACC itself is primarily responsible for the regulation of blood pressure and heart rate, but also for decision-making, impulse control, and emotional balance. Damage to the ACC can result in “a number of psychiatric disorders, including schizophrenia, OCD, depression, bipolar disorder, post-traumatic stress disorder and autism,” according to an article published by the National Library of Medicine.

  1. Right Insular Cortex

Teenage alcohol abuse also eats away at the right side of the insular cortex. This part of the brain is responsible for perception, motor control, self-awareness, cognitive function, and is believed to be at least partly responsible for consciousness. Just as with the ACC, grey matter breaks down in the right insular cortex in drinking teens’ brains.

Damage to the right insular cortex can lead to “disturbances” in all senses except sight. Also, perception, body awareness, mood, disgust, addiction behavior, and even language can be affected by insular damage. Experts believe there are several more responsibilities of the insular cortex. Therefore, damaging this part of the brain can lead to any number of disorders.

  1. GABA

Gamma-Aminobutyric acid, or GABA, is an inhibitory neurotransmitter. This means it’s responsible for calming your nerves by slowing down brain activity. This sounds dangerous, slowing down the brain, but GABA is both naturally-occurring and vital.

Basically, it prevents nerve overstimulation. Without it, we would be anxious, depressed, panicky and unable to sleep, all at once. However, too much of it can cause all of these symptoms and more. Excess GABA also causes shortness of breath, high blood pressure, increased heartrate, and night terrors.

Well, wouldn’t you know it, teen alcohol abuse leads to a higher volume of GABA in the brain. In a United Press International article about the University of Eastern Finland’s teenage brain study, author Amy Wallace mentions the effects this increase could have on teenagers: “GABA is a vital neurotransmitter that inhibits brain and central nervous system function and may cause… the pathogenesis [development] of numerous neurological disorders.”

  1. Cortical Thinning

The fourth major brain change caused by teen alcohol abuse is cortical thinning. This is when the thickness of the cerebral cortex decreases. Someone’s cortical thickness is “often taken as indicative of the cognitive abilities of an individual…” and cortical thinning is closely related to Alzheimer’s disease.

Old age brings the only natural occurrence of cortical thinning in humans. Therefore, when teens abuse alcohol, they are literally aging their cerebral cortex. This part of the brain is at least partly responsible for most of our human functions. Damaging the cerebral cortex leads to endless possible brain disorders.

  1. Overall Transmission

Simply put, overall brain function decreases in alcohol-abusing teens. Wallace mentions this in her article: “Researchers found that heavy alcohol use causes alterations in the electrical and chemical neurotransmission in study participants.” The human brain is already a near-perfect machine. Any outside ‘alterations’ cannot be good. If a normal brain is live-streaming, then the brain of someone who spent their teenage years drunk must be in slow-motion.

Parts of the teenage brain are damaged by alcohol use, but so is the connection between these parts. The University of Eastern Finland research team believes their findings to be a reason for changing how alcohol disorders are diagnosed in teens.

New Way to Diagnose?

“As is true with virtually any mental-health diagnosis, there is no one test that definitively indicates that someone has an alcohol-use disorder,” states MedicineNet.com. The current method for diagnosing an alcohol disorder actually seems primitive when compared to TMS and EEG. Plus, aside from pre-existing knowledge and screening for other disorders, doctors pretty much have to trust what their patients tell them. Let’s compare the current method for diagnosis with what could be a new way to diagnose.

Currently, health professionals begin with a patient’s full medical history, including family history. Also, a physical examination, including blood tests, is usually performed. The idea is to have the clearest possible picture of the patient’s current overall health. Also, patients are screened for any other disorders, since alcohol abuse could cause another disorder, and vice-versa.

In addition to using medical history and conducting a physical exam, according to MedicineNet.com, “Physicians may provide the people they evaluate with a quiz or self-test as a screening tool for substance-use disorders.” Several variations of these quizzes exist, and you can access them online.

In Conclusion

Doesn’t this sort of mean that doctors are relying on a combination of medical history, screening for other disorders, and trust in their patients? No part of the current method for diagnosing is an actual test for alcohol disorders. In the Science Daily article, linked again here, lead researcher Heikkinen very nicely sums everything up to this point, even adding some much-needed hope:

“The exact mechanism behind these structural changes is not known. However, it has been suggested that some of the volumetric changes may be reversible if alcohol consumption is reduced significantly. As risk limits of alcohol consumption have not been defined for adolescents, it would be important to screen and record adolescent substance use, and intervene if necessary.”

So, these brain changes are reversible, to some degree. Better yet, they can be prevented very easily. Screening and recording adolescent alcohol use, as Heikkinen suggests, combined with TMS and EEG would seemingly be the perfect method for diagnosis. We would know how much teens are drinking, how much their brains have changes as a result, and how to best reverse the damage.

Ultimately, prevention is what we’re after. If teens knew they would be screened for and tested for brain changes caused by alcohol, it might stop them from drinking. Worst case scenario, we can begin to reverse these negative effects.