Corey Negin, Devin Glim, Aman Gill, Helen Marzec, Kimberly Dias

Keywords: Alcohol, Brain, Development, Hippocampus, Frontal areas, Cerebellum, Neuroplasticity, Addiction, Deleterious behaviour and Chronic consumption.

Rational/Goal: This video will fixate on alcohol, but will explore the effects of underage drinking on the brain, targeted to teenagers. Underage drinking is widespread as adolescents undergo stressful developmental transitional periods rendering them vulnerable to alcohol consumption. Research indicates that adolescents consume a lot of their alcohol intake by binge drinking, which has detrimental effects upon brain development, as brain maturity and refinement is not finalized until an individual reaches their mid-twenties. Subsequently, the brain development compromised by chronic alcohol consumption can promote deleterious behaviours that persist into adulthood and future functioning.

Description/Summary: We will first describe the regions in the brain affected by alcohol consumption. Early in development, the brain creates as many synaptic connections as possible. However, development then shifts to creating efficient neural pathways. Our video will delve into the heightened neuroplasticity that occurs within adolescence. This is a duration by which the prefrontal cortex undergoes myelination and extensive synaptic pruning. The prefrontal cortex governs decision-making and concentration. However, periods of binge drinking have been shown to cause significant white matter loss and myelin damage within the prefrontal cortex. Our video will describe the importance of myelination and how myelin sheath aids in increasing nerve impulse speed. Thereafter, we will denote that a compromise within the nerve’s ability to conduct impulses would result in cognitive impairment. We will then continue onto the structural and functional changes that the hippocampus incurs due to underage drinking; specifically, an increase in immature dendritic spines whereby the branches off the nerve cells appear long and thin. The hippocampus is crucial for learning and memory. This therefore cultivates alcohol-induced memory deficits. Furthermore, the altered brain functioning appears to be irreversible. Additional evidence exhibits a thinner prefrontal cortex and smaller hippocampus within adolescent drinking individuals, relative to the age the alcohol consumption began.

Script:

(Skit beginning)-45secs

(Start of party scene; incoherent speaking)

(Sees person two stammering, falling over the table, and trying to stand properly)

1: Are you okay?

2: Ye a…a… I’m more than okay! I’m gr e aaa t! (Swinging an alcoholic beverage around) Hey… hey…. (Points towards friend and walks over to them struggling, falling over) Don’t you feel great too?

3: Yeah, I feel awesome man! Hey… eve ee ryo on e! Le t’s taake shoots s!

Everyone: Yeah!

(Shots by LMFAO playing)

1: Don’t you think you’ve had enough?

2: You can never have enough! (Takes 3 shots in a row)

(Continues dancing to the music [Shots by lmfao])

1: Sure, but don’t you also have a paper due on Friday?

2: Do I? I forgot – It’s okay, I still have a day to do it

1: It’s 10 pages

2: What was on again?

1: You don’t remember?

2: More relevant things are on my mind, like how great this alcohol is

3: (Nodding in agreement, 3 & 1 toast with their shot glasses)

(Continues to dance, however, while dancing backwards, 2 hits the 3, and both fall face forward, blacking out)

[Cut to dream-like scene when 2 is older in university, conducting thesis on underage drinking]

Main:

1. Describe brain regions affected by alcohol consumption (eg. prefrontal cortex, hippocampus, cerebellum) [Both structural & functional changes)

1. Hippocampus: learning & memory (learning new information would become difficult; transfer from short term to long term memory [propagating blackouts]) -Kim- 30secs

Many regions of the brain, including the hippocampus and prefrontal cortex, are actively developing throughout one’s adolescence, and are therefore more susceptible to damage due to alcohol consumption. The hippocampus is a small part of your brain that processes and stores memories. Drinking excessive alcohol can affects one’s ability to form new memories, and hold on to new information. This is because alcohol can impair your brain’s ability to transfer new learned information from your short term to your long term memory (Hiller-Sturmhöfel, & Swartzwelder, 2004). As a result, you may be able to remember what’s happening in the moment during a night of drinking, but may find it hard to recall the events that occurred that night the following day. Alcohol can also affect your ability to form new explicit memories, which are memories of facts such as names and phone numbers, or events, like what you did last night. Excessive drinking can cause excessive damage to the hippocampus, resulting in blackouts: periods of time that you cannot remember what happened at all. (Anderson et al., 2009). Finally, studies have shown a correlation between excessive drinking and a decrease in hippocampus size in the brain. (Debellis et al., 2000).

2. Frontal areas: impulses, thinking through consequences (poor decision making, lack of self control)- Aman -30secs
   As soon as we take that shot of vodka, one of the first parts of the brain the alcohol will affect is the frontal lobe, specifically the prefrontal cortex. The prefrontal cortex involves planning complex cognitive behaviour, attention, and decision making (Abernathy, Chandler, & Woodward, 2010). Therefore, it should come to no surprise that alcohol’s profound effects on the prefrontal cortex, ultimately impair our ability to make rational decisions, as well as our reasoning and judgement! In fact, George, Rogers & Duka, conducted a study among social drinkers to assess the decisions they made through various gambling tasks. They concluded that acute alcohol intake lead them to make significantly more risky decisions (George, Rogers, & Duka, 2005). To add, another study conducted on the effects of adolescent binge drinking and decision making showed a high association between relatively more disadvantageous decisions and those who started binge drinking at an early age (Goudriaan, Grekin, & Sher, 2007). So how exactly does alcohol lead us to tell our crush how obsessed we are with them? The prefrontal cortex inhibits cortical and subcortical structures, which help prevent us from the urges to say something socially unacceptable (Munakata et al., 2011). Alcohol affects the NMDA glutamate receptors by inhibiting these same inhibitory effects of the prefrontal cortex, essentially making us “disinhibited” (Tu et al., 2007)!

3. Cerebellum: motor control (balance; difficulties standing or walking)- Devin – 20secs
   Along with the hippocampus and frontal areas, the cerebellum may also be affected by heavy adolescent alcohol consumption. The cerebellum’s main functions are to control motor function while also participating in cognitive learning related to spatial awareness (Doya, 2000). This is why we have difficulties walking, standing, or even preventing our drink from accidentally spilling on our crush as we tell them how much we like them! Unfortunately, these “difficulties” can become long-lasting as alcohol can change the biochemical function of the cerebellum (Ward et al., 2009). Microglia levels (the brain’s immune cells) also increase in response to alcohol exposure, resulting in an increase in the inflammation of the surrounding brain tissue, leading to eventual long term neuronal death (Riikonen et al., 2002)

2. Heightened neuroplasticity that occurs during adolescent brain development (myelination, synaptic pruning; see letter of intent for more)- 30secs

3. The brain isn’t fully developed until 25 years old thereby critical development is interrupted [Explain the long term lasting consequences]- 30secs

Adolescence is a time between childhood and adulthood whereby neural development is composed by physical, psychological and social changes – marking this a period of vulnerability and adjustment (Bourque et al., 2016). It also marks a time of increased emotional reactivity and sensitivity which contributes to a greater degree of addiction during the developmental period (Bourque et al., 2016; Case, Jones, & Hare, 2008). Indeed, neuroplasticity, the ability to form new neural connections, is influenced by the environment, and particularly within adolescence when the brain is still within development (Hiller-Sturmhöfel & Swartzwelder, 2004). The cognitive development that occurs during adolescence is linked to greater cognitive control and modulation whereby increased activation in the prefrontal regions is indicative of maturity (Bourque et al., 2016; Case, Jones, & Hare, 2008). However, adolescents indulge in deleterious and high-risk behaviour such as binge drinking which significantly impair the neuroplasticity of the brain, involving the myelination of the prefrontal fiber tracts (Clark, Thatcher, & Tapert, 2008). As myelin sheath aids in increasing nerve impulse speed, a compromise within the nerve’s ability to conduct impulses results in cognitive impairment. The rational portion of an adolescent’s brain isn’t fully developed until 25 years old therefore obstructing connections in the prefrontal cortex hinders the adolescent’s social and mental health trajectories for years to come.

4. Susceptibility to addiction (Underage drinkers are 4x more likely to develop an addiction to alcohol, as opposed to an individual who waits until legal drinking age)

[Basically the conclusion? Can also do a bit of an introduction about binge drinking in general to lead into the portion about the structural/functional changes that occur]-30secs – Corey

To wrap things up, underage drinkers are 4x more likely to develop an addiction to alcohol as opposed to an individual who waits until legal drinking age to start consuming! As a result, binge drinking can start to develop, which is the consumption of excess amounts of alcohol in a short period of time. Binge drinking can lead to many structural and functional changes such as difficulty walking, blurred vision, slurred speech, slowed reaction times and impaired memory. It is important to note that maturational changes in brain anatomy, connectivity, and function continue well into late adolescence. To date, imaging studies using different modalities have consistently reported that alcohol use during adolescence is associated with abnormalities in brain structure, function and connectivity. Furthermore, the altered brain functioning appears to be irreversible. Additional evidence exhibits a thinner prefrontal cortex and smaller hippocampus within adolescent drinking individuals, relative to the age the alcohol consumption began.So is it really worth it? I don’t think so! Yes you are a teenager but I promise you, you don’t need alcohol to have fun!

(Skit ending)-20secs

2 wakes up to people looking over him

3: Hey man, are you okay?

2: Yeah, I think so

3: Are you down to take another shot? The alcohol is almost finished, and I saved the best for last

2: (Thinks back to what has happened)

2: No, it’s okay – I have a paper to do… (Scratches head; zooming in on face)

2: (Face expression displayed is sort of like this: https://media.giphy.com/media/pai7N0iFj01CU/giphy.gif)

Camera zooms out; scene fades to black)

Examples of videos with alike infrastructure relative to alcohol & the developing brain:

https://www.youtube.com/watch?v=EY37BFmVxwQ (Animation)

https://www.youtube.com/watch?v=g2gVzVIBc_g (Animation)

https://www.youtube.com/watch?v=j_Pe4R9Myu4 (Animation; brain scans shown)

Member Contributions:

All 5 group members equally contributed to the research and writing of the script for this video. Helen is the facilitator for the knowledge translation video, and is responsible for the part of the video pertaining to the heightened neuroplasticity that occurs during development. Aman is responsible for the portion that covers the effects of alcohol on the prefrontal cortex, and Kimberly is responsible for the effects of alcohol on the hippocampus and memory. Devin is responsible for alcohol’s effect on the cerebellum and motor control, and Corey for Conclusion and take home messages. Helen will also be narrating the audio for the video, while we all will be involved in the production of the skit, and editing of the video cuts and final video. Finally, all 5 group members will be equally contributing to the production and editing of this video.

References

Abernathy, K., Chandler, L. J., & Woodward, J. J. (2010). Alcohol and the prefrontal cortex. International review of neurobiology, 91, 289-320.

Anderson, P., De Bruijn, A., Angus, K., Gordon, R., & Hastings, G. (2009). Impact of alcohol advertising and media exposure on adolescent alcohol use: a systematic review of longitudinal studies. Alcohol and alcoholism, 44(3), 229-243.

Bourque, J., Baker, T., Dagher, A., Evans, A., Garavan, H., & Leyton, M. et al. (2016). Effects of delaying binge drinking on adolescent brain development: a longitudinal neuroimaging study. BMC Psychiatry, 16(1). http://dx.doi.org/10.1186/s12888-016-1148-3

Casey, B. J., Jones, R. M., & Hare, T. A. (2008). The adolescent brain. Annals of the New York Academy of Sciences, 1124(1), 111-126.

Clark, D. B., Thatcher, D. L., & Tapert, S. F. (2008). Alcohol, psychological dysregulation, and adolescent brain development. Alcoholism: Clinical and Experimental Research, 32(3), 375-385.

De Bellis, M. D., Clark, D. B., Beers, S. R., Soloff, P. H., Boring, A. M., Hall, J., … & Keshavan, M. S. (2000). Hippocampal volume in adolescent-onset alcohol use disorders. American Journal of Psychiatry, 157(5), 737-744.

Doya, K. (2000). Complementary roles of basal ganglia and cerebellum in learning and motor control. Current opinion in neurobiology, 10(6), 732-739.

George, S., Rogers, R. D., & Duka, T. (2005). The acute effect of alcohol on decision making in social drinkers. Psychopharmacology, 182(1), 160-169.

Goudriaan, A. E., Grekin, E. R., & Sher, K. J. (2007). Decision making and binge drinking: a longitudinal study. Alcoholism: Clinical and Experimental Research, 31(6), 928-938.

Hiller-Sturmhöfel, S., & Swartzwelder, H.S. (2004). Alcohol’s Effects on the Adolescent Brain-What Can Be Learned From Animal Models. Alcohol Research and Health, 28(4), 213-221

Munakata, Y., Herd, S. A., Chatham, C. H., Depue, B. E., Banich, M. T., & O’Reilly, R. C. (2011). A unified framework for inhibitory control. Trends in cognitive sciences, 15(10), 453-459.

Riikonen, J., Jaatinen, P., Rintala, J., Pörsti, I., Karjala, K., & Hervonen, A. (2002). Intermittent ethanol exposure increases the number of cerebellar microglia. Alcohol and alcoholism, 37(5), 421-426.

Squeglia, L. M., Jacobus, J., & Tapert, S. F. (2009). The influence of substance use on adolescent brain development. Clinical EEG and neuroscience, 40(1), 31-38.

Tu, Y., Kroener, S., Abernathy, K., Lapish, C., Seamans, J., Chandler, L. J., & Woodward, J. J. (2007). Ethanol inhibits persistent activity in prefrontal cortical neurons. Journal of Neuroscience, 27(17), 4765-4775.

Ward, R. J., Lallemand, F., & De Witte, P. (2009). Biochemical and neurotransmitter changes implicated in alcohol-induced brain damage in chronic or ‘binge drinking’ alcohol abuse. Alcohol and Alcoholism, 44(2), 128-135.