Neuroeconomic Decision-Making for Alcoholism

Overseen By Michael Amlung, PhD

Age: 18 - 65

Sex: Any

Trial Phase: Academic

Sponsor: McMaster University

Must not be taking: Psychotropic, Cerebral blood flow

Disqualifiers: Substance use disorder, Schizophrenia, Bipolar, PTSD, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 1

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to understand how the brain responds to alcohol-related cues and how these responses affect drinking decisions. Participants will view images of alcoholic and non-alcoholic drinks while researchers monitor their brain activity using an fMRI (a type of brain scan). The study focuses on heavy drinkers who aren't seeking treatment and regularly consume more than average amounts of alcohol. It explores how environmental factors and personal choices influence the desire to drink. Eligible participants are those who identify as heavy drinkers but are not currently seeking help for alcohol issues. As an unphased trial, this study offers participants the opportunity to contribute to valuable research that could lead to better understanding and interventions for alcohol use.

Will I have to stop taking my current medications?

If you are currently taking psychotropic medications or medications that could affect blood flow in the brain, you would not be eligible to participate in this study.

What prior data suggests that these neuroeconomic techniques are safe for participants?

Research has shown that exposing people to alcohol-related images or scenarios, known as alcohol cue exposure, has been widely studied in relation to alcohol use disorders. One review found that this therapy can have varying effects on drinking habits, sometimes leading to small to moderate reductions in alcohol consumption. Another study discovered that using technology to assist with cue exposure significantly reduced cravings and drinking more effectively than traditional methods.

Alcohol cue exposure is a well-established approach in studying alcohol use disorder. Its long history in research supports its safety. Generally, participants handle the exposure well, with few negative effects reported. This suggests that alcohol cue exposure is safe, especially in controlled research settings. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about this trial because it explores how different cues might influence decision-making in individuals with alcoholism. Unlike traditional treatments that focus on medication or therapy, this approach examines how exposure to alcohol-related and neutral images can affect the brain's purchasing decisions related to alcohol. The trial's unique angle lies in its use of neuroeconomics, which combines neuroscience and economic principles, to potentially uncover new ways to reduce alcohol consumption by altering decision-making processes. This could pave the way for innovative, non-invasive strategies to help people struggling with alcohol addiction.

What evidence suggests that this trial's treatments could be effective for understanding decision-making in alcoholism?

This trial will compare the effects of viewing alcohol-related images versus neutral images on participants' brain activity and decision-making. Studies have shown that pictures of alcohol can increase the desire to drink in heavy drinkers. Alcohol-related images activate brain areas associated with reward and motivation more than neutral images, such as those of water or juice. Research also shows a connection between the intensity of alcohol cravings and the severity of a person's drinking problem. Understanding these brain reactions can help explain why some people struggle to control their drinking. ^{6 7 8 9 10}

Who Is on the Research Team?

Michael Amlung, PhD

Principal Investigator

University of Kansas

Are You a Good Fit for This Trial?

This trial is for right-handed, English-speaking adults aged 21-55 who drink heavily (more than 14/7 drinks per week for males/females) and have at least one heavy drinking episode weekly. It's not for those seeking alcohol treatment, with other substance use disorders (except tobacco), frequent recreational drug use, certain mental health conditions, brain injuries, or MRI contraindications like metal implants.

Inclusion Criteria

21-55 years old

Right-handed

Fluent English speaker

Exclusion Criteria

Weekly or more frequent use of recreational drugs

Currently receiving treatment, or seeking treatment, for alcohol related problems

Current Diagnostic and Statistical Manual (DSM-5) substance use disorder other than alcohol or tobacco

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Experimental Manipulation

Participants undergo an in-scanner alcohol cue exposure task, making decisions about alcohol consumption at various prices while brain activity is measured

1 hour

1 visit (in-person, MRI scan)

Follow-up

Participants are monitored for safety and effectiveness after the experimental manipulation

4 weeks

What Are the Treatments Tested in This Trial?

Interventions

• Alcohol cue
• Neutral cue

Trial Overview The study tests how the brain values alcohol when exposed to alcohol-related cues versus neutral ones using fMRI scans. Participants will make hypothetical choices about alcohol consumption at different prices while their brain activity is monitored after seeing images of alcoholic or non-alcoholic beverages.

How Is the Trial Designed?

Group I: Neutral Cue, then Alcohol Cue Experimental Treatment 1 Intervention

Participants first completed an in-scanner neutral cue exposure prior to the first two in-scanner alcohol purchase tasks runs. Participants then received an in-scanner alcohol cue exposure prior to the final two in-scanner alcohol purchase task runs. Cue exposures consisted of images of neutral (water) or alcohol (beer, wine, liquor) beverages and an imaginal script describing a drinking scenario.

Who Is Running the Clinical Trial?

McMaster University

Lead Sponsor

Trials

936

Recruited

2,630,000+

Citations

1. pubmed.ncbi.nlm.nih.gov pubmed.ncbi.nlm.nih.gov/38547596/

Neural correlates of increased alcohol demand following ... This functional magnetic resonance imaging study combined a neuroeconomic alcohol purchase task with an alcohol cue exposure in 72 heavy ...

2. sciencedirect.com sciencedirect.com/science/article/abs/pii/S0149763421002736

Neurobiological correlates of cue-reactivity in alcohol-use ... Our meta-analysis revealed that alcohol cues evoke greater cue-reactivity than neutral cues in the mesocorticolimbic circuit and lower reactivity in the ...

3. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC4846981/

The Behavioral Economics and Neuroeconomics of ... The neuroeconomics of alcohol demand: an initial investigation of the neural correlates of alcohol cost-benefit decision making in heavy drinking men.

4. nature.com nature.com/articles/s41398-019-0591-6

Developing neuroscience-based treatments for alcohol ... Excessive alcohol use is the cause of an ongoing public health crisis, and accounts for ~5% of global disease burden. A minority of people ...

5. neurotherapeuticsjournal.org neurotherapeuticsjournal.org/article/S1878-7479(23)01378-8/fulltext

Alcohol Use Disorder Interventions Targeting Brain Sites for ... We find that interventions on alcohol cue reactivity localize to ventral prefrontal cortex, dorsal anterior cingulate, and temporal, striatal, and thalamic ...

6. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC12368849/

Who is alcohol cue-reactive? A machine learning approach Participants exhibited AUQ scores that ranged from 0 (minimum) to 48 (maximum) prior to cue-exposure and during both water and alcohol ...

7. sciencedirect.com sciencedirect.com/science/article/pii/S0272735817301058

Review Cue exposure therapy for the treatment of alcohol ... CET showed no to small additional effects on drinking intensity and drinking frequency, a small additional effect on total drinking score and a moderate ...

8. onlinelibrary.wiley.com onlinelibrary.wiley.com/doi/10.1111/acer.70170?af=R

The alcohol cue‐exposure paradigm as a screening tool ... The alcohol cue-exposure paradigm has a long history in alcohol use disorder (AUD) research. This review examined the paradigm's utility as ...

9. frontiersin.org frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2025.1544763/full

The efficacy of conventional and technology assisted cue ... Technology-assisted CET reported significant reduction in craving and consumption relatively more often than conventional CET studies, particularly when ...

10. academic.oup.com academic.oup.com/alcalc/article/60/2/agaf001/7961459

Preliminary effects of oral ANS-6637, an ALDH2 inhibitor, on ... Short Summary: This human laboratory clinical trial evaluated the safety and preliminary efficacy of ANS-6637 for treating alcohol use ...