Alcohol Affects the Brain’s Resting-State Network in Social Drinkers Chrysa Lithari1, Manousos A. Klados1, Costas Pappas1, Maria Albani2, Dorothea Kapoukranidou2, Leda Kovatsi3, Panagiotis D. Bamidis1*., Christos L. Papadelis4. 1 Lab of Medical Informatics, Medical School, Thessaloniki, Greece, 2 Laboratory of Physiology, Department of Physiology and Pharmacology, Medical School, Thessaloniki, Greece, 3 Department of Forensic Medicine and Toxicology, Medical School, Thessaloniki, Greece, 4 Department of Neurology, Boston Children’s Hospital, Harvard Medical School, Waltham, Massachusetts, United States of America Abstract Acute alcohol intake is known to enhance inhibition through facilitation of GABAA receptors, which are present in 40% of the synapses all over the brain. Evidence suggests that enhanced GABAergic transmission leads to increased large-scale brain connectivity. Our hypothesis is that acute alcohol intake would increase the functional connectivity of the human brain resting-state network (RSN). To test our hypothesis, electroencephalographic (EEG) measurements were recorded from healthy social drinkers at rest, during eyes-open and eyes-closed sessions, after administering to them an alcoholic beverage or placebo respectively. Salivary alcohol and cortisol served to measure the inebriation and stress levels. By calculating Magnitude Square Coherence (MSC) on standardized Low Resolution Electromagnetic Tomography (sLORETA) solutions, we formed cortical networks over several frequency bands, which were then analyzed in the context of functional connectivity and graph theory. MSC was increased (p,0.05, corrected with False Discovery Rate, FDR corrected) in alpha, beta (eyes- open) and theta bands (eyes-closed) following acute alcohol intake. Graph parameters were accordingly altered in these bands quantifying the effect of alcohol on the structure of brain networks; global efficiency and density were higher and path length was lower during alcohol (vs. placebo, p,0.05). Salivary alcohol concentration was positively correlated with the density of the network in beta band. The degree of specific nodes was elevated following alcohol (vs. placebo). Our findings support the hypothesis that short-term inebriation considerably increases large-scale connectivity in the RSN. The increased baseline functional connectivity can -at least partially- be attributed to the alcohol-induced disruption of the delicate balance between inhibitory and excitatory neurotransmission in favor of inhibitory influences. Thus, it is suggested that short-term inebriation is associated, as expected, to increased GABA transmission and functional connectivity, while long-term alcohol consumption may be linked to exactly the opposite effect. Citation: Lithari C, Klados MA, Pappas C, Albani M, Kapoukranidou D, et al. (2012) Alcohol Affects the Brain’s Resting-State Network in Social Drinkers. PLoS ONE 7(10): e48641. doi:10.1371/journal.pone.0048641 Editor: Gareth Robert Barnes, University College of London - Institute of Neurology, United Kingdom Received June 8, 2012; Accepted September 28, 2012; Published October 31, 2012 Copyright: ß 2012 Lithari et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Funding: This work has been partially funded by the Committee for Biomedical Research, Central Health Council of the Greek Ministry of Health and Social Solidarity (project 83785). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Competing Interests: The authors have declared that no competing interests exist. * E-mail: [email protected] . These authors contributed equally to this work. Introduction An important finding is that short-term alcohol consumption disrupts the delicate balance between inhibitory and excitatory Social drinking, for most people, is an inseparable part of every- neurotransmission in favor of inhibitory influences [12], [13]. day life. Alcohol is used and abused for its ability to modify Inhibitory neurotransmitters transiently decrease the responsive- emotional states, and more precisely, to reduce anxiety [1], [2]. It ness of other neurons to further stimuli, whereas excitatory is therefore essential to study the effects of inebriation in healthy, neurotransmitters produce the opposite effect. Evidence suggests non-dependent individuals, given the frequency of abuse and that alcohol can acts by increasing inhibitory neurotransmission, binge drinking. A better understanding of the neural underpin- by decreasing excitatory neurotransmission, or through a combi- nings of alcohol consumption could have a number of social nation of both [13]. The general consensus is that acute alcohol implications, including driving situations, work-related hazards intake facilitates the GABAergic transmission, and inhibits and others [3]. glutamatergic function [14]. The transmission and function of Acute alcohol administration affects behavior [4], [5] cognition other neurotransmitters like dopamine, serotonin and opiates is [6], [7], and affective stimuli processing [8], [9]. It is responsible also affected. for the attention deficit observed even in low or moderate levels of Alcohol’s effect on neurotransmitters may, at least partially, inebriation [8], [10], [11]. The neurophysiological mechanisms by explain some of the complex behavioral manifestations of which alcohol acts on the brain modifying behavior have received intoxication in both animals and humans. GABA induction has much attention from scientists especially during the last few been associated with the observed sedation effects [15], [16] of decades. However, they are still poorly understood. alcohol, the reinforcement of dopaminergic [17] and opiate PLOS ONE | www.plosone.org 1 October 2012 | Volume 7 | Issue 10 | e48641 Brain Connectivity following Inebriation pathways [18] are responsible for the excitement following alcohol Materials and Methods administration, and the inhibition of the glutamate activity [19] is linked to difficulty in the formation of new memories and muscular Participants coordination [20]. Twenty-six healthy right-handed individuals (12 females, 14 The GABA neurotransmission is of particular interest in alcohol males), with a mean age of 26.161.8 (mean 6 SD), and free of any intoxication, since (i) it has been associated with a person’s neurological or hepatic disorders, participated in the study. Female susceptibility to develop alcohol abuse or dependence [21], (ii) it is participants were in the first half of their menstrual cycle. All the main inhibitory neurotransmitter in the human brain, and (iii) participants were free of any medication and completed a its receptors are the most common in the mammalian nervous questionnaire on their drinking habits. The selected participants system [22]. Alcohol inhibits the activity of signal-receiving were characterized as light drinkers [34], meaning that they were neurons by interacting with the GABAA receptor embedded in accustomed to drinking 1–3 drinks per occasion, 1–2 times weekly. their cell membrane [23]. When GABA molecules bind to the Their Body Mass Index (BMI) was 21.863.1 (mean 6 SD). receptor and activate it, the latter temporarily opens and allows Participants were asked to refrain from alcohol consumption for at the entrance of negatively charged molecules, such as chloride least 48 hours prior to recordings, as well as from smoking, ions. Alcohol enhances the ions flow into cells thereby enhancing caffeine, and food for at least 3 hours prior to recordings. The neuronal inhibition. experimental procedure was approved by the ethical committee of The disrupted balance between inhibitory and excitatory the Medical School of the Aristotle University of Thessaloniki. All neurotransmission at the microscopic level caused by alcohol volunteers provided written informed consent prior to experimen- intoxication, may be reflected at the macroscopic level in the brain tation. activity recorded even from outside the human scalp. Recent electroencephalographic (EEG) findings suggest that neurotrans- Experimental design mission inhibition, induced by GABAergic agonist lorazepam, can Each participant was tested in two experimental sessions and cause a widespread increase in the inter-area functional connec- received a real alcohol dose (alcohol session) and a placebo tivity and an increase in the strength of functional long-range and beverage (placebo session). The order of the sessions was inter-hemispheric connections [24]. Thus, it was proposed that counterbalanced, while the doses were administered double- enhanced inhibition is an efficient mechanism for the synchroni- blindly. Thus, half of the participants had an alcoholic beverage zation of large neuronal populations in the human brain. The in the first session and a non-alcoholic placebo beverage in the neural synchronization is regarded as a candidate neurophysio- second, while the order was reversed for the other half. The two logical mechanism to explain the dynamic interaction between sessions were performed at least six weeks apart to ascertain that spatially distributed regions ([25], see [26] for a review on this the participants had no clear memory of the first session topic). inebriation level. All experiments started at the same time of the Since alcohol admission affects