Adolescent risky alcohol use is associated with electrophysiological markers of error processing: Findings from a large cohort study

Background: Altered electrophysiological error processing, measured via the error-related negativity (ERN), error-related positivity (Pe) and midfrontal theta power (FM-theta), has been associated with problematic alcohol use and alcohol dependence in clinical populations. However, large-scale studies focusing on adolescent use in the general population are scarce. Moreover, the extent to which potential confounding factors shape the relationship between brain activity and alcohol use remains unclear.Methods: The current study examined the relationship between adolescent alcohol use and electrophysiological markers of error processing (ERN, Pe and FM-theta) in a large adolescent sample drawn from a population-based cohort (N = 1525, 806 female, M_age = 18.4). Alcohol use variables included initiation, age at initiation, recent alcohol use quantity and recent binge drinking frequency. Confounders included sex, IQ, socioeconomic factors, and alcohol-related risk factors such as prenatal alcohol and tobacco exposure or a parental history of substance use disorder.Results: Linear regressions showed that smaller absolute ERN amplitude (indicating reduced implicit error processing) was associated with risk factors for alcohol use disorder, including early alcohol use initiation and higher binge drinking frequency. Surprisingly, higher binge drinking frequency was also associated with larger Pe amplitude. These findings remained present after adjusting for confounding variables, and were not moderated by sexConclusions: These findings show an important link between prevalent alcohol use behaviors and altered electrophysiological markers of error processing, representing a promising step forward in using large-scale EEG for brain-alcohol use research and its clinical implications.