Social multi-sensory alcohol cue reactivity and ad libitum social drinking: an fMRI study

Research demonstrates the effects of social context on individual drinking, but the underlying neural processes remain unclear. For this purpose, we developed a social multi-sensory alcohol cue-reactivity (SMAC) fMRI task. Neural activity during visually presented offers to drink beer or water while listening to audio fragments of social drinking contexts were compared in 38 social drinkers and associations with craving, drinking willingness, and ad libitum alcohol consumption in a social context were investigated. Procedures were repeated one week later assessing test-retest reliability. The SMAC increased craving in Sessions 1 and 2, with post-task craving predicting drinking willingness in Session 1. Post-task craving in Session 2 predicted the chance of ad libitum drinking. No other effects were significant. Alcohol-cue specific activity in a priori regions of interests (ROIs) did not correlate with alcohol use measures, however, lower ratings of willingness to accept soft drinks was associated with higher activity in response to alcohol cues in the insula (Session 1). Test-retest reliability of the task was poor. Whole-brain and ROI activity during beer and water conditions correlated consistently with multiple measures of alcohol use. One possible interpretation of these findings is that social context itself may act as a phasic alcohol-relevant cue regardless of whether a water or alcohol cue is displayed.