Objective: Driving under the influence (DUI) of alcohol recidivism may be a risk-taking behavior motivated by a change in decision-making capacity. Decision-making capacity has been investigated by event-related potentials (ERPs) acquisition and specifically by analyzing feedback-related negativity (FRN) reflecting the activity of medial prefrontal cortex. Thus, the aim of our study was to test the role of FRN as a possible neurophysiological marker of underestimation of risk associated with DUI recidivism to provide novel insights into the influence of neurocognitive aspects of driving ability.Methods: The research was structured as a case-control study. The total cohort (30 Italian male subjects) was divided into 2 groups, according to positive or negative history of DUI recidivism. The protocol included informed consent collection, medical history and clinical examination, ERP registration, and sensation-seeking scale administration. ERPs were acquired during a gambling task. The data were analyzed with 2 analysis of variance (ANOVA) repeated measures. Statistical analyses were conducted using R to test the participants' risk behaviors. A multivariate ANOVA was run to compare the personality traits of the groups. ANOVAs and planned comparisons were performed with StatSoft software.Results: FRN amplitude analyses showed that the interaction Reward Magnitude × Valence (large vs. small × gains vs. losses) was significant for recidivists (F(1,13) = 11.75, P < .01) but not for controls (F(1,14) = 0.04, P = .84). The results of the logistic generalized linear models analysis showed that the 2 groups differed in risk-taking behavior (z = -3.65; P < .001) with an average of 70 risky choices for recidivists and 63 for controls. Both groups were homogeneous for personality traits.Conclusions: The FRN and gambling task results suggest that DUI recidivists seemed attracted by the prospect of a large reward and appeared unable to recognize small losses read as wins These results, if confirmed in a larger sample, could indicate the usefulness of ERP analysis in clinical and forensic evaluation of DUI subjects.
Keywords: Alcohol use disorders; DUI recidivism; decision-making capacity; event-related potentials; feedback-related negativity; risk taking behavior.