51
|
White matter damage is associated with memory decline in chronic alcoholics: A quantitative diffusion tensor tractography study. Behav Brain Res 2013; 250:192-8. [DOI: 10.1016/j.bbr.2013.05.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2013] [Revised: 04/30/2013] [Accepted: 05/03/2013] [Indexed: 12/28/2022]
|
52
|
Karoly HC, Stevens CJ, Thayer RE, Magnan RE, Bryan AD, Hutchison KE. Aerobic exercise moderates the effect of heavy alcohol consumption on white matter damage. Alcohol Clin Exp Res 2013; 37:1508-15. [PMID: 23551199 DOI: 10.1111/acer.12135] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2012] [Accepted: 01/31/2013] [Indexed: 11/28/2022]
Abstract
BACKGROUND Chronic alcohol abuse is related to numerous deleterious neurobiological consequences, including loss of gray matter, damage to white matter (WM), and impairment of cognitive and motor functions. Aerobic exercise has been demonstrated to slow cognitive decline and decrease the negative neural changes resulting from normal aging and from several diseases. It is possible that exercise may also prevent or repair alcohol-related neurological damage. This study tested the hypothesis that aerobic exercise protects WM in anterior and dorsal areas of the brain from damage related to heavy alcohol use. METHODS Sixty individuals underwent a diffusion tensor imaging session and completed measures of alcohol consumption, loss of control over drinking, and aerobic exercise participation. Analyses examined the relationship of exercise, alcohol, and their interaction to fractional anisotropy (FA) in the superior longitudinal fasciculus (SLF), external capsule (EC), superior and anterior corona radiata, and fornix. The relationship of aerobic exercise and alcohol consumption to self-reported loss of control over drinking were also examined. RESULTS A significant interaction was observed between alcohol consumption and aerobic exercise participation on FA in the SLF and EC. In the models examining loss of control over drinking, a significant interaction between aerobic exercise and alcohol consumption was observed, such that alcohol consumption was associated with loss of control more strongly for low exercisers than high exercisers. CONCLUSIONS These results indicate that the association between heavy alcohol consumption and WM damage in the EC and SLF and the association between alcohol consumption and loss of control over drinking are greater among individuals who do not exercise regularly. These results are consistent with the notion that exercise may protect WM integrity from alcohol-related damage.
Collapse
Affiliation(s)
- Hollis C Karoly
- Department of Psychology and Neuroscience, University of Colorado at Boulder, Boulder, Colorado
| | | | | | | | | | | |
Collapse
|
53
|
Herzig DA, Brooks R, Mohr C. Inferring about individual drug and schizotypy effects on cognitive functioning in polydrug using mephedrone users before and after clubbing. Hum Psychopharmacol 2013; 28:168-82. [PMID: 23532749 DOI: 10.1002/hup.2307] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2012] [Accepted: 02/20/2013] [Indexed: 11/05/2022]
Abstract
OBJECTIVE Mephedrone has been recently made illegal in Europe, but little empirical evidence is available on its impact on human cognitive functions. We investigated acute and chronic effects of mephedrone consumption on drug-sensitive cognitive measures, while also accounting for the influence of associated additional drug use and personality features. METHOD Twenty-six volunteers from the general population performed tasks measuring verbal learning, verbal fluency and cognitive flexibility before and after a potential drug-taking situation (pre-clubbing and post-clubbing at dance clubs, respectively). Participants also provided information on chronic and recent drug use, schizotypal (Oxford-Liverpool Inventory of Feelings and Experiences) and depressive symptoms (Beck Depression Inventory), sleep pattern and premorbid IQ. RESULTS We found that (i) mephedrone users performed worse than non-users pre-clubbing and deteriorated from the pre-clubbing to the post-clubbing assessment; (ii) pre-clubbing cannabis and amphetamine (not mephedrone) use predicted relative cognitive attenuations; (iii) post-clubbing, depression scores predicted relative cognitive attenuations; and (iv) schizotypy was largely unrelated to cognitive functioning, apart from a negative relationship between cognitive disorganisation and verbal fluency. CONCLUSION Results suggest that polydrug use and depressive symptoms in the general population negatively affect cognition. For schizotypy, only elevated cognitive disorganisation showed potential links to a pathological cognitive profile previously reported along the psychosis dimension.
Collapse
Affiliation(s)
- Daniela A Herzig
- Department of Experimental Psychology, University of Bristol, Bristol, UK.
| | | | | |
Collapse
|
54
|
Bates ME, Buckman JF, Nguyen TT. A role for cognitive rehabilitation in increasing the effectiveness of treatment for alcohol use disorders. Neuropsychol Rev 2013; 23:27-47. [PMID: 23412885 PMCID: PMC3610413 DOI: 10.1007/s11065-013-9228-3] [Citation(s) in RCA: 139] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2012] [Accepted: 01/31/2013] [Indexed: 12/14/2022]
Abstract
Neurocognitive impairments are prevalent in persons seeking treatment for alcohol use disorders (AUDs). These impairments and their physical, social, psychological and occupational consequences vary in severity across persons, much like those resulting from traumatic brain injury; however, due to their slower course of onset, alcohol-related cognitive impairments are often overlooked both within and outside of the treatment setting. Evidence suggests that cognitive impairments can impede treatment goals through their effects on treatment processes. Although some recovery of alcohol-related cognitive impairments often occurs after cessation of drinking (time-dependent recovery), the rate and extent of recovery is variable across cognitive domains and individuals. Following a long hiatus in scientific interest, a new generation of research aims to facilitate treatment process and improve AUD treatment outcomes by directly promoting cognitive recovery (experience-dependent recovery). This review updates knowledge about the nature and course of cognitive and brain impairments associated with AUD, including cognitive effects of adolescent AUD. We summarize current evidence for indirect and moderating relationships of cognitive impairment to treatment outcome, and discuss how advances in conceptual frameworks of brain-behavior relationships are fueling the development of novel AUD interventions that include techniques for cognitive remediation. Emerging evidence suggests that such interventions can be effective in promoting cognitive recovery in persons with AUD and other substance use disorders, and potentially increasing the efficacy of AUD treatments. Finally, translational approaches based on cognitive science, neurophysiology, and neuroscience research are considered as promising future directions for effective treatment development that includes cognitive rehabilitation.
Collapse
Affiliation(s)
- Marsha E Bates
- Center of Alcohol Studies, Rutgers, The State University of New Jersey, 607 Allison Road, Piscataway, NJ 08854-8001, USA.
| | | | | |
Collapse
|
55
|
Luhar RB, Sawyer KS, Gravitz Z, Ruiz SM, Oscar-Berman M. Brain volumes and neuropsychological performance are related to current smoking and alcoholism history. Neuropsychiatr Dis Treat 2013; 9:1767-84. [PMID: 24273408 PMCID: PMC3836660 DOI: 10.2147/ndt.s52298] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Dual dependence on alcohol and nicotine is common, with many reports suggesting that more than 80% of alcoholics also smoke cigarettes. Even after cessation of alcohol consumption, many recovering alcoholics continue to smoke. In this exploratory study, we examined how current smoking and a history of alcoholism interacted in relation to brain volumes and neuropsychological performance. METHODS Participants were 14 abstinent long-term alcoholics (seven current smokers and seven nonsmokers), and 13 nonalcoholics (six current smokers and seven nonsmokers). The groups were equivalent in age, gender, education, and intelligence quotient. Two multiecho magnetization-prepared rapid acquisition with gradient echo (MP-RAGE) scans were collected for all participants using a 3T magnetic resonance imaging scanner with a 32 channel head coil. Brain volumes for each gray and white matter region of interest were derived using FreeSurfer. Participants completed a battery of neuropsychological tests measuring intelligence quotient, memory, executive functions, personality variables, and affect. RESULTS COMPARED TO NONSMOKING NONALCOHOLICS, ALCOHOLICS WHO SMOKE (THE COMORBID GROUP) HAD VOLUMETRIC ABNORMALITIES IN: pre- and para-central frontal cortical areas and rostral middle frontal white matter; parahippocampal and temporal pole regions; the amygdala; the pallidum; the ventral diencephalic region; and the lateral ventricle. The comorbid group performed worse than nonsmoking nonalcoholics on tests of executive functioning and on visually-based memory tests. History of alcoholism was associated with higher neuroticism scores among smokers, and current smoking was associated with higher sensation seeking scores and lower extraversion scores among nonalcoholics. CONCLUSION Results from this exploratory study support and extend prior reports showing that alcoholism and smoking, alone and in combination, are associated with structural brain abnormalities and poorer performance on neuropsychological tests. Therefore, it is important to consider smoking status in alcoholism studies and vice versa.
Collapse
Affiliation(s)
- Riya B Luhar
- US Department of Veterans Affairs, Boston Healthcare System, Massachusetts General Hospital, Boston, MA, USA ; Boston University School of Medicine, Massachusetts General Hospital, Boston, MA, USA
| | | | | | | | | |
Collapse
|
56
|
Gierski F, Hubsch B, Stefaniak N, Benzerouk F, Cuervo-Lombard C, Bera-Potelle C, Cohen R, Kahn JP, Limosin F. Executive functions in adult offspring of alcohol-dependent probands: toward a cognitive endophenotype? Alcohol Clin Exp Res 2012; 37 Suppl 1:E356-63. [PMID: 23240659 DOI: 10.1111/j.1530-0277.2012.01903.x] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2011] [Accepted: 05/23/2012] [Indexed: 11/27/2022]
Abstract
BACKGROUND Executive function (EF) impairment in alcohol dependence (AD) has been related to the toxic effects of alcohol on frontal lobes. However, this impairment could be partially present before the onset of the disease and might constitute a vulnerability factor. Although a considerable body of research has investigated executive functioning among AD patients, much less attention has been directed toward high-risk individuals. Most studies were carried out among children or adolescents, and very few were conducted in adults. The aim of this study was to examine EF in a group of adult offspring of AD individuals. METHODS One hundred and fifty-five nonalcoholic adults with (family history positive [FHP]) or without (family history negative [FHN]) family history of AD were included in the study. All participants were screened for past and current psychiatric diagnoses, and alcohol, tobacco, and other substance use. They were compared on self-rated impulsiveness using the Barratt Impulsiveness Scale-11 (BIS-11) and EF using a neuropsychological test battery. RESULTS Group comparison revealed that FHP participants had significantly higher BIS-11 scores than the FHN participants, while neuropsychological examination revealed lower EF scores for FHP participants. Hierarchical regression analysis revealed that the number of AD family members was a predictor of EF results, whereas impulsiveness was not. CONCLUSIONS Nonalcoholic adult offspring of AD individuals showed increased impulsiveness and decreased EF, suggesting weakness of 2 distinct neurobehavioral decision systems. Findings support evidence that EF weaknesses may qualify as a suitable endophenotype candidate for AD.
Collapse
Affiliation(s)
- Fabien Gierski
- Department of Psychiatry, Reims University Hospital, Reims, France.
| | | | | | | | | | | | | | | | | |
Collapse
|
57
|
Kopera M, Wojnar M, Brower K, Glass J, Nowosad I, Gmaj B, Szelenberger W. Cognitive functions in abstinent alcohol-dependent patients. Alcohol 2012; 46:665-71. [PMID: 22703992 DOI: 10.1016/j.alcohol.2012.04.005] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2011] [Revised: 03/22/2012] [Accepted: 04/25/2012] [Indexed: 10/28/2022]
Abstract
The objective of this cross-sectional study was to compare cognitive functioning of abstaining alcohol-dependent (AD) male patients and healthy controls as well as to investigate whether their cognitive performance varied by abstinence length. Forty-two maintaining abstinent (AD) patients and 34 healthy controls were examined. Tests from the Cambridge Neuropsychological Test Automated Battery (CANTAB) were used to assess cognitive functions. Differences in cognitive performance were found between AD patients and healthy controls. Nonverbal tasks in cognitive domains such as attention, visual memory and working memory were impaired in AD patients who presented deficits in visual episodic memory, had slower reaction time and reduced working memory span. Patients who were abstinent for less than one year made more errors in both attentional set shifting and working memory tests than healthy controls and patients with longer durations of abstinence. Impairments identified in multiple cognitive domains in abstinent alcohol-dependent subjects suggest functional deficits in extensive brain networks connecting interrelated brain structures. Attentional control and spatial working memory were less impaired in those AD patients who maintained abstinence for at least one year.
Collapse
|
58
|
Pfefferbaum A, Rosenbloom MJ, Sassoon SA, Kemper CA, Deresinski S, Rohlfing T, Sullivan EV. Regional brain structural dysmorphology in human immunodeficiency virus infection: effects of acquired immune deficiency syndrome, alcoholism, and age. Biol Psychiatry 2012; 72:361-70. [PMID: 22458948 PMCID: PMC3393798 DOI: 10.1016/j.biopsych.2012.02.018] [Citation(s) in RCA: 76] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2011] [Revised: 02/11/2012] [Accepted: 02/15/2012] [Indexed: 12/12/2022]
Abstract
BACKGROUND Human immunodeficiency virus (HIV) infection and alcoholism each carries liability for disruption of brain structure and function integrity. Despite considerable prevalence of HIV-alcoholism comorbidity, few studies examined the potentially heightened burden of disease comorbidity. METHODS Participants were 342 men and women: 110 alcoholics, 59 with HIV infection, 65 with HIV infection and alcoholism, and 108 healthy control subjects. This design enabled examination of independent and combined effects of HIV infection and alcoholism along with other factors (acquired immune deficiency syndrome [AIDS]-defining events, hepatitis C infection, age) on regional brain volumes derived from T1-weighted magnetic resonance images. RESULTS Brain volumes, expressed as Z scores corrected for intracranial volume and age, were measured in 20 tissue and 5 ventricular and sulcal regions. The most profound and consistent volume deficits occurred with alcohol use disorders, notable in the cortical mantle, insular and anterior cingulate cortices, thalamus, corpus callosum, and frontal sulci. The HIV-only group had smaller thalamic and larger frontal sulcal volumes than control subjects. HIV disease-related factors associated with greater volume abnormalities included CD4 cell count nadir, clinical staging, history of AIDS-defining events, infection age, and current age. Longer sobriety and less lifetime alcohol consumption were predictive of attenuated brain volume abnormalities in both alcohol groups. CONCLUSIONS Having HIV infection with alcoholism and AIDS had an especially poor outcome on brain structures. That longer periods of sobriety and less lifetime alcohol consumption were predictive of attenuated brain volume abnormalities encourages the inclusion of alcohol recovery efforts in HIV/AIDS therapeutic settings.
Collapse
Affiliation(s)
- Adolf Pfefferbaum
- Neuroscience Program, SRI International, Menlo Park, CA
- Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, CA
| | - Margaret J. Rosenbloom
- Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, CA
| | | | - Carol A. Kemper
- Division of Infectious Diseases, Santa Clara Valley Medical Center, Santa Clara, CA
- Department of Medicine, Stanford University School of Medicine, Stanford, CA
| | - Stanley Deresinski
- Division of Infectious Diseases, Santa Clara Valley Medical Center, Santa Clara, CA
- Department of Medicine, Stanford University School of Medicine, Stanford, CA
| | | | - Edith V. Sullivan
- Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, CA
| |
Collapse
|
59
|
Badanich KA, Becker HC, Woodward JJ. Effects of chronic intermittent ethanol exposure on orbitofrontal and medial prefrontal cortex-dependent behaviors in mice. Behav Neurosci 2012; 125:879-91. [PMID: 22122149 DOI: 10.1037/a0025922] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
In humans, stroke or trauma-induced damage to the orbitofrontal cortex (OFC) or medial prefrontal cortex (mPFC) results in impaired cognitive flexibility. Alcoholics also exhibit similar deficits in cognitive flexibility, suggesting that the OFC and mPFC are susceptible to alcohol-induced dysfunction. The present experiments investigated this issue using an attention set-shifting assay in ethanol dependent adult male C57BL/6J mice. Ethanol dependence was induced by exposing mice to repeated cycles of chronic intermittent ethanol (CIE) vapor inhalation. Behavioral testing was conducted 72 hours or 10 days following CIE exposure to determine whether ethanol-induced changes in OFC-dependent (reversal learning) and mPFC-dependent (set-shifting) behaviors are long lasting. During early ethanol abstinence (72 hrs), CIE mice showed reduced reversal learning performance as compared to controls. Reversal learning deficits were revealed as greater number of trials to criterion, more errors made, and a greater difficulty in performing a reversal learning task relative to baseline performance. Furthermore, the magnitude of the impairment was greater during reversal of a simple discrimination rather than reversal of an intra-dimensional shift. Reversal learning deficits were no longer present when mice were tested 10 days after CIE exposure, suggesting that ethanol-induced changes in OFC function can recover. Unexpectedly, performance on the set-shifting task was not impaired during abstinence from ethanol. These data suggest reversal learning, but not attention set-shifting, is transiently disrupted during short-term abstinence from CIE. Given that reversal learning requires an intact OFC, these findings support the idea that the OFC may be vulnerable to the cognitive impairing actions of ethanol.
Collapse
Affiliation(s)
- Kimberly A Badanich
- Center for Drug and Alcohol Programs, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC 29425, USA.
| | | | | |
Collapse
|
60
|
Neuropsychological functioning in patients with alcohol-related liver disease before and after liver transplantation. Transplantation 2012; 92:1371-7. [PMID: 22075529 DOI: 10.1097/tp.0b013e3182375881] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND Cognitive dysfunction is common in both end-stage liver disease and chronic alcohol misuse. The impact of orthotopic liver transplantation (OLT) on neuropsychological function is poorly documented. This prospective study examined changes in cognitive function pre- and post-OLT in patients with alcohol-related liver disease (ALD). METHODS Comprehensive neuropsychological assessment was conducted with 92 abstinent patients with ALD scheduled for OLT. Forty-two patients were available for reassessment 12 months post-OLT. RESULTS Posttransplantation, cognitive performance on all measures fell within normal limits. Greatest improvement occurred in visuomotor speed, complex visual attention processes, and the ability to solve visually presented problems. Performance on memory assessment tasks also improved posttransplantation. Applying a more robust assessment of change (Reliable Change Index), approximately half improved reliably on overall cognitive function. One quarter improved in memory performance. With the exception of the Full-Scale Intelligence Quotient scales, discriminant analysis was unable to successfully predict which patients reliably improved. CONCLUSIONS Overall improvement in cognitive function occurs after liver transplantation in ALD. It was not possible to identify which patient characteristics were associated with reliable change.
Collapse
|
61
|
Rustemeier M, Römling J, Czybulka C, Reymann G, Daum I, Bellebaum C. Learning from positive and negative monetary feedback in patients with alcohol dependence. Alcohol Clin Exp Res 2012; 36:1067-74. [PMID: 22420690 DOI: 10.1111/j.1530-0277.2011.01696.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2011] [Accepted: 10/03/2011] [Indexed: 12/01/2022]
Abstract
BACKGROUND Chronic and excessive consumption of alcohol is associated with structural, physiological, and functional changes in multiple regions of the human brain including the prefrontal cortex, the medial temporal lobe, and the structures of the reward system. The present study aimed to assess the ability of alcohol-dependent patients (ADP) to learn probabilistic stimulus-reward contingencies and to transfer the acquired knowledge to new contexts. During transfer, the relative preference to learn from positive or negative feedback was also assessed. METHODS Twenty-four recently detoxified ADP and 20 healthy controls engaged in a feedback learning task with monetary rewards. The learning performance per se and transfer performance including positive versus negative learning were examined, as well as the relationship between different learning variables and variables comprising alcohol and nicotine consumption patterns, depression, and personality traits (harm avoidance and impulsivity). RESULTS Patients did not show a significant general learning deficit in the acquisition of stimulus-response-outcome associations. Fifteen healthy subjects and 13 patients reached the transfer phase, in which ADP showed generally lower performance than healthy controls. There was no specific deficit with regard to learning from positive or negative feedback. The only near-significant (negative) correlation between learning variables and drug consumption patterns, depression, and personality traits emerged for harm avoidance and positive learning in controls. CONCLUSIONS Impaired transfer performance suggests that ADP had problems applying their acquired knowledge in a new context. Potential relations to dysfunctions of specific brain structures and implications of the finding for therapy are discussed.
Collapse
Affiliation(s)
- Martina Rustemeier
- Institute of Cognitive Neuroscience, Department of Neuropsychology, Ruhr University Bochum, Bochum, Germany.
| | | | | | | | | | | |
Collapse
|
62
|
Montgomery C, Fisk JE, Murphy PN, Ryland I, Hilton J. The effects of heavy social drinking on executive function: a systematic review and meta-analytic study of existing literature and new empirical findings. Hum Psychopharmacol 2012; 27:187-99. [PMID: 22389083 DOI: 10.1002/hup.1268] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Previous investigations of executive function in alcohol dependent and in social drinkers have not always produced consistent results and have not utilised key indicators of recent theoretical models of Executive Function (EF). The present paper reports the results of two studies that seek to address these limitations. METHOD Study 1 took the form of a systematic review and meta-analysis of studies examining EF in social drinkers. In Study 2, 41 participants completed an alcohol use inventory and were assigned to either light or heavy alcohol use via median split of average weekly dose. Participants completed measures of the fractionated executive processes of updating, shifting, inhibition and access to semantic memory. RESULTS Study 1 only identified seven studies of EF in social drinkers, and the mean effect size was non-significant. In study 2, the heavy alcohol use group performed worse on all measures of executive functioning except memory updating. CONCLUSIONS To our knowledge, this is the first systematic investigation of executive functioning in social drinkers. Given that the participants were non-treatment seeking social drinking students, the EF deficit in the heavy user group is particularly worrying and could increase the likelihood of developing an alcohol use disorder.
Collapse
Affiliation(s)
- Catharine Montgomery
- Department of Psychology, School of Natural Sciences & Psychology, Liverpool, UK.
| | | | | | | | | |
Collapse
|
63
|
Laloyaux J, Michel C, Mourad H, Bertrand H, Domken MA, Van der Linden M, Larøi F. Performance on an everyday life activity in persons diagnosed with alcohol dependency compared to healthy controls: relations between a computerized shopping task and cognitive and clinical variables. Alcohol Alcohol 2012; 47:240-7. [PMID: 22355014 DOI: 10.1093/alcalc/ags014] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
AIM Persons diagnosed with alcohol dependency often suffer from cognitive impairments. Little is known, however, concerning how these cognitive deficits impact complex, everyday life activities. We set out to better characterize the nature of everyday life difficulties in patients with alcohol dependency using a computerized shopping task. METHODS A computerized real-life activity task (shopping task) required participants to shop for a list of eight grocery store items. Twenty individuals diagnosed with alcohol dependency and 20 healthy controls were administered a battery of cognitive tests, clinical scales and the shopping task. RESULTS Performance on the shopping task significantly differentiated patients and healthy controls for several variables and, in particular, for total time. Total time to complete the task correlated significantly with poor performance on measures of processing speed, verbal episodic memory, cognitive flexibility and inhibition. Total time was significantly correlated with poorer everyday life functioning and longer duration of illness. CONCLUSION This computerized task is a good proxy measure of the level of everyday life and cognitive functioning of persons diagnosed with alcohol dependency.
Collapse
|
64
|
Stavro K, Pelletier J, Potvin S. Widespread and sustained cognitive deficits in alcoholism: a meta-analysis. Addict Biol 2012; 18:203-13. [PMID: 22264351 DOI: 10.1111/j.1369-1600.2011.00418.x] [Citation(s) in RCA: 367] [Impact Index Per Article: 30.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
The cognitive repercussions of alcohol dependence are well documented. However, the literature remains somewhat ambiguous with respect to which distinct cognitive functions are more susceptible to impairment in alcoholism and to how duration of abstinence affects cognitive recovery. Some theories claim alcohol negatively affects specific cognitive functions, while others assert that deficits are more diffuse in nature. This is the first meta-analysis to examine cognition in alcohol abuse/dependence and the duration of abstinence necessary to achieve cognitive recovery. A literature search yielded 62 studies that assessed cognitive dysfunction among alcoholics. Effect size estimates were calculated using the Comprehensive Meta-Analysis V2, for the following 12 cognitive domains: intelligence quotient, verbal fluency/language, speed of processing, working memory, attention, problem solving/executive functions, inhibition/impulsivity, verbal learning, verbal memory, visual learning, visual memory and visuospatial abilities. Within these 12 domains, three effect size estimates were calculated based on abstinence duration. The three groups were partitioned into short- (< 1 month), intermediate- (2 to 12 months) and long- (> 1 year) term abstinence. Findings revealed moderate impairment across 11 cognitive domains during short-term abstinence, with moderate impairment across 10 domains during intermediate term abstinence. Small effect size estimates were found for long-term abstinence. These results suggest significant impairment across multiple cognitive functions remains stable during the first year of abstinence from alcohol. Generally, dysfunction abates by 1 year of sobriety. These findings support the diffuse brain hypothesis and suggest that cognitive dysfunction may linger for up to an average of 1 year post-detoxification from alcohol.
Collapse
Affiliation(s)
- Katherine Stavro
- Centre de Recherche Fernand-Seguin, Department of Psychiatry, Faculty of Medicine, University of Montreal, Canada
| | | | | |
Collapse
|
65
|
Vetreno RP, Hall JM, Savage LM. Alcohol-related amnesia and dementia: animal models have revealed the contributions of different etiological factors on neuropathology, neurochemical dysfunction and cognitive impairment. Neurobiol Learn Mem 2011; 96:596-608. [PMID: 21256970 PMCID: PMC3086968 DOI: 10.1016/j.nlm.2011.01.003] [Citation(s) in RCA: 103] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2010] [Revised: 11/09/2010] [Accepted: 01/04/2011] [Indexed: 12/21/2022]
Abstract
Chronic alcoholism is associated with impaired cognitive functioning. Over 75% of autopsied chronic alcoholics have significant brain damage and over 50% of detoxified alcoholics display some degree of learning and memory impairment. However, the relative contributions of different etiological factors to the development of alcohol-related neuropathology and cognitive impairment are questioned. One reason for this quandary is that both alcohol toxicity and thiamine deficiency result in brain damage and cognitive problems. Two alcohol-related neurological disorders, alcohol-associated dementia and Wernicke-Korsakoff syndrome have been modeled in rodents. These pre-clinical models have elucidated the relative contributions of ethanol toxicity and thiamine deficiency to the development of dementia and amnesia. What is observed in these models--from repeated and chronic ethanol exposure to thiamine deficiency--is a progression of both neural and cognitive dysregulation. Repeated binge exposure to ethanol leads to changes in neural plasticity by reducing GABAergic inhibition and facilitating glutamatergic excitation, long-term chronic ethanol exposure results in hippocampal and cortical cell loss as well as reduced hippocampal neurotrophin protein content critical for neural survival, and thiamine deficiency results in gross pathological lesions in the diencephalon, reduced neurotrophic protein levels, and neurotransmitters levels in the hippocampus and cortex. Behaviorally, after recovery from repeated or chronic ethanol exposure there is impairment in working or episodic memory that can recover with prolonged abstinence. In contrast, after thiamine deficiency there is severe and persistent spatial memory impairments and increased perseverative behavior. The interaction between ethanol and thiamine deficiency does not produce more behavioral or neural pathology, with the exception of reduction of white matter, than long-term thiamine deficiency alone.
Collapse
Affiliation(s)
- Ryan P. Vetreno
- Behavioral Neuroscience Program, Department of Psychology, State University of New York at Binghamton, Binghamton NY, 13902
| | - Joseph M. Hall
- Behavioral Neuroscience Program, Department of Psychology, State University of New York at Binghamton, Binghamton NY, 13902
| | - Lisa M. Savage
- Behavioral Neuroscience Program, Department of Psychology, State University of New York at Binghamton, Binghamton NY, 13902
| |
Collapse
|
66
|
Pandey AK, Kamarajan C, Tang Y, Chorlian DB, Roopesh BN, Manz N, Stimus A, Rangaswamy M, Porjesz B. Neurocognitive deficits in male alcoholics: an ERP/sLORETA analysis of the N2 component in an equal probability Go/NoGo task. Biol Psychol 2011; 89:170-82. [PMID: 22024409 DOI: 10.1016/j.biopsycho.2011.10.009] [Citation(s) in RCA: 75] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2011] [Revised: 10/04/2011] [Accepted: 10/07/2011] [Indexed: 10/16/2022]
Abstract
In alcoholism research, studies concerning time-locked electrophysiological aspects of response inhibition have concentrated mainly on the P3 component of the event-related potential (ERP). The objective of the present study was to investigate the N2 component of the ERP to elucidate possible brain dysfunction related to the motor response and its inhibition using a Go/NoGo task in alcoholics. The sample consisted of 78 abstinent alcoholic males and 58 healthy male controls. The N2 peak was compared across group and task conditions. Alcoholics showed significantly reduced N2 peak amplitudes compared to normal controls for Go as well as NoGo task conditions. Control subjects showed significantly larger NoGo than Go N2 amplitudes at frontal regions, whereas alcoholics did not show any differences between task conditions at frontal regions. Standardized low resolution electromagnetic tomography analysis (sLORETA) indicated that alcoholics had significantly lower current density at the source than control subjects for the NoGo condition at bilateral anterior prefrontal regions, whereas the differences between groups during the Go trials were not statistically significant. Furthermore, NoGo current density across both groups revealed significantly more activation in bilateral anterior cingulate cortical (ACC) areas, with the maximum activation in the right cingulate regions. However, the magnitude of this difference was much less in alcoholics compared to control subjects. These findings suggest that alcoholics may have deficits in effortful processing during the motor response and its inhibition, suggestive of possible frontal lobe dysfunction.
Collapse
Affiliation(s)
- A K Pandey
- Henri Begleiter Neurodynamics Laboratory, Department of Psychiatry and Behavioral Sciences, SUNY Downstate Medical Center, Box 1203, 450 Clarkson Avenue, Brooklyn, NY 11203, USA.
| | | | | | | | | | | | | | | | | |
Collapse
|
67
|
Effects of acamprosate on cognition in a treatment study of patients with schizophrenia spectrum disorders and comorbid alcohol dependence. J Nerv Ment Dis 2011; 199:499-505. [PMID: 21716064 DOI: 10.1097/nmd.0b013e3182214297] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Problems with memory and attention are common to both schizophrenia and alcohol dependence. The objectives of this study were to examine the effect of acamprosate treatment on cognition and to assess whether the changes in drinking patterns or psychotic symptoms were related to changes in cognitive functioning. Outpatients with schizophrenia spectrum disorders and alcohol dependence (n = 23) were randomized (double-blind) to either acamprosate or placebo treatment for 12 weeks. Assessments (baseline and week 12) included alcohol use, symptoms of psychosis, memory, and attention. The results showed that acamprosate had no effect on cognitive functioning and that there was no relationship between change in alcohol consumption or psychotic symptoms and change in cognitive functioning in this sample of patients. The finding that acamprosate had no negative effects on cognition is clinically relevant and reinforces previous reports that acamprosate can be used safely for alcohol reduction in this group of patients.
Collapse
|
68
|
Heinz AJ, Beck A, Meyer-Lindenberg A, Sterzer P, Heinz A. Cognitive and neurobiological mechanisms of alcohol-related aggression. Nat Rev Neurosci 2011; 12:400-13. [PMID: 21633380 DOI: 10.1038/nrn3042] [Citation(s) in RCA: 194] [Impact Index Per Article: 14.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Alcohol-related violence is a serious and common social problem. Moreover, violent behaviour is much more common in alcohol-dependent individuals. Animal experiments and human studies have provided insights into the acute effect of alcohol on aggressive behaviour and into common factors underlying acute and chronic alcohol intake and aggression. These studies have shown that environmental factors, such as early-life stress, interact with genetic variations in serotonin-related genes that affect serotonergic and GABAergic neurotransmission. This leads to increased amygdala activity and impaired prefrontal function that, together, predispose to both increased alcohol intake and impulsive aggression. In addition, acute and chronic alcohol intake can further impair executive control and thereby facilitate aggressive behaviour.
Collapse
Affiliation(s)
- Adrienne J Heinz
- Department of Psychology, University of Illinois at Chicago, 1007 W Harrison Street, MC 285 Chicago, Illinois 60607, USA. andreas.heinz@ charite.de
| | | | | | | | | |
Collapse
|
69
|
Yakovleva T, Bazov I, Watanabe H, Hauser KF, Bakalkin G. Transcriptional control of maladaptive and protective responses in alcoholics: a role of the NF-κB system. Brain Behav Immun 2011; 25 Suppl 1:S29-38. [PMID: 21195164 PMCID: PMC3588165 DOI: 10.1016/j.bbi.2010.12.019] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2010] [Revised: 12/22/2010] [Accepted: 12/22/2010] [Indexed: 11/27/2022] Open
Abstract
Alcohol dependence and associated cognitive impairment appear to result from maladaptive neuroplasticity in response to chronic alcohol consumption, neuroinflammation and neurodegeneration. The inherent stability of behavioral alterations associated with the addicted state suggests that transcriptional and epigenetic mechanisms are operative. NF-κB transcription factors are regulators of synaptic plasticity and inflammation, and responsive to a variety of stimuli including alcohol. These factors are abundant in the brain where they have diverse functions that depend on the composition of the NF-κB complex and cellular context. In neuron cell bodies, NF-κB is constitutively active, and involved in neuronal injury and neuroprotection. However, at the synapse, NF-κB is present in a latent form and upon activation is transported to the cell nucleus. In glia, NF-κB is inducible and regulates inflammatory processes that exacerbate alcohol-induced neurodegeneration. Animal studies demonstrate that acute alcohol exposure transiently activates NF-κB, which induces neuroinflammatory responses and neurodegeneration. Postmortem studies of brains of human alcoholics suggest that repeated cycles of alcohol consumption and withdrawal cause adaptive changes in the NF-κB system that may permit the system to better tolerate excessive stimulation. This type of tolerance, ensuring a low degree of responsiveness to applied stimuli, apparently differs from that in the immune system, and may represent a compensatory response that protects brain cells against alcohol neurotoxicity. This view is supported by findings showing preferential downregulation of pro-apoptotic gene expression in the affected brain areas in human alcoholics. Although further verification is needed, we speculate that NF-κB-driven neuroinflammation and disruption to neuroplasticity play a significant role in regulating alcohol dependence and cognitive impairment.
Collapse
Affiliation(s)
- Tatjana Yakovleva
- Division of Biological Research on Drug Dependence, Department of Pharmaceutical Biosciences, Uppsala University, Uppsala, Sweden
| | - Igor Bazov
- Division of Biological Research on Drug Dependence, Department of Pharmaceutical Biosciences, Uppsala University, Uppsala, Sweden
| | - Hiroyuki Watanabe
- Division of Biological Research on Drug Dependence, Department of Pharmaceutical Biosciences, Uppsala University, Uppsala, Sweden
| | - Kurt F. Hauser
- Department of Pharmacology & Toxicology, and Institute for Drug and Alcohol Studies, Virginia Commonwealth University School of Medicine, Richmond, Virginia 23298, USA
| | - Georgy Bakalkin
- Division of Biological Research on Drug Dependence, Department of Pharmaceutical Biosciences, Uppsala University, Uppsala, Sweden,To whom correspondence may be addressed: Georgy Bakalkin, Division of Biological Research on Drug Dependence, Department of Pharmaceutical Biosciences, Uppsala University, Box 591, 751 24 Uppsala, Sweden, , Phone: (+46) 18 471 5050, Fax: (+046) 18-50 19 20
| |
Collapse
|
70
|
Fernández-Serrano MJ, Pérez-García M, Verdejo-García A. What are the specific vs. generalized effects of drugs of abuse on neuropsychological performance? Neurosci Biobehav Rev 2011; 35:377-406. [DOI: 10.1016/j.neubiorev.2010.04.008] [Citation(s) in RCA: 257] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2009] [Revised: 04/21/2010] [Accepted: 04/29/2010] [Indexed: 12/22/2022]
|
71
|
Molecular targets of alcohol action: Translational research for pharmacotherapy development and screening. PROGRESS IN MOLECULAR BIOLOGY AND TRANSLATIONAL SCIENCE 2011; 98:293-347. [PMID: 21199775 DOI: 10.1016/b978-0-12-385506-0.00007-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Alcohol abuse and dependence are multifaceted disorders with neurobiological, psychological, and environmental components. Research on other complex neuropsychiatric diseases suggests that genetically influenced intermediate characteristics affect the risk for heavy alcohol consumption and its consequences. Diverse therapeutic interventions can be developed through identification of reliable biomarkers for this disorder and new pharmacological targets for its treatment. Advances in the fields of genomics and proteomics offer a number of possible targets for the development of new therapeutic approaches. This brain-focused review highlights studies identifying neurobiological systems associated with these targets and possible pharmacotherapies, summarizing evidence from clinically relevant animal and human studies, as well as sketching improvements and challenges facing the fields of proteomics and genomics. Concluding thoughts on using results from these profiling technologies for medication development are also presented.
Collapse
|
72
|
Guillot CR, Fanning JR, Bullock JS, McCloskey MS, Berman ME. Effects of alcohol on tests of executive functioning in men and women: a dose response examination. Exp Clin Psychopharmacol 2010; 18:409-17. [PMID: 20939644 PMCID: PMC3968820 DOI: 10.1037/a0021053] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Alcohol has been shown to affect performance on tasks associated with executive functioning. However, studies in this area have generally been limited to a single dose or gender or have used small sample sizes. The purpose of this study was to provide a more nuanced and systematic examination of alcohol's effects on commonly used tests of executive functioning at multiple dosages in both men and women. Research volunteers (91 women and 94 men) were randomly assigned to one of four drink conditions (alcohol doses associated with target blood alcohol concentrations of .000%, .050%, .075%, and .100%). Participants then completed three tasks comprising two domains of executive functioning: two set shifting tasks, the Trail Making Test and a computerized version of the Wisconsin Card Sorting Task, and a response inhibition task, the GoStop Impulsivity Paradigm. Impaired performance on set shifting tasks was found at the .100% and .075% dosages, but alcohol intoxication did not impair performance on the GoStop. No gender effects emerged. Thus, alcohol negatively affects set shifting at moderately high levels of intoxication in both men and women, likely attributable to alcohol's interference with prefrontal cortex function. Although it is well established that alcohol negatively affects response inhibition as measured by auditory stop-signal tasks, alcohol does not appear to exert a negative effect on response inhibition as measured by the GoStop, a visual stop-signal task.
Collapse
Affiliation(s)
- Casey R. Guillot
- Department of Psychology, The University of Southern Mississippi, 118 College Drive #5025, Hattiesburg, MS 39406
| | - Jennifer R. Fanning
- Department of Psychology, The University of Southern Mississippi, 118 College Drive #5025, Hattiesburg, MS 39406
| | - Joshua S. Bullock
- Department of Psychology, The University of Southern Mississippi, 118 College Drive #5025, Hattiesburg, MS 39406
| | - Michael S. McCloskey
- The Department of Psychology, Weiss Hall, Temple University, 1701 North 13th Street, Philadelphia, PA 19122-6085
| | - Mitchell E. Berman
- Corresponding author. Department of Psychology, The University of Southern Mississippi, 118 College Drive #5025, Hattiesburg, MS 39406, Tel.: +1-601-266-4570; fax: +1-601-266-5580.
| |
Collapse
|
73
|
Verdejo-García A, Del Mar Sánchez-Fernández M, Alonso-Maroto LM, Fernández-Calderón F, Perales JC, Lozano O, Pérez-García M. Impulsivity and executive functions in polysubstance-using rave attenders. Psychopharmacology (Berl) 2010; 210:377-92. [PMID: 20386885 DOI: 10.1007/s00213-010-1833-8] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2009] [Accepted: 03/10/2010] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Rave parties are characterized by high levels of drug use and polysubstance-using patterns that may be especially harmful for psychological and neuropsychological functioning. The aim of this study was to conduct a comprehensive assessment of different aspects of impulsivity and executive functions in a sample of polysubstance-using rave attenders. METHODS We collected data from two groups: rave attenders (RvA, n = 25) and drug-free healthy comparison individuals (HCI, n = 27). RvA were regular users of cannabis, cocaine, methampethamine, hallucinogens, and alcohol. The assessment protocol included a drug-taking interview, the UPPS-P Impulsive Behavior Scale, the delay-discounting questionnaire and a set of neuropsychological tests taxing different aspects of executive functions: response speed, working memory, reasoning, response inhibition and switching, self-regulation, decision making, and emotion perception. RESULTS For impulsivity measures, RvA had significantly elevated scores on lack of perseverance and positive and negative urgency, but did not differ from controls on lack of premeditation or sensation seeking. For neuropsychological functioning, RvA had significantly poorer performance on indices of analogical reasoning, processing speed, working memory, inhibition/switching errors, and decision making, but performed similar to controls on indices of self-regulation, reversal learning, and emotion processing. Peak and binge alcohol and drug use were positively correlated with positive urgency, and negatively correlated with performance on executive indices. CONCLUSION Rave attenders have selective alterations of impulsive personality and executive functions. These findings can contribute to delineate the neuropsychological profiles that distinguish recreational polysubstance use from substance dependence.
Collapse
Affiliation(s)
- Antonio Verdejo-García
- Department of Personalidad, Evaluación y Tratamiento Psicológico, Universidad de Granada, Granada, Spain.
| | | | | | | | | | | | | |
Collapse
|
74
|
Fernández-Serrano MJ, Pérez-García M, Perales JC, Verdejo-García A. Prevalence of executive dysfunction in cocaine, heroin and alcohol users enrolled in therapeutic communities. Eur J Pharmacol 2010; 626:104-12. [DOI: 10.1016/j.ejphar.2009.10.019] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2009] [Revised: 08/03/2009] [Accepted: 10/09/2009] [Indexed: 10/20/2022]
|
75
|
Hudetz JA, Patterson KM, Byrne AJ, Iqbal Z, Gandhi SD, Warltier DC, Pagel PS. A history of alcohol dependence increases the incidence and severity of postoperative cognitive dysfunction in cardiac surgical patients. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2009; 6:2725-39. [PMID: 20049218 PMCID: PMC2800057 DOI: 10.3390/ijerph6112725] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/27/2009] [Accepted: 10/17/2009] [Indexed: 12/12/2022]
Abstract
Postoperative cognitive dysfunction (POCD) commonly occurs after cardiac surgery. We tested the hypothesis that a history of alcohol dependence is associated with an increased incidence and severity of POCD in male patients undergoing cardiac surgery using cardiopulmonary bypass. Recent verbal and nonverbal memory and executive functions were assessed before and one week after surgery in patients with or without a history of alcohol dependence. Cognitive function was significantly reduced after cardiac surgery in patients with versus without a history of alcohol dependence. The results suggest that a history of alcohol dependence increases the incidence and severity of POCD after cardiac surgery.
Collapse
Affiliation(s)
- Judith A. Hudetz
- Department of Anesthesiology, Medical College of Wisconsin, Milwaukee, WI 53226, USA; E-Mails:
(Z.I.);
(S.D.G.);
(D.C.W.);
(P.S.P)
- Clement J. Zablocki Veterans Administration Medical Center, Milwaukee, WI 53295, USA; E-Mails:
(K.M.P.);
(A.J.B.)
| | - Kathleen M. Patterson
- Clement J. Zablocki Veterans Administration Medical Center, Milwaukee, WI 53295, USA; E-Mails:
(K.M.P.);
(A.J.B.)
- Departments of Psychiatry, Behavioral Medicine, and Neurology Medical College of Wisconsin, Milwaukee, WI 53226, USA
| | - Alison J. Byrne
- Clement J. Zablocki Veterans Administration Medical Center, Milwaukee, WI 53295, USA; E-Mails:
(K.M.P.);
(A.J.B.)
| | - Zafar Iqbal
- Department of Anesthesiology, Medical College of Wisconsin, Milwaukee, WI 53226, USA; E-Mails:
(Z.I.);
(S.D.G.);
(D.C.W.);
(P.S.P)
- Clement J. Zablocki Veterans Administration Medical Center, Milwaukee, WI 53295, USA; E-Mails:
(K.M.P.);
(A.J.B.)
| | - Sweeta D. Gandhi
- Department of Anesthesiology, Medical College of Wisconsin, Milwaukee, WI 53226, USA; E-Mails:
(Z.I.);
(S.D.G.);
(D.C.W.);
(P.S.P)
- Clement J. Zablocki Veterans Administration Medical Center, Milwaukee, WI 53295, USA; E-Mails:
(K.M.P.);
(A.J.B.)
| | - David C. Warltier
- Department of Anesthesiology, Medical College of Wisconsin, Milwaukee, WI 53226, USA; E-Mails:
(Z.I.);
(S.D.G.);
(D.C.W.);
(P.S.P)
- Clement J. Zablocki Veterans Administration Medical Center, Milwaukee, WI 53295, USA; E-Mails:
(K.M.P.);
(A.J.B.)
| | - Paul S. Pagel
- Department of Anesthesiology, Medical College of Wisconsin, Milwaukee, WI 53226, USA; E-Mails:
(Z.I.);
(S.D.G.);
(D.C.W.);
(P.S.P)
- Clement J. Zablocki Veterans Administration Medical Center, Milwaukee, WI 53295, USA; E-Mails:
(K.M.P.);
(A.J.B.)
| |
Collapse
|
76
|
Campanella S, Petit G, Maurage P, Kornreich C, Verbanck P, Noël X. Chronic alcoholism: insights from neurophysiology. Neurophysiol Clin 2009; 39:191-207. [PMID: 19853791 DOI: 10.1016/j.neucli.2009.08.002] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2009] [Revised: 08/10/2009] [Accepted: 08/10/2009] [Indexed: 12/27/2022] Open
Abstract
INTRODUCTION Increasing knowledge of the anatomical structures and cellular processes underlying psychiatric disorders may help bridge the gap between clinical signs and basic physiological processes. Accordingly, considerable insight has been gained in recent years into a common psychiatric condition, i.e., chronic alcoholism. MATERIAL AND METHODS We reviewed various physiological parameters that are altered in chronic alcoholic patients compared to healthy individuals--continuous electroencephalogram, oculomotor measures, cognitive event-related potentials and event-related oscillations--to identify links between these physiological parameters, altered cognitive processes and specific clinical symptoms. RESULTS Alcoholic patients display: (1) high beta and theta power in the resting electroencephalogram, suggesting hyperarousal of their central nervous system; (2) abnormalities in smooth pursuit eye movements, in saccadic inhibition during antisaccade tasks, and in prepulse inhibition, suggesting disturbed attention modulation and abnormal patterns of prefrontal activation that may stem from the same prefrontal "inhibitory" cortical dysfunction; (3) decreased amplitude for cognitive event-related potentials situated along the continuum of information-processing, suggesting that alcoholism is associated with neurophysiological deficits at the level of the sensory cortex and not only disturbances involving associative cortices and limbic structures; and (4) decreased theta, gamma and delta oscillations, suggesting cognitive disinhibition at a functional level. DISCUSSION The heterogeneity of alcoholic disorders in terms of symptomatology, course and outcome is the result of various pathophysiological processes that physiological parameters may help to define. These alterations may be related to precise cognitive processes that could be easily monitored neurophysiologically in order to create more homogeneous subgroups of alcoholic individuals.
Collapse
Affiliation(s)
- S Campanella
- Laboratory of Medical Psychology, Psychiatry Department, CHU Brugmann, University of Brussels, 4, place Vangehuchten, 1020 Brussels, Belgium.
| | | | | | | | | | | |
Collapse
|
77
|
van Holst RJ, van den Brink W, Veltman DJ, Goudriaan AE. Why gamblers fail to win: a review of cognitive and neuroimaging findings in pathological gambling. Neurosci Biobehav Rev 2009; 34:87-107. [PMID: 19632269 DOI: 10.1016/j.neubiorev.2009.07.007] [Citation(s) in RCA: 214] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2009] [Revised: 07/16/2009] [Accepted: 07/16/2009] [Indexed: 10/20/2022]
Abstract
The purpose of this review is to gain more insight in the neuropathology of pathological gambling (PG) and problem gambling, and to discuss challenges in this research area. Results from the reviewed PG studies show that PG is more than just an impulse control disorder. PG seems to fit very well with recent theoretical models of addiction, which stress the involvement of the ventral tegmental-orbito frontal cortex. Differentiating types of PG on game preferences (slot machines vs. casino games) seems to be useful because different PG groups show divergent results, suggesting different neurobiological pathways to PG. A framework for future studies is suggested, indicating the need for hypothesis driven pharmacological and functional imaging studies in PG and integration of knowledge from different research areas to further elucidate the neurobiological underpinnings of this disorder.
Collapse
Affiliation(s)
- Ruth J van Holst
- Academic Medical Center, University of Amsterdam, Department of Psychiatry, Amsterdam Institute for Addiction Research, Amsterdam, The Netherlands.
| | | | | | | |
Collapse
|
78
|
Oscar-Berman M, Valmas MM, Sawyer KS, Kirkley SM, Gansler DA, Merritt D, Couture A. Frontal brain dysfunction in alcoholism with and without antisocial personality disorder. Neuropsychiatr Dis Treat 2009; 5:309-26. [PMID: 19557141 PMCID: PMC2699656 DOI: 10.2147/ndt.s4882] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2009] [Indexed: 11/26/2022] Open
Abstract
Alcoholism and antisocial personality disorder (ASPD) often are comorbid conditions. Alcoholics, as well as nonalcoholic individuals with ASPD, exhibit behaviors associated with prefrontal brain dysfunction such as increased impulsivity and emotional dysregulation. These behaviors can influence drinking motives and patterns of consumption. Because few studies have investigated the combined association between ASPD and alcoholism on neuropsychological functioning, this study examined the influence of ASPD symptoms and alcoholism on tests sensitive to frontal brain deficits. The participants were 345 men and women. Of them, 144 were abstinent alcoholics (66 with ASPD symptoms), and 201 were nonalcoholic control participants (24 with ASPD symptoms). Performances among the groups were examined with Trails A and B tests, the Wisconsin Card Sorting Test, the Controlled Oral Word Association Test, the Ruff Figural Fluency Test, and Performance subtests of the Wechsler Adult Intelligence Scale. Measures of affect also were obtained. Multiple regression analyses showed that alcoholism, specific drinking variables (amount and duration of heavy drinking), and ASPD were significant predictors of frontal system and affective abnormalities. These effects were different for men and women. The findings suggested that the combination of alcoholism and ASPD leads to greater deficits than the sum of each.
Collapse
Affiliation(s)
- Marlene Oscar-Berman
- Department of Veterans Affairs Healthcare System, Boston University School of Medicine, Boston, MA, USA.
| | | | | | | | | | | | | |
Collapse
|
79
|
BROWN THOMASG, OUIMET MARIECLAUDE, NADEAU LOUISE, GIANOULAKIS CHRISTINA, LEPAGE MARTIN, TREMBLAY JACQUES, DONGIER MAURICE. From the brain to bad behaviour and back again: Neurocognitive and psychobiological mechanisms of driving while impaired by alcohol. Drug Alcohol Rev 2009; 28:406-18. [DOI: 10.1111/j.1465-3362.2009.00053.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
80
|
Thoma P, Johann K, Wähner A, Juckel G, Daum I. Recollective experience in alcohol dependence: a laboratory study. Addiction 2008; 103:1969-78. [PMID: 19469740 DOI: 10.1111/j.1360-0443.2008.02374.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIMS Alcohol dependence has been linked to dysfunction of fronto-temporo-striatal circuits which mediate memory and executive function. The present study aimed to explore the specificity of recognition memory changes in alcohol dependence. DESIGN setting and participants Twenty hospitalized alcohol-dependent detoxified patients and 20 healthy control subjects completed a verbal list discrimination task. Measurements Hits and false alarm rates were analysed. Additionally, both the dual process signal detection model (DPSD) and the process dissociation procedure (PDP) were used to derive estimates of the contribution of recollection and familiarity processes to the recognition memory performance in patients and controls. FINDINGS Alcohol-dependent patients showed intact hit rates, but increased false alarm rates and an impaired ability to remember the learning context. Both the DPSD model and PDP estimates yielded significantly reduced recollection estimates in the alcohol-dependent compared to control subjects. Whether or not familiarity was impaired, depended upon the sensitivity of the estimation procedure. CONCLUSION Taken together, the result pattern suggests a significant impairment in recollection and mild familiarity changes in recently detoxified, predominantly male, alcohol-dependent subjects.
Collapse
Affiliation(s)
- Patrizia Thoma
- Institute of Cognitive Neuroscience, Department of Neuropsychology, Faculty of Psychology, Ruhr-University of Bochum, Bochum, Germany.
| | | | | | | | | |
Collapse
|
81
|
Makris N, Oscar-Berman M, Kim S, Hodge SM, Kennedy DN, Caviness VS, Marinkovic K, Breiter HC, Gasic GP, Harris GJ. Decreased volume of the brain reward system in alcoholism. Biol Psychiatry 2008; 64:192-202. [PMID: 18374900 PMCID: PMC2572710 DOI: 10.1016/j.biopsych.2008.01.018] [Citation(s) in RCA: 297] [Impact Index Per Article: 18.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2007] [Revised: 12/26/2007] [Accepted: 01/16/2008] [Indexed: 12/31/2022]
Abstract
BACKGROUND Reinforcement of behavioral responses involves a complex cerebral circuit engaging specific neuronal networks that are modulated by cortical oversight systems affiliated with emotion, memory, judgment, and decision making (collectively referred to in this study as the "extended reward and oversight system" or "reward network"). We examined whether reward-network brain volumes are reduced in alcoholics and how volumes of subcomponents within this system are correlated with memory and drinking history. METHODS Morphometric analysis was performed on magnetic resonance brain scans in 21 abstinent long-term chronic alcoholic men and 21 healthy control men, group-matched on age, verbal IQ, and education. We derived volumes of total brain and volumes of cortical and subcortical reward-related structures including the dorsolateral-prefrontal, orbitofrontal, cingulate cortices, and the insula, as well as the amygdala, hippocampus, nucleus accumbens septi (NAc), and ventral diencephalon. RESULTS Morphometric analyses of reward-related regions revealed decreased total reward-network volume in alcoholic subjects. Volume reduction was most pronounced in right dorsolateral-prefrontal cortex, right anterior insula, and right NAc, as well as left amygdala. In alcoholics, NAc and anterior insula volumes increased with length of abstinence, and total reward-network and amygdala volumes correlated positively with memory scores. CONCLUSIONS The observation of decreased reward-network volume suggests that alcoholism is associated with alterations in this neural reward system. These structural reward system deficits and their correlation with memory scores elucidate underlying structural-functional relationships between alcoholism and emotional and cognitive processes.
Collapse
Affiliation(s)
- Nikos Makris
- Athinoula A. Martinos Center, Harvard Medical School Departments of Neurology, Psychiatry and Radiology Services, Center for Morphometric Analysis, Massachusetts General Hospital, Boston, MA 02129,VA Healthcare System, Boston Campus, and Boston University School of Medicine, Departments of Psychiatry, Neurology, and Anatomy & Neurobiology, Boston, MA 02118
| | - Marlene Oscar-Berman
- VA Healthcare System, Boston Campus, and Boston University School of Medicine, Departments of Psychiatry, Neurology, and Anatomy & Neurobiology, Boston, MA 02118
| | - Sharon Kim
- Athinoula A. Martinos Center, Harvard Medical School Departments of Neurology, Psychiatry and Radiology Services, Center for Morphometric Analysis, Massachusetts General Hospital, Boston, MA 02129,Radiology Computer Aided Diagnostics Laboratory, Department of Radiology, Massachusetts General Hospital, Boston, MA 02114
| | - Steven M. Hodge
- Athinoula A. Martinos Center, Harvard Medical School Departments of Neurology, Psychiatry and Radiology Services, Center for Morphometric Analysis, Massachusetts General Hospital, Boston, MA 02129,Radiology Computer Aided Diagnostics Laboratory, Department of Radiology, Massachusetts General Hospital, Boston, MA 02114
| | - David N. Kennedy
- Athinoula A. Martinos Center, Harvard Medical School Departments of Neurology, Psychiatry and Radiology Services, Center for Morphometric Analysis, Massachusetts General Hospital, Boston, MA 02129
| | - Verne S. Caviness
- Athinoula A. Martinos Center, Harvard Medical School Departments of Neurology, Psychiatry and Radiology Services, Center for Morphometric Analysis, Massachusetts General Hospital, Boston, MA 02129
| | - Ksenija Marinkovic
- Athinoula A. Martinos Center, Harvard Medical School Departments of Neurology, Psychiatry and Radiology Services, Center for Morphometric Analysis, Massachusetts General Hospital, Boston, MA 02129
| | - Hans C. Breiter
- Athinoula A. Martinos Center, Harvard Medical School Departments of Neurology, Psychiatry and Radiology Services, Center for Morphometric Analysis, Massachusetts General Hospital, Boston, MA 02129
| | - Gregory P. Gasic
- Athinoula A. Martinos Center, Harvard Medical School Departments of Neurology, Psychiatry and Radiology Services, Center for Morphometric Analysis, Massachusetts General Hospital, Boston, MA 02129
| | - Gordon J. Harris
- Radiology Computer Aided Diagnostics Laboratory, Department of Radiology, Massachusetts General Hospital, Boston, MA 02114
| |
Collapse
|
82
|
Noël X, Billieux J, Van der Linden M, Dan B, Hanak C, de Bournonville S, Baurain C, Verbanck P. Impaired inhibition of proactive interference in abstinent individuals with alcoholism. J Clin Exp Neuropsychol 2008; 31:57-64. [PMID: 18608675 DOI: 10.1080/13803390801982726] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Cognitive impairment has been associated with higher risk of alcoholism and relapse. Recent theoretical refinements have separated inhibition of dominant response and inhibition of proactive interference. We assessed the latter using a directed-forgetting procedure in 38 recently detoxified individuals with alcoholism and in 26 controls. On this task, memory performance of letter trigrams was compared when presented alone, followed by a second trigram to be recalled, then a second trigram to be forgotten (directed-forgetting condition). Individuals with alcoholism recalled more letters to be forgotten and performed worse than controls in the directed-forgetting condition, which significantly correlated with the duration of alcoholism.
Collapse
Affiliation(s)
- Xavier Noël
- Clinic of Addiction, CHU-Brugmann, Free University of Brussels, Brussels, Belgium.
| | | | | | | | | | | | | | | |
Collapse
|
83
|
Barry D, Petry NM. Predictors of decision-making on the Iowa Gambling Task: independent effects of lifetime history of substance use disorders and performance on the Trail Making Test. Brain Cogn 2008; 66:243-52. [PMID: 17942206 PMCID: PMC2292486 DOI: 10.1016/j.bandc.2007.09.001] [Citation(s) in RCA: 82] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2007] [Revised: 08/28/2007] [Accepted: 09/04/2007] [Indexed: 11/27/2022]
Abstract
Poor decision-making and executive function deficits are frequently observed in individuals with substance use disorders (SUDs), and executive deficits may contribute to poor decision-making in this population. This study examined the influence of lifetime history of an alcohol, cocaine, heroin, or polysubstance use disorder on decision-making as measured by the Iowa Gambling Task (IGT) after controlling for executive ability, demographic characteristics, and current substance use. Participants (131 with lifetime history of SUD and 37 controls) completed the IGT and two neuropsychological tests: the Trail Making Test and the Controlled Oral Word Association Test. Control participants performed significantly better than those with a lifetime SUD history on the IGT, but performance on the neuropsychological tests was comparable for the two groups. A lifetime SUD diagnosis was associated with performance on the IGT after controlling for covariates, and Trail Making Test performance was associated with IGT performance in both SUD and control participants.
Collapse
Affiliation(s)
- Danielle Barry
- Department of Psychiatry (MC 3944), University of Connecticut Health Center, 263 Farmington Avenue, Farmington, CT 06030, USA
| | | |
Collapse
|
84
|
Mayfield RD, Harris RA, Schuckit MA. Genetic factors influencing alcohol dependence. Br J Pharmacol 2008; 154:275-87. [PMID: 18362899 DOI: 10.1038/bjp.2008.88] [Citation(s) in RCA: 147] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Plentiful data from both animal and human studies support the importance of genetic influences in substance abuse and dependence (Bierut et al., 1998; Tsuang et al., 1998; Kendler et al., 2003). This review summarizes the evidence supporting such genetic influences, places them into perspective regarding animal and human studies, discusses the importance of both genes and environment, and highlights some specific genes of interest regarding the vulnerabilities for problems associated with alcohol use disorders. A long history of repetitive heavy use of alcohol exists across generations as well as the high prevalence of alcohol-related problems in Western societies. Moreover, the information offered here addresses the importance of more general issues regarding genetics and gene expression related to alcohol abuse and dependence.
Collapse
Affiliation(s)
- R D Mayfield
- Waggoner Center for Alcohol and Addiction Research, University of Texas at Austin, Austin, TX 78712, USA
| | | | | |
Collapse
|
85
|
Dolan SL, Bechara A, Nathan PE. Executive dysfunction as a risk marker for substance abuse: the role of impulsive personality traits. BEHAVIORAL SCIENCES & THE LAW 2008; 26:799-822. [PMID: 19039793 DOI: 10.1002/bsl.845] [Citation(s) in RCA: 62] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
The relationships between family history of substance use, executive functions, impaired decision making, and current substance dependence are the focus of this study. Thirty-eight substance-dependent inpatients were compared with 30 community controls on performance on the Wisconsin Card Sorting Test, Trail-Making Test-B, the Stroop Color Word Test, the Wais-II Digit Span, and the Iowa Gambling Task. Recent alcohol use, depressive symptoms, and impulsivity were also assessed. As hypothesized, individuals with substance dependence exhibited poorer executive functioning. Family history status was modestly related to impaired performance on tests designed to measure the integrity of the dorsolateral prefrontal cortex. In particular, substance-dependent, family history positive individuals performed less well on the Wisconsin Card Sorting Test than substance-dependent individuals without a family history. Digit Span performances were worse among family history positive controls when compared with family history negative controls. Impulsive personality traits--specifically, difficulty thinking before acting (Urgency)--were related, as hypothesized, to executive functioning. Results indicate that family history status confers an increased risk of impairment beyond that conferred by recent substance abuse, and that impulsive personality traits are related to performance on tests of executive functions. Implications for criminality are discussed.
Collapse
Affiliation(s)
- Sara L Dolan
- Department of Psychology and Neuroscience, Baylor University, One Bear Place #97334, Waco, TX 76798, USA
| | | | | |
Collapse
|
86
|
Tivis LJ, Ceballos NA, Chastain G, Tivis RD. Alcohol and estrogen replacement therapy in postmenopausal women. Direct and mediated effects on cognitive component processes. Neuropsychobiology 2008; 58:104-10. [PMID: 18843196 PMCID: PMC2723943 DOI: 10.1159/000162357] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2008] [Accepted: 08/03/2008] [Indexed: 02/04/2023]
Abstract
The literature remains contentious regarding the separate and combined effects of moderate drinking and estrogen replacement therapy (ERT) on cognition. In the current study, the authors sought to disentangle the predictive utility of alcohol use, ERT and their interaction on the episodic and semantic memory stores of postmenopausal women. It was predicted that relationships between moderate drinking, ERT and cognition would be attenuated by demographic and health-related factors. Postmenopausal women (n = 298) completed a battery of cognitive tests designed to assess speed and accuracy of episodic and knowledge-based cognitive processing. Potentially confounding variables were categorized and tested as mediators in hierarchical regression analyses. Moderate drinking was a weak predictor of episodic availability prior to removal of potential mediators. ERT use was a significant predictor of episodic and knowledge-based availability; no mediators were identified. Alcohol moderated ERT, as a combined alcohol/ERT variable was shown to be related to cognition. Neither moderate drinking nor ERT use was associated with cognitive speed. These findings suggest that positive relationships between alcohol and cognition are likely mediated by other variables, and should not be regarded as a benefit of drinking. Further, results support ERT as a predictor of knowledge-based and episodic availability, independent of mood stabilization or socioeconomic influences. Finally, alcohol and ERT appear to interact to impact both episodic and knowledge-based performance.
Collapse
|
87
|
Abstract
It has been proposed that alcohol weakens control processes, which in turn supports the occurrence of disinhibited behaviours. Two studies were run, in parallel (both with 32 participants) using a between-subject design to investigate any disinhibiting effects of a moderate dose of alcohol (0.6 g/kg compared to placebo), previously found to trigger increased desire for alcohol. Disinhibiting effects were tested on basic motoric and cognitive control processes, using a go/no-go (GNG) and the Stroop task (ST) respectively. Although a higher proportion of participants wanted more alcohol under the alcohol preload (priming effect), this effect was not found to be significant. In the GNG task, correct response latency (RL) decreased from baseline [P = 0.008] while number of incorrect hits increased [P = 0.030] irrespective of treatment, indicating the formation of a habit-like response and motoric disinhibition. Although error rate did not differ between groups, an interaction occurred with regard to erroneous RL: participants under alcohol became quicker, while those under placebo became slower [P = 0.014]. In the ST, those preloaded with alcohol made significantly more errors [P = 0.021] and were quicker to complete the task [P = 0.044] compared with those preloaded with placebo, indicating a strong alcohol effect on cognitive disinhibition. The data suggest that a moderate dose of alcohol, which induces priming to want more alcohol, had disinhibiting effects both on a basic motoric and a cognitive inhibitory task. Thus the idea that priming may be mediated by the disinhibitory effects of alcohol is supported.
Collapse
Affiliation(s)
- A K Rose
- Psychology, School of Life Sciences. University of Sussex, Falmer, Brighton, BN1 9QG, UK
| | | |
Collapse
|
88
|
Abstract
Alcoholism results from an interplay between genetic and environmental factors, and is linked to brain defects and associated cognitive, emotional, and behavioral impairments. A confluence of findings from neuroimaging, physiological, neuropathological, and neuropsychological studies of alcoholics indicate that the frontal lobes, limbic system, and cerebellum are particularly vulnerable to damage and dysfunction. An integrative approach employing a variety of neuroscientific technologies is essential for recognizing the interconnectivity of the different functional systems affected by alcoholism. In that way, relevant experimental techniques can be applied to assist in determining the degree to which abstinence and treatment contribute to the reversal of atrophy and dysfunction.
Collapse
Affiliation(s)
- Marlene Oscar-Berman
- Department of Anatomy and Neurobiology, Boston University School of Medicine, L-815, 715 Albany Street, Boston, MA 02118, USA.
| | | |
Collapse
|
89
|
Sassoon SA, Fama R, Rosenbloom MJ, O'Reilly A, Pfefferbaum A, Sullivan EV. Component cognitive and motor processes of the digit symbol test: differential deficits in alcoholism, HIV infection, and their comorbidity. Alcohol Clin Exp Res 2007; 31:1315-24. [PMID: 17550370 DOI: 10.1111/j.1530-0277.2007.00426.x] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Alcoholism (ALC) is highly prevalent in patients with human immunodeficiency virus (HIV) infection (HIV), and those with comorbidity (ALC+HIV) may suffer compounded deficits in cognitive and motor functions affected by both conditions. Given that each disease can adversely affect motor, visuospatial, and executive functions, we used an expanded version of the Digit Symbol (DS) test to assess the separate and combined effects of ALC and HIV infection on these cognitive and motor components. METHODS Participants were 44 ALC, 43 HIV, 55 ALC+HIV, and 49 normal controls (NC). We modified DS test administration to assess sustained attention (grid completion speed), associative learning (number of boxes completed in 15-second epochs), and incidental learning (total number-symbol pairs correctly recalled) and also used ancillary tests of fine motor, visuospatial, and executive functions to assess their relationship with the different components of DS performance. All scores were corrected for age and education based on NC performance. RESULTS Neither single diagnosis group-ALC nor HIV-was impaired on DS score or grid completion speed compared with the NC group, but the dual-diagnosis ALC+HIV group was impaired. Greater lifetime alcohol consumption was associated with longer grid completion time in both ALC and ALC+HIV. The HIV group demonstrated associative learning on DS but ALC+HIV and ALC did not. All groups performed similarly on incidental learning. Multiple regression analyses demonstrated that executive functions, assessed by Color Trails 2, predicted traditional DS performance in all groups. Fine Finger Movement additionally predicted traditional DS performance and grid completion speed in HIV. Visuospatial function, assessed by ability to copy the Rey-Osterrieth complex figure, did not contribute independently to DS performance in either alcohol group. CONCLUSIONS Alcoholism combined with HIV infection resulted in deficits in visuospatial psychomotor function, as assessed by the DS test, although deficits were not observed in either disease condition alone. Neither alcohol group showed associative learning, and both had compromised sustained attention. Combined cognitive and motor adverse effects of alcoholism and HIV infection were manifest in psychomotor speed, sustained attention, and associative learning of visuospatial material and are testimony to the dangers of alcohol abuse even in relatively healthy patients with HIV infection.
Collapse
|
90
|
Noël X, Van der Linden M, d'Acremont M, Bechara A, Dan B, Hanak C, Verbanck P. Alcohol cues increase cognitive impulsivity in individuals with alcoholism. Psychopharmacology (Berl) 2007; 192:291-8. [PMID: 17279375 DOI: 10.1007/s00213-006-0695-6] [Citation(s) in RCA: 129] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2006] [Accepted: 12/30/2006] [Indexed: 10/23/2022]
Abstract
BACKGROUND Individuals with alcoholism are characterized by both attentional bias for alcohol cues and prepotent response inhibition deficit. We tested the hypothesis that alcoholics exhibit greater cognitive disinhibition when the response to be suppressed is associated with alcohol-related information. METHODS Forty recently detoxified individuals with alcoholism were compared with 40 healthy non-substance abusers on the "Alcohol-Shifting Task", a variant of the go/no-go paradigm requiring a motor response to targets and no response to distracters. The aim was to test the ability of alcoholics to discriminate between alcohol-related and neutral words. Sometimes, the alcohol-related words were the targets for the "go" response, with neutral words as distracters, sometimes the reverse. Several shifts in target type occurred during the task. RESULTS Alcoholics made significantly more commission errors (i.e., press a key when a distracter displayed) and more omission errors (i.e., not press a key when a target displayed) than controls. Moreover, the number of commission errors was greater in alcoholics when alcohol-related stimuli had to be detected. CONCLUSIONS These results demonstrate that alcoholics exhibit a basic prepotent response inhibition deficit, which is enhanced when the response to be suppressed is related to alcohol. We discuss clinical and theoretical implications of these findings.
Collapse
Affiliation(s)
- Xavier Noël
- Clinic of Addictions, C.H.U Brugmann, Free University of Brussels (ULB), Salle 72, 4, place Van Gehuchten, 1020, Brussels, Belgium.
| | | | | | | | | | | | | |
Collapse
|
91
|
Thoma P, Wiebel B, Daum I. Response inhibition and cognitive flexibility in schizophrenia with and without comorbid substance use disorder. Schizophr Res 2007; 92:168-80. [PMID: 17399952 DOI: 10.1016/j.schres.2007.02.004] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2006] [Revised: 01/12/2007] [Accepted: 02/15/2007] [Indexed: 10/23/2022]
Abstract
Addiction is a frequent comorbid disorder in schizophrenia related to dopaminergic dysfunction in fronto-subcortical circuits. These brain networks are relevant for both (executive) cognition and the neuropathology of schizophrenia. The aim of the present study was to elucidate whether response inhibition and cognitive flexibility - executive abilities relevant for achieving and maintaining abstinence - are differentially impaired in schizophrenia patients with or without comorbid substance use disorder. Patients suffering from major depression or alcoholism as well as healthy controls served as comparison groups. The ability to inhibit predominant response tendencies during response conflict and to efficiently shift the focus of attention between different task requirements was assessed by verbal and non-verbal cognitive tasks. Contrary to expectation, non-addicted schizophrenia patients showed the most pronounced executive function impairments relative to the control groups, affecting both response suppression and cognitive flexibility. Dual diagnosis patients did not differ significantly from non-addicted schizophrenia patients or from the alcoholic group, but were impaired at cognitive flexibility relative to the depression subgroup and healthy controls. Whether the relative preservation of response inhibition and cognitive flexibility in the dual disorder patients is due to high premorbid functioning, beneficial self-medication effects or compensatory brain activation remains to be elucidated. The relatively intact executive abilities in young, addicted schizophrenia patients might represent a beneficial resource for treatment strategies.
Collapse
Affiliation(s)
- Patrizia Thoma
- Institute of Cognitive Neuroscience, Department of Neuropsychology, Faculty of Psychology, Ruhr-University of Bochum, 44780 Bochum, Germany.
| | | | | |
Collapse
|
92
|
Chanraud S, Martelli C, Delain F, Kostogianni N, Douaud G, Aubin HJ, Reynaud M, Martinot JL. Brain morphometry and cognitive performance in detoxified alcohol-dependents with preserved psychosocial functioning. Neuropsychopharmacology 2007; 32:429-38. [PMID: 17047671 DOI: 10.1038/sj.npp.1301219] [Citation(s) in RCA: 298] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The extent of structural brain damage and related cognitive deficits has been little described in alcohol-dependent individuals with preserved social functioning. Thus, we investigated the relationship between regional alterations, executive performance, and drinking history. Volumes of gray and white matter were assessed using magnetic resonance imaging voxel-based morphometry in healthy men and in detoxified alcohol-dependent men with good psychosocial functioning. Their executive performance was assessed using neuropsychological tests. Regression analyses were carried out in the regions in which volume differences were detected. Decreases in gray matter were detected bilaterally in alcohol-dependents in the dorsolateral frontal cortex (up to 20% lower), and to a lesser extent in the temporal cortex, insula, thalamus, and cerebellum. Decreases in white matter volume were widespread, being up to 10% in corpus callosum. The degradation of neuropsychological performance correlated with gray matter volume decreases in the frontal lobe, insula, hippocampus, thalami and cerebellum, and with white matter decrease in the brainstem. An early age at first drinking was associated with decreased gray matter volumes in the cerebellum, brainstem (pons), and frontal regions. Regional alteration in gray and white matter volume was associated with impairment of executive function despite preserved social and somatic functioning in detoxified patients. Besides involving frontal regions, these findings are consistent with a cerebello-thalamo-cortical model of impaired executive functions in alcohol-dependent individuals.
Collapse
Affiliation(s)
- Sandra Chanraud
- Inserm U.797, CEA-INSERM Research Unit Neuroimaging & Psychiatry, Institute for Health and Medical Research and Atomic Energy Commission Hospital Department Frédéric Joliot, IFR49, Univ Paris-sud, Univ Paris 5, Orsay, France
| | | | | | | | | | | | | | | |
Collapse
|
93
|
Rangaswamy M, Jones KA, Porjesz B, Chorlian DB, Padmanabhapillai A, Kamarajan C, Kuperman S, Rohrbaugh J, O'Connor SJ, Bauer LO, Schuckit MA, Begleiter H. Delta and theta oscillations as risk markers in adolescent offspring of alcoholics. Int J Psychophysiol 2007; 63:3-15. [PMID: 17129626 PMCID: PMC2020838 DOI: 10.1016/j.ijpsycho.2006.10.003] [Citation(s) in RCA: 69] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2006] [Revised: 09/28/2006] [Accepted: 10/04/2006] [Indexed: 01/07/2023]
Abstract
BACKGROUND Visual P300 is consistently lower in alcohol-dependent individuals, their offspring and subjects at risk. Delta and theta event-related oscillations (ERO) are the major contributors to the P300 signal. The total and evoked power in delta and theta bands in the 300 to 700 ms post-stimulus window (corresponding to the zone of P300 maxima) was compared between adolescent offspring of alcoholics (high-risk) and age-matched normal controls (low-risk), to assess the utility of the risk markers. METHODS EEG was recorded during the performance of a visual oddball task. The S-transform algorithm decomposed the EEG signals into different frequency bands and the group differences in total and evoked power in the oscillatory responses during the P300 time window (300 to 700 ms) were analyzed using a multivariate design. Similar analysis was performed on P300 peak amplitude for the target. RESULTS The high-risk group showed significantly lower parietal post-stimulus evoked and total power in the delta band for targets. A decrease in total power was seen centrally and parietally in the theta band. The P300 peak amplitude in the parietal electrodes was also significantly lower in the high-risk group. CONCLUSIONS The decreased total theta power and total and evoked delta power for visual targets in high risk individuals may serve as an endophenotypic marker in the development of alcoholism and other disinhibitory disorders. The differences seen between the offspring of alcoholics and controls may have a cholinergic basis. The ERO measures appear to be more robust than the P300 amplitude in differentiating the groups.
Collapse
Affiliation(s)
- Madhavi Rangaswamy
- Department of Psychiatry, State University of New York, Health Science Center at Brooklyn, NY 11203, USA.
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
94
|
Rupp CI, Fleischhacker WW, Drexler A, Hausmann A, Hinterhuber H, Kurz M. Executive function and memory in relation to olfactory deficits in alcohol-dependent patients. Alcohol Clin Exp Res 2006; 30:1355-62. [PMID: 16899038 DOI: 10.1111/j.1530-0277.2006.00162.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
BACKGROUND Prior research indicates that chronic alcoholism is accompanied by olfactory deficits. These have been suggested to reflect dysfunctions in olfactory brain regions. The present study investigated the role of neurocognitive functioning in tests (executive function and memory) sensitive to the functional integrity of brain areas that are crucial to olfactory processing in patients with alcohol dependence. METHODS Performance on olfactory functions (detection threshold, quality discrimination, identification), executive function (Wisconsin Card Sorting Test), and memory (German version of the California Verbal Learning Test) was assessed in 32 alcohol-dependent patients and 30 healthy comparison subjects, comparable in age, gender, and smoking status. RESULTS Compared with controls, alcohol-dependent patients were impaired in all 3 domains, olfactory functions, executive function, and memory. In patients, olfactory discrimination ability was positively correlated with executive function performance. Regression analyses conducted to clarify the relation between group (patients vs controls), executive function, memory, and olfactory functions indicated that group was the only significant predictor of olfactory detection threshold and identification, and both group and executive function were found to be the significant predictors of olfactory discrimination. CONCLUSIONS Olfactory deficits in alcohol dependence appear to be associated with prefrontal cognitive dysfunction. Results indicate that olfactory quality discrimination deficits are related to executive function impairment. These findings add to the available research on frontal lobe dysfunction in alcoholism, suggesting that alcohol-related olfactory discrimination deficits may be associated with impairment in the functional integrity of the prefrontal lobe.
Collapse
Affiliation(s)
- Claudia I Rupp
- Department of Psychiatry, Innsbruck Medical University, Innsbruck, Austria.
| | | | | | | | | | | |
Collapse
|
95
|
de Bruin EA, Stam CJ, Bijl S, Verbaten MN, Kenemans JL. Moderate-to-heavy alcohol intake is associated with differences in synchronization of brain activity during rest and mental rehearsal. Int J Psychophysiol 2006; 60:304-14. [PMID: 16150505 DOI: 10.1016/j.ijpsycho.2005.07.007] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2004] [Revised: 02/17/2005] [Accepted: 07/11/2005] [Indexed: 11/30/2022]
Abstract
In alcohol-dependent individuals, synchronization of brain activity is different from that in non-alcohol-dependent individuals as reflected by EEG differences at alpha and beta frequencies (8-30 Hz). These EEG differences may not only be related to long-term alcohol intake but also to genetic factors that are associated with alcohol dependence. Thus, it is not known what the pure effect of long-term alcohol intake on synchronization of brain activity is. Therefore, we investigated whether EEG synchronization differs between light (0.5-6 drinks per week), moderate (7-20 drinks per week), and heavy (21-53 drinks per week) drinkers. All participants (49 males and 47 females) were free of a personal and family history of alcohol dependence. Eyes-closed EEG was recorded at rest and during mental rehearsal of pictures. EEG synchronization was determined by computing Synchronization Likelihood for six frequency bands (0.5-4 Hz, 4-8 Hz, 8-12 Hz, 12-20 Hz, 20-30 Hz, 30-45 Hz). Both male and female heavy drinkers displayed a loss of lateralization in alpha (8-12 Hz) and slow-beta (12-20 Hz) synchronization. In addition, moderately and heavily drinking males had lower fast-beta (20-30 Hz) synchronization than lightly drinking males. It is concluded that both male and female drinkers who drink 21 alcoholic drinks per week or more have impaired synchronization of brain activity during rest and mental rehearsal at alpha and beta frequencies as compared to individuals who drink less. As individuals with a personal or family history of alcohol dependence were excluded, the confounding effects of genetic factors related to alcohol dependence on synchronization of brain activity were minimized.
Collapse
Affiliation(s)
- Eveline A de Bruin
- Utrecht Institute of Pharmaceutical Sciences, Department of Psychopharmacology, Utrecht University, The Netherlands.
| | | | | | | | | |
Collapse
|
96
|
Flatscher-Bader T, van der Brug MP, Landis N, Hwang JW, Harrison E, Wilce PA. Comparative gene expression in brain regions of human alcoholics. GENES BRAIN AND BEHAVIOR 2006; 5 Suppl 1:78-84. [PMID: 16417620 DOI: 10.1111/j.1601-183x.2006.00197.x] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The mesocorticolimbic system is the reward centre of the brain and the major target for drugs of abuse including alcohol. Neuroadaptive changes in this region are thought to underlie the process of tolerance and dependence. Recently, several research groups have searched for alcohol-responsive genes using high-throughput microarrays and well-characterized human post-mortem material. Comparison of data from these studies of cortical regions highlights the differences in experimental approach and selection of cases. However, alcohol-responsive gene sets associated with transcription, oxidative stress and energy production were common to these studies. In marked contrast, alcohol-responsive genes in the nucleus accumbens and the ventral tegmental area are primarily associated with changes in neurotransmission and signal transduction. These data support the concept that, within cortical regions, changes in gene expression are associated with alcoholism-related pathology. In the dopaminergic tract of the mesocorticolimbic system, alcohol-responsive gene sets suggest long-term neuroplastic changes in synaptic transmission.
Collapse
Affiliation(s)
- T Flatscher-Bader
- Department of Biochemistry and Molecular Biology, School of Molecular and Microbial Sciences, The University of Queensland, Queensland, Australia
| | | | | | | | | | | |
Collapse
|
97
|
Padmanabhapillai A, Porjesz B, Ranganathan M, Jones KA, Chorlian DB, Tang Y, Kamarajan C, Rangaswamy M, Stimus A, Begleiter H. Suppression of early evoked gamma band response in male alcoholics during a visual oddball task. Int J Psychophysiol 2006; 60:15-26. [PMID: 16019097 DOI: 10.1016/j.ijpsycho.2005.03.026] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2004] [Revised: 02/15/2005] [Accepted: 03/03/2005] [Indexed: 11/15/2022]
Abstract
We investigated the early evoked gamma frequency band activity in alcoholics (n=122) and normal controls (n=72) during a visual oddball task. A time-frequency representation method was applied to EEG data in order to obtain phase-locked gamma band activity (29-45 Hz) and was analyzed within a 0-150 ms time window range. Significant reduction of the gamma band response in the frontal region during target stimulus processing was observed in alcoholic compared to control subjects. In contrast, significantly higher gamma band response for the non-target stimulus was observed in alcoholics compared to controls. It is suggested that the reduction in early evoked frontal gamma band response to targets may be associated with frontal lobe dysfunction commonly observed in alcoholics. This perhaps can be characterized by a deficient top-down processing mechanism.
Collapse
Affiliation(s)
- Ajayan Padmanabhapillai
- Department of Psychiatry, Neurodynamics Laboratory, SUNY Health Science Center, Brooklyn, NY, USA
| | | | | | | | | | | | | | | | | | | |
Collapse
|
98
|
Kamarajan C, Porjesz B, Jones K, Chorlian D, Padmanabhapillai A, Rangaswamy M, Stimus A, Begleiter H. Event-related oscillations in offspring of alcoholics: neurocognitive disinhibition as a risk for alcoholism. Biol Psychiatry 2006; 59:625-34. [PMID: 16213472 PMCID: PMC3766847 DOI: 10.1016/j.biopsych.2005.08.017] [Citation(s) in RCA: 96] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2005] [Revised: 07/28/2005] [Accepted: 08/10/2005] [Indexed: 11/18/2022]
Abstract
BACKGROUND Event-related oscillations (EROs) are increasingly being used to assess neurocognitive functioning in normal and clinical populations. The current study compares different frequency activities in offspring of alcoholics (OA) and in normal control subjects (NC) to examine whether the OA group exhibits any abnormality in oscillatory activity while performing a Go/NoGo task. METHODS The S-transform algorithm was employed to decompose the electroencephalographic (EEG) signals into different time-frequency bands, and the oscillatory responses in the P300 time window (300-700 milliseconds) were statistically analyzed in both groups. RESULTS The OA group manifested significantly decreased activity in delta (1-3 Hz), theta (4-7 Hz), and alpha1 (8-9 Hz) bands during the NoGo condition, as well as reduced delta and theta activity during the Go condition. This reduction was more prominent in the NoGo than in the Go condition. CONCLUSIONS The decreased response in delta, theta, and alpha1 oscillations, especially during the NoGo condition in high-risk individuals, is perhaps suggestive of cognitive and neural disinhibition and may serve as an endophenotypic marker in the development of alcoholism and/or other disinhibitory disorders.
Collapse
Affiliation(s)
- Chella Kamarajan
- Neurodynamics Laboratory, Department of Psychiatry, SUNY Downstate Medical Center, Brooklyn, New York, U.S.A
| | - Bernice Porjesz
- Neurodynamics Laboratory, Department of Psychiatry, SUNY Downstate Medical Center, Brooklyn, New York, U.S.A
| | - Kevin Jones
- Neurodynamics Laboratory, Department of Psychiatry, SUNY Downstate Medical Center, Brooklyn, New York, U.S.A
| | - David Chorlian
- Neurodynamics Laboratory, Department of Psychiatry, SUNY Downstate Medical Center, Brooklyn, New York, U.S.A
| | - Ajayan Padmanabhapillai
- Neurodynamics Laboratory, Department of Psychiatry, SUNY Downstate Medical Center, Brooklyn, New York, U.S.A
| | - Madhavi Rangaswamy
- Neurodynamics Laboratory, Department of Psychiatry, SUNY Downstate Medical Center, Brooklyn, New York, U.S.A
| | - Arthur Stimus
- Neurodynamics Laboratory, Department of Psychiatry, SUNY Downstate Medical Center, Brooklyn, New York, U.S.A
| | - Henri Begleiter
- Neurodynamics Laboratory, Department of Psychiatry, SUNY Downstate Medical Center, Brooklyn, New York, U.S.A
| |
Collapse
|
99
|
Lamers CTJ, Bechara A, Rizzo M, Ramaekers JG. Cognitive function and mood in MDMA/THC users, THC users and non-drug using controls. J Psychopharmacol 2006; 20:302-11. [PMID: 16510488 DOI: 10.1177/0269881106059495] [Citation(s) in RCA: 65] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Repeated ecstasy (MDMA) use is reported to impair cognition and cause increased feelings of depression and anxiety. Yet, many relevant studies have failed to control for use of drugs other than MDMA, especially marijuana (THC). To address these confounding effects we compared behavioural performance of 11 MDMA/THC users, 15 THC users and 15 non-drug users matched for age and intellect. We tested the hypothesis that reported feelings of depression and anxiety and cognitive impairment (memory, executive function and decision making) are more severe in MDMA/THC users than in THC users. MDMA/THC users reported more intense feelings of depression and anxiety than THC users and non-drug users. Memory function was impaired in both groups of drug users. MDMA/THC users showed slower psychomotor speed and less mental flexibility than non-drug users. THC users exhibited less mental flexibility and performed worse on the decision making task compared to non-drug users but these functions were similar to those in MDMA/THC users. It was concluded that MDMA use is associated with increased feelings of depression and anxiety compared to THC users and non-drug users. THC users were impaired in some cognitive abilities to the same degree as MDMA/THC users, suggesting that some cognitive impairment attributed to MDMA is more likely due to concurrent THC use.
Collapse
Affiliation(s)
- C T J Lamers
- Experimental Psychopharmacology Unit, Department of Neurocognition, Brain and Behaviour Institute, Maastricht University, The Netherlands
| | | | | | | |
Collapse
|
100
|
Mackin RS, Horner MD. Relationship of the Wender Utah Rating Scale to objective measures of attention. Compr Psychiatry 2005; 46:468-71. [PMID: 16275215 DOI: 10.1016/j.comppsych.2005.03.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2004] [Accepted: 03/04/2005] [Indexed: 11/26/2022] Open
Abstract
The Wender Utah Rating Scale (WURS) is a 25-item self-report questionnaire for the retrospective assessment of childhood attention-deficit hyperactivity disorder (ADHD) symptoms; high scores indicate greater symptoms. The current study used 35 male Veterans Affairs outpatients to determine if WURS scores were associated with objective measures of current attentional functioning, including the Trail Making Test, Gordon Diagnostic System, Wechsler Adult Intelligence Scale-Revised digit span and digit symbol subtests, and Wechsler Memory Scale-Revised mental control subtest. Participants included both adults diagnosed with ADHD (n = 14) and non-ADHD adults (n = 21). After Bonferroni correction, Pearson product moment correlation coefficients revealed that greater symptoms on the WURS were associated with poorer digit symbol performance (r = -0.69, P < .05). To determine which indices best predicted WURS scores, scores on attention tests and demographic variables were entered into a stepwise multiple regression analysis. Digit symbol performance was the only significant predictor of WURS scores (R(2) = 0.59, P < .01). Thus, poor performance on a sensitive, but nonspecific, measure of attention with executive function, response speed, and visuomotor coordination components was related to greater self-report of childhood ADHD symptoms.
Collapse
Affiliation(s)
- R Scott Mackin
- Department of Psychiatry, University of California, San Francisco, 94143-0984, USA
| | | |
Collapse
|