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Watson P, Prior K, Ridley N, Monds L, Manning V, Wiers RW, Le Pelley ME. Sign-tracking to non-drug reward is related to severity of alcohol-use problems in a sample of individuals seeking treatment. Addict Behav 2024; 154:108010. [PMID: 38479081 DOI: 10.1016/j.addbeh.2024.108010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 02/28/2024] [Accepted: 03/08/2024] [Indexed: 04/14/2024]
Abstract
BACKGROUND A prominent neuroscientific theory of drug addiction is the incentive sensitization model. Individual differences in the tendency to ascribe motivational salience to cues that predict reward, and involuntary "sign-tracking" (orientation towards) such cues have been identified as potentially important in understanding vulnerability to addiction and relapse. However, to date this behaviour has not been assessed in a treatment-seeking clinical population, who typically represent those most susceptible to alcohol-related harms and episodes of relapse. This highlights a significant gap in the literature pertaining to incentive sensitization and drug dependence. METHODS Individuals accessing inpatient drug and alcohol services with alcohol as primary drug of concern were recruited to participate in a Cognitive Bias Modification (CBM) intervention. At the baseline assessment, participants completed various self-report measures (including the Alcohol Use Disorders Identification Test; AUDIT) in addition to a visual search task measuring sign-tracking to cues signalling monetary reward. At 3-month follow up, abstinence from alcohol was the primary outcome measure. All analyses and hypotheses were pre-registered. RESULTS At baseline (57 participants), AUDIT scores correlated with sign-tracking to signals of monetary reward. In a subsequent regression analysis sign-tracking, gender and self-reported alcohol craving predicted abstinence at 3-month follow up (41 participants). CONCLUSIONS Our work demonstrates that involuntary sign-tracking to cues signalling non-drug reward is associated with problematic alcohol use and return to use at 3-month follow up, in a treatment-seeking sample. Whether this automatic prioritisation of cues signalling reward is a consequence or vulnerability for problematic alcohol use remains to be investigated.
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Affiliation(s)
- Poppy Watson
- University of Technology Sydney, Australia; UNSW Sydney, Australia.
| | - Katrina Prior
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Australia
| | - Nicole Ridley
- South Eastern Sydney Local Health District Drug and Alcohol Services, Sydney, Australia
| | - Lauren Monds
- Specialty of Addiction Medicine, Faculty of Medicine and Health, University of Sydney, Australia
| | - Victoria Manning
- Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Melbourne, Australia; Turning Point, Eastern Health, Melbourne, Australia
| | - Reinout W Wiers
- Developmental Psychology, University of Amsterdam, Netherlands
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2
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Suchy Y, DesRuisseaux LA, Gereau Mora M, Brothers SL, Niermeyer MA. Conceptualization of the term "ecological validity" in neuropsychological research on executive function assessment: a systematic review and call to action. J Int Neuropsychol Soc 2024; 30:499-522. [PMID: 38251679 DOI: 10.1017/s1355617723000735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2024]
Abstract
OBJECTIVE "Ecological validity" (EV) is classically defined as test's ability to predict real-world functioning, either alone or together with test's similarity to real-world tasks. In neuropsychological literature on assessment of executive functions (EF), EV is conceptualized inconsistently, leading to misconceptions about the utility of tests. The goal of this systematic review was to examine how EV is conceptualized in studies of EF tests described as ecologically valid. METHOD MEDLINE and PsychINFO Databases were searched. PRISMA guidelines were observed. After applying inclusion and exclusion criteria, this search yielded 90 articles. Deductive content analysis was employed to determine how the term EV was used. RESULTS About 1/3 of the studies conceptualized EV as the test's ability to predict functional outcomes, 1/3 as both the ability to predict functional outcome and similarity to real-world tasks, and 1/3 were either unclear about the meaning of the term or relied on notions unrelated to classical definitions (e.g., similarity to real-world tasks alone, association with other tests, or the ability to discriminate between populations). CONCLUSIONS Conceptualizations of the term EV in literature on EF assessment vary grossly, subsuming the notions of criterion, construct, and face validity, as well as sensitivity/specificity. Such inconsistency makes it difficult to interpret clinical utility of tests that are described as ecologically valid. We call on the field to require that, at minimum, the term EV be clearly defined in all publications, or replaced with more concrete terminology (e.g., criterion validity).
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Affiliation(s)
- Yana Suchy
- Department of Psychology, University of Utah, Salt Lake City, UT, USA
| | | | | | | | - Madison A Niermeyer
- Department of Physical Medicine and Rehabilitation, University of Utah, Salt Lake City, UT, USA
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3
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Suchy Y, Gereau Mora M, Brothers SL, DesRuisseaux LA. Six elements test vs D-KEFS: what does "Ecological Validity" tell us? J Int Neuropsychol Soc 2024; 30:350-359. [PMID: 38465734 DOI: 10.1017/s1355617723000723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/12/2024]
Abstract
OBJECTIVE Extensive research shows that tests of executive functioning (EF) predict instrumental activities of daily living (IADLs) but are nevertheless often criticized for having poor ecological validity. The Modified Six Elements Test (MSET) is a pencil-and-paper test that was developed to mimic the demands of daily life, with the assumption that this would result in a more ecologically valid test. Although the MSET has been extensively validated in its ability to capture cognitive deficits in various populations, support for its ability to predict functioning in daily life is mixed. This study aimed to examine the MSET's ability to predict IADLs assessed via three different modalities relative to traditional EF measures. METHOD Participants (93 adults aged 60 - 85) completed the MSET, traditional measures of EF (Delis-Kaplan Executive Function System; D-KEFS), and self-reported and performance-based IADLs in the lab. Participants then completed three weeks of IADL tasks at home, using the Daily Assessment of Independent Living and Executive Skills (DAILIES) protocol. RESULTS The MSET predicted only IADLs completed at home, while the D-KEFS predicted IADLs across all three modalities. Further, the D-KEFS predicted home-based IADLs beyond the MSET when pitted against each other, whereas the MSET did not contribute beyond the D-KEFS. CONCLUSIONS Traditional EF tests (D-KEFS) appear to be superior to the MSET in predicting IADLs in community-dwelling older adults. The present results argue against replacing traditional measures with the MSET when addressing functional independence of generally high-functioning and cognitive healthy older adult patients.
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Affiliation(s)
- Yana Suchy
- Department of Psychology, University of Utah, Salt Lake City, UT, USA
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4
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Marquez-Arrico JE, Gonzalez-Sanchez A, Navarro JF, Penadés R, Adan A. Patients with Schizophrenia Showed Worse Cognitive Performance than Bipolar and Major Depressive Disorder in a Sample with Comorbid Substance Use Disorders. J Clin Med 2022; 11:jcm11226648. [PMID: 36431125 PMCID: PMC9698443 DOI: 10.3390/jcm11226648] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 11/04/2022] [Accepted: 11/07/2022] [Indexed: 11/11/2022] Open
Abstract
Comorbidity of substance use disorders (SUD) and severe mental illness (SMI) is highly frequent in patients, the most common diagnoses being schizophrenia (SZ), bipolar disorder (BD) and major depressive disorder (MDD). Since comorbidity has its own clinical features, and neurocognitive functioning is not always similar to psychiatric symptoms the present study explores the cognitive performance of patients with dual disorders. A neuropsychological battery of tests was used to assess 120 under treatment male patients, 40 for each group considered (SZ + SUD, BD + SUD and MDD + SUD) who were mainly polyconsumers. Significant differences (with premorbid IQ as a covariate) were found among the groups, with SZ + SUD having a worse performance in attention, verbal learning, short term memory and recognition. The consideration of a global Z score for performance evidenced an impaired neurocognitive pattern for SZ + SUD compared with BD + SUD and MDD + SUD. According to norms, all patients showed difficulties in verbal learning, short-term memory and recognition. Our research indicated that the neurocognitive functioning of dual disorder patients was influenced by the comorbid SMI, with SZ + SUD presenting major difficulties. Future studies should thoroughly explore the role of such difficulties as indicators or endophenotypes for dual schizophrenia disorders, and their usefulness for prevention and treatment.
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Affiliation(s)
- Julia E. Marquez-Arrico
- Department of Clinical Psychology and Psychobiology, School of Psychology, University of Barcelona, Passeig de la Vall d’Hebrón 171, 08035 Barcelona, Spain
- Institute of Neurosciences, University of Barcelona, 08035 Barcelona, Spain
| | - Alvaro Gonzalez-Sanchez
- Department of Clinical Psychology and Psychobiology, School of Psychology, University of Barcelona, Passeig de la Vall d’Hebrón 171, 08035 Barcelona, Spain
- Institute of Neurosciences, University of Barcelona, 08035 Barcelona, Spain
| | - José Francisco Navarro
- Department of Psychobiology, School of Psychology, University of Málaga, Campus de Teatinos s/n, 29071 Málaga, Spain
| | - Rafael Penadés
- Department of Clinical Psychology and Psychobiology, School of Psychology, University of Barcelona, Passeig de la Vall d’Hebrón 171, 08035 Barcelona, Spain
- Barcelona Clínic Schizophrenia Unit (BCSU), Hospital Clínic Barcelona, 08036 Barcelona, Spain
- Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain
- Centro de Investigación Biomédica en Red Salud Mental (CIBERSAM), 28029 Madrid, Spain
| | - Ana Adan
- Department of Clinical Psychology and Psychobiology, School of Psychology, University of Barcelona, Passeig de la Vall d’Hebrón 171, 08035 Barcelona, Spain
- Institute of Neurosciences, University of Barcelona, 08035 Barcelona, Spain
- Correspondence:
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Peräkylä J, Järventausta K, Haapaniemi P, Camprodon JA, Hartikainen KM. Threat-Modulation of Executive Functions-A Novel Biomarker of Depression? Front Psychiatry 2021; 12:670974. [PMID: 34276442 PMCID: PMC8283506 DOI: 10.3389/fpsyt.2021.670974] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 04/29/2021] [Indexed: 12/15/2022] Open
Abstract
Background: Alterations in executive functions, emotion regulation, and their interaction are common concomitants of depression. Executive dysfunction frequently lingers after treatment, has adverse effects on daily life, and predisposes to recurrence of depression. Yet, sensitive measures of executive function for reliable assessment of cognitive outcomes are still lacking in clinical practice. To better understand the impact of depression and its most effective treatment, electroconvulsive therapy (ECT), on cognition, we assessed executive functions pre- and post-ECT and whether objective measures reflecting alterations in emotion-executive function interaction correlate with depression severity or with cognitive outcome. Methods: Executive functions were assessed in 21 patients with major depressive disorder (MDD) before and after ECT using subjective measures from the Behavior Rating Inventory of Executive Function-Adult version (BRIEF-A) and objective cognitive performance measures derived from computer-based test of executive function, Executive Reaction Time (RT) Test. In addition, we created novel indices reflecting emotional modulation of cognitive performance by subtracting different performance measures in the context of neutral distractors from those in the context of threat-related distractors. We correlated these indices with Beck Depression Inventory (BDI) and BRIEF-A scores. Results: Depression was significantly alleviated, and executive functions improved post-ECT, as seen in reduced BDI scores, BRIEF-A scores, and number of errors in Executive RT Test. Pre-ECT BDI scores correlated with threat modulation of RT (tmRT) and threat modulation of working memory (tmWM). Post-ECT tmRT correlated with several Behavioral Regulation scales and tmWM with several Metacognition scales of BRIEF-A. Conclusion: While caution is warranted, results from both subjective and objective measures suggest that ECT significantly improves executive functions and emotion regulation along with alleviation of depression. Novel indices derived from threat modulation of executive function and working memory show promise as objective biomarkers of depression severity pre-ECT and cognitive outcome post-ECT with potential for guiding depression treatments.
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Affiliation(s)
- Jari Peräkylä
- Behavioral Neurology Research Unit, Tampere University Hospital, Tampere, Finland.,Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Kaija Järventausta
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.,Department of Psychiatry, Tampere University Hospital, Tampere, Finland
| | - Piia Haapaniemi
- Behavioral Neurology Research Unit, Tampere University Hospital, Tampere, Finland.,Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Joan A Camprodon
- Department of Psychiatry, Harvard Medical School, Massachusetts General Hospital, Boston, MA, United States
| | - Kaisa M Hartikainen
- Behavioral Neurology Research Unit, Tampere University Hospital, Tampere, Finland.,Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
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6
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Pihlaja M, Failla L, Peräkylä J, Hartikainen KM. Reduced Frontal Nogo-N2 With Uncompromised Response Inhibition During Transcutaneous Vagus Nerve Stimulation-More Efficient Cognitive Control? Front Hum Neurosci 2020; 14:561780. [PMID: 33132877 PMCID: PMC7573492 DOI: 10.3389/fnhum.2020.561780] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 08/24/2020] [Indexed: 12/11/2022] Open
Abstract
We have previously shown invasive vagus nerve stimulation to improve attention and working memory and alter emotion-attention interaction in patients with refractory epilepsy, suggesting that VNS might be useful in the treatment of cognitive impairment. The current research focuses on whether non-invasive, transcutaneous vagus nerve stimulation (tVNS) has similar effects to VNS. Furthermore, we aimed to assess whether tVNS has an impact on cognitive control in general or on underlying brain physiology in a task that mimics everyday life demands where multiple executive functions are engaged while encountering intervening emotional stimuli. Event-related potentials (ERP) evoked in such a task, specifically centro-parietal P3 and frontal N2 were used as biomarkers for attention allocation and cognitive control required to carry out the task. A single-blinded, sham-controlled, within-subject study on healthy subjects (n = 25) was conducted using Executive Reaction Time Test (RT-test), a Go/NoGo task engaging multiple executive functions along with intervening threat-related distractors while EEG was recorded. tVNS at the left tragus and sham stimulation at the left ear lobe was alternately delivered throughout the task. To assess the impact of tVNS on neural activity underlying attention and cognitive control, centro-parietal P3 and frontal N2 peak amplitudes were measured in Go and NoGo conditions. Task performance was assessed with RTs and different error types reflecting cognitive control in general and distinct executive functions, such as working memory and response inhibition.No significant effects due to tVNS on performance in the Executive RT-test were observed. For N2 there was a main effect of stimulator status and a significant interaction of trial type (Go, NoGo) and stimulator status. Post hoc analysis revealed that tVNS resulted in a significant reduction of frontal N2 only in the NoGo condition. No significant effects were observed for P3 nor were there any effects of emotion. Diminished NoGo-N2 potential along with unaltered task performance during tVNS suggests fewer cognitive control resources were required to successfully withhold a prepotent response. Though caution is warranted, we suggest that tVNS may lead to more efficient neural processing with fewer resources needed for successful cognitive control, providing promise for its potential use in cognitive enhancement.
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Affiliation(s)
- Mia Pihlaja
- Behavioral Neurology Research Unit, Tampere University Hospital, Tampere, Finland.,Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Laura Failla
- Behavioral Neurology Research Unit, Tampere University Hospital, Tampere, Finland.,Faculty of Biological and Environmental Sciences, University of Helsinki, Helsinki, Finland
| | - Jari Peräkylä
- Behavioral Neurology Research Unit, Tampere University Hospital, Tampere, Finland.,Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Kaisa M Hartikainen
- Behavioral Neurology Research Unit, Tampere University Hospital, Tampere, Finland.,Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
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Van Kampen AD, Cousijn J, Engel C, Rinck M, Dijkstra BAG. Attentional bias, craving and cannabis use in an inpatient sample of adolescents and young adults diagnosed with cannabis use disorder: The moderating role of cognitive control. Addict Behav 2020; 100:106126. [PMID: 31605838 DOI: 10.1016/j.addbeh.2019.106126] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Revised: 09/04/2019] [Accepted: 09/09/2019] [Indexed: 11/18/2022]
Abstract
Motivational processes like attentional bias and craving have been related to substance use. However, results are inconclusive. The present cross-sectional study was designed to replicate and extend previous research by investigating the relationships between attentional bias, craving, cognitive control and (severity of) cannabis use in a sample of inpatient adolescents and young adults (aged 18-30) diagnosed with CUD according to DSM-5. Contrary to expectations, our sample did not show attentional bias for cannabis words, neither did attentional bias correlate with craving, cognitive control or (severity of) cannabis use. In line with our hypotheses, however, increased session-induced craving was correlated to more daily cannabis use and reduced cognitive control. Furthermore, participants who displayed reduced cognitive control used more cannabis per day. A bootstrapped hierarchical regression model showed that, contrary to expectations, cognitive control did not modulate the relationships between attentional bias, craving and cannabis use. This study highlights the unique role of craving in relation to cannabis use and extends previous findings that cognitive control appears to have no moderating role regarding cannabis use disorder. Based on our results, it might well be that the underlying mechanisms of cannabis use disorder differ from those in other substance use disorders.
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Affiliation(s)
| | - J Cousijn
- ADAPT-Research Center, Department of Psychology, University of Amsterdam, the Netherlands
| | - C Engel
- Iriszorg, Nijmegen, the Netherlands
| | - M Rinck
- Radboud University, Behavioural Science Institute, Nijmegen, the Netherlands
| | - B A G Dijkstra
- Radboud University, Behavioural Science Institute, Nijmegen, the Netherlands; Nijmegen Institute for Scientist-Practitioners in Addiction (NISPA), Nijmegen, the Netherlands; Novadic-Kentron, Vugt, the Netherlands
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8
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Lima DR, Gonçalves PD, Ometto M, Malbergier A, Amaral RA, Dos Santos B, Cavallet M, Chaim-Avancini T, Serpa MH, Ferreira LRK, Duran FLDS, Zanetti MV, Nicastri S, Busatto GF, Andrade AG, Cunha PJ. The role of neurocognitive functioning, substance use variables and the DSM-5 severity scale in cocaine relapse: A prospective study. Drug Alcohol Depend 2019; 197:255-261. [PMID: 30875646 DOI: 10.1016/j.drugalcdep.2019.01.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Revised: 12/19/2018] [Accepted: 01/19/2019] [Indexed: 01/02/2023]
Abstract
BACKGROUND The severity of substance use disorder (SUD) is currently defined by the sum of DSM-5 criteria. However, little is known about the validity of this framework or the role of additional severity indicators in relapse prediction. This study aimed to investigate the relationship between DSM-5 criteria, neurocognitive functioning, substance use variables and cocaine relapse among inpatients with cocaine use disorder (CUD). METHODS 128 adults aged between 18 and 45 years were evaluated; 68 (59 males, 9 females) had CUD and 60 (52 males, 8 females) were healthy controls. For the group with CUD, the use of other substances was not an exclusion criterion. Participants were tested using a battery of neurocognitive tests. Cocaine relapse was evaluated 3 months after discharge. RESULTS Scores for attention span and working memory were worse in patients compared to controls. Earlier onset and duration of cocaine use were related to poorer inhibitory control and global executive functioning, respectively; recent use was related to worse performance in inhibitory control, attention span and working memory. More DSM-5 criteria at baseline were significantly associated with relapse. CONCLUSIONS Recent cocaine use was the most predictive variable for neurocognitive impairments, while DSM-5 criteria predicted cocaine relapse at three months post treatment. The integration of neurocognitive measures, DSM-5 criteria and cocaine use variables in CUD diagnosis could improve severity differentiation. Longitudinal studies using additional biomarkers are needed to disentangle the different roles of severity indicators in relapse prediction and to achieve more individualized and effective treatment strategies for these patients.
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Affiliation(s)
- Danielle Ruiz Lima
- Grupo Interdisciplinar de Estudos de Álcool e Drogas GREA, Instituto de Psiquiatria IPq, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, R. Dr. Ovídio Pires de Campos, 785, Cerqueira César, 01060-970, Sao Paulo, SP, Brazil; Laboratorio de Neuroimagem em Psiquiatria (LIM 21), Instituto de Psiquiatria IPq, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, R. Dr. Ovídio Pires de Campos, 785, Cerqueira César, 01060-970, Sao Paulo, SP, Brazil.
| | - Priscila Dib Gonçalves
- Grupo Interdisciplinar de Estudos de Álcool e Drogas GREA, Instituto de Psiquiatria IPq, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, R. Dr. Ovídio Pires de Campos, 785, Cerqueira César, 01060-970, Sao Paulo, SP, Brazil; Laboratorio de Neuroimagem em Psiquiatria (LIM 21), Instituto de Psiquiatria IPq, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, R. Dr. Ovídio Pires de Campos, 785, Cerqueira César, 01060-970, Sao Paulo, SP, Brazil
| | - Mariella Ometto
- Grupo Interdisciplinar de Estudos de Álcool e Drogas GREA, Instituto de Psiquiatria IPq, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, R. Dr. Ovídio Pires de Campos, 785, Cerqueira César, 01060-970, Sao Paulo, SP, Brazil; Laboratorio de Neuroimagem em Psiquiatria (LIM 21), Instituto de Psiquiatria IPq, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, R. Dr. Ovídio Pires de Campos, 785, Cerqueira César, 01060-970, Sao Paulo, SP, Brazil
| | - Andre Malbergier
- Grupo Interdisciplinar de Estudos de Álcool e Drogas GREA, Instituto de Psiquiatria IPq, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, R. Dr. Ovídio Pires de Campos, 785, Cerqueira César, 01060-970, Sao Paulo, SP, Brazil
| | - Ricardo Abrantes Amaral
- Grupo Interdisciplinar de Estudos de Álcool e Drogas GREA, Instituto de Psiquiatria IPq, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, R. Dr. Ovídio Pires de Campos, 785, Cerqueira César, 01060-970, Sao Paulo, SP, Brazil
| | - Bernardo Dos Santos
- Escola de Enfermagem, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Av. Dr. Enéas de Carvalho Aguiar, 419, Cerqueira César, 05403-000, Sao Paulo, SP, Brazil
| | - Mikael Cavallet
- Laboratorio de Neuroimagem em Psiquiatria (LIM 21), Instituto de Psiquiatria IPq, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, R. Dr. Ovídio Pires de Campos, 785, Cerqueira César, 01060-970, Sao Paulo, SP, Brazil
| | - Tiffany Chaim-Avancini
- Laboratorio de Neuroimagem em Psiquiatria (LIM 21), Instituto de Psiquiatria IPq, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, R. Dr. Ovídio Pires de Campos, 785, Cerqueira César, 01060-970, Sao Paulo, SP, Brazil
| | - Mauricio Henriques Serpa
- Laboratorio de Neuroimagem em Psiquiatria (LIM 21), Instituto de Psiquiatria IPq, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, R. Dr. Ovídio Pires de Campos, 785, Cerqueira César, 01060-970, Sao Paulo, SP, Brazil
| | - Luiz Roberto Kobuti Ferreira
- Laboratorio de Neuroimagem em Psiquiatria (LIM 21), Instituto de Psiquiatria IPq, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, R. Dr. Ovídio Pires de Campos, 785, Cerqueira César, 01060-970, Sao Paulo, SP, Brazil
| | - Fabio Luis de Souza Duran
- Laboratorio de Neuroimagem em Psiquiatria (LIM 21), Instituto de Psiquiatria IPq, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, R. Dr. Ovídio Pires de Campos, 785, Cerqueira César, 01060-970, Sao Paulo, SP, Brazil
| | - Marcus Vinicius Zanetti
- Laboratorio de Neuroimagem em Psiquiatria (LIM 21), Instituto de Psiquiatria IPq, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, R. Dr. Ovídio Pires de Campos, 785, Cerqueira César, 01060-970, Sao Paulo, SP, Brazil
| | - Sergio Nicastri
- Grupo Interdisciplinar de Estudos de Álcool e Drogas GREA, Instituto de Psiquiatria IPq, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, R. Dr. Ovídio Pires de Campos, 785, Cerqueira César, 01060-970, Sao Paulo, SP, Brazil; Laboratorio de Neuroimagem em Psiquiatria (LIM 21), Instituto de Psiquiatria IPq, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, R. Dr. Ovídio Pires de Campos, 785, Cerqueira César, 01060-970, Sao Paulo, SP, Brazil
| | - Geraldo Filho Busatto
- Laboratorio de Neuroimagem em Psiquiatria (LIM 21), Instituto de Psiquiatria IPq, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, R. Dr. Ovídio Pires de Campos, 785, Cerqueira César, 01060-970, Sao Paulo, SP, Brazil
| | - Arthur Guerra Andrade
- Grupo Interdisciplinar de Estudos de Álcool e Drogas GREA, Instituto de Psiquiatria IPq, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, R. Dr. Ovídio Pires de Campos, 785, Cerqueira César, 01060-970, Sao Paulo, SP, Brazil; Departmento de Neurociencias, Escola de Medicina do ABC, Av. Lauro Gomes, 2000, Vila Sacadura Cabral, 09060-870, Santo Andre, SP, Brazil
| | - Paulo Jannuzzi Cunha
- Grupo Interdisciplinar de Estudos de Álcool e Drogas GREA, Instituto de Psiquiatria IPq, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, R. Dr. Ovídio Pires de Campos, 785, Cerqueira César, 01060-970, Sao Paulo, SP, Brazil; Laboratorio de Neuroimagem em Psiquiatria (LIM 21), Instituto de Psiquiatria IPq, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, R. Dr. Ovídio Pires de Campos, 785, Cerqueira César, 01060-970, Sao Paulo, SP, Brazil
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Erkkilä M, Peräkylä J, Hartikainen KM. Executive Functions and Emotion-Attention Interaction in Assessment of Brain Health: Reliability of Repeated Testing With Executive RT Test and Correlation With BRIEF-A Questionnaire. Front Psychol 2018; 9:2556. [PMID: 30618977 PMCID: PMC6297677 DOI: 10.3389/fpsyg.2018.02556] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Accepted: 11/29/2018] [Indexed: 12/17/2022] Open
Abstract
Executive functions (EF) rely on intact fronto-subcortical networks. An insult, disorder or treatment compromising brain health may impair the functioning of these widespread networks and consequently disrupt EF. Changes in brain health due to treatment or disorder can be assessed by repeating an EF test at different time points, but practice effect may confound the results. In this study we examined reliability of repeated testing using a computer-based test of EF, Executive Reaction Time (RT) Test, that allows assessment of different executive functions and emotion–attention interaction. In addition, we investigated whether performance measures correlate with scores derived from a clinically validated questionnaire of executive functions, Behavior Rating Inventory of Executive Function, Adult version (BRIEF-A). Healthy subjects performed the test twice, 3–4 weeks apart. When the entire tests were compared, subjects were faster and their odds to make an error reflecting disruption of working memory was lower in the second test. When two (error analysis) or four (RT analysis) blocks out of total eight test blocks were removed from the beginning of the test, the differences disappeared. In the first test emotional distractors prolonged RTs of younger, but not older, participants. In the second test emotional distractors had no effect on RTs of either age group. RTs correlated with Global Executive Composite score of BRIEF-A. Test–retest reliability analysis showed that the Executive RT Test is reliable in repeated testing with 0.83 intraclass correlation coefficient for RTs, 0.72 for total errors and 0.68 for working memory related errors. In summary, performance speed in the Executive RT Test correlate with subjective evaluations of executive functions and is reliable in repeated assessment when enough practice is ensured before the actual test. Thus, the Executive RT test holds promise as a potential indicator of brain health reflecting level of executive functions linked with daily life demands as well as typical emotion–attention interaction or possible aberrations in it.
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Affiliation(s)
- Mikko Erkkilä
- Behavioral Neurology Research Unit, Tampere University Hospital, Tampere, Finland.,Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland
| | - Jari Peräkylä
- Behavioral Neurology Research Unit, Tampere University Hospital, Tampere, Finland.,Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland
| | - Kaisa M Hartikainen
- Behavioral Neurology Research Unit, Tampere University Hospital, Tampere, Finland.,Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland
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Development of a Contextualized Version of the Multiple Errands Test for People with Substance Dependence. J Int Neuropsychol Soc 2018; 24:347-359. [PMID: 29041993 DOI: 10.1017/s1355617717001023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
BACKGROUND Substance dependence is associated with deficits in several areas of executive functioning, such as planning and multitasking. Traditional tests of executive functioning have been criticized for their low ecological validity. Shallice and Burgess (1991) developed the Multiple Errands Test (MET), where participants are required to perform multiple tasks in a real-world setting. In this study, we aimed to adapt the MET for use in populations with substance dependence. OBJECTIVES This study aimed to: (1) examine the applicability of a contextualized version of the Multiple Errands Test, namely, the Multiple Errands Test - Contextualized Version (MET-CV); (2) study the testing context reliability and convergent validity of MET-CV scores; (3) compare the performance of people with substance dependence to a control group. METHODS Data were collected from 60 participants with substance dependence and 30 healthy controls. Both groups performed a neuropsychological assessment, which consisted of the MET-CV and traditional neuropsychological tests (Letter Number Sequencing, Zoo Map Test, Revised Strategy Application Test, Information Sampling Test, Stockings of Cambridge). RESULTS The MET-CV has adequate testing context reliability and moderate convergent validity relative to traditional planning measures. People with substance dependence (PWSD) showed significant deficits in executive function tests compared to healthy controls, most notably on the MET-CV rather than on traditional neuropsychological tests. CONCLUSIONS The MET-CV can be feasibly applied in the context of therapeutic communities treatment in PWSD. The MET-CV showed adequate reliability and validity, and detected planning deficits in PWSD. (JINS, 2018, 24, 347-359).
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11
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Resting state brain connectivity patterns before eventual relapse into cocaine abuse. Behav Brain Res 2017; 327:121-132. [DOI: 10.1016/j.bbr.2017.01.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Revised: 12/27/2016] [Accepted: 01/01/2017] [Indexed: 11/20/2022]
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12
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Alcorn JL, Pike E, Stoops WS, Lile JA, Rush CR. A pilot investigation of acute inhibitory control training in cocaine users. Drug Alcohol Depend 2017; 174:145-149. [PMID: 28329718 PMCID: PMC5400705 DOI: 10.1016/j.drugalcdep.2017.01.014] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Revised: 12/22/2016] [Accepted: 01/09/2017] [Indexed: 10/20/2022]
Abstract
BACKGROUND Disrupted response inhibition and presence of drug-cue attentional bias in cocaine-using individuals have predicted poor treatment outcomes. Inhibitory control training could help improve treatment outcomes by strengthening cognitive control. This pilot study assessed the effects of acute inhibitory control training to drug- and non-drug-related cues on response inhibition performance and cocaine-cue attentional bias in cocaine-using individuals. METHODS Participants who met criteria for a cocaine-use disorder underwent five sessions of inhibitory control training to either non-drug-related cues (i.e., rectangles) or cocaine cues (n=10/condition) in a single day. Response inhibition and attentional bias were assessed prior to and following training using the stop-signal task and visual-probe task with eye tracking, respectively. RESULTS Training condition groups did not differ on demographics, inhibitory control training performance, response inhibition, or cocaine-cue attentional bias. Response inhibition performance improved as a function of inhibitory control training in both conditions. Cocaine-cue attentional bias was observed, but did not change as a function of inhibitory control training in either condition. CONCLUSIONS Response inhibition in cocaine-using individuals was augmented by acute inhibitory control training, which may improve treatment outcomes through better behavioral inhibition. Future studies should investigate longer-term implementation of inhibitory control training, as well as combining inhibitory control training with other treatment modalities.
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Affiliation(s)
- Joseph L. Alcorn
- Department of Behavioral Science, University of Kentucky College of Medicine, 1110 Veterans Drive, Medical Behavioral Science Building Room 140, Lexington KY, 40536-0086, U.S.A
| | - Erika Pike
- Department of Behavioral Science, University of Kentucky College of Medicine, 1110 Veterans Drive, Medical Behavioral Science Building Room 140, Lexington KY, 40536-0086, U.S.A,Department of Psychology, University of Kentucky College of Arts and Sciences, 110 Kastle Hall, Lexington, KY, 40506-0044, U.S.A
| | - William S. Stoops
- Department of Behavioral Science, University of Kentucky College of Medicine, 1110 Veterans Drive, Medical Behavioral Science Building Room 140, Lexington KY, 40536-0086, U.S.A,Department of Psychology, University of Kentucky College of Arts and Sciences, 110 Kastle Hall, Lexington, KY, 40506-0044, U.S.A,Department of Psychiatry, University of Kentucky College of Medicine, 245 Fountain Court, Lexington, KY, 40509-1810, U.S.A
| | - Joshua A. Lile
- Department of Behavioral Science, University of Kentucky College of Medicine, 1110 Veterans Drive, Medical Behavioral Science Building Room 140, Lexington KY, 40536-0086, U.S.A,Department of Psychology, University of Kentucky College of Arts and Sciences, 110 Kastle Hall, Lexington, KY, 40506-0044, U.S.A,Department of Psychiatry, University of Kentucky College of Medicine, 245 Fountain Court, Lexington, KY, 40509-1810, U.S.A
| | - Craig R. Rush
- Department of Behavioral Science, University of Kentucky College of Medicine, 1110 Veterans Drive, Medical Behavioral Science Building Room 140, Lexington KY, 40536-0086, U.S.A,Department of Psychology, University of Kentucky College of Arts and Sciences, 110 Kastle Hall, Lexington, KY, 40506-0044, U.S.A,Department of Psychiatry, University of Kentucky College of Medicine, 245 Fountain Court, Lexington, KY, 40509-1810, U.S.A
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13
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Verdejo-Garcia A. Neuroclinical Assessment of Addiction Needs to Incorporate Decision-Making Measures and Ecological Validity. Biol Psychiatry 2017; 81:e53-e54. [PMID: 27776736 DOI: 10.1016/j.biopsych.2016.07.015] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Accepted: 07/20/2016] [Indexed: 11/17/2022]
Affiliation(s)
- Antonio Verdejo-Garcia
- School of Psychological Sciences and Monash Institute of Cognitive and Clinical Neurosciences, Melbourne, Australia
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Meil WM, LaPorte DJ, Mills JA, Sesti A, Collins SM, Stiver AG. Sensation seeking and executive deficits in relation to alcohol, tobacco, and marijuana use frequency among university students: Value of ecologically based measures. Addict Behav 2016; 62:135-44. [PMID: 27355485 DOI: 10.1016/j.addbeh.2016.06.014] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Revised: 05/31/2016] [Accepted: 06/10/2016] [Indexed: 01/22/2023]
Abstract
INTRODUCTION The development of substance use and addiction has been linked to impaired executive function which relies on systems that converge in the prefrontal cortex. This study examined several measures of executive function as predictors of college student alcohol, tobacco, and marijuana use frequency and abuse. METHODS College students (N=321) were administered the Delis-Kaplan Executive Function System (D-KEFS) test battery, the Sensation Seeking Scale V (SSSV), the Frontal Systems Behavioral Scale (FrSBe), the Perceived Stress Scale (PSS), the Michigan Alcohol Screening Test (MAST), the Fagerstrom Test of Nicotine Dependence (FTND). RESULTS Alcohol use frequency was predicted by sensation seeking and FrSBe Disinhibition scores, but the latter only emerged as a unique predictor for binge drinking frequency. Sex and Disinhibition, Apathy and Executive Function FrSBe subscales predicted the frequency of tobacco use. FrSBe scores uniquely predicted tobacco use among daily users. Marijuana use frequency was predicted by sensation seeking, sex, perceived stress, and FrSBe Disinhibition scores, but only sensation seeking predicted daily use after controlling for other variables. FrSBe Disinhibition scores reached levels considered to be clinically significant for frequent binge drinkers and daily marijuana users. Sensation seeking emerged as the predominate predictor of the early stages of alcohol and tobacco related problems. CONCLUSIONS These results suggest ecologically based self-report measures of frontal lobe function and sensation seeking are significant predictors of use frequency among college students and the extent of frontal dysfunction may be clinically significant among some heavy users.
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Affiliation(s)
- William M Meil
- Department of Psychology, Indiana University of Pennsylvania, Indiana, PA, United States.
| | - David J LaPorte
- Department of Psychology, Indiana University of Pennsylvania, Indiana, PA, United States
| | - John A Mills
- Department of Psychology, Indiana University of Pennsylvania, Indiana, PA, United States
| | - Ann Sesti
- Alcohol, Tobacco, and Other Drugs Program, Center for Health and Well-Being, Indiana University of Pennsylvania, Indiana, PA, United States
| | - Sunshine M Collins
- Department of Psychology, Indiana University of Pennsylvania, Indiana, PA, United States
| | - Alyssa G Stiver
- Department of Psychology, Indiana University of Pennsylvania, Indiana, PA, United States
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Inozemtseva O, Pérez-Solís L, Matute E, Juárez J. Differential Improvement of Executive Functions During Abstinence in Cocaine-Dependent Patients: A Longitudinal Study. Subst Use Misuse 2016; 51:1428-40. [PMID: 27355934 DOI: 10.1080/10826084.2016.1178293] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND In substance abusers, deficits in executive functioning (EF) are relevant to understanding the behavioral regulation of substance consumption and the failure to remain abstinent. OBJECTIVE To determine the course of EF impairment, measured with traditional and ecological instruments, after 1 and 3 months of abstinence in patients with cocaine dependence. METHODS 26 cocaine-only-dependent in-patients (cocaine-dependent group, CDG) and 24 nondependent controls (control group, CG) recruited from a typical population were assessed using several EF tests and questionnaires [Stroop, verbal and graphic fluency, Wisconsin Card-Sorting Test (WCST), Tower of London (TOL), and Behavior Rating Inventory of Executive Function-Adult Version (BRIEF-A)] after three periods of abstinence: 1 week, 1 month, and 3 months. RESULTS At 1 week (baseline), CDG underperformed CG on most EF measures (WCST categories completed; TOL-total number of moves, execution time, and rule violations; and various BRIEF-A subscales). At 1 month, CDG moderately improved its performance on several measures, meanwhile the improvement in the 12 patients who would eventually complete the 3-month abstinence proved particularly significant when compared to their baseline values. In the a posteriori comparison of the baseline values of noncompleters versus completers, scores for the former were lower on the EF tasks, but higher on the BRIEF-A. Both groups, showed significantly worse scores than CG on both instruments. CONCLUSIONS/IMPORTANCE Cocaine-dependent patients showed marked difficulties in the EF associated mainly with adaptive behavior to their environment. Cocaine-dependent patients with better EF at baseline improved significantly during abstinence and had better treatment adherence. Results suggest that executive improvement and treatment adherence in cocaine abusers in abstinence is related to intrinsic cognitive characteristics of patients.
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Affiliation(s)
- Olga Inozemtseva
- a Instituto de Neurociencias, Universidad de Guadalajara , Guadalajara , Mexico.,b Departamento de Educación , Universidad de Guadalajara , Zapopan , Mexico
| | - Lina Pérez-Solís
- a Instituto de Neurociencias, Universidad de Guadalajara , Guadalajara , Mexico
| | - Esmeralda Matute
- a Instituto de Neurociencias, Universidad de Guadalajara , Guadalajara , Mexico.,b Departamento de Educación , Universidad de Guadalajara , Zapopan , Mexico
| | - Jorge Juárez
- a Instituto de Neurociencias, Universidad de Guadalajara , Guadalajara , Mexico
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16
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[Alcohol-related neuropsychological impairments: Nature, impact and detection]. Presse Med 2016; 45:1124-1132. [PMID: 27039333 DOI: 10.1016/j.lpm.2016.01.030] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2015] [Revised: 01/15/2016] [Accepted: 01/20/2016] [Indexed: 01/13/2023] Open
Abstract
Alcohol-related neuropsychological deficits result from chronic and excessive alcohol consumption and are associated with structural and functional damage of Papez's circuit and frontocerebellar circuit. Alcohol-related cognitive deficits are heterogeneous but especially affect executive functions and memory abilities. They result in difficulties to change alcohol behavior combined with a tendency for patients to overestimate their capacity to succeed. Alcohol-related cognitive deficits could be a risk-factor for relapse since they hamper patients to benefit fully from treatment (especially when based on relapse prevention). Screening tools usable by non-psychologists are available and can be completed by an extensive neuropsychological examination conducted by a neuropsychologist when necessary. Alcohol treatment should be adjusted to take alcohol-related cognitive deficits into account, by promoting longer treatment in healthy environment for example. Improvements of alcohol treatment options, including specific neuropsychological rehabilitation, are required for patients with persistent alcohol-related cognitive deficits.
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17
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van Hemel-Ruiter ME, Wiers RW, Brook FG, de Jong PJ. Attentional bias and executive control in treatment-seeking substance-dependent adolescents: A cross-sectional and follow-up study. Drug Alcohol Depend 2016; 159:133-41. [PMID: 26747417 DOI: 10.1016/j.drugalcdep.2015.12.005] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2015] [Revised: 12/04/2015] [Accepted: 12/04/2015] [Indexed: 02/03/2023]
Abstract
BACKGROUND Research in adults shows that substance dependent individuals demonstrate attentional bias (AB) for substance-related stimuli. This study investigated the role of AB in adolescents diagnosed with alcohol, cannabis, amphetamine or GHB dependency on entering therapy and six months later, and the role of executive control (EC) as a moderator of the relationship between problem severity and AB. METHODS Seventy-eight young substance-dependent (SD) patients (mean age=19.5), and 64 healthy controls (HC; mean age=19.0) were tested. Thirty-eight SD patients took part at 6-month follow-up (FU). AB was indexed by a visual probe task, EC by the attention network task, problem severity by the short alcohol (or drug) use disorder identification test and the severity of dependence questionnaire. RESULTS SD patients demonstrated an AB for substance stimuli presented for 500 ms and 1250 ms, with the latter related to severity of dependence. There was a nonsignificant tendency indicating that EC was higher in HC than SD participants, but EC did not moderate the relationship between AB and dependency. Substance use, dependency, EC and AB remained unchanged in the 6 month FU period. CONCLUSIONS Young SD patients showed a stronger relatively early as well as maintained AB toward substance cues. A stronger maintained attention was related to higher severity of dependence. Further, there were some indications that EC might play a role in adolescent substance use. The finding that at FU AB and problem severity were not decreased, and EC was not increased underlines the persistent character of addiction.
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Affiliation(s)
- Madelon E van Hemel-Ruiter
- Department of Clinical Psychology and Experimental Psychopathology, University of Groningen, P.O. Box 72, 9700 AB Groningen, The Netherlands; Verslavingszorg Noord-Nederland, Addiction Treatment, P.O. Box 8003, 9702 KA Groningen, The Netherlands.
| | - Reinout W Wiers
- Department of Developmental Psychology, University of Amsterdam, P.O. Box 19268, 1000 GG Amsterdam, The Netherlands
| | - Frank G Brook
- Verslavingszorg Noord-Nederland, Addiction Treatment, P.O. Box 8003, 9702 KA Groningen, The Netherlands
| | - Peter J de Jong
- Department of Clinical Psychology and Experimental Psychopathology, University of Groningen, P.O. Box 72, 9700 AB Groningen, The Netherlands
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Wiers RW, Boelema SR, Nikolaou K, Gladwin TE. On the Development of Implicit and Control Processes in Relation to Substance Use in Adolescence. CURRENT ADDICTION REPORTS 2015; 2:141-155. [PMID: 25960940 PMCID: PMC4412508 DOI: 10.1007/s40429-015-0053-z] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Adolescence is a period in which brain structures involved in motivation and cognitive control continue to develop and also a period in which many youth begin substance use. Dual-process models propose that, among substance users, implicit or automatically activated neurocognitive processes gain in relative influence on substance use behavior, while the influence of cognitive control or reflective processes weakens. There is evidence that a variety of implicit cognitive processes, such as attentional bias, biased action tendencies (approach bias), memory bias and at a neural level, cue reactivity, are associated with adolescent substance use. The impact of these implicit processes on the further development of addictive behaviors appears to depend on moderating factors, such as (premorbid) executive control functions. Clear negative effects of adolescent substance use on executive control functions generally have not been found using behavioral tasks, although some studies have identified subtle and specific effects on cognitive functioning.
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Affiliation(s)
- Reinout W. Wiers
- Addiction Development and Psychopathology (ADAPT) Lab, Department of Psychology, University of Amsterdam, Weesperplein 4, 1018 XA Amsterdam, The Netherlands
| | - Sarai R. Boelema
- Department of Cultural Diversity and Youth, Utrecht University, Utrecht, The Netherlands
| | - Kiki Nikolaou
- Addiction Development and Psychopathology (ADAPT) Lab, Department of Psychology, University of Amsterdam, Weesperplein 4, 1018 XA Amsterdam, The Netherlands
| | - Thomas E. Gladwin
- Addiction Development and Psychopathology (ADAPT) Lab, Department of Psychology, University of Amsterdam, Weesperplein 4, 1018 XA Amsterdam, The Netherlands
- Research Centre-Military Mental Health, Ministry of Defense, Utrecht, The Netherlands
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LoBue C, Cullum CM, Braud J, Walker R, Winhusen T, Suderajan P, Adinoff B. Optimal neurocognitive, personality and behavioral measures for assessing impulsivity in cocaine dependence. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2014; 40:455-62. [PMID: 25083938 DOI: 10.3109/00952990.2014.939752] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Impulsivity may underlie the poor treatment retention and high relapse rates observed in cocaine-dependent persons. However, observed differences in measures of impulsivity between cocaine-dependent and healthy control participants often do not reach clinical significance, suggesting that the clinical relevance of these differences may be limited. OBJECTIVES To examine which measures of impulsivity (i.e. self-report impulsivity, self-report personality, neurocognitive testing) best distinguish cocaine-dependent and healthy control participants (i.e. showing differences at least 1.5 standard deviations [SD] from controls). Optimal measures were considered to demonstrate sufficient classification accuracy. METHODS Sixty-five recently abstinent cocaine-dependent and 25 healthy control participants were assessed using select neurocognitive tests and self-report questionnaires including the NEO Personality Inventory-Revised (NEO-PI-R), Temperament and Character Inventory (TCI), Barratt Impulsiveness Scale (BIS-11a), and the Frontal Systems Behavior Scale (FrSBe). RESULTS When corrected for years of education and gender, neurocognitive measures did not demonstrate clinically significant differences between cocaine-dependent and control participants. The personality measures TCI Purposefulness and Congruent Second Nature and NEO-PI-R Impulsiveness, and the self-rating measures FrSBe Disinhibition and BIS-11 Motor Impulsivity and Total successfully identified clinically meaningful elevations in impulsivity within cocaine-dependent participants (>1.5 SDs from controls). Furthermore, these measures achieved 84-93% accuracy in discriminating cocaine-dependent from control participants. CONCLUSION Clinically significant neurocognitive impairment in cocaine-dependent participants was not observed in this sample. As the BIS-11 or FrSBe are brief to administer, accurate, and have been shown to predict treatment retention and relapse, these measures appear to be optimal, relative to the personality measures, for examining trait impulsivity in cocaine dependence.
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Affiliation(s)
- Christian LoBue
- Department of Psychiatry, University of Texas Southwestern Medical Center , Dallas, TX
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20
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Fox H, Sinha R. The role of guanfacine as a therapeutic agent to address stress-related pathophysiology in cocaine-dependent individuals. ADVANCES IN PHARMACOLOGY (SAN DIEGO, CALIF.) 2014; 69:217-65. [PMID: 24484979 DOI: 10.1016/b978-0-12-420118-7.00006-8] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
The pathophysiology of cocaine addiction is linked to changes within neural systems and brain regions that are critical mediators of stress system sensitivity and behavioral processes associated with the regulation of adaptive goal-directed behavior. This is characterized by the upregulation of core adrenergic and corticotropin-releasing factor mechanisms that subserve negative affect and anxiety and impinge upon intracellular pathways in the prefrontal cortex underlying cognitive regulation of stress and negative emotional state. Not only are these mechanisms essential to the severity of cocaine withdrawal symptoms, and hence the trajectory of clinical outcome, but also they may be particularly pertinent to the demography of cocaine dependence. The ability of guanfacine to target overlapping stress, reward, and anxiety pathophysiology suggests that it may be a useful agent for attenuating the stress- and cue-induced craving state not only in women but also in men. This is supported by recent research findings from our own laboratory. Additionally, the ability of guanfacine to improve regulatory mechanisms that are key to exerting cognitive and emotional control over drug-seeking behavior also suggests that guanfacine may be an effective medication for reducing craving and relapse vulnerability in many drugs of abuse. As cocaine-dependent individuals are typically polydrug abusers and women may be at a greater disadvantage for compulsive drug use than men, it is plausible that medications that target catecholaminergic frontostriatal inhibitory circuits and simultaneously reduce stress system arousal may provide added benefits for attenuating cocaine dependence.
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Affiliation(s)
- Helen Fox
- Yale Stress Center, Yale University School of Medicine, New Haven Connecticut USA.
| | - Rajita Sinha
- Yale Stress Center, Yale University School of Medicine, New Haven Connecticut USA
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21
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Wiers CE, Kühn S, Javadi AH, Korucuoglu O, Wiers RW, Walter H, Gallinat J, Bermpohl F. Automatic approach bias towards smoking cues is present in smokers but not in ex-smokers. Psychopharmacology (Berl) 2013; 229:187-97. [PMID: 23604335 DOI: 10.1007/s00213-013-3098-5] [Citation(s) in RCA: 80] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2012] [Accepted: 03/27/2013] [Indexed: 10/26/2022]
Abstract
RATIONALE Drug-addicted individuals show automatic approach tendencies towards drug-related cues, i.e., an approach bias (ApB). Nevertheless, little is known about ApB in tobacco smokers and about the presence of ApB after smoking abstinence. OBJECTIVES We investigated ApB to smoking cues in heavy tobacco smokers versus never-smokers and studied its relation to smoking characteristics and craving. Second, we compared ApBs of heavy smokers with biases of abstinent heavy smokers. METHOD A group of current heavy smokers (n = 24), ex-smokers who were abstinent for at least 5 years (n = 20), and never-smokers (n = 20) took part in the experiment. An indirect smoking approach avoidance task was performed, in which participants were required to respond to pictures of smoking and neutral cues by pulling (approach) or pushing (avoid) on a joystick, according to the content-irrelevant format of the picture (landscape or portrait). Craving scores were examined using the Questionnaire of Smoking Urges. RESULTS Heavy smokers showed an ApB for smoking cues compared to ex-smokers and never-smokers, which correlated positively to craving scores. There were no group differences in ApB scores for ex-smokers and never-smokers. CONCLUSION These results suggest that ApBs for smoking cues are present in heavy smokers and decrease after long-term successful smoking cessation.
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Affiliation(s)
- Corinde E Wiers
- Department of Psychiatry and Psychotherapy, Charité-Universitätsmedizin Berlin, Berlin, Germany.
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Everitt BJ, Robbins TW. From the ventral to the dorsal striatum: devolving views of their roles in drug addiction. Neurosci Biobehav Rev 2013; 37:1946-54. [PMID: 23438892 DOI: 10.1016/j.neubiorev.2013.02.010] [Citation(s) in RCA: 455] [Impact Index Per Article: 41.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2012] [Revised: 01/30/2013] [Accepted: 02/12/2013] [Indexed: 12/15/2022]
Abstract
We revisit our hypothesis that drug addiction can be viewed as the endpoint of a series of transitions from initial voluntarily drug use to habitual, and ultimately compulsive drug use. We especially focus on the transitions in striatal control over drug seeking behaviour that underlie these transitions since functional heterogeneity of the striatum was a key area of Ann Kelley's research interests and one in which she made enormous contributions. We also discuss the hypothesis in light of recent data that the emergence of a compulsive drug seeking habit both reflects a shift to dorsal striatal control over behaviour and impaired prefontal cortical inhibitory control mechanisms. We further discuss aspects of the vulnerability to compulsive drug use and in particular the impact of impulsivity. In writing this review we acknowledge the untimely death of an outstanding scientist and a dear personal friend.
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Affiliation(s)
- Barry J Everitt
- Department of Psychology and Behavioural and Clinical Neuroscience Institute, University of Cambridge, UK.
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Parkitna JR, Sikora M, Gołda S, Gołembiowska K, Bystrowska B, Engblom D, Bilbao A, Przewlocki R. Novelty-seeking behaviors and the escalation of alcohol drinking after abstinence in mice are controlled by metabotropic glutamate receptor 5 on neurons expressing dopamine d1 receptors. Biol Psychiatry 2013; 73:263-70. [PMID: 22902169 DOI: 10.1016/j.biopsych.2012.07.019] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2012] [Revised: 06/15/2012] [Accepted: 07/05/2012] [Indexed: 12/28/2022]
Abstract
BACKGROUND Novel experiences activate the brain's reward system in a manner similar to drugs of abuse, and high levels of novelty-seeking and sensation-seeking behavior have been associated with increased susceptibility to alcohol and drug abuse. Here, we show that metabotropic glutamate receptor 5 (mGluR5) signaling on dopaminoceptive neurons is necessary for both novelty-seeking behavior and the abstinence-induced escalation of alcohol drinking. METHODS Mice harboring a transgene expressing microRNA hairpins against mGluR5 messenger RNA under the control of the D1 dopamine receptor gene promoter (mGluR5(KD-D1)) were tested in a battery of behavioral tests measuring learning abilities, anxiety levels, reactions to novelty, operant sensation seeking, and alcohol sensitivity. In addition, we have developed a method to assess long-term patterns of alcohol drinking in mice housed in groups using the IntelliCage system. RESULTS mGluR5(KD-D1) mice showed no behavioral deficits and exhibited normal anxiety-like behaviors and learning abilities. However, mGluR5(KD-D1) animals showed reduced locomotor activity when placed in a novel environment, and exhibited decreased interaction with a novel object. Moreover, unlike control animals, mutant mice did not perform instrumental responses under the operant sensation-seeking paradigm, although they learned to respond for food normally. When mGluR5(KD-D1) mice were provided access to alcohol, they showed similar patterns of consumption as wild-type animals. However, mutant mice did not escalate their alcohol consumption after a period of forced abstinence, but control mice almost doubled their intake. CONCLUSIONS These data identify mGluR5 receptors on D1-expressing neurons as a common molecular substrate of novelty-seeking behaviors and behaviors associated with alcohol abuse.
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Affiliation(s)
- Jan Rodriguez Parkitna
- Department of Molecular Neuropharmacology, Institute of Pharmacology of the Polish Academy of Sciences, Krakow, Poland
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Increased vulnerability to cocaine in mice lacking dopamine D3 receptors. Proc Natl Acad Sci U S A 2012; 109:17675-80. [PMID: 23045656 DOI: 10.1073/pnas.1205297109] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Neuroimaging studies using positron emission tomography suggest that reduced dopamine D(2) receptor availability in the neostriatum is associated with increased vulnerability to drug addiction in humans and experimental animals. The role of D(3) receptors (D(3)Rs) in the neurobiology of addiction remains unclear, however. Here we report that D(3)R KO (D(3)(-/-)) mice display enhanced cocaine self-administration and enhanced motivation for cocaine-taking and cocaine-seeking behavior. This increased vulnerability to cocaine is accompanied by decreased dopamine response to cocaine secondary to increased basal levels of extracellular dopamine in the nucleus accumbens, suggesting a compensatory response to decreased cocaine reward in D(3)(-/-) mice. In addition, D(3)(-/-) mice also display up-regulation of dopamine transporters in the striatum, suggesting a neuroadaptative attempt to normalize elevated basal extracellular dopamine. These findings suggest that D(3)R deletion increases vulnerability to cocaine, and that reduced D(3)R availability in the brain may constitute a risk factor for the development of cocaine addiction.
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Persistence of the effects of attention and executive functions intensive rehabilitation in relapsing remitting multiple sclerosis. Mult Scler Relat Disord 2012; 1:168-73. [PMID: 25877265 DOI: 10.1016/j.msard.2012.06.004] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2011] [Revised: 02/24/2012] [Accepted: 06/24/2012] [Indexed: 11/24/2022]
Abstract
BACKGROUND Neuropsychological rehabilitation efficacy in multiple sclerosis (MS) is a currently investigated issue. We reported, in a single blind controlled study, that an intensive short duration cognitive training of attention and executive functions significantly improves the treated functions and reduces depression in MS. The persistence of these effects over time are unknown. OBJECTIVE To evaluate the persistence over time of neuropsychological improvement due to cognitive training nine months after rehabilitation onset. METHODS This is a single blind randomized controlled study. 24 MS patients were randomly assigned to experimental group (n=13) and received PC assisted neuropsychological treatment for three months, or to control group (n=11), receiving no treatment. Patients were submitted to neuropsychological evaluation, depression and quality of life questionnaires at baseline, three months and nine months later. RESULTS Nine months follow up compared to baseline evaluation shows a statistically significant improvement (p<0.05) in attention, information processing and executive functions tests (PASAT 3″, COWA/S, WCSTpe), in depression and quality of life questionnaires in rehabilitated patients only. reliable change index (RCI) and modified RCI confirmed the clinical significance of this improvement in rehabilitated patients. CONCLUSIONS Three months intensive neuropsychological rehabilitation of attention, information processing and executive functions induces a long lasting and clinically relevant neuropsychological improvement over time and a persistent depression and quality of life amelioration in patients with RR MS.
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Verdejo-García A, Betanzos-Espinosa P, Lozano OM, Vergara-Moragues E, González-Saiz F, Fernández-Calderón F, Bilbao-Acedos I, Pérez-García M. Self-regulation and treatment retention in cocaine dependent individuals: a longitudinal study. Drug Alcohol Depend 2012; 122:142-8. [PMID: 22018602 DOI: 10.1016/j.drugalcdep.2011.09.025] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2011] [Revised: 09/27/2011] [Accepted: 09/27/2011] [Indexed: 02/03/2023]
Abstract
BACKGROUND We aimed to explore the association between baseline executive functioning and treatment outcome in Therapeutic Communities (TCs). METHODS We used a longitudinal descriptive design: a baseline neuropsychological assessment was performed within the first 30 days of treatment in TCs. Once participants finished or abandoned treatment, the information about time of stay in treatment was computed for each individual. The study was conducted across six TCs located in the region of Andalusia (Spain): Cartaya, Almonte, Mijas, Los Palacios, La Línea, and Tarifa. Participants were 131 patients with cocaine dependence who initiated and finished treatment in TCs between January 2009 and December 2010 (2 years). Cognitive assessment was composed of general measures of executive functioning: Letter Number Sequencing (working memory) and Similarities (reasoning), and executive tasks sensitive to ventromedial prefrontal cortex dysfunction, including the Delis-Kaplan Stroop test (inhibition/cognitive switching), the Revised-Strategy Application Test (strategy application/multitasking), and the Iowa Gambling Task (decision-making). The outcome measure was retention, defined as time in TC treatment (number of days). RESULTS Poor executive functioning significantly predicted shorter treatment retention in cocaine dependent individuals on TC residential treatment (14% of explained variance). Reduced performance on the R-SAT, a multitasking test taxing the ability to develop and apply the best strategy to organize multiple sub-routine tasks in order to achieve a long-term goal, was the most powerful predictor of treatment retention. CONCLUSIONS Self-regulation deficits predict the capacity to remain in residential treatment among cocaine dependents.
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Affiliation(s)
- A Verdejo-García
- Department of Clinical Psychology, Universidad de Granada, Spain.
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Alfonso JP, Caracuel A, Delgado-Pastor LC, Verdejo-García A. Combined Goal Management Training and Mindfulness meditation improve executive functions and decision-making performance in abstinent polysubstance abusers. Drug Alcohol Depend 2011; 117:78-81. [PMID: 21277705 DOI: 10.1016/j.drugalcdep.2010.12.025] [Citation(s) in RCA: 139] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2010] [Revised: 12/28/2010] [Accepted: 12/28/2010] [Indexed: 11/15/2022]
Abstract
The clinical relevance of neuropsychological deficits in addicted individuals has fostered interest in treatment strategies aimed to effectively target executive and decision-making dysfunction. One of the best-validated interventions for executive dysfunction is Goal Management Training (GMT) (Robertson et al., 2005), an interactive program aimed at improving participants' organization and ability to achieve goals. Mindfulness-based meditation can complement GMT training in order to improve attentional scanning and "reading" of emotional signals involved in adaptive decision-making. In this pilot study we investigated the efficacy of a 7-week program including GMT+Mindfulness (GMT+MF), as compared to standard treatment alone (STx), for reducing executive and decision-making deficits in an outpatient sample of alcohol and polysubstance abusers. Eighteen participants were enrolled in the GMT+MF group, whereas 16 participants formed the STx group; both groups were matched for relevant demographic and clinical variables, and pre-treatment degree of executive dysfunction. Results showed that the individuals enrolled in GMT+MF significantly improved their performance on neuropsychological measures of working memory (Letter Number Sequencing), response inhibition (Stroop) and decision-making (Iowa Gambling Task) after the treatment; whereas individuals enrolled in STx alone failed to show significant changes. These preliminary results indicate that the GMT+MF intervention may be effective in reducing executive and decision-making deficits in polysubstance abusers, and they support future randomized controlled studies aimed at examining the extent to which these improvements may generalize to every day functioning and may affect the capacity of addicted individuals to achieve and maintain abstinence.
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Affiliation(s)
- José P Alfonso
- Departamento de Psicología de la Salud, Universidad Miguel Hernández (Elche), 03202, Elche, Alicante, Spain
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Payne JM, Hyman SL, Shores EA, North KN. Assessment of executive function and attention in children with neurofibromatosis type 1: Relationships between cognitive measures and real-world behavior. Child Neuropsychol 2011; 17:313-29. [PMID: 21347908 DOI: 10.1080/09297049.2010.542746] [Citation(s) in RCA: 103] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Nesic J, Rusted J, Duka T, Jackson A. Degree of dependence influences the effect of smoking on cognitive flexibility. Pharmacol Biochem Behav 2011; 98:376-84. [PMID: 21281663 PMCID: PMC3078331 DOI: 10.1016/j.pbb.2011.01.015] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2009] [Revised: 01/14/2011] [Accepted: 01/23/2011] [Indexed: 11/30/2022]
Abstract
Pre-frontal cortical (PFC) dysfunction has been put forward as the basis for development and maintenance of addiction. To explore this relationship, the present study investigated the effects of smoking on PFC-mediated cognitive flexibility and subjective states in low- (LD) and high-dependent (HD) smokers. Twenty-four LD and 24 HD smokers (Fagerström dependence scores ≤ 4 and ≥ 5, respectively) were randomly allocated to non-smoking or smoking condition (12 LD and 12 HD participants per condition). After abstaining from smoking for a minimum of two hours volunteers completed a battery of questionnaires [nicotine-specific Visual Analogue Scales (Nic-VAS), Questionnaire of Smoking Urges (QSU) and Profile of Mood States (POMS)] at baseline [T1] and again after smoking one cigarette or remaining abstinent [T2]. Cognitive flexibility was evaluated at T2 using the Intra-Extra Dimensional Set-Shift test. The Rapid Visual Information Processing test was performed as a control nicotine-sensitive task at several time points during the experiment. Compared to LD smokers, HD smokers had higher salivary cotinine and breath CO levels at baseline and reported more craving (QSU) and felt less stimulated (Nic-VAS), vigorous, friendly and elated (POMS) throughout the experiment. Smoking increased Nic-VAS ratings of 'Buzzed' and 'Dizzy' and decreased craving in all participants. Smoking selectively impaired cognitive flexibility in HD smokers since HD smokers allocated to the smoking condition made significantly more errors with the intra-dimensional set-shift than their counterparts in the abstinent condition. No effect of smoking on RVIP test was observed, most likely due to the practice effect which was significant in both groups of smokers. The practice effect, however, was more pronounced in LD smokers. This study demonstrates that PFC-mediated cognitive effects of smoking as well as subjective reports vary according to the degree of nicotine dependence.
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Affiliation(s)
- J. Nesic
- Department of Pharmacology and Therapeutics, School of Pharmacy and Biomolecular Sciences, University of Brighton, Moulsecoomb, Brighton BN2 4GJ, UK
| | - J. Rusted
- School of Psychology, University of Sussex, Falmer, Brighton BN1 9QG, UK
| | - T. Duka
- School of Psychology, University of Sussex, Falmer, Brighton BN1 9QG, UK
| | - A. Jackson
- Department of Pharmacology and Therapeutics, School of Pharmacy and Biomolecular Sciences, University of Brighton, Moulsecoomb, Brighton BN2 4GJ, UK
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Neurobiological substrate of smoking-related attentional bias. Neuroimage 2011; 54:2374-81. [DOI: 10.1016/j.neuroimage.2010.09.064] [Citation(s) in RCA: 87] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2010] [Revised: 09/22/2010] [Accepted: 09/23/2010] [Indexed: 11/20/2022] Open
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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]
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Hoffman R, Al'Absi M. Khat use and neurobehavioral functions: suggestions for future studies. JOURNAL OF ETHNOPHARMACOLOGY 2010; 132:554-563. [PMID: 20553832 PMCID: PMC2976806 DOI: 10.1016/j.jep.2010.05.033] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2009] [Revised: 03/05/2010] [Accepted: 05/16/2010] [Indexed: 05/29/2023]
Abstract
Although there is a rich body of research available regarding the effect of acute and chronic khat dosing in animal models, research on the behavioral and cognitive effects of khat in human subjects is not extensive and several of the available studies have been done only in the context of observational and single-case studies. In light of the absence of a substantial literature on the neurobehavioral deficits associated with khat use and to provide a context that could be used to identify themes for future research we review previous research that has focused on other stimulant drugs. This review highlights multiple areas of neurocognitive deficit that have been identified in previous studies of individuals who have been chronic users of stimulants, such as amphetamines and methamphetamines. The review highlights a substantial body of evidence demonstrating a wide range of learning and memory impairments including deficits that persist during abstinence from active drug use. This review does not imply a similar khat effect, but due to some similarities pharmacologically between the active components of khat (cathinone and cathine) and amphetamines, future studies examining these same domains of cognitive functioning in chronic khat users and abstinent khat users appears to be warranted, if possible using some of the same or similar laboratory measures.
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Affiliation(s)
- Richard Hoffman
- Department of Behavioral Sciences, University of Minnesota Medical School Duluth, 1035 University Avenue, Duluth, MN 55812-3031, USA.
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Cunha PJ, Bechara A, de Andrade AG, Nicastri S. Decision-making deficits linked to real-life social dysfunction in crack cocaine-dependent individuals. Am J Addict 2010; 20:78-86. [PMID: 21175924 DOI: 10.1111/j.1521-0391.2010.00097.x] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Crack cocaine-dependent individuals (CCDI) present abnormalities in both social adjustment and decision making, but few studies have examined this association. This study investigated cognitive and social performance of 30 subjects (CCDI × controls); CCDI were abstinent for 2 weeks. We used the Social Adjustment Scale (SAS), Wisconsin Card Sorting Test (WCST), and Iowa Gambling Task (IGT). Disadvantageous choices on the IGT were associated with higher levels of social dysfunction in CCDI, suggesting the ecological validity of the IGT. Social dysfunction and decision making may be linked to the same underlying prefrontal dysfunction, but the nature of this association should be further investigated.
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Affiliation(s)
- Paulo Jannuzzi Cunha
- Interdisciplinary Group of Studies on Alcohol and Drugs, Institute and Department of Psychiatry, University of São Paulo College of Medicine, São Paulo, Brazil.
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Henry BL, Minassian A, Perry W. Effect of methamphetamine dependence on everyday functional ability. Addict Behav 2010; 35:593-8. [PMID: 20167435 DOI: 10.1016/j.addbeh.2010.01.013] [Citation(s) in RCA: 67] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2009] [Revised: 01/11/2010] [Accepted: 01/28/2010] [Indexed: 11/26/2022]
Abstract
BACKGROUND Methamphetamine (METH) is an increasingly popular and highly addictive psychostimulant with a significant impact on public health. Chronic METH exposure has been associated with neurotoxic effects, profound neuropsychological deficits, and impaired quality of life, but few studies have examined the effect of the drug on the ability to carry out everyday activities. We assessed the effect of METH dependence on everyday functioning using the UCSD Performance-Based Skills Assessment (UPSA-2), a performance-based measure designed to evaluate real-life skills. METHOD UPSA-2 performance was quantified in 15 currently abstinent individuals with a history of METH dependence and 15 drug-free comparison subjects. The Positive and Negative Syndrome Scale (PANSS) and Wisconsin Card Sorting Task (WCST) were administered to assess psychopathology and executive function. RESULTS METH-dependent participants exhibited significant impairment on the UPSA-2 total score and several UPSA-2 subscales, including comprehension, finance, transportation, communication, and medication management compared to drug-free comparison subjects. Lower UPSA-2 scores were associated with impaired performance on the WCST, higher PANSS scores, and drug use at an earlier age. CONCLUSION METH dependence may be associated with decreased everyday functioning ability potentially mediated by frontal cortex dysfunction or the emergence of psychopathology related to chronic drug use.
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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]
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White SJ, Burgess PW, Hill EL. Impairments on "open-ended" executive function tests in autism. Autism Res 2009; 2:138-47. [PMID: 19536839 DOI: 10.1002/aur.78] [Citation(s) in RCA: 70] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The executive function (EF) theory of autism has received much support recently from a growing number of studies. However, executive impairments have not always been easy to identify consistently and so novel "ecologically valid" tests have been designed which tap into real-life scenarios that are relevant to and representative of everyday behavior. One characteristic of many of these tasks is that they present the participant with an "ill-structured" or "open-ended" situation. Here, we investigated the possibility that tasks with greater degrees of open-endedness might prove more sensitive to detecting executive impairment in autism. Forty-five children with autism spectrum disorder (ASD) were compared to 27 age- and IQ-matched control children on a range of cognitive tests of EF. Group differences were found on half of the tasks, with the greatest degree of impairment detected on the more open-ended tasks. The ASD group also performed more poorly on a simple control condition of a task. Detailed consideration of task performance suggested that the ASD group tended to create fewer spontaneous strategies and exhibit more idiosyncratic behavior, which particularly disadvantaged them on the more open-ended tasks. These kinds of behaviors have been reported in studies of neurological patients with frontal lobe involvement, prima facie suggesting a link between the scientific fields. However, we suggest that this behavior might equally result from a poor understanding of the implicit demands made by the experimenter in open-ended test situations, due to the socio-communicative difficulties of these children.
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Affiliation(s)
- Sarah J White
- Institute of Cognitive Neuroscience, University College London, UK.
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van der Plas EAA, Crone EA, van den Wildenberg WPM, Tranel D, Bechara A. Executive control deficits in substance-dependent individuals: a comparison of alcohol, cocaine, and methamphetamine and of men and women. J Clin Exp Neuropsychol 2009; 31:706-19. [PMID: 19037812 PMCID: PMC2829119 DOI: 10.1080/13803390802484797] [Citation(s) in RCA: 135] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Substance dependence is associated with executive function deficits, but the nature of these executive defects and the effect that different drugs and sex have on these defects have not been fully clarified. Therefore, we compared the performance of alcohol- (n = 33; 18 women), cocaine- (n = 27; 14 women), and methamphetamine-dependent individuals (n = 38; 25 women) with sex-matched healthy comparisons (n = 36; 17 women) on complex decision making as measured with the Iowa Gambling Task, working memory, cognitive flexibility, and response inhibition. Cocaine- and methamphetamine-dependent individuals were impaired on complex decision making, working memory, and cognitive flexibility, but not on response inhibition. The deficits in working memory and cognitive flexibility were milder than the decision-making deficits and did not change as a function of memory load or task switching. Interestingly, decision making was significantly more impaired in women addicted to cocaine or methamphetamine than in men addicted to these drugs. Together, these findings suggest that drug of choice and sex have different effects on executive functioning, which, if replicated, may help tailor intervention.
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Behavioral Assessment of the Dysexecutive Syndrome Battery (BADS) in Schizophrenia. Cogn Behav Neurol 2009; 22:95-100. [DOI: 10.1097/wnn.0b013e318192cd08] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Everitt BJ, Belin D, Economidou D, Pelloux Y, Dalley JW, Robbins TW. Review. Neural mechanisms underlying the vulnerability to develop compulsive drug-seeking habits and addiction. Philos Trans R Soc Lond B Biol Sci 2008; 363:3125-35. [PMID: 18640910 PMCID: PMC2607322 DOI: 10.1098/rstb.2008.0089] [Citation(s) in RCA: 629] [Impact Index Per Article: 39.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
We hypothesize that drug addiction can be viewed as the endpoint of a series of transitions from initial voluntary drug use through the loss of control over this behaviour, such that it becomes habitual and ultimately compulsive. We describe evidence that the switch from controlled to compulsive drug seeking represents a transition at the neural level from prefrontal cortical to striatal control over drug-seeking and drug-taking behaviours as well as a progression from ventral to more dorsal domains of the striatum, mediated by its serially interconnecting dopaminergic circuitry. These neural transitions depend upon the neuroplasticity induced by chronic self-administration of drugs in both cortical and striatal structures, including long-lasting changes that are the consequence of toxic drug effects. We further summarize evidence showing that impulsivity, a spontaneously occurring behavioural tendency in outbred rats that is associated with low dopamine D2/3 receptors in the nucleus accumbens, predicts both the propensity to escalate cocaine intake and the switch to compulsive drug seeking and addiction.
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Affiliation(s)
- Barry J Everitt
- Department of Experimental Psychology, Behavioural and Clinical Neuroscience Institute, University of Cambridge, Downing Street, Cambridge, UK.
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Verdejo-García A, Bechara A. A somatic marker theory of addiction. Neuropharmacology 2008; 56 Suppl 1:48-62. [PMID: 18722390 DOI: 10.1016/j.neuropharm.2008.07.035] [Citation(s) in RCA: 217] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2008] [Revised: 07/19/2008] [Accepted: 07/28/2008] [Indexed: 12/12/2022]
Abstract
Similar to patients with ventromedial prefrontal cortex (VMPC) lesions, substance abusers show altered decision-making, characterized by a tendency to choose the immediate reward, at the expense of negative future consequences. The somatic marker model proposes that decision-making depends on neural substrates that regulate homeostasis, emotion and feeling. According to this model, there should be a link between alterations in processing emotions in substance abusers, and their impairments in decision-making. Growing evidence from neuroscientific studies indicate that core aspects of addiction may be explained in terms of abnormal emotional/homeostatic guidance of decision-making. Behavioral studies have revealed emotional processing and decision-making deficits in substance abusers. Neuroimaging studies have shown that altered decision-making in addiction is associated with abnormal functioning of a distributed neural network critical for the processing of emotional information, and the experience of "craving", including the VMPC, the amygdala, the striatum, the anterior cingulate cortex, and the insular/somato-sensory cortices, as well as non-specific neurotransmitter systems that modulate activities of neural processes involved in decision-making. The aim of this paper is to review this growing evidence, and to examine the extent to which these studies support a somatic marker theory of addiction. We conclude that there are at least two underlying types of dysfunction where emotional signals (somatic markers) turn in favor of immediate outcomes in addiction: (1) a hyperactivity in the amygdala or impulsive system, which exaggerates the rewarding impact of available incentives, and (2) hypoactivity in the prefrontal cortex or reflective system, which forecasts the long-term consequences of a given action.
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Affiliation(s)
- Antonio Verdejo-García
- Department of Clinical Psychology & Institute of Neuroscience, Universidad de Granada, Spain
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Ersche KD, Sahakian BJ. The neuropsychology of amphetamine and opiate dependence: implications for treatment. Neuropsychol Rev 2007; 17:317-36. [PMID: 17690986 PMCID: PMC3639428 DOI: 10.1007/s11065-007-9033-y] [Citation(s) in RCA: 81] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2007] [Accepted: 06/22/2007] [Indexed: 01/08/2023]
Abstract
Chronic use of amphetamines and/or opiates has been associated with a wide range of cognitive deficits, involving domains of attention, inhibitory control, planning, decision-making, learning and memory. Although both amphetamine and opiate users show marked impairment in various aspects of cognitive function, the impairment profile is distinctly different according to the substance of abuse. In light of evidence showing that cognitive impairment in drug users has a negative impact on treatment engagement and efficacy, we review substance-specific deficits on executive and memory function, and discuss possibilities to address these during treatment intervention.
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Affiliation(s)
- Karen D Ersche
- School of Clinical Medicine, Department of Psychiatry, University of Cambridge, Brain Mapping Unit, Box 255, Addenbrooke's Hospital, Cambridge, UK.
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