1
|
Hendricks ML, Emsley RA, Nel DG, Thornton HB, Jordaan GP. Cognitive changes in alcohol-induced psychotic disorder. BMC Res Notes 2017; 10:166. [PMID: 28446210 PMCID: PMC5406896 DOI: 10.1186/s13104-017-2485-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Accepted: 04/18/2017] [Indexed: 11/10/2022] Open
Abstract
AIMS This study aimed to explore the neuro-cognitive deficits of alcohol-induced psychotic disorder as compared to the cognitive deficits of uncomplicated alcohol dependence. METHODS Participants were recruited from the acute psychiatric admission wards of the Department of Psychiatry, University of Stellenbosch and Stikland and Tygerberg Academic Hospitals in the Western-Cape, South Africa. Participants who met DSM IV TR criteria (American Psychiatric Association. Diagnostic and statistical manual of mental disorders. American Psychiatric Association, Washington, DC, 2000) for Alcohol Dependence and for alcohol-induced psychotic disorder, respectively, were included. Participants who met criteria for another current DSM IV TR Axis I disorder were excluded. A structured interview was done prior to neuropsychological assessment to ascertain current mental state and to obtain relevant demographic detail and history. Neuropsychological assessments were performed and supervised by clinical psychologists at either Tygerberg or Stikland Hospital. RESULTS The groups were matched demographically with similar period of abstinence prior to assessment. The alcohol-induced psychotic disorder group experienced first psychotic symptoms at age 35. The results reflected statistically significant differences on tasks measuring immediate memory; recall upon delay; exaggeration of memory difficulty and abstract thinking. CONCLUSION This study concurs with earlier literature that some cognitive deficits are greater in alcohol-induced psychotic disorder compared to uncomplicated alcohol dependence.
Collapse
Affiliation(s)
- Melany L. Hendricks
- Department of Psychiatry, Health Sciences Faculty, Stellenbosch University, P.O Box 241, Cape Town, 8000 South Africa
| | - R. A. Emsley
- Department of Psychiatry, Health Sciences Faculty, Stellenbosch University, P.O Box 241, Cape Town, 8000 South Africa
| | - D. G. Nel
- Centre for Statistical Consultation, Health Sciences Faculty, Stellenbosch University, Cape Town, South Africa
| | - H. B. Thornton
- Department of Psychiatry, Health Sciences Faculty, Stellenbosch University, P.O Box 241, Cape Town, 8000 South Africa
| | - G. P. Jordaan
- Department of Psychiatry, Health Sciences Faculty, Stellenbosch University, P.O Box 241, Cape Town, 8000 South Africa
| |
Collapse
|
2
|
Maurage P, de Timary P, Billieux J, Collignon M, Heeren A. Attentional alterations in alcohol dependence are underpinned by specific executive control deficits. Alcohol Clin Exp Res 2014; 38:2105-12. [PMID: 24844400 DOI: 10.1111/acer.12444] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2013] [Accepted: 04/02/2014] [Indexed: 11/30/2022]
Abstract
BACKGROUND Attentional biases and deficits play a central role in the development and maintenance of alcohol dependence, but the underlying attentional processes accounting for these deficits have been very little explored. Importantly, the differential alterations across the 3 attentional networks (alerting, orienting, and executive control) remain unclear in this pathology. METHODS Thirty recently detoxified alcohol-dependent individuals and 30 paired controls completed the Attention Network Test, which allow exploring the attentional alterations specifically related to the 3 attentional networks. RESULTS Alcohol-dependent individuals presented globally delayed reaction times compared to controls. More centrally, they showed a differential deficit across attention networks, with a preserved performance for alerting and orienting networks but impaired executive control (p < 0.001). This deficit was not related to psychopathological comorbidities but was positively correlated with the duration of alcohol-dependence habits, the number of previous detoxification treatments and the mean alcohol consumption before detoxification. CONCLUSIONS These results suggest that attentional alterations in alcohol dependence are centrally due to a specific alteration of executive control. Intervention programs focusing on executive components of attention should be promoted, and these results support the frontal lobe hypothesis.
Collapse
Affiliation(s)
- Pierre Maurage
- Laboratory for Experimental Psychopathology, Psychological Sciences Research Institute, Université Catholique de Louvain, Louvain-la-Neuve, Belgium
| | | | | | | | | |
Collapse
|
3
|
Likhitsathian S, Saengcharnchai P, Uttawichai K, Yingwiwattanapong J, Wittayanookulluk A, Srisurapanont M. Cognitive changes in topiramate-treated patients with alcoholism: a 12-week prospective study in patients recently detoxified. Psychiatry Clin Neurosci 2012; 66:235-41. [PMID: 22443246 DOI: 10.1111/j.1440-1819.2012.02326.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIMS The aim of this study was to determine the 12-week cognitive changes in topiramate-treated patients recently detoxified from alcohol. METHODS Participants were inpatients with DSM-IV alcohol dependence. All of them were discharged within 14 days after the initiation of topiramate treatment. The topiramate dose range was 50-300 mg/day. The Montreal Cognitive Assessment (MoCA) was used on day 0, day 29, day 57, and day 85. Differences of the MoCA total and seven subtest scores among four time-points were compared. RESULTS Thirty-eight participants (36 men and two women) had a mean ± SD age of 43.1 ± 8.6 years old. At enrollment, they were abstinent for a mean ± SD of 11.5 ± 5.3 days. Five, one, and three patients dropped out of the study on day 29, day 57, and day 85, respectively. On day 85, the mean ± SD dose of topiramate was 253.1 ± 60.8 mg/day. Alcohol consumption decreased drastically during follow up. At each time-point, 75%-80% of the participants were continuous abstainers. The mean ± SD MoCA total, language subtest, and delayed recall subtest scores increased significantly from day 0 to day 85, from 22.0 ± 4.7 to 24.7 ± 3.4 (P < 0.01), from 1.1 ± 1.0 to 1.3 ± 1.0 (P = 0.03), and from 2.7 ± 1.7 to 4.1 ± 1.0 (P < 0.01), respectively. CONCLUSION Topiramate-treated patients recently detoxified from alcohol usually have an improvement of their cognitive function, especially in the language and delayed recall domains. This phenomenon may be caused by the greater influence of cognitive recovery associated with decreased drinking as compared with topiramate-induced cognitive impairment.
Collapse
Affiliation(s)
- Surinporn Likhitsathian
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University Chiang Mai Drug Dependence Treatment Center, Chiang Mai, Thailand
| | | | | | | | | | | |
Collapse
|
4
|
Prendergast MA, Mulholland PJ. Glucocorticoid and polyamine interactions in the plasticity of glutamatergic synapses that contribute to ethanol-associated dependence and neuronal injury. Addict Biol 2012; 17:209-23. [PMID: 21967628 PMCID: PMC3254017 DOI: 10.1111/j.1369-1600.2011.00375.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Stress contributes to the development of ethanol dependence and is also a consequence of dependence. However, the complexity of physiological interactions between activation of the hypothalamic-pituitary-adrenal (HPA) axis and ethanol itself is not well delineated. Emerging evidence derived from examination of corticotropin-releasing factor systems and glucocorticoid receptor systems in ethanol dependence suggests a role for pharmacological manipulation of the HPA axis in attenuating ethanol intake, though it is not clear how activation of the HPA axis may promote ethanol dependence or contribute to the neuroadaptative changes that accompany the development of dependence and the severity of ethanol withdrawal. This review examines the role that glucocorticoids, in particular, have in promoting ethanol-associated plasticity of glutamatergic synapses by influencing expression of endogenous linear polyamines and polyamine-sensitive polypeptide subunits of N-methyl-D-aspartate (NMDA)-type glutamate receptors. We provide evidence that interactions among glucocorticoid systems, polyamines and NMDA receptors are highly relevant to both the development of ethanol dependence and to behavioral and neuropathological sequelae associated with ethanol withdrawal. Examination of these issues is likely to be of critical importance not only in further elucidating the neurobiology of HPA axis dysregulation in ethanol dependence, but also with regard to identification of novel therapeutic targets that may be exploited in the treatment of ethanol dependence.
Collapse
Affiliation(s)
- Mark A. Prendergast
- University of Kentucky, Department of Psychology, 741 South Limestone Street, Lexington, KY 40536, U.S.A
- Spinal Cord and Brain Injury Research Center, B449 Biomedical and Biological Sciences Research Building, 741 South Limestone Street, Lexington, KY 40536, U.S.A
| | - Patrick J. Mulholland
- Departments of Neurosciences and Psychiatry & Behavioral Sciences, Medical University of South Carolina, 67 President Street, IOP 462 North Charleston, South Carolina 29425, U.S.A
| |
Collapse
|
5
|
Ritz L, Pitel AL, Vabret F, Eustache F, Beaunieux H. Alcoolodépendance : atteintes neuropsychologiques et diagnostics différentiels. ACTA ACUST UNITED AC 2012. [DOI: 10.3917/rne.043.0196] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
|
6
|
Dingwall KM, Maruff P, Cairney S. Similar profile of cognitive impairment and recovery for Aboriginal Australians in treatment for episodic or chronic alcohol use. Addiction 2011; 106:1419-26. [PMID: 21438935 DOI: 10.1111/j.1360-0443.2011.03434.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIMS The cognitive impairment and recovery associated with chronic alcohol abuse and subsequent abstinence is well understood. However, the recovery profile following heavy episodic or 'binge' use, which is common among some Australian Aboriginal users, has not been investigated thoroughly and no empirical studies have examined chronic use in this population. The aim of this study was to identify and compare cognitive impairment and recovery associated with chronic and episodic alcohol use among Aboriginal Australians. DESIGN Longitudinal case-control design. SETTING Residential alcohol treatment programmes in northern Australia. PARTICIPANTS Forty chronic alcohol users, 24 episodic users and 41 healthy controls [mean age = 34.24; standard deviation (SD) = 9.73]. MEASUREMENTS Cognitive assessments of visual motor, attention, memory, learning and executive functions at baseline (start of treatment), then 4 weeks and 8 weeks later. Reassessment of 31% of participants an average of 11 months later (SD = 4.4) comparing those who remained abstinent (n = 5), those who relapsed (n = 11) and healthy controls (n = 19). FINDINGS At baseline, chronic and episodic alcohol users showed impaired visual motor, learning, memory and executive functions. With the exception of visual motor impairment, all deficits had improved to normal levels within 4 weeks. Visual motor deficits had normalized within 11 months. Performances did not differ at any time between chronic and episodic alcohol groups. CONCLUSIONS In Aboriginal Australians, episodic drinking is associated with similar patterns of impairment and recovery as chronic alcohol use. Most cognitive deficits appear to recover within the first month of abstinence, while persisting visual motor problems recover within 1 year.
Collapse
Affiliation(s)
- Kylie M Dingwall
- Menzies School of Health Research, Institute of Advanced Studies, Charles Darwin University, Darwin, Australia.
| | | | | |
Collapse
|
7
|
Indian adaptation of the Cognistat: Psychometric properties of a cognitive screening tool for patients of traumatic brain injury. INDIAN JOURNAL OF NEUROTRAUMA 2009. [DOI: 10.1016/s0973-0508(09)80006-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
8
|
Krull KR, Okcu MF, Potter B, Jain N, Dreyer Z, Kamdar K, Brouwers P. Screening for Neurocognitive Impairment in Pediatric Cancer Long-Term Survivors. J Clin Oncol 2008; 26:4138-43. [DOI: 10.1200/jco.2008.16.8864] [Citation(s) in RCA: 92] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Purpose Recent studies suggest that up to 40% of childhood cancer survivors may experience neurocognitive problems, a finding that has led the Children's Oncology Group to recommend regular evaluation. However, for a variety of reasons, including costs, time restraints, health insurance, and access to professional resources, these guidelines are often difficult to implement. We report reliability and validity data on a brief neurocognitive screening method that could be used to routinely screen patients in need of comprehensive follow-up. Patients and Methods Two hundred forty consecutive patients were screened during their annual visits to a long-term survivor clinic using standard neurocognitive measures and brief parent rating. From this total, 48 patients had a second screening, and 52 patients had a comprehensive follow-up evaluation. Test-retest reliability and predictive and discriminative validity were examined. Results Good test-retest reliability was demonstrated, with an overall r = 0.72 and all individual subtest correlations greater than r = 0.40. Although means tended to improve from first to second testing, no significant changes were detected (all P > .10). The screen accurately predicted global intellect (F6,45 = 11.81, P < .0001), reading skills (F6,45 = 4.74, P < .001), and mathematics (F6,45 = 3.35, P < .008). Parent rating was a marginal indicator of global intellect only. Conclusion The brief neurocognitive screening was a better predictor of child functioning than specific parent rating. This brief measure, which can be completed in 30 minutes, is a practical and reliable method to identify cancer survivors in need of further neurocognitive follow-up.
Collapse
Affiliation(s)
- Kevin R. Krull
- From the Department of Child Psychology, Texas Children's Hospital; Department of Pediatrics, Baylor College of Medicine; Texas Children's Cancer Center, Houston, TX; and Division of AIDS and Health and Behavior Research, National Institute of Mental Health, Rockville, MD
| | - M. Fatih Okcu
- From the Department of Child Psychology, Texas Children's Hospital; Department of Pediatrics, Baylor College of Medicine; Texas Children's Cancer Center, Houston, TX; and Division of AIDS and Health and Behavior Research, National Institute of Mental Health, Rockville, MD
| | - Brian Potter
- From the Department of Child Psychology, Texas Children's Hospital; Department of Pediatrics, Baylor College of Medicine; Texas Children's Cancer Center, Houston, TX; and Division of AIDS and Health and Behavior Research, National Institute of Mental Health, Rockville, MD
| | - Neelam Jain
- From the Department of Child Psychology, Texas Children's Hospital; Department of Pediatrics, Baylor College of Medicine; Texas Children's Cancer Center, Houston, TX; and Division of AIDS and Health and Behavior Research, National Institute of Mental Health, Rockville, MD
| | - ZoAnn Dreyer
- From the Department of Child Psychology, Texas Children's Hospital; Department of Pediatrics, Baylor College of Medicine; Texas Children's Cancer Center, Houston, TX; and Division of AIDS and Health and Behavior Research, National Institute of Mental Health, Rockville, MD
| | - Kala Kamdar
- From the Department of Child Psychology, Texas Children's Hospital; Department of Pediatrics, Baylor College of Medicine; Texas Children's Cancer Center, Houston, TX; and Division of AIDS and Health and Behavior Research, National Institute of Mental Health, Rockville, MD
| | - Pim Brouwers
- From the Department of Child Psychology, Texas Children's Hospital; Department of Pediatrics, Baylor College of Medicine; Texas Children's Cancer Center, Houston, TX; and Division of AIDS and Health and Behavior Research, National Institute of Mental Health, Rockville, MD
| |
Collapse
|
9
|
Schottenbauer MA, Hommer D, Weingartner H. Memory Deficits Among Alcoholics: Performance on a Selective Reminding Task. AGING NEUROPSYCHOLOGY AND COGNITION 2007; 14:505-16. [PMID: 17828626 DOI: 10.1080/13825580600681305] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
This article compared alcoholics and healthy controls on the Buschke Selective Reminding Task. Alcoholics demonstrated deficits in memory and learning when compared to healthy controls, even when controlling for age. Examination of the alcoholic sample initially showed that age predicted memory deficits; however, age was no longer a significant predictor once the number of years of heavy drinking was entered into the regression equation. Findings suggest a direct link or mechanism of action between alcohol use and memory impairments, above and beyond effects of age or education.
Collapse
|
10
|
Schrimsher GW, Parker JD, Burke RS. Relation between cognitive testing performance and pattern of substance use in males at treatment entry. Clin Neuropsychol 2007; 21:498-510. [PMID: 17455033 DOI: 10.1080/13803390600674441] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
This study examined the frequency and pattern of cognitive impairment in individuals entering substance use disorder treatment and additionally examined the relation between pattern of cognitive impairment and type of substance(s) used: alcohol (n = 116), cocaine (n = 49), alcohol/cocaine (n = 76), and alcohol/multiple substance (n = 54). The Cognistat, a screening measure of cognitive functioning, and the Addiction Severity Index were given to male veterans at the time of entering 3- to 4-week residential/day drug treatment. The most prominent areas of impairment were memory (37% of the total sample) and similarities or abstract concept formation (21% of the total sample). Moderate or greater severity of impairment was noted on at least one Cognistat scale in 35% of the participants. Results indicated no significant differences in the patterns of cognitive domain impairment between groups based on type(s) of substances used at the time of entering treatment. Multiple substance use was significantly related to greater levels of psychiatric problems as identified by the Alcohol Severity Index. Given the rate of impairment in memory and verbal abstract reasoning noted, it is suggested that cognitive screening be a standard consideration in residential substance use disorder treatment to assist in treatment selection and delivery that is optimized to provide maximal benefit to patients.
Collapse
|
11
|
Maurage P, Philippot P, Verbanck P, Noel X, Kornreich C, Hanak C, Campanella S. Is the P300 deficit in alcoholism associated with early visual impairments (P100, N170)? An oddball paradigm. Clin Neurophysiol 2007; 118:633-44. [PMID: 17208045 DOI: 10.1016/j.clinph.2006.11.007] [Citation(s) in RCA: 69] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2006] [Revised: 11/10/2006] [Accepted: 11/15/2006] [Indexed: 10/23/2022]
Abstract
OBJECTIVE Studies exploring chronic alcoholism with event-related potentials (ERPs) have shown delayed latency and reduced amplitude of the P300, a long-lasting positive potential reflecting decisional processing. This P300 deficit in alcoholism is generally interpreted as a disturbance in central nervous system inhibition or in memory/attention. The present study aimed at identifying if this electrophysiological deficit is already present on earlier components, and advances a new hypothesis concerning the interpretation of the P300 alteration. METHODS Patients suffering from alcoholism and matched healthy controls had to detect, in an oddball paradigm, emotional faces among a succession of neutral faces. Behavioral performance and ERP data (recorded from 32 electrodes) were analyzed. RESULTS In line with previous studies, data showed that alcoholism led to a P300 deficit. Moreover, we observed for the first time that this deficit begins at earlier visual (P100) and face-processing (N170) stages, and we found high positive correlations between P100, N170 and P300 for amplitude and latency values, suggesting cumulative deficits on the cognitive continuum. CONCLUSIONS We suggest that the P300 deficit observed in chronic alcoholism could be linked to earlier visuo-spatial deficits rather than being an impairment of the specific processes linked to the P300. SIGNIFICANCE These results call for reconsidering the interpretation of P300 impairments at a fundamental and clinical level, and shows that earlier ERP components must be taken into account in future studies.
Collapse
Affiliation(s)
- P Maurage
- Cognitive Neurosciences and Clinical Psychology Research Units, Faculty of Psychology, Catholic University of Louvain, Louvain-la-Neuve, Belgium.
| | | | | | | | | | | | | |
Collapse
|
12
|
Ceballos NA. Tobacco Use, Alcohol Dependence, and Cognitive Performance. The Journal of General Psychology 2006; 133:375-88. [PMID: 17128957 DOI: 10.3200/genp.133.4.375-388] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Chronic alcohol abuse has long been associated with a mild, generalized pattern of cognitive decrements. However, it is important to note that problem drinking rarely occurs in isolation from abuse of other drugs. For people dependent upon alcohol, tobacco is one of the mostly commonly coabused substances. Recent research suggests that individuals with alcohol dependency may gravitate toward tobacco use, in part, because of the positive effects of nicotine on aspects of cognitive performance that may be compromised as a consequence of chronic alcohol misuse. In this article, the author focuses on the effects of nicotine on behavioral and electrophysiological indexes of cognitive performance, and the impact of these effects on alcohol-related cognitive decrements. The author discusses implications of these findings in the context of treatment and recovery of people with alcoholism.
Collapse
Affiliation(s)
- Natalie A Ceballos
- Department of Psychology, Texas State University, San Marcos, Texas 78666, USA.
| |
Collapse
|