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Míguez-Burbano MJ, Espinoza L, Whitehead NE, Bryant VE, Vargas M, Cook RL, Quiros C, Lewis JE, Deshratan A. Brain derived neurotrophic factor and cognitive status: the delicate balance among people living with HIV, with and without alcohol abuse. Curr HIV Res 2015; 12:254-64. [PMID: 25053366 DOI: 10.2174/1570162x12666140721121238] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2014] [Revised: 04/07/2014] [Accepted: 04/07/2014] [Indexed: 02/02/2023]
Abstract
INTRODUCTION The advent of combination antiretroviral therapy(cART) has lead to a significant reduction in morbidity and mortality among people living with HIV(PLWH). However, HIV-associated neurocognitive disorders (HAND) still remain a significant problem. One possible mechanism for the persistence of these disorders is through the effect of HIV on brain-derived neurotrophic factor (BDNF). BDNF is influenced by various factors including hazardous alcohol use (HAU), which is prevalent among PLWH. This study attempts to elucidate the relationships between HAU, BDNF and HAND. METHODS Cross-sectional analyses were conducted on a sample of 199 hazardous alcohol users and 198 non-HAU living with HIV. Members of each group were matched according to sociodemographic characteristics and CD4 count. Research procedures included validated questionnaires, neuropsychological assessments and a blood sample to obtain BDNF and immune measurements. RESULTS Hazardous alcohol users showed either significantly lower or significantly higher BDNF levels compared to the Non-hazardous (OR=1,4; 95% CI: 1-2.1, p = 0.003). Therefore, for additional analyses, subjects were categorized based on BDNF values in: Group 1 < 4000, Group 2: 4001-7,999 (reference group), and Group 3 for those >8,000 pg/mL. Groups 1 and 3 performed significantly worse than those in Group 2 in the domains of processing speed, auditory-verbal and visuospatial learning and memory. Multivariate analyses confirmed that HAU and BDNF are significant contributors of HAND. CONCLUSION Our findings offer novel insights into the relationships between BDNF, and alcohol use among PLWH. Our results also lend support to expanding clinical movement to use BDNF as an intervention target for PLWH, in those with evidence of deficiencies, and highlight the importance of including HAUat the inception of clinical trials.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Asthana Deshratan
- School of Integrated Science and Humanity, Florida International University, Miami, FL, USA.
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2
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Hundal JS, Morris J. Clinical validity of the children's category test-level 2 in a mixed sample of school-aged children. Arch Clin Neuropsychol 2011; 26:331-9. [PMID: 21576093 DOI: 10.1093/arclin/acr031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The Children's Category Test (CCT) is a widely used measure of problem solving with adequate psychometric properties. Yet, Shriver and Vacc (n.d.) were fairly critical of the CCT in The Mental Measurement Yearbook and highlighted its limitations. Thus, to explore the clinical validity of the widely used CCT-Level 2 (CCT-2) version, results of that test were analyzed post hoc in a sample of 265 children with mixed etiology referred for neuropsychological testing at a private outpatient laboratory. Overall, the CCT-2 correctly classified 57.7% of the sample, with 72.2% accuracy in classifying the Neuropsychologically Normal Clinical Comparison group but only 54% for the Brain Injured group. Predictive power was further reduced when the Brain Injury group was subdivided. Predictive power fell to 27.2%, with the best predictions coming for the Mental Retardation (MR) group (58.3%) and the lowest for the Learning Disorder NOS group (2.5%). The current findings suggest that the CCT's clinical application should be used with caution.
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Lin K, Taylor MJ, Heaton R, Franklin D, Jernigan T, Fennema-Notestine C, McCutchan A, Atkinson JH, Ellis RJ, McArthur J, Morgello S, Simpson D, Collier AC, Marra C, Gelman B, Clifford D, Grant I. Effects of traumatic brain injury on cognitive functioning and cerebral metabolites in HIV-infected individuals. J Clin Exp Neuropsychol 2011; 33:326-34. [PMID: 21229435 PMCID: PMC3062232 DOI: 10.1080/13803395.2010.518140] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
We explored the possible augmenting effect of traumatic brain injury (TBI) history on HIV (human immunodeficiency virus) associated neurocognitive complications. HIV-infected participants with self-reported history of definite TBI were compared to HIV patients without TBI history. Groups were equated for relevant demographic and HIV-associated characteristics. The TBI group evidenced significantly greater deficits in executive functioning and working memory. N-acetylaspartate, a putative marker of neuronal integrity, was significantly lower in the frontal gray matter and basal ganglia brain regions of the TBI group. Together, these results suggest an additional brain impact of TBI over that from HIV alone. One clinical implication is that HIV patients with TBI history may need to be monitored more closely for increased risk of HIV-associated neurocognitive disorder signs or symptoms.
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Affiliation(s)
- Kenny Lin
- University of California San Diego, San Diego, CA 92093, USA
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Glass J, Buu A, Adams K, Nigg J, Puttler L, Jester J, Zucker R. Effects of alcoholism severity and smoking on executive neurocognitive function. Addiction 2009; 104:38-48. [PMID: 19133887 PMCID: PMC2734473 DOI: 10.1111/j.1360-0443.2008.02415.x] [Citation(s) in RCA: 78] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
AIMS Neurocognitive deficits in chronic alcoholic men are well documented. Impairments include memory, visual-spatial processing, problem solving and executive function. The cause of impairment could include direct effects of alcohol toxicity, pre-existing cognitive deficits that predispose towards substance abuse, comorbid psychiatric disorders and abuse of substances other than alcohol. Cigarette smoking occurs at higher rates in alcoholism and has been linked to poor cognitive performance, yet the effects of smoking on cognitive function in alcoholism are often ignored. We examined whether chronic alcoholism and chronic smoking have effects on executive function. METHODS Alcoholism and smoking were examined in a community-recruited sample of alcoholic and non-alcoholic men (n = 240) using standard neuropsychological and reaction-time measures of executive function. Alcoholism was measured as the average level of alcoholism diagnoses across the study duration (12 years). Smoking was measured in pack-years. RESULTS Both alcoholism and smoking were correlated negatively with a composite executive function score. For component measures, alcoholism was correlated negatively with a broad range of measures, whereas smoking was correlated negatively with measures that emphasize response speed. In regression analyses, both smoking and alcoholism were significant predictors of executive function composite. However, when IQ is included in the regression analyses, alcoholism severity is no longer significant. CONCLUSIONS Both smoking and alcoholism were related to executive function. However, the effect of alcoholism was not independent of IQ, suggesting a generalized effect, perhaps affecting a wide range of cognitive abilities of which executive function is a component. On the other hand, the effect of smoking on measures relying on response speed were independent of IQ, suggesting a more specific processing speed deficit associated with chronic smoking.
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Affiliation(s)
- J.M. Glass
- University of Michigan, Department of Psychiatry, Substance Abuse Section
| | | | - K.M. Adams
- University of Michigan, Department of Psychiatry, Substance Abuse Section
| | - J.T. Nigg
- Michigan State University, Department of Psychology
| | - L.I. Puttler
- Michigan State University, Department of Psychology
| | - J.M. Jester
- University of Michigan, Department of Psychiatry, Substance Abuse Section
| | - R.A. Zucker
- University of Michigan, Department of Psychiatry, Substance Abuse Section
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5
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Meyerhoff DJ, Tizabi Y, Staley JK, Durazzo TC, Glass JM, Nixon SJ. Smoking comorbidity in alcoholism: neurobiological and neurocognitive consequences. Alcohol Clin Exp Res 2006; 30:253-64. [PMID: 16441274 DOI: 10.1111/j.1530-0277.2006.00034.x] [Citation(s) in RCA: 77] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Considerable research attests to the adverse effects of chronic smoking on cardiac, pulmonary, and vascular function as well as on increased risk for various cancers. However, comparatively little is known about the effects of chronic smoking on brain function. Although smoking rates have decreased in the developed world (they have increased in the developing world), smoking rates have been at a persistently high level in individuals with alcohol use disorders. Despite the high prevalence of comorbid chronic smoking and alcohol dependence, very few studies have addressed the separate and interactive effects that smoking and alcoholic drinking may have on neurobiology and brain function. This symposium, which took place at the annual meeting of the Research Society on Alcoholism in Santa Barbara, California, on June 29, 2005, postulates that the neurobiologic and neurocognitive abnormalities commonly described in studies of alcohol-dependent individuals are modulated by concurrent abuse of tobacco products and that brain recovery in abstinent alcoholic individuals is affected by chronic smoking. Four expert speakers and a discussant from different research disciplines focus in this symposium on the description of neurobiological and neurobehavioral effects because of concomitant drinking and smoking. Understanding the potential separate effects and interactions of chronic nicotine/smoking and alcohol consumption promotes a better understanding of specific mechanisms and neurocognitive consequences of brain injury and brain recovery with abstinence. The material presented contributes useful information to ongoing discussions about treatment strategies for these comorbid disorders and valuable educational material that can be used to affect public perception about smoking and perhaps health policy.
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Affiliation(s)
- Dieter J Meyerhoff
- Department of Radiology, University of California at San Francisco, San Francisco, California, USA.
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Glass JM, Adams KM, Nigg JT, Wong MM, Puttler LI, Buu A, Jester JM, Fitzgerald HE, Zucker RA. Smoking is associated with neurocognitive deficits in alcoholism. Drug Alcohol Depend 2006; 82:119-26. [PMID: 16169161 PMCID: PMC2261373 DOI: 10.1016/j.drugalcdep.2005.08.013] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2005] [Revised: 08/22/2005] [Accepted: 08/22/2005] [Indexed: 11/29/2022]
Abstract
BACKGROUND Impaired problem solving, visual-spatial processing, memory, and cognitive proficiency are consequences of severe alcoholism. Smoking is much more prevalent among alcoholics than the general population, yet the possible neurocognitive effects of cigarette smoking in alcoholism have not been studied, despite evidence that long-term smoking is associated with neurocognitive deficits. OBJECTIVE Determine whether smoking contributes to neurocognitive deficits associated with alcoholism. DESIGN Neurocognitive function was examined in a community-recruited (n=172) sample of men. Alcohol problems/alcoholism were measured by the lifetime alcohol problems score (LAPS), DSM-IV diagnosis, and monthly drinking rate. Smoking was measured in pack-years. Neurocognitive function was measured with IQ (short version of WAIS-R), and cognitive proficiency (fast, accurate performance). RESULTS Both alcoholism and smoking were negatively correlated with neurocognitive function. When alcoholism and smoking were included in regression models, smoking remained a significant predictor for both measures, but alcoholism remained significant only for IQ. CONCLUSIONS Both smoking and alcoholism were related to neurocognitive function. Smoking may explain some of the relationship between alcoholism and neurocognitive function, perhaps especially for measures that focus on proficiency. Future studies are necessary to more fully understand the effects of smoking on neurocognitive function in alcoholism.
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Affiliation(s)
- Jennifer M Glass
- Department of Psychiatry, University of Michigan, Addiction Research Center, 2025 Traverwood, Suite A, Ann Arbor, 48105-2194, USA.
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7
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Bates ME, Voelbel GT, Buckman JF, Labouvie EW, Barry D. Short-term neuropsychological recovery in clients with substance use disorders. Alcohol Clin Exp Res 2005; 29:367-77. [PMID: 15770112 PMCID: PMC3059764 DOI: 10.1097/01.alc.0000156131.88125.2a] [Citation(s) in RCA: 62] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Cognitive impairments are frequently observed in clients who enter treatment programs for substance abuse. The potential for early recovery of cognitive abilities is suggested by previous research; however, the extent of improvement and risk factors that may help predict individual differences in rates of recovery remain unclear. This study is a 6-week follow-up and retest of an original sample of 197 men and women who had received a broad neuropsychological assessment at addiction treatment entry. The aim was to examine the potential clinical significance of changes in cognitive functioning and the extent to which differential recovery was predictable from client background information. METHODS Fifteen neuropsychological tests were readministered to 169 of 197 clients 6 weeks after treatment entry. Structural equation modeling was used to estimate separately the practice effects and recovery in four cognitive domains: executive function, memory, information processing speed, and verbal ability. Client background information included age, sex, education, substance use and consequences, psychopathology, medical problems, familial alcoholism history, and childhood behavior problems. RESULTS A four-factor model of latent neuropsychological ability that was previously identified at treatment entry was replicated at follow-up. Statistically significant increases in the means of the four latent abilities were found. Memory showed a medium effect size improvement. Executive function, verbal ability, and information processing speed, however, showed only small effect size improvements, suggesting limited clinical significance. Substance use between treatment entry and follow-up, antisocial personality disorder, negative use consequences, less education, and medical problems were modestly predictive of less recovery. CONCLUSION Cognitive recovery in the first 6 weeks of treatment is possible, but, with the possible exception of memory, improvement may be minor in terms of clinical relevance.
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Affiliation(s)
- Marsha E Bates
- Center of Alcohol Studies, Rutgers University, 607 Allison Road, Piscataway, NJ 08854, USA.
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8
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Abstract
BACKGROUND Executive dysfunction is among the cognitive impairments that may persist after abstinence in alcohol-dependent persons. The type(s) and extent of executive dysfunction early in abstinence have not been well characterized, but they may have important implications for the evolution of behavioral treatment strategies. METHODS To determine which aspects of executive functioning were impaired in early abstinence, we administered memory and executive function tests to veterans who successively presented for treatment at an outpatient substance abuse clinic. We then compared the neuropsychological performance of these recovering alcoholics (n = 27) with that of age-matched primary care outpatients (n = 18). We also examined group differences in self-evaluation of cognitive decline and evaluated associations between drinking history and cognitive impairment in the index group. RESULTS We found that the normal and alcohol-dependent groups differed on abstract reasoning, memory discrimination, and effectiveness on timed tasks. Patients in the alcohol-dependent sample were also more likely to perceive themselves as cognitively impaired. It is interesting to note that the duration of alcohol use did not relate to neuropsychological test performance, but recent quantity consumed and days of sobriety were associated with nonverbal abstract reasoning ability. CONCLUSIONS Executive functions are impaired early in abstinence and should, therefore, be taken into account when early behavioral treatments are being developed.
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Affiliation(s)
- Sandra Zinn
- Research and Development, Health Services Research and Development, Durham Veterans Affairs Medical Center, Durham, North Carolina 27705, USA
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9
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Vasterling JJ, Brailey K, Sutker PB. Olfactory identification in combat-related posttraumatic stress disorder. J Trauma Stress 2000; 13:241-53. [PMID: 10838673 DOI: 10.1023/a:1007754611030] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Recent neuropsychological conceptualizations of posttraumatic stress disorder (PTSD) implicate dysfunction of the fronto-limbic system, a brain system thought to be involved in the mediation of emotion. However, few studies have examined fronto-limbic subregions, such as the orbitofrontal cortex, in PTSD. As a measure of orbitofrontal integrity, olfactory identification was assessed in 26 Vietnam War veterans with PTSD, 25 Vietnam War veterans without mental disorders, and 17 Vietnam-era, non-war-zone veterans without mental disorders. Relative to veterans without PTSD, those diagnosed with PTSD were less proficient in odor identification and verbal learning but not on other cognitive tests sensitive to dorsolateral prefrontal and mesial temporal functioning. Results bolster prior research indicating fronto-limbic dysfunction in PTSD, and suggest involvement of the orbitofrontal region.
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Affiliation(s)
- J J Vasterling
- Mental Health Service Line (COS6), Veterans Affairs Medical Center, New Orleans, Louisiana 70112, USA.
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10
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Horner MD, Harvey RT, Denier CA. Self-report and objective measures of cognitive deficit in patients entering substance abuse treatment. Psychiatry Res 1999; 86:155-61. [PMID: 10397417 DOI: 10.1016/s0165-1781(99)00031-1] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
The relationship between self-reported cognitive deficits and objectively measured cognitive performance was examined in 86 patients entering substance abuse treatment. Self-ratings of cognitive impairment were strongly correlated with indices of depression and vulnerability to stress, but not with objective cognitive performance. Confirming the lack of relationship between self-report and objective cognitive measures, cognitive performance did not differ between patients at the extremes of the cognitive-complaint distribution; and cognitively impaired patients did not differ from cognitively intact patients in their self-ratings of impairment.
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Affiliation(s)
- M D Horner
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston 29425-0742, USA.
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Adams KM, Gilman S, Johnson-Greene D, Koeppe RA, Junck L, Kluin KJ, Martorello S, Johnson MJ, Heumann M, Hill E. The Significance of Family History Status in Relation to Neuropsychological Test Performance and Cerebral Glucose Metabolism Studied with Positron Emission Tomography in Older Alcoholic Patients. Alcohol Clin Exp Res 1998. [DOI: 10.1111/j.1530-0277.1998.tb03622.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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12
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Dupont RM, Rourke SB, Grant I, Lehr PP, Reed RJ, Challakere K, Lamoureux G, Halpern S. Single photon emission computed tomography with iodoamphetamine-123 and neuropsychological studies in long-term abstinent alcoholics. Psychiatry Res 1996; 67:99-111. [PMID: 8876010 DOI: 10.1016/0925-4927(96)02769-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Ten long-term abstinent alcoholics (mean abstinence = 7.7 years) were compared with 13 recently detoxified substance-dependent inpatients (mean abstinence = 25 days) and 8 nonalcoholic control subjects on global end regional measures of cortical cerebral blood flow (CBF), and on neuropsychological measures. CBF was assessed using 123iodoamphetamine (IMP) single photon emission computed tomography (SPECT) under conditions of behavioral challenge (Raven's Progressive Matrices). CBF and neuropsychological test performance were worse in the recently detoxified inpatients. Of greater interest, there was a dissociation in the long-term abstinent group, which, while neuropsychologically indistinguishable from controls, showed significantly decreased mean cortical IMP uptake. We conclude that there may be persistent physiologic abnormalities in long-term abstinent alcoholics who have achieved full behavioral recovery. Smoking on the day of SPECT scanning was also identified to be a significant confound to understanding CBF changes in alcoholism.
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Affiliation(s)
- R M Dupont
- Psychiatry Service, San Diego VA Medical Center, CA 92161, USA
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13
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Tracy JI, Josiassen RC, Bellack AS. Neuropsychology of dual diagnosis: Understanding the combined effects of schizophrenia and substance use disorders. Clin Psychol Rev 1995. [DOI: 10.1016/0272-7358(95)00001-6] [Citation(s) in RCA: 26] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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14
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Fals-Stewart W, Schafer J, Lucente S, Rustine T, Brown L. Neurobehavioral consequences of prolonged alcohol and substance abuse: A review of findings and treatment implications. Clin Psychol Rev 1994. [DOI: 10.1016/0272-7358(94)90041-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Mearns J, Lees-Haley PR. Discriminating neuropsychological sequelae of head injury from alcohol-abuse-induced deficits: a review and analysis. J Clin Psychol 1993; 49:714-20. [PMID: 8254080 DOI: 10.1002/1097-4679(199309)49:5<714::aid-jclp2270490515>3.0.co;2-h] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Alcohol abuse is linked strongly with neuropsychological deficits that may resemble deficits seen in head-injured individuals. Heavy daily drinking appears more damaging than episodic abusive consumption. Cognitive deficits associated with alcohol include abstraction, perceptuospatial, and problem-solving skills. Verbal abilities are spared. For alcoholics younger than 40, abstinence is associated with improved functioning. For those over 40, deficits may be permanent. Intelligence tests are unlikely to pick up alcohol-induced deficits. Points for neuropsychologists to consider in differentiating between head injury and alcohol-induced deficits include abstinence from drinking prior to testing, intactness of remote memory and verbal functions, and changes in tolerance for alcohol.
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Adams KM, Gilman S, Koeppe RA, Kluin KJ, Brunberg JA, Dede D, Berent S, Kroll PD. Neuropsychological deficits are correlated with frontal hypometabolism in positron emission tomography studies of older alcoholic patients. Alcohol Clin Exp Res 1993; 17:205-10. [PMID: 8488956 DOI: 10.1111/j.1530-0277.1993.tb00750.x] [Citation(s) in RCA: 151] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
In an extension of previous work, we studied the behavioral correlates of medial frontal lobe glucose hypometabolism in chronically alcohol-dependent patients. Thirty-one male patients who were detoxified, medically stable, and free of other central nervous system risk factors for neuropsychological impairment were examined with (1) anatomic imaging (CT or MR), (2) functional imaging with [18F] fluorodeoxyglucose (18F-FDG) and positron emission tomography (PET), and (3) a battery of neuropsychological tests, including two measures of abstraction known to be generally sensitive to frontal lobe disease or dysfunction [the Wisconsin Card Sorting Test (WCST) and the Halstead Category Test (HCT)]. 18F-FDG PET data from 18 age- and sex-matched normal control subjects were used for comparison. All patients met criteria for severe alcohol dependence and for at least a mild degree of alcoholic-induced cognitive impairment. Although the mean IQ level of the alcoholic patients was in the average range, the concepts attained and the error scores on the WCST and HCT were significantly impaired in comparison with established norms. Local cerebral metabolic rate for glucose (LCMRglc) was significantly decreased in a sagittal strip of the medial frontal cortex in the alcoholic patients as compared with the normal controls. Comparison of data from PET scans and anatomic images indicated that the reduced LCMRglc could not be attributed to reduced amounts of tissue alone. A statistically significant relationship was found between LCMRglc in the medial frontal region of the cerebral cortex and performance on the WCST, but not the HCT. These findings suggest that chronic alcohol intake results in impaired function of cerebral tissue in the medial frontal region.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- K M Adams
- Psychology Service, Veteran's Affairs Medical Center, Ann Arbor, MI
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Abstract
It is generally believed that many non-Korsakoff alcoholics have subtle defects in memory. To determine whether such defects vary as a function of length of abstinence (LOA), we performed extensive memory testing with: (1) recently detoxified (n = 31; LOA-29 days); (2) intermediate-term abstinent (n = 28; LOA = 1.9 years); (3) long-term abstinent (n = 32; LOA-7.0 years) alcoholics; and (4) nonalcoholic controls (n = 37). All subjects were matched on age and education. Alcoholics were matched on years of alcoholic drinking. Memory measures were divided into the following domains: verbal learning, verbal recall, visual learning, visual recall, and paired associate learning. A series of MANOVAs were conducted that revealed a significant relationship between visual learning and length of abstinence, and a significant interaction between age and length of abstinence on visual recall. Long-term abstinent subjects were not significantly different from controls on any test. We conclude that memory disturbance demonstrable among recently detoxified alcoholics in the early weeks of their abstinence is not evident in demographically matched long-term abstinent alcoholics with similar drinking histories.
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Affiliation(s)
- R J Reed
- Alcoholism Research Center, San Diego Veterans Affairs Medical Center, La Jolla, California
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18
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Gilman S, Adams K, Koeppe RA, Berent S, Kluin KJ, Modell JG, Kroll P, Brunberg JA. Cerebellar and frontal hypometabolism in alcoholic cerebellar degeneration studied with positron emission tomography. Ann Neurol 1990; 28:775-85. [PMID: 2285264 DOI: 10.1002/ana.410280608] [Citation(s) in RCA: 140] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Local cerebral metabolic rate for glucose was studied utilizing 18F-2-fluoro-2-deoxy-D-glucose and positron emission tomography (PET) in 14 chronically alcohol-dependent patients and 8 normal control subjects of similar age and sex. Nine of the 14 patients (Group A) had clinical signs of alcoholic cerebellar degeneration, and the remaining 5 (Group B) did not have signs of alcoholic cerebellar degeneration. PET studies of Group A revealed significantly decreased local cerebral metabolic rates for glucose in the superior cerebellar vermis in comparison with the normal control subjects. Group B did not show decreased rates in the cerebellum. Both Groups A and B showed decreased local cerebral metabolic rates for glucose bilaterally in the medial frontal area of the cerebral cortex in comparison with the normal control subjects. The severity of the clinical neurological impairment was significantly correlated with the degree of hypometabolism in both the superior cerebellar vermis and the medial frontal region of the cerebral cortex. The degree of atrophy detected in computed tomography scans was significantly correlated with local cerebral metabolic rates in the medial frontal area of the cerebral cortex, but not in the cerebellum. The data indicate that hypometabolism in the superior cerebellar vermis closely follows clinical symptomatology in patients with alcoholic cerebellar degeneration, and does not occur in alcohol-dependent patients without clinical evidence of cerebellar dysfunction. Hypometabolism in the medial frontal region of the cerebral cortex is a prominent finding in alcohol-dependent patients with or without alcoholic cerebellar degeneration.
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Affiliation(s)
- S Gilman
- Department of Neurology, University of Michigan, Ann Arbor 48109-0316
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19
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Abstract
Twenty-five male and 13 female patients with alcoholic Korsakoff's syndrome (AKS) were compared with age- and sex-matched non-Korsakoff chronic alcoholics and healthy volunteers in a neuropsychological study, which included computer-administered tests of cognitive function. The performance of male Korsakoff patients was significantly inferior to that of healthy male controls, not only in tests of memory, but also in visuo-perceptual tasks with a speed or motor component, and on category sorting and verbal fluency measures. Compared with male alcoholics, the performance of male Korsakoff patients was again inferior on similar tests. Female Korsakoff patients showed more extensive deficits compared with female controls, but differed less from matched female alcoholics. The results suggest that, in addition to their amnesia, many Korsakoff patients have sustained widespread cognitive deficits, affecting particularly visuo-perceptual and abstracting functions, which are sensitive to cortical lesions. The range of deficits falls short of what may be regarded as 'global' in male, but probably not in female, Korsakoffs. The implications for a dual aetiology of AKS involving thiamine deficiency and other features associated with alcoholism, probably direct alcohol neurotoxicity, are discussed.
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Abstract
The study of drinking and cognitive impairment has been very popular. Over the past 15 years much work has been conducted examining the specific characteristics of alcohol-related impairment, concurrent morphological changes and the process itself. Numerous theories have been advanced and progress has been made in a number of areas. However, at the present time the area is undergoing a period of re-evaluation. it is clear that if there is an association between alcohol consumption and cognitive impairment, there are a multitude of 'other factors' which need to be controlled for, before one can maintain that observed impairment is indeed a result of alcohol consumed.
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Affiliation(s)
- C Clifford
- Department of Psychiatry, University of Tasmania, Hobart, Tasmania, 7000, Australia
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Tarter RE, Van Thiel DH, Arria AM, Carra J, Moss H. Impact of cirrhosis on the neuropsychological test performance of alcoholics. Alcohol Clin Exp Res 1988; 12:619-21. [PMID: 3067603 DOI: 10.1111/j.1530-0277.1988.tb00252.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Alcoholics and nonalcoholics with biopsy-proven cirrhosis were compared to each other and to a normal control group on a comprehensive battery of neuropsychological tests. No systematic differences were found between the two liver disease groups. These results indicate that a history of alcoholism does not substantially contribute to the manifest neuropsychological deficits beyond that due to a coexistent hepatic encephalopathy.
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Affiliation(s)
- R E Tarter
- Department of Psychiatry, University of Pittsburgh, School of Medicine, Pennsylvania
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22
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Abstract
A group of young male alcoholics with a mean age of 26.7 years performed less well than matched controls on a test of complex maze learning. The relatively short period of time during which these alcoholics had been drinking to excess (M = 5.7 years) suggests that acquired deficits may appear earlier in the drinking history of many alcoholics than has been previously assumed. Data from the maze was analyzed by modelling each individuals' cumulative error scores with a two-parameter hyperbolic function. The model provided an excellent fit to individual data and group differences were observed in both parameters of the model. It is concluded that curve fitting provides an efficient method for representing individual performance on a multitrial learning task.
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Affiliation(s)
- S C Bowden
- Department of Psychology, University of Melbourne, Parkville, Victoria, Australia
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23
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Reed R, Grant I, Adams KM. Family history of alcoholism does not predict neuropsychological performance in alcoholics. Alcohol Clin Exp Res 1987; 11:340-4. [PMID: 3307503 DOI: 10.1111/j.1530-0277.1987.tb01322.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
We examined the relationship of history of alcoholism in first-degree relatives to neuropsychological performance of alcoholics abstinent from several weeks to several years. Eighty-four men were assigned to four groups based on "strength" of family history of alcoholism. The groups were: (1) "strong history," a parent plus another first-degree relative positive; (2) "moderate," parent only positive; (3) "weak," nonparent first-degree relative only positive; and (4) "negative," no first-degree relative positive. There were no significant between-group differences in NP performance. In other analyses there were no NP differences between alcoholics classified positive or negative purely on basis of paternal alcoholism, and no differences between subjects who had multigenerational versus unigenerational versus negative familial histories of alcoholism. It is concluded that genetic loading for alcoholism does not significantly affect the NP status of abstinent alcoholic groups equated for education, drinking history, and medical risk.
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24
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Hänninen H, Antti-Poika M, Savolainen P. Psychological performance, toluene exposure and alcohol consumption in rotogravure printers. Int Arch Occup Environ Health 1987; 59:475-83. [PMID: 3653993 DOI: 10.1007/bf00377842] [Citation(s) in RCA: 25] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
A psychological test battery was administered to a group of 43 rotogravure printers exposed to toluene (mean age 41 years, mean duration of exposure 22 years) and to a referent group comprising 31 offset printers of the same age. Eighteen of the rotogravure printers and one of the referents were heavy drinkers of alcohol. The test battery included tests for verbal and visual cognition and memory, perceptual motor speed, and psychomotor abilities. A vocabulary test (Synonyms) was used as a measure of initial intelligence. Performances in the two groups were compared, and descriptive data analyses were made in four subgroups formed according to toluene exposure and drinking habits. The rotogravure printers performance was inferior to the referents in tests measuring visual cognitive abilities. The mean test performances in the subgroups indicated that the difference in drinking habits did not explain the differences: the heavy drinkers tended to perform better than those with more moderate drinking habits. An antagonistic interaction between toluene and alcohol was suggested by intact performances among the heavy drinkers with high exposure (n = 8). The question deserves to be investigated further.
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Affiliation(s)
- H Hänninen
- Institute of Occupational Health, Helsinki, Finland
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