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Bralet MC, Mitelman SA, Goodman CR, Lincoln S, Hazlett EA, Buchsbaum MS. Fluorodeoxyglucose positron emission tomography scans in patients with alcohol use disorder. Alcohol Clin Exp Res 2022; 46:994-1010. [PMID: 35451074 DOI: 10.1111/acer.14845] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 03/17/2022] [Accepted: 04/16/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Diminished uptake of fluorodeoxyglucose (FDG) has been observed in patients with alcohol use disorder (AUD) but little statistical contrast of the regional brain deficits has been undertaken. This study examined prefrontal cortex inter-regional Brodmann area differences to delineate patterns associated with behavioral, neurotransmitter, and general toxicity hypotheses of cerebral involvement in AUD. METHODS We obtained data from FDG positron emission tomography (PET) and anatomical magnetic resonance imaging (MRI) for 87 patients with AUD and 41 age- and sex-matched healthy volunteers. Patients were alcohol dependent and had negative breathalyzer tests at the time of imaging. They were assessed with the Beck Depression Inventory, Alcohol Urge Questionnaire, Obsessive Compulsive Drinking Scale, Spielberger State/Trait Anxiety Scale, Buss-Durkee Hostility Inventory, and the Drinker Inventory of Consequences (DrInC). PET images were co-registered to MRI and both voxel × voxel statistical mapping and stereotaxic regions of interest were obtained. RESULTS Compared with healthy volunteers, patients with AUD had lower relative metabolic rates in the frontal, temporal, and parietal lobes, localizable most prominently to the dorsolateral and nearly all orbital prefrontal cortex, superior temporal gyrus, and inferior parietal lobule. In contrast, metabolic rates in the medial orbitofrontal and anterior cingulate cortex, and the subcortical structures (thalamus, cerebellum, ventral striatum, and the dorsal raphe nucleus) in patients were significantly greater. The severity of alcohol-related consequences as assessed by the DrInC scale was most highly associated with lower metabolism in the caudate, dorsolateral prefrontal, frontopolar, and anteroposterior cingulate cortex. CONCLUSIONS Despite widespread metabolic abnormalities, decreases in AUD were most marked in frontal executive areas, consistent with diminished impulse control, and increases were most prominent in the striatum and cingulate areas, consistent with a suppressed reward system.
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Affiliation(s)
- Marie-Cécile Bralet
- Crisalid Unit (FJ5), CHI Clermont de l'Oise, Clermont, France.,Inserm Unit U669, Maison de Solenn, Universities Paris, Paris, France.,GDR 3557 Recherche Psychiatrie, Paris, France
| | - Serge A Mitelman
- Departments of Psychiatry and Neuroscience, Icahn School of Medicine at Mount Sinai, New York, New York, USA.,Department of Psychiatry, Division of Child and Adolescent Psychiatry, Elmhurst Hospital Center, Elmhurst, New York, USA
| | - Chelain R Goodman
- Department of Radiation Oncology, Division of Radiation Oncology, University of Texas, Austin, Texas, USA
| | - Samantha Lincoln
- Departments of Psychiatry and Neuroscience, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Erin A Hazlett
- Departments of Psychiatry and Neuroscience, Icahn School of Medicine at Mount Sinai, New York, New York, USA.,Mental Illness Research, Education, and Clinical Center (VISN 2), James J. Peters VAMC, Bronx, New York, USA
| | - Monte S Buchsbaum
- Departments of Psychiatry and Radiology, University of California, San Diego, San Diego, California, USA.,Departments of Psychiatry and Radiology, University of California, Irvine, Irvine, California, USA
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Moe FD, Moltu C, McKay JR, Nesvåg S, Bjornestad J. Is the relapse concept in studies of substance use disorders a 'one size fits all' concept? A systematic review of relapse operationalisations. Drug Alcohol Rev 2021; 41:743-758. [PMID: 34792839 DOI: 10.1111/dar.13401] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 10/01/2021] [Accepted: 10/04/2021] [Indexed: 11/28/2022]
Abstract
ISSUES Relapse is a theoretical construct and empirical object of inquiry. It is unclear how relapse is operationalised with regard to the various phases in substance use disorders (SUD). The aim was to investigate relapse operationalisations in SUDs studies after short- and long-term abstinence and remission, recovery and slip/lapse. APPROACH Systematic review using the following databases: Epistemonikos, Cochrane Central Register of Controlled Trials (CENTRAL and DARE), MEDLINE, EMBASE, Google Scholar, CINAHL, Web of Science and PsycINFO. Search returned 3426 articles, with 276 meeting the following inclusion criteria: empirical study published in English in a peer-reviewed journal; samples meet diagnostic criteria for dependence syndrome or moderate-severe drug use disorder or alcohol use disorder; reports relapse, abstinence, recovery, remission, slip or lapse. Review protocol registration: PROSPERO (CRD42020154062). KEY FINDINGS Thirty-two percent of the studies had no definition of 'relapse'. Most relapse operationalisations were defined according to measure (26%), time (17%), use (26%) and amount and frequency (27%). Of the 16 studies with a follow-up duration of up to 2 years, one (6%) contained a definition of 'long-term abstinence'. Of the 64 studies with a follow-up duration of more than 2 years, four (6%) contained a definition of 'long-term abstinence'. Of those, one (2%) mentioned 'early relapse' and one (2%) mentioned 'late relapse'. IMPLICATIONS Future research is needed to explore the possible difference between early and late relapse. Moreover, working to increase consensus on relapse operationalisations in SUD research is warranted. CONCLUSIONS We identified no consensus on relapse operationalisations nor agreement on the differentiation between early and late relapse. The clinical utility of current relapse operationalisations seems low and may compromise knowledge accumulation about relapse and implementation of research into treatment.
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Affiliation(s)
- Fredrik D Moe
- Department of Social Studies, Faculty of Social Sciences, University of Stavanger, Stavanger, Norway
| | - Christian Moltu
- Department of Psychiatry, District General Hospital of Førde, Førde, Norway
| | - James R McKay
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA.,Philadelphia VA Medical Center, Philadelphia, USA.,Centre for Alcohol and Drug Research, Stavanger University Hospital, Stavanger, Norway
| | - Sverre Nesvåg
- Centre for Alcohol and Drug Research, Stavanger University Hospital, Stavanger, Norway.,Department of Public Health, Faculty of Health, University of Stavanger, Stavanger, Norway
| | - Jone Bjornestad
- Department of Social Studies, Faculty of Social Sciences, University of Stavanger, Stavanger, Norway.,Department of Psychiatry, District General Hospital of Førde, Førde, Norway.,TIPS-Network for Clinical Research in Psychosis, Stavanger University Hospital, Stavanger, Norway
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3
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Maillard A, Laniepce A, Cabé N, Boudehent C, Chételat G, Urso L, Eustache F, Vabret F, Segobin S, Pitel AL. Temporal Cognitive and Brain Changes in Korsakoff Syndrome. Neurology 2021; 96:e1987-e1998. [PMID: 33637634 DOI: 10.1212/wnl.0000000000011749] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Accepted: 01/13/2021] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVE To investigate cognitive and brain changes in patients with Korsakoff syndrome (KS) over months and up to 10 years after the diagnosis. METHODS Two groups of 8 patients with KS underwent neuropsychological, motor, and neuroimaging investigations, including structural MRI and 18F-fluorodeoxyglucose-PET. The KSC group, recruited at Caen University Hospital, was examined early after the KS diagnosis (KSC-T1) and 1 year later (KSC-T2). The KSR group, recruited at nursing home at Roubaix, was evaluated 10 years after the diagnosis. Longitudinal comparisons in KSC explored short-term changes, while cross-sectional comparisons between KSC-T1 and KSR informed about long-term changes. RESULTS No cognitive, motor, or brain deterioration occurred over time in patients with KS. There was no clear improvement either, with only modest recovery in the frontocerebellar circuit. Compared to the norms, KSC-T1 had severe episodic memory impairments, ataxia, and some executive dysfunctions. They also presented widespread atrophy and hypometabolism as well as cerebellar hypermetabolism compared to 44 healthy matched controls. Episodic memory remained significantly impaired in KSC-T2 and KSR. Contrary to KSC at T1 and T2, KSR had preserved inhibition abilities. Atrophy was similar but less extended in KSC-T2 and even more limited in KSR. At all times, the thalamus, hypothalamus, and fornix remained severely atrophied. Hypometabolism was still widespread in KSC-T2 and KSR, notably affecting the diencephalon. Cerebellar metabolism decreased over time and normalized in KSR, whereas motor dysfunction persisted. CONCLUSION In KS, structural and metabolic alterations of the Papez circuit persisted over time, in accordance with the irreversible nature of amnesia. There was neither significant recovery as observed in patients with alcohol use disorder nor progressive decline as in neurodegenerative diseases.
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Affiliation(s)
- Angéline Maillard
- From Normandie Université (A.M., A.L., N.C., C.B., F.E., F.V., S.S., A.-L.P.), UNICAEN, PSL Université Paris, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, Neuropsychologie et Imagerie de la Mémoire Humaine; Service d'addictologie (N.C., C.B., F.V.), Centre Hospitalier Universitaire de Caen; Normandie Université (G.C.), UNICAEN, INSERM, U1237, PhIND "Physiopathology and Imaging of Neurological Disorders," Institut Blood and Brain at Caen-Normandie, Cyceron, Caen; Service d'addictologie (L.U.), Centre Hospitalier de Roubaix; and Institut Universitaire de France (A.-L.P.), Paris
| | - Alice Laniepce
- From Normandie Université (A.M., A.L., N.C., C.B., F.E., F.V., S.S., A.-L.P.), UNICAEN, PSL Université Paris, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, Neuropsychologie et Imagerie de la Mémoire Humaine; Service d'addictologie (N.C., C.B., F.V.), Centre Hospitalier Universitaire de Caen; Normandie Université (G.C.), UNICAEN, INSERM, U1237, PhIND "Physiopathology and Imaging of Neurological Disorders," Institut Blood and Brain at Caen-Normandie, Cyceron, Caen; Service d'addictologie (L.U.), Centre Hospitalier de Roubaix; and Institut Universitaire de France (A.-L.P.), Paris
| | - Nicolas Cabé
- From Normandie Université (A.M., A.L., N.C., C.B., F.E., F.V., S.S., A.-L.P.), UNICAEN, PSL Université Paris, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, Neuropsychologie et Imagerie de la Mémoire Humaine; Service d'addictologie (N.C., C.B., F.V.), Centre Hospitalier Universitaire de Caen; Normandie Université (G.C.), UNICAEN, INSERM, U1237, PhIND "Physiopathology and Imaging of Neurological Disorders," Institut Blood and Brain at Caen-Normandie, Cyceron, Caen; Service d'addictologie (L.U.), Centre Hospitalier de Roubaix; and Institut Universitaire de France (A.-L.P.), Paris
| | - Céline Boudehent
- From Normandie Université (A.M., A.L., N.C., C.B., F.E., F.V., S.S., A.-L.P.), UNICAEN, PSL Université Paris, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, Neuropsychologie et Imagerie de la Mémoire Humaine; Service d'addictologie (N.C., C.B., F.V.), Centre Hospitalier Universitaire de Caen; Normandie Université (G.C.), UNICAEN, INSERM, U1237, PhIND "Physiopathology and Imaging of Neurological Disorders," Institut Blood and Brain at Caen-Normandie, Cyceron, Caen; Service d'addictologie (L.U.), Centre Hospitalier de Roubaix; and Institut Universitaire de France (A.-L.P.), Paris
| | - Gael Chételat
- From Normandie Université (A.M., A.L., N.C., C.B., F.E., F.V., S.S., A.-L.P.), UNICAEN, PSL Université Paris, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, Neuropsychologie et Imagerie de la Mémoire Humaine; Service d'addictologie (N.C., C.B., F.V.), Centre Hospitalier Universitaire de Caen; Normandie Université (G.C.), UNICAEN, INSERM, U1237, PhIND "Physiopathology and Imaging of Neurological Disorders," Institut Blood and Brain at Caen-Normandie, Cyceron, Caen; Service d'addictologie (L.U.), Centre Hospitalier de Roubaix; and Institut Universitaire de France (A.-L.P.), Paris
| | - Laurent Urso
- From Normandie Université (A.M., A.L., N.C., C.B., F.E., F.V., S.S., A.-L.P.), UNICAEN, PSL Université Paris, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, Neuropsychologie et Imagerie de la Mémoire Humaine; Service d'addictologie (N.C., C.B., F.V.), Centre Hospitalier Universitaire de Caen; Normandie Université (G.C.), UNICAEN, INSERM, U1237, PhIND "Physiopathology and Imaging of Neurological Disorders," Institut Blood and Brain at Caen-Normandie, Cyceron, Caen; Service d'addictologie (L.U.), Centre Hospitalier de Roubaix; and Institut Universitaire de France (A.-L.P.), Paris
| | - Francis Eustache
- From Normandie Université (A.M., A.L., N.C., C.B., F.E., F.V., S.S., A.-L.P.), UNICAEN, PSL Université Paris, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, Neuropsychologie et Imagerie de la Mémoire Humaine; Service d'addictologie (N.C., C.B., F.V.), Centre Hospitalier Universitaire de Caen; Normandie Université (G.C.), UNICAEN, INSERM, U1237, PhIND "Physiopathology and Imaging of Neurological Disorders," Institut Blood and Brain at Caen-Normandie, Cyceron, Caen; Service d'addictologie (L.U.), Centre Hospitalier de Roubaix; and Institut Universitaire de France (A.-L.P.), Paris
| | - François Vabret
- From Normandie Université (A.M., A.L., N.C., C.B., F.E., F.V., S.S., A.-L.P.), UNICAEN, PSL Université Paris, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, Neuropsychologie et Imagerie de la Mémoire Humaine; Service d'addictologie (N.C., C.B., F.V.), Centre Hospitalier Universitaire de Caen; Normandie Université (G.C.), UNICAEN, INSERM, U1237, PhIND "Physiopathology and Imaging of Neurological Disorders," Institut Blood and Brain at Caen-Normandie, Cyceron, Caen; Service d'addictologie (L.U.), Centre Hospitalier de Roubaix; and Institut Universitaire de France (A.-L.P.), Paris
| | - Shailendra Segobin
- From Normandie Université (A.M., A.L., N.C., C.B., F.E., F.V., S.S., A.-L.P.), UNICAEN, PSL Université Paris, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, Neuropsychologie et Imagerie de la Mémoire Humaine; Service d'addictologie (N.C., C.B., F.V.), Centre Hospitalier Universitaire de Caen; Normandie Université (G.C.), UNICAEN, INSERM, U1237, PhIND "Physiopathology and Imaging of Neurological Disorders," Institut Blood and Brain at Caen-Normandie, Cyceron, Caen; Service d'addictologie (L.U.), Centre Hospitalier de Roubaix; and Institut Universitaire de France (A.-L.P.), Paris
| | - Anne-Lise Pitel
- From Normandie Université (A.M., A.L., N.C., C.B., F.E., F.V., S.S., A.-L.P.), UNICAEN, PSL Université Paris, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, Neuropsychologie et Imagerie de la Mémoire Humaine; Service d'addictologie (N.C., C.B., F.V.), Centre Hospitalier Universitaire de Caen; Normandie Université (G.C.), UNICAEN, INSERM, U1237, PhIND "Physiopathology and Imaging of Neurological Disorders," Institut Blood and Brain at Caen-Normandie, Cyceron, Caen; Service d'addictologie (L.U.), Centre Hospitalier de Roubaix; and Institut Universitaire de France (A.-L.P.), Paris
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4
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Alcohol. Alcohol 2021. [DOI: 10.1016/b978-0-12-816793-9.00001-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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5
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Desfosses M, Meadows H, Jackson M, Crowe SF. The Relationship Between Neuropsychological Functioning and Mental Health Outcomes of Chronic Alcohol Users Involved in Counselling: Prediction of Treatment Outcome. AUSTRALIAN PSYCHOLOGIST 2020. [DOI: 10.1111/ap.12071] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Melissa Desfosses
- School of Psychological Science, Faculty of Science, Technology and Engineering, La Trobe University,
| | - Holly Meadows
- School of Psychological Science, Faculty of Science, Technology and Engineering, La Trobe University,
| | - Martin Jackson
- School of Psychological Science, Faculty of Science, Technology and Engineering, La Trobe University,
| | - Simon F Crowe
- School of Psychological Science, Faculty of Science, Technology and Engineering, La Trobe University,
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6
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Polles AG, Williams MK, Phalin BR, Teitelbaum S, Merlo LJ. Neuropsychological impairment associated with substance use by physicians. J Neurol Sci 2020; 411:116714. [DOI: 10.1016/j.jns.2020.116714] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 11/05/2019] [Accepted: 01/29/2020] [Indexed: 10/25/2022]
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Charlet K, Rosenthal A, Lohoff FW, Heinz A, Beck A. Imaging resilience and recovery in alcohol dependence. Addiction 2018; 113:1933-1950. [PMID: 29744956 PMCID: PMC6128779 DOI: 10.1111/add.14259] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2015] [Revised: 01/26/2016] [Accepted: 04/25/2018] [Indexed: 12/15/2022]
Abstract
BACKGROUND AND AIMS Resilience and recovery are of increasing importance in the field of alcohol dependence (AD). This paper describes how imaging studies in man can be used to assess the neurobiological correlates of resilience and, if longitudinal, of disease trajectories, progression rates and markers for recovery to inform treatment and prevention options. METHODS Original papers on recovery and resilience in alcohol addiction and its neurobiological correlates were identified from PubMed and have been analyzed and condensed within a systematic literature review. RESULTS Findings deriving from functional magnetic resonance imaging (fMRI) and positron emission tomography (PET) studies have identified links between increased resilience and less task-elicited neural activation within the basal ganglia, and benefits of heightened neural pre-frontal cortex (PFC) engagement regarding resilience in a broader sense; namely, resilience against relapse in early abstinence of AD. Furthermore, findings consistently propose at least partial recovery of brain glucose metabolism and executive and general cognitive functioning, as well as structural plasticity effects throughout the brain of alcohol-dependent patients during the course of short-, medium- and long-term abstinence, even when patients only lowered their alcohol consumption to a moderate level. Additionally, specific factors were found that appear to influence these observed brain recovery processes in AD, e.g. genotype-dependent neuronal (re)growth, gender-specific neural recovery effects, critical interfering effects of psychiatric comorbidities, additional smoking or marijuana influences or adolescent alcohol abuse. CONCLUSIONS Neuroimaging research has uncovered neurobiological markers that appear to be linked to resilience and improved recovery capacities that are furthermore influenced by various factors such as gender or genetics. Consequently, future system-oriented approaches may help to establish a broad neuroscience-based research framework for alcohol dependence.
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Affiliation(s)
- Katrin Charlet
- Section on Clinical Genomics and Experimental Therapeutics, National Institute on Alcohol Abuse and Alcoholism (NIAAA), National Institutes of Health (NIH), Bethesda, MD, USA,Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité – Universitätsmedizin Berlin, Germany
| | - Annika Rosenthal
- Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité – Universitätsmedizin Berlin, Germany
| | - Falk W. Lohoff
- Section on Clinical Genomics and Experimental Therapeutics, National Institute on Alcohol Abuse and Alcoholism (NIAAA), National Institutes of Health (NIH), Bethesda, MD, USA
| | - Andreas Heinz
- Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité – Universitätsmedizin Berlin, Germany
| | - Anne Beck
- Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité – Universitätsmedizin Berlin, Germany
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8
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Le Berre AP, Fama R, Sullivan EV. Executive Functions, Memory, and Social Cognitive Deficits and Recovery in Chronic Alcoholism: A Critical Review to Inform Future Research. Alcohol Clin Exp Res 2017; 41:1432-1443. [PMID: 28618018 PMCID: PMC5531758 DOI: 10.1111/acer.13431] [Citation(s) in RCA: 213] [Impact Index Per Article: 30.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Accepted: 06/04/2017] [Indexed: 12/13/2022]
Abstract
Alcoholism is a complex and dynamic disease, punctuated by periods of abstinence and relapse, and influenced by a multitude of vulnerability factors. Chronic excessive alcohol consumption is associated with cognitive deficits, ranging from mild to severe, in executive functions, memory, and metacognitive abilities, with associated impairment in emotional processes and social cognition. These deficits can compromise efforts in initiating and sustaining abstinence by hampering efficacy of clinical treatment and can obstruct efforts in enabling good decision making success in interpersonal/social interactions, and awareness of cognitive and behavioral dysfunctions. Despite evidence for differences in recovery levels of selective cognitive processes, certain deficits can persist even with prolonged sobriety. Herein is presented a review of alcohol-related cognitive impairments affecting component processes of executive functioning, memory, and the recently investigated cognitive domains of metamemory, social cognition, and emotional processing; also considered are trajectories of cognitive recovery with abstinence. Finally, in the spirit of critical review, limitations of current knowledge are noted and avenues for new research efforts are proposed that focus on (i) the interaction among emotion-cognition processes and identification of vulnerability factors contributing to the development of emotional and social processing deficits and (ii) the time line of cognitive recovery by tracking alcoholism's dynamic course of sobriety and relapse. Knowledge about the heterochronicity of cognitive recovery in alcoholism has the potential of indicating at which points during recovery intervention may be most beneficial.
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Affiliation(s)
- Anne-Pascale Le Berre
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Rosemary Fama
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA 94305, USA
- Neuroscience Program, SRI International, Menlo Park, CA 94025, USA
| | - Edith V. Sullivan
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA 94305, USA
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9
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Willoughby AR, de Zambotti M, Baker FC, Colrain IM. Partial K-Complex Recovery Following Short-Term Abstinence in Individuals with Alcohol Use Disorder. Alcohol Clin Exp Res 2015; 39:1417-24. [PMID: 26175209 DOI: 10.1111/acer.12769] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Accepted: 05/05/2015] [Indexed: 11/30/2022]
Abstract
BACKGROUND The K-complex (KC) is a brain potential characteristic of nonrapid eye movement (NREM) sleep resulting from the synchronous activity of a large population of neurons and hypothesized to reflect brain integrity. KC amplitude is lower in individuals with alcohol use disorder (AUD) compared with age-matched controls, but its recovery with short-term abstinence has not been studied. Therefore, we investigated whether the KC shows significant recovery over the first 4 months of abstinence in individuals with AUD. METHODS A total of 16 recently abstinent AUD individuals (46.6 ± 9.3 years) and 13 gender and age-matched healthy controls (41.6 ± 8.3 years) were studied on 3 occasions: the Initial session was within 1 month of the AUD individuals' last drink, then 1 and 3 months later. Overnight electroencephalogram was recorded while participants were presented with tones during stage 2 NREM sleep to elicit KCs. RESULTS At the Initial session, AUD participants showed significantly lower KC amplitude and incidence compared with controls. In the AUD individuals, KC amplitude increased significantly from the Initial to the 1-month session. KC incidence showed a marginally significant increase. Neither KC amplitude nor incidence changed from the 1-month to the 3-month session. No changes in KC amplitude or incidence across sessions were observed in the control group. CONCLUSIONS Our results demonstrate partial KC recovery during the first 2 months of abstinence. This recovery is consistent with the time course of structural brain recovery in abstinent AUD individuals demonstrated by recent neuroimaging results.
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Affiliation(s)
| | | | - Fiona C Baker
- Center for Health Sciences , SRI International, Menlo Park, California.,Brain Function Research Group, University of the Witwatersrand, Johannesburg, South Africa
| | - Ian M Colrain
- Melbourne School of Psychological Sciences University of Melbourne, Melbourne, Victoria, Australia
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10
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Thalamic abnormalities are a cardinal feature of alcohol-related brain dysfunction. Neurosci Biobehav Rev 2014; 54:38-45. [PMID: 25108034 DOI: 10.1016/j.neubiorev.2014.07.023] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2014] [Revised: 07/11/2014] [Accepted: 07/28/2014] [Indexed: 01/27/2023]
Abstract
Two brain networks are particularly affected by the harmful effect of chronic and excessive alcohol consumption: the circuit of Papez and the frontocerebellar circuit, in both of which the thalamus plays a key role. Shrinkage of the thalamus is more severe in alcoholics with Korsakoff's syndrome (KS) than in those without neurological complication (AL). In accordance with the gradient effect of thalamic abnormalities between AL and KS, the pattern of brain dysfunction in the Papez's circuit results in anterograde amnesia in KS and only mild-to-moderate episodic memory disorders in AL. On the opposite, dysfunction of the frontocerebellar circuit results in a similar pattern of working memory and executive deficits in the AL and KS. Several hypotheses, mutually compatible, can be drawn to explain that the severe thalamic shrinkage observed in KS has different consequences in the neuropsychological profile associated with the two brain networks.
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11
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López-Caneda E, Rodríguez Holguín S, Corral M, Doallo S, Cadaveira F. Evolution of the binge drinking pattern in college students: neurophysiological correlates. Alcohol 2014; 48:407-18. [PMID: 24835220 DOI: 10.1016/j.alcohol.2014.01.009] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2013] [Revised: 01/20/2014] [Accepted: 01/20/2014] [Indexed: 12/30/2022]
Abstract
It is well known that alcohol impairs response inhibition and that adolescence is a critical period of neuromaturation where cognitive processes such as inhibitory control are still developing. In recent years, growing evidence has shown the negative consequences of alcohol binge drinking on the adolescent and young human brain. However, the effects of cessation of binge drinking on brain function remain unexplored. The objective of the present study was to examine brain activity during response execution and inhibition in young binge drinkers in relation to the progression of their drinking habits over time. Event-related potentials (ERPs) elicited by a Go/NoGo task were recorded twice within a 2-year interval in 57 undergraduate students (25 controls, 22 binge drinkers, and 10 ex-binge drinkers) with no personal or family history of alcoholism or psychopathological disorders. The results showed that the amplitude of NoGo-P3 over the frontal region correlated with an earlier age of onset of regular drinking as well as with greater quantity and speed of alcohol consumption. Regression analysis showed that NoGo-P3 amplitude was significantly predicted by the speed of alcohol intake and the age of onset of regular drinking. The group comparisons showed that, after maintaining a binge drinking pattern for at least 2 years, binge drinkers displayed significantly larger NoGo-P3 amplitudes than controls, whereas ex-binge drinkers were in an intermediate position between the two other groups (with no significant differences with respect to controls or binge drinkers). These findings suggest that binge drinking in young people may impair the neural functioning related to inhibitory processes, and that the cessation of binge drinking may act as a brake on the neurophysiological impairments related to response inhibition.
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Segobin SH, Chételat G, Le Berre AP, Lannuzel C, Boudehent C, Vabret F, Eustache F, Beaunieux H, Pitel AL. Relationship between brain volumetric changes and interim drinking at six months in alcohol-dependent patients. Alcohol Clin Exp Res 2014; 38:739-48. [PMID: 24483366 DOI: 10.1111/acer.12300] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2013] [Accepted: 09/04/2013] [Indexed: 11/26/2022]
Abstract
BACKGROUND Chronic alcohol consumption results in brain damage potentially reversible with abstinence. It is however difficult to gauge the degree of recovery of brain tissues with abstinence since changes are subtle and a significant portion of patients relapse. State-of-the-art morphometric methods are increasingly used in neuroimaging studies to detect subtle brain changes at a voxel level. Our aim was to use the most refined morphometric methods to observe in alcohol dependence the relationship between volumetric changes and interim drinking over a 6-month follow-up. METHODS Overall, 19 patients with alcohol dependence received volumetric T1-weighted magnetic resonance imaging (MRI) after detoxification. A 6-month follow-up study was then conducted, during which 11 of them received a second MRI scan. First, correlations were conducted between gray matter (GM) and white matter (WM) volumes of patients at alcohol treatment entry and the amount of alcohol consumed between treatment entry and follow-up. Second, longitudinal analyses were performed from pairs of MRI scans using tensor-based morphometry in the 11 patients, and correlations were computed between the resultant Jacobian maps of GM and WM and interim drinking. RESULTS Our preliminary results showed that, among others, alcoholics with smaller thalamus at alcohol treatment entry tended to resume with heavy alcohol consumption (p < 0.005 uncorrected [unc.]). Our longitudinal study revealed an overall inverse relationship between recovery of brain structures like the cerebellum, striatum, and cingulate gyrus, and the amount of alcohol consumed over the 6-month follow-up (p < 0.005 unc.). The recovery could be observed not only with strict abstinence but also in cases of moderate resumption of alcohol consumption, when there had been no drastic relapse into alcohol dependence. CONCLUSIONS Those preliminary findings indicate that the volume of the thalamus at treatment entry may have an influence on subsequent interim drinking. There is recovery of certain brain regions even when patients resume with moderate, but not drastic, alcohol consumption.
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Component processes of memory in alcoholism: pattern of compromise and neural substrates. HANDBOOK OF CLINICAL NEUROLOGY 2014; 125:211-25. [PMID: 25307577 DOI: 10.1016/b978-0-444-62619-6.00013-6] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Initially, alcohol-related memory deficits were considered only through the prism of Korsakoff's syndrome (KS). It is now clear, however, that chronic alcohol consumption results in memory disorders in alcoholics without ostensible neurologic complications, such as Wernicke's encephalopathy and KS. Most of the principal memory components are affected, including working memory, episodic memory, semantic memory, perceptual memory, and procedural memory. The extent of those cognitive impairments depends on several factors, such as age, gender, nutritional status, and psychiatric comorbidity. While memory disorders, especially episodic memory deficits, are largely definitive in patients with KS, recovery of memory abilities has been described with abstinence in uncomplicated alcoholics. Neuropsychologic impairments, and especially memory disorders, must be evaluated at alcohol treatment entry because they could impede patients from benefiting fully from cognitive and behavioral treatment approaches for alcohol dependence. Screening of memory deficits could also enable clinicians to detect, among alcoholics without ostensible neurologic complications, those at risk of developing permanent and debilitating amnesia that features KS.
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Changes in Affect and Drinking Outcomes in a Pharmacobehavioral Trial for Alcohol Dependence. ADDICTIVE DISORDERS & THEIR TREATMENT 2012; 11:14-25. [PMID: 22368517 DOI: 10.1097/adt.0b013e31821e1072] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE: Despite extensive research exploring affect in alcohol dependent individuals in recovery, empirical research on affective changes over the course of psychosocial treatment and their role on drinking outcomes has been minimal. The present study examined the relationship between changes in positive affect (PA), negative affect (NA), and drinking outcomes during a pharmacobehavioral trial. METHOD: Data for these post-hoc exploratory analyses were derived from a clinical trial of 321 alcohol dependent male and female individuals. The study design had four treatment arms for medication: three levels of dose of ondansetron as well as a control condition (placebo). All participants received weekly cognitive behavioral therapy for twelve weeks. We conducted an exploratory evaluation of changes in negative and positive affect and drinking behavior over time during the treatment phase of the trial using multilevel modeling. RESULTS: Participants experienced substantial reductions in drinking, decreases in NA, and increases in PA over the course of treatment. Individuals who experienced increases in PA over the course of treatment significantly reduced their drinking in subsequent weeks, while those who had reductions in NA only experienced reductions in drinking later in treatment if they also reported increases in PA. These results support the role of affect regulation in treatment. CONCLUSIONS: These results suggest that affective change during the course of treatment may serve as one potential mechanism of action for changes in drinking behavior. The interaction between reductions in NA and increases in PA may be particularly important in promoting new coping skills and reducing drinking.
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Marinkovic K, Rosen BQ, Cox B, Kovacevic S. Event-Related Theta Power during Lexical-Semantic Retrieval and Decision Conflict is Modulated by Alcohol Intoxication: Anatomically Constrained MEG. Front Psychol 2012; 3:121. [PMID: 22536192 PMCID: PMC3334511 DOI: 10.3389/fpsyg.2012.00121] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2012] [Accepted: 04/04/2012] [Indexed: 01/08/2023] Open
Abstract
Language processing is commonly characterized by an event-related increase in theta power (4-7 Hz) in scalp EEG. Oscillatory brain dynamics underlying alcohol's effects on language are poorly understood despite impairments on verbal tasks. To investigate how moderate alcohol intoxication modulates event-related theta activity during visual word processing, healthy social drinkers (N = 22, 11 females) participated in both alcohol (0.6 g/kg ethanol for men, 0.55 g/kg for women) and placebo conditions in a counterbalanced design. They performed a double-duty lexical decision task as they detected real words among non-words. An additional requirement to respond to all real words that also referred to animals induced response conflict. High density whole-head MEG signals and midline scalp EEG data were decomposed for each trial with Morlet wavelets. Each person's reconstructed cortical surface was used to constrain noise-normalized distributed minimum norm inverse solutions for theta frequencies. Alcohol intoxication increased reaction time and marginally affected accuracy. The overall spatio-temporal pattern is consistent with the left-lateralized fronto-temporal activation observed in language studies applying time-domain analysis. Event-related theta power was sensitive to the two functions manipulated by the task. First, theta estimated to the left-lateralized fronto-temporal areas reflected lexical-semantic retrieval, indicating that this measure is well suited for investigating the neural basis of language functions. While alcohol attenuated theta power overall, it was particularly deleterious to semantic retrieval since it reduced theta to real words but not pseudowords. Second, a highly overlapping prefrontal network comprising lateral prefrontal and anterior cingulate cortex was sensitive to decision conflict and was also affected by intoxication, in agreement with previous studies indicating that executive functions are especially vulnerable to alcohol intoxication.
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Affiliation(s)
- Ksenija Marinkovic
- Department of Radiology, University of CaliforniaSan Diego, CA, USA
- *Correspondence: Ksenija Marinkovic, Department of Radiology, University of California, San Diego, 9500 Gilman Drive 0841, La Jolla, CA 92093-0841, USA. e-mail:
| | - Burke Q. Rosen
- Department of Radiology, University of CaliforniaSan Diego, CA, USA
| | - Brendan Cox
- Martinos Center for Biomedical Imaging, Massachusetts General Hospital and Harvard Medical SchoolBoston, MA, USA
| | - Sanja Kovacevic
- Department of Radiology, University of CaliforniaSan Diego, CA, USA
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Newberg AB, Moss AS, Monti DA, Alavi A. Positron emission tomography in psychiatric disorders. Ann N Y Acad Sci 2011; 1228:E13-25. [DOI: 10.1111/j.1749-6632.2011.06162.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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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.
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Affiliation(s)
- Kylie M Dingwall
- Menzies School of Health Research, Institute of Advanced Studies, Charles Darwin University, Darwin, Australia.
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Guillot CR, Fanning JR, Bullock JS, McCloskey MS, Berman ME. Effects of alcohol on tests of executive functioning in men and women: a dose response examination. Exp Clin Psychopharmacol 2010; 18:409-17. [PMID: 20939644 PMCID: PMC3968820 DOI: 10.1037/a0021053] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Alcohol has been shown to affect performance on tasks associated with executive functioning. However, studies in this area have generally been limited to a single dose or gender or have used small sample sizes. The purpose of this study was to provide a more nuanced and systematic examination of alcohol's effects on commonly used tests of executive functioning at multiple dosages in both men and women. Research volunteers (91 women and 94 men) were randomly assigned to one of four drink conditions (alcohol doses associated with target blood alcohol concentrations of .000%, .050%, .075%, and .100%). Participants then completed three tasks comprising two domains of executive functioning: two set shifting tasks, the Trail Making Test and a computerized version of the Wisconsin Card Sorting Task, and a response inhibition task, the GoStop Impulsivity Paradigm. Impaired performance on set shifting tasks was found at the .100% and .075% dosages, but alcohol intoxication did not impair performance on the GoStop. No gender effects emerged. Thus, alcohol negatively affects set shifting at moderately high levels of intoxication in both men and women, likely attributable to alcohol's interference with prefrontal cortex function. Although it is well established that alcohol negatively affects response inhibition as measured by auditory stop-signal tasks, alcohol does not appear to exert a negative effect on response inhibition as measured by the GoStop, a visual stop-signal task.
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Affiliation(s)
- Casey R. Guillot
- Department of Psychology, The University of Southern Mississippi, 118 College Drive #5025, Hattiesburg, MS 39406
| | - Jennifer R. Fanning
- Department of Psychology, The University of Southern Mississippi, 118 College Drive #5025, Hattiesburg, MS 39406
| | - Joshua S. Bullock
- Department of Psychology, The University of Southern Mississippi, 118 College Drive #5025, Hattiesburg, MS 39406
| | - Michael S. McCloskey
- The Department of Psychology, Weiss Hall, Temple University, 1701 North 13th Street, Philadelphia, PA 19122-6085
| | - Mitchell E. Berman
- Corresponding author. Department of Psychology, The University of Southern Mississippi, 118 College Drive #5025, Hattiesburg, MS 39406, Tel.: +1-601-266-4570; fax: +1-601-266-5580.
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Abstract
The prefrontal cortex occupies the anterior portion of the frontal lobes and is thought to be one of the most complex anatomical and functional structures of the mammalian brain. Its major role is to integrate and interpret inputs from cortical and sub-cortical structures and use this information to develop purposeful responses that reflect both present and future circumstances. This includes both action-oriented sequences involved in obtaining rewards and inhibition of behaviors that pose undue risk or harm to the individual. Given the central role in initiating and regulating these often complex cognitive and behavioral responses, it is no surprise that alcohol has profound effects on the function of the prefrontal cortex. In this chapter, we review the basic anatomy and physiology of the prefrontal cortex and discuss what is known about the actions of alcohol on the function of this brain region. This includes a review of both the human and animal literature including information on the electrophysiological and behavioral effects that follow acute and chronic exposure to alcohol. The chapter concludes with a discussion of unanswered questions and areas needing further investigation.
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Asada T, Takaya S, Takayama Y, Yamauchi H, Hashikawa K, Fukuyama H. Reversible alcohol-related dementia: a five-year follow-up study using FDG-PET and neuropsychological tests. Intern Med 2010; 49:283-7. [PMID: 20154432 DOI: 10.2169/internalmedicine.49.2662] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVE As the pathophysiology of alcohol-related dementia (ARD) is unclear, we examined a patient with reversible ARD using neuropsychological tests and (18)F-fluorodeoxyglucose positron emission tomography (FDG-PET). DESIGN A five-year follow-up case study with neuropsychological tests and FDG-PET. SETTING Kyoto University Hospital. Patients A 42-year-old patient who was unable to perform his office duties because of slowly progressive amnesia with executive dysfunction. RESULTS The initial evaluation with neuropsychological tests showed severe verbal memory disturbance. The patient did not discuss his excessive alcohol consumption in the initial history-taking session and thiamine deficiency was absent; therefore, early-stage Alzheimer's disease was suspected. Later, the patient revealed prior excessive alcohol intake and his cognitive function improved markedly after a period of abstinence. Retrospective analysis of initial FDG-PET images using a voxel-wise statistical method revealed glucose hypometabolism in the diencephalon and basal forebrain. Follow-up for 5 years after the initial evaluation showed improved cognitive function and recovery of glucose metabolism in the two brain regions. CONCLUSION Hypofunction in the diencephalon and basal forebrain was associated with cognitive decline in our patient. This case may provide evidence for the etiopathic brain regions in reversible type ARD.
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Affiliation(s)
- Tomohiko Asada
- Human Brain Research Center, Kyoto University Graduate School of Medicine, Kyoto
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Green A, Garrick T, Sheedy D, Blake H, Shores EA, Harper C. The effect of moderate to heavy alcohol consumption on neuropsychological performance as measured by the repeatable battery for the assessment of neuropsychological status. Alcohol Clin Exp Res 2009; 34:443-50. [PMID: 20028356 DOI: 10.1111/j.1530-0277.2009.01108.x] [Citation(s) in RCA: 70] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Excessive alcohol use is associated with damage to the structure and function of the brain and impairment of cognition and behavior. Traditional test batteries used to assess cognitive performance in alcoholics are extensive and costly, limiting their use across various clinical and research settings. The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) is a relatively new instrument that attempts to overcome some of these limitations. As yet the individual effect of moderate to heavy alcohol consumption on RBANS performance has not been examined. The primary aim of this study was to explore and quantify differences in performance between controls and drinkers on the RBANS and to examine the influence of age, gender, and alcohol use patterns on test performance. METHODS Data from a subset of "Using Our Brains" (UoB) donors (n = 28) still actively drinking and meeting criteria for moderate to heavy alcohol use (30 to 80 g of ethanol per day) (Harper, 1988) and 28 matched controls (age, education, and premorbid Intelligence Quotient) were compared. RESULTS Participants in the alcohol group performed below the healthy control group on the visuospatial and immediate memory index, and also on the RBANS total score p < 0.001 and showed a greater decline in RBANS scores from estimated cross-sectional premorbid levels. There was a positive association between alcohol ingestion in the preceding 12 months and the language index p < 0.03 and the semantic fluency subtest (p < 0.03). Age was negatively associated with story memory (p < 0.02), coding (p < 0.001), list recognition (p < 0.01), story recall (p < 0.03), and figure recall (p < 0.02). CONCLUSION Our results suggest that the RBANS is able to detect and characterize differences in verbal fluency, visuospatial skills, components of declarative memory, and psychomotor speed between healthy controls and moderate to heavy active alcohol users. Executive functions, commonly affected by alcoholism and not included in the RBANS, require assessment with additional measures.
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Affiliation(s)
- Alisa Green
- Department of Pathology, University of Sydney, New South Wales, Australia.
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Hudetz JA, Patterson KM, Byrne AJ, Iqbal Z, Gandhi SD, Warltier DC, Pagel PS. A history of alcohol dependence increases the incidence and severity of postoperative cognitive dysfunction in cardiac surgical patients. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2009; 6:2725-39. [PMID: 20049218 PMCID: PMC2800057 DOI: 10.3390/ijerph6112725] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/27/2009] [Accepted: 10/17/2009] [Indexed: 12/12/2022]
Abstract
Postoperative cognitive dysfunction (POCD) commonly occurs after cardiac surgery. We tested the hypothesis that a history of alcohol dependence is associated with an increased incidence and severity of POCD in male patients undergoing cardiac surgery using cardiopulmonary bypass. Recent verbal and nonverbal memory and executive functions were assessed before and one week after surgery in patients with or without a history of alcohol dependence. Cognitive function was significantly reduced after cardiac surgery in patients with versus without a history of alcohol dependence. The results suggest that a history of alcohol dependence increases the incidence and severity of POCD after cardiac surgery.
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Affiliation(s)
- Judith A. Hudetz
- Department of Anesthesiology, Medical College of Wisconsin, Milwaukee, WI 53226, USA; E-Mails:
(Z.I.);
(S.D.G.);
(D.C.W.);
(P.S.P)
- Clement J. Zablocki Veterans Administration Medical Center, Milwaukee, WI 53295, USA; E-Mails:
(K.M.P.);
(A.J.B.)
| | - Kathleen M. Patterson
- Clement J. Zablocki Veterans Administration Medical Center, Milwaukee, WI 53295, USA; E-Mails:
(K.M.P.);
(A.J.B.)
- Departments of Psychiatry, Behavioral Medicine, and Neurology Medical College of Wisconsin, Milwaukee, WI 53226, USA
| | - Alison J. Byrne
- Clement J. Zablocki Veterans Administration Medical Center, Milwaukee, WI 53295, USA; E-Mails:
(K.M.P.);
(A.J.B.)
| | - Zafar Iqbal
- Department of Anesthesiology, Medical College of Wisconsin, Milwaukee, WI 53226, USA; E-Mails:
(Z.I.);
(S.D.G.);
(D.C.W.);
(P.S.P)
- Clement J. Zablocki Veterans Administration Medical Center, Milwaukee, WI 53295, USA; E-Mails:
(K.M.P.);
(A.J.B.)
| | - Sweeta D. Gandhi
- Department of Anesthesiology, Medical College of Wisconsin, Milwaukee, WI 53226, USA; E-Mails:
(Z.I.);
(S.D.G.);
(D.C.W.);
(P.S.P)
- Clement J. Zablocki Veterans Administration Medical Center, Milwaukee, WI 53295, USA; E-Mails:
(K.M.P.);
(A.J.B.)
| | - David C. Warltier
- Department of Anesthesiology, Medical College of Wisconsin, Milwaukee, WI 53226, USA; E-Mails:
(Z.I.);
(S.D.G.);
(D.C.W.);
(P.S.P)
- Clement J. Zablocki Veterans Administration Medical Center, Milwaukee, WI 53295, USA; E-Mails:
(K.M.P.);
(A.J.B.)
| | - Paul S. Pagel
- Department of Anesthesiology, Medical College of Wisconsin, Milwaukee, WI 53226, USA; E-Mails:
(Z.I.);
(S.D.G.);
(D.C.W.);
(P.S.P)
- Clement J. Zablocki Veterans Administration Medical Center, Milwaukee, WI 53295, USA; E-Mails:
(K.M.P.);
(A.J.B.)
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Pitel AL, Rivier J, Beaunieux H, Vabret F, Desgranges B, Eustache F. Changes in the Episodic Memory and Executive Functions of Abstinent and Relapsed Alcoholics Over a 6-Month Period. Alcohol Clin Exp Res 2009; 33:490-8. [DOI: 10.1111/j.1530-0277.2008.00859.x] [Citation(s) in RCA: 107] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Kashem MA, Harper C, Matsumoto I. Differential protein expression in the corpus callosum (genu) of human alcoholics. Neurochem Int 2008; 53:1-11. [DOI: 10.1016/j.neuint.2008.04.003] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2008] [Revised: 04/08/2008] [Accepted: 04/14/2008] [Indexed: 01/17/2023]
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Verdejo-García A, Pérez-García M. Ecological assessment of executive functions in substance dependent individuals. Drug Alcohol Depend 2007; 90:48-55. [PMID: 17382487 DOI: 10.1016/j.drugalcdep.2007.02.010] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2006] [Revised: 02/08/2007] [Accepted: 02/09/2007] [Indexed: 10/23/2022]
Abstract
Substance dependence is associated with executive function deficits. However, most available studies have examined the performance of substance dependent individuals (SDI) on traditional laboratory measures of executive functions, whereas few studies have used ecologically valid assessments with SDI. Our aim was to examine the performance of 37 SDI (poly-substance users) and 37 matched controls on an ecologically valid measure of executive function (the Behavioural Assessment of the Dysexecutive Syndrome - BADS). We also administered the Wisconsin Card Sorting Test (WCST) to investigate whether ecological measures were more discriminative than traditional tests in detecting SDI deficits. A related aim was to examine the ability of the BADS (and the WCST) to predict everyday executive problems. Results showed that SDI had widespread deficits on ecological measures of executive function. Conversely, we found no differences between groups on the WCST. Furthermore, the BADS (but not the WCST) predicted everyday problems related to apathy, disinhibition, and executive dysfunction.
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Abstract
Alcoholism results from an interplay between genetic and environmental factors, and is linked to brain defects and associated cognitive, emotional, and behavioral impairments. A confluence of findings from neuroimaging, physiological, neuropathological, and neuropsychological studies of alcoholics indicate that the frontal lobes, limbic system, and cerebellum are particularly vulnerable to damage and dysfunction. An integrative approach employing a variety of neuroscientific technologies is essential for recognizing the interconnectivity of the different functional systems affected by alcoholism. In that way, relevant experimental techniques can be applied to assist in determining the degree to which abstinence and treatment contribute to the reversal of atrophy and dysfunction.
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Affiliation(s)
- Marlene Oscar-Berman
- Department of Anatomy and Neurobiology, Boston University School of Medicine, L-815, 715 Albany Street, Boston, MA 02118, USA.
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Akine Y, Kato M, Muramatsu T, Umeda S, Mimura M, Asai Y, Tanada S, Obata T, Ikehira H, Kashima H, Suhara T. Altered brain activation by a false recognition task in young abstinent patients with alcohol dependence. Alcohol Clin Exp Res 2007; 31:1589-97. [PMID: 17624993 DOI: 10.1111/j.1530-0277.2007.00453.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Heavy alcohol intake induces both structural and functional changes in the central nervous system. Recent research developments converged on the idea that even in patients with alcohol dependence without apparent structural brain changes, some cognitive impairment exists, and associated functional change could be visualized by neuroimaging techniques. However, these data were from old (more than 50 years) patients using working memory and response inhibition tasks. Whether young abstinent patients show aberrant signs of brain activation is a matter of interest, specifically by the long-term memory retrieval task. METHODS Subjects were 9 young patients with alcohol dependence with long-term abstinent (8 males and 1 female) and age- and education-matched 9 healthy controls (7 males and 2 females). We used a modified false recognition task in a functional MRI study. RESULTS The young patients with alcohol dependence showed reduced activation in the right dorsolateral prefrontal cortex, anterior cingulate cortex (ACC), left pulvinar in the thalamus, and in the right ventral striatum, although behavioral performances and regional patterns of brain activation were similar between patients and controls. CONCLUSIONS Long-term memory retrieval induced altered activations in prefrontal lobes, ACC, thalamus, and ventral striatum in young patients with alcohol dependence. These findings were correspondent to deficits of goal directed behavior, monitoring the erroneous responses, memory function, and drug-seeking behavior. Furthermore, these reduced activations can be considered as latent "lesions," suggesting subclinical pathology in alcoholic brains.
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Affiliation(s)
- Yoshihide Akine
- Department of Molecular Neuroimaging, Molecular Imaging Center, National Institute of Radiological Sciences, Chiba, Japan
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Prendergast MA, Little HJ. Adolescence, glucocorticoids and alcohol. Pharmacol Biochem Behav 2006; 86:234-45. [PMID: 16930684 DOI: 10.1016/j.pbb.2006.07.008] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2006] [Revised: 06/05/2006] [Accepted: 07/06/2006] [Indexed: 11/22/2022]
Abstract
This review examines the evidence that glucocorticoids are involved, during both adolescence and adulthood, in the cognitive deficits caused by long-term alcohol consumption and in the mechanism(s) of alcohol dependence. During adolescence, the hypothalamopituitary-adrenal (HPA) axis undergoes well-characterized changes in basal activity and many of these are influenced by alcohol consumption. While the former have been fairly well studied, there is little information about whether alcohol effects on the HPA in adolescents differ from those in adults. The means by which glucocorticoids may influence alcohol-related neurotoxicity are presented, and potential differences between adolescence and adults in this regard noted. The substantial evidence for involvement of glucocorticoids in alcohol-induced cognitive deficits is described, with particular reference to the consequences of alcohol withdrawal. The use of immature organotypic cultures of rodent brain in the study of alcohol neurotoxicity is considered in detail, and the information obtained from this methodology concerning the role of glucocorticoid receptors and excitable membrane proteins in this neurotoxicity. The influence of glucocorticoids on alcohol consumption and possible contributions to alcohol dependence are then considered. In conclusion, more information concerning the effects of glucocorticoids on plasticity and alcohol neurotoxicity during the adolescent period is needed.
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Affiliation(s)
- Mark A Prendergast
- Department of Psychology, University of Kentucky, B363 BBSRB, 741 S. Limestone, University of Kentucky, Lexington, KY 40536-0509, USA
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Prendergast MA, Harris BR, Mullholland PJ, Blanchard JA, Gibson DA, Holley RC, Littleton JM. Hippocampal CA1 region neurodegeneration produced by ethanol withdrawal requires activation of intrinsic polysynaptic hippocampal pathways and function of N-methyl-D-aspartate receptors. Neuroscience 2004; 124:869-77. [PMID: 15026127 DOI: 10.1016/j.neuroscience.2003.12.013] [Citation(s) in RCA: 70] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/10/2003] [Indexed: 10/26/2022]
Abstract
Long-term intake of ethanol produces adaptive alterations in multiple transmitter systems in the hippocampal formation that likely contribute to ethanol withdrawal-induced seizure and excitotoxicity. The present studies were designed to examine the role of N-methyl-d-aspartate receptor activation and cytosolic Ca(2+) accumulation in the neurotoxic effects of ethanol withdrawal. Further, these studies investigated the role of hippocampal network excitation in promoting both Ca(2+) accumulation and neurotoxicity during ethanol withdrawal. Chronic, continuous (11 day) exposure to ethanol (91 mM starting concentration) did not produce neurotoxicity in any region of organotypic hippocampal explants, as measured by uptake of the non-vital fluorescent marker propidium iodide. Withdrawal from chronic (10 day) ethanol exposure was associated with rapid (30 min) and significant increases in intracellular Ca(2+), assessed by visualization of Calcium-Orange fluorescence, in each region of hippocampal explants. However, neurotoxicity was observed 24 h after initiation of withdrawal and was only seen in the cornu ammonis 1 (CA1) region. Exposure to MK-801 (20 microM) at the start of ethanol withdrawal markedly attenuated Ca(2+) entry in all regions, as well as, CA1 region neurodegeneration. Further, treatment of explants with tetrodotoxin (500 nM) as well as surgical transection of mossy fiber or Schaffer collateral projections immediately prior to ethanol withdrawal blocked both regional increases in Ca(2+) accumulation and CA1 neurotoxicity. These data suggest that neurodegeneration observed during ethanol withdrawal is dependent upon polysynaptic propagation of action potentials ("network excitation") and whole-hippocampal excitation of glutamatergic systems.
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Affiliation(s)
- M A Prendergast
- Department of Psychology, University of Kentucky, 115 Kastle Hall, Lexington, KY 40506-0044, USA.
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Zinn S, Bosworth HB, Edwards CL, Logue PE, Swartzwelder HS. Performance of recently detoxified patients with alcoholism on a neuropsychological screening test. Addict Behav 2003; 28:837-49. [PMID: 12788260 DOI: 10.1016/s0306-4603(02)00258-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
OBJECTIVE Early in recovery from alcoholism, cognitive deficits may compromise patients' utilization of rehabilitative information. Cognitive impairment in a sample of newly detoxified inpatients with alcoholism was examined using the Neurobehavioral Cognitive Status Examination (NCSE). METHODS Consecutively admitted psychiatric inpatients (N=233) with an alcohol-related primary diagnosis (63% male, mean age 46.3) were administered the NCSE following medical stabilization. Within-samples differences between age and diagnostic groups were examined and scores were compared to normative samples. RESULTS Inpatients older than 50 demonstrated significant cognitive deficits for all scales except Attention. In comparison with normative samples, patients with alcoholism produced lower scores, with the most pronounced deficits among middle-aged patients. In alcohol-abusing patients with medical comorbidities, language deficits and more severe memory deficits were observed. Abuse severity or comorbid psychiatric disorder produced no differences in NCSE scores. CONCLUSIONS Neuropsychological screening following detoxification in patients diagnosed with an alcohol disorder reflected the effects of increased age and medical comorbidity. Our finding of frequent deficits in abstraction, comprehension, and memory suggests that cognitive-behavioral treatments for inpatients may be less effective if cognitive impairment is not considered.
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Affiliation(s)
- Sandra Zinn
- Health Services Research and Development, Building 16, Room 55, Durham Veterans Affairs Medical Center (152), 508 Fulton Street, Durham, NC 27705, USA.
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Miguel-Hidalgo JJ, Wei J, Andrew M, Overholser JC, Jurjus G, Stockmeier CA, Rajkowska G. Glia pathology in the prefrontal cortex in alcohol dependence with and without depressive symptoms. Biol Psychiatry 2002; 52:1121-33. [PMID: 12488057 PMCID: PMC3115671 DOI: 10.1016/s0006-3223(02)01439-7] [Citation(s) in RCA: 108] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Reductions in glial density and enlargement of glial nuclei have been reported in the dorsolateral prefrontal cortex (dlPFC) in mood disorders. In alcohol dependence, often comorbid with depression, it is unclear whether there are changes in the density and size of glial cells in the dlPFC. METHODS The packing density and size of Nissl-stained glial cell nuclei were analyzed postmortem in the cortical layers of the dlPFC from 21 control and 17 alcohol-dependent (Alc) subjects without Wernicke or Korsakoff syndromes. Eight Alc subjects had depressive symptoms. The density of glial cells was measured with a three-dimensional cell counting method, and the areal fraction of glial fibrillary acidic protein immunoreactivity (GFAP) was also determined. RESULTS Glial density was reduced by 11-14% in layers V and VI and in all layers combined in the Alc group. The size of glial nuclei was decreased by 3.2% in Alc subjects. The Alc subjects with depressive symptoms showed the lowest values of density and size. There was no difference in GFAP immunoreactivity, although the lowest values were in the Alc group. CONCLUSIONS Alcohol dependence is characterized by decreases in both density and size of glia in the dlPFC. Glial pathology may be more severe in Alc subjects with depressive symptoms.
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Affiliation(s)
- José Javier Miguel-Hidalgo
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, Mississippi, USA
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Nath A, Hauser KF, Wojna V, Booze RM, Maragos W, Prendergast M, Cass W, Turchan JT. Molecular basis for interactions of HIV and drugs of abuse. J Acquir Immune Defic Syndr 2002; 31 Suppl 2:S62-9. [PMID: 12394784 DOI: 10.1097/00126334-200210012-00006] [Citation(s) in RCA: 189] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
In certain populations around the world, the HIV pandemic is being driven by drug-abusing populations. Mounting evidence suggests that these patient populations have accelerated and more severe neurocognitive dysfunction compared with non-drug-abusing HIV-infected populations. Because most drugs of abuse are central nervous system stimulants, it stands to reason that these drugs may synergize with neurotoxic substances released during the course of HIV infection. Clinical and laboratory evidence suggests that the dopaminergic systems are most vulnerable to such combined neurotoxicity. Identifying common mechanisms of neuronal injury is critical to developing therapeutic strategies for drug-abusing HIV-infected populations. This article reviews 1) the current evidence for neurodegeneration in the setting of combined HIV infection and use of methamphetamine, cocaine, heroin or alcohol; 2) the proposed underlying mechanisms involved in this combined neurotoxicity; and 3) future directions for research. This article also suggests therapeutic approaches based on our current understanding of the neuropathogenesis of dementia due to HIV infection and drugs of abuse.
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Affiliation(s)
- Avi Nath
- Department of Neurology, John Hopkins University, Baltimore, Maryland 21287, USA.
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Newberg A, Alavi A, Reivich M. Determination of regional cerebral function with FDG-PET imaging in neuropsychiatric disorders. Semin Nucl Med 2002; 32:13-34. [PMID: 11839066 DOI: 10.1053/snuc.2002.29276] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Functional brain imaging using 18F fluorodeoxyglucose (FDG) and positron emission tomography (PET) has greatly enhanced our understanding of brain function both in normal conditions as well as in a wide variety of neuropsychiatric disorders. We review the uses of FDG PET in the diagnosis, management, and follow-up of patients with neuropsychiatric disorders. This article will also explore what FDG-PET imaging has revealed in these neuropsychiatric disorders and how these findings relate to both research and clinical applications.
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Affiliation(s)
- Andrew Newberg
- Division of Nuclear Medicine, The Hospital of the University of Pennsylvania, Philadelphia 19104, USA
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Peterson MA, Patterson B, Pillman BM, Battista MA. Cognitive recovery following alcohol detoxification: A computerised remediation study. Neuropsychol Rehabil 2002. [DOI: 10.1080/09602010143000167] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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Wendt PE, Risberg J. Ethanol reduces rCFB activation of left dorsolateral prefrontal cortex during a verbal fluency task. BRAIN AND LANGUAGE 2001; 77:197-215. [PMID: 11300704 DOI: 10.1006/brln.2000.2434] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
In a previous study in normal subjects (Wendt et al., 1994), using a reversing checkerboard as activation stimulus, we found that the coupling between local neuronal activity and regional cerebral blood flow was preserved following ethanol, and that a right-sided occipital activation response seen during sobriety became symmetrical during inebriation. In the present study we investigated if ethanol has a detrimental effect also on the activation of the left dorsolateral prefrontal cortex found in normals during verbal fluency. Measurements of regional cerebral blood flow in 20 healthy, young, male, right-handed volunteers during rest and verbal fluency were made during sobriety and inebriation (0.06% blood alcohol concentration) with a 1-week interval. We found a decrease in word production during inebriation. The normal activation within the frontotemporal part of the left dorsolateral prefrontal cortext was preserved during inebriation. The activation of this region seems thus to be robust to the effects of ethanol. During inebriation no activation response to the word fluency test was found in the anterior prefrontal part of the dorsolateral prefrontal cortex. This region is important for working, temporal, and short-term memory functions, processes that are affected by ethanol. Hemispheric functioning and specialization seem to be adversely affected by ethanol, regardless of which hemisphere is most involved while sober.
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Affiliation(s)
- P E Wendt
- Department of Psychology, University of Lund, Lund, Sweden
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Prendergast MA, Harris BR, Mayer S, Littleton JM. Chronic, But Not Acute, Nicotine Exposure Attenuates Ethanol Withdrawal-Induced Hippocampal Damage In Vitro. Alcohol Clin Exp Res 2000. [DOI: 10.1111/j.1530-0277.2000.tb04578.x] [Citation(s) in RCA: 43] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Munro CA, Saxton J, Butters MA. The Neuropsychological Consequences of Abstinence Among Older Alcoholics: A Cross-Sectional Study. Alcohol Clin Exp Res 2000. [DOI: 10.1111/j.1530-0277.2000.tb04569.x] [Citation(s) in RCA: 84] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Ihara H, Berrios GE, London M. Group and case study of the dysexecutive syndrome in alcoholism without amnesia. J Neurol Neurosurg Psychiatry 2000; 68:731-7. [PMID: 10811696 PMCID: PMC1736975 DOI: 10.1136/jnnp.68.6.731] [Citation(s) in RCA: 99] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVES To test the dysexecutive syndrome (DES) hypothesis of chronic alcoholism by the neuropsychological group and case study approaches. METHODS A comprehensive neuropsychological assessment, including the "behavioural assessment of dysexecutive syndrome", a battery of tests recently designed to be "ecologically valid", was administered to 17 patients with chronic alcoholism without amnesia to examine executive functions, intelligence, and memory. In terms of each neuropsychological measure, reciprocal analyses of group means and individual case profiles were conducted: for the first contrasting the alcoholic patients with 17 age matched healthy subjects; and for the second making intersubject and intrasubject comparison of the patients, according to percentile basis impairment indices obtained from the control subjects. RESULTS Despite relatively unimpaired memory and intelligence, the patients as a whole had the impairment of a wide range of executive domains, extending to "everyday" problem solving as well as more elementary aspects of executive functions, such as visuospatial performance, mental set shifting, and the inhibition of habitual behaviour. The profile analysis divided individual patients into four groups: the representative DES characterised by a clear dissociation between impaired executive functions and preserved intelligence and memory; the group of a modified dysexecutive pattern in which memory as well as executive functions were impaired with intelligence preserved; the group of general cognitive deterioration; and the group of unimpaired cognitive functioning. About two thirds of the patients were categorised into either the first or the second type of DES. CONCLUSION DES characterised by the even more pronounced impairment of executive functions than of intelligence and memory afflicts a considerable proportion of patients with chronic alcoholism. Due to its subtlety, this would be potentially left out, unless appropriate behavioural measures were administered. This condition may prevent patients with alcoholism from achieving full recovery and benefiting from rehabilitation.
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MESH Headings
- Activities of Daily Living/psychology
- Adult
- Alcohol Amnestic Disorder/diagnosis
- Alcohol Amnestic Disorder/physiopathology
- Alcohol Amnestic Disorder/rehabilitation
- Alcohol-Induced Disorders, Nervous System/diagnosis
- Alcohol-Induced Disorders, Nervous System/physiopathology
- Alcohol-Induced Disorders, Nervous System/rehabilitation
- Brain Damage, Chronic/diagnosis
- Brain Damage, Chronic/physiopathology
- Brain Damage, Chronic/rehabilitation
- Disruptive, Impulse Control, and Conduct Disorders/diagnosis
- Disruptive, Impulse Control, and Conduct Disorders/physiopathology
- Disruptive, Impulse Control, and Conduct Disorders/rehabilitation
- Female
- Frontal Lobe/physiopathology
- Humans
- Intelligence/physiology
- Male
- Mental Recall/physiology
- Middle Aged
- Neuropsychological Tests
- Problem Solving/physiology
- Syndrome
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Affiliation(s)
- H Ihara
- Department of Psychiatry, University of Cambridge, UK.
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Abstract
Brain atrophy in alcoholics has been identified using both radiological and pathological techniques. However the magnitude and topography of the atrophy, and the factors which contribute to it, are unclear. This review compares the results of imaging and pathological studies in alcoholics examining variables which may contribute to any discrepancies. We conclude that significant brain damage does occur as a result of alcohol abuse per se, that the damage is regionally specific with the frontal lobes being particularly affected, and that both grey matter and white matter components are damaged.
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Affiliation(s)
- J J Kril
- Centre for Education and Research on Ageing, The University of Sydney, Concord Hospital, Australia.
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Affiliation(s)
- S J Gatley
- Medical Department, Brookhaven National Laboratory, Upton, New York 11973, USA.
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