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Powell A, Sumnall H, Smith J, Kuiper R, Montgomery C. Recovery of neuropsychological function following abstinence from alcohol in adults diagnosed with an alcohol use disorder: Systematic review of longitudinal studies. PLoS One 2024; 19:e0296043. [PMID: 38166127 PMCID: PMC10760842 DOI: 10.1371/journal.pone.0296043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 12/05/2023] [Indexed: 01/04/2024] Open
Abstract
BACKGROUND Alcohol use disorders (AUD) associate with structural and functional brain differences, including impairments in neuropsychological function; however, reviews (mostly cross-sectional) are inconsistent with regards to recovery of such functions following abstinence. Recovery is important, as these impairments associate with treatment outcomes and quality of life. OBJECTIVE(S) To assess neuropsychological function recovery following abstinence in individuals with a clinical AUD diagnosis. The secondary objective was to assess predictors of neuropsychological recovery in AUD. METHODS Following the preregistered protocol (PROSPERO: CRD42022308686), APA PsycInfo, EBSCO MEDLINE, CINAHL, and Web of Science Core Collection were searched between 1999-2022. Study reporting follows the Joanna Briggs Institute (JBI) Manual for Evidence Synthesis, study quality was assessed using the JBI Checklist for Cohort Studies. Eligible studies were those with a longitudinal design that assessed neuropsychological recovery following abstinence from alcohol in adults with a clinical diagnosis of AUD. Studies were excluded if participant group was defined by another or co-morbid condition/injury, or by relapse. Recovery was defined as function reaching 'normal' performance. RESULTS Sixteen studies (AUD n = 783, controls n = 390) were selected for narrative synthesis. Most functions demonstrated recovery within 6-12 months, including sub-domains within attention, executive function, perception, and memory, though basic processing speed and working memory updating/tracking recovered earlier. Additionally, verbal fluency was not impaired at baseline (while verbal function was not assessed compared to normal levels), and concept formation and reasoning recovery was inconsistent. CONCLUSIONS These results provide evidence that recovery of most functions is possible. While overall robustness of results was good, methodological limitations included lack of control groups, additional methods to self-report to confirm abstinence, description/control for attrition, statistical control of confounds, and of long enough study durations to capture change.
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Affiliation(s)
- Anna Powell
- School of Psychology, Faculty of Health, Liverpool John Moores University, Liverpool, United Kingdom
- Liverpool Centre for Alcohol Research, University of Liverpool, Liverpool, United Kingdom
| | - Harry Sumnall
- Liverpool Centre for Alcohol Research, University of Liverpool, Liverpool, United Kingdom
- Public Health Institute, Faculty of Health, Liverpool John Moores University, Liverpool, United Kingdom
| | - Jessica Smith
- Liverpool Centre for Alcohol Research, University of Liverpool, Liverpool, United Kingdom
- Public Health Institute, Faculty of Health, Liverpool John Moores University, Liverpool, United Kingdom
| | - Rebecca Kuiper
- School of Psychology, Faculty of Health, Liverpool John Moores University, Liverpool, United Kingdom
- Liverpool Centre for Alcohol Research, University of Liverpool, Liverpool, United Kingdom
| | - Catharine Montgomery
- School of Psychology, Faculty of Health, Liverpool John Moores University, Liverpool, United Kingdom
- Liverpool Centre for Alcohol Research, University of Liverpool, Liverpool, United Kingdom
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Ariesen AMD, Neubert JH, Gaastra GF, Tucha O, Koerts J. Risky Decision-Making in Adults with Alcohol Use Disorder-A Systematic and Meta-Analytic Review. J Clin Med 2023; 12:jcm12082943. [PMID: 37109278 PMCID: PMC10143407 DOI: 10.3390/jcm12082943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 04/11/2023] [Accepted: 04/14/2023] [Indexed: 04/29/2023] Open
Abstract
Alcohol use disorder (AUD) forms a major health concern and is the most common substance use disorder worldwide. The behavioural and cognitive deficits associated with AUD have often been related to impairments in risky decision-making. The aim of this study was to examine the magnitude and type of risky decision-making deficits of adults with AUD, as well as to explore the potential mechanisms behind these deficits. To this end, existing literature comparing risky decision-making task performance of an AUD group to a control group (CG) was systematically searched and analysed. A meta-analysis was performed to address overall effects. In total, 56 studies were included. In the majority of studies (i.e., 68%), the performance of the AUD group(s) deviated from the CG(s) on one or more of the adopted tasks, which was confirmed by a small to medium pooled effect size (Hedges' g = 0.45). This review therefore provides evidence of increased risk taking in adults with AUD as compared to CGs. The increased risk taking may be due to deficits in affective and deliberative decision-making. Making use of ecologically valid tasks, future research should investigate whether risky decision-making deficits predate and/or are consequential to the addiction of adults with AUD.
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Affiliation(s)
- Akke-Marij D Ariesen
- Department of Clinical and Developmental Neuropsychology, University of Groningen, 9712 TS Groningen, The Netherlands
| | - Julia H Neubert
- Department of Clinical and Developmental Neuropsychology, University of Groningen, 9712 TS Groningen, The Netherlands
| | - Geraldina F Gaastra
- Department of Clinical and Developmental Neuropsychology, University of Groningen, 9712 TS Groningen, The Netherlands
| | - Oliver Tucha
- Department of Clinical and Developmental Neuropsychology, University of Groningen, 9712 TS Groningen, The Netherlands
- Department of Psychiatry and Psychotherapy, University Medical Center Rostock, 18147 Rostock, Germany
- Department of Psychology, Maynooth University, National University of Ireland, W23 F2K8 Maynooth, Ireland
| | - Janneke Koerts
- Department of Clinical and Developmental Neuropsychology, University of Groningen, 9712 TS Groningen, The Netherlands
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Clergue-Duval V, Barré T, Cognat E, Brichet AL, Géraud C, Azuar J, Michaud P, Lecallier D, Arfaoui-Geffroy S, Hispard E, Paquet C, Bellivier F, Questel F, Vorspan F. Patients With Severe Alcohol-Related Cognitive Impairment Improve in Flexibility When Abstinence Is Maintained: A Comparative Study With Alzheimer’s Disease. Front Psychol 2022; 13:936639. [PMID: 35846663 PMCID: PMC9285013 DOI: 10.3389/fpsyg.2022.936639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 06/06/2022] [Indexed: 11/16/2022] Open
Abstract
The disease progression of severe alcohol-related cognitive impairment (ARCI) is debated. The aim of this study was to compare the cognitive change of patients with severe ARCI in inpatient setting to that of patients with Alzheimer’s disease (AD). Fifteen consecutive patients with severe ARCI were recruited between 2013 and 2015. They received inpatient detoxification, neurological assessment, and inpatient cognitive rehabilitation in specialized facilities. Twelve patients, with documented AD matched on sex and initial cognitive impairment severity, were selected. All have benefited from two neuropsychological assessments. The neurocognitive change was tested in both groups with pair-wised Wilcoxon tests. ARCI and AD patients’ time course was compared with Mann–Whitney–Wilcoxon test. In ARCI group, first assessment occurred at 2.9 (± 2.2) months of abstinence and follow-up 6.5 (± 2.9) months later, the mean age was 56.5 (± 7.4) years, and 12 were men. In AD group, follow-up occurred at 12.8 (± 2.9) months (p < 10–3), the mean age was 72.3 (± 8.4) years (p < 10–3), and 10 were men. ARCI patients significantly improved on one executive function test (TMT-B; p < 0.05), while AD patients have worsened memory subtests on Free-and-Cued-Selective-Reminding Test (p < 0.05). These tests showed a statistically different change between severe ARCI and AD group (p < 0.05). Severe ARCI patients have improved in executive functioning, discernible on the TMT-B test, in specific care setting, including abstinence maintenance and rehabilitation. The disease progression was different from that observed in AD patients.
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Affiliation(s)
- Virgile Clergue-Duval
- Département de Psychiatrie et de Médecine Addictologique, Site Lariboisière Fernand-Widal, GHU APHP. Nord - Université Paris Cité, APHP, Paris, France
- ResAlCog (Réseau Pour la Prise en Charge des Troubles Cognitifs Liés à L’alcool), Paris, France
- Inserm UMRS-1144, Optimisation Thérapeutique en Neuropsychopharmacologie, Université Paris Cité, Paris, France
- UFR de Médecine, Université Paris Cité, Paris, France
- *Correspondence: Virgile Clergue-Duval,
| | - Thomas Barré
- Département de Psychiatrie et de Médecine Addictologique, Site Lariboisière Fernand-Widal, GHU APHP. Nord - Université Paris Cité, APHP, Paris, France
- ResAlCog (Réseau Pour la Prise en Charge des Troubles Cognitifs Liés à L’alcool), Paris, France
| | - Emmanuel Cognat
- Inserm UMRS-1144, Optimisation Thérapeutique en Neuropsychopharmacologie, Université Paris Cité, Paris, France
- UFR de Médecine, Université Paris Cité, Paris, France
- Centre de Neurologie Cognitive, Site Lariboisière Fernand-Widal, GHU APHP. Nord - Université Paris Cité, APHP, Paris, France
| | - Anne-Laure Brichet
- ResAlCog (Réseau Pour la Prise en Charge des Troubles Cognitifs Liés à L’alcool), Paris, France
- Clinique des Epinettes, Paris, France
| | - Claire Géraud
- Département de Psychiatrie et de Médecine Addictologique, Site Lariboisière Fernand-Widal, GHU APHP. Nord - Université Paris Cité, APHP, Paris, France
- ResAlCog (Réseau Pour la Prise en Charge des Troubles Cognitifs Liés à L’alcool), Paris, France
| | - Julien Azuar
- Département de Psychiatrie et de Médecine Addictologique, Site Lariboisière Fernand-Widal, GHU APHP. Nord - Université Paris Cité, APHP, Paris, France
- ResAlCog (Réseau Pour la Prise en Charge des Troubles Cognitifs Liés à L’alcool), Paris, France
- Inserm UMRS-1144, Optimisation Thérapeutique en Neuropsychopharmacologie, Université Paris Cité, Paris, France
| | - Philippe Michaud
- ResAlCog (Réseau Pour la Prise en Charge des Troubles Cognitifs Liés à L’alcool), Paris, France
- Unité Serge Korsakoff-Maison d’Accueil Spécialisée, Villeneuve-la-Garenne, France
| | - Dorothée Lecallier
- ResAlCog (Réseau Pour la Prise en Charge des Troubles Cognitifs Liés à L’alcool), Paris, France
- Clinique des Epinettes, Paris, France
| | - Sonia Arfaoui-Geffroy
- ResAlCog (Réseau Pour la Prise en Charge des Troubles Cognitifs Liés à L’alcool), Paris, France
- Clinique Médicale du Parc, Saint-Ouen-l'Aumône, France
| | - Eric Hispard
- Département de Psychiatrie et de Médecine Addictologique, Site Lariboisière Fernand-Widal, GHU APHP. Nord - Université Paris Cité, APHP, Paris, France
- ResAlCog (Réseau Pour la Prise en Charge des Troubles Cognitifs Liés à L’alcool), Paris, France
| | - Claire Paquet
- Inserm UMRS-1144, Optimisation Thérapeutique en Neuropsychopharmacologie, Université Paris Cité, Paris, France
- UFR de Médecine, Université Paris Cité, Paris, France
- Centre de Neurologie Cognitive, Site Lariboisière Fernand-Widal, GHU APHP. Nord - Université Paris Cité, APHP, Paris, France
| | - Frank Bellivier
- Département de Psychiatrie et de Médecine Addictologique, Site Lariboisière Fernand-Widal, GHU APHP. Nord - Université Paris Cité, APHP, Paris, France
- Inserm UMRS-1144, Optimisation Thérapeutique en Neuropsychopharmacologie, Université Paris Cité, Paris, France
- UFR de Médecine, Université Paris Cité, Paris, France
| | - Frank Questel
- Département de Psychiatrie et de Médecine Addictologique, Site Lariboisière Fernand-Widal, GHU APHP. Nord - Université Paris Cité, APHP, Paris, France
- ResAlCog (Réseau Pour la Prise en Charge des Troubles Cognitifs Liés à L’alcool), Paris, France
- Inserm UMRS-1144, Optimisation Thérapeutique en Neuropsychopharmacologie, Université Paris Cité, Paris, France
| | - Florence Vorspan
- Département de Psychiatrie et de Médecine Addictologique, Site Lariboisière Fernand-Widal, GHU APHP. Nord - Université Paris Cité, APHP, Paris, France
- Inserm UMRS-1144, Optimisation Thérapeutique en Neuropsychopharmacologie, Université Paris Cité, Paris, France
- UFR de Médecine, Université Paris Cité, Paris, France
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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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Lloyd B, Oudman E, Altgassen M, Walvoort SJW, Kessels RPC, Postma A. Episodic future thinking together with observational learning benefits prospective memory in high-functioning Korsakoff's syndrome patients. BRITISH JOURNAL OF CLINICAL PSYCHOLOGY 2020; 59:369-383. [PMID: 32420647 PMCID: PMC7496103 DOI: 10.1111/bjc.12251] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Revised: 04/02/2020] [Indexed: 11/29/2022]
Abstract
Objective Patients with Korsakoff’s syndrome (KS) have difficulty carrying out tasks which rely on prospective memory (PM). Since remembering to carry out an action in the future is crucial for living independently, it is of primary interest to develop strategies that improve PM performance in KS patients. Design The study employed a computer categorization task as an ongoing activity into which a PM task was embedded. We included episodic future thinking (EFT) and observational learning (Experiment 2) to boost PM. Methods Experiment 1 evaluated the efficacy of EFT following written PM task instructions in ten KS patients. Due to floor‐level PM performance in Experiment 1, Experiment 2 included an instructional video demonstrating the PM intention. In Experiment 2, twenty‐six KS patients performed both conditions (EFT and no‐EFT) at least 1 week apart, while twelve controls with alcohol use disorder without KS performed the no‐EFT condition. In Experiment 2, the PM instructions were also shown through video (observational learning component). Mild cognitive impairment was assessed in a short test battery. Results Experiment 1 showed overall floor performance in both conditions. Experiment 2 showed that KS patients performed PM tasks less accurately than the control group in the no‐EFT condition. In Experiment 2, where the observational learning component was included, EFT improved PM performance in KS patients. This effect was driven by a sub‐group of high‐functioning KS patients. Conclusions This study showed the value of an observational learning component together with EFT in improving PM performance, in relatively high‐functioning KS patients. Practitioner points KS patients performed the PM task less accurately than non‐KS controls with alcohol use disorder, confirming PM impairment in this patient population. Controls with alcohol use disorder performed the PM task at ceiling level. Showing an instructional video demonstrating the PM intention improved PM performance and later recall of PM task instructions in KS patients. Episodic future thinking strategy improved PM performance in KS patients with relatively intact cognitive functioning.
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Affiliation(s)
- Beth Lloyd
- Helmholtz Institute, Experimental Psychology, Utrecht University, The Netherlands.,Slingedael Korsakoff Center, Rotterdam, The Netherlands
| | - Erik Oudman
- Helmholtz Institute, Experimental Psychology, Utrecht University, The Netherlands.,Slingedael Korsakoff Center, Rotterdam, The Netherlands
| | - Mareike Altgassen
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands.,Department of Psychology, Johannes Gutenberg-University Mainz, Germany
| | - Serge J W Walvoort
- Centre of Excellence for Korsakoff and Alcohol-Related Cognitive Disorders, Vincent van Gogh Institute for Psychiatry, Venray, The Netherlands
| | - Roy P C Kessels
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands.,Centre of Excellence for Korsakoff and Alcohol-Related Cognitive Disorders, Vincent van Gogh Institute for Psychiatry, Venray, The Netherlands.,Department of Medical Psychology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Albert Postma
- Helmholtz Institute, Experimental Psychology, Utrecht University, The Netherlands.,Slingedael Korsakoff Center, Rotterdam, The Netherlands
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6
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Tang WK, Lau CG, Ungvari GS, Lin SK, Lane HY. Recovery of cognitive functioning following abstinence from ketamine. Addict Behav 2019; 99:106081. [PMID: 31470241 DOI: 10.1016/j.addbeh.2019.106081] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 08/06/2019] [Accepted: 08/06/2019] [Indexed: 11/15/2022]
Abstract
BACKGROUND Acute and adverse effects of ketamine on cognitive functioning have been documented. No longitudinal study has examined whether cognitive deficits can be reversed following ketamine abstinence although it has been suggested in some cross-sectional studies. This study aimed to investigate the changes in cognitive functioning among ketamine users following a 12-week abstinence from ketamine. METHODS In this longitudinal study, 114 ketamine users completed clinical and cognitive assessments at both baseline and 12-week follow-up with the following instruments: Severity of Dependence Scale, Beck Depression Inventory (BDI), Anxiety Subscale of the Hospital Anxiety Depression Scale (HADSA), and a cognitive battery. RESULTS BDI (p < 0.001) and HADSA (p = 0.044) scores were significantly reduced at the 12-week follow-up. Significant improvements were found in Wechsler Adult Intelligence Scale (Third edition) immediate recall (p < 0.001) and delayed recall (p < 0.001) on the Rey-Osterrieth Complex Figure Test, and in delayed recall (p < 0.001), and immediate recall (p = 0.001) on the Logical Memory component of the Wechsler Memory Scale (Third Edition) at the 12-week follow-up. Participants completed the Stroop Inference Test significantly faster (p < 0.001); and required fewer number of attempts (p < 0.001) and produced fewer perseverative errors (p < 0.001) on the Wisconsin Card Sorting Test at the 12-week follow-up. CONCLUSION Chronic ketamine users' verbal and visual memory and executive functions improved after 12 weeks of ketamine abstinence.
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Affiliation(s)
- Wai Kwong Tang
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong, China.
| | - Chieh Grace Lau
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong, China
| | - Gabor S Ungvari
- Division of Psychiatry, Faculty of Health and Medical Sciences, University of Western Australia, Perth, Australia; Section of Psychiatry, University Notre Dame Australia, Fremantle, Australia
| | - Shih-Ku Lin
- Department of Psychiatry, School of Medicine, Taipei Medical University, Taipei, Taiwan; Department of Psychiatry, Taipei City Hospital, Taipei, Taiwan
| | - Hsien-Yuan Lane
- Department of Psychiatry, China Medical University Hospital, Taiwan; Graduate Institute of Biomedical Sciences, China Medical University, Taichung, Taiwan; Department of Psychology, College of Medical and Health Sciences, Asia University, Taichung, Taiwan
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Cutuli D, de Guevara-Miranda DL, Castilla-Ortega E, Santín L, Sampedro-Piquero P. Highlighting the Role of Cognitive and Brain Reserve in the Substance use Disorder Field. Curr Neuropharmacol 2019; 17:1056-1070. [PMID: 31204624 PMCID: PMC7052825 DOI: 10.2174/1570159x17666190617100707] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Revised: 04/17/2019] [Accepted: 05/31/2019] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Cognitive reserve (CR) refers to the ability of an individual to cope with brain pathology remaining free of cognitive symptoms. This protective factor has been related to compensatory and more efficient brain mechanisms involved in resisting brain damage. For its part, Brain reserve (BR) refers to individual differences in the structural properties of the brain which could also make us more resilient to suffer from neurodegenerative and mental diseases. OBJECTIVE This review summarizes how this construct, mainly mediated by educational level, occupational attainment, physical and mental activity, as well as successful social relationships, has gained scientific attention in the last years with regard to diseases, such as neurodegenerative diseases, stroke or traumatic brain injury. Nevertheless, although CR has been studied in a large number of disorders, few researches have addressed the role of this concept in drug addiction. METHODS We provide a selective overview of recent literature about the role of CR and BR in preventing substance use onset. Likewise, we will also discuss how variables involved in CR (healthy leisure, social support or job-related activities, among others) could be trained and included as complementary activities of substance use disorder treatments. RESULTS Evidence about this topic suggests a preventive role of CR and BR on drug use onset and when drug addiction is established, these factors led to less severe addiction-related problems, as well as better treatment outcomes. CONCLUSION CR and BR are variables not taken yet into account in drug addiction. However, they could give us a valuable information about people at risk, as well as patient's prognosis.
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Affiliation(s)
| | | | | | - L.J. Santín
- Address correspondence to these authors at the Instituto de Investigación Biomédica de Málaga (IBIMA), Doctor Miguel Díaz Recio, 28 Málaga 29010, Departamento de Psicobiología y Metodología de las Ciencias del Comportamiento, Facultad de Psicología, Universidad de Málaga, Campus de Teatinos S/N, 29071 Málaga, Spain; E-mails: (P. Sampedro-Piquero) and (L.J. Santín)
| | - P. Sampedro-Piquero
- Address correspondence to these authors at the Instituto de Investigación Biomédica de Málaga (IBIMA), Doctor Miguel Díaz Recio, 28 Málaga 29010, Departamento de Psicobiología y Metodología de las Ciencias del Comportamiento, Facultad de Psicología, Universidad de Málaga, Campus de Teatinos S/N, 29071 Málaga, Spain; E-mails: (P. Sampedro-Piquero) and (L.J. Santín)
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Heirene R, John B, Roderique-Davies G. Identification and Evaluation of Neuropsychological Tools Used in the Assessment of Alcohol-Related Cognitive Impairment: A Systematic Review. Front Psychol 2018; 9:2618. [PMID: 30619013 PMCID: PMC6305333 DOI: 10.3389/fpsyg.2018.02618] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Accepted: 12/05/2018] [Indexed: 12/27/2022] Open
Abstract
Background: Neuropsychological assessment is central to identifying and determining the extent of Alcohol-Related Cognitive Impairment (ARCI). The present systematic review aimed to synthesize and discuss the evidence appraising the neuropsychological tests used to assess ARCI in order to support clinicians and researchers in selecting appropriate tests for use with this population. Methods: We searched for studies investigating the psychometric, diagnostic and practical values of tools used in the screening, diagnosis, and assessment of Korsakoff's Syndrome (KS), Alcohol-Related Dementia (ARD), and those with a specific diagnosis of Alcohol-Related Brain Damage (ARBD). The following databases were searched in March 2016 and again in August 2018: MEDLINE, EMBASE, Psych-INFO, ProQuest Psychology, and Science Direct. Study quality was assessed using a checklist designed by the authors to evaluate the specific factors contributing to robust and clearly reported studies in this area. A total of 43 studies were included following the screening of 3646 studies by title and abstract and 360 at full-text. Meta-analysis was not appropriate due to heterogeneity in the tests and ARCI samples investigated in the studies reviewed. Instead, review findings were narratively synthesized and divided according to five domains of assessment: cognitive screening, memory, executive function, intelligence and test batteries, and premorbid ability. Effect sizes (d) were calculated to supplement findings. Results: Overall, several measures demonstrated sensitivity to the cognitive deficits associated with chronic alcoholism and an ability to differentiate between gradations of impairment. However, findings relating to the other psychometric qualities of the tests, including those important for the accurate assessment and monitoring of ARCI (e.g., test-retest reliability), were entirely absent or limited. Additionally, the synthesis of neuropsychological outcomes presented here supports the recent impetus for a move away from discrete diagnoses (e.g., KS, ARD) and the distinctions between them toward more broad and inclusive diagnostic conceptualizations of ARCI, thereby recognizing the heterogeneity in presentation. Conclusions: Based on the evidence reviewed, provisional recommendations for appropriate tests in each domain of assessment are presented, though further validation of most tests is warranted. Review findings can support efficient and evidenced-based test-selection and guide future research in this area.
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Affiliation(s)
- Robert Heirene
- Addictions Research Group, University of South Wales, School of Psychology & Therapeutic Studies, Pontypridd, United Kingdom
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Johnson JM, Fox V. Beyond Thiamine: Treatment for Cognitive Impairment in Korsakoff’s Syndrome. PSYCHOSOMATICS 2018; 59:311-317. [DOI: 10.1016/j.psym.2018.03.011] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2018] [Revised: 03/21/2018] [Accepted: 03/22/2018] [Indexed: 12/20/2022]
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Brion M, Dormal V, Lannoy S, Mertens S, de Timary P, Maurage P. Imbalance between cognitive systems in alcohol-dependence and Korsakoff syndrome: An exploration using the Alcohol Flanker Task. J Clin Exp Neuropsychol 2018; 40:820-831. [DOI: 10.1080/13803395.2018.1438371] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Mélanie Brion
- Laboratory for Experimental Psychopathology, Psychological Sciences Research Institute, Université catholique de Louvain, Louvain-la-Neuve, Belgium
| | - Valérie Dormal
- Laboratory for Experimental Psychopathology, Psychological Sciences Research Institute, Université catholique de Louvain, Louvain-la-Neuve, Belgium
| | - Séverine Lannoy
- Laboratory for Experimental Psychopathology, Psychological Sciences Research Institute, Université catholique de Louvain, Louvain-la-Neuve, Belgium
| | - Serge Mertens
- Department of Neuropsychiatry, Saint-Martin Hospital, Dave, Belgium
| | - Philippe de Timary
- Laboratory for Experimental Psychopathology, Psychological Sciences Research Institute, Université catholique de Louvain, Louvain-la-Neuve, Belgium
- Department of Adult Psychiatry, St Luc Hospital and Institute of Neuroscience, Université catholique de Louvain, Brussels, Belgium
| | - Pierre Maurage
- Laboratory for Experimental Psychopathology, Psychological Sciences Research Institute, Université catholique de Louvain, Louvain-la-Neuve, Belgium
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El Haj M, Nandrino JL. Phenomenological characteristics of autobiographical memory in Korsakoff’s syndrome. Conscious Cogn 2017; 55:188-196. [PMID: 28886469 DOI: 10.1016/j.concog.2017.08.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Revised: 08/25/2017] [Accepted: 08/25/2017] [Indexed: 01/21/2023]
Affiliation(s)
- Mohamad El Haj
- Univ. Lille, CNRS, CHU Lille, UMR 9193 - SCALab - Sciences Cognitives et Sciences Affectives, F-59000 Lille, France; Unité de Gériatrie, Centre Hospitalier de Tourcoing, Tourcoing, France.
| | - Jean-Louis Nandrino
- Univ. Lille, CNRS, CHU Lille, UMR 9193 - SCALab - Sciences Cognitives et Sciences Affectives, F-59000 Lille, France
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Brion M, D'Hondt F, Lannoy S, Pitel AL, Davidoff DA, Maurage P. Crossmodal processing of emotions in alcohol-dependence and Korsakoff syndrome. Cogn Neuropsychiatry 2017; 22:436-451. [PMID: 28885888 DOI: 10.1080/13546805.2017.1373639] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
INTRODUCTION Decoding emotional information from faces and voices is crucial for efficient interpersonal communication. Emotional decoding deficits have been found in alcohol-dependence (ALC), particularly in crossmodal situations (with simultaneous stimulations from different modalities), but are still underexplored in Korsakoff syndrome (KS). The aim of this study is to determine whether the continuity hypothesis, postulating a gradual worsening of cognitive and brain impairments from ALC to KS, is valid for emotional crossmodal processing. METHODS Sixteen KS, 17 ALC and 19 matched healthy controls (CP) had to detect the emotion (anger or happiness) displayed by auditory, visual or crossmodal auditory-visual stimuli. Crossmodal stimuli were either emotionally congruent (leading to a facilitation effect, i.e. enhanced performance for crossmodal condition compared to unimodal ones) or incongruent (leading to an interference effect, i.e. decreased performance for crossmodal condition due to discordant information across modalities). Reaction times and accuracy were recorded. RESULTS Crossmodal integration for congruent information was dampened only in ALC, while both ALC and KS demonstrated, compared to CP, decreased performance for decoding emotional facial expressions in the incongruent condition. CONCLUSIONS The crossmodal integration appears impaired in ALC but preserved in KS. Both alcohol-related disorders present an increased interference effect. These results show the interest of more ecological designs, using crossmodal stimuli, to explore emotional decoding in alcohol-related disorders. They also suggest that the continuum hypothesis cannot be generalised to emotional decoding abilities.
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Affiliation(s)
- Mélanie Brion
- a Laboratory for Experimental Psychopathology , Psychological Sciences Research Institute, Université catholique de Louvain , Louvain-la-Neuve , Belgium
| | - Fabien D'Hondt
- b Univ. Lille, CNRS , UMR 9193 - SCALab - Sciences Cognitives et Sciences Affectives , Lille , France.,c CHU Lille , Clinique de Psychiatrie, CURE , Lille , France
| | - Séverine Lannoy
- a Laboratory for Experimental Psychopathology , Psychological Sciences Research Institute, Université catholique de Louvain , Louvain-la-Neuve , Belgium
| | - Anne-Lise Pitel
- d INSERM, École Pratique des Hautes Études , Université de Caen-Basse Normandie, Unité U1077, GIP Cyceron, CHU Caen , Caen , France
| | - Donald A Davidoff
- e Harvard Medical School , Boston , MA , USA.,f Department of Neuropsychology , McLean Hospital , Belmont , USA
| | - Pierre Maurage
- a Laboratory for Experimental Psychopathology , Psychological Sciences Research Institute, Université catholique de Louvain , Louvain-la-Neuve , Belgium
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Petit G, Luminet O, Cordovil de Sousa Uva M, Zorbas A, Maurage P, de Timary P. Differential spontaneous recovery across cognitive abilities during detoxification period in alcohol-dependence. PLoS One 2017; 12:e0176638. [PMID: 28767647 PMCID: PMC5540274 DOI: 10.1371/journal.pone.0176638] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2016] [Accepted: 04/13/2017] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE There is a lack of consensus regarding the extent to which cognitive dysfunctions may recover upon cessation of alcohol intake by alcohol-dependents (AD), and the divergent findings are most likely due to methodological differences between the various studies. The present study was aimed at conducting a very strict longitudinal study of cognitive recovery in terms of assessment points, the duration of abstinence, control of age and duration of the addiction, and by use of individual analyses in addition to mean group comparisons. Our study further focused on the 2-3 week phase of alcohol detoxification that is already known to positively affect many biological, emotional, motivational, as well as neural variables, followed by longer-term therapies for which good cognitive functioning is needed. METHODS 41 AD inpatients undergoing a detoxification program, and 41 matched controls, were evaluated twice in terms of five cognitive functions (i.e., short-term memory, working memory, inhibition, cognitive flexibility, and verbal fluency) within a three-week interval [on the first day (T1) and the 18th day (T2) of abstinence for AD patients]. Emotional (positive and negative affectivity and depression) and motivational (craving) variables were also measured at both evaluation times. RESULTS Although verbal fluency, short-term memory, and cognitive flexibility did not appear to be affected, the patients exhibited impaired inhibition and working memory at T1. While no recovery of inhibition was found to occur, the average working memory performance of the patients was comparable to that of the controls at T2. Improvements in emotional and motivational dimensions were also observed, although they did not correlate with the ones in working memory. Individual analysis showed that not all participants were impaired or recover the same functions. CONCLUSIONS While inhibition deficits appear to persist after 18 days of detoxification, deficits in working memory, which is a central component of cognition, are greatly reduced after alcohol detoxification. Individual differences in the trajectory of recovery do arise however, and it might be worth implementing individual assessments of impaired functions at the end of the detoxification phase in order to maximize the chances of success in longer-term treatments and abstinence.
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Affiliation(s)
- Géraldine Petit
- Research Institute for Psychological Sciences, Université catholique de Louvain, Louvain-la-Neuve, Belgium
- Department of Adult Psychiatry, Saint-Luc Academic Hospital, Université catholique de Louvain, Brussels, Belgium
- Laboratory for Experimental Psychopathology, Psychological Sciences Research Institute, Université catholique de Louvain, Louvain-la-Neuve, Belgium
- Institute of Neuroscience, Université catholique de Louvain, Louvain-la-Neuve, Belgium
| | - Olivier Luminet
- Research Institute for Psychological Sciences, Université catholique de Louvain, Louvain-la-Neuve, Belgium
- The Belgian National Fund for Scientific Research (FRS-FNRS), Brussels, Belgium
| | - Mariana Cordovil de Sousa Uva
- Research Institute for Psychological Sciences, Université catholique de Louvain, Louvain-la-Neuve, Belgium
- Department of Adult Psychiatry, Saint-Luc Academic Hospital, Université catholique de Louvain, Brussels, Belgium
| | - Alexis Zorbas
- Research Institute for Psychological Sciences, Université catholique de Louvain, Louvain-la-Neuve, Belgium
- Department of Adult Psychiatry, Saint-Luc Academic Hospital, Université catholique de Louvain, Brussels, Belgium
| | - Pierre Maurage
- Research Institute for Psychological Sciences, Université catholique de Louvain, Louvain-la-Neuve, Belgium
- Laboratory for Experimental Psychopathology, Psychological Sciences Research Institute, Université catholique de Louvain, Louvain-la-Neuve, Belgium
- The Belgian National Fund for Scientific Research (FRS-FNRS), Brussels, Belgium
| | - Philippe de Timary
- Department of Adult Psychiatry, Saint-Luc Academic Hospital, Université catholique de Louvain, Brussels, Belgium
- Laboratory for Experimental Psychopathology, Psychological Sciences Research Institute, Université catholique de Louvain, Louvain-la-Neuve, Belgium
- Institute of Neuroscience, Université catholique de Louvain, Louvain-la-Neuve, Belgium
- Unité Intégrée d’Hépatologie, Saint-Luc Academic Hospital, Université catholique de Louvain, Brussels, Belgium
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Abstract
In this review, we present a survey on Korsakoff's syndrome (KS), a residual syndrome in patients who suffered from a Wernicke encephalopathy (WE) that is predominantly characterized by global amnesia, and in more severe cases also by cognitive and behavioral dysfunction. We describe the history of KS and its definition, its epidemiology, and the lack of consensus criteria for its diagnosis. The cognitive and behavioral symptoms of KS, which include anterograde and retrograde amnesia, executive dysfunction, confabulation, apathy, as well as affective and social-cognitive impairments, are discussed. Moreover, recent insights into the underlying neurocognitive mechanisms of these symptoms are presented. In addition, the evidence so far on the etiology of KS is examined, highlighting the role of thiamine and alcohol and discussing the continuity hypothesis. Furthermore, the neuropathology of KS is reviewed, focusing on abnormalities in the diencephalon, including the mammillary bodies and thalamic nuclei. Pharmacological treatment options and nonpharmacological interventions, such as those based on cognitive rehabilitation, are discussed. Our review shows that thiamine deficiency (TD) is a crucial factor in the etiology of KS. Although alcohol abuse is by far the most important context in which TD occurs, there is no convincing evidence for an essential contribution of ethanol neurotoxicity (EN) to the development of WE or to the progression of WE to KS. Future research on the postmortem histopathological analysis of brain tissues of KS patients is crucial for the advancement of our knowledge of KS, especially for associating its symptoms with lesions in various thalamic nuclei. A necessary requirement for the advancement of studies on KS is the broad acceptance of a comprehensive definition and definite diagnostic criteria. Therefore, in this review, we propose such a definition of KS and draft outlines for prospective diagnostic criteria.
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Affiliation(s)
- Nicolaas Jm Arts
- Centre of Excellence for Korsakoff and Alcohol-Related Cognitive Disorders, Vincent van Gogh Institute for Psychiatry, Venray.,Neuropsychiatry Center Thalamus, Institution for Integrated Mental Health Care Pro Persona, Wolfheze
| | - Serge Jw Walvoort
- Centre of Excellence for Korsakoff and Alcohol-Related Cognitive Disorders, Vincent van Gogh Institute for Psychiatry, Venray
| | - Roy Pc Kessels
- Centre of Excellence for Korsakoff and Alcohol-Related Cognitive Disorders, Vincent van Gogh Institute for Psychiatry, Venray.,Department of Neuropsychology and Rehabilitation Psychology, Donders Institute for Brain, Cognition and Behaviour, Radboud University.,Department of Medical Psychology, Radboud University Medical Center, Nijmegen, the Netherlands
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Brion M, Pitel AL, D'Hondt F. New Perspectives in the Exploration of Korsakoff's Syndrome: The Usefulness of Neurophysiological Markers. Front Psychol 2016; 7:168. [PMID: 26909060 PMCID: PMC4754411 DOI: 10.3389/fpsyg.2016.00168] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Accepted: 01/29/2016] [Indexed: 01/17/2023] Open
Abstract
This perspective aims at underlining the usefulness of event-related potentials (ERP) to better understand the brain correlates of Korsakoff’s syndrome (KS), a neuropsychiatric disease characterized by severe memory impairment and most frequently resulting as a neurological complication of alcohol-dependence (AD). While ERP have been broadly used in AD, it has up to now been very little applied in KS or in the comparison of KS and AD. Within the framework of dual-process models, an influential theory postulating that addictive states result from an imbalance between under-activated reflective system and over-activated automatic-affective one, this paper proposes: (1) a brief synthesis of the main results of ERP studies in AD and KS, and (2) new research avenues using ERP to identify the electrophysiological correlates of cognitive and emotional dysfunction in KS. These experimental perspectives aim at exploring the continuity hypothesis, which postulates a gradient of impairments from AD to KS. We conclude on the possibility of developing neuropsychological strategies with electrophysiological follow-up to ensure KS diagnosis and test the efficacy of patient’s neurocognitive rehabilitation.
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Affiliation(s)
- Mélanie Brion
- Laboratory for Experimental Psychopathology, Psychological Sciences Research Institute, Université catholique de Louvain Louvain-la-Neuve, Belgium
| | - Anne-Lise Pitel
- INSERM, Unité U1077, École Pratique des Hautes Études, Université de Caen-Basse Normandie - GIP Cyceron - CHU Caen Caen, France
| | - Fabien D'Hondt
- Laboratory for Experimental Psychopathology, Psychological Sciences Research Institute, Université catholique de Louvain Louvain-la-Neuve, Belgium
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Altgassen M, Ariese L, Wester AJ, Kessels RPC. Salient cues improve prospective remembering in Korsakoff's syndrome. BRITISH JOURNAL OF CLINICAL PSYCHOLOGY 2015; 55:123-36. [DOI: 10.1111/bjc.12099] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2014] [Revised: 09/30/2015] [Indexed: 12/01/2022]
Affiliation(s)
- Mareike Altgassen
- Donders Institute for Brain, Cognition and Behaviour; Radboud University; Nijmegen The Netherlands
- Department of Psychology; TU Dresden; Germany
| | - Laura Ariese
- Donders Institute for Brain, Cognition and Behaviour; Radboud University; Nijmegen The Netherlands
| | - Arie J. Wester
- Centre of Excellence for Korsakoff and Alcohol-Related Cognitive Disorders; Vincent van Gogh Institute for Psychiatry; Venray The Netherlands
| | - Roy P. C. Kessels
- Donders Institute for Brain, Cognition and Behaviour; Radboud University; Nijmegen The Netherlands
- Centre of Excellence for Korsakoff and Alcohol-Related Cognitive Disorders; Vincent van Gogh Institute for Psychiatry; Venray The Netherlands
- Department of Medical Psychology; Radboud University Medical Center; Nijmegen The Netherlands
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Horton L, Duffy T, Hollins Martin C, Martin CR. Comprehensive assessment of alcohol-related brain damage (ARBD): gap or chasm in the evidence? J Psychiatr Ment Health Nurs 2015; 22:3-14. [PMID: 24846298 DOI: 10.1111/jpm.12156] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/29/2014] [Indexed: 11/26/2022]
Abstract
Alcohol-related brain damage (ARBD) causes a broad range of both neurological and neurocognitive impairment. Mental health nurses are required to provide programmes designed to facilitate individuals with chronic alcohol dependency to radically change their drinking behaviour, invariably with an abstinence focus. No evidence that related to the nutritional and physical intervention needs of this group was found. Most instruments used to access domains relevant to ARBD in terms of providing a comprehensive assessment have not been validated in this group. Alcohol-related brain damage (ARBD) is primarily caused by chronic alcohol misuse and thiamine deficiency, and results in a broad range of impairments. Despite the increasing incidence of ARBD in the UK in recent decades, it is currently underdiagnosed, managed inappropriately and treated inadequately. Moreover, information about assessments for individuals with ARBD is currently absent from clinical guidelines and policy documents. The aim of this paper was to review the evidence relating to the neurological, neuropsychological, psychosocial, physical and nutritional assessment of individuals with ARBD to identify appropriate assessment tools that could be used to measure and monitor the impact of ARBD over time. A systematic online database search revealed a total of 160 separate references, 133 of which were rejected and two of which could not be accessed. Twenty-five papers were included in the review, including six neuroimaging studies, 17 neuropsychological studies and two studies using psychosocial methods of assessment. A lack of evidence for nutritional and physical assessment of individuals with ARBD was found. The review findings are inconclusive; most instruments currently used in ARBD research have not specifically been validated for use within an ARBD context. Further research is required to identify comprehensive methods of ARBD assessment.
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Affiliation(s)
- L Horton
- School of Health, Nursing and Midwifery, University of the West of Scotland, Paisley, UK
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Horton L, Duffy T, Martin CR. Assessing outcomes of alcohol-related brain damage (ARBD): What should we be measuring? DRUGS: EDUCATION, PREVENTION AND POLICY 2015. [DOI: 10.3109/09687637.2014.991278] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Abstract
BACKGROUND Korsakoff's syndrome (KS) is a neuropsychiatric disorder characterized by severe amnesia. Quality of life (QoL) is becoming an increasingly used outcome measure in clinical practice but little is known about QoL in KS and how it may change over time. The purpose of this study was therefore to assess the QoL in patients with KS at baseline and with a 20-month follow-up. METHODS The current study is a longitudinal study on the QoL in patients with KS living in two long-term care facilities for KS patients in the Netherlands. QoL was scored with the proxy-based QUALIDEM scale with a 20-month follow-up. RESULTS Of the 72 KS patients included at baseline, 57 KS patients had a follow-up QoL score (79.2%). On the subscales "Feeling at home," "Positive affect," and "Care relationship" of the QUALIDEM, there was a better QoL in the follow-up, although effects were relatively small. Other subscales indicated a stable QoL over time. There were inter-relations between changes in subscales. CONCLUSIONS The main finding of this study is that patients with KS on average do show a relatively stable moderate to good QoL despite the severity of the syndrome. On specific subscales, there is a small increase in QoL over time. Results do suggest that prolonged stay in a long-term care facility for KS patients does have a neutral to a positive effect on QoL in KS.
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Schulte MH, Cousijn J, den Uyl TE, Goudriaan AE, van den Brink W, Veltman DJ, Schilt T, Wiers RW. Recovery of neurocognitive functions following sustained abstinence after substance dependence and implications for treatment. Clin Psychol Rev 2014; 34:531-50. [DOI: 10.1016/j.cpr.2014.08.002] [Citation(s) in RCA: 72] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2014] [Revised: 06/19/2014] [Accepted: 08/14/2014] [Indexed: 10/24/2022]
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Brion M, Pitel AL, Beaunieux H, Maurage P. Revisiting the continuum hypothesis: toward an in-depth exploration of executive functions in korsakoff syndrome. Front Hum Neurosci 2014; 8:498. [PMID: 25071526 PMCID: PMC4081760 DOI: 10.3389/fnhum.2014.00498] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2014] [Accepted: 06/19/2014] [Indexed: 11/24/2022] Open
Abstract
Korsakoff syndrome (KS) is a neurological state mostly caused by alcohol-dependence and leading to disproportionate episodic memory deficits. KS patients present more severe anterograde amnesia than Alcohol-Dependent Subjects (ADS), which led to the continuum hypothesis postulating a progressive increase in brain and cognitive damages during the evolution from ADS to KS. This hypothesis has been extensively examined for memory but is still debated for other abilities, notably executive functions (EF). EF have up to now been explored by unspecific tasks in KS, and few studies explored their interactions with memory. Exploring EF in KS by specific tasks based on current EF models could thus renew the exploration of the continuum hypothesis. This paper will propose a research program aiming at: (1) clarifying the extent of executive dysfunctions in KS by tasks focusing on specific EF subcomponents; (2) determining the differential EF deficits in ADS and KS; (3) exploring EF-memory interactions in KS with innovative tasks. At the fundamental level, this exploration will test the continuum hypothesis beyond memory. At the clinical level, it will propose new rehabilitation tools focusing on the EF specifically impaired in KS.
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Affiliation(s)
- Mélanie Brion
- Laboratory for Experimental Psychopathology, Institute of Psychology, Université Catholique de Louvain , Louvain-la-Neuve , Belgium
| | - Anne-Lise Pitel
- INSERM, École Pratique des Hautes Études, Université de Caen-Basse Normandie, Unité U1077, GIP Cyceron, CHU Caen , Caen , France
| | - Hélène Beaunieux
- INSERM, École Pratique des Hautes Études, Université de Caen-Basse Normandie, Unité U1077, GIP Cyceron, CHU Caen , Caen , France
| | - Pierre Maurage
- Laboratory for Experimental Psychopathology, Institute of Psychology, Université Catholique de Louvain , Louvain-la-Neuve , Belgium
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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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Oudman E, Van der Stigchel S, Postma A, Wijnia JW, Nijboer TCW. A Case of Chronic Wernicke's Encephalopathy: A Neuropsychological Study. Front Psychiatry 2014; 5:59. [PMID: 24904442 PMCID: PMC4034510 DOI: 10.3389/fpsyt.2014.00059] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2014] [Accepted: 05/12/2014] [Indexed: 11/13/2022] Open
Abstract
A 54-year-old woman was referred to our Korsakoff Center because of extensive cognitive problems following acute Wernicke's encephalopathy (WE). She had a relatively short history of alcohol abuse and was found lying on the floor in her home by her son. After 5 days without treatment, she was diagnosed with WE in a general hospital. During the course of the disease, minimal change to the acute situation occurred, with chronic confusion, attention deficits, and incoherent behavior symptoms most notable unlike classical Korsakoff's syndrome. Neuropsychological assessment after 4 and 16 months after admission to the hospital revealed global cognitive decline, with striking impairments in attentional, executive, and memory functions. The present case study suggests that the state of confusion and the neuropsychological symptoms in WE can become chronic in case of very late treatment. We therefore recommend that confused alcoholics should receive appropriate parenteral thiamine according to the current clinical standards.
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Affiliation(s)
- Erik Oudman
- Department of Experimental Psychology, Helmholtz Institute, Utrecht University , Utrecht , Netherlands ; Slingedael Korsakoff Center , Rotterdam , Netherlands
| | - Stefan Van der Stigchel
- Department of Experimental Psychology, Helmholtz Institute, Utrecht University , Utrecht , Netherlands
| | - Albert Postma
- Department of Experimental Psychology, Helmholtz Institute, Utrecht University , Utrecht , Netherlands ; Department of Neurology, Brain Center Rudolf Magnus, University Medical Center Utrecht , Utrecht , Netherlands
| | - Jan W Wijnia
- Slingedael Korsakoff Center , Rotterdam , Netherlands
| | - Tanja C W Nijboer
- Department of Experimental Psychology, Helmholtz Institute, Utrecht University , Utrecht , Netherlands ; Department of Neurology, Brain Center Rudolf Magnus, University Medical Center Utrecht , Utrecht , Netherlands ; Brain Center Rudolf Magnus, Center of Excellence for Rehabilitation Medicine, De Hoogstraat Rehabilitation, University Medical Center Utrecht , Utrecht , Netherlands
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Maharasingam M, Macniven JAB, Mason OJ. Executive functioning in chronic alcoholism and Korsakoff syndrome. J Clin Exp Neuropsychol 2013; 35:501-8. [DOI: 10.1080/13803395.2013.795527] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Markowitsch HJ. Memory and self-neuroscientific landscapes. ISRN NEUROSCIENCE 2013; 2013:176027. [PMID: 24967303 PMCID: PMC4045540 DOI: 10.1155/2013/176027] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/13/2013] [Accepted: 04/22/2013] [Indexed: 02/07/2023]
Abstract
Relations between memory and the self are framed from a number of perspectives-developmental aspects, forms of memory, interrelations between memory and the brain, and interactions between the environment and memory. The self is seen as dividable into more rudimentary and more advanced aspects. Special emphasis is laid on memory systems and within them on episodic autobiographical memory which is seen as a pure human form of memory that is dependent on a proper ontogenetic development and shaped by the social environment, including culture. Self and episodic autobiographical memory are seen as interlocked in their development and later manifestation. Aside from content-based aspects of memory, time-based aspects are seen along two lines-the division between short-term and long-term memory and anterograde-future-oriented-and retrograde-past-oriented memory. The state dependency of episodic autobiographical is stressed and implications of it-for example, with respect to the occurrence of false memories and forensic aspects-are outlined. For the brain level, structural networks for encoding, consolidation, storage, and retrieval are discussed both by referring to patient data and to data obtained in normal participants with functional brain imaging methods. It is elaborated why descriptions from patients with functional or dissociative amnesia are particularly apt to demonstrate the facets in which memory, self, and personal temporality are interwoven.
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Affiliation(s)
- Hans J. Markowitsch
- Physiological Psychology, University of Bielefeld, Universitaetsstraße 25, 33615 Bielefeld, Germany
- Center of Excellence “Cognitive Interaction Technology” (CITEC), University of Bielefeld, 33615 Bielefeld, Germany
- Hanse Institute of Advanced Science, P. O. Box 1344, 27733 Delmenhorst, Germany
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Ridley NJ, Draper B, Withall A. Alcohol-related dementia: an update of the evidence. ALZHEIMERS RESEARCH & THERAPY 2013; 5:3. [PMID: 23347747 PMCID: PMC3580328 DOI: 10.1186/alzrt157] [Citation(s) in RCA: 145] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
The characteristics of dementia relating to excessive alcohol use have received increased research interest in recent times. In this paper, the neuropathology, nosology, epidemiology, clinical features, and neuropsychology of alcohol-related dementia (ARD) and alcohol-induced persisting amnestic syndrome (Wernicke-Korsakoff syndrome, or WKS) are reviewed. Neuropathological and imaging studies suggest that excessive and prolonged use of alcohol may lead to structural and functional damage that is permanent in nature; however, there is debate about the relative contributions of the direct toxic effect of alcohol (neurotoxicity hypothesis), and the impact of thiamine deficiency, to lasting damage. Investigation of alcohol-related cognitive impairment has been further complicated by differing definitions of patterns of alcohol use and associated lifestyle factors related to the abuse of alcohol. Present diagnostic systems identify two main syndromes of alcohol-related cognitive impairment: ARD and WKS. However, 'alcohol-related brain damage' is increasingly used as an umbrella term to encompass the heterogeneity of these disorders. It is unclear what level of drinking may pose a risk for the development of brain damage or, in fact, whether lower levels of alcohol may protect against other forms of dementia. Epidemiological studies suggest that individuals with ARD typically have a younger age of onset than those with other forms of dementia, are more likely to be male, and often are socially isolated. The cognitive profile of ARD appears to involve both cortical and subcortical pathology, and deficits are most frequently observed on tasks of visuospatial function as well as memory and higher-order (executive) tasks. The WKS appears more heterogeneous in nature than originally documented, and deficits on executive tasks commonly are reported in conjunction with characteristic memory deficits. Individuals with alcohol-related disorders have the potential to at least partially recover - both structurally and functionally - if abstinence is maintained. In this review, considerations in a clinical setting and recommendations for diagnosis and management are discussed.
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Affiliation(s)
- Nicole J Ridley
- Dementia Collaborative Research Centre, School of Psychiatry, University of New South Wales, Anzac Parade, Kensington, NSW, 2052 Australia ; Department of Psychology, Macquarie University, Balaclava Rd, North Ryde, NSW, 2109, Australia
| | - Brian Draper
- Dementia Collaborative Research Centre, School of Psychiatry, University of New South Wales, Anzac Parade, Kensington, NSW, 2052 Australia ; Academic Department for Old Age Psychiatry, Prince of Wales Hospital, Barker Street, Randwick, NSW 2031, Australia
| | - Adrienne Withall
- School of Public Health and Community Medicine, University of New South Wales, Anzac Parade, Kensington, NSW, 2052 Australia
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Quality of Life of Patients With Korsakoff's Syndrome and Patients With Dementia: A Cross-Sectional Study. J Am Med Dir Assoc 2012; 13:778-81. [DOI: 10.1016/j.jamda.2012.08.003] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2012] [Revised: 08/03/2012] [Accepted: 08/06/2012] [Indexed: 11/20/2022]
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Van der Stigchel S, Reichenbach RCL, Wester AJ, Nijboer TCW. Antisaccade performance in Korsakoff patients reveals deficits in oculomotor inhibition. J Clin Exp Neuropsychol 2012; 34:876-86. [DOI: 10.1080/13803395.2012.692771] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Vetreno RP, Hall JM, Savage LM. Alcohol-related amnesia and dementia: animal models have revealed the contributions of different etiological factors on neuropathology, neurochemical dysfunction and cognitive impairment. Neurobiol Learn Mem 2011; 96:596-608. [PMID: 21256970 PMCID: PMC3086968 DOI: 10.1016/j.nlm.2011.01.003] [Citation(s) in RCA: 103] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2010] [Revised: 11/09/2010] [Accepted: 01/04/2011] [Indexed: 12/21/2022]
Abstract
Chronic alcoholism is associated with impaired cognitive functioning. Over 75% of autopsied chronic alcoholics have significant brain damage and over 50% of detoxified alcoholics display some degree of learning and memory impairment. However, the relative contributions of different etiological factors to the development of alcohol-related neuropathology and cognitive impairment are questioned. One reason for this quandary is that both alcohol toxicity and thiamine deficiency result in brain damage and cognitive problems. Two alcohol-related neurological disorders, alcohol-associated dementia and Wernicke-Korsakoff syndrome have been modeled in rodents. These pre-clinical models have elucidated the relative contributions of ethanol toxicity and thiamine deficiency to the development of dementia and amnesia. What is observed in these models--from repeated and chronic ethanol exposure to thiamine deficiency--is a progression of both neural and cognitive dysregulation. Repeated binge exposure to ethanol leads to changes in neural plasticity by reducing GABAergic inhibition and facilitating glutamatergic excitation, long-term chronic ethanol exposure results in hippocampal and cortical cell loss as well as reduced hippocampal neurotrophin protein content critical for neural survival, and thiamine deficiency results in gross pathological lesions in the diencephalon, reduced neurotrophic protein levels, and neurotransmitters levels in the hippocampus and cortex. Behaviorally, after recovery from repeated or chronic ethanol exposure there is impairment in working or episodic memory that can recover with prolonged abstinence. In contrast, after thiamine deficiency there is severe and persistent spatial memory impairments and increased perseverative behavior. The interaction between ethanol and thiamine deficiency does not produce more behavioral or neural pathology, with the exception of reduction of white matter, than long-term thiamine deficiency alone.
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Affiliation(s)
- Ryan P. Vetreno
- Behavioral Neuroscience Program, Department of Psychology, State University of New York at Binghamton, Binghamton NY, 13902
| | - Joseph M. Hall
- Behavioral Neuroscience Program, Department of Psychology, State University of New York at Binghamton, Binghamton NY, 13902
| | - Lisa M. Savage
- Behavioral Neuroscience Program, Department of Psychology, State University of New York at Binghamton, Binghamton NY, 13902
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Oudman E, Van der Stigchel S, Wester AJ, Kessels RP, Postma A. Intact memory for implicit contextual information in Korsakoff's amnesia. Neuropsychologia 2011; 49:2848-55. [DOI: 10.1016/j.neuropsychologia.2011.06.010] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2011] [Revised: 06/06/2011] [Accepted: 06/08/2011] [Indexed: 10/18/2022]
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McCabe LF. Alcohol, ageing and dementia: A Scottish perspective. DEMENTIA 2011. [DOI: 10.1177/1471301211398984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
There are complex relationships between alcohol use; processes of ageing both social and biological; and cognitive impairment. This paper takes Scotland as a case study to begin to unpick and explore these relationships and their implications for people who drink as they age. In recent years several policy documents have been published in Scotland that acknowledge the increasing prevalence of alcohol problems among people as they age. This paper is based on a review of the literature, analysis of recent Scottish policy documents and two research projects undertaken by the author. The links between alcohol use and dementia are discussed, focusing on biological and social implications for individuals as they age. Current responses in Scotland to these different issues are examined from individual, cultural and policy perspectives. Despite efforts in Scotland the needs of ageing and older individuals who experience alcohol-related morbidity are not sufficiently addressed.
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