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Nippert KE, Rowland CP, Vazey EM, Moorman DE. Alcohol, flexible behavior, and the prefrontal cortex: Functional changes underlying impaired cognitive flexibility. Neuropharmacology 2024; 260:110114. [PMID: 39134298 DOI: 10.1016/j.neuropharm.2024.110114] [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: 02/15/2024] [Revised: 08/08/2024] [Accepted: 08/09/2024] [Indexed: 08/22/2024]
Abstract
Cognitive flexibility enables individuals to alter their behavior in response to changing environmental demands, facilitating optimal behavior in a dynamic world. The inability to do this, called behavioral inflexibility, is a pervasive behavioral phenotype in alcohol use disorder (AUD), driven by disruptions in cognitive flexibility. Research has repeatedly shown that behavioral inflexibility not only results from alcohol exposure across species but can itself be predictive of future drinking. Like many high-level executive functions, flexible behavior requires healthy functioning of the prefrontal cortex (PFC). The scope of this review addresses two primary themes: first, we outline tasks that have been used to investigate flexibility in the context of AUD or AUD models. We characterize these based on the task features and underlying cognitive processes that differentiate them from one another. We highlight the neural basis of flexibility measures, focusing on the PFC, and how acute or chronic alcohol in humans and non-human animal models impacts flexibility. Second, we consolidate findings on the molecular, physiological and functional changes in the PFC elicited by alcohol, that may contribute to cognitive flexibility deficits seen in AUD. Collectively, this approach identifies several key avenues for future research that will facilitate effective treatments to promote flexible behavior in the context of AUD, to reduce the risk of alcohol related harm, and to improve outcomes following AUD.
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Affiliation(s)
- Kathryn E Nippert
- Neuroscience and Behavior Graduate Program, University of Massachusetts Amherst, Amherst, MA, 01003, USA
| | - Courtney P Rowland
- Department of Biology, University of Massachusetts Amherst, Amherst, MA, 01003, USA
| | - Elena M Vazey
- Neuroscience and Behavior Graduate Program, University of Massachusetts Amherst, Amherst, MA, 01003, USA; Department of Biology, University of Massachusetts Amherst, Amherst, MA, 01003, USA.
| | - David E Moorman
- Neuroscience and Behavior Graduate Program, University of Massachusetts Amherst, Amherst, MA, 01003, USA; Department of Psychological and Brain Sciences, University of Massachusetts, Amherst, MA, 01003, USA.
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2
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Knountsen EK, Frank VA, Herold M. Uncovering young people's situational construction of sexual consent. NORDIC STUDIES ON ALCOHOL AND DRUGS 2024; 41:240-259. [PMID: 38903894 PMCID: PMC11186452 DOI: 10.1177/14550725231223888] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 12/15/2023] [Indexed: 06/22/2024] Open
Abstract
Aim: To investigate how young Danes construct sexual consent generally, but also specifically in relation to heavy alcohol intoxication. Methods: Drawing on 30 qualitative in-depth interviews with young people, aged 19-25 years, and adopting a critical discursive psychological framework, we explored the interpretative repertoires that the participants made use of to construct sexual consent and the subject positions those repertoires enabled. Results: The participants made use of three interpretative repertoires that we named as follows: (1) sexual consent as an agreement between rational individuals; (2) sexual consent as a heteronormative practice; and (3) intoxicated sexual consent. Discussion: Young people draw on different repertoires when discussing sexual consent in general, sexual consent in relation to gendered practices and expectations, and sexual consent in relation to heavy alcohol intoxication. Conclusion: It is vital to keep the situational nature of young people's constructions of sexual consent in mind if we wish to understand and eventually reduce the number of non-consensual sexual experiences.
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Affiliation(s)
| | - Vibeke Asmussen Frank
- Research Center for Management, Organization and Social Sciences, VIA University College, Aarhus N, Denmark
| | - Maria Herold
- Socialrådgiver uddannelsen, VIA University College, Aarhus, Denmark
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3
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Kulbida M, Kemps E, Williamson P, Tiggemann M. The role of decision-making and impulsivity in beverage consumption. Appetite 2024; 195:107233. [PMID: 38301568 DOI: 10.1016/j.appet.2024.107233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Revised: 12/22/2023] [Accepted: 01/22/2024] [Indexed: 02/03/2024]
Abstract
Soft drink and alcohol consumption have become significant public health issues. This study aimed to explore the mediating role of decision-making processes in the relationship between trait impulsivity and calorie dense beverage consumption. Participants comprised a community sample of 300 adults (aged 19-75). They completed self-report measures assessing impulsivity (SUPPS-P), reward sensitivity (RST-PQ), and participated in decision-making tasks related to risk propensity (BART), short-term strategy preference (IGT), and delay discounting rate. Beverage consumption was calculated using the BEVQ-15. Impulsivity was conceptualised within the framework of the two-factor model as consisting of rash impulsivity and reward sensitivity. Both facets of impulsivity were positively associated with both alcohol and soft drink consumption, and each independently predicted consumption of these beverages. Additionally, there was a significant interaction between rash impulsivity and reward sensitivity on soft drink consumption. Importantly, there were significant indirect effects of both rash impulsivity and reward sensitivity on soft drink consumption via delay discounting. The results support the logic of the two-factor model of impulsivity in the prediction of consumption of unhealthy beverages. Furthermore, the mediating role of delay discounting supports the hypothesis that personality traits can pass through to behaviour via decision-making processes. Further research should extend these findings to other consumption domains in both clinical and non-clinical populations.
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Affiliation(s)
- Max Kulbida
- Psychology, Flinders University, Adelaide, Australia.
| | - Eva Kemps
- Psychology, Flinders University, Adelaide, Australia
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4
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Renu K, Myakala H, Chakraborty R, Bhattacharya S, Abuwani A, Lokhandwala M, Vellingiri B, Gopalakrishnan AV. Molecular mechanisms of alcohol's effects on the human body: A review and update. J Biochem Mol Toxicol 2023; 37:e23502. [PMID: 37578200 DOI: 10.1002/jbt.23502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Revised: 07/18/2023] [Accepted: 07/31/2023] [Indexed: 08/15/2023]
Abstract
Alcohol consumption has been linked to numerous negative health outcomes although it has some beneficial effects on moderate dosages, the most severe of which being alcohol-induced hepatitis. The number of people dying from this liver illness has been shown to climb steadily over time, and its prevalence has been increasing. Researchers have found that alcohol consumption primarily affects the brain, leading to a wide range of neurological and psychological diseases. High-alcohol-consumption addicts not only experienced seizures, but also ataxia, aggression, social anxiety, and variceal hemorrhage that ultimately resulted in death, ascites, and schizophrenia. Drugs treating this liver condition are limited and can cause serious side effects like depression. Serine-threonine kinases, cAMP protein kinases, protein kinase C, ERK, RACK 1, Homer 2, and more have all been observed to have their signaling pathways disrupted by alcohol, and alcohol has also been linked to epigenetic changes. In addition, alcohol consumption induces dysbiosis by changing the composition of the microbiome found in the gastrointestinal tract. Although more studies are needed, those that have been done suggest that probiotics aid in keeping the various microbiota concentrations stable. It has been argued that reducing one's alcohol intake may seem less harmful because excessive drinking is a lifestyle disorder.
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Affiliation(s)
- Kaviyarasi Renu
- Department of Biochemistry, Centre of Molecular Medicine and Diagnostics (COMManD), Saveetha Dental College & Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India
| | - Haritha Myakala
- Department of Biomedical Sciences, School of Biosciences and Technology, Vellore Institute of Technology (VIT), Vellore, Tamil Nadu, India
| | - Rituraj Chakraborty
- Department of Biomedical Sciences, School of Biosciences and Technology, Vellore Institute of Technology (VIT), Vellore, Tamil Nadu, India
| | - Sharmishtha Bhattacharya
- Department of Biomedical Sciences, School of Biosciences and Technology, Vellore Institute of Technology (VIT), Vellore, Tamil Nadu, India
| | - Asmita Abuwani
- Department of Biomedical Sciences, School of Biosciences and Technology, Vellore Institute of Technology (VIT), Vellore, Tamil Nadu, India
| | - Mariyam Lokhandwala
- Department of Biomedical Sciences, School of Biosciences and Technology, Vellore Institute of Technology (VIT), Vellore, Tamil Nadu, India
| | - Balachandar Vellingiri
- Department of Zoology, Stem Cell and Regenerative Medicine/Translational Research, School of Basic Sciences, Central University of Punjab (CUPB), Bathinda, Punjab, India
| | - Abilash Valsala Gopalakrishnan
- Department of Biomedical Sciences, School of Biosciences and Technology, Vellore Institute of Technology (VIT), Vellore, Tamil Nadu, India
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Kurihara K, Shiroma A, Koda M, Shinzato H, Takaesu Y, Kondo T. Age-related cognitive decline is accelerated in alcohol use disorder. Neuropsychopharmacol Rep 2023; 43:587-595. [PMID: 37926928 PMCID: PMC10739134 DOI: 10.1002/npr2.12395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 09/26/2023] [Accepted: 10/23/2023] [Indexed: 11/07/2023] Open
Abstract
This study aimed to examine potential cognitive impairments in patients with alcohol use disorder (AUD), and explore the factors affecting them. We recruited 97 inpatients with AUD, showing superficially normal cognitive function (mini-mental state examination score ≥24) for this study. We assessed cognitive function after a 4-week post-abstinence period using the Brief Assessment of Cognition in Schizophrenia-Japanese version (BACS-J). Relationships between BACS-J subcategory/composite raw scores and Z-scores (deviation from standard data in healthy Japanese) and background factors such as age, sex, education, smoking status, mini-mental state examination score, body mass index, systolic blood pressure, severity of depression, alcohol consumption, and laboratory findings were analyzed. Multiple regression analysis showed that the age (p < 0.001) and total bilirubin level (p = 0.014) were worsening factors for the BACS-J composite raw score, whereas education (p < 0.001) was a protective factor. An inverse correlation was apparent between the age and the composite Z-score of the BACS-J (r = -0.431, p < 0.001). Receiver operating characteristic (ROC) analysis identified 53 years as the cutoff age for predicting more than -2SD cognitive decline from the normal standard, with a high negative predictive value (95%). Patients with AUD aged ≥53 years showed more pronounced impairments in verbal memory, working memory, verbal fluency, and attention than those younger than 53 years (p < 0.05). These findings clearly demonstrate accelerated age-related cognitive decline in patients with AUD, especially those aged ≥53 years, suggesting the necessity of early intervention in patients with AUD to prevent progressive cognitive impairment and preserve their quality of life.
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Affiliation(s)
- Kazuhiro Kurihara
- Department of Neuropsychiatry, Graduate School of MedicineUniversity of the RyukyusOkinawaJapan
| | - Ayano Shiroma
- Department of Neuropsychiatry, Graduate School of MedicineUniversity of the RyukyusOkinawaJapan
| | - Munenaga Koda
- Graduate School of Technology, Industrial and Social SciencesTokushima UniversityTokushimaJapan
| | - Hotaka Shinzato
- Department of Neuropsychiatry, Graduate School of MedicineUniversity of the RyukyusOkinawaJapan
| | - Yoshikazu Takaesu
- Department of Neuropsychiatry, Graduate School of MedicineUniversity of the RyukyusOkinawaJapan
| | - Tsuyoshi Kondo
- Department of Neuropsychiatry, Graduate School of MedicineUniversity of the RyukyusOkinawaJapan
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6
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Zeng J, You L, Sheng H, Luo Y, Yang X. The differential neural substrates for reward choice under gain-loss contexts and risk in alcohol use disorder: Evidence from a voxel-based meta-analysis. Drug Alcohol Depend 2023; 248:109912. [PMID: 37182355 DOI: 10.1016/j.drugalcdep.2023.109912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 04/15/2023] [Accepted: 04/30/2023] [Indexed: 05/16/2023]
Abstract
BACKGROUND Making a risky decision is a complex process that involves the evaluation of both the values of the options and the associated risk level; this process is distinct from reward processing in gain versus loss contexts. Although disrupted reward processing in mesolimbic dopamine circuitry is suggested to underlie pathological incentive processing in patients with alcohol use disorder (AUD), the differential neural processes subserving these motivational tendencies for risk situations or gain/loss choices in decision-making have not been identified. METHODS To examine the common or distinct neural mechanisms in the evaluation of risk versus outcomes for AUD, we conducted two separate coordinate-based meta-analyses of functional neuroimaging studies by using Seed-Based d Mapping software to evaluate 13 studies investigating gain and loss processing and 10 studies investigating risky decision-making. RESULTS During gain and loss processing, relative to healthy controls, AUD patients showed reduced activation in the mesocortical-limbic circuit, including the orbital prefrontal cortex (OFC), dorsal striatum, insula, hippocampus, cerebellum, cuneus cortex and superior temporal gyrus, but hyperactivation in the inferior temporal gyrus and paracentral lobule (extending to the middle cingulate cortex (MCC) and precuneus). During decision-making under risk, AUD patients exhibited hypoactivity of the prefrontal and cingulate cortices, including the posterior cingulate cortex (extending to the MCC), middle frontal gyrus, medial prefrontal cortex, dorsolateral prefrontal cortex, OFC and anterior cingulate cortex. CONCLUSIONS Our results extend existing neurological evidence by showing that a reduced response in the mesocortical-limbic circuit is found in gain versus loss processing, with decreased responsivity in cortical regions in risk decision-making. Our results implicate dissociable neural circuit responses for gain-loss processing and risk decision-making, which contribute to a better understanding of the pathophysiological mechanism underlying nondrug incentive and risk processing in individuals with AUD.
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Affiliation(s)
- Jianguang Zeng
- School of Economics and Business Administration, Chongqing University, Chongqing, China
| | - Lantao You
- School of Economics and Business Administration, Chongqing University, Chongqing, China
| | - Haoxuan Sheng
- School of Public Policy and Administration, Chongqing University, Chongqing, China
| | - Ya Luo
- Department of Psychiatry, State Key Lab of Biotherapy, West China Hospital of Sichuan University, Chengdu, China
| | - Xun Yang
- School of Public Policy and Administration, Chongqing University, Chongqing, China.
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7
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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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8
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Yao G, Wei L, Jiang T, Dong H, Baeken C, Wu GR. Neural mechanisms underlying empathy during alcohol abstinence: evidence from connectome-based predictive modeling. Brain Imaging Behav 2022; 16:2477-2486. [PMID: 35829876 DOI: 10.1007/s11682-022-00702-0] [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: 03/14/2022] [Revised: 06/20/2022] [Accepted: 06/27/2022] [Indexed: 01/10/2023]
Abstract
Empathy impairments have been linked to alcohol dependence even during abstinent periods. Nonetheless, the neural underpinnings of abstinence-induced empathy deficits remain unclear. In this study, we employed connectome-based predictive modeling (CPM) by using whole brain resting-state functional connectivity (rs-FC) to predict empathy capability of abstinent alcoholics (n = 47) versus healthy controls (n = 59). In addition, the generalizability of the predictive model (i.e., one group treated as a training dataset and another one treated as a test dataset) was performed to determine whether healthy controls and abstinent alcoholics share common neural fingerprints of empathy. Our results showed that abstinent alcoholics relative to healthy controls had decreased empathy capacity. Although no predictive models were observed in the abstinence group, we found that individual empathy scores in the healthy group can be reliably predicted by functional connectivity from the default mode network (DMN) to the sensorimotor network (SMN), occipital network, and cingulo-opercular network (CON). Moreover, the identified connectivity fingerprints of healthy controls could be generalized to predict empathy in the abstinence group. These findings indicate that neural circuits accounting for empathy may be disrupted by alcohol use and the impaired degree varies greatly among abstinent individuals. The large inter-individual variation may impede identification of the predictive model of empathy in alcohol abstainers.
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Affiliation(s)
- Guanzhong Yao
- Key Laboratory of Cognition and Personality, Faculty of Psychology, Southwest University, Chongqing, China
| | - Luqing Wei
- School of Psychology, Jiangxi Normal University, Nanchang, China.
| | - Ting Jiang
- Key Laboratory of Cognition and Personality, Faculty of Psychology, Southwest University, Chongqing, China
| | - Hui Dong
- Key Laboratory of Cognition and Personality, Faculty of Psychology, Southwest University, Chongqing, China
| | - Chris Baeken
- Faculty of Medicine and Health Sciences, Department of Head and Skin, Ghent Experimental Psychiatry (GHEP) lab, Ghent University, Ghent, Belgium.,Department of Psychiatry, University Hospital (UZBrussel), Brussels, Belgium.,Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands
| | - Guo-Rong Wu
- Key Laboratory of Cognition and Personality, Faculty of Psychology, Southwest University, Chongqing, China. .,Faculty of Medicine and Health Sciences, Department of Head and Skin, Ghent Experimental Psychiatry (GHEP) lab, Ghent University, Ghent, Belgium.
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9
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Wei G, Sirohi S, Walker BM. Dysregulated kappa-opioid receptors in the medial prefrontal cortex contribute to working memory deficits in alcohol dependence. Addict Biol 2022; 27:e13138. [PMID: 35138672 PMCID: PMC8829053 DOI: 10.1111/adb.13138] [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: 11/07/2021] [Revised: 12/06/2021] [Accepted: 12/17/2021] [Indexed: 01/14/2023]
Abstract
Impaired working memory is one symptom contributing to compromised executive function in alcohol use disorder (AUD). Dysregulation of cortical dynorphin (DYN) and κ-opioid receptors (KORs) has been implicated in alcohol dependence-induced impairment in executive function. The present experiments test the hypothesis that dysregulated medial prefrontal cortex (mPFC) KORs contribute to impaired working memory in alcohol dependence. Alcohol dependence was induced in male Wistar rats via 4 months of intermittent ethanol vapor exposure prior to training/testing in an mPFC-dependent working memory task (delayed nonmatching-to-sample task; DNMST). mPFC KOR function in alcohol-naïve rats was compared with that of alcohol-dependent and nondependent rats using a DYN A-stimulated [35S ]GTPγS coupling assay. A functional role for mPFC KORs in the regulation of working memory was assessed via intra-mPFC infusions of a KOR agonist prior to assessment in the DNMST, and the contribution of mPFC KORs to compromised working memory in dependence was assessed via mPFC infusions of the KOR antagonist norbinaltorphimine (nor-BNI). In alcohol-dependent rats, impaired performance in the DNMST confirmed compromised working memory. Furthermore, DYN A-stimulated mPFC KOR function was pathologically increased in alcohol-dependent rats compared with nondependent and alcohol-naïve rats. Additionally, mPFC KOR involvement in working memory was functionally confirmed by intra-mPFC KOR agonist-induced deficits in DNMST performance. Importantly, alcohol dependence-induced impairment in the DNMST was ameliorated by intra-mPFC KOR antagonism. Regulation of working memory by mPFC KORs and alcohol dependence-induced dysregulation of mPFC KOR function identify a novel therapeutic target to treat AUD-related symptoms of working memory impairment.
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Affiliation(s)
- Gengze Wei
- Laboratory of Alcoholism and Addictions Neuroscience, Department of Psychiatry and Behavioral Neurosciences, Morsani College of Medicine, University of South Florida, Tampa, FL
| | - Sunil Sirohi
- Laboratory of Endocrine and Neuropsychiatric Disorders, Division of Basic Pharmaceutical Sciences, College of Pharmacy, Xavier University of Louisiana, New Orleans, LA
| | - Brendan M Walker
- Laboratory of Alcoholism and Addictions Neuroscience, Department of Psychiatry and Behavioral Neurosciences, Morsani College of Medicine, University of South Florida, Tampa, FL.,Correspondence: Brendan M. Walker, Ph.D., Laboratory of Alcoholism and Addictions Neuroscience, Department of Psychiatry & Behavioral Neurosciences, University of South Florida, 3515 E. Fletcher, Tampa, FL 33613, 813-974-3715 (office),
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Livne O, Feinn R, Knox J, Hartwell EE, Gelernter J, Hasin DS, Kranzler HR. Alcohol withdrawal in past-year drinkers with unhealthy alcohol use: Prevalence, characteristics, and correlates in a national epidemiologic survey. Alcohol Clin Exp Res 2022; 46:422-433. [PMID: 35275407 PMCID: PMC8928097 DOI: 10.1111/acer.14781] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 12/19/2021] [Accepted: 01/22/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND Despite its potential to produce serious adverse outcomes, DSM-5 alcohol withdrawal syndrome (AWS) has not been widely studied in the general population. METHODS We used cross-sectional data from 36,309 U.S. adults from the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions-III to examine the past-year prevalence of AWS and its correlates. We focused on an important clinical population-past-year drinkers with unhealthy alcohol use-i.e., those with a positive score on the Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) questionnaire. We also examined the association of AWS with sociodemographic measures, psychiatric disorders, alcohol-related measures, and healthcare utilization. RESULTS Approximately one-third (n = 12,634) of respondents reported unhealthy alcohol use (AUDIT-C+). Of these, 14.3% met criteria for a DSM-5 AWS diagnosis. The mean (SE) number of withdrawal symptoms among individuals with AWS was 2.83 (1.88), with the most common being nausea/vomiting and insomnia (19.8% and 11.6%, respectively). Among AUDIT-C+ respondents, the odds of AWS were significantly higher among males (adjusted odds ratio [aOR] = 1.17 [95% CI, 1.02-1.33]), unmarried participants (aOR = 1.55 [95% CI, 1.25-1.92]), and those at the lowest (vs. highest) income levels (aOR = 1.62 [95% CI, 1.37-1.92]). Among AUDIT-C+ respondents, AWS was also associated with psychiatric disorders (with aORs that ranged from 2.08 [95% CI, 1.79-2.41]) for major depressive disorder to 3.14 (95% CI, 1.79-2.41) for borderline personality disorder. AUDIT-C+ respondents with AWS also had higher odds of past-year alcohol use disorder (aOR = 11.2 [95% CI, 9.66-13.07]), other alcohol-related features (e.g., binge drinking), and healthcare utilization. CONCLUSIONS Among individuals with unhealthy alcohol use, AWS is prevalent, highly comorbid, and disabling. Given the risk of AWS among unhealthy drinkers, a comparatively large segment of the general population, clinicians should seek to identify individuals with AWS and intervene with them to prevent serious adverse outcomes.
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Affiliation(s)
- Ofir Livne
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY
| | - Richard Feinn
- Department of Medical Sciences, Frank H. Netter School of Medicine at Quinnipiac University, North Haven, CT
| | - Justin Knox
- Department of Psychiatry, Columbia University Vagelos College of Physicians & Surgeons, New York, NY,New York State Psychiatric Institute, HIV Center for Clinical and Behavioral Studies, New York, NY
| | - Emily E. Hartwell
- Center for Studies of Addiction, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine and Veterans Integrated Service Network 4 Mental Illness Research, Education and Clinical Center, Crescenz Veterans Affairs Medical Center, Philadelphia, PA
| | - Joel Gelernter
- Department of Psychiatry, Yale University School of Medicine and VA CT Healthcare Center, West Haven, CT
| | - Deborah S. Hasin
- Department of Psychiatry, Columbia University Vagelos College of Physicians & Surgeons, New York, NY
| | - Henry R. Kranzler
- Center for Studies of Addiction, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine and Veterans Integrated Service Network 4 Mental Illness Research, Education and Clinical Center, Crescenz Veterans Affairs Medical Center, Philadelphia, PA
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Dinesh A, Rai S, Praharaj SK. Decision-making and impulsivity in patients with alcohol dependence syndrome with comorbid attention deficit hyperactivity disorder. CLIN PSYCHOL-UK 2022. [DOI: 10.1080/13284207.2021.1985377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Archana Dinesh
- Department of Clinical Psychology, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, India
| | - Shweta Rai
- Department of Clinical Psychology, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, India
| | - Samir Kumar Praharaj
- Department of Psychiatry, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, India
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12
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Sasaki J, Matsubara T, Chen C, Fujii Y, Fujita Y, Nakamuta M, Nitta K, Egashira K, Hashimoto T, Nakagawa S. Prefrontal activity during the emotional go/no-go task and computational markers of risk-based decision-making predict future relapse in alcohol use disorder. Front Psychiatry 2022; 13:1048152. [PMID: 36683993 PMCID: PMC9845941 DOI: 10.3389/fpsyt.2022.1048152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 11/28/2022] [Indexed: 01/05/2023] Open
Abstract
AIM To longitudinally examine if the results of cognitive tasks or brain function during emotional or cognitive tasks can predict relapse in alcohol use disorder. METHODS We selected 41 patients with alcohol use disorder during hospitalization. Functional near-infrared spectroscopy (fNIRS) measured the relative change in oxygenated hemoglobin in the frontotemporal areas during an emotional go/no-go task and verbal fluency task (VFT). They performed the N-back and risk-based decision-making tasks for determining working memory or risk-based decision-making. The presence of relapse 6 months following discharge was the primary outcome. RESULTS Twenty-four patients (21 men, three women) remained abstinent, whereas 17 (14 men, three women) relapsed. Compared with the abstinent group, those with relapse displayed significantly decreased activation in the right frontotemporal region during the emotional go/no-go task, significantly shorter reaction time to non-emotional stimuli, and greater risk preference in the risk-based decision-making task. In the abstinent group, we observed a negative correlation between oxygenated hemoglobin and the craving scale. A logistic regression analysis demonstrated that the risk of relapse increased with smaller oxygenated hemoglobin in the right frontotemporal region (odds ratio = 0.161, p = 0.013) and with greater gambling thoughts (odds ratio = 7.04, p = 0.033). CONCLUSION Decreased activation in the right frontotemporal region in response to an emotional stimulus and risk preference could predict relapse in alcohol use disorder.
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Affiliation(s)
- Jun Sasaki
- Division of Neuropsychiatry, Department of Neuroscience, Yamaguchi University Graduate School of Medicine, Ube, Japan.,Koryo Hospital, Ube, Japan
| | - Toshio Matsubara
- Division of Neuropsychiatry, Department of Neuroscience, Yamaguchi University Graduate School of Medicine, Ube, Japan
| | - Chong Chen
- Division of Neuropsychiatry, Department of Neuroscience, Yamaguchi University Graduate School of Medicine, Ube, Japan
| | - Yuko Fujii
- Division of Neuropsychiatry, Department of Neuroscience, Yamaguchi University Graduate School of Medicine, Ube, Japan
| | | | | | | | | | | | - Shin Nakagawa
- Division of Neuropsychiatry, Department of Neuroscience, Yamaguchi University Graduate School of Medicine, Ube, Japan
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13
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Chaudhury S, Vijay P, Khan A, Sowmya AV, Chaudhari B, Saldanha D. Cognitive deficits in alcohol dependence—A case–control analytical study. MEDICAL JOURNAL OF DR. D.Y. PATIL VIDYAPEETH 2022. [DOI: 10.4103/mjdrdypu.mjdrdypu_921_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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14
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Verdejo-Garcia A, Hanegraaf L, Blanco-Gandía MC, López-Arnau R, Grau M, Miñarro J, Escubedo E, Pubill D, Rodríguez-Arias M. Impact of adolescent methamphetamine use on social cognition: A human-mice reverse translation study. Drug Alcohol Depend 2022; 230:109183. [PMID: 34847504 DOI: 10.1016/j.drugalcdep.2021.109183] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 10/11/2021] [Accepted: 10/25/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND Methamphetamine dependence is associated with social cognition deficits that may underpin negative social outcomes. However, there are considerable inter-individual differences in social cognition within people with methamphetamine dependence, with age of onset of methamphetamine use being a potential contributing factor. MATERIALS AND METHODS We conducted two sequential studies examining the link between age of onset of methamphetamine use (adolescence versus young adulthood) and performance in social cognition tests: (1) a human cross-sectional study in 95 participants with methamphetamine dependence varying in age of onset (38 with adolescent onset and 57 with adult onset) and 49 drug-naïve controls; (2) a mice study in which we tested the effects of methamphetamine exposure during adolescence versus young adulthood on social interaction and aggression, and their potential neurochemical substrates in the striatal dopaminergic system. RESULTS We initially showed that people with methamphetamine dependence who started use in adolescence had higher antisocial beliefs (p = 0.046, Cohen's d=0.42) and worse emotion recognition (p = 0.031, Cohen's d=0.44) than those who started use during adulthood. We reasoned that this could be due to either social cognition deficits leading to earlier onset of methamphetamine use, or methamphetamine-induced neuroadaptive effects specific to adolescence. Mice experiments showed that methamphetamine exposure during adolescence specifically decreased social investigation during social interaction and upregulated striatal tyrosine hydroxylase (p < 0.05, Bonferroni corrected). There was no evidence of adolescent-specific methamphetamine effects on aggression or other measures of dopaminergic function. CONCLUSION Together, translational findings demonstrate heightened sensitivity to methamphetamine effects on social cognition during adolescence.
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Affiliation(s)
- Antonio Verdejo-Garcia
- Turner Institute for Brain and Mental Health, Monash University, 18 Innovation Walk, Clayton, VIC 3800, Australia.
| | - Lauren Hanegraaf
- Turner Institute for Brain and Mental Health, Monash University, 18 Innovation Walk, Clayton, VIC 3800, Australia
| | - María Carmen Blanco-Gandía
- Department of Psychology and Sociology, University of Zaragoza, C/ Ciudad Escolar s/n, 44003 Teruel, Spain
| | - Raúl López-Arnau
- Department of Pharmacology, Toxicology and Therapeutic Chemistry, Pharmacology Section and Institute of Biomedicine (IBUB), Faculty of Pharmacy and Food Sciences, University of Barcelona, Av. Joan XXIII, 27-31, 08028 Barcelona, Spain
| | - Marina Grau
- Department of Pharmacology, Toxicology and Therapeutic Chemistry, Pharmacology Section and Institute of Biomedicine (IBUB), Faculty of Pharmacy and Food Sciences, University of Barcelona, Av. Joan XXIII, 27-31, 08028 Barcelona, Spain
| | - José Miñarro
- Department of Psychobiology, Facultad de Psicología, Universitat de Valencia, Avda. Blasco Ibáñez, 21, 46010 Valencia, Spain
| | - Elena Escubedo
- Department of Pharmacology, Toxicology and Therapeutic Chemistry, Pharmacology Section and Institute of Biomedicine (IBUB), Faculty of Pharmacy and Food Sciences, University of Barcelona, Av. Joan XXIII, 27-31, 08028 Barcelona, Spain
| | - David Pubill
- Department of Pharmacology, Toxicology and Therapeutic Chemistry, Pharmacology Section and Institute of Biomedicine (IBUB), Faculty of Pharmacy and Food Sciences, University of Barcelona, Av. Joan XXIII, 27-31, 08028 Barcelona, Spain
| | - Marta Rodríguez-Arias
- Department of Psychobiology, Facultad de Psicología, Universitat de Valencia, Avda. Blasco Ibáñez, 21, 46010 Valencia, Spain
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15
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Alderson Myers AB, Arienzo D, Molnar SM, Marinkovic K. Local and network-level dysregulation of error processing is associated with binge drinking. NEUROIMAGE-CLINICAL 2021; 32:102879. [PMID: 34768146 PMCID: PMC8591397 DOI: 10.1016/j.nicl.2021.102879] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 11/04/2021] [Accepted: 11/05/2021] [Indexed: 01/22/2023]
Abstract
Go/NoGo performance does not differ between binge (BDs) and light drinkers. BDs show greater BOLD activity to inhibition errors primarily in prefrontal areas. Greater functional connectivity in the frontal cortex correlates with drinking. Observed increase in error-related activity may serve a compensatory role. This is consistent with allostatic hyperexcitability reflecting neuroadaptation.
Binge drinking refers to the pattern of alcohol consumption that brings blood alcohol levels to or above legal intoxication levels. Commonly practiced by young adults, it is associated with neurofunctional alterations, raising health-related concerns. Executive deficits may contribute to the inability to refrain from excessive alcohol intake. As a facet of cognitive control, error processing allows for flexible modification of behavior to optimize future outcomes. It is highly relevant to addiction research, as a failure to inhibit excessive drinking results in relapses, which is a hallmark of alcohol use disorder. However, research on local and system-level neural underpinnings of inhibition failures as a function of binge drinking is limited. To address these gaps, functional magnetic resonance imaging (fMRI) was used to examine local changes and interregional functional connectivity during response inhibition errors on a Go/NoGo task. Young adult binge drinkers (BDs) performed equally well as light drinkers (LDs), a group of demographically matched individuals who drink regularly but in low-risk patterns. In contrast, BDs exhibited greater fMRI activity to inhibition errors contrasted with correct NoGo trials in the rostral anterior (rACC) and posterior cingulate cortices (PCC), as well as right middle frontal gyrus (R-MFG). Furthermore, BDs showed increased connectivity between the rACC and right lateral prefrontal cortex, in addition to greater connectivity between the R-MFG and the left ventrolateral and superior frontal cortices. Imaging indices were positively correlated only with alcohol-related measures, but not with those related to moods, disposition, or cognitive capacity. Taken together, greater error-related activity and expanded functional connectivity among prefrontal regions may serve a compensatory role to maintain efficiency of inhibitory control. Aligned with prominent models of addiction, these findings accentuate the importance of top-down control in maintaining low-risk drinking levels. They provide insight into potentially early signs of deteriorating cognitive control functions in BDs and may help guide intervention strategies aimed at preventing excessive drinking habits.
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Affiliation(s)
- Austin B Alderson Myers
- Department of Psychology, San Diego State University, 5500 Campanile Dr., San Diego, CA 92182, USA.
| | - Donatello Arienzo
- Department of Psychology, San Diego State University, 5500 Campanile Dr., San Diego, CA 92182, USA.
| | - Sean M Molnar
- Department of Psychology, San Diego State University, 5500 Campanile Dr., San Diego, CA 92182, USA.
| | - Ksenija Marinkovic
- Department of Psychology, San Diego State University, 5500 Campanile Dr., San Diego, CA 92182, USA; Department of Radiology, University of California, San Diego, 9500 Gilman Dr., La Jolla, CA 92093, USA.
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16
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Kouimtsidis C, Houghton B, Gage H, Notley C, Maskrey V, Clark A, Holland R, Lingford-Hughes A, Punukollu B, Touray M, Duka T. A feasibility trial of an intervention in alcohol dependence for structured preparation before detoxification versus usual care: the SPADe trial results. Pilot Feasibility Stud 2021; 7:148. [PMID: 34325743 PMCID: PMC8320093 DOI: 10.1186/s40814-021-00880-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 06/21/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Individuals who are 'moderately' or 'severely' dependent consume alcohol at levels that are likely to have a severe impact on their own health and mortality, the health and behaviours of others (family members) and to have economic and social implications. Treatment guidelines suggest that treatment needs to be planned with medically assisted withdrawal (also referred to as detoxification), and aftercare support but outcomes are poor with low proportions engaging in after care and high relapse rates. An approach of structured preparation before alcohol detoxification (SPADe) puts an emphasis on introducing lifestyle changes, development of coping strategies for cravings, stress and emotions as well as introducing changes to the immediate family and social environment in advance of alcohol cessation. Such a pre-habilitation paradigm compliments the established treatment approach. The key research question was: can we design a large scale, randomised controlled trial (RCT) that will answer whether such an approach is more effective than usual care in helping individuals to maintain longer periods of alcohol abstinence? METHODS This is a pragmatic, parallel, two-arm, feasibility RCT comparing SPADe and usual care against usual care only in maintaining alcohol abstinence in adults with alcohol dependence receiving care in two community addiction services in London. Feasibility outcomes, exploration of primary and secondary clinical outcomes and health economic outcomes are analysed. The trial follows the guidelines of phase 2 of the Medical Research Council (MRC) for complex interventions. RESULTS We were able to recruit 48/50 participants during a period of 9 months. Retention in the trial for the whole period of the 12 months was 75%. Treatment compliance was overall 44%. Data completion for the primary outcome was 65%, 50% and 63% at 3, 6 and 12 months, respectively. The intervention group had more days abstinent in the previous 90 days at the 12 months (n = 54.5) versus control (n = 41.5). CONCLUSIONS The results of this feasibility trial indicate that with the appropriate modifications, a full multicentred trial would be possible to test the effectiveness and cost-effectiveness of a pre-habilitation approach such as the SPADe group intervention in addition to usual care against usual care only. TRIAL REGISTRATION Name of registry: ISRCTN; Trial Registration Number: 14621127 ; Date of Registration: 22/02/2017.
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Affiliation(s)
- Christos Kouimtsidis
- Surrey & Borders NHS Trust, Research and Development, Abraham Cowley Uni, Chertsey, Surrey, KT16 0AE UK
| | - Ben Houghton
- Surrey & Borders NHS Trust, Research and Development, Abraham Cowley Uni, Chertsey, Surrey, KT16 0AE UK
| | - Heather Gage
- University of Surrey, 388 Stag Hill, Guildford, GU2 7XH UK
| | - Caitlin Notley
- Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich, NR4 7TJ UK
| | - Vivienne Maskrey
- University of East Anglia, Norwich Research Park, Norwich, NR4 7TJ UK
| | - Allan Clark
- University of East Anglia, Norwich Research Park, Norwich, NR4 7TJ UK
| | - Richard Holland
- University of Leicester, University Road, Leicester, LE1 7RH UK
| | - Anne Lingford-Hughes
- Imperial College London, Burlington Danes Building, Hammersmith Campus, 160 Du Cane Road, London, W12 0NN UK
| | - Bhaskar Punukollu
- Camden and Islington NHS Foundation Trust, St Pancras Hospital, 4 St Pancras Way, Kings Cross, London, NW1 0PE UK
| | - Morro Touray
- Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich, NR4 7TJ UK
| | - Theodora Duka
- University of Sussex, School of Psychology, Falmer, Brighton, BN1 9RH UK
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17
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Rowland JA, Stapleton-Kotloski JR, Alberto GE, Davenport AT, Epperly PM, Godwin DW, Daunais JB. Rich Club Characteristics of Alcohol-Naïve Functional Brain Networks Predict Future Drinking Phenotypes in Rhesus Macaques. Front Behav Neurosci 2021; 15:673151. [PMID: 34149371 PMCID: PMC8206638 DOI: 10.3389/fnbeh.2021.673151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 04/28/2021] [Indexed: 11/30/2022] Open
Abstract
Purpose: A fundamental question for Alcohol use disorder (AUD) is how and when naïve brain networks are reorganized in response to alcohol consumption. The current study aimed to determine the progression of alcohol’s effect on functional brain networks during transition from the naïve state to chronic consumption. Procedures: Resting-state brain networks of six female rhesus macaque (Macaca mulatta) monkeys were acquired using magnetoencephalography (MEG) prior to alcohol exposure and after free-access to alcohol using a well-established model of chronic heavy alcohol consumption. Functional brain network metrics were derived at each time point. Results: The average connection frequency (p < 0.024) and membership of the Rich Club (p < 0.022) changed significantly over time. Metrics describing network topology remained relatively stable from baseline to free-access drinking. The minimum degree of the Rich Club prior to alcohol exposure was significantly predictive of future free-access drinking (r = −0.88, p < 0.001). Conclusions: Results suggest naïve brain network characteristics may be used to predict future alcohol consumption, and that alcohol consumption alters functional brain networks, shifting hubs and Rich Club membership away from previous regions in a non-systematic manner. Further work to refine these relationships may lead to the identification of a high-risk drinking phenotype.
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Affiliation(s)
- Jared A Rowland
- Research and Academic Affairs Service Line, Mid-Atlantic Mental Illness Research Education and Clinical Center, Salisbury VA Medical Center, Salisbury, NC, United States.,Department of Neurobiology and Anatomy, Wake Forest School of Medicine, Winston-Salem, NC, United States.,Department of Psychiatry and Behavioral Medicine, Wake Forest School of Medicine, Winston-Salem, NC, United States
| | - Jennifer R Stapleton-Kotloski
- Research and Academic Affairs Service Line, Mid-Atlantic Mental Illness Research Education and Clinical Center, Salisbury VA Medical Center, Salisbury, NC, United States.,Department of Neurology, Wake Forest School of Medicine, Winston-Salem, NC, United States
| | - Greg E Alberto
- Department of Neurobiology and Anatomy, Wake Forest School of Medicine, Winston-Salem, NC, United States
| | - April T Davenport
- Department of Physiology and Pharmacology, Wake Forest School of Medicine, Winston-Salem, NC, United States
| | - Phillip M Epperly
- Department of Physiology and Pharmacology, Wake Forest School of Medicine, Winston-Salem, NC, United States
| | - Dwayne W Godwin
- Department of Neurobiology and Anatomy, Wake Forest School of Medicine, Winston-Salem, NC, United States.,Department of Neurology, Wake Forest School of Medicine, Winston-Salem, NC, United States.,Department of Physiology and Pharmacology, Wake Forest School of Medicine, Winston-Salem, NC, United States
| | - James B Daunais
- Department of Physiology and Pharmacology, Wake Forest School of Medicine, Winston-Salem, NC, United States
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18
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Lawes JC, Peden AE, Bugeja L, Strasiotto L, Daw S, Franklin RC. Suicide along the Australian coast: Exploring the epidemiology and risk factors. PLoS One 2021; 16:e0251938. [PMID: 34015048 PMCID: PMC8136651 DOI: 10.1371/journal.pone.0251938] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 05/05/2021] [Indexed: 01/22/2023] Open
Abstract
Suicide is an increasing global concern with multiple risk factors, yet location-based understanding is limited. In Australia, surf lifesavers (SLS) and lifeguards patrol the coast, performing rescues and assisting injured people, including people who suicide. This study is a descriptive epidemiological analysis of Australian coastal suicide deaths. The results will be used to inform training and support surf lifesaving personnel and suicide prevention organisations. This is a population-based cross-sectional study of suicide deaths at Australian coastal locations (between 1 January 2005 and 31 December 2019). Data were sourced from the National Coronial Information System and SLS Australia's Incident Report Database. Analyses explored decedent, incident, and risk factors by sex and method. Across the study period, there were 666 coastal suicide deaths (71.0% male, 43.4% jumping from high places [X80]). Males were more likely to suicide by other means (hanging, self-poisoning, firearm discharge; n = 145, 83.8%), compared to females who were more likely to suicide by drowning ([X71]; n = 77, 37.7%). In one third (n = 225, 38.3%) toxicology was a contributing factor. The risk of coastal suicides was 10.3 times higher during the seven-days prior to their birthday (p<0.001). Evidence of mental ill health was reported in 61.4% (n = 409) of cases and evidence of suicidal behaviour was reported for 37.4% of decedents (n = 249), more prevalent in females. SLS responded in 10.7% (n = 71) of coastal suicides (most jumps from high places; n = 36, 50.7%). Coastal suicides differ to national trends suggesting that location-based differences should be considered during development of preventative and protective measures, especially at a community level. Accessibility, availability, perceived lethality and symbolic qualities are proposed to influence suicide location decisions. These results will guide support and education strategies for surf lifesaving personnel, contributes to established, ongoing suicide surveillance efforts (including hot-spot identification) and add to the limited literature exploring place-based suicide.
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Affiliation(s)
- Jasmin C. Lawes
- Surf Life Saving Australia, Bondi Beach, Sydney, New South Wales, Australia
- Beach Safety Research Group, School of Biological, Earth and Environmental Sciences, UNSW Sydney, Kensington, New South Wales, Australia
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia
| | - Amy E. Peden
- Beach Safety Research Group, School of Biological, Earth and Environmental Sciences, UNSW Sydney, Kensington, New South Wales, Australia
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia
- School of Population Health, Faculty of Medicine, UNSW Sydney, Kensington, New South Wales, Australia
| | - Lyndal Bugeja
- Department of Forensic Medicine, Monash University, Southbank, Victoria, Australia
- Monash Nursing and Midwifery, Monash University, Clayton, Victoria, Australia
| | - Luke Strasiotto
- Surf Life Saving Australia, Bondi Beach, Sydney, New South Wales, Australia
| | - Shane Daw
- Surf Life Saving Australia, Bondi Beach, Sydney, New South Wales, Australia
| | - Richard C. Franklin
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia
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19
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Binge drinking is associated with altered resting state functional connectivity of reward-salience and top down control networks. Brain Imaging Behav 2021; 14:1731-1746. [PMID: 31073695 DOI: 10.1007/s11682-019-00107-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Binge drinking is characterized by bouts of high-intensity alcohol intake and is associated with an array of health-related harms. Even though the transition from occasional impulsive to addictive alcohol use is not well understood, neurobiological models of addiction suggest that repeated cycles of intoxication and withdrawal contribute to the development of addiction in part through dysregulation of neurofunctional networks. Research on the neural sequelae associated with binge drinking is scant but resting state functional connectivity (RSFC) studies of alcohol use disorders (AUD) indicate that the development and maintenance of long-term excessive drinking may be mediated by network-level disruptions. The present study examined RSFC in young adult binge (BD) and light (LD) drinkers with seeds representing the networks subserving reward (the nucleus accumbens and caudate nucleus), salience (anterior cingulate cortex, ACC), and executive control (inferior frontal cortex, IFC). BDs exhibited enhanced connectivity between the striatal reward areas and the orbitofrontal cortex and the ACC, which is consistent with AUD studies and may be indicative of alcohol-motivated appetitive behaviors. Conversely, BDs demonstrated lower connectivity between the IFC and hippocampus which was associated with higher craving. This may indicate impaired ability to suppress unwanted thoughts and a failure to employ memory of the harmful consequences of heavy drinking in prospective plans and intentions. The observed greater connectivity of the reward/salience network and the lower prefrontal-hippocampal connectivity were associated with hazardous drinking levels indicating that dysregulation of neurofunctional networks may underlie binge drinking patterns.
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20
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Different Effects of Alcohol Exposure on Action and Outcome-Related Orbitofrontal Cortex Activity. eNeuro 2021; 8:ENEURO.0052-21.2021. [PMID: 33785522 PMCID: PMC8174034 DOI: 10.1523/eneuro.0052-21.2021] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 03/12/2021] [Accepted: 03/18/2021] [Indexed: 11/21/2022] Open
Abstract
Alcohol dependence can result in long-lasting deficits to decision-making and action control. Neurobiological investigations have identified orbitofrontal cortex (OFC) as important for outcome-related contributions to goal-directed actions during decision-making. Prior work has shown that alcohol dependence induces long-lasting changes to OFC function that persist into protracted withdrawal and disrupts goal-directed control over actions. However, it is unclear whether these changes in function alter representation of action and outcome-related neural activity in OFC. Here, we used the well-validated chronic intermittent ethanol (CIE) exposure and withdrawal procedure to model alcohol dependence in mice and performed in vivo extracellular recordings during an instrumental task in which lever-press actions made for a food outcome. We found alcohol dependence disrupted goal-directed action control and increased OFC activity associated with lever-pressing but decreased OFC activity during outcome-related epochs. The ability to decode outcome-related information, but not action information, from OFC activity following CIE exposure was reduced. Hence, chronic alcohol exposure induced a long-lasting disruption to OFC function such that activity associated with actions was enhanced, but OFC activity contributions to outcome-related information was diminished. This has important implications for hypotheses regarding compulsive and habitual phenotypes observed in addiction.
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21
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Impulsivity and Decision-making Style Among Tramadol Drug Addicts and its Relation to Frontal Lobe Volume. ADDICTIVE DISORDERS & THEIR TREATMENT 2021. [DOI: 10.1097/adt.0000000000000256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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22
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Effect of Distance to Trauma Centre, Trauma Centre Level, and Trauma Centre Region on Fatal Injuries among Motorcyclists in Taiwan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18062998. [PMID: 33803979 PMCID: PMC7999330 DOI: 10.3390/ijerph18062998] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Revised: 03/10/2021] [Accepted: 03/11/2021] [Indexed: 11/30/2022]
Abstract
Background: Studies have suggested that trauma centre-related risk factors, such as distance to the nearest trauma hospital, are strong predictors of fatal injuries among motorists. Few studies have used a national dataset to study the effect of trauma centre-related risk factors on fatal injuries among motorists and motorcyclists in a country where traffic is dominated by motorcycles. This study investigated the effect of distance from the nearest trauma hospital on fatal injuries from two-vehicle crashes in Taiwan from 2017 to 2019. Methods: A crash dataset and hospital location dataset were combined. The crash dataset was extracted from the National Taiwan Traffic Crash Dataset from 1 January 2017 through 31 December 2019. The primary exposure in this study was distance to the nearest trauma hospital. This study performed a multiple logistic regression to calculate the adjusted odds ratios (AORs) for fatal injuries. Results: The multivariate logistic regression models indicated that motorcyclists involved in crashes located ≥5 km from the nearest trauma hospital and in Eastern Taiwan were approximately five times more likely to sustain fatal injuries (AOR = 5.26; 95% CI: 3.69–7.49). Conclusions: Distance to, level of, and region of the nearest trauma centre are critical risk factors for fatal injuries among motorcyclists but not motorists. To reduce the mortality rate of trauma cases among motorcyclists, interventions should focus on improving access to trauma hospitals.
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Kinreich S, McCutcheon VV, Aliev F, Meyers JL, Kamarajan C, Pandey AK, Chorlian DB, Zhang J, Kuang W, Pandey G, Viteri SSSD, Francis MW, Chan G, Bourdon JL, Dick DM, Anokhin AP, Bauer L, Hesselbrock V, Schuckit MA, Nurnberger JI, Foroud TM, Salvatore JE, Bucholz KK, Porjesz B. Predicting alcohol use disorder remission: a longitudinal multimodal multi-featured machine learning approach. Transl Psychiatry 2021; 11:166. [PMID: 33723218 PMCID: PMC7960734 DOI: 10.1038/s41398-021-01281-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 12/07/2020] [Accepted: 12/16/2020] [Indexed: 12/02/2022] Open
Abstract
Predictive models for recovering from alcohol use disorder (AUD) and identifying related predisposition biomarkers can have a tremendous impact on addiction treatment outcomes and cost reduction. Our sample (N = 1376) included individuals of European (EA) and African (AA) ancestry from the Collaborative Study on the Genetics of Alcoholism (COGA) who were initially assessed as having AUD (DSM-5) and reassessed years later as either having AUD or in remission. To predict this difference in AUD recovery status, we analyzed the initial data using multimodal, multi-features machine learning applications including EEG source-level functional brain connectivity, Polygenic Risk Scores (PRS), medications, and demographic information. Sex and ancestry age-matched stratified analyses were performed with supervised linear Support Vector Machine application and were calculated twice, once when the ancestry was defined by self-report and once defined by genetic data. Multifeatured prediction models achieved higher accuracy scores than models based on a single domain and higher scores in male models when the ancestry was based on genetic data. The AA male group model with PRS, EEG functional connectivity, marital and employment status features achieved the highest accuracy of 86.04%. Several discriminative features were identified, including collections of PRS related to neuroticism, depression, aggression, years of education, and alcohol consumption phenotypes. Other discriminated features included being married, employed, medication, lower default mode network and fusiform connectivity, and higher insula connectivity. Results highlight the importance of increasing genetic homogeneity of analyzed groups, identifying sex, and ancestry-specific features to increase prediction scores revealing biomarkers related to AUD remission.
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Affiliation(s)
- Sivan Kinreich
- Department of Psychiatry, State University of New York, Downstate Medical Center, Brooklyn, NY, USA.
| | - Vivia V McCutcheon
- Department of Psychiatry, Washington University School of Medicine in St Louis, St Louis, MO, USA
| | - Fazil Aliev
- Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA
- Faculty of Business, Karabuk University, Karabük, Turkey
| | - Jacquelyn L Meyers
- Department of Psychiatry, State University of New York, Downstate Medical Center, Brooklyn, NY, USA
| | - Chella Kamarajan
- Department of Psychiatry, State University of New York, Downstate Medical Center, Brooklyn, NY, USA
| | - Ashwini K Pandey
- Department of Psychiatry, State University of New York, Downstate Medical Center, Brooklyn, NY, USA
| | - David B Chorlian
- Department of Psychiatry, State University of New York, Downstate Medical Center, Brooklyn, NY, USA
| | - Jian Zhang
- Department of Psychiatry, State University of New York, Downstate Medical Center, Brooklyn, NY, USA
| | - Weipeng Kuang
- Department of Psychiatry, State University of New York, Downstate Medical Center, Brooklyn, NY, USA
| | - Gayathri Pandey
- Department of Psychiatry, State University of New York, Downstate Medical Center, Brooklyn, NY, USA
| | | | - Meredith W Francis
- Brown School of Social Work / Department of Psychiatry, Washington University in Saint Louis, St. Louis, MO, USA
| | - Grace Chan
- Department of Psychiatry, University of Connecticut School of Medicine, Farmington, CT, USA
| | - Jessica L Bourdon
- Department of Psychiatry, Washington University School of Medicine in St Louis, St Louis, MO, USA
| | - Danielle M Dick
- Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA
| | - Andrey P Anokhin
- Department of Psychiatry, Washington University School of Medicine in St Louis, St Louis, MO, USA
| | - Lance Bauer
- Department of Psychiatry, University of Connecticut School of Medicine, Farmington, CT, USA
| | - Victor Hesselbrock
- Department of Psychiatry, University of Connecticut School of Medicine, Farmington, CT, USA
| | - Marc A Schuckit
- Department of Psychiatry, University of California, San Diego School of Medicine, La Jolla, CA, USA
| | - John I Nurnberger
- Departments of Psychiatry and Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Tatiana M Foroud
- Department of Medical and Molecular Genetics at Indiana University School of Medicine, Indianapolis, IN, USA
| | - Jessica E Salvatore
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA
| | - Kathleen K Bucholz
- Department of Psychiatry, Washington University School of Medicine in St Louis, St Louis, MO, USA
| | - Bernice Porjesz
- Department of Psychiatry, State University of New York, Downstate Medical Center, Brooklyn, NY, USA
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24
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Manning V, Garfield JBB, Staiger PK, Lubman DI, Lum JAG, Reynolds J, Hall K, Bonomo Y, Lloyd-Jones M, Wiers RW, Piercy H, Jacka D, Verdejo-Garcia A. Effect of Cognitive Bias Modification on Early Relapse Among Adults Undergoing Inpatient Alcohol Withdrawal Treatment: A Randomized Clinical Trial. JAMA Psychiatry 2021; 78:133-140. [PMID: 33146693 PMCID: PMC7643044 DOI: 10.1001/jamapsychiatry.2020.3446] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
IMPORTANCE More than half of patients with alcohol use disorder who receive inpatient withdrawal treatment relapse within weeks of discharge, hampering subsequent uptake and effectiveness of psychological and pharmacologic interventions. Cognitive bias modification (CBM) improves outcomes after alcohol rehabilitation, but the efficacy of delivering CBM during withdrawal treatment has not yet been established. OBJECTIVE To test the hypothesis that CBM would increase the likelihood of abstaining from alcohol during the 2 weeks following discharge from inpatient withdrawal treatment. DESIGN, SETTING, AND PARTICIPANTS In a randomized clinical trial, 950 patients in 4 inpatient withdrawal units in Melbourne, Australia, were screened for eligibility between June 4, 2017, and July 14, 2019, to receive CBM or sham treatment. Patients with moderate or severe alcohol use disorder aged 18 to 65 years who had no neurologic illness or traumatic brain injury were eligible. Two-week follow-up, conducted by researchers blinded to the participant's condition, was the primary end point. Both per-protocol and intention-to-treat analysis were conducted. INTERVENTIONS Randomized to 4 consecutive daily sessions of CBM designed to reduce alcohol approach bias or sham training not designed to modify approach bias. MAIN OUTCOMES AND MEASURES Primary outcome was abstinence assessed using a timeline followback interview. Participants were classified as abstinent (no alcohol use in the first 14 days following discharge) or relapsed (any alcohol use during the first 14 days following discharge or lost to follow-up). RESULTS Of the 950 patients screened for eligibility, 338 did not meet inclusion criteria, 108 were discharged before being approached, and 192 refused. Of the 312 patients who consented (referred sample), 12 withdrew before being randomized. In the final population of 300 randomized patients (CBM, n = 147; sham, n = 153), 248 completed the intervention and 272 completed the follow-up. Of the 300 participants (173 [57.7%] men; mean [SD] age, 43.47 [10.43] years), 7 patients (3 controls, 4 CBM) withdrew after finding the training uncomfortable. Abstinence rates were 42.5% (95% CI, 34.3%-50.6%) in controls and 54.4% (95% CI, 46.0%-62.8%) in CBM participants, yielding an 11.9% (95% CI, 0.04%-23.8%; P = .04) difference in abstinence rates. In a per-protocol analysis including only those who completed 4 sessions of training and the follow-up, the difference in abstinence rate between groups was 17.0% (95% CI, 3.8%-30.2%; P = .008). CONCLUSIONS AND RELEVANCE The findings of this clinical trial support the efficacy of CBM for treatment of alcohol use disorder. Being safe and easy to implement, requiring only a computer and joystick, and needing no specialist staff/training, CBM could be routinely offered as an adjunctive intervention during withdrawal treatment to optimize outcomes. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry Identifier: ACTRN12617001241325.
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Affiliation(s)
- Victoria Manning
- Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Melbourne, Victoria, Australia,Turning Point, Eastern Health, Melbourne, Victoria, Australia
| | - Joshua B. B. Garfield
- Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Melbourne, Victoria, Australia,Turning Point, Eastern Health, Melbourne, Victoria, Australia
| | - Petra K. Staiger
- Deakin University School of Psychology, Geelong, Victoria, Australia,Centre for Drug Use, Addictive and Antisocial Behaviour Research, Deakin University, Geelong, Victoria, Australia
| | - Dan I. Lubman
- Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Melbourne, Victoria, Australia,Turning Point, Eastern Health, Melbourne, Victoria, Australia
| | - Jarrad A. G. Lum
- Deakin University School of Psychology, Geelong, Victoria, Australia
| | - John Reynolds
- Alfred Health and Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia
| | - Kate Hall
- Deakin University School of Psychology, Geelong, Victoria, Australia,Centre for Drug Use, Addictive and Antisocial Behaviour Research, Deakin University, Geelong, Victoria, Australia
| | - Yvonne Bonomo
- Department of Addiction Medicine, St Vincent's Hospital Melbourne, Melbourne, Victoria, Australia,Division of Medicine, Dentistry, and Health Sciences, University of Melbourne, Melbourne, Victoria, Australia
| | - Martyn Lloyd-Jones
- Department of Addiction Medicine, St Vincent's Hospital Melbourne, Melbourne, Victoria, Australia
| | - Reinout W. Wiers
- Addiction Development and Psychopathology Lab, Center for Urban Mental Health, Department of Psychology, University of Amsterdam, Amsterdam, the Netherlands
| | - Hugh Piercy
- Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Melbourne, Victoria, Australia,Turning Point, Eastern Health, Melbourne, Victoria, Australia
| | - David Jacka
- Monash Health Drug and Alcohol Service, Monash Health, Melbourne, Victoria, Australia
| | - Antonio Verdejo-Garcia
- Turning Point, Eastern Health, Melbourne, Victoria, Australia,Turner Institute for Brain and Mental Health, Monash University School of Psychological Sciences, Melbourne, Victoria, Australia
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25
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Walker LC, Berizzi AE, Chen NA, Rueda P, Perreau VM, Huckstep K, Srisontiyakul J, Govitrapong P, Xiaojian J, Lindsley CW, Jones CK, Riddy DM, Christopoulos A, Langmead CJ, Lawrence AJ. Acetylcholine Muscarinic M 4 Receptors as a Therapeutic Target for Alcohol Use Disorder: Converging Evidence From Humans and Rodents. Biol Psychiatry 2020; 88:898-909. [PMID: 32331824 DOI: 10.1016/j.biopsych.2020.02.019] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Revised: 02/03/2020] [Accepted: 02/19/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND Alcohol use disorder (AUD) is a major socioeconomic burden on society, and current pharmacotherapeutic treatment options are inadequate. Aberrant alcohol use and seeking alters frontostriatal function. METHODS We performed genome-wide RNA sequencing and subsequent quantitative polymerase chain reaction and receptor binding validation in the caudate-putamen of human AUD samples to identify potential therapeutic targets. We then back-translated our top candidate targets into a rodent model of long-term alcohol consumption to assess concordance of molecular adaptations in the rat striatum. Finally, we adopted rat behavioral models of alcohol intake and seeking to validate a potential therapeutic target. RESULTS We found that G protein-coupled receptors were the top canonical pathway differentially regulated in individuals with AUD. The M4 muscarinic acetylcholine receptor (mAChR) was downregulated at the gene and protein levels in the putamen, but not in the caudate, of AUD samples. We found concordant downregulation of the M4 mAChR, specifically on dopamine D1 receptor-expressing medium spiny neurons in the rat dorsolateral striatum. Systemic administration of the selective M4 mAChR positive allosteric modulator, VU0467154, reduced home cage and operant alcohol self-administration, motivation to obtain alcohol, and cue-induced reinstatement of alcohol seeking in rats. Local microinjections of VU0467154 in the rat dorsolateral striatum reduced alcohol self-administration and cue-induced reinstatement of alcohol seeking. CONCLUSIONS Collectively, these results identify the M4 mAChR as a potential therapeutic target for the treatment of AUD and the D1 receptor-positive medium spiny neurons in the dorsolateral striatum as a key site mediating the actions of M4 mAChR in relation to alcohol consumption and seeking.
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Affiliation(s)
- Leigh C Walker
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, Victoria, Australia
| | - Alice E Berizzi
- Drug Discovery Biology, Monash Institute of Pharmaceutical Sciences, Monash University, Parkville, Victoria, Australia
| | - Nicola A Chen
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, Victoria, Australia
| | - Patricia Rueda
- Drug Discovery Biology, Monash Institute of Pharmaceutical Sciences, Monash University, Parkville, Victoria, Australia
| | - Victoria M Perreau
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, Victoria, Australia
| | - Katherine Huckstep
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, Victoria, Australia
| | - Jirawoot Srisontiyakul
- Research Center for Neuroscience, Institute of Molecular Biosciences, Mahidol University, Salaya, Nakhon Pathom, Thailand
| | - Piyarat Govitrapong
- Research Center for Neuroscience, Institute of Molecular Biosciences, Mahidol University, Salaya, Nakhon Pathom, Thailand
| | - Jia Xiaojian
- Shenzhen Kangning Hospital, Shenzhen University Health Science Center, Shenzhen, China; Shenzhen Mental Health Center, Shenzhen University Health Science Center, Shenzhen, China
| | - Craig W Lindsley
- Department of Pharmacology, Vanderbilt Center for Neuroscience and Drug Discovery, Vanderbilt University, Nashville, Tennessee; Department of Chemistry, Vanderbilt Center for Neuroscience and Drug Discovery, Vanderbilt University, Nashville, Tennessee
| | - Carrie K Jones
- Department of Pharmacology, Vanderbilt Center for Neuroscience and Drug Discovery, Vanderbilt University, Nashville, Tennessee; Department of Chemistry, Vanderbilt Center for Neuroscience and Drug Discovery, Vanderbilt University, Nashville, Tennessee
| | - Darren M Riddy
- Drug Discovery Biology, Monash Institute of Pharmaceutical Sciences, Monash University, Parkville, Victoria, Australia
| | - Arthur Christopoulos
- Drug Discovery Biology, Monash Institute of Pharmaceutical Sciences, Monash University, Parkville, Victoria, Australia
| | - Christopher J Langmead
- Drug Discovery Biology, Monash Institute of Pharmaceutical Sciences, Monash University, Parkville, Victoria, Australia.
| | - Andrew J Lawrence
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, Victoria, Australia.
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26
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Meredith LR, Lim AC, Ray LA. Neurocognitive performance in alcohol use disorder using the NIH toolbox: Role of severity and sex differences. Drug Alcohol Depend 2020; 216:108269. [PMID: 32906037 PMCID: PMC7972314 DOI: 10.1016/j.drugalcdep.2020.108269] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 08/05/2020] [Accepted: 08/26/2020] [Indexed: 01/09/2023]
Abstract
AIMS Sustained heavy alcohol consumption is associated with a range of neurocognitive deficits. Yet, past research centers on a severe profile of alcohol use disorder (AUD), with persons recruited from in-patient settings. The current project aims to compare neurocognitive performance between individuals seeking AUD outpatient treatment with healthy comparisons while considering the association between performance, disorder severity, and sex. METHODS Enrollment included two matched groups (N = 125; 34 % female): 77 treatment-seeking individuals with AUD; 48 healthy comparison individuals with low drinking patterns. Neurocognitive performance on NIH Toolbox subtests measuring attention, inhibition, episodic memory, working memory, language, and processing speed were compared across groups. Within the AUD group, analyses examined the relationship between performance, disorder severity, recent alcohol consumption, and sex. RESULTS AUD group did not perform significantly lower than healthy comparisons on neurocognition subtests assessed. Within AUD group, females displayed significantly higher processing speeds than males (p = .007). Disorder severity and alcohol consumption were not significantly related to performance. However, a significant interaction between disorder severity and sex emerged (p = .010), with higher severity associated with poorer performance in males but not females, on a subtest measuring attention and inhibition. CONCLUSIONS Effect of heavy alcohol use on neurocognitive performance was not detected in this outpatient AUD sample. Weaknesses in domains of attention and inhibition may be correlated with AUD severity among males, but not females. Further research on AUD severity and sex in understanding individual differences in neurocognition is warranted, particularly using novel tools for large scale phenotyping, such as the NIH Toolbox.
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Affiliation(s)
| | - Aaron C. Lim
- Department of Psychology, University of California, Los Angeles, CA, USA
| | - Lara A. Ray
- Department of Psychology, University of California, Los Angeles, CA, USA,Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA,Corresponding author at: University of California Los Angeles, Department of Psychology, 1285 Franz Hall, Box 951563, Los Angeles, CA 90095-1563, USA. (L.A. Ray)
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27
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Copenhaver MM, Sanborn V, Shrestha R, Mistler C, Gunstad J. Association between the brief inventory of neurocognitive impairment (BINI) and objective cognitive testing among persons with opioid use disorders in drug treatment. J Addict Dis 2020; 39:166-174. [PMID: 33047651 DOI: 10.1080/10550887.2020.1831129] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
The current study examined the association between subjective cognitive dysfunction and objective test performance in persons enrolled in drug treatment and stabilized on methadone maintenance therapy (MMT). A total of 177 participants completed the self-reported brief inventory of neurocognitive impairment (BINI) and NIH Toolbox test battery. In participants with neurocognitive dysfunction, scores on all BINI subscales were negatively associated with objective performance on the NIH Toolbox (BINI Global r = -0.26, p = 0.01; BINI Subscales ranging -0.22 to -0.32, all p's < 0.03). Using cutoff scores, results showed participants who scored above the cutoff on the BINI Learning subscale demonstrated significant evidence of objective neurocognitive dysfunction on the NIH Toolbox (65% vs. 35%; χ2 = 6.57, p = 0.02), suggesting possible clinical utility. Future studies are needed to determine the feasibility of using the BINI to inform the accommodation of patients with specific neurocognitive profiles to optimize treatment outcomes.
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Affiliation(s)
- Michael M Copenhaver
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, USA.,Institute for Collaboration on Health, Intervention, and Policy, University of Connecticut, Storrs, CT, USA
| | | | - Roman Shrestha
- Institute for Collaboration on Health, Intervention, and Policy, University of Connecticut, Storrs, CT, USA.,Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, USA
| | - Colleen Mistler
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, USA.,Institute for Collaboration on Health, Intervention, and Policy, University of Connecticut, Storrs, CT, USA
| | - John Gunstad
- Department of Psychology, Kent State University, Kent, OH, USA
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28
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Laniepce A, Cabé N, André C, Bertran F, Boudehent C, Lahbairi N, Maillard A, Mary A, Segobin S, Vabret F, Rauchs G, Pitel AL. The effect of alcohol withdrawal syndrome severity on sleep, brain and cognition. Brain Commun 2020; 2:fcaa123. [PMID: 33543128 PMCID: PMC7846181 DOI: 10.1093/braincomms/fcaa123] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 06/22/2020] [Accepted: 07/13/2020] [Indexed: 12/28/2022] Open
Abstract
In alcohol use disorder, drinking cessation is frequently associated with an alcohol withdrawal syndrome. Early in abstinence (within the first 2 months after drinking cessation), when patients do not exhibit physical signs of alcohol withdrawal syndrome anymore (such as nausea, tremor or anxiety), studies report various brain, sleep and cognitive alterations, highly heterogeneous from one patient to another. While the acute neurotoxicity of alcohol withdrawal syndrome is well-known, its contribution to structural brain alterations, sleep disturbances and neuropsychological deficits observed early in abstinence has never been investigated and is addressed in this study. We included 54 alcohol use disorder patients early in abstinence (from 4 to 21 days of sobriety) and 50 healthy controls. When acute physical signs of alcohol withdrawal syndrome were no longer present, patients performed a detailed neuropsychological assessment, a T1-weighted MRI and a polysomnography for a subgroup of patients. According to the severity of the clinical symptoms collected during the acute withdrawal period, patients were subsequently classified as mild alcohol withdrawal syndrome (mild-AWS) patients (Cushman score ≤ 4, no benzodiazepine prescription, N = 17) or moderate alcohol withdrawal syndrome (moderate-AWS) patients (Cushman score > 4, benzodiazepine prescription, N = 37). Patients with severe withdrawal complications (delirium tremens or seizures) were not included. Mild-AWS patients presented similar grey matter volume and sleep quality as healthy controls, but lower processing speed and episodic memory performance. Compared to healthy controls, moderate-AWS patients presented non-rapid eye movement sleep alterations, widespread grey matter shrinkage and lower performance for all the cognitive domains assessed (processing speed, short-term memory, executive functions and episodic memory). Moderate-AWS patients presented a lower percentage of slow-wave sleep, grey matter atrophy in fronto-insular and thalamus/hypothalamus regions, and lower short-term memory and executive performance than mild-AWS patients. Mediation analyses revealed both direct and indirect (via fronto-insular and thalamus/hypothalamus atrophy) relationships between poor sleep quality and cognitive performance. Alcohol withdrawal syndrome severity, which reflects neurotoxic hyperglutamatergic activity, should be considered as a critical factor for the development of non-rapid eye movement sleep alterations, fronto-insular atrophy and executive impairments in recently detoxified alcohol use disorder patients. The glutamatergic activity is involved in sleep-wake circuits and may thus contribute to molecular mechanisms underlying alcohol-related brain damage, resulting in cognitive deficits. Alcohol withdrawal syndrome severity and sleep quality deserve special attention for a better understanding and treatment of brain and cognitive alterations observed early in abstinence, and ultimately for more efficient relapse prevention strategies.
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Affiliation(s)
- Alice Laniepce
- Normandie Univ, UNICAEN, PSL Université, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, NIMH, 14000 Caen, France
| | - Nicolas Cabé
- Normandie Univ, UNICAEN, PSL Université, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, NIMH, 14000 Caen, France
| | - Claire André
- Normandie Univ, UNICAEN, PSL Université, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, NIMH, 14000 Caen, France
| | - Françoise Bertran
- Normandie Univ, UNICAEN, PSL Université, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, NIMH, 14000 Caen, France
| | - Céline Boudehent
- Normandie Univ, UNICAEN, PSL Université, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, NIMH, 14000 Caen, France
| | - Najlaa Lahbairi
- Normandie Univ, UNICAEN, PSL Université, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, NIMH, 14000 Caen, France
| | - Angéline Maillard
- Normandie Univ, UNICAEN, PSL Université, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, NIMH, 14000 Caen, France
| | - Alison Mary
- Normandie Univ, UNICAEN, PSL Université, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, NIMH, 14000 Caen, France
| | - Shailendra Segobin
- Normandie Univ, UNICAEN, PSL Université, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, NIMH, 14000 Caen, France
| | - François Vabret
- Normandie Univ, UNICAEN, PSL Université, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, NIMH, 14000 Caen, France
| | - Géraldine Rauchs
- Normandie Univ, UNICAEN, PSL Université, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, NIMH, 14000 Caen, France
| | - Anne-Lise Pitel
- Normandie Univ, UNICAEN, PSL Université, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, NIMH, 14000 Caen, France
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29
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Wiratama BS, Chen PL, Ma ST, Chen YH, Saleh W, Lin HA, Pai CW. Evaluating the combined effect of alcohol-involved and un-helmeted riding on motorcyclist fatalities in Taiwan. ACCIDENT; ANALYSIS AND PREVENTION 2020; 143:105594. [PMID: 32474168 DOI: 10.1016/j.aap.2020.105594] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 04/22/2020] [Accepted: 05/13/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Alcohol-involved riders tend to engage in other risk-taking behaviours such as un-helmeted riding which could further increases injury severity. The combined effect of alcohol-involved and un-helmeted riding on fatal injuries is rarely investigated. This study investigated the interaction effect between blood alcohol concentration and helmet use on fatal injuries. METHODS This study used the National Taiwan Traffic Crash Dataset for the period from 2011 to 2015. Data on road crashes involving a motorcycle and an automobile were extracted and analysed. Multiple logistic regression models were used to calculate the adjusted odds ratio (AOR). We calculated an interaction effect for blood alcohol concentration and helmet use based on STROBE guidelines. RESULTS There were a total of 669,292 motorcyclist casualties; among these casualties, 3459 (0.5 %) motorcyclists sustained fatal injuries. Alcohol-involved riders were 9.47 times (AOR = 9.47; 95 % CI = 8.75-10.25) more likely than sober ones to sustain fatal injuries. Alcohol-involved and un-helmeted riders were approximately 18 times (AOR = 18.1; CI: 15.9-20.4) more likely to sustain fatal injuries than sober and helmeted riders. Riders involved in head-on crashes and approach-turn motorcycle crashes had an increased probability of sustaining fatal injuries by 240 % (AOR = 3.4; 95 % CI = 2.91-4.09) and 132 % (AOR = 2.3; 95 % CI = 2.016-2.67), respectively. CONCLUSIONS This study found that alcohol-involved riding acts synergistically with un-helmeted riding to increase motorcyclist injury severity.
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Affiliation(s)
- Bayu Satria Wiratama
- Graduate Institute of Injury Prevention and Control, College of Public Health, Taipei Medical University, Taipei, Taiwan; Department of Epidemiology, Biostatistics and Population Health, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta City, Indonesia.
| | - Ping-Ling Chen
- Graduate Institute of Injury Prevention and Control, College of Public Health, Taipei Medical University, Taipei, Taiwan.
| | - Shiao-Tzu Ma
- Graduate Institute of Injury Prevention and Control, College of Public Health, Taipei Medical University, Taipei, Taiwan.
| | - Yi-Hua Chen
- Graduate Institute of Injury Prevention and Control, College of Public Health, Taipei Medical University, Taipei, Taiwan; Department of Emergency Medicine, New Taipei City Hospital, New Taipei City, Taiwan.
| | - Wafaa Saleh
- Transport Research Institute, Edinburgh Napier University, Scotland, United Kingdom; Department of Engineering, Princess Nora bint Abdul Rahman University Riyadh, Saudi Arabia.
| | - Hui-An Lin
- Graduate Institute of Injury Prevention and Control, College of Public Health, Taipei Medical University, Taipei, Taiwan; Department of Emergency Medicine, Taipei Medical University Hospital, Taipei City, Taiwan.
| | - Chih-Wei Pai
- Graduate Institute of Injury Prevention and Control, College of Public Health, Taipei Medical University, Taipei, Taiwan.
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30
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Cannady R, Nimitvilai-Roberts S, Jennings SD, Woodward JJ, Mulholland PJ. Distinct Region- and Time-Dependent Functional Cortical Adaptations in C57BL/6J Mice after Short and Prolonged Alcohol Drinking. eNeuro 2020; 7:ENEURO.0077-20.2020. [PMID: 32439714 PMCID: PMC7307629 DOI: 10.1523/eneuro.0077-20.2020] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Revised: 05/03/2020] [Accepted: 05/15/2020] [Indexed: 12/27/2022] Open
Abstract
Alcohol (ethanol) use disorder is associated with changes in frontal cortical areas including the anterior cingulate cortex (ACC) and orbitofrontal cortex (OFC) that contribute to cognitive deficits, uncontrolled drinking, and relapse. Acute ethanol exposure reduces intrinsic excitability of lateral OFC (lOFC) neurons, while chronic exposure and long-term drinking influence plasticity of intrinsic excitability and function of glutamatergic synapses. However, the time course that these adaptations occur across a history of ethanol drinking is unknown. The current study examined whether short-term and long-term voluntary ethanol consumption using an intermittent access paradigm would alter the biophysical properties of deep-layer pyramidal neurons in the ACC and lOFC. Neuronal spiking varied in the ACC with an initial increase in evoked firing after 1 d of drinking followed by a decrease in firing in mice that consumed ethanol for one week. No difference in lOFC spike number was observed between water controls and 1-d ethanol drinking mice, but mice that consumed ethanol for one week or more showed a significant increase in evoked firing. Voluntary ethanol drinking for 4 weeks also produced a total loss of ethanol inhibition of lOFC neurons. There was no effect of drinking on excitatory or inhibitory synaptic events in ACC or lOFC neurons across all time points in this model. Overall, these results demonstrate that voluntary drinking alters neuronal excitability in the ACC and lOFC in distinct ways and on a different time scale that may contribute to the impairment of prefrontal cortex-dependent behaviors observed in individuals with alcohol use disorder (AUD).
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Affiliation(s)
| | | | - Sarah D Jennings
- Department of Neuroscience, Charleston Alcohol Research Center, Medical University of South Carolina, Charleston, SC 29425
| | - John J Woodward
- Department of Neuroscience, Charleston Alcohol Research Center, Medical University of South Carolina, Charleston, SC 29425
| | - Patrick J Mulholland
- Department of Neuroscience, Charleston Alcohol Research Center, Medical University of South Carolina, Charleston, SC 29425
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Abstract
AbstractAlcohol-dependent individuals usually favor instant gratification of alcohol use and ignore its long-term negative consequences, reflecting impaired decision-making. According to the somatic marker hypothesis, decision-making abilities are subtended by an extended brain network. As chronic alcohol consumption is known to be associated with brain shrinkage in this network, the present study investigated relationships between brain shrinkage and decision-making impairments in alcohol-dependent individuals early in abstinence using voxel-based morphometry. Thirty patients performed the Iowa Gambling Task and underwent a magnetic resonance imaging investigation (1.5T). Decision-making performances and brain data were compared with those of age-matched healthy controls. In the alcoholic group, a multiple regression analysis was conducted with two predictors (gray matter [GM] volume and decision-making measure) and two covariates (number of withdrawals and duration of alcoholism). Compared with controls, alcoholics had impaired decision-making and widespread reduced gray matter volume, especially in regions involved in decision-making. The regression analysis revealed links between high GM volume in the ventromedial prefrontal cortex, dorsal anterior cingulate cortex and right hippocampal formation, and high decision-making scores (P < 0.001, uncorrected). Decision-making deficits in alcoholism may result from impairment of both emotional and cognitive networks.
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Zahr NM, Lenart AM, Karpf JA, Casey KM, Pohl KM, Sullivan EV, Pfefferbaum A. Multi-modal imaging reveals differential brain volumetric, biochemical, and white matter fiber responsivity to repeated intermittent ethanol vapor exposure in male and female rats. Neuropharmacology 2020; 170:108066. [PMID: 32240669 DOI: 10.1016/j.neuropharm.2020.108066] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Revised: 03/09/2020] [Accepted: 03/20/2020] [Indexed: 12/11/2022]
Abstract
A generally accepted framework derived predominately from animal models asserts that repeated cycles of chronic intermittent ethanol (EtOH; CIE) exposure cause progressive brain adaptations associated with anxiety and stress that promote voluntary drinking, alcohol dependence, and further brain changes that contribute to the pathogenesis of alcoholism. The current study used CIE exposure via vapor chambers to test the hypothesis that repeated episodes of withdrawals from chronic EtOH would be associated with accrual of brain damage as quantified using in vivo magnetic resonance imaging (MRI), diffusion tensor imaging (DTI), and MR spectroscopy (MRS). The initial study group included 16 male (~325g) and 16 female (~215g) wild-type Wistar rats exposed to 3 cycles of 1-month in vapor chambers + 1 week of abstinence. Half of each group (n = 8) was given vaporized EtOH to blood alcohol levels approaching 250 mg/dL. Blood and behavior markers were also quantified. There was no evidence for dependence (i.e., increased voluntary EtOH consumption), increased anxiety, or an accumulation of pathology. Neuroimaging brain responses to exposure included increased cerebrospinal fluid (CSF) and decreased gray matter volumes, increased Choline/Creatine, and reduced fimbria-fornix fractional anisotropy (FA) with recovery seen after one or more cycles and effects in female more prominent than in male rats. These results show transient brain integrity changes in response to CIE sufficient to induce acute withdrawal but without evidence for cumulative or escalating damage. Together, the current study suggests that nutrition, age, and sex should be considered when modeling human alcoholism.
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Affiliation(s)
- Natalie M Zahr
- Neuroscience Program, SRI International, Menlo Park, CA, 94025, USA; Department of Psychiatry & Behavioral Sciences, Stanford University, School of Medicine, Stanford, CA, 94305, USA.
| | - Aran M Lenart
- Neuroscience Program, SRI International, Menlo Park, CA, 94025, USA
| | - Joshua A Karpf
- Neuroscience Program, SRI International, Menlo Park, CA, 94025, USA
| | - Keriann M Casey
- Department of Comparative Medicine, Stanford University, School of Medicine, Stanford, CA. 94305, USA
| | - Kilian M Pohl
- Neuroscience Program, SRI International, Menlo Park, CA, 94025, USA; Department of Psychiatry & Behavioral Sciences, Stanford University, School of Medicine, Stanford, CA, 94305, USA
| | - Edith V Sullivan
- Department of Psychiatry & Behavioral Sciences, Stanford University, School of Medicine, Stanford, CA, 94305, USA
| | - Adolf Pfefferbaum
- Neuroscience Program, SRI International, Menlo Park, CA, 94025, USA; Department of Psychiatry & Behavioral Sciences, Stanford University, School of Medicine, Stanford, CA, 94305, USA
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Dixit V, Kumar S, Chaudhury S. Neuropsychological dysfunctions among chronic schizophrenia patients, alcohol dependence cases, and normal subjects: A comparative study. Ind Psychiatry J 2020; 29:105-122. [PMID: 33776284 PMCID: PMC7989451 DOI: 10.4103/ipj.ipj_70_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 05/27/2020] [Indexed: 11/04/2022] Open
Abstract
AIM The aim of this study is to assess the neuropsychological profiles of chronic schizophrenia and alcohol-dependent subjects. MATERIALS AND METHODS This hospital-based cross-sectional study included 30 chronic schizophrenia patients, 30 alcohol-dependent patients and 30-matched normal controls. Demographic and clinical data were collected on a self-designed pro forma. Positive and Negative Syndrome Scale (PANSS) and Severity of Alcohol Dependence Questionnaire (SADQ-C) were administered to chronic schizophrenia and alcohol-dependent patients, respectively. The AIIMS Comprehensive Neuropsychological Battery in Hindi (Adult Form) was used to assess neuropsychological dysfunctions. RESULTS Neuropsychological dysfunctions were found in 83.3% of chronic schizophrenia patients, 36.7% alcohol dependents and none of the normal subjects. In comparison to normal subjects, schizophrenia patients had significantly more dysfunctions in neuropsychological-domains such as motor, tactile, visual, receptive and expressive speech, reading, writing, arithmetic, memory, and intellectual processes. A significant positive correlation was found between the PANSS total score and T scores of most of the clinical scales except motor and visual scales; the PANSS general psychopathology score and T scores of most of the clinical scales except motor visual and pathognomonic scales; the PANSS negative score and T scores of most of the clinical scales except visual scale; and the PANSS positive score and T scores of receptive speech, arithmetic, and memory scales. In comparison to normal subjects, the alcohol dependents had significantly more dysfunctions in neuropsychological-domains such as motor, tactile, visual, receptive and expressive speech, reading, writing, arithmetic, and memory. A significant positive correlation was found between the SADQ total scale and T scores of clinical scales such as expressive speech, writing, arithmetic, intellectual processes, left hemisphere, and total battery scales. CONCLUSIONS Neuropsychological dysfunction was significantly more common and severe in chronic schizophrenia patients than in alcohol-dependent patients. In comparison to alcohol dependents, the chronic schizophrenia patients had more dysfunctions in neuropsychological-domains such as tactile, arithmetic, memory, and intellectual processes.
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Affiliation(s)
- Vidhata Dixit
- Department of Clinical Psychology, RINPAS, Ranchi, Jharkhand, India
| | - Santosh Kumar
- Department of Psychiatry, Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India
| | - Suprakash Chaudhury
- Department of Psychiatry, Dr. D. Y. Patil Medical College, Dr. D. Y. Patil Vidyapeeth, Pune, Maharashtra, India
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Miranda AR, Franchetto Sierra J, Martínez Roulet A, Rivadero L, Serra SV, Soria EA. Age, education and gender effects on Wisconsin card sorting test: standardization, reliability and validity in healthy Argentinian adults. AGING NEUROPSYCHOLOGY AND COGNITION 2019; 27:807-825. [PMID: 31744387 DOI: 10.1080/13825585.2019.1693491] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
The Wisconsin Card Sorting Test (WCST) is a widely used neuropsychological assessment of executive functioning. The aim of this study was to provide norm values and analyze the psychometric properties of WCST in healthy Argentinian adults aged from 18 to 89 years old (N = 235). Descriptive statistics are reported as means, standard deviations and percentiles, with the effects of age, education and gender being investigated by ANOVA, and with the effect sizes being calculated. The psychometrics were studied using the WCST structure, reliability, convergent validity, and discriminant validity, and WCST norms adjusted for age and educational level are proposed. This instrument is a reliable and valid tool for the assessment of executive functions. However, as the age- and educational-related effects were demonstrated, these characteristics need to be considered before interpreting WCST scores. Regarding gender, no differences were found. Our results expand the geographical and sociocultural applicability of WCST.
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Affiliation(s)
- Agustín R Miranda
- Facultad de Ciencias Médicas, Escuela de Fonoaudiología. Córdoba, Universidad Nacional de Córdoba , Cordoba, Argentina.,Consejo Nacional de Investigaciones Científicas y Técnicas, CONICET, INICSA , Córdoba, Argentina
| | - Juliana Franchetto Sierra
- Facultad de Ciencias Médicas, Escuela de Fonoaudiología. Córdoba, Universidad Nacional de Córdoba , Cordoba, Argentina
| | - Amparo Martínez Roulet
- Facultad de Ciencias Médicas, Escuela de Fonoaudiología. Córdoba, Universidad Nacional de Córdoba , Cordoba, Argentina
| | - Luisina Rivadero
- Facultad de Ciencias Médicas, Escuela de Fonoaudiología. Córdoba, Universidad Nacional de Córdoba , Cordoba, Argentina
| | - Silvana V Serra
- Facultad de Ciencias Médicas, Escuela de Fonoaudiología. Córdoba, Universidad Nacional de Córdoba , Cordoba, Argentina
| | - Elio A Soria
- Consejo Nacional de Investigaciones Científicas y Técnicas, CONICET, INICSA , Córdoba, Argentina.,Universidad Nacional de Córdoba, Facultad de Ciencias Médicas, Cátedra de Biología Celular, Histología y Embriología, Instituto de Biología Celular , Cordoba, Argentina
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Sampedro-Piquero P, Ladrón de Guevara-Miranda D, Pavón FJ, Serrano A, Suárez J, Rodríguez de Fonseca F, Santín LJ, Castilla-Ortega E. Neuroplastic and cognitive impairment in substance use disorders: a therapeutic potential of cognitive stimulation. Neurosci Biobehav Rev 2019; 106:23-48. [DOI: 10.1016/j.neubiorev.2018.11.015] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Revised: 10/15/2018] [Accepted: 11/23/2018] [Indexed: 01/08/2023]
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Effects of Ethanol Exposure and Withdrawal on Neuronal Morphology in the Agranular Insular and Prelimbic Cortices: Relationship with Withdrawal-Related Structural Plasticity in the Nucleus Accumbens. Brain Sci 2019; 9:brainsci9080180. [PMID: 31357611 PMCID: PMC6721441 DOI: 10.3390/brainsci9080180] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Revised: 07/22/2019] [Accepted: 07/22/2019] [Indexed: 12/21/2022] Open
Abstract
The present study investigated the effects of chronic intermittent ethanol exposure and withdrawal on dendritic morphology and spine density in the agranular insular and prelimbic cortices. Adult male Sprague–Dawley rats were passively exposed to vaporized ethanol (~37 mg/L; 12 h/day) or air (control) for ten consecutive days. Dendritic length, branching, and spine density were quantified in layer II/III pyramidal neurons 24 hours or seven days following the final ethanol exposure. Compared to unexposed control animals there were structural alterations on neurons in the prelimbic cortex, and to a lesser extent the agranular insular cortex. The most prominent ethanol-related differences were the transient increases in dendritic length and branching in prelimbic neurons at 24 h post-cessation, and increased mushroom-shaped spines at seven days post-cessation. The results obtained in the prelimbic cortex are the opposite of those previously reported in the nucleus accumbens core (Peterson, et al. 2015), suggesting that these regions undergo distinct functional adaptations following ethanol exposure and withdrawal.
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Kumar R, Kumar KJ, Benegal V, Roopesh BN, Ravi GS. Effectiveness of an Integrated Intervention Program for Alcoholism (IIPA) for enhancing self-regulation: Preliminary evidence. Asian J Psychiatr 2019; 43:37-44. [PMID: 31078094 DOI: 10.1016/j.ajp.2019.05.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2018] [Revised: 04/07/2019] [Accepted: 05/02/2019] [Indexed: 12/25/2022]
Abstract
OBJECTIVE Alcoholism could be a core problem of self-regulatory failure. Several neurocognitive theories have hypothesized hypo-functioning or dysfunction of reflective (executive) system and heightened functioning of reactive (impulsive) system in self-regulatory failure implicated in drug addiction. Similarly, stress and affect dysregulation may breakdown self-regulation. The present study aimed to develop an Integrated Intervention Program for Alcoholism (IIPA) to enhance self-regulation and to test its effectiveness in the treatment of alcoholism. METHOD Individuals with early onset alcoholism (n = 50) were recruited after getting written informed consent. The study used randomized case control design. The participants were matched on age (+/-1 year) and education (+/-1 year). The TAU group received usual treatment for alcoholism which included pharmacotherapy, 6 sessions/week yoga and 3 sessions/week group therapy on relapse prevention. The intervention group received IIPA for 18 days along with usual treatment (except yoga sessions). The IIPA included several cognitive remediation tasks and mind-body exercise (Qigong and Tai Chi Chuan). Both groups were assessed on executive function tests and affect regulation scale at pre and post-intervention. The subjects were also followed up for 6 months to compare the abstinence between groups. RESULTS Both groups were comparable at baseline. At post-intervention, the IIPA group showed a significant improvement compared to the TAU group on executive functioning and affect regulation. Follow-up results showed lower relapses in six months in the IIPA group. CONCLUSION Preliminary evidence showed that IIPA is effective in facilitating self-regulation. Further study may examine its utility and feasibility in other clinical conditions.
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Affiliation(s)
- Rajesh Kumar
- Department of Clinical Psychology, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru 560029, India.
| | - Keshav J Kumar
- Department of Clinical Psychology, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru 560029, India.
| | - Vivek Benegal
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru 560029, India.
| | - Bangalore N Roopesh
- Department of Clinical Psychology, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru 560029, India.
| | - Girikematha S Ravi
- Department of Biostatistics, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru 560029, India.
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Ueno F, Suzuki T, Nakajima S, Matsushita S, Mimura M, Miyazaki T, Takahashi T, Uchida H. Alteration in AMPA receptor subunit expression and receptor binding among patients with addictive disorders: A systematic review of human postmortem studies. Neuropsychopharmacol Rep 2019; 39:148-155. [PMID: 31070872 PMCID: PMC7292281 DOI: 10.1002/npr2.12058] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Revised: 03/12/2019] [Accepted: 04/02/2019] [Indexed: 02/06/2023] Open
Abstract
Background and Objectives Altered trafficking of α‐amino‐3‐hydroxy‐5‐methyl‐4‐isoxazolepropionic acid (AMPA) receptors has been reported in postmortem studies and suggested the involvement of AMPA receptors in the pathophysiology underpinning addictive disorders. However, these findings seemed mixed. Methods A systematic literature search was conducted, using PubMed and Embase (last search, August 2018), to identify human postmortem studies that examined the expression of proteins and mRNA of AMPA receptor subunits in patients with addictive disorders in comparison with healthy controls. Results Twelve (18 studies) out of 954 articles were identified to be relevant. Eight studies included alcohol use disorders, and four studies included heroin/cocaine abusers. The most frequently investigated regions were the hippocampus (three studies), amygdala (three studies), and putamen (three studies). In summary, two out of the three studies showed an increase in the expression of AMPA receptors in the hippocampus, while the other study found no change. Two studies to examine the amygdala demonstrated either a decreased or no change in receptor expression or binding. Concerning putamen, two studies showed no significant change whereas an overexpression of receptors was observed in the other. Conclusions and Scientific Significance The hippocampus and amygdala may be pertinent to addictive disorders through their functions on learning and memory, whereas findings in other regions were inconsistent across the studies. Human postmortem studies are prone to degenerative changes after death. Moreover, only qualitative assessment was conducted because of the limited, heterogenous data. These limitations emphasize the need to investigate AMPA receptors in the living human brains. Postmortem studies on AMPA receptors in patients with addiction show that the hippocampus and amygdala may be pertinent to addictive disorders through their functions on learning and memory, whereas findings in other regions were inconsistent across the studies. Human postmortem studies are prone to degenerative changes after death, which emphasizes the need to investigate AMPA receptors in the living human brains.![]()
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Affiliation(s)
- Fumihiko Ueno
- National Hospital Organization Kurihama Medical and Addiction Center, Yokosuka, Japan.,Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Takefumi Suzuki
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan.,Department of Neuropsychiatry and Clinical Ethics, University of Yamanashi, Kofu, Japan
| | - Shinichiro Nakajima
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Sachio Matsushita
- National Hospital Organization Kurihama Medical and Addiction Center, Yokosuka, Japan
| | - Masaru Mimura
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Tomoyuki Miyazaki
- Department of Physiology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Takuya Takahashi
- Department of Physiology, Yokohama City University Graduate School of Medicine, Yokohama, Japan.,Dominick P. Purpura Department of Neuroscience, Albert Einstein College of Medicine, New York, New York
| | - Hiroyuki Uchida
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan.,Geriatric Mental Health Program, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
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Hust SJT, Rodgers KB, Cameron N, Li J. Viewers' Perceptions of Objectified Images of Women in Alcohol Advertisements and Their Intentions to Intervene in Alcohol-Facilitated Sexual Assault Situations. JOURNAL OF HEALTH COMMUNICATION 2019; 24:328-338. [PMID: 31038010 DOI: 10.1080/10810730.2019.1604911] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Alcohol-facilitated sexual assault is a serious problem on college campuses, and bystander intervention has been shown to be a successful method in reducing sexual assaults. Although there are a number of factors associated with individuals' intentions to intervene in sexual assault situations, the media's cultural scripts that link alcohol consumption to sexual success may play a role. Alcohol advertisements, in particular, routinely portray women as sexual objects and often link alcohol consumption to sexual success; therefore, exposure to such content may be negatively associated with people's intentions to intervene in alcohol-facilitated sexual assault situations. Thus, the current study investigated if exposure to and perceptions of objectified images of women in alcoholic beverage advertisements were associated with college students' intentions to intervene in alcohol-facilitated sexual assault situations. Undergraduate college students (N = 1208) were randomly assigned to view three alcohol advertisements that either included highly-objectified or low-objectified women, and then they reported their perceptions of the women in each of the alcohol advertisements and their intentions to intervene in sexual assault situations. Hierarchical regression analyses indicated that individuals' perceptions of alcohol advertisements moderate the relationship between exposure to objectifying alcohol advertisements and intentions to intervene in sexual assault situations.
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Affiliation(s)
- Stacey J T Hust
- a The Edward R. Murrow College of Communication , Washington State University , Pullman , WA , USA
| | | | | | - Jiayu Li
- a The Edward R. Murrow College of Communication , Washington State University , Pullman , WA , USA
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Kouimtsidis C, Houghton B, Gage H, Notley C, Maskrey V, Clark A, Holland R, Lingford-Hughes A, Punukollu B, Duka T. A feasibility study of an intervention for structured preparation before detoxification in alcohol dependence: the SPADe trial protocol. Pilot Feasibility Stud 2019; 5:59. [PMID: 31057808 PMCID: PMC6486697 DOI: 10.1186/s40814-019-0446-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Accepted: 04/09/2019] [Indexed: 12/01/2022] Open
Abstract
Background Alcohol-related harm is currently estimated to cost the National Health Service (NHS) in England £3.5 bn a year. Of the estimated 1.6 million people with some degree of alcohol dependence, some 600,000 are believed to be moderately or severely dependent and may benefit from intensive treatment. Outcomes from medically assisted withdrawal, also referred to as detoxification, are often poor, with poor engagement in relapse prevention interventions and subsequent high relapse rates. Detoxification is costly both financially and to the individual. It has been found that people who experience multiple detoxifications show more emotional and cognitive impairments. These changes may confer upon them the inability to resolve conflict and increased sensitivity to stress thus contributing to increased vulnerability risk of relapse. The study aims to test the feasibility of using a group intervention aiming to prepare participants for long-term abstinence before, rather than after, they have medically assisted detoxification. The current study will establish key parameters that influence trial design such as recruitment, compliance with the intervention, retention, and sensitivity of alternative outcome measures, in preparation for a future randomised controlled trial (RCT). This paper presents the protocol of the feasibility study. Methods The study corresponds to phase 2 of the Medical Research Council (MRC) complex interventions guidelines which cover the development and feasibility testing of an intervention. The work is in three stages. The development, adaptation and implementation of the Structured Preparation before Alcohol Detoxification (SPADe) intervention (stage 1), a randomised feasibility study with economic evaluation (stage 2) and a qualitative study (stage 3). Fifty participants will be recruited from two community alcohol treatment services in England. Participants will be randomised in two arms: the treatment as usual arm (TAU), which includes planned medically assisted detoxification and aftercare and the intervention arm in which participants will receive structured group preparation before detoxification in addition to TAU. The main outcomes are duration of continuous abstinence with no incidents of lapse or relapse, percentage of days abstinent and time to relapse. Discussion The socioeconomic harms associated with alcohol have been well-documented, yet existing treatment options have not been able to reduce high relapse rates. This study will build on existing naturalistic studies underpinned by psychological interventions offered early and before detoxification from alcohol, which aim to reverse automatised habitual behaviours and thus may help us to understand how better to support people to remain abstinent and improve post detoxification outcomes. Trial registration ISRCTN, 14621127; Registered on 22 Feb 2017
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Affiliation(s)
- Christos Kouimtsidis
- 1Research and Development, Abraham Cowley Unit, Surrey and Borders NHS Foundation Trust, Surrey, Chertsey, KT16 0AE UK
| | - Ben Houghton
- 1Research and Development, Abraham Cowley Unit, Surrey and Borders NHS Foundation Trust, Surrey, Chertsey, KT16 0AE UK
| | - Heather Gage
- 2University of Surrey, 388 Stag Hill, Guildford, GU2 7XH UK
| | - Caitlin Notley
- 3Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich, NR4 7TJ UK
| | - Vivienne Maskrey
- 4University of East Anglia, Norwich Research Park, Norwich, NR4 7TJ UK
| | - Allan Clark
- 4University of East Anglia, Norwich Research Park, Norwich, NR4 7TJ UK
| | - Richard Holland
- 5University of Leicester, University Road, Leicester, LE1 7RH UK
| | - Anne Lingford-Hughes
- 6Imperial College London, Burlington Danes Building, Hammersmith Campus, 160, Du Cane Road, London, W12 0NN UK
| | - Bhaskar Punukollu
- 7Camden and Islington NHS Foundation Trust, St Pancras Hospital, 4 St Pancras Way, Kings Cross, London, NW1 0PE UK
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Lagström O, Danielsson K, Söderpalm B, Ericson M, Adermark L. Voluntary Ethanol Intake Produces Subregion-Specific Neuroadaptations in Striatal and Cortical Areas of Wistar Rats. Alcohol Clin Exp Res 2019; 43:803-811. [PMID: 30860600 DOI: 10.1111/acer.14014] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Accepted: 02/27/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND Addiction has been conceptualized as a shift from controlled recreational use toward compulsive and habitual drug-taking behavior. Although the brain reward system is vital for alcohol reward and reinforcement, other neuronal circuits may be involved in controlling long-term alcohol-seeking and drug-taking behaviors. The aim of this study was to outline alcohol-induced neuroplasticity in defined cortical and striatal subregions, previously implicated in alcohol use disorder. METHODS Male Wistar rats were allowed to voluntarily consume ethanol (EtOH) in an intermittent manner for 2 months, after which ex vivo electrophysiological recordings were performed and data compared with isolated water controls housed in parallel. RESULTS Field potential recordings revealed an increase in field excitatory postsynaptic potentials (fEPSPs) in the dorsomedial striatum (DMS) of rats consuming EtOH, while a depression of evoked potentials was detected in the dorsolateral striatum (DLS). Mean activity in cortical (medial prefrontal cortex, lateral orbitofrontal cortex [OFC]), and accumbal regions (nucleus accumbens [nAc] core/shell) was not significantly altered as compared to water-drinking controls, but a correlation between the amount of alcohol consumed and evoked potentials could be found in both dorsal striatal subregions, OFC, and nAc core. Removal of EtOH for 1 to 2 days was sufficient to restore neurotransmission in the DLS, while the increase in fEPSP amplitude sustained in the DMS. CONCLUSIONS These preclinical findings are in line with clinical observations indicating that alcohol produces neurophysiological transformations in dorsal striatal circuits, which in turn may lead to disruptions in decision-making processes that could further promote alcohol misuse.
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Affiliation(s)
- Oona Lagström
- Addiction Biology Unit, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Klara Danielsson
- Addiction Biology Unit, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Bo Söderpalm
- Addiction Biology Unit, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Mia Ericson
- Addiction Biology Unit, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Louise Adermark
- Addiction Biology Unit, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
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Airagnes G, Ducoutumany G, Laffy-Beaufils B, Le Faou AL, Limosin F. Alcohol withdrawal syndrome management: Is there anything new? Rev Med Interne 2019; 40:373-379. [PMID: 30853380 DOI: 10.1016/j.revmed.2019.02.001] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Revised: 01/20/2019] [Accepted: 02/06/2019] [Indexed: 01/19/2023]
Abstract
Patients with alcohol use disorder experience frequently alcohol withdrawal syndrome (AWS), which is a potentially life-threatening condition mainly caused by glutamate overactivity. The aim of therapeutic alcohol withdrawal is the entry into a process of complete and lasting abstinence. Therefore preparing withdrawal is crucial to optimize compliance and efficacy of aftercare. Indeed, performing repeated withdrawal per se without any project of subsequent abstinence may be deleterious, at least because of repeated exposure to glutamate neurotoxicity. Managing AWS mainly consists in anticipating severe withdrawal, decreasing the risk of complications, making this experience as comfortable as possible, preventing from long-term benzodiazepine use, and enhancing motivation to aftercare and long-term abstinence. In particular, there are specific guidelines to choose which benzodiazepine administration approach to adopt (i.e. symptom-triggered, fixed schedule or loading dosage) and which other drugs to deliver (e.g. thiamine, folate, magnesium). Specific precautions should be taken in the elderly.
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Affiliation(s)
- G Airagnes
- Hôpitaux universitaires Paris Ouest, Department of Psychiatry and Addictology, AP-HP, 75015 Paris, France; Faculté de médecine, Université Paris Descartes, Sorbonne Paris Cité, 75006 Paris, France; UMS 011, Population-based Epidemiological Cohorts, Inserm, 94800 Villejuif, France.
| | - G Ducoutumany
- Hôpitaux universitaires Paris Ouest, Department of Psychiatry and Addictology, AP-HP, 75015 Paris, France; Faculté de médecine, Université Paris Descartes, Sorbonne Paris Cité, 75006 Paris, France
| | - B Laffy-Beaufils
- Hôpitaux universitaires Paris Ouest, Department of Psychiatry and Addictology, AP-HP, 75015 Paris, France; Faculté de médecine, Université Paris Descartes, Sorbonne Paris Cité, 75006 Paris, France
| | - A-L Le Faou
- Hôpitaux universitaires Paris Ouest, Department of Psychiatry and Addictology, AP-HP, 75015 Paris, France; Faculté de médecine, Université Paris Descartes, Sorbonne Paris Cité, 75006 Paris, France; UMR-S 1123, Épidémiologie Clinique et Évaluation Économique Appliquées aux Populations Vulnérables (ECEVE), Inserm, 75010 Paris, France
| | - F Limosin
- Hôpitaux universitaires Paris Ouest, Department of Psychiatry and Addictology, AP-HP, 75015 Paris, France; Faculté de médecine, Université Paris Descartes, Sorbonne Paris Cité, 75006 Paris, France; U 894, Centre Psychiatrie et Neurosciences, Inserm, 75014 Paris, France
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Crowe SF, Cammisuli DM, Stranks EK. Widespread Cognitive Deficits in Alcoholism Persistent Following Prolonged Abstinence: An Updated Meta-analysis of Studies That Used Standardised Neuropsychological Assessment Tools. Arch Clin Neuropsychol 2019; 35:31-45. [DOI: 10.1093/arclin/acy106] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Revised: 12/11/2018] [Accepted: 12/19/2018] [Indexed: 11/14/2022] Open
Abstract
Abstract
Objective
This study presents an updated meta-analysis replicating the study of (Stavro, K., Pelletier, J., & Potvin, S. (2013). Widespread and sustained cognitive deficits in alcoholism: A meta-analysis. Addiction Biology, 18, 203–213. doi:10.1111/j.1369-1600.2011.00418.x) regarding the cognitive functioning of alcoholics as a function of time abstinent.
Methods
A total of 34 studies (including a total of 2,786 participants) that met pre-determined inclusion and exclusion criteria were included in the analyses. The alcoholics were categorised into recently detoxified alcoholics (0–31 days sober), alcoholics 32–365 days sober and alcoholics >365 days sober consistent with the previous study. The current study employed more stringent control on the tests included in the analysis to include only those tasks described in contemporary neuropsychological test compendia. Forty-seven percent of the papers surveyed were not include in the previous meta-analysis.
Results
The results indicated that there was a diffuse and pervasive pattern of cognitive deficit among recently detoxified alcoholics and that these deficits, particularly with regard to memory functioning, persisted even in longer term abstinent alcoholics. This was inconsistent with the prior meta-analysis which contended that significant cognitive recovery was possible after as little as 1 year.
Conclusion
The persisting cognitive deficits were noted across a wide range of cognitive functions, supporting the notion of a diffuse rather than a specific compromise of cognition in alcoholism following discontinuation, as measured using standardised neuropsychological tests. Limitations on the finding included the fact that it was a cross-sectional rather than a longitudinal analysis, was subject to heterogeneity of method, had low representation of females in the samples, and had fewer studies of long-term sober samples.
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Affiliation(s)
- Simon F Crowe
- School of Psychology and Public Health, La Trobe University, Victoria, Australia
| | - Davide M Cammisuli
- Department of Surgical, Medical, Molecular, and Critical Area Pathology, Pisa University Medical School, Pisa, Italy
| | - Elizabeth K Stranks
- School of Psychology and Public Health, La Trobe University, Victoria, Australia
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Kouimtsidis C, Duka T, Palmer E, Lingford-Hughes A. Prehabilitation in Alcohol Dependence as a Treatment Model for Sustainable Outcomes. A Narrative Review of Literature on the Risks Associated With Detoxification, From Animal Models to Human Translational Research. Front Psychiatry 2019; 10:339. [PMID: 31156483 PMCID: PMC6531862 DOI: 10.3389/fpsyt.2019.00339] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Accepted: 04/30/2019] [Indexed: 11/13/2022] Open
Abstract
In this review paper, we discuss how the overarching concept of prehabilitation is applicable to alcohol dependence. Central to prehabilitation are the concepts of expected harm, risks, and proactive planning to eliminate the harm or cope with the risks. We review the evidence from animal models, psychological experimental studies, as well as pharmacological studies, on the potential risks and harms associated with medically assisted alcohol detoxification and the current treatment paradigm for alcohol dependence. Animal models provide an approximation mostly of the physical aspect of alcohol withdrawal and detoxification process and make predictions about the development of the phenomena in humans. Despite their limitations, these models provide good evidence that withdrawal from chronic ethanol use induces cognitive impairment, which is worsened by repeated bouts of withdrawal and that these impairments are dependent on the duration of alcohol withdrawal. Initial clinical observations with alcohol-dependent patients confirmed increased incidence of seizures. In recent years, accumulating evidence suggests that patients who have had repeated episodes of withdrawal also show changes in their affect, increased craving, as well as significant deterioration of cognitive abilities, when compared to patients with fewer withdrawals. Alcohol dependence is associated with tolerance and withdrawal, with neuroadaptations in γ-Aminobutyric Acid-A Receptor (GABA-A) and glutamatergic N-methyl-D-aspartate (NMDA) receptors playing key roles. It is suggested that dysregulation of the NMDA receptor system underpins alcohol-related memory impairments. Finally, we discuss the Structured Preparation for Alcohol Detoxification (SPADe) as an example of how prehabilitation has been applied in clinical practice. We discuss the importance of partial control over drinking as an interim step toward abstinence and early introduction of lifestyle changes for both the patient and the immediate environment prior to detoxification and while the patient is still drinking.
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Affiliation(s)
| | - Theodora Duka
- Sussex Addiction Research and Intervention Centre (SARIC), School of Psychology, University of Sussex, Brighton, United Kingdom
| | - Emily Palmer
- Centre for Psychiatry, Imperial College London, London, United Kingdom
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Crouse JJ, Moustafa AA, Bogaty SER, Hickie IB, Hermens DF. Parcellating cognitive heterogeneity in early psychosis-spectrum illnesses: A cluster analysis. Schizophr Res 2018; 202:91-98. [PMID: 30042029 DOI: 10.1016/j.schres.2018.06.060] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2017] [Revised: 04/04/2018] [Accepted: 06/24/2018] [Indexed: 01/27/2023]
Abstract
Cognitive impairment is argued to represent a core feature of psychosis-spectrum illnesses. However, within-diagnosis heterogeneity is common, and risk factors for poor cognition remain to be examined after statistically accounting for heterogeneity. Accordingly, we used a data-driven technique (cluster analysis) to empirically-derive cognitive clusters across diagnoses and examined whether concurrent substance use or a history of a neurodevelopmental/behavioral disorder differed between clusters. Data from 135 young help-seekers (aged 12-30 years) with a psychosis-spectrum illness were retrospectively analyzed. Ward's hierarchical cluster analysis classified three cognitive clusters characterized by: (1) normal-range; (2) mixed; and (3) grossly-impaired performance. Despite mostly comparable clinical and demographic measures, cluster 1 had superior socio-occupational functioning and the highest estimated premorbid IQ, followed sequentially by clusters 2 and 3. Proportions of cannabis and amphetamine users did not differ significantly across clusters, nor did rates of patients with a neurodevelopmental/behavioral disorder history. Cluster 3 was however comprised of fewer 'risky' drinkers, possibly reflecting reduced opportunity for social drinking associated with cognitive impairment. Estimated premorbid IQ predicted cluster membership (2 vs. 1 & 3 vs. 1), as did clinician-rated socio-occupational functioning and 'not being enrolled in school or tertiary education' (3 vs. 1). Our results suggest that concurrent substance use and history of a neurodevelopmental/behavioral disorder do not adequately explain cluster-level cognitive variance in this sample. Future work should integrate neurobiological measures associated with cognition (e.g. white matter integrity) to discern whether clusters reflect neurobiological subtypes better representative of pathophysiology than present symptom-based classifications.
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Affiliation(s)
- Jacob J Crouse
- Youth Mental Health Team, Brain & Mind Centre, The University of Sydney, NSW, Australia.
| | - Ahmed A Moustafa
- MARCS Institute for Brain, Behaviour & Development, NSW, Australia; School of Social Sciences & Psychology, Western Sydney University, NSW, Australia; Department of Social Sciences, College of Arts and Sciences, Qatar University, Doha, Qatar
| | - Sophia E R Bogaty
- Youth Mental Health Team, Brain & Mind Centre, The University of Sydney, NSW, Australia
| | - Ian B Hickie
- Youth Mental Health Team, Brain & Mind Centre, The University of Sydney, NSW, Australia
| | - Daniel F Hermens
- Youth Mental Health Team, Brain & Mind Centre, The University of Sydney, NSW, Australia; Sunshine Coast Mind & Neuroscience - Thompson Institute, University of the Sunshine Coast, QLD, Australia
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Bazov I, Sarkisyan D, Kononenko O, Watanabe H, Karpyak VM, Yakovleva T, Bakalkin G. Downregulation of the neuronal opioid gene expression concomitantly with neuronal decline in dorsolateral prefrontal cortex of human alcoholics. Transl Psychiatry 2018; 8:122. [PMID: 29925858 PMCID: PMC6010434 DOI: 10.1038/s41398-017-0075-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Revised: 10/02/2017] [Accepted: 11/01/2017] [Indexed: 01/03/2023] Open
Abstract
Molecular changes in cortical areas of addicted brain may underlie cognitive impairment and loss of control over intake of addictive substances and alcohol. Prodynorphin (PDYN) gives rise to dynorphin (DYNs) opioid peptides which target kappa-opioid receptor (KOR). DYNs mediate alcohol-induced impairment of learning and memory, while KOR antagonists block excessive, compulsive-like drug and alcohol self-administration in animal models. In human brain, the DYN/KOR system may undergo adaptive changes, which along with neuronal loss, may contribute to alcohol-associated cognitive deficit. We addressed this hypothesis by comparing the expression levels and co-expression (transcriptionally coordinated) patterns of PDYN and KOR (OPRK1) genes in dorsolateral prefrontal cortex (dlPFC) between human alcoholics and controls. Postmortem brain specimens of 53 alcoholics and 55 controls were analyzed. PDYN was found to be downregulated in dlPFC of alcoholics, while OPRK1 transcription was not altered. PDYN downregulation was confined to subgroup of subjects carrying C, a high-risk allele of PDYN promoter SNP rs1997794 associated with alcoholism. Changes in PDYN expression did not depend on the decline in neuronal proportion in alcoholics, and thereby may be attributed to transcriptional adaptations in alcoholic brain. Absolute expression levels of PDYN were lower compared to those of OPRK1, suggesting that PDYN expression is a limiting factor in the DYN/KOR signaling, and that the PDYN downregulation diminishes efficacy of DYN/KOR signaling in dlPFC of human alcoholics. The overall outcome of the DYN/KOR downregulation may be disinhibition of neurotransmission, which when overactivated could contribute to formation of alcohol-related behavior.
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Affiliation(s)
- Igor Bazov
- Division of Biological Research on Drug Dependence, Department of Pharmaceutical Biosciences, Uppsala University, SE-751 24, Uppsala, Sweden.
| | - Daniil Sarkisyan
- 0000 0004 1936 9457grid.8993.bDivision of Biological Research on Drug Dependence, Department of Pharmaceutical Biosciences, Uppsala University, SE-751 24 Uppsala, Sweden
| | - Olga Kononenko
- 0000 0004 1936 9457grid.8993.bDivision of Biological Research on Drug Dependence, Department of Pharmaceutical Biosciences, Uppsala University, SE-751 24 Uppsala, Sweden
| | - Hiroyuki Watanabe
- 0000 0004 1936 9457grid.8993.bDivision of Biological Research on Drug Dependence, Department of Pharmaceutical Biosciences, Uppsala University, SE-751 24 Uppsala, Sweden
| | - Victor M. Karpyak
- 0000 0004 0459 167Xgrid.66875.3aDepartment of Psychiatry and Psychology, Mayo Clinic College of Medicine, Rochester, MN 55905 USA
| | - Tatiana Yakovleva
- 0000 0004 1936 9457grid.8993.bDivision of Biological Research on Drug Dependence, Department of Pharmaceutical Biosciences, Uppsala University, SE-751 24 Uppsala, Sweden
| | - Georgy Bakalkin
- Division of Biological Research on Drug Dependence, Department of Pharmaceutical Biosciences, Uppsala University, SE-751 24, Uppsala, Sweden.
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Ioime L, Guglielmo R, Affini GF, Quatrale M, Martinotti G, Callea A, Savi E, Janiri L. Neuropsychological Performance in Alcohol Dependent Patients: A One-Year Longitudinal Study. Psychiatry Investig 2018; 15:505-513. [PMID: 29674602 PMCID: PMC5975996 DOI: 10.30773/pi.2017.09.27.1] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Accepted: 09/27/2017] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE Despite several studies that have highlighted the harmful effects of alcohol consumption on cognitive functions it remains unclear whether certain brain areas are more sensitive than others are or whether alcohol causes widespread cognitive deficit. Moreover, the role of continued abstinence has yet to be clarified regarding the quality of recovery on the different cognitive domains. The aim of this 1-year longitudinal study was to evaluate the recovery of cognitive deficits in the medium (6 months) and long term (12 months) after the interruption of drinking. METHODS Forty-one alcohol-dependent patients were recruited from two outpatient treatment facilities and cognitive functions were compared on a control group of forty healthy controls. The patients were then re-assessed at 6 and 12 months. Changes in neuropsychological measures were evaluated with repeated measures analysis of variance (ANOVA). We also compared 1-year follow-up scores with control data (unpaired t tests) to identify tests on which significant differences persisted. RESULTS Patients performed significantly worse than controls in all cognitive domains investigated and this cognitive impairment was evident in recently abstinent patients. A year of abstinence resulted in a significant improvement in all cognitive domains assessed after detoxification from alcohol. After year 1, alcoholic subjects had returned to normal levels compared to healthy controls on all domains except for general non-verbal intelligence, verbal memory and some visuospatial skills. CONCLUSION Our results support the hypothesis of widespread impairment resulting from alcohol consumption. The recovery of cognitive functions is not homogeneous during prolonged abstinence.
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Affiliation(s)
- Lucia Ioime
- Department of Human Science, Lumsa University of Rome, Rome, Italy
| | - Riccardo Guglielmo
- Department of Geriatrics, Neuroscience and Orthopedics, Institute of Psychiatry, Catholic University Medical School of Rome, Rome, Italy
| | | | - Marianna Quatrale
- Department of Geriatrics, Neuroscience and Orthopedics, Institute of Psychiatry, Catholic University Medical School of Rome, Rome, Italy
| | - Giovanni Martinotti
- Department of Neuroscience and Imaging, University ''G. D'Annunzio'', Chieti, Italy
| | - Antonino Callea
- Department of Human Science, Lumsa University of Rome, Rome, Italy
| | - Evelina Savi
- Department of Mental Health and Addictions, Local Health Unit of Parma, Parma, Italy
| | - Luigi Janiri
- Department of Geriatrics, Neuroscience and Orthopedics, Institute of Psychiatry, Catholic University Medical School of Rome, Rome, Italy
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van Duijvenbode N, Didden R, VanDerNagel JE, Korzilius HP, Engels RC. Cognitive deficits in problematic drinkers with and without mild to borderline intellectual disability. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2018; 22:5-17. [PMID: 27555557 DOI: 10.1177/1744629516664840] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
We examined cognitive deficits in problematic drinkers with and without mild to borderline intellectual disability (MBID). Problematic drinkers were expected to show a significantly lower estimated performance IQ (PIQ), but not a lower estimated verbal IQ (VIQ), compared to light drinkers. Participants ( N = 474) were divided into four groups based on IQ and severity of alcohol use-related problems. IQ was estimated using (a short form of) the Wechsler Adult Intelligence Scale third edition. Severity of alcohol use-related problems was assessed using the Alcohol Use Disorder Identification Test. Overall, there were no significant differences between light and problematic drinkers on estimated VIQ. Within the group without MBID, estimated PIQ was significantly lower. Estimated PIQ was not lower in problematic drinkers with MBID compared to light drinkers with MBID. The results are indicative of cognitive deficits in problematic drinkers without MBID. Screening for cognitive deficits with additional instruments is advised.
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Affiliation(s)
| | - Robert Didden
- Radboud University, the Netherlands; Trajectum, the Netherlands
| | - Joanne El VanDerNagel
- Aveleijn, the Netherlands; Radboud University, the Netherlands; Tactus, the Netherlands
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Chronic alcohol exposure disrupts top-down control over basal ganglia action selection to produce habits. Nat Commun 2018; 9:211. [PMID: 29335427 PMCID: PMC5768774 DOI: 10.1038/s41467-017-02615-9] [Citation(s) in RCA: 102] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Accepted: 12/13/2017] [Indexed: 12/15/2022] Open
Abstract
Addiction involves a predominance of habitual control mediated through action selection processes in dorsal striatum. Research has largely focused on neural mechanisms mediating a proposed progression from ventral to dorsal lateral striatal control in addiction. However, over reliance on habit striatal processes may also arise from reduced cortical input to striatum, thereby disrupting executive control over action selection. Here, we identify novel mechanisms through which chronic intermittent ethanol exposure and withdrawal (CIE) disrupts top-down control over goal-directed action selection processes to produce habits. We find CIE results in decreased excitability of orbital frontal cortex (OFC) excitatory circuits supporting goal-directed control, and, strikingly, selectively reduces OFC output to the direct output pathway in dorsal medial striatum. Increasing the activity of OFC circuits restores goal-directed control in CIE-exposed mice. Our findings show habitual control in alcohol dependence can arise through disrupted communication between top-down, goal-directed processes onto basal ganglia pathways controlling action selection. Drug dependence shifts the balance in action selection away from goal-directed to habitual responding. Here, the authors report that chronic passive exposure to alcohol leads to suppression of orbitofrontal cortex inputs to dorsomedial striatum resulting in downregulation of goal-directed behavior.
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Profiling Online Poker Players: Are Executive Functions Correlated with Poker Ability and Problem Gambling? J Gambl Stud 2018; 34:823-851. [PMID: 29330827 DOI: 10.1007/s10899-017-9741-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Poker playing and responsible gambling both entail the use of the executive functions (EF), which are higher-level cognitive abilities. This study investigated if online poker players of different ability showed different performances in their EF and if so, which functions were the most discriminating for their playing ability. Furthermore, it assessed if the EF performance was correlated to the quality of gambling, according to self-reported questionnaires (PGSI, SOGS, GRCS). Three poker experts evaluated anonymized poker hand history files and, then, a trained professional administered an extensive neuropsychological test battery. Data analysis determined which variables of the tests correlated with poker ability and gambling quality scores. The highest correlations between EF test results and poker ability and between EF test results and gambling quality assessment showed that mostly different clusters of executive functions characterize the profile of the strong(er) poker player and those ones of the problem gamblers (PGSI and SOGS) and the one of the cognitions related to gambling (GRCS). Taking into consideration only the variables overlapping between PGSI and SOGS, we found some key predictive factors for a more risky and harmful online poker playing: a lower performance in the emotional intelligence competences (Emotional Quotient inventory Short) and, in particular, those grouped in the Intrapersonal scale (emotional self-awareness, assertiveness, self-regard, independence and self-actualization).
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