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Seddon J, Wadd S. The characteristics and treatment outcomes of people with very late onset of problem drinking. Alcohol Clin Exp Res 2023; 47:756-762. [PMID: 37093459 DOI: 10.1111/acer.15029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 12/17/2022] [Accepted: 01/25/2023] [Indexed: 04/25/2023]
Abstract
BACKGROUND The characteristics and outcomes of people who begin to experience problems with alcohol later in life are not well understood. This study examines whether people with a very late-onset of problem drinking, defined as occurring after the age of 60, differ in their use of alcohol, mental health functioning, and alcohol treatment outcomes from people with an earlier onset of problem drinking. METHOD Seven hundred eighty participants aged 50+ were categorized as either early onset (<25 years, n = 119, 15%), mid-onset (25-39 years, n = 200, 26%), late-onset (40-59 years, n = 376, 48%) or very late-onset problem drinkers (≥60 years, n = 85, 11%). Participants completed measures on alcohol use, mental health, and cognitive functioning. RESULTS Eleven percent of participants had very late onset of problem drinking. After controlling for age as a covariate, age of onset of problem drinking was not associated with level of alcohol intake or cognitive functioning, but individuals with very late onset of problem drinking had significantly lower levels of depression and significantly better mental health well-being. Age of onset was not associated with treatment outcomes (i.e., change in alcohol use following treatment or treatment completion). CONCLUSION People who first experience problems with alcohol after the age of 60 may have better mental health functioning than people with an earlier age of problem drinking. The results suggest that the age of onset of problem drinking may be a poor predictor of alcohol use severity and treatment outcomes and older adults can benefit from alcohol treatment irrespective of the age problem drinking began.
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Affiliation(s)
- Jennifer Seddon
- Centre for Psychological Research, Oxford Brookes University, Oxford, UK
| | - Sarah Wadd
- Substance Misuse and Ageing Research Team, University of Bedfordshire, Luton, UK
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2
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Requena-Ocaña N, Araos P, Serrano-Castro PJ, Flores-López M, García-Marchena N, Oliver-Martos B, Ruiz JJ, Gavito A, Pavón FJ, Serrano A, Mayoral F, Suarez J, de Fonseca FR. Plasma Concentrations of Neurofilament Light Chain Protein and Brain-Derived Neurotrophic Factor as Consistent Biomarkers of Cognitive Impairment in Alcohol Use Disorder. Int J Mol Sci 2023; 24:ijms24021183. [PMID: 36674698 PMCID: PMC9866623 DOI: 10.3390/ijms24021183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 12/12/2022] [Accepted: 01/03/2023] [Indexed: 01/11/2023] Open
Abstract
For a long time, Substance Use Disorders (SUDs) were not considered a component in the etiology of dementia. The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders introduced substance-induced neurocognitive disorders, incorporating this notion to clinical practice. However, detection and monitoring of neurodegenerative processes in SUD patients remain a major clinical challenge, especially when early diagnosis is required. In the present study, we aimed to investigate new potential biomarkers of neurodegeneration that could predict cognitive impairment in SUD patients: the circulating concentrations of Neurofilament Light chain protein (NfL) and Brain-Derived Neurotrophic Factor (BDNF). Sixty SUD patients were compared with twenty-seven dementia patients and forty healthy controls. SUD patients were recruited and assessed using the Psychiatric Research Interview for Substance and Mental (PRISM) and a battery of neuropsychological tests, including the Montreal Cognitive Assessment test for evaluation of cognitive impairment. When compared to healthy control subjects, SUD patients showed increases in plasma NfL concentrations and NfL/BDNF ratio, as well as reduced plasma BDNF levels. These changes were remarkable in SUD patients with moderate-severe cognitive impairment, being comparable to those observed in dementia patients. NfL concentrations correlated with executive function and memory cognition in SUD patients. The parameters "age", "NfL/BDNF ratio", "first time alcohol use", "age of onset of alcohol use disorder", and "length of alcohol use disorder diagnosis" were able to stratify our SUD sample into patients with cognitive impairment from those without cognitive dysfunction with great specificity and sensibility. In conclusion, we propose the combined use of NfL and BDNF (NfL/BDNF ratio) to monitor substance-induced neurocognitive disorder.
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Affiliation(s)
- Nerea Requena-Ocaña
- Neuropsychopharmacology Group, Instituto IBIMA, Hospital Regional Universitario de Málaga, Avda. Carlos Haya 82, Sótano, 29010 Malaga, Spain
- School of Psychology, Complutense University of Madrid, Campus de Somosaguas, 28040 Madrid, Spain
| | - Pedro Araos
- Neuropsychopharmacology Group, Instituto IBIMA, Hospital Regional Universitario de Málaga, Avda. Carlos Haya 82, Sótano, 29010 Malaga, Spain
| | - Pedro J. Serrano-Castro
- Andalusian Network for Clinical and Translational Research in Neurology (NEURO-RECA), 29010 Malaga, Spain
- Neurology Service, Regional University Hospital of Malaga, 29010 Malaga, Spain
| | - María Flores-López
- Neuropsychopharmacology Group, Instituto IBIMA, Hospital Regional Universitario de Málaga, Avda. Carlos Haya 82, Sótano, 29010 Malaga, Spain
| | - Nuria García-Marchena
- Neuropsychopharmacology Group, Instituto IBIMA, Hospital Regional Universitario de Málaga, Avda. Carlos Haya 82, Sótano, 29010 Malaga, Spain
- Institute D, Research in Health Sciences Germans Trias i Pujol (IGTP), Addictions Unit-Internal Medicine Service, Campus Can Ruti, Carrer del Canyet s/n, 08916 Badalona, Spain
| | - Begoña Oliver-Martos
- Andalusian Network for Clinical and Translational Research in Neurology (NEURO-RECA), 29010 Malaga, Spain
- Neurology Service, Regional University Hospital of Malaga, 29010 Malaga, Spain
| | - Juan Jesús Ruiz
- Provincial Drug Addiction Center (CPD) of Malaga, Provincial Council of Malaga, C/Ana Solo de Zaldívar, n3, 29010 Malaga, Spain
| | - Ana Gavito
- Neuropsychopharmacology Group, Instituto IBIMA, Hospital Regional Universitario de Málaga, Avda. Carlos Haya 82, Sótano, 29010 Malaga, Spain
| | - Francisco Javier Pavón
- Neuropsychopharmacology Group, Instituto IBIMA, Hospital Regional Universitario de Málaga, Avda. Carlos Haya 82, Sótano, 29010 Malaga, Spain
- Center for Biomedical Research in the Cardiovascular Diseases Network (CIBERCV), Carlos III Health Institute, Calle de Melchor Fernández Almagro, 3, 28029 Madrid, Spain
| | - Antonia Serrano
- Neuropsychopharmacology Group, Instituto IBIMA, Hospital Regional Universitario de Málaga, Avda. Carlos Haya 82, Sótano, 29010 Malaga, Spain
| | - Fermín Mayoral
- Mental Health Clinical Management Unit, Institute of Biomedical Research of Malaga-IBIMA, Regional University Hospital of Málaga, 29010 Malaga, Spain
| | - Juan Suarez
- Neuropsychopharmacology Group, Instituto IBIMA, Hospital Regional Universitario de Málaga, Avda. Carlos Haya 82, Sótano, 29010 Malaga, Spain
- Department of Anatomy, Legal Medicine and History of Science, School of Medicine, University of Malaga, Boulevard Louis Pasteur 32, 29071 Malaga, Spain
- Correspondence: (J.S.); (F.R.d.F.)
| | - Fernando Rodríguez de Fonseca
- Neuropsychopharmacology Group, Instituto IBIMA, Hospital Regional Universitario de Málaga, Avda. Carlos Haya 82, Sótano, 29010 Malaga, Spain
- Andalusian Network for Clinical and Translational Research in Neurology (NEURO-RECA), 29010 Malaga, Spain
- Neurology Service, Regional University Hospital of Malaga, 29010 Malaga, Spain
- Mental Health Clinical Management Unit, Institute of Biomedical Research of Malaga-IBIMA, Regional University Hospital of Málaga, 29010 Malaga, Spain
- Correspondence: (J.S.); (F.R.d.F.)
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Li W, Risacher SL, McAllister TW, Saykin AJ. Traumatic brain injury and age at onset of cognitive impairment in older adults. J Neurol 2016; 263:1280-5. [PMID: 27007484 DOI: 10.1007/s00415-016-8093-4] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Revised: 03/08/2016] [Accepted: 03/09/2016] [Indexed: 12/21/2022]
Abstract
There is a deficiency of knowledge regarding how traumatic brain injury (TBI) is associated with age at onset (AAO) of cognitive impairment in older adults. Participants with a TBI history were identified from the Alzheimer's disease neuroimaging initiative (ADNI 1/GO/2) medical history database. Using an analysis of covariance (ANCOVA) model, the AAO was compared between those with and without TBI, and potential confounding factors were controlled. The AAO was also compared between those with mild TBI (mTBI) and moderate or severe TBI (sTBI). Lastly, the effects of mTBI were analyzed on the AAO of participants with clinical diagnoses of either mild cognitive impairment (MCI) or Alzheimer's disease (AD). The AAO for a TBI group was 68.2 ± 1.1 years [95 % confidence interval (CI) 66.2-70.3, n = 62], which was significantly earlier than the AAO for the non-TBI group of 70.9 ± 0.2 years (95 % CI 70.5-71.4, n = 1197) (p = 0.013). Participants with mTBI history showed an AAO of 68.5 ± 1.1 years (n = 56), which was significantly earlier than the AAO for the non-TBI group (p = 0.032). Participants with both MCI and mTBI showed an AAO of 66.5 ± 1.3 years (95 % CI 63.9-69.1, n = 45), compared to 70.6 ± 0.3 years for the non-TBI MCI group (95 % CI 70.1-71.1, n = 935) (p = 0.016). As a conclusion, a history of TBI may accelerate the AAO of cognitive impairment by two or more years. These results were consistent with reports of TBI as a significant risk factor for cognitive decline in older adults, and TBI is associated with an earlier AAO found in patients with MCI or AD.
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Affiliation(s)
- Wei Li
- School of Health and Rehabilitation Sciences, Indiana University Purdue University, 2039 N. Capitol Avenue, Indianapolis, IN, 46202, USA.
| | - Shannon L Risacher
- Department of Radiology and Imaging Sciences, Center for Neuroimaging, Indiana Alzheimer Disease Center, Indiana University School of Medicine, 355 W. 16th Street, Suite 4100, Indianapolis, IN, 46202, USA
| | - Thomas W McAllister
- Department of Psychiatry, Indiana University School of Medicine, 355 W. 16th Street, Suite 4800, Indianapolis, IN, 46202, USA
| | - Andrew J Saykin
- Department of Radiology and Imaging Sciences, Center for Neuroimaging, Indiana Alzheimer Disease Center, Indiana University School of Medicine, 355 W. 16th Street, Suite 4100, Indianapolis, IN, 46202, USA
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Brasil A, Castro AJO, Martins ICVS, Lacerda EMCB, Souza GS, Herculano AM, Rosa AAM, Rodrigues AR, Silveira LCL. Colour Vision Impairment in Young Alcohol Consumers. PLoS One 2015; 10:e0140169. [PMID: 26465148 PMCID: PMC4605530 DOI: 10.1371/journal.pone.0140169] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Accepted: 09/22/2015] [Indexed: 12/22/2022] Open
Abstract
Alcohol consumption among young adults is widely accepted in modern society and may be the starting point for abusive use of alcohol at later stages of life. Chronic alcohol exposure can lead to visual function impairment. In the present study, we investigated the spatial luminance contrast sensitivity, colour arrangement ability, and colour discrimination thresholds on young adults that weekly consume alcoholic beverages without clinical concerns. Twenty-four young adults were evaluated by an ophthalmologist and performed three psychophysical tests to evaluate their vision functions. We estimated the spatial luminance contrast sensitivity function at 11 spatial frequencies ranging from 0.1 to 30 cycles/degree. No difference in contrast sensitivity was observed comparing alcohol consumers and control subjects. For the evaluation of colour vision, we used the Farnsworth-Munsell 100 hue test (FM 100 test) to test subject’s ability to perform a colour arrangement task and the Mollon-Reffin test (MR test) to measure subject’s colour discrimination thresholds. Alcohol consumers made more mistakes than controls in the FM100 test, and their mistakes were diffusely distributed in the FM colour space without any colour axis preference. Alcohol consumers also performed worse than controls in the MR test and had higher colour discrimination thresholds compared to controls around three different reference points of a perceptually homogeneous colour space, the CIE 1976 chromaticity diagram. There was no colour axis preference in the threshold elevation observed among alcoholic subjects. Young adult weekly alcohol consumers showed subclinical colour vision losses with preservation of spatial luminance contrast sensitivity. Adolescence and young adult age are periods of important neurological development and alcohol exposure during this period of life might be responsible for deficits in visual functions, especially colour vision that is very sensitive to neurotoxicants.
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Affiliation(s)
- Alódia Brasil
- Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, Pará, Brazil
| | | | | | | | - Givago S. Souza
- Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, Pará, Brazil
- Núcleo de Medicina Tropical, Universidade Federal do Pará, Belém, Pará, Brazil
| | | | - Alexandre Antônio M. Rosa
- Instituto de Ciências da Saúde, Universidade Federal do Pará, Belém, Pará, Brazil
- Hospital Universitário Bettina Ferro de Souza, Universidade Federal do Pará, Belém, Pará, Brazil
| | | | - Luiz Carlos L. Silveira
- Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, Pará, Brazil
- Núcleo de Medicina Tropical, Universidade Federal do Pará, Belém, Pará, Brazil
- Universidade Ceuma, São Luís, Maranhão, Brazil
- * E-mail:
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Abstract
BACKGROUND Alcohol dependence in older adults is associated with cognitive impairment. Age of onset of alcohol dependence is an important criterion to distinguish subgroups of alcohol-dependent people. Little is known about the influence of the age of onset of alcohol dependence on cognitive functioning. The primary aim of this study was to examine if older alcohol-dependent people with early, late or very late onset of alcohol dependence differ in terms of cognitive dysfunction. METHODS A total of eighty-five older alcohol-dependent people who were admitted to an inpatient detoxification program, were categorized into three age of onset groups: early onset (< 25 years: N = 27, mean age 57.7 ± 7.4), late onset (25-44 years: N = 28, mean age 61.1 ± 6.7) and very late onset (≥ 45 years: N = 30, mean age 65.6 ± 6.5). A neuropsychological test battery (Kaufman-Short Neuropsychological Assessment Procedure (K-SNAP), Trail Making Test (TMT) and Stroop Color Word Test) was administered to assess cognitive functioning. Differences between groups were examined with analyses of variance (ANOVAs). RESULTS There were no significant differences in performance on any of the neuropsychological measures between the three age of onset groups. However, compared to a non-alcohol-dependent norm group, all three age of onset groups performed below average. CONCLUSIONS The results suggest that older adults who start drinking heavily (very) late in life have similar cognitive impairments compared to their peers who have been drinking for decades. This emphasizes the vulnerability of the aging brain to the toxic effects of alcohol.
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Matsumoto I, Alexander-Kaufman K, Iwazaki T, Kashem MA, Matsuda-Matsumoto H. CNS proteomes in alcohol and drug abuse and dependence. Expert Rev Proteomics 2014; 4:539-52. [PMID: 17705711 DOI: 10.1586/14789450.4.4.539] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Drugs of abuse, including alcohol, can induce dependency formation and/or brain damage in brain regions important for cognition. 'High-throughput' approaches, such as cDNA microarray and proteomics, allow the analysis of global expression profiles of genes and proteins. These technologies have recently been applied to human brain tissue from patients with psychiatric illnesses, including substance abuse/dependence and appropriate animal models to help understand the causes and secondary effects of these complex disorders. Although these types of studies have been limited in number and by proteomics techniques that are still in their infancy, several interesting hypotheses have been proposed. Focusing on CNS proteomics, we aim to review and update current knowledge in this rapidly advancing area.
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Affiliation(s)
- Izuru Matsumoto
- University of Sydney, Discipline of Pathology, NSW, Australia.
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7
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López-Caneda E, Cadaveira F, Crego A, Doallo S, Corral M, Gómez-Suárez A, Rodríguez Holguín S. Effects of a persistent binge drinking pattern of alcohol consumption in young people: a follow-up study using event-related potentials. Alcohol Alcohol 2013; 48:464-71. [PMID: 23695975 DOI: 10.1093/alcalc/agt046] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
AIMS The objective of this study was to examine brain activity related to visual attention processes in youths who had maintained a binge drinking (BD) pattern of alcohol consumption for >2 years. METHODS The participants were 57 university students (26 binge drinkers: BDs) with no personal or family history of alcoholism or psychopathological disorders in first-degree relatives. Event-related potentials (ERPs) were recorded while participants performed a visual oddball task (twice within a 2-year interval). The latency and amplitude of the P3b component of the ERPs were analysed. RESULTS The P3b amplitude was larger in young BDs than in aged-matched controls at both evaluation times, and the difference was more pronounced after 2 years of maintenance of a BD pattern of consumption. The larger P3b amplitude was associated with an earlier onset of regular drinking and with a greater quantity and intensity of consumption. CONCLUSIONS These findings suggest that young BDs exhibit anomalies in neural activity involved in attentional/working memory processes, which increase after 2 years of maintenance of BD. This anomalous neural activity may reflect underlying dysfunctions in neurophysiological mechanisms as well as the recruitment of additional attentional/working memory resources to enable the binge drinkers to perform the task adequately.
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Affiliation(s)
- Eduardo López-Caneda
- Departamento de Psicoloxía Clínica e Psicobioloxía, Facultade de Psicoloxía, Campus Universitario Sur, E-15782 Santiago de Compostela, Galicia, Spain.
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8
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Pathways to alcohol-induced brain impairment in young people: A review. Cortex 2013; 49:3-17. [DOI: 10.1016/j.cortex.2012.05.021] [Citation(s) in RCA: 110] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2011] [Revised: 04/02/2012] [Accepted: 05/23/2012] [Indexed: 12/18/2022]
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Abstract
Alcohol intake at levels posing an acute heath risk is common amongst teenagers. Alcohol abuse is the second most common mental disorder worldwide. The incidence of smoking is decreasing in the Western world but increasing in developing countries and is the leading cause of preventable death worldwide. Considering the longstanding history of alcohol and tobacco consumption in human societies, it might be surprising that the molecular mechanisms underlying alcohol and smoking dependence are still incompletely understood. Effective treatments against the risk of relapse are lacking. Drugs of abuse exert their effect manipulating the dopaminergic mesocorticolimbic system. In this brain region, alcohol has many potential targets including membranes and several ion channels, while other drugs, for example nicotine, act via specific receptors or binding proteins. Repeated consumption of drugs of abuse mediates adaptive changes within this region, resulting in addiction. The high incidence of alcohol and nicotine co-abuse complicates analysis of the molecular basis of the disease. Gene expression profiling is a useful approach to explore novel drug targets in the brain. Several groups have utilised this technology to reveal drug-sensitive pathways in the mesocorticolimbic system of animal models and in human subjects. These studies are the focus of the present review.
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Fortier CB, Steffen EM, LaFleche G, Venne JR, Disterhoft JF, McGlinchey RE. Delay discrimination and reversal eyeblink classical conditioning in abstinent chronic alcoholics. Neuropsychology 2008; 22:196-208. [PMID: 18331162 DOI: 10.1037/0894-4105.22.2.196] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Evidence has shown that alcoholism leads to volume reductions in brain regions critical for associative learning using the eyeblink classical conditioning paradigm (EBCC). Evidence indicates that cerebellar shrinkage causes impairment in simple forms of EBCC, whereas changes in forebrain structures result in impairment in more complex tasks. In this study, the ability of abstinent alcoholics and matched control participants to acquire learned responses during delay discrimination and discrimination reversal was examined and related to severity of drinking history and neuropsychological performance. During discrimination learning, one tone (CS+) predicted the occurrence of an airpuff (unconditioned stimulus), and another tone (CS-) served as a neutral stimulus; then the significance of the tones was reversed. Alcoholics who learned the initial discrimination were impaired in acquiring the new CS+ after the tones reversed; this is a function that has previously been linked to forebrain structures. It is suggested that a factor important to alcoholic addiction may be the presence of alcoholic-related associative responses that interfere with the ability to learn new more adaptive associations.
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Affiliation(s)
- Catherine Brawn Fortier
- Geriatric Research Education and Clinical Center (GRECC), Veterans Affairs Boston Healthcare System
| | - Elizabeth M Steffen
- Geriatric Research Education and Clinical Center (GRECC), Veterans Affairs Boston Healthcare System
| | - Ginette LaFleche
- Memory Disorders Research Center (MDRC), Boston University School of Medicin
| | - Jonathan R Venne
- Geriatric Research Education and Clinical Center (GRECC), Veterans Affairs Boston Healthcare System
| | - John F Disterhoft
- Department of Physiology, Northwestern University, Feinberg School of Medicine
| | - Regina E McGlinchey
- Geriatric Research Education and Clinical Center (GRECC), Veterans Affairs Boston Healthcare System
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Alexander-Kaufman K, Cordwell S, Harper C, Matsumoto I. A proteome analysis of the dorsolateral prefrontal cortex in human alcoholic patients. Proteomics Clin Appl 2007; 1:62-72. [DOI: 10.1002/prca.200600417] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2006] [Indexed: 12/20/2022]
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Wilson JJ, Levin FR, Donovan SJ, Nunes EV. Verbal abilities as predictors of retention among adolescents in a therapeutic community. Child Psychiatry Hum Dev 2006; 36:393-401. [PMID: 16773448 DOI: 10.1007/s10578-006-0010-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The relationship between verbal skills and retention among adolescents in substance abuse treatment is understudied. In order to assess verbal predictors of retention, twenty-eight 16-19 year old adolescents in a therapeutic community for substance abuse were evaluated between 30 and 90 days after admission. These adolescents were then followed prospectively for 1 year. Verbal and non-verbal cognitive screens, audio taped narrative responses, and self-reports of socio-emotional function and psychiatric symptoms were completed. Verbal scores were associated with self-restraint and counselor reports of therapeutic engagement and comprehension. General verbal scores predicted attrition, while therapeutic expressiveness (verbal expressiveness in a therapeutic context) predicted retention. Remediation of verbal communication skills may be an overlooked aspect of the therapeutic process in treating adolescent substance abusers.
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Affiliation(s)
- Jeffrey J Wilson
- Department of Psychiatry, Division on Substance Abuse, Columbia University College of Physicians and Surgeons, New York State Psychiatric Institute, 1051 Riverside Drive, Box 66, New York, NY 10032, USA.
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Meyers K, Hagan TA, McDermott P, Webb A, Randall M, Frantz J. Factor structure of the Comprehensive Adolescent Severity Inventory (CASI): results of reliability, validity, and generalizability analyses. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2006; 32:287-310. [PMID: 16864465 DOI: 10.1080/00952990500479464] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
This article describes the results of psychometric work conducted on the Comprehensive Adolescent Severity Inventory (CASI) among 205 in-treatment substance-abusing adolescents. Four dimensions, each composed of component subscales, resulted from standard psychometric analyses: Chemical Dependency, Psychosocial Functioning, Delinquency, and Risk Behavior. Each dimension had high internal consistency (alpha coefficients for the component subscales comprising each clinical dimension range from .78 to .96) and test-retest reliability (intraclass correlation coefficients range from .88 to .96 and all are significant at p < .0001.). Concurrent validity and specificity of the CASI dimensions also were found: significant and substantial variance in NIMH Diagnostic Interview Schedule for Children-Revised (DISC-IV) and Brief Symptom Inventory (BSI) scores was associated with relevant CASI dimensions; CASI dimensions that theoretically should show no significant relationship with divergent pathology were not associated. The dimensions forecasted substantial variance in adolescent functioning posttreatment discharge, supporting predictive validity. Finally, the dimensional clinical structure was found to be generalizable over male and female adolescents, younger and older adolescents, and adolescents from different ethnic groups. These results provide further evidence for the CASI's promise in research and practice as an adolescent-specific assessment instrument that comprehensively assesses multidimensional areas of functioning within a developmental context of measurement. Limitations of the study along with future work currently being conducted on the CASI are discussed.
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Affiliation(s)
- Kathleen Meyers
- University of Pennsylvania School of Medicine, Department of Psychiatry, Center for Treatment and Evaluation, Philadelphia, Pennsylvania, USA.
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Alexander-Kaufman K, James G, Sheedy D, Harper C, Matsumoto I. Differential protein expression in the prefrontal white matter of human alcoholics: a proteomics study. Mol Psychiatry 2006; 11:56-65. [PMID: 16172612 DOI: 10.1038/sj.mp.4001741] [Citation(s) in RCA: 74] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Neuroimaging and post-mortem studies indicate that chronic alcohol use induces global changes in brain morphology, such as cortical and subcortical atrophy. Recent studies have shown that frontal lobe structures are specifically susceptible to alcohol-related brain damage and shrinkage in this area is largely due to a loss of white matter. This may explain the high incidence of cognitive dysfunction observed in alcoholics. Using a proteomics-based approach, changes in protein expression in the dorsolateral prefrontal region (BA9) white matter were identified in human alcoholic brains. Protein extracts from the BA9 white matter of 25 human brains (10 controls; eight uncomplicated alcoholics; six alcoholics complicated with hepatic cirrhosis; one reformed alcoholic) were separated using two-dimensional gel electrophoresis. Overall, changes in the relative expression of 60 proteins were identified (P<0.05, ANOVA) in the alcoholic BA9 white matter. In total, 18 protein spots have been identified using MALDI-TOF; including hNP22, alpha-internexin, transketolase, creatine kinase chain B, ubiquitin carboxy-terminal hydrolase L1 and glyceraldehyde-3-phosphate dehydrogenase. Several of these proteins have been previously implicated in alcohol-related disorders and brain damage. By identifying changes in protein expression in this region from alcoholics, hypotheses may draw upon more mechanistic explanations as to how chronic ethanol consumption causes white matter damage.
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Affiliation(s)
- K Alexander-Kaufman
- Department of Pathology, Blackburn Building D06, The University of Sydney, NSW 2006, Australia
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15
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Tapert SF, Schweinsburg AD. The human adolescent brain and alcohol use disorders. RECENT DEVELOPMENTS IN ALCOHOLISM : AN OFFICIAL PUBLICATION OF THE AMERICAN MEDICAL SOCIETY ON ALCOHOLISM, THE RESEARCH SOCIETY ON ALCOHOLISM, AND THE NATIONAL COUNCIL ON ALCOHOLISM 2005; 17:177-97. [PMID: 15789866 DOI: 10.1007/0-306-48626-1_9] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Affiliation(s)
- Susan F Tapert
- Department of Psychiatry, VA San Diego Healthcare System, and University of California San Diego, San Diego, California 92161, USA
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Kamarajan C, Porjesz B, Jones KA, Choi K, Chorlian DB, Padmanabhapillai A, Rangaswamy M, Stimus AT, Begleiter H. The role of brain oscillations as functional correlates of cognitive systems: a study of frontal inhibitory control in alcoholism. Int J Psychophysiol 2004; 51:155-80. [PMID: 14693365 PMCID: PMC3766846 DOI: 10.1016/j.ijpsycho.2003.09.004] [Citation(s) in RCA: 119] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Event-related oscillations play a key role in understanding the brain dynamics and human information processing. In the present study, the Go/No-Go paradigm has been used to examine whether alcoholics have poor inhibitory control as compared to control subjects in terms of different oscillatory brain responses. The matching pursuit algorithm was used to decompose the event-related electroencephalogram into oscillations of different frequencies. It was found that alcoholics (n=58) showed significant reduction in delta (1.0-3.0 Hz) and theta (3.5-7.0 Hz) power during No-Go trials as compared to controls (n=29). This reduction was prominent at the frontal region. The decreased delta and theta power associated with No-Go processing perhaps suggests a deficient inhibitory control and information-processing mechanism. A neuro-cognitive model has been provided to explain the findings. It is suggested that the oscillatory correlates during cognitive processing can be an endophenotypic marker in alcoholism.
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Affiliation(s)
- Chella Kamarajan
- Department of Psychiatry, Neurodynamics Laboratory, SUNY Health Science Center, Brooklyn, New York, U.S.A
| | - Bernice Porjesz
- Department of Psychiatry, Neurodynamics Laboratory, SUNY Health Science Center, Brooklyn, New York, U.S.A
| | - Kevin A Jones
- Department of Psychiatry, Neurodynamics Laboratory, SUNY Health Science Center, Brooklyn, New York, U.S.A
| | - Keewhan Choi
- Department of Psychiatry, Neurodynamics Laboratory, SUNY Health Science Center, Brooklyn, New York, U.S.A
| | - David B Chorlian
- Department of Psychiatry, Neurodynamics Laboratory, SUNY Health Science Center, Brooklyn, New York, U.S.A
| | - Ajayan Padmanabhapillai
- Department of Psychiatry, Neurodynamics Laboratory, SUNY Health Science Center, Brooklyn, New York, U.S.A
| | - Madhavi Rangaswamy
- Department of Psychiatry, Neurodynamics Laboratory, SUNY Health Science Center, Brooklyn, New York, U.S.A
| | - Arthur T Stimus
- Department of Psychiatry, Neurodynamics Laboratory, SUNY Health Science Center, Brooklyn, New York, U.S.A
| | - Henri Begleiter
- Department of Psychiatry, Neurodynamics Laboratory, SUNY Health Science Center, Brooklyn, New York, U.S.A
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17
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Reid MC, Maciejewski PK, Hawkins KA, Bogardus ST. Relationship between alcohol consumption and Folstein mini-mental status examination scores among older cognitively impaired adults. J Geriatr Psychiatry Neurol 2002; 15:31-7. [PMID: 11936241 DOI: 10.1177/089198870201500107] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The purpose of this study was to determine whether older cognitively impaired adults with significant current or past alcohol histories manifest distinctive cognitive profiles as determined by a widely used cognitive screen, the Folstein Mini-Mental Status Examination (MMSE) test, when compared with older persons without significant alcohol histories. Study participants included 801 consecutive patients, ages 65 years or above, who underwent comprehensive geriatric assessments. Proxy-reported current alcohol intake was classified as none, former, light (<1 drink/week), moderate (> or = 1 but < 14 drinks/week), and heavy (> or = 14 drinks/week), and the presence of an alcohol abuse/dependence disorder was determined by medical record review. Potential exposure-outcome associations were assessed for patients (n = 470) with established cognitive impairment, defined as an MMSE score < 24, and for individuals with MMSE scores > or = 24 (n = 331). Among participants with established cognitive impairment, mean (total) MMSE scores were not significantly different (17.2 vs 16.4 vs 18.5 vs 18.5 vs 17.4) across the categories of current alcohol exposure (none, former, light, moderate, and heavy). Mini-Mental State Examination subscores also did not vary as a function of current alcohol consumption, and a history of alcohol abuse/dependence was not associated with differences in total scores or individual MMSE subscores in this patient group. Among participants with MMSE scores > 24, increased current use of alcohol or a history of alcohol abuse/dependence was not associated with lower total MMSE scores or individual MMSE subscores. Despite these negative findings, prospective investigations of older populations that incorporate more comprehensive cognitive measures are warranted because (1) the Folstein is a brief cognitive screen that does not assess all cognitive domains, and (2) alcohol is a demonstrated risk factor for adverse cognitive outcomes in middle-aged adults and is potentially modifiable.
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Affiliation(s)
- M Carrington Reid
- Clinical Epidemiology Unit, VA Connecticut Healthcare System, West Haven, Connecticut 06515, USA
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18
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Costa L, Bauer L, Kuperman S, Porjesz B, O'Connor S, Hesselbrock V, Rohrbaugh J, Begleiter H. Frontal P300 decrements, alcohol dependence, and antisocial personality disorder. Biol Psychiatry 2000; 47:1064-71. [PMID: 10862806 DOI: 10.1016/s0006-3223(99)00317-0] [Citation(s) in RCA: 112] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND The purpose of this study was to examine the independent and interactive effects of alcohol dependence, antisocial personality disorder (ASPD), and age on brain function. METHODS P300 event-related potentials (ERPs) were recorded from 393 alcohol-dependent and 170 non-alcohol-dependent adults while they performed a visual oddball task. The two subject groups were further subdivided based upon age and the presence/absence of ASPD. RESULTS Alcohol dependence was associated with a significant P300 amplitude decrement at anterior electrode sites only. Antisocial personality disorder was also associated with reduced P300 amplitudes at anterior electrode sites; however, the effects were only significant among subjects 30 years of age or younger. To validate this association between ASPD and P300 amplitude a correlational analysis was performed; the correlation between anterior P300 amplitude and the total number of childhood conduct disorder and adult ASPD symptoms was significant. CONCLUSIONS The P300 amplitude decrement found at anterior electrode sites among subjects with ASPD is consistent with the results of numerous ERP, neuroimaging, or neuropsychologic studies of anterior brain function. Our study is unique in suggesting that the effects of ASPD on anterior brain function are best detected during early adulthood. The study also suggests that the detrimental neurophysiologic effects of alcohol dependence predominantly involve the anterior brain.
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Affiliation(s)
- L Costa
- Alcohol Research Center, Department of Psychiatry, University of Connecticut School of Medicine, Farmington 06030-2103, USA
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19
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Luthar SS, Cushing G, Rounsaville BJ. Gender differences among opioid abusers: pathways to disorder and profiles of psychopathology. Drug Alcohol Depend 1996; 43:179-89. [PMID: 9023074 DOI: 10.1016/s0376-8716(96)01310-5] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
This study focused on gender differences in childhood disorders and severity of adult psychosocial impairment among 106 females and 95 males seeking treatment for opiate addiction. Results indicated that as compared to males, female addicts reported significantly lower levels of conduct problems and higher levels of internalizing problems during childhood; these differences held even after controlling for comorbid adult psychiatric diagnosis. Findings also revealed that female addicts were at a disadvantage relative to males in terms of overall severity of psychiatric distress. Concomitantly, however, females showed less social deviance-on a range of illegal behaviors-as compared to men. Results were discussed in terms of implications for treatment planning: they underscore the need to consider gender differences in pathways to, and nature of, adult psychopathology among addicted individuals.
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Affiliation(s)
- S S Luthar
- Yale University, Psychiatry, Psychology & Child Study Center, Connecticut Mental Health Center-S207, New Haven, 06519, USA
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20
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Gilman S, Adams KM, Johnson-Greene D, Koeppe RA, Junck L, Kluin KJ, Martorello S, Heumann M, Hill E. Effects of disulfiram on positron emission tomography and neuropsychological studies in severe chronic alcoholism. Alcohol Clin Exp Res 1996; 20:1456-61. [PMID: 8947325 DOI: 10.1111/j.1530-0277.1996.tb01149.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Disulfiram is an aldehyde dehydrogenase inhibitor that is widely used as an adjunctive agent in the treatment of patients with severe chronic alcoholism. Recent positron emission tomography (PET) studies of local cerebral metabolic rates for glucose (ICMRglc) and benzodiazepine receptor binding in alcoholic patients have shown regional cerebral abnormalities; however, some of the patients were studied while receiving disulfiram, which could influence the biochemical processes under investigation. In a retrospective investigation, we examined the influence of disulfiram administration on the results of PET studies of ICMRglc and benzodiazepine receptor binding and neuropsychological tests of cognition and executive function in patients with severe chronic alcoholism. [18F]Fluorodeoxyglucose was used to measure ICMRglc in 48 male patients, including 11 receiving and 37 not receiving disulfiram in therapeutic doses. [11C]Flumazenil was used to measure benzodiazepine receptor binding in 17 male patients, including 3 receiving and 14 not receiving disulfiram. All patients studied with FMZ were also examined with fluorodeoxyglucose. PET studies of ICMRglc revealed significantly decreased global values in the patients receiving disulfiram compared with those not receiving disulfiram. PET studies of benzodiazepine receptor binding revealed decreased flumazenil influx and distribution volume in patients receiving disulfiram. The neuropsychological tests demonstrated no differences between the two groups of subjects. The findings suggest that disulfiram may influence the results of PET studies of glucose metabolism and benzodiazepine receptor binding.
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Affiliation(s)
- S Gilman
- Department of Neurology, University of Michigan, Ann Arbor 48109-0316, USA
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21
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Tracy JI, Josiassen RC, Bellack AS. Neuropsychology of dual diagnosis: Understanding the combined effects of schizophrenia and substance use disorders. Clin Psychol Rev 1995. [DOI: 10.1016/0272-7358(95)00001-6] [Citation(s) in RCA: 26] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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22
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Abstract
This study determined the influence of adolescent alcohol abuse on academic achievement. Substance Abusing (SA), Conduct Disordered (CD), and Normal Student Control (NSC) adolescents, stratified on Family History (FH) of alcoholism and gender, were tested on the Peabody Individual Achievement Test (PIAT). While SAs and CDs did not differ on the PIAT, both had lower subtest and total test standard scores than NSCs. FH + SAs did not differ from FH + CDs on the Spelling subtest, but both groups had significantly lower scores than FH - NSCs. For SAs and NSCs there were no significant correlations between measures of alcohol intake and PIAT subtest scores.
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Affiliation(s)
- J T Braggio
- Willow View Mental Health System, Veterans Affairs Medical Center, Oklahoma City, OK 73104
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23
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Braggio JT, Pishkin V. Systolic blood pressure and neuropsychological test performance of alcoholics. Alcohol Clin Exp Res 1992; 16:726-33. [PMID: 1326904 DOI: 10.1111/j.1530-0277.1992.tb00669.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
This study examined resting systolic blood pressure (SBP) as a mediator of neuropsychological (NP) test performance in nonhypertensive alcoholics and controls. A median-split was used to assign alcoholics and controls to low and high SBP groups. Results showed that: (1) When SBP level was not considered, alcoholics only performed worse than controls on the WAIS Comprehension subtest. (2) Alcoholics and controls in the high SBP groups had fewer correct items on the WAIS Comprehension and Raven's, Set I tests than subjects in the low SBP groups. (3) Significant Diagnostic Group by SBP Group interaction was found for the Sentence Writing test. For this test only controls in the High SBP Group did worse than controls in the Low SBP Group. (4) Individual group comparisons for all NP tests showed that alcoholics in the High SBP Group were more impaired than controls in the Low SBP Group on the WAIS Comprehension, Shipley Abstraction Age and Stark Visual-Spatial tests; but alcoholics in the Low SBP Group did not differ from, or outperformed, controls in the High SBP Group on the WAIS Comprehension, Shipley Abstraction Age, Raven's, Set I, and Stark Visual-Spatial tests. These data demonstrate that both alcoholism and high SBP adversely and differentially affect the NP test performance of alcoholics and controls.
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Affiliation(s)
- J T Braggio
- Veterans Affairs Medical Center, Behavioral Sciences Center, Oklahoma City, OK 73104
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24
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Arria AM, Tarter RE, Kabene MA, Laird SB, Moss H, Van Thiel DH. The role of cirrhosis in memory functioning of alcoholics. Alcohol Clin Exp Res 1991; 15:932-7. [PMID: 1789389 DOI: 10.1111/j.1530-0277.1991.tb05192.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
The effects of alcoholism and liver disease on memory functioning in alcoholics were studied by comparing four groups: normal healthy controls, alcoholics without liver disease, alcoholics with biopsy-confirmed cirrhosis, and nonalcoholics with postnecrotic cirrhosis. Memory capacity was evaluated employing the Benton Visual Retention Test (BVRT), the Rey-Osterreith Complex Figure Test, Digit Span, and the Brown Peterson four-word short-term memory test. A 2 x 2 ANOVA revealed significant main effects for both alcohol and cirrhosis on Digits Forward and the total score on the Brown Peterson test. Additionally, there were significant main effects for cirrhosis on the BVRT. The Brown Peterson test was analyzed using a repeated measures 2 x 2 ANOVA. Significant effects for cirrhosis were observed at all three interpolation periods. The effects for alcohol approached significance at the 30-sec (most difficult) interpolation period. Analysis of error patterns on the Brown Peterson test indicated that overall omission errors were most commonly made among all groups. Significant effects were found for alcohol on omissions and intrusion, while the cirrhosis factor yielded significant effects for phonemic, perseverative, and omission errors. This study demonstrates the importance of liver disease underlying the etiology of memory impairments in alcoholics. The results confirm our earlier findings that neuropsychologic deficits seen in alcoholics may be the result of the combination of alcohol abuse and liver disease.
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Affiliation(s)
- A M Arria
- University of Pittsburgh School of Medicine, Department of Psychiatry, PA 15213
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25
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Choquet M, Menke H, Ledoux S. Self-reported alcohol consumption among adolescents and the signification of early onset. A longitudinal approach. Soc Psychiatry Psychiatr Epidemiol 1989; 24:102-12. [PMID: 2499051 DOI: 10.1007/bf01788634] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
A cohort study of 327 French adolescents was carried out from 1983 to 1985 to investigate 1) the prevalence, incidence and remission rates of alcohol consumption 2) the significance of alcohol consumption before age 16 and its evolution. Among the young people with high alcohol consumption at age 16 (20%), 40% (30% among boys, 68% among girls) decrease their consumption at age 17 or 18. There are great differences between problem drinkers at age 16, and the others. They reveal more risky behaviour, more psychosomatic symptoms and have a more active life style. Even if they decrease their alcohol consumption between age 16 and their 18, their behaviour and psychosomatic problems persist.
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27
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Hasin DS, Grant BF. Neuropsychological functioning in alcoholics: psychiatric comorbidity, drinking history, and demographic characteristics. Compr Psychiatry 1987; 28:520-9. [PMID: 3691076 DOI: 10.1016/0010-440x(87)90018-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
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28
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Abstract
Correlations between measures of alcohol consumption and cognitive test scores have been interpreted to reflect a chronic toxic effect of ethanol on brain function in light to moderate social drinkers. However, the data indicate that there is little support across research groups for any specific relationship and, at best, the effect of alcohol consumption accounts for only a small proportion of variance. Consideration of test validity suggests that the principal measure of ability used in this research is not capable of elucidating cerebral deficit. Further, the pattern of observed correlations is not consistent with the assumption that the putative effects of social drinking involve deficits less severe but similar in type to those seen in chronic alcoholics. Instead, an association between innate ability, demographic variables, and drinking behavior in the general population is the most parsimonious explanation of all the data.
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