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Galbo-Thomma LK, Epperly PM, Blough BE, Landavazo A, Saldaña SJ, Carroll FI, Czoty PW. Cognitive-Enhancing Effects of Acetylcholine Receptor Agonists in Group-Housed Cynomolgus Monkeys Who Drink Ethanol. J Pharmacol Exp Ther 2024; 389:258-267. [PMID: 38135508 PMCID: PMC11125785 DOI: 10.1124/jpet.123.001854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 11/20/2023] [Accepted: 11/30/2023] [Indexed: 12/24/2023] Open
Abstract
The cognitive impairments that are often observed in patients with alcohol use disorder (AUD) partially contribute to the extremely low rates of treatment initiation and adherence. Brain acetylcholine receptors (AChR) mediate and modulate cognitive and reward-related behavior, and their distribution can be altered by long-term heavy drinking. Therefore, AChRs are promising pharmacotherapeutic targets for treating the cognitive symptoms of AUD. In the present study, the procognitive efficacy of two AChR agonists, xanomeline and varenicline, were evaluated in group-housed monkeys who self-administered ethanol for more than 1 year. The muscarinic AChR antagonist scopolamine was used to disrupt performance of a serial stimulus discrimination and reversal (SDR) task designed to probe cognitive flexibility, defined as the ability to modify a previously learned behavior in response to a change in reinforcement contingencies. The ability of xanomeline and varenicline to remediate the disruptive effects of scopolamine was compared between socially dominant and subordinate monkeys, with lighter and heavier drinking histories, respectively. We hypothesized that subordinate monkeys would be more sensitive to all three drugs. Scopolamine dose-dependently impaired performance on the serial SDR task in all monkeys at doses lower than those that produced nonspecific impairments (e.g., sedation); its potency did not differ between dominant and subordinate monkeys. However, both AChR agonists were effective in remediating the scopolamine-induced deficit in subordinate monkeys but not in dominant monkeys. These findings suggest xanomeline and varenicline may be effective for enhancing cognitive flexibility in individuals with a history of heavy drinking. SIGNIFICANCE STATEMENT: Procognitive effects of two acetylcholine (ACh) receptor agonists were assessed in group-housed monkeys who had several years' experience drinking ethanol. The muscarinic ACh receptor agonist xanomeline and the nicotinic ACh receptor agonist varenicline reversed a cognitive deficit induced by the muscarinic ACh receptor antagonist scopolamine. However, this effect was observed only in lower-ranking (subordinate) monkeys and not higher-ranking (dominant monkeys). Results suggest that ACh agonists may effectively remediate alcohol-induced cognitive deficits in a subpopulation of those with alcohol use disorder.
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Affiliation(s)
- Lindsey K Galbo-Thomma
- Department of Physiology and Pharmacology, Wake Forest University School of Medicine, Winston-Salem, North Carolina (L.K.G.-T., P.M.E., S.J.S., P.W.C.) and Center for Drug Discovery, Research Triangle Institute, Research Triangle Park, North Carolina (B.E.B., A.L., F.I.C.)
| | - Phillip M Epperly
- Department of Physiology and Pharmacology, Wake Forest University School of Medicine, Winston-Salem, North Carolina (L.K.G.-T., P.M.E., S.J.S., P.W.C.) and Center for Drug Discovery, Research Triangle Institute, Research Triangle Park, North Carolina (B.E.B., A.L., F.I.C.)
| | - Bruce E Blough
- Department of Physiology and Pharmacology, Wake Forest University School of Medicine, Winston-Salem, North Carolina (L.K.G.-T., P.M.E., S.J.S., P.W.C.) and Center for Drug Discovery, Research Triangle Institute, Research Triangle Park, North Carolina (B.E.B., A.L., F.I.C.)
| | - Antonio Landavazo
- Department of Physiology and Pharmacology, Wake Forest University School of Medicine, Winston-Salem, North Carolina (L.K.G.-T., P.M.E., S.J.S., P.W.C.) and Center for Drug Discovery, Research Triangle Institute, Research Triangle Park, North Carolina (B.E.B., A.L., F.I.C.)
| | - Santiago J Saldaña
- Department of Physiology and Pharmacology, Wake Forest University School of Medicine, Winston-Salem, North Carolina (L.K.G.-T., P.M.E., S.J.S., P.W.C.) and Center for Drug Discovery, Research Triangle Institute, Research Triangle Park, North Carolina (B.E.B., A.L., F.I.C.)
| | - F Ivy Carroll
- Department of Physiology and Pharmacology, Wake Forest University School of Medicine, Winston-Salem, North Carolina (L.K.G.-T., P.M.E., S.J.S., P.W.C.) and Center for Drug Discovery, Research Triangle Institute, Research Triangle Park, North Carolina (B.E.B., A.L., F.I.C.)
| | - Paul W Czoty
- Department of Physiology and Pharmacology, Wake Forest University School of Medicine, Winston-Salem, North Carolina (L.K.G.-T., P.M.E., S.J.S., P.W.C.) and Center for Drug Discovery, Research Triangle Institute, Research Triangle Park, North Carolina (B.E.B., A.L., F.I.C.)
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Rure D, Shakya M, Singhal A, Varma A, Mishra N, Pathak U. A Study of the association of neurocognition with relapse and quality of life in patients of alcohol dependence. Ind Psychiatry J 2024; 33:133-140. [PMID: 38853790 PMCID: PMC11155649 DOI: 10.4103/ipj.ipj_158_23] [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: 07/24/2023] [Revised: 10/05/2023] [Accepted: 10/17/2023] [Indexed: 06/11/2024] Open
Abstract
Background Alcohol is a widely consumed substance associated with around 5.6% of all causes of death. Alcohol use disorder (AUD) is a chronic relapsing and remitting illness and has been known to be associated with impaired executive functions, processing speed, memory, attention, and fluency. It is also associated with impaired quality of life (QoL), which in turn can affect overall prognosis. Aim To assess neurocognition in patients with alcohol dependence and correlate it with QoL and relapse. Materials and Methods This study was a prospective, longitudinal study of sixty alcohol dependence patients from January 2020 to June 2021 after appropriate ethical approval. Participants were assessed for baseline alcohol dependence, neurocognition (focused, sustained and divided attention; processing speed; verbal and category fluency; working memory; response inhibition; verbal comprehension; verbal learning and memory; visuospatial construction; visual learning and memory) and QoL using Alcohol Use Disorders Identification Test (AUDIT), National Institute of Mental Health and Neurosciences (NIMHANS) battery for neurocognition and WHO-BREF (WHO-Quality of Life-short-form scale) World Health Organization-scale, respectively. A follow-up was conducted in three months to assess relapse in the patients. Statistical analysis was conducted by International Business Machines Statistical Package for the Social Sciences (IBM SPSS) v16. Results Mean age of the study participants was 41.3 ± 5.03 years, mean age of onset of alcohol use was 20.88 ± 4.27 years, mean duration of alcohol use of 16.6 ± 7.92 years, and average 14.55 ± 4.86 drinks per day. The mean AUDIT score of the study population was 25.21 ± 7.18. There was significant positive correlation between duration of use and CTT-2; 37 out of 57 participants relapsed to alcohol (three participants had died in follow-up) with mean 37.48 ± 23.27 days of relapse, mean 3.32 ± 1.2 drinking days per week, and mean 6 ± 1.2 drinks per drinking day. There was negative and positive correlation between neurocognition and relapse and between neurocognition and QoL. Conclusion Alcohol use also resulted in impaired cognitive function of the study participants. There was also significant difference in score for neurocognition test between relapse and abstinent group. The significant correlation between neurocognition and QoL as well as neurocognition and relapse proves the deleterious effect of alcohol in every aspect of life.
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Affiliation(s)
- Daisy Rure
- Department of Psychiatry, R D Gardi Medical College, Ujjain, Madhya Pradesh, India
| | - Makhan Shakya
- Department of Psychiatry, Shyam Shah Medical College, Rewa, Madhya Pradesh, India
| | - Akanksha Singhal
- Department of Psychiatry, Shyam Shah Medical College, Rewa, Madhya Pradesh, India
| | - Akshat Varma
- Department of Psychiatry, 5 Air Force Hospital, Jorhat, Assam, India
| | - Nimisha Mishra
- Department of Psychiatry, Shyam Shah Medical College, Rewa, Madhya Pradesh, India
| | - Umesh Pathak
- Department of Psychiatry, Birsa Munda Government Medical College, Shahdol, Madhya Pradesh, 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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Janssen GTL, Egger JIM, Kessels RPC. Impaired Executive Functioning Associated with Alcohol-Related Neurocognitive Disorder including Korsakoff's Syndrome. J Clin Med 2023; 12:6477. [PMID: 37892615 PMCID: PMC10607036 DOI: 10.3390/jcm12206477] [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: 09/15/2023] [Revised: 09/30/2023] [Accepted: 10/11/2023] [Indexed: 10/29/2023] Open
Abstract
(1) Background: chronic alcohol use is consistently associated with impaired executive functioning, but its profile across the spectrum from mild to major alcohol-related cognitive impairment is, to date, unclear. This study aims to compare executive performances of patients with alcohol-induced neurocognitive disorder, including Korsakoff's syndrome (KS), by using a computerized assessment battery allowing a fine-grained and precise neuropsychological assessment; (2) Methods: performances of 22 patients with alcohol-related cognitive impairment (ARCI) and 20 patients with KS were compared to those of 22 matched non-alcoholic controls. All participants were diagnosed in accordance with DSM-5-TR criteria and were at least six weeks abstinent from alcohol prior to assessment. Executive function was evaluated using four subtests of Cambridge Neuropsychological Test Automated Battery (CANTAB®); (3) Results: significant differences between groups were found on spatial working memory (updating), sustained attention and inhibitory control, set shifting, and planning. Healthy controls performed significantly better than both patient groups (Games-Howell post hoc; p < 0.05), but no differences in performance were found between the ARCI and KS group; (4) Conclusions: ARCI and KS patients showed significant executive impairments, most prominent in updating, set-shifting and general planning abilities. Findings suggest equivalent levels of executive function in ARCI and KS patients. Our results highlight executive function as a significant hallmark of alcohol-induced neurocognitive disorder and stipulate the importance of early assessment and evaluation of skills to guide treatment.
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Affiliation(s)
- Gwenny T. L. Janssen
- Centre of Excellence for Korsakoff and Alcohol-Related Cognitive Disorders, Vincent van Gogh Institute for Psychiatry, 5803 DN Venray, The Netherlands; (J.I.M.E.); (R.P.C.K.)
| | - Jos I. M. Egger
- Centre of Excellence for Korsakoff and Alcohol-Related Cognitive Disorders, Vincent van Gogh Institute for Psychiatry, 5803 DN Venray, The Netherlands; (J.I.M.E.); (R.P.C.K.)
- Centre of Excellence for Neuropsychiatry, Vincent van Gogh Institute for Psychiatry, 5803 DN Venray, The Netherlands
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, 6525 GD Nijmegen, The Netherlands
| | - Roy P. C. Kessels
- Centre of Excellence for Korsakoff and Alcohol-Related Cognitive Disorders, Vincent van Gogh Institute for Psychiatry, 5803 DN Venray, The Netherlands; (J.I.M.E.); (R.P.C.K.)
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, 6525 GD Nijmegen, The Netherlands
- Tactus Addiction Care, 7418 ET Deventer, The Netherlands
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Pérez-Cervera L, De Santis S, Marcos E, Ghorbanzad-Ghaziany Z, Trouvé-Carpena A, Selim MK, Pérez-Ramírez Ú, Pfarr S, Bach P, Halli P, Kiefer F, Moratal D, Kirsch P, Sommer WH, Canals S. Alcohol-induced damage to the fimbria/fornix reduces hippocampal-prefrontal cortex connection during early abstinence. Acta Neuropathol Commun 2023; 11:101. [PMID: 37344865 PMCID: PMC10286362 DOI: 10.1186/s40478-023-01597-8] [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: 05/09/2023] [Accepted: 05/30/2023] [Indexed: 06/23/2023] Open
Abstract
INTRODUCTION Alcohol dependence is characterized by a gradual reduction in cognitive control and inflexibility to contingency changes. The neuroadaptations underlying this aberrant behavior are poorly understood. Using an animal model of alcohol use disorders (AUD) and complementing diffusion-weighted (dw)-MRI with quantitative immunohistochemistry and electrophysiological recordings, we provide causal evidence that chronic intermittent alcohol exposure affects the microstructural integrity of the fimbria/fornix, decreasing myelin basic protein content, and reducing the effective communication from the hippocampus (HC) to the prefrontal cortex (PFC). Using a simple quantitative neural network model, we show how disturbed HC-PFC communication may impede the extinction of maladaptive memories, decreasing flexibility. Finally, combining dw-MRI and psychometric data in AUD patients, we discovered an association between the magnitude of microstructural alteration in the fimbria/fornix and the reduction in cognitive flexibility. Overall, these findings highlight the vulnerability of the fimbria/fornix microstructure in AUD and its potential contribution to alcohol pathophysiology. Fimbria vulnerability to alcohol underlies hippocampal-prefrontal cortex dysfunction and correlates with cognitive impairment.
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Affiliation(s)
- Laura Pérez-Cervera
- Instituto de Neurociencias, Consejo Superior de Investigaciones Científicas and Universidad Miguel Hernández, Sant Joan d'Alacant, Alicante, Spain
| | - Silvia De Santis
- Instituto de Neurociencias, Consejo Superior de Investigaciones Científicas and Universidad Miguel Hernández, Sant Joan d'Alacant, Alicante, Spain
| | - Encarni Marcos
- Instituto de Neurociencias, Consejo Superior de Investigaciones Científicas and Universidad Miguel Hernández, Sant Joan d'Alacant, Alicante, Spain
| | - Zahra Ghorbanzad-Ghaziany
- Instituto de Neurociencias, Consejo Superior de Investigaciones Científicas and Universidad Miguel Hernández, Sant Joan d'Alacant, Alicante, Spain
- Radiation Science and Biomedical Imaging, University of Sherbrooke, Sherbrooke, Québec, Canada
| | - Alejandro Trouvé-Carpena
- Instituto de Neurociencias, Consejo Superior de Investigaciones Científicas and Universidad Miguel Hernández, Sant Joan d'Alacant, Alicante, Spain
| | - Mohamed Kotb Selim
- Instituto de Neurociencias, Consejo Superior de Investigaciones Científicas and Universidad Miguel Hernández, Sant Joan d'Alacant, Alicante, Spain
| | - Úrsula Pérez-Ramírez
- Center for Biomaterials and Tissue Engineering, Universitat Politècnica de València, Valencia, Spain
| | - Simone Pfarr
- Institute of Psychopharmacology, Central Institute of Mental Health, Medical faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Patrick Bach
- Department of Addiction Medicine, Department of Clinical Psychology, Medical Faculty Mannheim, Central Institute of Mental Health, University of Heidelberg, Mannheim, Germany
| | - Patrick Halli
- Department of Psychology, University of Heidelberg, Heidelberg, Germany
| | - Falk Kiefer
- Department of Addiction Medicine, Department of Clinical Psychology, Medical Faculty Mannheim, Central Institute of Mental Health, University of Heidelberg, Mannheim, Germany
| | - David Moratal
- Center for Biomaterials and Tissue Engineering, Universitat Politècnica de València, Valencia, Spain
| | - Peter Kirsch
- Department of Psychology, University of Heidelberg, Heidelberg, Germany
| | - Wolfgang H Sommer
- Institute of Psychopharmacology, Central Institute of Mental Health, Medical faculty Mannheim, University of Heidelberg, Mannheim, Germany.
- Department of Addiction Medicine, Department of Clinical Psychology, Medical Faculty Mannheim, Central Institute of Mental Health, University of Heidelberg, Mannheim, Germany.
| | - Santiago Canals
- Instituto de Neurociencias, Consejo Superior de Investigaciones Científicas and Universidad Miguel Hernández, Sant Joan d'Alacant, Alicante, Spain.
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Laniepce A, Segobin S, André C, Bertran F, Boudehent C, Lahbairi N, Maillard A, Mary A, Urso L, Vabret F, Cabé N, Pitel AL, Rauchs G. Distinct Sleep Alterations in Alcohol Use Disorder Patients with and without Korsakoff's Syndrome: Relationship with Episodic Memory. J Clin Med 2023; 12:jcm12062440. [PMID: 36983439 PMCID: PMC10058993 DOI: 10.3390/jcm12062440] [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: 02/17/2023] [Revised: 03/20/2023] [Accepted: 03/21/2023] [Indexed: 03/30/2023] Open
Abstract
Alcohol Use Disorder (AUD) results in sleep disturbances that may have deleterious impacts on cognition, especially on memory. However, little is known about the sleep architecture in patients with Korsakoff's syndrome (KS). This study aims at characterizing sleep disturbances in KS compared to AUD without KS and at specifying the relationships with cognitive impairments. Twenty-nine AUD patients (22 without KS and 7 with KS) and 15 healthy controls underwent a neuropsychological assessment and a polysomnography. The severity of sleep-disordered breathing and sleep fragmentation was similar in AUD and KS patients compared to controls. Sleep architecture differed between both patient groups: the proportion of slow-wave sleep was reduced in AUD patients only, while a lower proportion of rapid-eye movement (REM) sleep was specifically observed in KS patients. The proportion of REM sleep correlated with the severity of episodic memory deficits when AUD and KS were examined together. These data provide evidence for both similarities and specificities regarding sleep alterations in AUD patients with and without KS. They also indicate that altered sleep architecture may contribute to the pathophysiology of alcohol-related memory disorders.
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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
- Normandie Univ, UNIROUEN, CRFDP (EA 7475), 76000 Rouen, France
- Normandie Univ, UNICAEN, INSERM, U1237, PhIND "Physiopathology and Imaging of Neurological Disorders", Team NeuroPresage, Institut Blood and Brain @ Caen-Normandie, Cyceron, 14074 Caen, France
| | - Shailendra Segobin
- 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
- Normandie Univ, UNICAEN, INSERM, U1237, PhIND "Physiopathology and Imaging of Neurological Disorders", Team NeuroPresage, Institut Blood and Brain @ Caen-Normandie, Cyceron, 14074 Caen, France
| | - Françoise Bertran
- Normandie Univ, UNICAEN, PSL Université, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, NIMH, 14000 Caen, France
- Unité D'exploration et de Traitement des Troubles du Sommeil, CHU de Caen, 14000 Caen, France
| | - Céline Boudehent
- Normandie Univ, UNICAEN, PSL Université, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, NIMH, 14000 Caen, France
- Addiction Department, CHU de Caen, 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
| | - Laurent Urso
- Addiction Department, Centre Hospitalier de Roubaix, 59100 Roubaix, France
| | - François Vabret
- 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
- Normandie Univ, UNICAEN, INSERM, U1237, PhIND "Physiopathology and Imaging of Neurological Disorders", Team NeuroPresage, Institut Blood and Brain @ Caen-Normandie, Cyceron, 14074 Caen, France
- Addiction Department, CHU de Caen, 14000 Caen, France
| | - Anne-Lise Pitel
- Normandie Univ, UNICAEN, PSL Université, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, NIMH, 14000 Caen, France
- Normandie Univ, UNICAEN, INSERM, U1237, PhIND "Physiopathology and Imaging of Neurological Disorders", Team NeuroPresage, Institut Blood and Brain @ Caen-Normandie, Cyceron, 14074 Caen, France
- Institut Universitaire de France (IUF), 75231 Paris, France
| | - Géraldine Rauchs
- Normandie Univ, UNICAEN, PSL Université, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, NIMH, 14000 Caen, France
- Normandie Univ, UNICAEN, INSERM, U1237, PhIND "Physiopathology and Imaging of Neurological Disorders", Team NeuroPresage, Institut Blood and Brain @ Caen-Normandie, Cyceron, 14074 Caen, France
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Carlson ER, Guerin SP, Nixon K, Fonken LK. The neuroimmune system - Where aging and excess alcohol intersect. Alcohol 2023; 107:153-167. [PMID: 36150610 PMCID: PMC10023388 DOI: 10.1016/j.alcohol.2022.08.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 08/21/2022] [Accepted: 08/31/2022] [Indexed: 01/05/2023]
Abstract
As the percentage of the global population over age 65 grows, and with it a subpopulation of individuals with alcohol use disorder (AUD), understanding the effect of alcohol on the aged brain is of utmost importance. Neuroinflammation is implicated in both natural aging as well as alcohol use, and its role in alterations to brain morphology and function may be exacerbated in aging individuals who drink alcohol to excess. The neuroimmune response to alcohol in aging is complex. The few studies investigating this issue have reported heightened basal activity and either hypo- or hyper-reactivity to an alcohol challenge. This review of preclinical research will first introduce key players of the immune system, then explore changes in neuroimmune function with aging or alcohol alone, with discussion of vulnerable brain regions, changes in cytokines, and varied reactions of microglia and astrocytes. We will then consider different levels of alcohol exposure, relevant animal models of AUD, and neuroimmune activation by alcohol across the lifespan. By identifying key findings, challenges, and targets for future research, we hope to bring more attention and resources to this underexplored area of inquiry.
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Affiliation(s)
- Erika R Carlson
- Division of Pharmacology and Toxicology, College of Pharmacy, The University of Texas at Austin, Austin, TX 78712, United States
| | - Steven P Guerin
- Division of Pharmacology and Toxicology, College of Pharmacy, The University of Texas at Austin, Austin, TX 78712, United States
| | - Kimberly Nixon
- Division of Pharmacology and Toxicology, College of Pharmacy, The University of Texas at Austin, Austin, TX 78712, United States
| | - Laura K Fonken
- Division of Pharmacology and Toxicology, College of Pharmacy, The University of Texas at Austin, Austin, TX 78712, United States.
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Pandey AK, Ardekani BA, Byrne KNH, Kamarajan C, Zhang J, Pandey G, Meyers JL, Kinreich S, Chorlian DB, Kuang W, Stimus AT, Porjesz B. Statistical Nonparametric fMRI Maps in the Analysis of Response Inhibition in Abstinent Individuals with History of Alcohol Use Disorder. Behav Sci (Basel) 2022; 12:bs12050121. [PMID: 35621418 PMCID: PMC9137506 DOI: 10.3390/bs12050121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 04/13/2022] [Accepted: 04/14/2022] [Indexed: 11/26/2022] Open
Abstract
Inhibitory impairments may persist after abstinence in individuals with alcohol use disorder (AUD). Using traditional statistical parametric mapping (SPM) fMRI analysis, which requires data to satisfy parametric assumptions often difficult to satisfy in biophysical system as brain, studies have reported equivocal findings on brain areas responsible for response inhibition, and activation abnormalities during inhibition found in AUD persist after abstinence. Research is warranted using newer analysis approaches. fMRI scans were acquired during a Go/NoGo task from 30 abstinent male AUD and 30 healthy control participants with the objectives being (1) to characterize neuronal substrates associated with response inhibition using a rigorous nonparametric permutation-based fMRI analysis and (2) to determine whether these regions were differentially activated between abstinent AUD and control participants. A blood oxygen level dependent contrast analysis showed significant activation in several right cortical regions and deactivation in some left cortical regions during successful inhibition. The largest source of variance in activation level was due to group differences. The findings provide evidence of cortical substrates employed during response inhibition. The largest variance was explained by lower activation in inhibition as well as ventral attentional cortical networks in abstinent individuals with AUD, which were not found to be associated with length of abstinence, age, or impulsiveness.
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Affiliation(s)
- Ashwini Kumar Pandey
- Henri Begleiter Neurodynamics Laboratory, Department of Psychiatry and Behavioral Sciences, SUNY Downstate Health Sciences University, 450 Clarkson Avenue, MSC #1203, Brooklyn, NY 11203, USA; (C.K.); (J.Z.); (G.P.); (J.L.M.); (S.K.); (D.B.C.); (W.K.); (A.T.S.); (B.P.)
- Correspondence:
| | - Babak Assai Ardekani
- Center for Biomedical Imaging and Neuromodulation, The Nathan S. Kline Institute for Psychiatric Research, 140 Old Orangeburg Road, Orangeburg, NY 10962, USA; (B.A.A.); (K.N.-H.B.)
| | - Kelly Nicole-Helen Byrne
- Center for Biomedical Imaging and Neuromodulation, The Nathan S. Kline Institute for Psychiatric Research, 140 Old Orangeburg Road, Orangeburg, NY 10962, USA; (B.A.A.); (K.N.-H.B.)
| | - Chella Kamarajan
- Henri Begleiter Neurodynamics Laboratory, Department of Psychiatry and Behavioral Sciences, SUNY Downstate Health Sciences University, 450 Clarkson Avenue, MSC #1203, Brooklyn, NY 11203, USA; (C.K.); (J.Z.); (G.P.); (J.L.M.); (S.K.); (D.B.C.); (W.K.); (A.T.S.); (B.P.)
| | - Jian Zhang
- Henri Begleiter Neurodynamics Laboratory, Department of Psychiatry and Behavioral Sciences, SUNY Downstate Health Sciences University, 450 Clarkson Avenue, MSC #1203, Brooklyn, NY 11203, USA; (C.K.); (J.Z.); (G.P.); (J.L.M.); (S.K.); (D.B.C.); (W.K.); (A.T.S.); (B.P.)
| | - Gayathri Pandey
- Henri Begleiter Neurodynamics Laboratory, Department of Psychiatry and Behavioral Sciences, SUNY Downstate Health Sciences University, 450 Clarkson Avenue, MSC #1203, Brooklyn, NY 11203, USA; (C.K.); (J.Z.); (G.P.); (J.L.M.); (S.K.); (D.B.C.); (W.K.); (A.T.S.); (B.P.)
| | - Jacquelyn Leigh Meyers
- Henri Begleiter Neurodynamics Laboratory, Department of Psychiatry and Behavioral Sciences, SUNY Downstate Health Sciences University, 450 Clarkson Avenue, MSC #1203, Brooklyn, NY 11203, USA; (C.K.); (J.Z.); (G.P.); (J.L.M.); (S.K.); (D.B.C.); (W.K.); (A.T.S.); (B.P.)
| | - Sivan Kinreich
- Henri Begleiter Neurodynamics Laboratory, Department of Psychiatry and Behavioral Sciences, SUNY Downstate Health Sciences University, 450 Clarkson Avenue, MSC #1203, Brooklyn, NY 11203, USA; (C.K.); (J.Z.); (G.P.); (J.L.M.); (S.K.); (D.B.C.); (W.K.); (A.T.S.); (B.P.)
| | - David Balin Chorlian
- Henri Begleiter Neurodynamics Laboratory, Department of Psychiatry and Behavioral Sciences, SUNY Downstate Health Sciences University, 450 Clarkson Avenue, MSC #1203, Brooklyn, NY 11203, USA; (C.K.); (J.Z.); (G.P.); (J.L.M.); (S.K.); (D.B.C.); (W.K.); (A.T.S.); (B.P.)
| | - Weipeng Kuang
- Henri Begleiter Neurodynamics Laboratory, Department of Psychiatry and Behavioral Sciences, SUNY Downstate Health Sciences University, 450 Clarkson Avenue, MSC #1203, Brooklyn, NY 11203, USA; (C.K.); (J.Z.); (G.P.); (J.L.M.); (S.K.); (D.B.C.); (W.K.); (A.T.S.); (B.P.)
| | - Arthur T. Stimus
- Henri Begleiter Neurodynamics Laboratory, Department of Psychiatry and Behavioral Sciences, SUNY Downstate Health Sciences University, 450 Clarkson Avenue, MSC #1203, Brooklyn, NY 11203, USA; (C.K.); (J.Z.); (G.P.); (J.L.M.); (S.K.); (D.B.C.); (W.K.); (A.T.S.); (B.P.)
| | - Bernice Porjesz
- Henri Begleiter Neurodynamics Laboratory, Department of Psychiatry and Behavioral Sciences, SUNY Downstate Health Sciences University, 450 Clarkson Avenue, MSC #1203, Brooklyn, NY 11203, USA; (C.K.); (J.Z.); (G.P.); (J.L.M.); (S.K.); (D.B.C.); (W.K.); (A.T.S.); (B.P.)
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9
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Cognitive training in recently-abstinent individuals with alcohol use disorder improves emotional stroop performance: Evidence from a randomized pilot trial. Drug Alcohol Depend 2022; 231:109239. [PMID: 34998253 PMCID: PMC9311324 DOI: 10.1016/j.drugalcdep.2021.109239] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 10/19/2021] [Accepted: 11/10/2021] [Indexed: 01/29/2023]
Abstract
BACKGROUND Cognitive training interventions appear capable of improving alcohol-associated neurobehavioral deficits in recently detoxified individuals. However, efficacy remains incompletely characterized in alcohol use disorder (AUD) and available data address only non-affective cognitive outcomes; enhancement of social cognition remains uninvestigated. We utilized a training paradigm in which successfully ignoring emotionally-valent stimuli benefitted task performance. We hypothesized trained individuals would display improvements in an affective inhibitory control task, and that individuals trained with high valence (relative to neutral) stimuli would evince greater improvement. METHODS 42 recently detoxified inpatients with AUD were assigned to one of three groups (Emotional Training, Neutral Training, or Treatment as Usual [TAU]). Training consisted of two computerized working memory tasks (dual-modality n-back task; attend/ignore task) which included task-irrelevant stimuli (emotional vs. neutral). Post-training performance efficiency (indexing speed-accuracy tradeoffs) in an emotional Stroop task was the outcome of interest. RESULTS Significant group by time interactions were detected for emotional Stroop performance, supporting our hypothesis that trained groups would exhibit greater improvement than TAU controls (F[2,39]=8.61, p < .01). Additionally, the emotional training condition appeared to result in greater improvement relative to neutral training (F[1,26]=4.98, p < .01). CONCLUSION Results are consistent with current literature suggesting the potential of training to enhance cognitive recovery in early abstinence. Findings inform the development of training protocols, suggesting integration of task-irrelevant distractor stimuli in training may enhance cognitive control outcomes. Further, they expand the relevant domains for application of training approaches, providing novel evidence that among individuals with AUD, training-associated benefits may extend to social cognitive domains.
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10
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Yuwono NL, Warton K, Ford CE. The influence of biological and lifestyle factors on circulating cell-free DNA in blood plasma. eLife 2021; 10:e69679. [PMID: 34752217 PMCID: PMC8577835 DOI: 10.7554/elife.69679] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 10/23/2021] [Indexed: 01/02/2023] Open
Abstract
Research and clinical use of circulating cell-free DNA (cirDNA) is expanding rapidly; however, there remain large gaps in our understanding of the influence of lifestyle and biological factors on the amount of cirDNA present in blood. Here, we review 66 individual studies of cirDNA levels and lifestyle and biological factors, including exercise (acute and chronic), alcohol consumption, occupational hazard exposure, smoking, body mass index, menstruation, hypertension, circadian rhythm, stress, biological sex and age. Despite technical and methodological inconsistences across studies, we identify acute exercise as a significant influence on cirDNA levels. Given the large increase in cirDNA induced by acute exercise, we recommend that controlling for physical activity prior to blood collection is routinely incorporated into study design when total cirDNA levels are of interest. We also highlight appropriate selection and complete reporting of laboratory protocols as important for improving the reproducibility cirDNA studies and ability to critically evaluate the results.
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Affiliation(s)
- Nicole Laurencia Yuwono
- Gynaecological Cancer Research Group, Adult Cancer Program, Lowy Cancer Research Centre, Department of Obstetrics & Gynaecology, School of Women's and Children's Health, Faculty of Medicine & Health, University of New South WalesSydneyAustralia
| | - Kristina Warton
- Gynaecological Cancer Research Group, Adult Cancer Program, Lowy Cancer Research Centre, Department of Obstetrics & Gynaecology, School of Women's and Children's Health, Faculty of Medicine & Health, University of New South WalesSydneyAustralia
| | - Caroline Elizabeth Ford
- Gynaecological Cancer Research Group, Adult Cancer Program, Lowy Cancer Research Centre, Department of Obstetrics & Gynaecology, School of Women's and Children's Health, Faculty of Medicine & Health, University of New South WalesSydneyAustralia
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11
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Bryant VE, Britton MK, Gullett JM, Porges EC, Woods AJ, Cook RL, Williamson J, Ennis N, Bryant KJ, Bradley C, Cohen RA. Reduced Working Memory is Associated with Heavier Alcohol Consumption History, Role Impairment and Executive Function Difficulties. AIDS Behav 2021; 25:2720-2727. [PMID: 33550519 PMCID: PMC8935631 DOI: 10.1007/s10461-021-03170-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/16/2021] [Indexed: 12/14/2022]
Abstract
Both HIV status and heavy alcohol use have been associated with reduced cognitive function, particularly in the domains of working memory and executive function. It is unclear what aspects of working memory and executive function are associated with HIV status and heavy alcohol use and whether performance on these measures are associated with functional impairment. We examined the relationship between HIV, history of heavy alcohol consumption, and HIV/alcohol interaction on speeded tests of frontal inhibitory abilities, a working memory task related to mental manipulation of letters and numbers, cognitive flexibility, and measures of functional impairment. Study participants included 284 individuals (151 HIV +) recruited from two different studies focusing on HIV associated brain dysfunction, one specific to the effects of alcohol, the other specific to the effects of aging. HIV status was not independently associated with working memory and executive function measures. Higher level of alcohol consumption was associated with reduced performance on Letter Number Sequencing. Poorer Letter Number Sequencing performance was associated with role impairment (an inability to do certain kinds of work, housework, or schoolwork) and executive function difficulties. Future studies should examine causal associations and interventions targeting working memory abilities.
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Affiliation(s)
- Vaughn E Bryant
- Department of Epidemiology, University of Florida, Emerging Pathogens Institute, 2055 Mowry Road, P.O. Box 100009, Gainesville, FL, 32610, USA.
- Department of Clinical and Health Psychology, University of Florida, Center for Cognitive Aging and Memory, Cognitive Aging and Memory Clinical Translational Research Program, 1225 Center Drive, Gainesville, FL, 32607, USA.
| | - Mark K Britton
- Department of Clinical and Health Psychology, University of Florida, Center for Cognitive Aging and Memory, Cognitive Aging and Memory Clinical Translational Research Program, 1225 Center Drive, Gainesville, FL, 32607, USA
| | - Joseph M Gullett
- Department of Clinical and Health Psychology, University of Florida, Center for Cognitive Aging and Memory, Cognitive Aging and Memory Clinical Translational Research Program, 1225 Center Drive, Gainesville, FL, 32607, USA
| | - Eric C Porges
- Department of Clinical and Health Psychology, University of Florida, Center for Cognitive Aging and Memory, Cognitive Aging and Memory Clinical Translational Research Program, 1225 Center Drive, Gainesville, FL, 32607, USA
| | - Adam J Woods
- Department of Clinical and Health Psychology, University of Florida, Center for Cognitive Aging and Memory, Cognitive Aging and Memory Clinical Translational Research Program, 1225 Center Drive, Gainesville, FL, 32607, USA
| | - Robert L Cook
- Department of Epidemiology, University of Florida, Emerging Pathogens Institute, 2055 Mowry Road, P.O. Box 100009, Gainesville, FL, 32610, USA
| | - John Williamson
- Department of Clinical and Health Psychology, University of Florida, Center for Cognitive Aging and Memory, Cognitive Aging and Memory Clinical Translational Research Program, 1225 Center Drive, Gainesville, FL, 32607, USA
| | - Nicole Ennis
- Department of Behavioral Sciences and Social Medicine, Florida State University, 2010 Levy Ave, Suite 254, Tallahassee, FL, 32310, USA
| | - Kendall J Bryant
- National Institute of Alcohol Abuse and Alcoholism, 6700B Rockledge Drive, Bethesda, MD, 20892-6902, USA
| | - Carolyn Bradley
- Department of Epidemiology, University of Florida, Emerging Pathogens Institute, 2055 Mowry Road, P.O. Box 100009, Gainesville, FL, 32610, USA
| | - Ronald A Cohen
- Department of Clinical and Health Psychology, University of Florida, Center for Cognitive Aging and Memory, Cognitive Aging and Memory Clinical Translational Research Program, 1225 Center Drive, Gainesville, FL, 32607, USA
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12
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Dannenhoffer CA, Robertson MM, Macht VA, Mooney SM, Boettiger CA, Robinson DL. Chronic alcohol exposure during critical developmental periods differentially impacts persistence of deficits in cognitive flexibility and related circuitry. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2021; 160:117-173. [PMID: 34696872 DOI: 10.1016/bs.irn.2021.07.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Cognitive flexibility in decision making depends on prefrontal cortical function and is used by individuals to adapt to environmental changes in circumstances. Cognitive flexibility can be measured in the laboratory using a variety of discrete, translational tasks, including those that involve reversal learning and/or set-shifting ability. Distinct components of flexible behavior rely upon overlapping brain circuits, including different prefrontal substructures that have separable impacts on decision making. Cognitive flexibility is impaired after chronic alcohol exposure, particularly during development when the brain undergoes rapid maturation. This review examines how cognitive flexibility, as indexed by reversal and set-shifting tasks, is impacted by chronic alcohol exposure in adulthood, adolescent, and prenatal periods in humans and animal models. We also discuss areas for future study, including mechanisms that may contribute to the persistence of cognitive deficits after developmental alcohol exposure and the compacting consequences from exposure across multiple critical periods.
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Affiliation(s)
- C A Dannenhoffer
- Bowles Center for Alcohol Studies, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - M M Robertson
- Department of Psychology and Neuroscience, University of North Carolina, Chapel Hill, NC, United States
| | - Victoria A Macht
- Bowles Center for Alcohol Studies, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - S M Mooney
- Nutrition Research Institute and Department of Nutrition, University of North Carolina, Chapel Hill, NC, United States
| | - C A Boettiger
- Bowles Center for Alcohol Studies, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States; Department of Psychology and Neuroscience, University of North Carolina, Chapel Hill, NC, United States; Neuroscience Curriculum, University of North Carolina, Chapel Hill, NC, United States; Biomedical Research Imaging Center, University of North Carolina, Chapel Hill, NC, United States
| | - Donita L Robinson
- Bowles Center for Alcohol Studies, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States; Department of Psychiatry, University of North Carolina, Chapel Hill, NC, United States; Neuroscience Curriculum, University of North Carolina, Chapel Hill, NC, United States.
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13
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Decreased information processing speed and decision-making performance in alcohol use disorder: combined neurostructural evidence from VBM and TBSS. Brain Imaging Behav 2021; 15:205-215. [PMID: 32124275 DOI: 10.1007/s11682-019-00248-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Alcohol Use Disorder (AUD) is a chronic relapsing condition characterized by excessive alcohol consumption despite its multifaceted adverse consequences, associated with impaired performance in several cognitive domains including decision-making. While choice deficits represent a core component of addictive behavior, possibly consecutive to brain changes preceding the onset of the addiction cycle, the evidence on grey-matter and white-matter damage underlying abnormal choices in AUD is still limited. To fill this gap, we assessed the neurostructural bases of decision-making performance in 22 early-abstinent alcoholic patients and 18 controls, by coupling the Cambridge Gambling Task (CGT) with quantitative magnetic resonance imaging metrics of grey-matter density and white-matter integrity. Regardless of group, voxel based morphometry highlighted an inverse relationship between deliberation time and grey-matter density, with alcoholics displaying slower choices related to grey-matter atrophy in key nodes of the motor control network. In particular, grey-matter density in the supplementary motor area, reduced in alcoholic patients, explained a significant amount of variability in their increased deliberation time. Tract-based spatial statistics revealed a significant relationship between CGT deliberation time and all white-matter indices, involving the most relevant commissural, projection and associative tracts. The lack of choice impairments other than increased deliberation time highlights reduced processing speed, mediated both by grey-matter and white-matter alterations, as a possible marker of a generalized executive impairment extending to the output stages of decision-making. These results pave the way to further studies aiming to tailor novel rehabilitation strategies and assess their functional outcomes.
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14
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Visuoperceptive Impairments in Severe Alcohol Use Disorder: A Critical Review of Behavioral Studies. Neuropsychol Rev 2021; 31:361-384. [PMID: 33591477 DOI: 10.1007/s11065-020-09469-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Accepted: 11/29/2020] [Indexed: 01/13/2023]
Abstract
The present literature review is aimed at offering a comprehensive and critical view of behavioral data collected during the past seventy years concerning visuoperception in severe alcohol use disorders (AUD). To pave the way for a renewal of research and clinical approaches in this very little understood field, this paper (1) provides a critical review of previous behavioral studies exploring visuoperceptive processing in severe AUD, (2) identifies the alcohol-related parameters and demographic factors that influence the deficits, and (3) addresses the limitations of this literature and their implications for current clinical strategies. By doing so, this review highlights the presence of visuoperceptive deficits but also shows how the lack of in-depth studies exploring the visual system in this clinical population results in the current absence of integration of these deficits in the dominant models of vision. Given the predominance of vision in everyday life, we stress the need to better delineate the extent, the specificity, and the actual implications of the deficits for severe AUD.
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15
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Creupelandt C, D'Hondt F, Maurage P. Neural correlates of visuoperceptive changes in severe alcohol use disorder: A critical review of neuroimaging and electrophysiological findings. J Neurosci Res 2021; 99:1253-1275. [PMID: 33550638 DOI: 10.1002/jnr.24799] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 01/04/2021] [Accepted: 01/06/2021] [Indexed: 01/04/2023]
Abstract
Visuoperceptive deficits are frequently reported in severe alcohol use disorder (SAUD) and are considered as pervasive and persistent in time. While this topic of investigation has previously driven researchers' interest, far fewer studies have focused on visuoperception in SAUD since the '90s, leaving open central questions regarding the origin and implications of these deficits. To renew research in the field and provide a solid background to work upon, this paper reviews the neural correlates of visuoperception in SAUD, based on data from neuroimaging and electrophysiological studies. Results reveal structural and functional changes within the visual system but also in the connections between occipital and frontal areas. We highlight the lack of integration of these findings in the dominant models of vision which stress the dynamic nature of the visual system and consider the presence of both bottom-up and top-down cerebral mechanisms. Visuoperceptive changes are also discussed in the framework of long-lasting debates regarding the influence of demographic and alcohol-related factors, together stressing the presence of inter-individual differences. Capitalizing on this review, we provide guidelines to inform future research, and ultimately improve clinical care.
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Affiliation(s)
- Coralie Creupelandt
- Louvain Experimental Psychopathology Research Group (UCLEP), Faculté de Psychologie, Psychological Sciences Research Institute (IPSY), UCLouvain, Louvain-la-Neuve, Belgium
| | - Fabien D'Hondt
- Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Lille, France.,CHU Lille, Clinique de Psychiatrie, CURE, Lille, France.,Centre National de Ressources et de Résilience Lille-Paris (CN2R), Lille, France
| | - Pierre Maurage
- Louvain Experimental Psychopathology Research Group (UCLEP), Faculté de Psychologie, Psychological Sciences Research Institute (IPSY), UCLouvain, Louvain-la-Neuve, Belgium
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16
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Creupelandt C, Maurage P, Lenoble Q, Lambot C, Geus C, D'Hondt F. Magnocellular and Parvocellular Mediated Luminance Contrast Discrimination in Severe Alcohol Use Disorder. Alcohol Clin Exp Res 2021; 45:375-385. [PMID: 33349930 DOI: 10.1111/acer.14541] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 12/17/2020] [Accepted: 12/17/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Severe alcohol use disorder (SAUD) is associated with widespread cognitive impairments, including low-level visual processing deficits that persist after prolonged abstinence. However, the extent and characteristics of these visual deficits remain largely undetermined, impeding the identification of their underlying mechanisms and influence on higher-order processing. In particular, little work has been conducted to assess the integrity of the magnocellular (MC) and parvocellular (PC) visual pathways, namely the 2 main visual streams that convey information from the retina up to striate, extrastriate, and dorsal/ventral cerebral regions. METHODS We investigated achromatic luminance contrast processing mediated by inferred MC and PC pathways in 33 patients with SAUD and 32 matched healthy controls using 2 psychophysical pedestal contrast discrimination tasks that promote responses of inferred MC or PC pathways. We relied on a staircase procedure to assess participants' ability to detect small changes in luminance within an array of 4 gray squares that were either continuously presented (steady pedestal, MC-biased) or briefly flashed (pulsed pedestal, PC-biased). RESULTS We replicated the expected pattern of MC and PC contrast responses in healthy controls. We found preserved dissociation of MC and PC contrast signatures in SAUD but higher MC-mediated mean contrast discrimination thresholds combined with a steeper PC-mediated contrast discrimination slope compared with healthy controls. CONCLUSION These findings indicate altered MC-mediated contrast sensitivity and PC-mediated contrast gain, confirming the presence of early sensory disturbances in individuals with SAUD. Such low-level deficits, while usually overlooked, might influence higher-order abilities (e.g., memory, executive functions) in SAUD by disturbing the "coarse-to-fine" tuning of the visual system, which relies on the distinct functional properties of MC and PC pathways and ensures proper and efficient monitoring of the environment.
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Affiliation(s)
- Coralie Creupelandt
- Louvain Experimental Psychopathology Research Group (UCLEP), Psychological Sciences Research Institute (IPSY), UCLouvain, Louvain-la-Neuve, Belgium
| | - Pierre Maurage
- Louvain Experimental Psychopathology Research Group (UCLEP), Psychological Sciences Research Institute (IPSY), UCLouvain, Louvain-la-Neuve, Belgium
| | - Quentin Lenoble
- Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Lille, France
| | - Carine Lambot
- Clinique Regina Pacis, Le Beau Vallon, Saint-Servais, Belgium
| | - Christophe Geus
- Psychiatry Unit, Clinique Saint Pierre Ottignies, Ottignies, Belgium
| | - Fabien D'Hondt
- Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Lille, France.,CHU Lille, Clinique de Psychiatrie, CURE, Lille, France.,Centre National de Ressources et de Résilience Lille-Paris (CN2R), Lille, France
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17
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The contribution of mamillary body damage to Wernicke's encephalopathy and Korsakoff's syndrome. HANDBOOK OF CLINICAL NEUROLOGY 2021; 180:455-475. [PMID: 34225949 DOI: 10.1016/b978-0-12-820107-7.00029-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Histopathological alterations of the mamillary bodies are the most conspicuous and the most consistent neuropathological features of several disorders that occur after severe thiamine deficiency, such as Wernicke's encephalopathy and Korsakoff's syndrome. Moreover, they are among the few abnormalities that are visible to the naked eye in these disorders. With a lifetime prevalence of approximately 1.3%, Wernicke's encephalopathy is by far the most frequent cause of damage to the mamillary bodies in humans. Still, there is a persisting uncertainty with regard to the development and the clinical consequences of this damage, because it is virtually impossible to study in isolation. As a rule, it always occurs alongside neuropathology in other subcortical gray matter structures, notably the medial thalamus. Converging evidence from other pathologies and animal experiments is needed to assess the clinical impact of mamillary body damage and to determine which functions can be attributed to these structures in healthy subjects. In this chapter, we describe the history and the current state of knowledge with regard to thiamine deficiency disorders and the contribution of mamillary body damage to their clinical presentations.
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18
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Melugin PR, Nolan SO, Siciliano CA. Bidirectional causality between addiction and cognitive deficits. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2020; 157:371-407. [PMID: 33648674 PMCID: PMC8566632 DOI: 10.1016/bs.irn.2020.11.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Cognitive deficits are highly comorbid with substance use disorders. Deficits span multiple cognitive domains, are associated with disease severity across substance classes, and persist long after cessation of substance use. Furthermore, recovery of cognitive function during protracted abstinence is highly predictive of treatment adherence, relapse, and overall substance use disorder prognosis, suggesting that addiction may be best characterized as a disease of executive dysfunction. While the association between cognitive deficits and substance use disorders is clear, determining causalities is made difficult by the complex interplay between these variables. Cognitive dysfunction present prior to first drug use can act as a risk factor for substance use initiation, likelihood of pathology, and disease trajectory. At the same time, substance use can directly cause cognitive impairments even in individuals without preexisting deficits. Thus, parsing preexisting risk factors from substance-induced adaptations, and how they may interact, poses significant challenges. Here, focusing on psychostimulants and alcohol, we review evidence from clinical literature implicating cognitive deficits as a risk factor for addiction, a consequence of substance use, and the role the prefrontal cortex plays in these phenomena. We then review corresponding preclinical literature, highlighting the high degree of congruency between animal and human studies, and emphasize the unique opportunity that animal models provide to test causality between cognitive phenotypes and substance use, and to investigate the underlying neurobiology at a cellular and molecular level. Together, we provide an accessible resource for assessing the validity and utility of forward- and reverse-translation between these clinical and preclinical literatures.
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Affiliation(s)
- Patrick R Melugin
- Department of Pharmacology, Vanderbilt Brain Institute, Vanderbilt Center for Addiction Research, Vanderbilt University, Nashville, TN, United States
| | - Suzanne O Nolan
- Department of Pharmacology, Vanderbilt Brain Institute, Vanderbilt Center for Addiction Research, Vanderbilt University, Nashville, TN, United States
| | - Cody A Siciliano
- Department of Pharmacology, Vanderbilt Brain Institute, Vanderbilt Center for Addiction Research, Vanderbilt University, Nashville, TN, United States.
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19
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Gaillard A, Fehring DJ, Rossell SL. A systematic review and meta-analysis of behavioural sex differences in executive control. Eur J Neurosci 2020; 53:519-542. [PMID: 32844505 DOI: 10.1111/ejn.14946] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 07/28/2020] [Accepted: 08/14/2020] [Indexed: 12/24/2022]
Abstract
Literature investigating whether an individuals' sex affects their executive control abilities and performance on cognitive tasks in a normative population has been contradictory and inconclusive. Using meta-analytic procedures (abiding by PRISMA guidelines), this study attempts to identify the magnitude of behavioural sex differences in three prominent executive control domains of cognitive set-shifting, performance monitoring, and response inhibition. PubMed, Web of Science, and Scopus were systematically searched. Across 46 included studies, a total of 1988 females and 1884 males were included in the analysis. Overall, males and females did not differ on performance in any of the three domains of performance monitoring, response inhibition, or cognitive set-shifting. Task-specific sex differences were observed in the domains of performance monitoring, in the CANTAB Spatial Working Memory task-males scored statistically higher than females (Hedges' g = -0.60), and response inhibition, in the Delay Discounting task-females scored statistically higher than males (Hedges' g = 0.64). While the meta-analysis did not detect overall behavioural sex differences in executive control, significant heterogeneity and task-specific sex differences were found. To further understand sex differences within these specific tasks and domains, future research must better control for age and sex hormone levels.
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Affiliation(s)
- Alexandra Gaillard
- Centre for Mental Health, Faculty of Health, Arts and Design, Swinburne University of Technology, Hawthorn, VIC, Australia
| | - Daniel J Fehring
- Cognitive Neuroscience Laboratory, Monash Biomedicine Discovery Institute, Department of Physiology, Monash University, Clayton, VIC, Australia.,ARC Centre of Excellence in Integrative Brain Function, Monash University, Clayton, VIC, Australia
| | - Susan L Rossell
- Centre for Mental Health, Faculty of Health, Arts and Design, Swinburne University of Technology, Hawthorn, VIC, Australia.,Psychiatry, St Vincent's Hospital, Melbourne, VIC, Australia
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20
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Sawyer KS, Adra N, Salz DM, Kemppainen MI, Ruiz SM, Harris GJ, Oscar-Berman M. Hippocampal subfield volumes in abstinent men and women with a history of alcohol use disorder. PLoS One 2020; 15:e0236641. [PMID: 32776986 PMCID: PMC7416961 DOI: 10.1371/journal.pone.0236641] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Accepted: 07/10/2020] [Indexed: 12/05/2022] Open
Abstract
Alcohol Use Disorder (AUD) has been associated with abnormalities in hippocampal volumes, but these relationships have not been fully explored with respect to sub-regional volumes, nor in association with individual characteristics such as age, gender differences, drinking history, and memory. The present study examined the impact of those variables in relation to hippocampal subfield volumes in abstinent men and women with a history of AUD. Using Magnetic Resonance Imaging at 3 Tesla, we obtained brain images from 67 participants with AUD (31 women) and 64 nonalcoholic control (NC) participants (31 women). The average duration of the most recent period of sobriety for AUD participants was 7.1 years. We used Freesurfer 6.0 to segment the hippocampus into 12 regions. These were imputed into statistical models to examine the relationships of brain volume with AUD group, age, gender, memory, and drinking history. Interactions with gender and age were of particular interest. Compared to the NC group, the AUD group had approximately 5% smaller subiculum, CA1, molecular layer, and hippocampal tail regions. Age was negatively associated with volumes for the AUD group in the subiculum and the hippocampal tail, but no significant interactions with gender were identified. The relationships for delayed and immediate memory with hippocampal tail volume differed for AUD and NC groups: Higher scores on tests of immediate and delayed memory were associated with smaller volumes in the AUD group, but larger volumes in the NC group. Length of sobriety was associated with decreasing CA1 volume in women (0.19% per year) and increasing volume size in men (0.38% per year). The course of abstinence on CA1 volume differed for men and women, and the differential relationships of subfield volumes to age and memory could indicate a distinction in the impact of AUD on functions of the hippocampal tail. These findings confirm and extend evidence that AUD, age, gender, memory, and abstinence differentially impact volumes of component parts of the hippocampus.
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Affiliation(s)
- Kayle S. Sawyer
- VA Boston Healthcare System, Boston, MA, United States of America
- Boston University School of Medicine, Boston, MA, United States of America
- Massachusetts General Hospital, Boston, MA, United States of America
- Sawyer Scientific, LLC, Boston, MA, United States of America
| | - Noor Adra
- VA Boston Healthcare System, Boston, MA, United States of America
- Massachusetts General Hospital, Boston, MA, United States of America
| | - Daniel M. Salz
- VA Boston Healthcare System, Boston, MA, United States of America
- Boston University School of Medicine, Boston, MA, United States of America
- Massachusetts General Hospital, Boston, MA, United States of America
| | - Maaria I. Kemppainen
- VA Boston Healthcare System, Boston, MA, United States of America
- Boston University School of Medicine, Boston, MA, United States of America
- Massachusetts General Hospital, Boston, MA, United States of America
| | - Susan M. Ruiz
- VA Boston Healthcare System, Boston, MA, United States of America
- Boston University School of Medicine, Boston, MA, United States of America
- Massachusetts General Hospital, Boston, MA, United States of America
| | - Gordon J. Harris
- Boston University School of Medicine, Boston, MA, United States of America
- Massachusetts General Hospital, Boston, MA, United States of America
- Harvard Medical School, Boston, MA, United States of America
| | - Marlene Oscar-Berman
- VA Boston Healthcare System, Boston, MA, United States of America
- Boston University School of Medicine, Boston, MA, United States of America
- Massachusetts General Hospital, Boston, MA, United States of America
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21
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Maillard A, Poussier H, Boudehent C, Lannuzel C, Vicente A, Vabret F, Cabe N, Pitel AL. Short-term neuropsychological recovery in alcohol use disorder: A retrospective clinical study. Addict Behav 2020; 105:106350. [PMID: 32070907 DOI: 10.1016/j.addbeh.2020.106350] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 02/04/2020] [Accepted: 02/07/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND Neuropsychological impairments found in recently detoxified patients with alcohol use disorder (AUD) can limit the benefit of psychosocial treatments and increase the risk of relapse. These neuropsychological deficits are reversible with abstinence. The aim of this retrospective clinical study was to investigate whether a short-term stay as inpatients in a convalescent home enables neuropsychological deficits observed in recently detoxified AUD patients to recover and even performance to return to normal. METHODS Neuropsychological data were collected in 84 AUD patients. Five neuropsychological components were assessed before and after a three-week stay in a convalescent home offering multidisciplinary support. Baseline and follow-up performance were compared in the entire group of patients and in subgroups defined by the nature and intensity of the therapy (OCCASIONAL: occasional occupational and physical therapy; INTENSIVE: intensive occupational and physical therapy and neuropsychological training). RESULTS In the entire group of patients, neuropsychological performance significantly improved between baseline and follow-up for all 5 components and even returned to a normal level for 4 of them. The ratio of patients with impaired performance was significantly lower at follow-up than baseline examination for 3 components in the INTENSIVE group only. CONCLUSION Recently detoxified AUD patients with cognitive deficits benefit from a short-term stay in an environment ensuring sobriety and healthy nutrition. Cognitive recovery may be enhanced by intensive care including neuropsychological training. Alcohol programs could be postponed in patients with cognitive deficits in order to offer psychosocial treatment when patients are cognitively able to benefit from it.
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22
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ZHAO FY, XU Y, YUE LP, CHEN FL, ZHANG ZY, SONG HL, XU H, WANG GH, FU QQ. Escitalopram with or without combined electroacupuncture on protracted alcohol withdrawal symptoms (PAWS) among male inpatients with alcohol dependence. WORLD JOURNAL OF ACUPUNCTURE-MOXIBUSTION 2020. [DOI: 10.1016/j.wjam.2020.05.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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23
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Lew BJ, Wiesman AI, Rezich MT, Wilson TW. Altered neural dynamics in occipital cortices serving visual-spatial processing in heavy alcohol users. J Psychopharmacol 2020; 34:245-253. [PMID: 31331222 PMCID: PMC7238290 DOI: 10.1177/0269881119863120] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
BACKGROUND Visual-spatial processing deficits have been previously linked to heavy alcohol use, but the underlying neurological mechanisms are poorly understood. Neuroimaging studies have shown alcohol-related aberrations in occipital cortices that appear to be associated with these neuropsychological deficits in visual-spatial processing, however the neural dynamics underlying this altered processing remains unknown. METHODS Twenty-three adults with high scores on the Alcohol Use Disorders Identification Test - Consumption (male: ⩾5, female: ⩾4) were compared to 30 demographically-matched controls with low Alcohol Use Disorders Identification Test - Consumption scores (⩽2). All participants completed a visual-spatial processing task while undergoing high-density magnetoencephalography. Time-frequency windows of interest were determined using a data-driven method, and spectrally-specific neural activity was imaged using a beamforming approach. Permutation testing of peak voxel time series was then used to statistically compare across groups. RESULTS Participants with heavy alcohol use responded slower on the task and their performance was more variable. The magnetoencephalography data indicated strong theta (4-8 Hz), alpha (10-16 Hz), and gamma (62-72 Hz) responses in posterior brain regions across both groups. Following voxel time-series extraction, significant group differences were found in the left and right visual association cortices from about 375-550 ms post-stimulus, such that adults with heavy alcohol use had blunted alpha responses compared to controls. CONCLUSION Individuals with heavy alcohol use exhibited aberrant occipital alpha activity during visual-spatial processing. These data are the first to show spectrally-specific differences during visual-spatial processing related to heavy alcohol use, and highlight alcohol's effect on systems-level neural activity.
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Affiliation(s)
- Brandon J Lew
- Department of Neurological Sciences, University of Nebraska Medical Center, Omaha, NE, USA
| | - Alex I Wiesman
- Department of Neurological Sciences, University of Nebraska Medical Center, Omaha, NE, USA
| | - Michael T Rezich
- Department of Neurological Sciences, University of Nebraska Medical Center, Omaha, NE, USA
| | - Tony W Wilson
- Department of Neurological Sciences, University of Nebraska Medical Center, Omaha, NE, USA
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Caneva S, Ottonello M, Torselli E, Pistarini C, Spigno P, Fiabane E. Cognitive Impairments in Early-Detoxified Alcohol-Dependent Inpatients and Their Associations with Socio-Demographic, Clinical and Psychological Factors: An Exploratory Study. Neuropsychiatr Dis Treat 2020; 16:1705-1716. [PMID: 32764946 PMCID: PMC7369414 DOI: 10.2147/ndt.s254369] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Accepted: 05/20/2020] [Indexed: 12/19/2022] Open
Abstract
PURPOSE Cognitive impairment is common among patients with alcohol use disorder (AUD). However, neuropsychological assessment is not usually included as routine practice in alcohol rehabilitation programs. The aim of this study was to describe qualitatively the cognitive deficits in early-detoxified AUD patients undergoing rehabilitation and to explore relevant associations with socio-demographic, clinical and psychological factors. PATIENTS AND METHODS Forty-one patients with a diagnosis of AUD were consecutively recruited from a residential rehabilitation hospital in Northern Italy. Cognitive impairment was assessed using the Brief Neuropsychological Examination 2 (ENB-2). Anxiety, depression and severity of alcohol dependence were also evaluated using validated self-report questionnaires. Alcohol relapse was investigated 1 month after discharge. RESULTS Overall, 31.7% of AUD patients showed cognitive impairments according to the global score scale. However, 70.7% had an impaired performance on at least one test of the ENB-2, with particular regard to executive function, visuospatial and memory domains. Age, education and abstinence at admission were the most relevant factors associated with cognitive deficits in this clinical population. CONCLUSION The detection of cognitive impairments is essential in order to adapt alcohol rehabilitation treatment to patients with cognitive deficits and enhance clinical outcomes.
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Affiliation(s)
- Stefano Caneva
- Department of Physical and Rehabilitation Medicine, ICS Maugeri Spa SB, Institute of Genoa Nervi, Genoa, Italy
| | - Marcella Ottonello
- Department of Physical and Rehabilitation Medicine, ICS Maugeri Spa SB, Institute of Genoa Nervi, Genoa, Italy
| | - Elisa Torselli
- Department of Physical and Rehabilitation Medicine, ICS Maugeri Spa SB, Institute of Genoa Nervi, Genoa, Italy.,Miller Institute for Behavioral and Cognitive Therapy, Genoa, Italy
| | - Caterina Pistarini
- Department of Physical and Rehabilitation Medicine, ICS Maugeri Spa SB, Scientific Institute of Pavia, Genoa, Italy
| | - Paola Spigno
- Department of Physical and Rehabilitation Medicine, ICS Maugeri Spa SB, Institute of Genoa Nervi, Genoa, Italy
| | - Elena Fiabane
- Department of Physical and Rehabilitation Medicine, ICS Maugeri Spa SB, Institute of Genoa Nervi, Genoa, Italy.,Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
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25
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Nixon SJ, Lewis B. Cognitive training as a component of treatment of alcohol use disorder: A review. Neuropsychology 2019; 33:822-841. [PMID: 31448949 DOI: 10.1037/neu0000575] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
OBJECTIVE Cognitive training is an effective means of improving performance in a range of populations. Whether it may serve to facilitate cognitive recovery and longer-term outcomes in persons with alcohol use disorders (AUDs) is unclear. Here, we review historical and current literature and offer perspectives for model development and potential implementation. METHOD We considered a large literature regarding the nature of alcohol-related compromise, early efforts to clarify the nature of recovery and current models and methods underlying cognitive training paradigms. We then constructed a narrative review demonstrating evolving frameworks and empirical data informing the critical review of cognitive training methods as a means of mitigating compromise and facilitating functional outcomes. RESULTS Cognitive improvement with abstinence is generally noted, but training protocols may enhance performance and generalize benefit to untrained, but highly similar, tasks. Transfer of training to dissimilar tasks and functional outcomes is uncommonly reported. It is noteworthy that some work suggests that clinician ratings for participants are improved. Inconsistency in sample characteristics, training protocols, and outcome measures constrain general conclusions while suggesting opportunities for study and development. CONCLUSIONS Cognitive training protocols have shown benefit in a variety of populations but have been examined infrequently in persons with AUDs. This overview indicates significant opportunity for cognitive improvement and recovery and thus a strong potential role for training protocols. However, supportive data are not robustly obtained. We suggest that one step in bridging this gap is the implementation of a conceptual framework incorporating contextual, behavioral, and neurobiological variables. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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26
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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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27
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Nunes PT, Kipp BT, Reitz NL, Savage LM. Aging with alcohol-related brain damage: Critical brain circuits associated with cognitive dysfunction. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2019; 148:101-168. [PMID: 31733663 PMCID: PMC7372724 DOI: 10.1016/bs.irn.2019.09.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Alcoholism is associated with brain damage and impaired cognitive functioning. The relative contributions of different etiological factors, such as alcohol, thiamine deficiency and age vulnerability, to the development of alcohol-related neuropathology and cognitive impairment are still poorly understood. One reason for this quandary is that both alcohol toxicity and thiamine deficiency produce brain damage and cognitive problems that can be modulated by age at exposure, aging following alcohol toxicity or thiamine deficiency, and aging during chronic alcohol exposure. Pre-clinical models of alcohol-related brain damage (ARBD) have elucidated some of the contributions of ethanol toxicity and thiamine deficiency to neuroinflammation, neuronal loss and functional deficits. However, the critical variable of age at the time of exposure or long-term aging with ARBD has been relatively ignored. Acute thiamine deficiency created a massive increase in neuroimmune genes and proteins within the thalamus and significant increases within the hippocampus and frontal cortex. Chronic ethanol treatment throughout adulthood produced very minor fluctuations in neuroimmune genes, regardless of brain region. Intermittent "binge-type" ethanol during the adolescent period established an intermediate neuroinflammatory response in the hippocampus and frontal cortex, that can persist into adulthood. Chronic excessive drinking throughout adulthood, adolescent intermittent ethanol exposure, and thiamine deficiency all led to a loss of the cholinergic neuronal phenotype within the basal forebrain, reduced hippocampal neurogenesis, and alterations in the frontal cortex. Only thiamine deficiency results in gross pathological lesions of the thalamus. The behavioral impairment following these types of treatments is hierarchical: Thiamine deficiency produces the greatest impairment of hippocampal- and prefrontal-dependent behaviors, chronic ethanol drinking ensues mild impairments on both types of tasks and adolescent intermittent ethanol exposure leads to impairments on frontocortical tasks, with sparing on most hippocampal-dependent tasks. However, our preliminary data suggest that as rodents age following adolescent intermittent ethanol exposure, hippocampal functional deficits began to emerge. A necessary requirement for the advancement of understanding the neural consequences of alcoholism is a more comprehensive assessment and understanding of how excessive alcohol drinking at different development periods (adolescence, early adulthood, middle-aged and aged) influences the trajectory of the aging process, including pathological aging and disease.
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Affiliation(s)
- Polliana Toledo Nunes
- Developmental Exposure Alcohol Research Center, Behavioral Neuroscience Program, Department of Psychology, Binghamton University, State University of New York, Binghamton, NY, United States
| | - Brian T Kipp
- Developmental Exposure Alcohol Research Center, Behavioral Neuroscience Program, Department of Psychology, Binghamton University, State University of New York, Binghamton, NY, United States
| | - Nicole L Reitz
- Developmental Exposure Alcohol Research Center, Behavioral Neuroscience Program, Department of Psychology, Binghamton University, State University of New York, Binghamton, NY, United States
| | - Lisa M Savage
- Developmental Exposure Alcohol Research Center, Behavioral Neuroscience Program, Department of Psychology, Binghamton University, State University of New York, Binghamton, NY, United States.
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28
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Creupelandt C, D'Hondt F, Maurage P. Towards a Dynamic Exploration of Vision, Cognition and Emotion in Alcohol-Use Disorders. Curr Neuropharmacol 2019; 17:492-506. [PMID: 30152285 PMCID: PMC6712295 DOI: 10.2174/1570159x16666180828100441] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Revised: 07/30/2018] [Accepted: 08/17/2018] [Indexed: 11/23/2022] Open
Abstract
Abstract: Visuoperceptive impairments are among the most frequently reported deficits in alcohol-use disorders, but only very few studies have investigated their origin and interactions with other categories of dysfunctions. Besides, these deficits have generally been interpreted in a linear bottom-up perspective, which appears very restrictive with respect to the new models of vision developed in healthy populations. Indeed, new theories highlight the predictive nature of the visual system and demonstrate that it interacts with higher-level cognitive functions to generate top-down predictions. These models nota-bly posit that a fast but coarse visual analysis involving magnocellular pathways helps to compute heuristic guesses regard-ing the identity and affective value of inputs, which are used to facilitate conscious visual recognition. Building on these new proposals, the present review stresses the need to reconsider visual deficits in alcohol-use disorders as they might have cru-cial significance for core features of the pathology, such as attentional bias, loss of inhibitory control and emotion decoding impairments. Centrally, we suggest that individuals with severe alcohol-use disorders could present with magnocellular dam-age and we defend a dynamic explanation of the deficits. Rather than being restricted to high-level processes, deficits could start at early visual stages and then extend and potentially intensify during following steps due to reduced cerebral connec-tivity and dysfunctional cognitive/emotional regions. A new research agenda is specifically provided to test these hypotheses.
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Affiliation(s)
- Coralie Creupelandt
- Laboratory for Experimental Psychopathology, Psychological Science Research Institute, Université catholique de Louvain, Louvain-la-Neuve, Belgium.,SCALab-Sciences Cognitives et Sciences Affectives, CNRS, UMR 9193, Université de Lille, Lille, France
| | - Fabien D'Hondt
- SCALab-Sciences Cognitives et Sciences Affectives, CNRS, UMR 9193, Université de Lille, Lille, France.,CHU Lille, Clinique de Psychiatrie, CURE, Lille, France
| | - Pierre Maurage
- Laboratory for Experimental Psychopathology, Psychological Science Research Institute, Université catholique de Louvain, Louvain-la-Neuve, Belgium
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Hoffman LA, Lewis B, Nixon SJ. Neurophysiological and Interpersonal Correlates of Emotional Face Processing in Alcohol Use Disorder. Alcohol Clin Exp Res 2019; 43:1928-1936. [PMID: 31403716 DOI: 10.1111/acer.14152] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Accepted: 07/05/2019] [Indexed: 12/22/2022]
Abstract
BACKGROUND A growing literature suggests deficient emotional facial expression (EFE) processing among recently abstinent individuals with alcohol use disorders (AUDs). Further investigation is needed to clarify valence-related discrepancies and elucidate neural and psychosocial correlates. We examined neurobehavioral indices of EFE processing and interpersonal problems in treatment seekers with AUDs and healthy community controls (CCs). METHODS Thirty-four individuals with AUDs and 39 CCs completed an emotion judgment task (EJT), requiring discrimination between happy, angry, and sad EFEs. A second task requiring discrimination of male and female faces with neutral expressions served as the control task (i.e., sex judgment task, SJT). Neurophysiological (i.e., N170 and P3) and behavioral measures were analyzed using generalized linear mixed models (GLMM). Interpersonal problems were assessed with the Inventory of Interpersonal Problems-64 (IIP-64). The relationship of IIP-64 and EJT performance was investigated via within-group correlations. RESULTS Analysis of the SJT revealed no group differences in behavioral measures, N170 amplitude, or P3 latency. P3 amplitudes, however, were significantly lower in the AUD group. For the EJT, initial observations of group differences in P3 amplitude were accounted for by differences in the control task. Behavioral analyses indicated that the AUD group was significantly less accurate than the CC group. Hypothesis-driven analyses using GLMM-estimated group differences indicated that anger processing was affected to a greater degree than were other emotions. Significant EJT/IIP-64 correlations were observed for anger processing within the AUD group and were confined to IIP-64 subscales with relatively high ratings on the affiliation dimension. CONCLUSIONS Findings provide partial support for an emotion-specific processing deficit in persons with AUDs. Anger processing was more robustly affected than other emotions and was associated with interpersonal problems characterized by being overly needy, nonassertive, and overly accommodating. Results extend prior reports and reinforce the need for comprehensive study of emotion processing and its real-world implications.
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Affiliation(s)
- Lauren A Hoffman
- Recovery Research Institute, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Ben Lewis
- Department of Psychiatry, University of Florida, Gainesville, Florida.,Center for Addiction Research & Education, University of Florida, Gainesville, Florida
| | - Sara Jo Nixon
- Department of Psychiatry, University of Florida, Gainesville, Florida.,Center for Addiction Research & Education, University of Florida, Gainesville, Florida
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30
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Romero-Martínez Á, Vitoria-Estruch S, Moya-Albiol L. Emotional and autonomic dysregulation in abstinent alcoholic men: An idiosyncratic profile? Alcohol 2019; 77:155-162. [PMID: 30664984 DOI: 10.1016/j.alcohol.2019.01.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Revised: 01/03/2019] [Accepted: 01/14/2019] [Indexed: 01/29/2023]
Abstract
Men who misuse alcohol tend to experience negative affect, which may entail difficulties in regulating emotions to cope effectively with stressful or anxiety-provoking situations, thus increasing the risk of alcohol relapse. This dysphoric state has been associated with alexithymia, which compromises an individual's abilities to acknowledge, recognize, and regulate emotional states. A physiological correlate of emotional regulation is autonomic flexibility, as shown by emotional dysregulation in men who misuse alcohol being correlated with reduced parasympathetic activation to control heart rate variability during stress and/or conflict situations. Hence, the main aim of this study was to investigate whether long-term abstinent alcoholic (LTAA) men exhibit higher levels of negative affect and sympathetic activation (cardiovascular and electrodermal) in response to acute standardized laboratory stress than non-alcoholic controls. In addition, we hypothesized that the higher the alexithymic traits, the greater would be the increase in negative affect and sympathetic activation in response to stress, especially in LTAAs. Our data demonstrated that LTAAs experienced slightly greater increases in anxiety, states of anger, and worsening of mood than controls. Moreover, they exhibited lower high-frequency heart rate variability, respiratory sinus arrhythmia values, shorter pre-ejection periods, and higher respiratory rates than controls. Finally, alexithymic traits imply greater worsening of mood and sympathetic predominance (shorter pre-ejection periods and smaller magnitude of response), with the associations being stronger in LTAAs. These findings indicate a different emotional and cardiovascular response to psychosocial stress in LTAA than non-alcoholic men. Improving our knowledge of the way this population reacts to stress may help identify risk factors for alcohol relapse.
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31
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Liu J, Shi YC, Lee DYW. Applications of Pueraria lobata in treating diabetics and reducing alcohol drinking. CHINESE HERBAL MEDICINES 2019; 11:141-149. [PMID: 32831815 PMCID: PMC7434045 DOI: 10.1016/j.chmed.2019.04.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Pueraria lobata is one of the most important medicinal herbs used traditionally in China. According to Shanghan Lun (Treatise on Exogenous Febrile Disease), it has been used traditionally to relieve body heat, eye soring, dry mouth, headache associated with high blood pressure, and stiff neck problems. Modern studies in the 1970s revealed that isoflavonoids extracted from P. lobata were the bioactive components of an herbal remedy namely Yufeng Ningxin Tablets for the treatment of patients after stroke. This article reviews recent application of P. lobota in the treatment of diabetics and in reducing alcohol drinking. In view of its low toxicity profile, P. lobota stands an excellent chance to be developed as a phytomedicine for treating human diseases.
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Affiliation(s)
- Jing Liu
- Bio-Organic and Natural Products Research Laboratory, Mailman Research Center, McLean Hospital/Harvard Medical School, Belmont, MA 02478, USA
| | | | - David Yue-Wei Lee
- Bio-Organic and Natural Products Research Laboratory, Mailman Research Center, McLean Hospital/Harvard Medical School, Belmont, MA 02478, USA
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32
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Lannoy S, Billieux J, Dormal V, Maurage P. Behavioral and Cerebral Impairments Associated with Binge Drinking in Youth: A Critical Review. Psychol Belg 2019; 59:116-155. [PMID: 31328014 PMCID: PMC6625552 DOI: 10.5334/pb.476] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Accepted: 02/19/2019] [Indexed: 12/16/2022] Open
Abstract
Binge drinking is a widespread alcohol consumption pattern in youth that is linked to important behavioral and cerebral impairments, in both the short and the long term. From a critical review of the current literature on this topic, we conclude that binge drinkers display executive impairments, cerebral modifications, and problems with emotion-related processes. Five key empirical and theoretical topics are discussed to pave the way for future research in the field: (1) the specificity of the brain modifications observed in binge drinkers that may index a compensatory mechanism or result from multiple withdrawals; (2) the nature of the relationship between binge drinking and impairments, suggesting reciprocal influences between excessive alcohol consumption and executive deficits; (3) the possible recovery of brain and cognitive functioning after the cessation of binge drinking; (4) the validity of the continuum hypothesis, suggesting links between binge drinking and severe alcohol use disorders; and (5) the existing strategies to reduce binge drinking habits or rehabilitate the associated cognitive deficits. Future perspectives are described in relation to the questions raised to identify the crucial variables to be addressed in research and clinical practice.
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Affiliation(s)
- Séverine Lannoy
- Cognition Health Society Laboratory (C2S – EA 6291), Université de Reims Champagne-Ardenne, Reims, FR
- Laboratory for Experimental Psychopathology (LEP), Psychological Science Research Institute, Université catholique de Louvain, Louvain-la-Neuve, BE
| | - Joël Billieux
- Addictive and Compulsive Behaviours Lab (ACB-Lab), Institute for Health and Behaviour, University of Luxembourg, Esch-sur-Alzette, LU
| | - Valérie Dormal
- Laboratory for Experimental Psychopathology (LEP), Psychological Science Research Institute, Université catholique de Louvain, Louvain-la-Neuve, BE
| | - Pierre Maurage
- Laboratory for Experimental Psychopathology (LEP), Psychological Science Research Institute, Université catholique de Louvain, Louvain-la-Neuve, BE
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Martins ICVDS, Souza GDS, Brasil A, Herculano AM, Lacerda EMDCB, Rodrigues AR, Rosa AAM, Ventura DF, Castro AJDO, Silveira LCDL. Psychophysical Evaluation of Visual Functions of Ex-Alcoholic Subjects After Prolonged Abstinence. Front Neurosci 2019; 13:179. [PMID: 30894798 PMCID: PMC6414438 DOI: 10.3389/fnins.2019.00179] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Accepted: 02/14/2019] [Indexed: 12/31/2022] Open
Abstract
Chronic alcohol abuse can lead to a brain damages, and the health status of alcoholics even after a long-term alcohol abstinence is a public health concern. The present study investigated the color vision and spatial luminance contrast sensitivity of a group of 17 ex-alcoholics (46.3 ± 6.7 years old) in long-term alcohol abstinence after having been previously under alcohol dependence for many years. We also investigated the association of impaired psychophysical performance in different tests we applied. The mean time of alcohol consumption was 16.9 ± 5.1 years and the mean abstinence period was 12.4 ± 8.5 years. Achromatic vision of all subjects was evaluated using spatial luminance contrast sensitivity function (CSF) test and color vision was evaluated using Mollon-Reffin color discrimination test (MR) and the Farnsworth-Munsell 100 hue arrangement test (FM100). Relative to controls, the spatial luminance contrast sensitivity was lower in 10/17 of the ex-alcoholic subjects. In the color vision tests, 11/16 ex-alcoholic subjects had impaired results compared to controls in the FM100 test and 13/14 subjects had color vision deficits measured in the MR test. Fourteen subjects performed all visual tests, three subjects had impaired results for all tests, seven subjects had impaired results in two tests, three subjects had visual deficit in one test, and one had normal results for all tests. The results showed the existence of functional deficits in achromatic and chromatic vision of subjects with history of chronic alcoholism after long abstinence. Most subjects had altered result in more than one test, especially in the color vision tests. The present investigation suggests that the damage in visual functions produced by abusive alcohol consumption is not reversed after long term alcohol abstinence.
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Affiliation(s)
- Isabelle Christine Vieira da Silva Martins
- Instituto de Ciências da Saúde, Faculdade de Nutrição, Universidade Federal do Pará, Belém, Brazil
- Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, Brazil
| | - Givago da Silva Souza
- Instituto de Ciências da Saúde, Faculdade de Nutrição, Universidade Federal do Pará, Belém, Brazil
- Núcleo de Medicina Tropical, Universidade Federal do Pará, Belém, Brazil
| | - Alódia Brasil
- Instituto de Ciências da Saúde, Faculdade de Nutrição, Universidade Federal do Pará, Belém, Brazil
- Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, Brazil
| | | | | | | | | | - Dora Fix Ventura
- Instituto de Psicologia, Universidade de São Paulo, São Paulo, Brazil
| | | | - Luiz Carlos de Lima Silveira
- Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, Brazil
- Núcleo de Medicina Tropical, Universidade Federal do Pará, Belém, Brazil
- Biomedical School, Universidade Ceuma, São Luís, Brazil
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Fama R, Le Berre AP, Hardcastle C, Sassoon SA, Pfefferbaum A, Sullivan EV, Zahr NM. Neurological, nutritional and alcohol consumption factors underlie cognitive and motor deficits in chronic alcoholism. Addict Biol 2019; 24:290-302. [PMID: 29243370 DOI: 10.1111/adb.12584] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2017] [Revised: 10/12/2017] [Accepted: 10/29/2017] [Indexed: 01/14/2023]
Abstract
Variations in pattern and extent of cognitive and motor impairment occur in alcoholism (ALC). Causes of such heterogeneity are elusive and inconsistently accounted for by demographic or alcohol consumption differences. We examined neurological and nutritional factors as possible contributors to heterogeneity in impairment. Participants with ALC (n = 96) and a normal comparison group (n = 41) were examined on six cognitive and motor domains. Signs of historically determined subclinical Wernicke's encephalopathy were detected using the Caine et al. criteria, which were based on postmortem examination and chart review of antemortem data of alcoholic cases with postmortem evidence for Wernicke's encephalopathy. Herein, four Caine criteria provided quantification of dietary deficiency, cerebellar dysfunction, low general cognitive functioning and oculomotor abnormalities in 86 of the 96 ALC participants. Subgroups based on Caine criteria yielded a graded effect, where those meeting more criteria exhibited greater impairment than those meeting no to fewer criteria. These results could not be accounted for by history of drug dependence. Multiple regression indicated that compromised performance on ataxia, indicative of cerebellar dysfunction, predicted non-mnemonic and upper motor deficits, whereas low whole blood thiamine level, consistent with limbic circuit dysfunction, predicted mnemonic deficits. This double dissociation indicates biological markers that contribute to heterogeneity in expression of functional impairment in ALC. That non-mnemonic and mnemonic deficits are subserved by the dissociable neural systems of frontocerebellar and limbic circuitry, both commonly disrupted in ALC, suggests neural mechanisms that can differentially affect selective functions, thereby contributing to heterogeneity in pattern and extent of dysfunction in ALC.
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Affiliation(s)
- Rosemary Fama
- Department of Psychiatry and Behavioral Sciences; Stanford University School of Medicine; Stanford CA USA
- Neuroscience Program; SRI International; Menlo Park CA USA
| | - Anne-Pascale Le Berre
- Department of Psychiatry and Behavioral Sciences; Stanford University School of Medicine; Stanford CA USA
| | - Cheshire Hardcastle
- Department of Psychiatry and Behavioral Sciences; Stanford University School of Medicine; Stanford CA USA
- Neuroscience Program; SRI International; Menlo Park CA USA
| | | | - Adolf Pfefferbaum
- Department of Psychiatry and Behavioral Sciences; Stanford University School of Medicine; Stanford CA USA
- Neuroscience Program; SRI International; Menlo Park CA USA
| | - Edith V. Sullivan
- Department of Psychiatry and Behavioral Sciences; Stanford University School of Medicine; Stanford CA USA
| | - Natalie M. Zahr
- Department of Psychiatry and Behavioral Sciences; Stanford University School of Medicine; Stanford CA USA
- Neuroscience Program; SRI International; Menlo Park CA USA
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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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Neural correlates of visual attention in alcohol use disorder. Drug Alcohol Depend 2019; 194:430-437. [PMID: 30502544 DOI: 10.1016/j.drugalcdep.2018.10.032] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Revised: 10/30/2018] [Accepted: 10/31/2018] [Indexed: 10/27/2022]
Abstract
Numerous studies have documented cognitive impairments in multiple domains in patients with an alcohol use disorder (AUD), including perceptuomotor, executive, and visuospatial functions. Although the neural underpinnings of cognitive deficits in AUD have been studied extensively, the neural basis of attention deficits in AUD remains relatively unexplored. Here, we investigated neural responses to a visual attention task (VAT) in 19 recently abstinent patients with AUD and 23 healthy control participants (HC) using functional MRI (fMRI). AUD had a mean number of 62 ± 34SD drinks per week and 29 ± 13 years' history of alcohol use. Results show that there were no behavioral differences (accuracy or reaction time) between groups during the VAT. For both groups, the VAT activated brain areas associated with visual attention load (i.e., parietal and prefrontal cortices) and visual processing (i.e., occipital cortex), which is in line with previous reports on the same task in healthy volunteers. Despite similar behavioral performances, AUD participants showed decreased VAT activation in regions of the dorsal and ventral attention networks, including parietal and prefrontal cortices, and in the insula as compared to controls. These findings corroborate differences in attention networks in AUD compared to HC that might underlie attention deficits in AUD, whereas impairments in the insula could reflect a disruption of interoception processing as found in other addictions.
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Ros-Cucurull E, Palma-Álvarez RF, Cardona-Rubira C, García-Raboso E, Jacas C, Grau-López L, Abad AC, Rodríguez-Cintas L, Ros-Montalbán S, Casas M, Ramos-Quiroga JA, Roncero C. Alcohol use disorder and cognitive impairment in old age patients: A 6 months follow-up study in an outpatient unit in Barcelona. Psychiatry Res 2018; 261:361-366. [PMID: 29353762 DOI: 10.1016/j.psychres.2017.12.069] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Revised: 10/11/2017] [Accepted: 12/30/2017] [Indexed: 10/18/2022]
Abstract
There has been little research about deleterious effects, including cognitive impairment, related to hazardous long-term alcohol use in old adults. This study aims to assess cognitive decline in old patients with alcohol use disorder and changes in cognitive state at 6 months follow-up, achieving or not abstinence. A six-month follow-up study was conducted in an outpatient center in Barcelona on a sample of old adults (≥65 years old) who had hazardous alcohol use. The sample was compared with healthy volunteers adjusted for age, sex and years of education. A neuropsychological protocol was performed at baseline and after 6 months follow-up covering four cognitive domains: attention, visuospatial abilities, memory and executive functions. Several domains were significant impaired at baseline: visual immediate and delayed recall, working memory, immediate verbal learning, total words learned, set switching and sustained attention. At 6 months reassessment, alcohol abstinence was achieved in 93.5% of patients and it was detected a trend towards improvement in direct mean scores of all cognitive areas, although it was not significant. The current study points out a cognitive impairment in many areas secondary to alcohol long-term hazardous use in old adults. A trend towards cognitive improvement after recovery was detected in most patients.
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Affiliation(s)
- Elena Ros-Cucurull
- Addiction and Dual Diagnosis Unit, Vall Hebron University Hospital, Barcelona, Spain; Psychiatry Service, CIBERSAM, Vall Hebron University Hospital, Barcelona, Spain; Autonomous University of Barcelona, Barcelona, Spain.
| | - Raúl Felipe Palma-Álvarez
- Addiction and Dual Diagnosis Unit, Vall Hebron University Hospital, Barcelona, Spain; Psychiatry Service, CIBERSAM, Vall Hebron University Hospital, Barcelona, Spain; Autonomous University of Barcelona, Barcelona, Spain
| | | | - Elena García-Raboso
- Psychiatry Service, CIBERSAM, Vall Hebron University Hospital, Barcelona, Spain
| | - Carlos Jacas
- Psychiatry Service, CIBERSAM, Vall Hebron University Hospital, Barcelona, Spain; Autonomous University of Barcelona, Barcelona, Spain
| | - Lara Grau-López
- Addiction and Dual Diagnosis Unit, Vall Hebron University Hospital, Barcelona, Spain; Psychiatry Service, CIBERSAM, Vall Hebron University Hospital, Barcelona, Spain; Autonomous University of Barcelona, Barcelona, Spain
| | - Alfonso Carlos Abad
- Addiction and Dual Diagnosis Unit, Vall Hebron University Hospital, Barcelona, Spain; Psychiatry Service, CIBERSAM, Vall Hebron University Hospital, Barcelona, Spain
| | - Laia Rodríguez-Cintas
- Addiction and Dual Diagnosis Unit, Vall Hebron University Hospital, Barcelona, Spain; Autonomous University of Barcelona, Barcelona, Spain
| | | | - Miguel Casas
- Autonomous University of Barcelona, Barcelona, Spain
| | - Josep Antoni Ramos-Quiroga
- Psychiatry Service, CIBERSAM, Vall Hebron University Hospital, Barcelona, Spain; Autonomous University of Barcelona, Barcelona, Spain
| | - Carlos Roncero
- Addiction and Dual Diagnosis Unit, Vall Hebron University Hospital, Barcelona, Spain; Psychiatry Service, CIBERSAM, Vall Hebron University Hospital, Barcelona, Spain; Autonomous University of Barcelona, Barcelona, Spain; Psychiatry Service, University of Salamanca Health Care Complex, Salamanca, Spain; Institute of Biomedicine. University of Salamanca. Salamanca, Spain
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Geary DC. Evolution of Human Sex-Specific Cognitive Vulnerabilities. QUARTERLY REVIEW OF BIOLOGY 2017. [DOI: 10.1086/694934] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Ekhtiari H, Rezapour T, Aupperle RL, Paulus MP. Neuroscience-informed psychoeducation for addiction medicine: A neurocognitive perspective. PROGRESS IN BRAIN RESEARCH 2017; 235:239-264. [PMID: 29054291 PMCID: PMC5771228 DOI: 10.1016/bs.pbr.2017.08.013] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Psychoeducation (PE) is defined as an intervention with systematic, structured, and didactic knowledge transfer for an illness and its treatment, integrating emotional and motivational aspects to enable patients to cope with the illness and to improve its treatment adherence and efficacy. PE is considered an important component of treatment in both medical and psychiatric disorders, especially for mental health disorders associated with lack of insight, such as alcohol and substance use disorders (ASUDs). New advancements in neuroscience have shed light on how various aspects of ASUDs may relate to neural processes. However, the actual impact of neuroscience in the real-life clinical practice of addiction medicine is minimal. In this chapter, we provide a perspective on how PE in addiction medicine can be informed by neuroscience in two dimensions: content (knowledge we transfer in PE) and structure (methods we use to deliver PE). The content of conventional PE targets knowledge about etiology of illness, treatment process, adverse effects of prescribed medications, coping strategies, family education, and life skill training. Adding neuroscience evidence to the content of PE could be helpful in communicating not only the impact of drug use but also the beneficial impact of various treatments (i.e., on brain function), thus enhancing motivation for compliance and further destigmatizing their symptoms. PE can also be optimized in its "structure" by implicitly and explicitly engaging different neurocognitive processes, including salience/attention, memory, and self-awareness. There are many interactions between these two dimensions, structure and content, in the delivery of neuroscience-informed psychoeducation (NIPE). We explore these interactions in the development of a cartoon-based NIPE to promote brain recovery during addiction treatment as a part of the brain awareness for addiction recovery initiative.
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Affiliation(s)
- Hamed Ekhtiari
- Laureate Institute for Brain Research, Tulsa, OK, United States; Iranian National Center for Addiction Studies, Tehran University of Medical Sciences, Tehran, Iran.
| | - Tara Rezapour
- Iranian National Center for Addiction Studies, Tehran University of Medical Sciences, Tehran, Iran; Translational Neuroscience Program, Institute for Cognitive Science Studies, Tehran, Iran
| | - Robin L Aupperle
- Laureate Institute for Brain Research, Tulsa, OK, United States; School of Community Medicine, University of Tulsa, Tulsa, OK, United States
| | - Martin P Paulus
- Laureate Institute for Brain Research, Tulsa, OK, United States
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Rensen YCM, Egger JIM, Westhoff J, Walvoort SJW, Kessels RPC. Errorless (re)learning of everyday activities in patients with Korsakoff’s syndrome: A feasibility study. Neuropsychol Rehabil 2017; 29:1211-1225. [DOI: 10.1080/09602011.2017.1379419] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Yvonne C. M. Rensen
- Centre of Excellence for Korsakoff and Alcohol-Related Cognitive Disorders, Vincent van Gogh Institute for Psychiatry, Venray, The Netherlands
| | - Jos I. M. Egger
- Centre of Excellence for Neuropsychiatry, Vincent van Gogh Institute for Psychiatry, Venray, The Netherlands
- Donders Institute for Brain, Cognition, and Behaviour, Radboud University, Nijmegen, The Netherlands
| | - Josette Westhoff
- Centre of Excellence for Korsakoff and Alcohol-Related Cognitive Disorders, Vincent van Gogh Institute for Psychiatry, Venray, The Netherlands
- Department of Medical Psychology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Serge J. W. Walvoort
- Centre of Excellence for Korsakoff and Alcohol-Related Cognitive Disorders, Vincent van Gogh Institute for Psychiatry, Venray, The Netherlands
| | - Roy P. C. Kessels
- Centre of Excellence for Korsakoff and Alcohol-Related Cognitive Disorders, Vincent van Gogh Institute for Psychiatry, Venray, The Netherlands
- Donders Institute for Brain, Cognition, and Behaviour, Radboud University, Nijmegen, The Netherlands
- Department of Medical Psychology, Radboud University Medical Center, Nijmegen, The Netherlands
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Abstract
Alcohol use disorder (AUD) has been a major cause of family, social, and personal strife for centuries, with current prevalence estimates of 14% for 12-month and 29% lifetime AUD. Neuropsychological testing of selective cognitive, sensory, and motor functions complemented with in vivo brain imaging has enabled tracking the consequences of AUD, which follows a dynamic course of development, maintenance, and recovery or relapse. Controlled studies of alcoholism reviewed herein provide evidence for disruption of selective functions involving executive, visuospatial, mnemonic, emotional, and attentional processes, response inhibition, prosody, and postural stability and brain systems supporting these functions. On a hopeful front, longitudinal study provides convincing evidence for improvement in brain structure and function following sustained sobriety. These discoveries have a strong legacy in the International Neuropsychological Society (INS), starting from its early days when assumptions regarding which brain regions were disrupted relied solely on patterns of functional sparing and impairment deduced from testing. This review is based on the symposium presentation delivered at the 2017 annual North American meeting of the INS in celebration of the 50th anniversary since its institution in 1967. In the spirit of the meeting's theme, "Binding the Past and Present," the lecture and this review recognized the past by focusing on early, rigorous neuropsychological studies of alcoholism and their influence on research currently conducted using imaging methods enabling hypothesis testing of brain substrates of observed functional deficits. (JINS, 2017, 23, 843-859).
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Le Berre AP, Fama R, Sullivan EV. Executive Functions, Memory, and Social Cognitive Deficits and Recovery in Chronic Alcoholism: A Critical Review to Inform Future Research. Alcohol Clin Exp Res 2017; 41:1432-1443. [PMID: 28618018 PMCID: PMC5531758 DOI: 10.1111/acer.13431] [Citation(s) in RCA: 214] [Impact Index Per Article: 30.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Accepted: 06/04/2017] [Indexed: 12/13/2022]
Abstract
Alcoholism is a complex and dynamic disease, punctuated by periods of abstinence and relapse, and influenced by a multitude of vulnerability factors. Chronic excessive alcohol consumption is associated with cognitive deficits, ranging from mild to severe, in executive functions, memory, and metacognitive abilities, with associated impairment in emotional processes and social cognition. These deficits can compromise efforts in initiating and sustaining abstinence by hampering efficacy of clinical treatment and can obstruct efforts in enabling good decision making success in interpersonal/social interactions, and awareness of cognitive and behavioral dysfunctions. Despite evidence for differences in recovery levels of selective cognitive processes, certain deficits can persist even with prolonged sobriety. Herein is presented a review of alcohol-related cognitive impairments affecting component processes of executive functioning, memory, and the recently investigated cognitive domains of metamemory, social cognition, and emotional processing; also considered are trajectories of cognitive recovery with abstinence. Finally, in the spirit of critical review, limitations of current knowledge are noted and avenues for new research efforts are proposed that focus on (i) the interaction among emotion-cognition processes and identification of vulnerability factors contributing to the development of emotional and social processing deficits and (ii) the time line of cognitive recovery by tracking alcoholism's dynamic course of sobriety and relapse. Knowledge about the heterochronicity of cognitive recovery in alcoholism has the potential of indicating at which points during recovery intervention may be most beneficial.
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Affiliation(s)
- Anne-Pascale Le Berre
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Rosemary Fama
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA 94305, USA
- Neuroscience Program, SRI International, Menlo Park, CA 94025, USA
| | - Edith V. Sullivan
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA 94305, USA
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Brion M, D'Hondt F, Pitel AL, Lecomte B, Ferauge M, de Timary P, Maurage P. Executive functions in alcohol-dependence: A theoretically grounded and integrative exploration. Drug Alcohol Depend 2017; 177:39-47. [PMID: 28554151 DOI: 10.1016/j.drugalcdep.2017.03.018] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Revised: 02/13/2017] [Accepted: 03/10/2017] [Indexed: 02/04/2023]
Abstract
BACKGROUND Alcohol-dependence is related to large-scale cognitive impairments, particularly for executive functions (EF). These deficits persist even after long-term abstinence and have a major impact on patients' everyday life and relapse risk. Earlier studies, based on multi-determined tasks, mostly focused on inhibition and did not offer a theoretically-grounded and exhaustive view of the differential deficit across EF. The present paper proposes a model-based exploration of EF in alcohol-dependent individuals (ALC), to precisely compare the specific deficit related to each executive subcomponent. METHODS Forty-seven recently detoxified ALC were compared to 47 matched healthy participants on a nine-tasks validated neuropsychological battery, simultaneously exploring and comparing the three main executive subcomponents (shifting, updating, and inhibition). Psychopathological comorbidities were also controlled for. RESULTS Reaction time indexes revealed a global slowing down among ALC, whatever the EF explored. Accuracy indexes revealed a moderate deficit for inhibition tasks but a massive impairment for shifting and updating ones. Complementary analyses indicated that the executive deficits observed were centrally related to alcohol-dependence, while comorbid depressive symptoms appeared to intensify the deficits observed. CONCLUSIONS By offering a direct comparison between the three major EF, these results showed that alcohol-related executive deficits extend beyond the classically described inhibition impairment. This impairment encompasses each EF subcomponent, as ALC actually presented stronger deficits for updating and shifting abilities. This first observation of a multifaceted EF deficit stresses the need for an individualized evaluation and rehabilitation of EF during and/or after the detoxification process.
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Affiliation(s)
- Mélanie Brion
- Laboratory for Experimental Psychopathology, Psychological Sciences Research Institute, Université catholique de Louvain,10 Place C. Mercier, B-1348 Louvain-la-Neuve, Belgium
| | - Fabien D'Hondt
- Univ. Lille, CNRS UMR 9193 - SCALab - Sciences Cognitives et Sciences Affectives, psyCHIC team,1 Place de Verdun, F-59045 Lille, France; CHU Lille, Clinique de Psychiatrie, CURE, F-59000, Lille, France
| | - Anne-Lise Pitel
- INSERM, École Pratique des Hautes Études, Université de Caen-Normandie, Unité U1077, GIP Cyceron, CHU Caen, F-14000 Caen, France
| | - Benoît Lecomte
- Department of Neuropsychiatry, Saint-Martin Hospital, 84 rue Saint-Hubert, B-5100 Dave, Belgium
| | - Marc Ferauge
- Department of Addiction Rehabilitation, Beau-Vallon Hospital, 205 rue de Bricgniot, B-5002 Saint-Servais, Belgium
| | - Philippe de Timary
- Laboratory for Experimental Psychopathology, Psychological Sciences Research Institute, Université catholique de Louvain,10 Place C. Mercier, B-1348 Louvain-la-Neuve, Belgium; Department of Adult Psychiatry, St Luc Hospital and Institute of Neuroscience, Université catholique de Louvain,10 Avenue Hippocrate, B-1200 Brussels, Belgium
| | - Pierre Maurage
- Laboratory for Experimental Psychopathology, Psychological Sciences Research Institute, Université catholique de Louvain,10 Place C. Mercier, B-1348 Louvain-la-Neuve, Belgium.
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Ceccanti M, Coriale G, Hamilton DA, Carito V, Coccurello R, Scalese B, Ciafrè S, Codazzo C, Messina MP, Chaldakov GN, Fiore M. Virtual Morris task responses in individuals in an abstinence phase from alcohol. Can J Physiol Pharmacol 2017; 96:128-136. [PMID: 28763626 DOI: 10.1139/cjpp-2017-0013] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
The present study was aimed at examining spatial learning and memory, in 33 men and 12 women with alcohol use disorder (AUD) undergoing ethanol detoxification, by using a virtual Morris task. As controls, we recruited 29 men and 10 women among episodic drinkers without a history of alcohol addiction or alcohol-related diseases. Elevated latency to the first movement in all trials was observed only in AUD persons; furthermore, control women had longer latencies compared with control men. Increased time spent to reach the hidden platform in the learning phase was found for women of both groups compared with men, in particular during trial 3. As predicted, AUD persons (more evident in men) spent less time in the target quadrant during the probe trial; however, AUD women had longer latencies to reach the platform in the visible condition during trials 6 and 7 that resulted in a greater distance moved. As for the probe trial, men of both groups showed increased virtual locomotion compared with the women of both groups. The present investigation confirms and extends previous studies showing (i) different gender responses in spatial learning tasks, (ii) some alterations due to alcohol addiction in virtual spatial learning, and (iii) differences between AUD men and AUD women in spatial-behaviour-related paradigms.
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Affiliation(s)
- Mauro Ceccanti
- a Center for Alcohol Abuse (Centro Riferimento Alcologico Regione Lazio-CRARL), Department of Clinical Medicine, Sapienza University of Rome, 00186 Rome, Italy
| | - Giovanna Coriale
- a Center for Alcohol Abuse (Centro Riferimento Alcologico Regione Lazio-CRARL), Department of Clinical Medicine, Sapienza University of Rome, 00186 Rome, Italy
| | - Derek A Hamilton
- b Department of Psychology, University of New Mexico, Albuquerque, NM 87131-0001, USA
| | - Valentina Carito
- c Institute of Cell Biology and Neurobiology, National Research Council (IBCN-CNR)/Santa Lucia Foundation, 00143 Rome, Italy
| | - Roberto Coccurello
- c Institute of Cell Biology and Neurobiology, National Research Council (IBCN-CNR)/Santa Lucia Foundation, 00143 Rome, Italy
| | - Bruna Scalese
- a Center for Alcohol Abuse (Centro Riferimento Alcologico Regione Lazio-CRARL), Department of Clinical Medicine, Sapienza University of Rome, 00186 Rome, Italy
| | - Stefania Ciafrè
- c Institute of Cell Biology and Neurobiology, National Research Council (IBCN-CNR)/Santa Lucia Foundation, 00143 Rome, Italy
| | - Claudia Codazzo
- a Center for Alcohol Abuse (Centro Riferimento Alcologico Regione Lazio-CRARL), Department of Clinical Medicine, Sapienza University of Rome, 00186 Rome, Italy
| | - Marisa Patrizia Messina
- a Center for Alcohol Abuse (Centro Riferimento Alcologico Regione Lazio-CRARL), Department of Clinical Medicine, Sapienza University of Rome, 00186 Rome, Italy
| | - George N Chaldakov
- d Laboratory of Cell Biology, Department of Anatomy and Histology, Medical University, Varna, 9002 Bulgaria
| | - Marco Fiore
- c Institute of Cell Biology and Neurobiology, National Research Council (IBCN-CNR)/Santa Lucia Foundation, 00143 Rome, Italy
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Erol A, Akyalcin Kirdok A, Zorlu N, Polat S, Mete L. Empathy, and its relationship with cognitive and emotional functions in alcohol dependency. Nord J Psychiatry 2017; 71:205-209. [PMID: 27924662 DOI: 10.1080/08039488.2016.1263683] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Empathy can be defined as the ability to understand the other's thoughts and feelings. It contains both cognitive and emotional components. AIMS The aim of this study was to investigate the empathy ability of patients with alcohol dependency in association with cognitive and emotional functions, after acute detoxification and during long-term abstinence. METHODS Thirty-three alcohol dependent inpatients that completed a detoxification process and stayed abstinent throughout the study, and 33 healthy comparison subjects that matched the patients for age, gender, and education level were included in the study. All the participants were administered the Facial Emotion Identification Test (FEIT), Facial Emotion Discrimination Test (FEDT), Trail Making Test (TMT), Digit Span Test (DST), Auditory Consonant Trigram Test (ACT), and Empathy Quotient Scale (EQS). All the tests were repeated after 3 months of abstinence. RESULTS At the first evaluation conducted after detoxification, patients performed significantly worse than healthy comparisons in almost all tests. At the second evaluation, which was conducted after 3 months of abstinence, the patients improved significantly in all measures, and no significant differences were detected between the patient and comparison groups. There were significant correlations between the test scores and EQS score. CONCLUSIONS Alcohol dependency has deleterious effects on empathy ability, and cognitive and emotional functions. Those impairments can improve with abstinence. Empathy ability has strong relationships with cognitive and emotional functions.
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Affiliation(s)
- Almila Erol
- a Department of Psychiatry , Ataturk Education and Research Hospital , Izmir , Turkey
| | | | - Nabi Zorlu
- a Department of Psychiatry , Ataturk Education and Research Hospital , Izmir , Turkey
| | - Serap Polat
- a Department of Psychiatry , Ataturk Education and Research Hospital , Izmir , Turkey
| | - Levent Mete
- a Department of Psychiatry , Ataturk Education and Research Hospital , Izmir , Turkey
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Nowakowska-Domagała K, Jabłkowska-Górecka K, Mokros Ł, Koprowicz J, Pietras T. Differences in the verbal fluency, working memory and executive functions in alcoholics: Short-term vs. long-term abstainers. Psychiatry Res 2017; 249:1-8. [PMID: 28063392 DOI: 10.1016/j.psychres.2016.12.034] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2016] [Accepted: 12/24/2016] [Indexed: 10/20/2022]
Abstract
The aim of the study was to assess differences in verbal fluency, working memory and executive functions in two subgroups of alcohol-dependent patients, those undergoing short-term abstinence (STA) and those undergoing long-term abstinence (LTA), and to compare the level of cognitive functions in patients after long-term abstinence with healthy subjects. The study group consisted of 106 alcohol-dependent patients (53 immediately after drinking at least 3 days and 53 after at least one-year abstinence). The control group comprised 53 subjects, whose age, sex and education levels matched those of the patients in the experimental group. The dependence intensity was assessed using SADD and MAST scales. The neuropsychological assessment was based on the FAS Test, Stroop Test and TMT A&B Test. The results obtained for alcohol-dependent patients revealed significant disturbances of cognitive functions. Such results indicate the presence of severe frontal cerebral cortex dysfunctions. Frontal cortex dysfunctions affecting the verbal fluency and working memory subsystems and the executive functions also persisted during long-term abstinence periods. No significant correlations between the duration of dependence, quantity of alcohol consumed and efficiency of the working memory and executive functions were observed in alcohol-dependent subjects after short-term or long-term abstinence.
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Affiliation(s)
- Katarzyna Nowakowska-Domagała
- Department of Cognitive Science, Institute of Psychology, Faculty of Educational Sciences University of Lodz, Smugowa 10/12, 91-433 Lodz, Poland.
| | - Karolina Jabłkowska-Górecka
- Public Health Division, Faculty of Health Sciences, Medical University of Warsaw, Poland Żwirki i Wigury 61, 02-091 Warsaw, Poland.
| | - Łukasz Mokros
- Department Clinical Pharmacology, Medical University of Lodz, Kopcinskiego 22, Lodz 91-153, Poland.
| | - Jacek Koprowicz
- Psychiatry Centre of Pabianice, Jana Pawla II 68, 95-200 Pabianice, Poland.
| | - Tadeusz Pietras
- Department Clinical Pharmacology, Medical University of Lodz, Kopcinskiego 22, Lodz 91-153, Poland.
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Keynejad RC, Marková H, Šiffelová K, Kumar N, Vlček K, Laczó J, Migo EM, Hort J, Kopelman MD. Spatial navigation deficits in amnestic mild cognitive impairment with neuropsychiatric comorbidity. AGING NEUROPSYCHOLOGY AND COGNITION 2017. [PMID: 28632038 DOI: 10.1080/13825585.2017.1290212] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
AIMS To find out whether neuropsychiatric comorbidity (comMCI) influences spatial navigation performance in amnestic mild cognitive impairment (aMCI). METHODS We recruited aMCI patients with (n = 21) and without (n = 21) neuropsychiatric comorbidity or alcohol abuse, matched for global cognitive impairment and cognitively healthy elderly participants (HE, n = 22). They completed the Mini-Mental State Examination and a virtual Hidden Goal Task in egocentric, allocentric, and delayed recall subtests. RESULTS In allocentric navigation, aMCI and comMCI performed significantly worse than HE and similarly to each other. Although aMCI performed significantly worse at egocentric navigation than HE, they performed significantly better than patients with comMCI. CONCLUSIONS Despite the growing burden of dementia and the prevalence of neuropsychiatric symptoms in the elderly population, comMCI remains under-studied. Since trials often assess "pure" aMCI, we may underestimate patients' navigation and other deficits. This finding emphasizes the importance of taking account of the cognitive effects of psychiatric disorders in aMCI.
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Affiliation(s)
- Roxanne C Keynejad
- a Psychology and Neuroscience , Institute of Psychiatry, King's College London , London , UK
| | - Hana Marková
- b Memory Clinic, Department of Neurology , Charles University and Motol University Hospital , Prague , Czech Republic.,c International Clinical Research Center , St Anne's University Hospital Brno , Brno , Czech Republic
| | - Kamila Šiffelová
- b Memory Clinic, Department of Neurology , Charles University and Motol University Hospital , Prague , Czech Republic
| | - Naveen Kumar
- a Psychology and Neuroscience , Institute of Psychiatry, King's College London , London , UK
| | - Kamil Vlček
- d Department of Neurophysiology of Memory , Institute of Physiology, Academy of Sciences of the Czech Republic , Prague , Czech Republic
| | - Jan Laczó
- b Memory Clinic, Department of Neurology , Charles University and Motol University Hospital , Prague , Czech Republic.,c International Clinical Research Center , St Anne's University Hospital Brno , Brno , Czech Republic
| | - Ellen M Migo
- a Psychology and Neuroscience , Institute of Psychiatry, King's College London , London , UK
| | - Jakub Hort
- b Memory Clinic, Department of Neurology , Charles University and Motol University Hospital , Prague , Czech Republic.,c International Clinical Research Center , St Anne's University Hospital Brno , Brno , Czech Republic
| | - Michael D Kopelman
- a Psychology and Neuroscience , Institute of Psychiatry, King's College London , London , UK
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Martelli C, Petillion A, Brunet-Lecomte M, Miranda Marcos R, Chanraud S, Amirouche A, Letierce A, Kostogianni N, Lemaitre H, Aubin HJ, Blecha L, Reynaud M, Martinot JL, Benyamina A. Neuropsychological Impairment in Detoxified Alcohol-Dependent Subjects with Preserved Psychosocial Functioning. Front Psychiatry 2017; 8:193. [PMID: 29033861 PMCID: PMC5626858 DOI: 10.3389/fpsyt.2017.00193] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Accepted: 09/19/2017] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Chronic alcoholism and its related cognitive impairments are associated with increased social, relational, and professional deficits which have a variable overall impact on social integration. These impairments are known to have varying severities and have rarely been studied among healthy alcohol-dependent subjects with preserved psychosocial functioning. Thus, the objective of this study is to describe neuropsychological performance in this particular population. METHOD Twenty-nine socially adjusted alcohol-dependent men, hospitalized for a first or second withdrawal and abstinent for 3 weeks minimum, were compared to 29 healthy non-alcoholic controls. All subjects underwent clinical and psychiatric examination, neuropsychological tests of memory (M), working memory (WM), and executive functions (EF). Comparisons were performed using Student's t-tests or Mann-Whitney U tests. RESULTS No group differences were found on the Self-Reported Social Adjustment Scale (SAS-SR) or in the Mini-Mental State Examination. Compared to controls, patients had greater episodic, spatial, and WM deficits as well as slightly altered executive functions. In contrast, their executive functions (spontaneous flexibility, criteria generation, rule maintenance, and inhibitory control) were relatively preserved. CONCLUSION Our sample of socially and professionally integrated alcoholic patients shows fewer cognitive deficits than described in previous studies. Our results suggest that early on, alcohol-dependent subjects develop compensatory adaptation processes to preserve social function and adaptation. Minor cognitive impairments should be screened early in the disease to integrate cognitive interventions into the health-care plan to thus eventually prevent further socio-professional marginalization.
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Affiliation(s)
- Catherine Martelli
- AP-HP, Paul Brousse Hospital, Department of Psychiatry and Addictology, Villejuif, France.,INSERM U1018, Centre de recherche en Epidémiologie et Santé des Populations, Villejuif, France.,Université Paris-Sud, Le Kremlin Bicêtre, France
| | - Amélie Petillion
- AP-HP, Paul Brousse Hospital, Department of Psychiatry and Addictology, Villejuif, France
| | - Marine Brunet-Lecomte
- AP-HP, Paul Brousse Hospital, Department of Psychiatry and Addictology, Villejuif, France
| | - Rubén Miranda Marcos
- INSERM, U1000 "Neuroimaging & Psychiatry", IFR49, Orsay, France.,CEA, "Neuroimaging & Psychiatry" U1000 Unit, Hospital Department Frédéric Joliot, Orsay, France
| | - Sandra Chanraud
- Bordeaux University, INCIA, UMR 5287, Talence, France.,CNRS, INCIA, UMR 5287, Talence, France
| | - Ammar Amirouche
- AP-HP, Paul Brousse Hospital, Department of Psychiatry and Addictology, Villejuif, France.,INSERM U1018, Centre de recherche en Epidémiologie et Santé des Populations, Villejuif, France.,Université Paris-Sud, Le Kremlin Bicêtre, France
| | - Alexia Letierce
- AP-HP, Bicêtre Hospital, Clinical Research Unit, Le Kremlin Bicêtre, France
| | - Nikoleta Kostogianni
- AP-HP, Paul Brousse Hospital, Department of Psychiatry and Addictology, Villejuif, France
| | - Hervé Lemaitre
- INSERM, U1000 "Neuroimaging & Psychiatry", IFR49, Orsay, France.,Bordeaux University, INCIA, UMR 5287, Talence, France.,CNRS, INCIA, UMR 5287, Talence, France
| | - Henri-Jean Aubin
- AP-HP, Paul Brousse Hospital, Department of Psychiatry and Addictology, Villejuif, France.,Université Paris-Sud, Orsay, France.,Université Paris Descartes, UMR U797, Paris, France
| | - Lisa Blecha
- AP-HP, Paul Brousse Hospital, Department of Psychiatry and Addictology, Villejuif, France.,INSERM U1018, Centre de recherche en Epidémiologie et Santé des Populations, Villejuif, France.,Université Paris-Sud, Le Kremlin Bicêtre, France
| | - Michel Reynaud
- AP-HP, Paul Brousse Hospital, Department of Psychiatry and Addictology, Villejuif, France.,INSERM U1018, Centre de recherche en Epidémiologie et Santé des Populations, Villejuif, France.,Université Paris-Sud, Le Kremlin Bicêtre, France
| | - Jean-Luc Martinot
- INSERM, U1000 "Neuroimaging & Psychiatry", IFR49, Orsay, France.,CEA, "Neuroimaging & Psychiatry" U1000 Unit, Hospital Department Frédéric Joliot, Orsay, France.,Bordeaux University, INCIA, UMR 5287, Talence, France.,CNRS, INCIA, UMR 5287, Talence, France
| | - Amine Benyamina
- AP-HP, Paul Brousse Hospital, Department of Psychiatry and Addictology, Villejuif, France.,INSERM U1018, Centre de recherche en Epidémiologie et Santé des Populations, Villejuif, France.,Université Paris-Sud, Le Kremlin Bicêtre, France
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Rensen YC, Egger JI, Westhoff J, Walvoort SJ, Kessels RP. The effect of errorless learning on quality of life in patients with Korsakoff's syndrome. Neuropsychiatr Dis Treat 2017; 13:2867-2873. [PMID: 29225465 PMCID: PMC5708189 DOI: 10.2147/ndt.s140950] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Errorless learning (EL) is a promising rehabilitation principle for (re)learning instrumental activities in patients with amnesia, including patients with Korsakoff's syndrome (KS). Successfully (re)learning tasks might improve the sense of competence and independence, and subsequently the quality of life. Quality of life in patients with KS has received limited attention, and no studies have been conducted to experimentally examine the effect of EL on quality of life in patients in this patient group. MATERIALS AND METHODS The QUALIDEM, an observation scale for quality of life, was completed by professional nurses before and after EL training in a group of fifty-one patients with KS. This scale was also completed for a group of thirty-one control patients receiving care as usual but no EL training. RESULTS Quality of life was significantly increased on eight of the nine subscales in the Korsakoff group who participated in an EL training. There was a trend toward a significant increase in "positive affect" (ie, the ninth subscale). In contrast, no changes over time were found on any of the subscales in the control group that did not participate in any EL training. CONCLUSION Despite severe memory impairments, patients with KS still have the potential to (partially) (re)learn tasks using EL. This potential should be exploited, as the successes of (re)-learning might improve the quality of life of Korsakoff patients in nursing homes.
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Affiliation(s)
- Yvonne Cm Rensen
- Center of Excellence for Korsakoff and Alcohol-Related Cognitive Disorders, Vincent van Gogh Institute for Psychiatry, Venray, the Netherlands
| | - Jos Im Egger
- Center of Excellence for Neuropsychiatry, Vincent van Gogh Institute for Psychiatry, Venray, the Netherlands.,Donders Institute for Brain, Cognition, and Behavior, Radboud University, Nijmegen, the Netherlands
| | - Josette Westhoff
- Center of Excellence for Korsakoff and Alcohol-Related Cognitive Disorders, Vincent van Gogh Institute for Psychiatry, Venray, the Netherlands
| | - Serge Jw Walvoort
- Center of Excellence for Korsakoff and Alcohol-Related Cognitive Disorders, Vincent van Gogh Institute for Psychiatry, Venray, the Netherlands
| | - Roy Pc Kessels
- Center of Excellence for Korsakoff and Alcohol-Related Cognitive Disorders, Vincent van Gogh Institute for Psychiatry, Venray, the Netherlands.,Donders Institute for Brain, Cognition, and Behavior, Radboud University, Nijmegen, the Netherlands.,Department of Medical Psychology, Radboud University Medical Center, Nijmegen, the Netherlands
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Investigation of Cognitive Improvement in Alcohol-Dependent Inpatients Using the Montreal Cognitive Assessment (MoCA) Score. JOURNAL OF ADDICTION 2016; 2016:1539096. [PMID: 28044121 PMCID: PMC5156817 DOI: 10.1155/2016/1539096] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Revised: 10/10/2016] [Accepted: 11/08/2016] [Indexed: 02/06/2023]
Abstract
Background. Cognitive dysfunction is a common feature in alcohol use disorders. Its persistence following alcohol detoxification may impair quality of life and increase the risk of relapse. We analyzed cognitive impairment changes using the Montreal Cognitive Assessment (MoCA) score in a large sample of alcohol-dependent inpatients hospitalized for at least 4 weeks. Method. This was an observational longitudinal survey. Inclusion criteria were alcohol dependence (DSM-IV) and alcohol abstinence for at least one week. The MoCA test was administered on admission and at discharge. Results. 236 patients were included. The mean MoCA score significantly increased from 22.1 ± 3.7 on admission to 25.11 ± 3.12 at discharge. The corresponding effect-size of improvement was high, 1.1 [95% CI 1.0–1.2]. The degree of improvement was inversely correlated with the baseline MoCA score. The rate of high and normal, that is, >26, MoCA values increased from 15.8% on admission to 53.8% at discharge. MoCA score improvement was not correlated with the total length of abstinence prior to admission. Conclusion. The MoCA score seems to be a useful tool for measuring changes in cognitive performance in alcohol-dependent patients. A significant improvement in cognitive function was observed whatever the degree of impairment on admission and even after a long abstinence period.
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