Specific vs generalized deficits of abstracting ability in chronic alcoholics

Visuoperceptive Impairments in Severe Alcohol Use Disorder: A Critical Review of Behavioral Studies

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.

Towards a Dynamic Exploration of Vision, Cognition and Emotion in Alcohol-Use Disorders

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.

Event-Related Oscillations in Alcoholism Research: A Review

Alcohol dependence is characterized as a multi-factorial disorder caused by a complex interaction between genetic and environmental liabilities across development. A variety of neurocognitive deficits/dysfunctions involving impairments in different brain regions and/or neural circuitries have been associated with chronic alcoholism, as well as with a predisposition to develop alcoholism. Several neurobiological and neurobehavioral approaches and methods of analyses have been used to understand the nature of these neurocognitive impairments/deficits in alcoholism. In the present review, we have examined relatively novel methods of analyses of the brain signals that are collectively referred to as event-related oscillations (EROs) and show promise to further our understanding of human brain dynamics while performing various tasks. These new measures of dynamic brain processes have exquisite temporal resolution and allow the study of neural networks underlying responses to sensory and cognitive events, thus providing a closer link to the physiology underlying them. Here, we have reviewed EROs in the study of alcoholism, their usefulness in understanding dynamical brain functions/dysfunctions associated with alcoholism as well as their utility as effective endophenotypes to identify and understand genes associated with both brain oscillations and alcoholism.

Neurocognitive deficits in male alcoholics: an ERP/sLORETA analysis of the N2 component in an equal probability Go/NoGo task

In alcoholism research, studies concerning time-locked electrophysiological aspects of response inhibition have concentrated mainly on the P3 component of the event-related potential (ERP). The objective of the present study was to investigate the N2 component of the ERP to elucidate possible brain dysfunction related to the motor response and its inhibition using a Go/NoGo task in alcoholics. The sample consisted of 78 abstinent alcoholic males and 58 healthy male controls. The N2 peak was compared across group and task conditions. Alcoholics showed significantly reduced N2 peak amplitudes compared to normal controls for Go as well as NoGo task conditions. Control subjects showed significantly larger NoGo than Go N2 amplitudes at frontal regions, whereas alcoholics did not show any differences between task conditions at frontal regions. Standardized low resolution electromagnetic tomography analysis (sLORETA) indicated that alcoholics had significantly lower current density at the source than control subjects for the NoGo condition at bilateral anterior prefrontal regions, whereas the differences between groups during the Go trials were not statistically significant. Furthermore, NoGo current density across both groups revealed significantly more activation in bilateral anterior cingulate cortical (ACC) areas, with the maximum activation in the right cingulate regions. However, the magnitude of this difference was much less in alcoholics compared to control subjects. These findings suggest that alcoholics may have deficits in effortful processing during the motor response and its inhibition, suggestive of possible frontal lobe dysfunction.

Suppression of early evoked gamma band response in male alcoholics during a visual oddball task

We investigated the early evoked gamma frequency band activity in alcoholics (n=122) and normal controls (n=72) during a visual oddball task. A time-frequency representation method was applied to EEG data in order to obtain phase-locked gamma band activity (29-45 Hz) and was analyzed within a 0-150 ms time window range. Significant reduction of the gamma band response in the frontal region during target stimulus processing was observed in alcoholic compared to control subjects. In contrast, significantly higher gamma band response for the non-target stimulus was observed in alcoholics compared to controls. It is suggested that the reduction in early evoked frontal gamma band response to targets may be associated with frontal lobe dysfunction commonly observed in alcoholics. This perhaps can be characterized by a deficient top-down processing mechanism.

The role of brain oscillations as functional correlates of cognitive systems: a study of frontal inhibitory control in alcoholism

Event-related oscillations play a key role in understanding the brain dynamics and human information processing. In the present study, the Go/No-Go paradigm has been used to examine whether alcoholics have poor inhibitory control as compared to control subjects in terms of different oscillatory brain responses. The matching pursuit algorithm was used to decompose the event-related electroencephalogram into oscillations of different frequencies. It was found that alcoholics (n=58) showed significant reduction in delta (1.0-3.0 Hz) and theta (3.5-7.0 Hz) power during No-Go trials as compared to controls (n=29). This reduction was prominent at the frontal region. The decreased delta and theta power associated with No-Go processing perhaps suggests a deficient inhibitory control and information-processing mechanism. A neuro-cognitive model has been provided to explain the findings. It is suggested that the oscillatory correlates during cognitive processing can be an endophenotypic marker in alcoholism.

Effects of alcohol consumption on lateralized aggression in Anolis carolinensis

Previous work has suggested that the lizard Anolis carolinensis, like many other reptiles, has a functionally split brain. Specifically, the left eye of this species projects primarily to the right hemisphere (and vice versa), there is no corpus callosum, and the physical placement of the eyes restricts their field(s) of vision to one region of hemispace. The current experiment used this preparation to examine the effect of alcohol administration and withdrawal on lateralized brain functioning during territorial aggression. Thirteen adult males were divided into control (CON) or alcohol (ETOH) groups. Baseline territorial aggression was assessed, following which ETOH subjects were then given twice daily solutions of 19% alcohol. After 19 days of ETOH consumption, territorial aggression was again assessed. Eye use during aggressive encounters was measured either following short periods (24 h) of alcohol withdrawal, or 90 m following alcohol consumption. Control subjects were found to have a predominance of left eye/right hemisphere-mediated aggressive responses, as has previously been reported. Alcohol withdrawn subjects were found to have a suppression of left eye/right hemisphere-mediated aggression. This reached statistical significance on several measures of aggression, including the number of dewlaps and headbob (P < 0.001) and the total number of aggressive responses (P = 0.001). Consumption of ETOH reversed this pattern and reinstated the normal pattern of left eye/right hemisphere dominance during aggression. Conversely, right eye/left hemisphere mediation of aggression was found to be increased, or not affected, during alcohol withdrawal, and to show no differences from CON following ETOH administration. Extrapolating from other recent findings in this species, these results suggest that the stress caused by ETOH withdrawal on the CNS may differentially effect the right hemisphere of the brain while having little effect on the left.

Intermanual differences on motor and psychomotor tests in alcoholics: no evidence for selective right-hemisphere dysfunction

Some previous studies have suggested that alcoholics exhibit selective right-hemisphere dysfunction, based on alcoholics' poor performance on tests believed to subserve the right hemisphere. However, some of these experiments did not account adequately for differences in difficulty or novelty in putative right hemisphere tasks. This experiment was designed to evaluate and compare intermanual differences in grip strength, motor speed, fine-motor dexterity, and nonverbal problem-solving ability in 93 recently detoxified alcoholics, 54 long-term abstinent alcoholics, and 73 nonalcoholic controls. All subjects were right-handed men, matched for age and education, and both alcoholic groups had similar drinking histories. Using percent difference scores to assess intermanual differences, adjusted for demographics where appropriate, we found that, although recently detoxified alcoholics demonstrate some motor and psychomotor impairments, there is no evidence using these tests to suggest the right hemisphere is selectively more vulnerable to the effects of chronic alcohol abuse.

Effects of chronic alcohol abuse and HIV infection on brain phosphorus metabolites

We examined the effects of human immunodeficiency virus (HIV) infection and chronic alcohol consumption on cerebral phosphorus metabolites to determine if chronic alcohol abuse is a risk factor for the progression of neurological effects of HIV infection. We studied 15 HIV- alcoholics, 8 HIV- light/nondrinkers, 32 HIV+ alcoholics, and 41 HIV+ light/nondrinking men, with both HIV+ groups having similar CD4 lymphocyte counts. We used localized 31-phosphorus magnetic resonance spectroscopy after magnetic resonance imaging to examine two brain volumes in superior white matter and subcortical gray matter. Chronic alcohol consumption was associated with reduced white matter concentrations of phosphodiester (PDE) and phosphocreatine (PCr). Also in the white matter, acquired immune deficiency syndrome (AIDS) and AIDS-related complex (ARC) were associated with reduced concentrations of PDE and PCr, compared with both HIV- and clinically asymptomatic HIV+ subjects. Because no alcohol-by-HIV interactions were detected, the effects of HIV infection and alcohol abuse were cumulative. This is reflected in a successive decrease of white matter PDE and PCr concentrations in the order HIV- light/nondrinkers/HIV- alcoholics/HIV+ light/nondrinkers/HIV+ alcoholics. Subcortical gray matter PDE concentrations were lower in ARC/AIDS alcoholics than in HIV- light/nondrinking individuals. These findings suggest altered brain phospholipid metabolites and energy metabolites with alcohol abuse and HIV infection. They demonstrate that the adverse metabolic effects of HIV on the brain are augmented by chronic alcohol abuse.

Alcohol abuse and HIV infection have additive effects on frontal cortex function as measured by auditory evoked potential P3A latency

Both alcohol and human immunodeficiency virus (HIV) infection have been shown to produce central nervous system (CNS) morbidity in frontal brain regions. The degree to which the CNS morbidity in HIV infection, as it affects frontal cortex function, may be preferentially increased by alcohol abuse was examined using the auditory P3A evoked potential. The P3A indexes an orienting response, maximal over frontal cortex that occurs when novel nontarget stimuli are presented in the midst of a target detection paradigm. Four groups of subjects were compared: HIV+ alcohol abusers, HIV+ light/nondrinkers, HIV- alcohol abusers, and HIV- light/nondrinkers. The alcohol abuser and light/nondrinker HIV+ groups were matched on percent CD4 lymphocytes, insuring that the results reflected specific CNS effects and were not a result of differences between the groups in the degree of systemic immune suppression. Alcohol abuse and HIV infection had at least additive effects on P3A latency, consistent with alcohol abuse worsening the effect of HIV disease on frontal cortex function. Post-hoc analyses suggested that concomitant alcohol abuse results in the effects of HIV infection on P3A latency becoming manifest earlier in the HIV disease process.

Effects of a history of heavy alcohol consumption on Alzheimer's disease

Neuropsychological and psychiatric evaluations were made of 39 subjects with possible Alzheimer's disease and a history of excessive alcohol consumption (AD + ETOH), who had been abstinent or had drunk minimally for at least three months before evaluation, and 225 patients with probable Alzheimer's disease (PAD) of comparable age, years of education, and baseline global impairment. At baseline, there were no significant differences between the groups in terms of age of onset of dementia, neuropsychological test scores, or current behavioural or psychiatric symptoms. One year later, no differences in rates of decline between 20 abstinent AD + ETOH patients and 88 PAD subjects could be shown. Thus, past heavy alcohol consumption does not appear to modify the presentation of dementia of the Alzheimer's type, nor does it modify progression over a one-year interval.

Measuring the learning potential of abstinent alcoholics

The performance of 89 Finnish alcoholics was measured on a Vygotskian test of learning potential. There were four questions to analyse: (1) can the performance of alcoholics be improved by means of instruction in non-verbal problem solving tasks; (2) how extensive is the transfer effect; (3) how does the duration of abstinence affect test performance; and (4) how does the actual performance level affect post-test results? Results indicated that instruction had a clear positive effect on the performance of alcoholics in simple tasks, but no transfer effect was evident in the more complex tasks. The duration of abstinence had no general effect. Although analysis of the mean scores of time-level groups showed some improvement in performance with increasing duration of abstinence, intra-group deviation was so high that the trends were not statistically significant. The subjects' actual performance level, on the other hand, was a very relevant factor. This was particularly evident in complex transfer tasks.

Cognitive dysfunction and aging among male alcoholics and social drinkers

The relationship between aging and various drinking styles was examined. Four age groups (25-34, 35-44, 45-54, and 55-65 years) and four drinking styles (nondrinkers, social drinkers, alcoholics, and abstinent alcoholics) were compared. A battery of eight neuropsychological tests was administered to 322 men; 72 nondrinkers, 100 social drinkers, 58 abstinent alcoholics, and 92 alcoholics. Cognitive dysfunction related to aging was found to be a more significant factor than decline with alcohol use. Cognitive dysfunction associated with alcohol use was significant for three Wechsler Adult Intelligence Scale subtests; Vocabulary, Digit Symbol and Block Design. Alcohol-related differences in intellectual functioning tended to diminish with increasing subject age.

The effect of alcohol abuse on perceptual reference frames

Visuospatial processing in alcoholics was investigated by aligning two elements along different axes of an equilateral triangle and asking subjects to report the direction the triangle appeared to point when first observed. Alcoholics were not as affected as controls by alignment of the elements. The implications of these findings are discussed.

Intellectual and memory impairment in moderate and heavy drinkers

Heavy drinkers (more than 2 liters of wine per day), without clinical evidence of brain dysfunction, moderate drinkers (1 liter of wine per day) and control subjects (no more than 250 cc of wine per day) were given the Progressive Matrices test and two learning tests, one tapping verbal memory and the other spatial memory. Heavy drinkers' performance was significantly worse than that of the other groups on the Progressive Matrices test and the spatial learning test. With a more lenient method of analysis, the difference between heavy drinkers and controls on the verbal learning test and that between moderate drinkers and controls on the Progressive Matrices test were also significant. When the influence of intelligence on memory performance was partialled out by covarying memory scores for Progressive Matrices scores, all differences on the verbal learning test disappeared whereas the spatial learning test still discriminated heavy drinkers from mild drinkers and controls. The bearing of these findings on the continuum of impairment hypothesis and the right hemisphere vulnerability hypothesis is discussed.

Age and alcoholism: independent memory decrements

Similarities and differences in performances on 18 verbal and nonverbal memory tasks were studied in young and old alcoholics and in young and old controls as test of hypotheses postulating that cognitive decrements from alcoholism either mimic "premature aging," are "age sensitive," or are "independent" from those of normal aging. Young and old alcoholics were matched in length and rate of heavy drinking and were also equated with their controls in age, education, and vocabulary. The multivariate memory and decision data, when converted to independent factor scores, separated alcoholic from control groups on a factor reflecting memory for auditorily presented information. This was independent from factor scores affected mainly by age, such as memory for visuospatial items or decision bias. Age and alcoholism produced overlapping but distinctly different profiles of memory impairments. Decrements in young alcoholics did not resemble those of aging nor did old alcoholics surpass old controls in any but one factor, so that neither the premature aging nor the age sensitivity hypothesis were invariably supported.

Is memory impairment greater than cognitive impairment in moderate chronic alcoholics?

The aims of the research were to test (i) whether moderate chronic alcoholics (A/pts) perform worse than non teetotaler controls (C/pts) either on memory or on intelligence tasks or on both, and (ii) whether there was a significant difference between verbal and spatial memory scores pointing to the claimed prevailing right hemisphere sensitivity to alcohol abuse. Great care was taken in selecting C/pts not to exaggerate by sample biasing the psychological effects of alcoholism. Intelligence was tested by means of verbal and performance Wechsler-Bellevue IQ and Raven PM47; memory was tested by means of serial immediate memory span and learning by means of verbal and spatial devices. The results support the conclusion that chronic wine alcoholism in a band of drinkers with lowish educational background and very set drinking habits impairs memory and intelligence without any significant difference. Moreover there is no evidence of a prevalent right hemisphere sensitivity to chronic alcohol addiction.

A Revised Table for Computing Conceptual Quotient Equivalents for the Shipley Institute of Living Scale

Errors were noted in the table of conceptual quotients provided in the manual for the Shipley Institute of Living Scale. In this paper, corrected values for these conceptual quotients are provided.

A comparison of the effects of long-term alcohol abuse and aging on the performance of verbal and nonverbal divided attention tasks

The purpose of this study was to assess two versions of the hypothesis that alcohol abuse results in premature aging of the brain and of cognitive functioning. The performances of detoxified long-term alcoholic was compared with that of nonalcoholic controls on three divided attention tasks known to be sensitive to aging. While both forms of the premature aging hypothesis predicted that alcoholics should perform more poorly than controls, the hypotheses differed in their predictions of the interactions between the effects of alcohol and normal aging. The results showed that while all three tasks were sensitive to age, only two were affected by long-term alcohol abuse. On one of the tests affected by both age and alcohol abuse, the performance of both young and old alcoholics was equally impaired whereas on the other, only the older alcoholics had significant difficulties. Based on these findings it was concluded that there was only partial overlap between the effects of alcohol and aging, and that neither of the two forms of the premature aging hypothesis could predict the observed pattern of results.

Disturbances of attention in alcohol withdrawal syndrome

Disturbances of attention have often been noted clinically in the alcohol withdrawal syndrome, but no studies to date have systematically explored this phenomenon. The present study examined attentional impairment in 20 tranquilizer-free alcohol withdrawal patients by using continuous performance tests assessing concentration in both an auditory and a visual mode. It was found that withdrawal patients generally evidenced poorer auditory than visual concentration. To investigate the relationship between the time-course of withdrawal and attentional impairment, the alcoholics were divided into an Early "Detox" and a Late "Detox" group, predicated on the reported amount of time since last alcohol consumption. Contrary to expectation, those alcoholics with a longer time-lapse since cessation exhibited poorer attentional performance than those with a shorter time-lapse. The possibility of an independent course for mental symptoms apart from physiological withdrawal signs was discussed.

Neuropsychological performance in schizophrenics with histories of substance abuse

Both schizophrenia and substance abuse have been associated with cerebral impairment, although the neuro psychological performance of schizophrenic patients with substance abuse histories has not been examined. In this study, the Luria-Nebraska Neuropsychological Battery was administered to schizophrenic patients with or without histories of substance abuse. The study found that the schizophrenics without substance abuse histories showed evidence of cerebral dysfunction, while those schizophrenics with histories of substance abuse could not be differentiated from normal.

Thalamic mediodorsal nucleus and memory: a critical evaluation of studies in animals and man

Following a general description of the anatomical organization of the thalamic mediodorsal nucleus (MD) of animals and man, the involvement of this nucleus in the processing of memory related information has been evaluated by reviewing stimulation, electrophysiological, and lesion studies in animals, and by reviewing research on induced lesions, degenerative changes and vascular damage of MD in humans. Neither the results from animal experiments nor those from studies on humans provide clear-cut evidence for a specific, memory related role of MD. However, the findings here presented do support the theory that MD is one of several, possible memory related relay stations. While therapeutically induced and circumscribed lesions of MD rarely result in long-lasting memory deficits, pathological processes in MD are more likely to be followed by severe memory disturbances if one or more particular structures in addition to MD are included in the lesioned regions. Consequently, it is emphasized that only the disruption of more than one site along memory related pathways will result in severe and enduring memory deficits. To account for apparent inter-species differences in the involvement of MD in memory related processes, it has been argued that MD and its principal cortical target region might basically be involved in arousal and emotional processes, but that for primates and especially for man the phylogenetically young parvocellular sector of MD and its cortical projection region, the dorsolateral prefrontal cortex, are furthermore involved in memory functions, which are modulated by emotional factors via the rest of MD and the prefrontal cortex.

Cognitive impairment and other psychological scores derived from the content analysis of speech in detoxified male chronic alcoholics

Sober chronic alcoholic males, sober nonalcoholic males, and intoxicated nonalcoholic males were assessed along several psychological dimensions by means of the content analysis of speech. Average cognitive impairment scores were significantly greater among intoxicated nonalcoholics than sober chronic alcoholics and significantly greater in sober chronic alcoholics than in sober nonalcoholics. Sober chronic alcoholics, also, had a significantly higher score than sober nonalcoholics on depression, social alienation-personal disorganization (schizoid traits), separation, guilt, and diffuse anxiety, and hostility inward. The general mental health, including cognitive function, of sober chronic alcoholics is clearly impaired when compared to sober nonalcoholic individuals.

Cognitive impairment and chronic alcohol abuse: a neuropsychological study

Twenty-eight chronic alcoholic subjects were submitted to our Mental Deterioration Battery. The scores obtained by this group, corrected for age and educational level, were compared with those achieved by a control group. Our data do not confirm a selective impairment of the functions related to the right hemisphere; they show a diffuse cerebral damage and suggest, perhaps, a major impairment of the verbal functions subserved by the left hemisphere. Therefore, according to our data the question of selective hemispheric impairment as opposed to more diffuse cerebral damage in chronic alcoholism still remains open.

Specific memory deficits associated with prolonged alcohol abuse

The relationship between age, education, length and amount of heavy drinking, and performance on five memory tasks was investigated in 54 chronic alcoholics and 18 age-matched controls. Alcoholics with less than 12 yr of heavy drinking differed reliably from long-term (13-22 yr) and extended long-term drinkers (greater than 23 yr) in recognition memory for visual patterns when scores were corrected for age. Compared with controls, both groups of long-term drinkers were deficient on the visual, auditory, and Faces recognition tests. Age and education of alcoholics accounted for part of performance differences; length of alcohol abuse, however, predicted reliably the decline in memory scores on all but the tactual test. The profile of memory performances seemed to decrease linearly with increasing age and length of alcohol abuse.

Neuropsychological effect of chronic alcoholism on tactual-spatial performance and memory in males

To examine the hypothesis that the functioning of the right hemisphere is disrupted as a result of prolonged alcohol abuse, male middle-aged alcoholic patients and nonalcoholic controls were tested on the standard Tactual Performance Test (TPT) from the Halstead-Reitan Neuropsychological Test Battery or on a modified form of the TPT employing stimuli of low verbal codability. On the standard TPT, alcoholic patients were impaired relative to controls on timed performance and memory for TPT figures but not for location. Analysis of the pattern of timed performance indicated the presence of an alcohol-related deficit for the left hand; however, right-hand scores were not impaired in alcoholic patients. For the modified TPT, alcoholic patients were impaired relative to controls for level but not pattern of timed performance; memory for TPT figures was impaired in alcoholic patients although location scores were not. The standard and modified TPT were found to discriminate alcoholic and control subjects with equal accuracy. The results support the hypothesis that chronic alcoholism leads to a disruption in the normal function of the right cerebral hemisphere.

Assessment of neuropsychological functions in chronic alcoholics using a standardized version of Luria's Neuropsychological Technique

The Standardized Version of Luria's Neuropsychological Technique was administered to separate groups of alcoholics 3 and 11 weeks abstinent from alcohol and to an equated control group. The alcoholics were impaired compared to controls on most of the battery scales; 3-week abstinent alcoholics performed poorer than 11-week abstinent alcoholics on most scales, however, only on the Rhythm scale was the difference significant. These results and other analyses suggest that chronic alcoholics suffer from a mild diffuse-generalized brain dysfunction which persists for up to at least 11 weeks of abstinence.

Neuropsychological consequences of posttreatment drinking behavior in male alcoholics

A prospective study was designed to determine the neuropsychological consequences of continued alcohol consumption after treatment for alcoholism. Performance on 24 commonly used clinical neuropsychological tests was examined in 56 male alcoholics approximately 7 months after completion of an inpatient alcoholism treatment program. Abstainers (n = 17) performed better than those who resumed alcohol consumption. Although there was a significant decrease in alcohol consumption, posttreatment drinking behavior still predicted cognitive performance, with increased frequency and quantity per occasion having more deleterious consequences even at consumption levels that are deemed by some to be socially acceptable. It is concluded that alcohol consumption by former alcoholics might serve to maintain cognitive performance at reduced levels, and that this possibility should be considered in determining appropriate treatment goals for alcoholic patients.

Alcoholism and brain damage: an investigation using the Luria-Nebraska Neuropsychological Battery

Numerous neuropsychological tests have been used to assess the effects of chronic alcohol use on the brain. Recently, the introduction of the Standardized Luria-Nebraska Neuropsychological Battery has presented a fresh way of evaluating disorders due to brain dysfunction. The present paper is an investigation of deficits in alcoholics on the Luria-Nebraska Neuropsychological Battery. It was found that alcoholics differed from age--and education--matched controls on six of the fourteen scales of the test: Visual, Receptive Language, Arithmetic, Memory, Intelligence, and the Pathognomonic scale. An investigation of the individual items which differentiated alcoholics and controls found evidence that the effects of alcoholism are primarily seen in the more complex association areas of the brain, consistent with the conclusions reached by Gudeman and his associates. The implication and limitations of the present results were also discussed.