Spatial learning deficits in preschool children of alcoholics

Transgenerational Abnormalities Induced by Paternal Preconceptual Alcohol Drinking: Findings from Humans and Animal Models

Alcohol consumption during pregnancy and lactation is a widespread preventable cause of neurodevelopmental impairment in newborns. While the harmful effects of gestational alcohol use have been well documented, only recently, the role of paternal preconceptual alcohol consumption (PPAC) prior to copulating has drawn specific epigenetic considerations. Data from human and animal models have demonstrated that PPAC may affect sperm function, eliciting oxidative stress. In newborns, PPAC may induce changes in behavior, cognitive functions, and emotional responses. Furthermore, PPAC may elicit neurobiological disruptions, visuospatial impairments, hyperactivity disorders, motor skill disruptions, hearing loss, endocrine, and immune alterations, reduced physical growth, placental disruptions, and metabolic alterations. Neurobiological studies on PPAC have also disclosed changes in brain function and structure by disrupting the growth factors pathways. In particular, as shown in animal model studies, PPAC alters brain nerve growth factor (NGF) and brainderived neurotrophic factor (BDNF) synthesis and release. This review shows that the crucial topic of lifelong disabilities induced by PPAC and/or gestational alcohol drinking is quite challenging at the individual, societal, and familial levels. Since a nontoxic drinking behavior before pregnancy (for both men and women), during pregnancy, and lactation cannot be established, the only suggestion for couples planning pregnancies is to completely avoid the consumption of alcoholic beverages.

Recognition of facial expressions by alcoholic patients: a systematic literature review

BACKGROUND

Alcohol abuse and dependence can cause a wide variety of cognitive, psychomotor, and visual-spatial deficits. It is questionable whether this condition is associated with impairments in the recognition of affective and/or emotional information. Such impairments may promote deficits in social cognition and, consequently, in the adaptation and interaction of alcohol abusers with their social environment. The aim of this systematic review was to systematize the literature on alcoholics' recognition of basic facial expressions in terms of the following outcome variables: accuracy, emotional intensity, and latency time.

METHODS

A systematic literature search in the PsycINFO, PubMed, and SciELO electronic databases, with no restrictions regarding publication year, was employed as the study methodology.

RESULTS

The findings of some studies indicate that alcoholics have greater impairment in facial expression recognition tasks, while others could not differentiate the clinical group from controls. However, there was a trend toward greater deficits in alcoholics. Alcoholics displayed less accuracy in recognition of sadness and disgust and required greater emotional intensity to judge facial expressions corresponding to fear and anger.

CONCLUSION

The current study was only able to identify trends in the chosen outcome variables. Future studies that aim to provide more precise evidence for the potential influence of alcohol on social cognition are needed.

Family history of alcohol-use disorders and spatial working memory: effects on adolescent alcohol expectancies

OBJECTIVE

Family history (FH) of alcohol-use disorders (AUDs) has been associated with frontal lobe deficits, more positive expectations for alcohol effects, and increased risk of developing AUDs. We tested the hypothesis that anterior brain regions mediate the relationship between FH of AUDs and alcohol expectancies in adolescents.

METHOD

Nondrinking adolescents (N = 50) ages 12-14 completed measures of FH of AUDs, alcohol expectancies, and substance use and performed spatial working memory and vigilance tasks during functional magnetic resonance imaging.

RESULTS

Activation of the anterior cingulate significantly predicted alcohol expectancies (R(2)Delta = 9%, beta = .32, F(change) = 6.09, 1/43 df, p < .05). However, FH of AUDs was not associated with brain response or alcohol expectancies.

CONCLUSIONS

Although a mediational model was not supported, activation in the anterior cingulate was linked to alcohol expectancies, such that adolescents with less neural differentiation to task demands had more positive expectancies for alcohol's effects. These results provide a greater understanding of the interrelations among risk factors for AUD and point to individuals who might be targeted for early, cognitively based interventions.

An inverse relationship between typical alcohol consumption and facial symmetry detection ability in young women

The relationship between monthly alcohol consumption over the past 6 months and facial symmetry perception ability was examined in young sober women with typical college-age drinking patterns. Facial symmetry detection performance was inversely related to typical monthly alcohol consumption, r (41) = -0.57, p < 0.001. Other variables that were predictive of facial symmetry detection included alcohol-related hangover and blackout frequency over the past 6 months, number of alcoholic drinks over the past week, early adolescent alcohol consumption and frequency of drug use. The relationship between alcohol use and symmetry detection could not be explained by individual differences in personality, family alcoholism history or other drug use. These findings suggest the possibility of a neurotoxic effect of alcohol on facial symmetry perception ability in female undergraduate students. As similar results did not emerge for a test of dot symmetry detection, the findings appear specific to facial symmetry. No previous studies have examined the effect of alcohol history on symmetry detection. The findings add to a growing literature indicating negative visuospatial effects of early alcohol use, and suggest the importance of further research examining alcohol and drug effects on sober facial perception in non-alcoholic populations.

Impaired Emotional Facial Expression Recognition in Alcohol Dependence: Do These Deficits Persist With Midterm Abstinence?

BACKGROUND

Emotional facial expression (EFE) decoding has been repetitively shown to be impaired in alcoholic inpatients. The present study aimed to replicate and extend previous findings on EFE recognition deficits in alcoholism.

METHODS

Alcoholic and control participants' performances were compared on an EFE decoding task with a transversal and a longitudinal design. More specifically, 49 alcoholic individuals were recruited at a long-stay postdetoxification treatment center at the third or fourth week of their detoxification process. Twenty-two of them [abstinent alcoholic participants (AA)] were met at the end of their hospitalization process, 2 months later. The 27 remaining patients [dropping alcoholic participants(AD)] dropped out from treatment before the second meeting. A control group (C) of 22 participants was constituted, and assessed twice with the same average time as AA between the 2 assessments. The 3 groups were similar regarding age, sex, and education level. Participants were presented at both times with an EFE decoding test consisting of 16 photographs depicting EFE of happiness, anger, disgust, and sadness.

RESULTS

The results corroborated previous findings highlighting more EFE decoding deficits in alcoholic participants compared with control participants, with no improvement after 3 months of abstinence. Transversal analyses further evidenced more EFE decoding difficulties in AD than in AA compared with controls.

CONCLUSIONS

EFE decoding deficits in alcoholism persist with midterm abstinence. Alcoholic patients who dropped from treatment had the worst EFE decoding performance at baseline. Emotional facial expression decoding deficit could have a prognostic value in alcohol dependence.

Is the P300 deficit in alcoholism associated with early visual impairments (P100, N170)? An oddball paradigm

OBJECTIVE

Studies exploring chronic alcoholism with event-related potentials (ERPs) have shown delayed latency and reduced amplitude of the P300, a long-lasting positive potential reflecting decisional processing. This P300 deficit in alcoholism is generally interpreted as a disturbance in central nervous system inhibition or in memory/attention. The present study aimed at identifying if this electrophysiological deficit is already present on earlier components, and advances a new hypothesis concerning the interpretation of the P300 alteration.

METHODS

Patients suffering from alcoholism and matched healthy controls had to detect, in an oddball paradigm, emotional faces among a succession of neutral faces. Behavioral performance and ERP data (recorded from 32 electrodes) were analyzed.

RESULTS

In line with previous studies, data showed that alcoholism led to a P300 deficit. Moreover, we observed for the first time that this deficit begins at earlier visual (P100) and face-processing (N170) stages, and we found high positive correlations between P100, N170 and P300 for amplitude and latency values, suggesting cumulative deficits on the cognitive continuum.

CONCLUSIONS

We suggest that the P300 deficit observed in chronic alcoholism could be linked to earlier visuo-spatial deficits rather than being an impairment of the specific processes linked to the P300.

SIGNIFICANCE

These results call for reconsidering the interpretation of P300 impairments at a fundamental and clinical level, and shows that earlier ERP components must be taken into account in future studies.

P300 development during adolescence: Effects of DRD2 genotype

OBJECTIVE

Young boys at high risk for alcoholism by having a family history of alcoholism (FH+) have lower amplitude of the visual P300 event-related scalp potential. They have also been reported to have a slowing in the rate of P300 amplitude change during adolescence. The present study examined whether the change in P300 amplitude during adolescence in sons of alcoholics and nonalcoholics is affected by D2 dopamine receptor (DRD2) polymorphism.

METHODS

P300 was elicited with a visual discrimination task from 71 adolescent sons of alcoholics and social drinkers (Time 1, T1). The task was readministered 2 years later (Time 2, T2). Comparisons were made between boys who had the DRD2 A1 allele (A1+) and boys who did not (A1-), and between boys with one or both parents being alcoholic (FH+) and boys having no alcoholic parents (FH-).

RESULTS

Discrimination task accuracy was lowest in the highest risk group (A1+, FH+) at T1, and highest in the lowest risk group (A1-, FH-) at T2, producing a significant interaction of allelic group x family history group x session. Reaction time was faster at T2 than T1, and this effect was larger in FH-boys (125 ms) than FH+boys (40 ms). Overall, the behavioral results suggest mild performance deficits on the discrimination task are associated with higher risk for alcoholism. In both testing sessions, P300 attained larger amplitudes in sons of nonalcoholics than sons of alcoholics. At T2 compared to T1, both the latency and amplitude of the P300 were decreased. However, while the developmental P300 latency effect was equivalent in both the A1+ and A1- allelic groups, the P300 amplitude reduction during adolescence, measured both in response to targets and in target minus non-target subtraction waveforms, was only found in boys with the A1- allele.

CONCLUSION

Differences in the developmental course of P300 amplitude over the course of adolescence are dependent on DRD2 polymorphism.

SIGNIFICANCE

These results suggest the importance of genetic determinants of the dopaminergic system in understanding the P300 as a risk marker for substance abuse using an integrative developmental perspective.

Neuropsychological executive functioning in children at elevated risk for alcoholism: findings in early adolescence

One component of individual risk for alcoholism may involve cognitive vulnerabilities prodromal to alcoholism onset. This prospective study of 198 boys followed between 3 and 14 years of age evaluated neurocognitive functioning across three groups who varied in familial risk for future alcoholism. Measures of intelligence, reward-response, and a battery of neuropsychological executive and cognitive inhibitory measures were used. Executive functioning weaknesses were greater in families with alcoholism but no antisocial comorbidity. IQ and reward-response weaknesses were associated with familial antisocial alcoholism. Executive function effects were clearest for response inhibition, response speed, and symbol-digit modalities. Results suggest that executive deficits are not part of the highest risk, antisocial pathway to alcoholism but that some executive function weaknesses may contribute to a secondary risk pathway.

Neurobehavioral effects in rat pups whose sires were exposed to alcohol

Developmental neurobehavioral effects associated with maternal exposure to alcohol during pregnancy are well described, but little is known about the effects of paternal exposure prior to conception. Using a quasi-experimental, within-subjects design, neurobehavioral outcomes (reflex acquisition, activity, gait) and cerebral cortical layer thickness were assessed in Sprague-Dawley rat pups from breeding pairs where the sires were exposed to alcohol. Comparisons were made on the basis of the timing of conception relative to alcohol exposure: phase 1 (controls), prior to initiation of alcohol exposure; phase 2, during the period of treatment with 20% alcohol; and phase 3, following cessation of alcohol exposure. Phase 2 and 3 pups were noted to attain negative geotaxis and reflex suspension benchmarks earlier than control pups and to have more difficulty with balance. Phase 3 pups were noted to attain righting reflex earlier than controls. In addition, phase 3 pups demonstrated increased levels of reverse maze activity and a shorter and narrower gait. Brain morphometry revealed thickening of cortical sections I-IV and V-VI resulting in overall cortical enlargement in both phase 2 and 3 pups. Further analysis of phase 2 and 3 subphases based on the presumed stages of the spermatogenic cycle during which sires were exposed to alcohol revealed significant differences in maze activity, reflex acquisition, and gait length. These findings suggest pre-conception male exposure to alcohol may have an effect on the offspring and the extent of the effects may vary with the timing of alcohol exposure relative to conception.

Clinical validation of characteristics of the alcoholic family

PURPOSE

To validate, from a client and family perspective, the defining characteristics for the nursing diagnosis altered family processes: alcoholism; and to identify demographic, family, and selected treatment information from clients and family members.

METHODS

Subjects (N = 150) completed Fehring's (1987) Clinical Diagnostic Validation (CVD) Index for 110 defining characteristics of the nursing diagnosis altered family processes: alcoholism.

FINDINGS

Alcoholic families display behaviors of alcohol abuse, loss of control of drinking, denial, nicotine addiction, impaired communication, inappropriate expression of anger, and enabling behaviors. Family feelings indicate the presence of unhappiness, hurt, frustration, guilt, moodiness, powerlessness, loneliness, mistrust, anger, anxiety, and hopelessness.

CONCLUSIONS

These clinically validated characteristics will complete the assessment phase of this research and direct the path to future studies to determine appropriate goals/outcomes and interventions related to alcoholic families.

Thiamin deficiency and Korsakoff's syndrome: failure to find memory impairments following nonalcoholic Wernicke's encephalopathy

Prolonged alcohol consumption is associated with a variety of neuropsychiatric conditions, including the dense amnesic disorder known as Korsakoff's syndrome. Korsakoff's syndrome is frequently diagnosed in alcoholics after an episode of acute thiamin deficiency. The accepted view within the medical literature is that the etiology of this disorder lies in thiamin deficiency or Wernicke's encephalopathy. However, examination of the published reports of pure thiamin deficiency unaccompanied by chronic and excessive consumption of alcohol shows that, in this group of patients, the rate of progression to Korsakoff's syndrome is low. This result suggests that the memory impairments associated with alcohol-related brain damage cannot be attributed to thiamin deficiency alone. The etiology of alcohol-related cognitive impairments such as Korsakoff's syndrome is still poorly understood but several lines of evidence suggest multiple causal factors interact to produce deficits in performance. Animal models that manipulate only a single putative etiological factor are unlikely to elucidate the multiple influences that lead to Korsakoff's syndrome. A study of the natural history of alcohol-related brain damage is needed that will allow an assessment of individual risk factors and their interactions.