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Angerville B, Jurdana MA, Martinetti MP, Sarba R, Nguyen-Khac É, Naassila M, Dervaux A. Alcohol-related cognitive impairments in patients with and without cirrhosis. Alcohol Alcohol 2024; 59:agae008. [PMID: 38366913 DOI: 10.1093/alcalc/agae008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 01/17/2024] [Accepted: 01/26/2024] [Indexed: 02/19/2024] Open
Abstract
AIMS up to 80% of patients with alcohol use disorder display cognitive impairments. Some studies have suggested that alcohol-related cognitive impairments could be worsened by hepatic damage. The primary objective of this study was to compare mean scores on the Brief Evaluation of Alcohol-Related Neurocognitive Impairments measure between alcohol use disorder patients with (CIR+) or without cirrhosis (CIR-). METHODS we conducted a prospective case-control study in a hepatology department of a university hospital. All patients were assessed using the Evaluation of Alcohol-Related Neuropsychological Impairments test. RESULTS a total of 82 patients (50 CIR+, 32 CIR-) were included in this study. CIR- patients were significantly younger than CIR+ patients (respectively, 45.5 ± 6.8 vs 60.1 ± 9.0; P < .0001). After adjusting for age and educational level, the mean Evaluation of Alcohol-Related Neuropsychological Impairments total scores in the CIR+ group were significantly lower than in the group of CIR- patients (14.1 ± 0.7 vs 7.8 ± 0.4, respectively, P < .0001). The mean subscores on delayed verbal memory, alphabetical ordination, alternating verbal fluency, visuospatial abilities, and ataxia subtests were also significantly lower in the CIR+ than in the CIR- group (respectively, 1.9 ± 0.2 vs 2.8 ± 0.2; 1.8 ± 0.2 vs 2.7 ± 0.2; 2.2 ± 0.2 vs 3.6 ± 0.2; 0.7 ± 0.2 vs 1.6 ± 0.2; 0.7 ± 0.2 vs 3.1 ± 0.2; P < .0001 for all comparisons). CONCLUSIONS in the present study, alcohol use disorder patients with cirrhosis presented more severe cognitive impairments than those without cirrhosis. Longitudinal studies are needed to investigate how cirrhosis can influence cognitive impairments.
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Affiliation(s)
- Bernard Angerville
- Filière universitaire d'addictologie, EPS Barthélémy Durand, Étampes, 91150, France
- Université de Picardie Jules Verne, Centre Universitaire de Recherche en Santé, INSERM UMR 1247, Groupe de Recherche sur l'Alcool & les Pharmacodépendances, Amiens, 80000, France
| | - Marie-Alix Jurdana
- Université de Picardie Jules Verne, Centre Universitaire de Recherche en Santé, INSERM UMR 1247, Groupe de Recherche sur l'Alcool & les Pharmacodépendances, Amiens, 80000, France
| | | | - Ruxandra Sarba
- Département d'Hépato-Gastroenterologie, CHU d'Amiens, Amiens, 80000, France
| | - Éric Nguyen-Khac
- Université de Picardie Jules Verne, Centre Universitaire de Recherche en Santé, INSERM UMR 1247, Groupe de Recherche sur l'Alcool & les Pharmacodépendances, Amiens, 80000, France
- Département d'Hépato-Gastroenterologie, CHU d'Amiens, Amiens, 80000, France
| | - Mickael Naassila
- Université de Picardie Jules Verne, Centre Universitaire de Recherche en Santé, INSERM UMR 1247, Groupe de Recherche sur l'Alcool & les Pharmacodépendances, Amiens, 80000, France
| | - Alain Dervaux
- Filière universitaire d'addictologie, EPS Barthélémy Durand, Étampes, 91150, France
- Université de Picardie Jules Verne, Centre Universitaire de Recherche en Santé, INSERM UMR 1247, Groupe de Recherche sur l'Alcool & les Pharmacodépendances, Amiens, 80000, France
- Laboratoire de recherche PSYCHOMADD, Université paris Saclay, Villejuif, 94800, France
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Maurage P, Rolland B, Pitel AL, D'Hondt F. Five Challenges in Implementing Cognitive Remediation for Patients with Substance Use Disorders in Clinical Settings. Neuropsychol Rev 2023:10.1007/s11065-023-09623-1. [PMID: 37843739 DOI: 10.1007/s11065-023-09623-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 10/02/2023] [Indexed: 10/17/2023]
Abstract
Many patients with substance use disorders (SUDs) present cognitive deficits, which are associated with clinical outcomes. Neuropsychological remediation might help rehabilitate cognitive functions in these populations, hence improving treatment effectiveness. Nardo and colleagues (Neuropsychology Review, 32, 161-191, 2022) reviewed 32 studies applying cognitive remediation for patients with SUDs. They underlined the heterogeneity and lack of quality of studies in this research field but concluded that cognitive remediation remains a promising tool for addictive disorders. We capitalize on the insights of this review to identify the key barriers that currently hinder the practical implementation of cognitive remediation in clinical settings. We outline five issues to be addressed, namely, (1) the integration of cognitive remediation in clinical practices; (2) the selection criteria and individual factors to consider; (3) the timing to be followed; (4) the priority across trained cognitive functions; and (5) the generalization of the improvements obtained. We finally propose that cognitive remediation should not be limited to classical cognitive functions but should also be extended toward substance-related biases and social cognition, two categories of processes that are also involved in the emergence and persistence of SUDs.
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Affiliation(s)
- Pierre Maurage
- Louvain Experimental Psychopathology Research Group (LEP), Psychological Science Research Institute, UCLouvain, Louvain-La-Neuve, Belgium.
- Faculté de Psychologie, Place du Cardinal Mercier, 10, B-1348, Louvain-La-Neuve, Belgium.
| | - Benjamin Rolland
- Service Universitaire d'Addictologie de Lyon (SUAL), Hospices Civils de Lyon, CH Le Vinatier, Lyon, France & PSYR, CRNL, INSERM U1028, CNRS UMR5292, UCBL1, Lyon, France
| | - Anne-Lise Pitel
- Normandie Univ, UNICAEN, INSERM, U1237, Physiopathology and Imaging of Neurological Disorders (PhIND), Institut Blood and Brain @ Caen-Normandie, Cyceron, France
| | - Fabien D'Hondt
- Univ. Lille, Inserm, CHU Lille, U1172-LilNCog-Lille Neuroscience & Cognition, Lille, France
- Centre National de Ressources Et de Résilience Lille-Paris (CN2R), Lille, France
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Jones L, Owens L, Thompson A, Gilmore I, Richardson P. Informing the development of diagnostic criteria for differential diagnosis of alcohol-related cognitive impairment (ARCI) among heavy drinkers: A systematic scoping review. PLoS One 2023; 18:e0280749. [PMID: 36753517 PMCID: PMC9907814 DOI: 10.1371/journal.pone.0280749] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 01/08/2023] [Indexed: 02/09/2023] Open
Abstract
BACKGROUND Early detection and diagnosis of alcohol-related cognitive impairment (ARCI) among heavy drinkers is crucial to facilitating appropriate referral and treatment. However, there is lack of consensus in defining diagnostic criteria for ARCI. Uncertainty in attributing a diagnosis of suspected ARCI commonly arises in clinical practice and opportunities to intervene are missed. A systematic scoping review approach was taken to (i) summarise evidence relating to screening or diagnostic criteria used in clinical studies to detect ARCI; and (ii) to determine the extent of the research available about cognitive assessment tools used in 'point-of-care' screening or assessment of patients with suspected non-Korsakoff Syndrome forms of ARCI. METHODS We searched Medline, PsycINFO, Cinahl and the Web of Science, screened reference lists and carried out forward and backwards citation searching to identify clinical studies about screening, diagnosis or assessment of patients with suspected ARCI. RESULTS In total, only 7 studies met our primary objective and reported on modifications to existing definitions or diagnostic criteria for ARCI. These studies revealed a lack of coordinated research and progress towards the development and standardisation of diagnostic criteria for ARCI. Cognitive screening tools are commonly used in practice to support a diagnosis of ARCI, and as a secondary objective we included an additional 12 studies, which covered a range of settings and patient populations relevant to screening, diagnosis or assessment in acute, secondary or community 'point-of-care' settings. Across two studies with a defined ARCI patient sample and a further four studies with an alcohol use disorder patient sample, the accuracy, validity and/or reliability of seven different cognitive assessment tools were examined. The remaining seven studies reported descriptive findings, demonstrating the lack of evidence available to draw conclusions about which tools are most appropriate for screening patients with suspected ARCI. CONCLUSION This review confirms the scarcity of evidence available on the screening, diagnosis or assessment of patients with suspected ARCI. The lack of evidence is an important barrier to the development of clear guidelines for diagnosing ARCI, which would ultimately improve the real-world management and treatment of patients with ARCI.
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Affiliation(s)
- Lisa Jones
- Liverpool Centre for Alcohol Research, Institute of Translational Medicine, University of Liverpool, Liverpool, United Kingdom
- Public Health Institute, Faculty of Health, Liverpool John Moores University, Liverpool, United Kingdom
- * E-mail:
| | - Lynn Owens
- Liverpool Centre for Alcohol Research, Institute of Translational Medicine, University of Liverpool, Liverpool, United Kingdom
- Department of Gastroenterology and Hepatology, Liverpool University Hospitals NHS Foundation Trust, Liverpool, United Kingdom
- Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, United Kingdom
| | - Andrew Thompson
- Liverpool Centre for Alcohol Research, Institute of Translational Medicine, University of Liverpool, Liverpool, United Kingdom
- Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, United Kingdom
| | - Ian Gilmore
- Liverpool Centre for Alcohol Research, Institute of Translational Medicine, University of Liverpool, Liverpool, United Kingdom
| | - Paul Richardson
- Liverpool Centre for Alcohol Research, Institute of Translational Medicine, University of Liverpool, Liverpool, United Kingdom
- Department of Gastroenterology and Hepatology, Liverpool University Hospitals NHS Foundation Trust, Liverpool, United Kingdom
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Lahbairi N, Laniepce A, Segobin S, Cabé N, Boudehent C, Vabret F, Rauchs G, Pitel AL. Determinants of health-related quality of life in recently detoxified patients with severe alcohol use disorder. Health Qual Life Outcomes 2022; 20:149. [PMID: 36310156 PMCID: PMC9620657 DOI: 10.1186/s12955-022-02058-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 09/19/2022] [Accepted: 10/03/2022] [Indexed: 11/04/2022] Open
Abstract
Background Health-related quality of life (HRQoL) is an important clinical outcome in Alcohol Use Disorder (AUD) and is considered as a relevant indicator of treatment success. While a better understanding of the factors affecting HRQoL would enable to adjust patients’ care to favour treatment outcome, the determinants of HRQoL in AUD remain unclear. This study aims at describing HRQoL in AUD patients and at identifying its best predictors. Methods 53 recently detoxified patients with severe AUD (sAUD) underwent a cognitive assessment and filled in a HRQoL questionnaire dedicated to AUD patients (Alcohol Quality of Life Scale; AQoLS), as well as questionnaires concerning socio-demographics, alcohol history, sleep quality, depression, anxiety and impulsivity. 38 healthy controls (HC) underwent the same assessment (except AQoLS) in order to identify the altered cognitive and clinical variables that could potentially be determinants of HRQoL in sAUD. Results sAUD patients reported that alcohol affects their HRQoL mainly in the “negative emotions”, “control”, “relationships”, and “sleep” domains. Compared to HC, they were impaired on episodic memory, working memory, executive functions, and processing speed tasks. They also reported lower sleep quality, higher depression, anxiety and impulsivity. No association was found between AQoLS total score and socio-demographics, cognitive performance, or sleep quality in patients. We found a significant correlation between HRQoL and depression/anxiety as well as impulsivity. Anxiety and impulsivity were indeed the only significant predictors of HRQoL, explaining 47.7% of the variance. Conclusion Anxiety and impulsivity are crucial determinants of HRQoL in recently detoxified sAUD patients. Since anxiety and impulsivity are frequent issues in addiction and especially in AUD, they should be particularly considered by clinicians to favour treatment outcomes.
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Affiliation(s)
- Najlaa Lahbairi
- grid.412043.00000 0001 2186 4076Neuropsychologie et Imagerie de la Mémoire Humaine, Normandie Univ, UNICAEN, PSL Université de Paris, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, 14000 Caen, France
| | - Alice Laniepce
- grid.412043.00000 0001 2186 4076Neuropsychologie et Imagerie de la Mémoire Humaine, Normandie Univ, UNICAEN, PSL Université de Paris, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, 14000 Caen, France ,grid.460771.30000 0004 1785 9671Normandie Univ, UNIROUEN, CRFDP (EA 7475), 76000 Rouen, France
| | - Shailendra Segobin
- grid.412043.00000 0001 2186 4076Neuropsychologie et Imagerie de la Mémoire Humaine, Normandie Univ, UNICAEN, PSL Université de Paris, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, 14000 Caen, France
| | - Nicolas Cabé
- grid.412043.00000 0001 2186 4076Neuropsychologie et Imagerie de la Mémoire Humaine, Normandie Univ, UNICAEN, PSL Université de Paris, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, 14000 Caen, France ,grid.411149.80000 0004 0472 0160Service d’Addictologie, Centre Hospitalier Universitaire de Caen, 14000 Caen, France ,grid.417831.80000 0004 0640 679XNormandie Univ, UNICAEN, INSERM, U1237, PhIND Physiopathology and Imaging of Neurological Disorders, NEUROPRESAGE Team, (Institut Blood and Brain @ Caen-Normandie), Cyceron, 14000 Caen, France
| | - Céline Boudehent
- grid.412043.00000 0001 2186 4076Neuropsychologie et Imagerie de la Mémoire Humaine, Normandie Univ, UNICAEN, PSL Université de Paris, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, 14000 Caen, France ,grid.411149.80000 0004 0472 0160Service d’Addictologie, Centre Hospitalier Universitaire de Caen, 14000 Caen, France ,grid.417831.80000 0004 0640 679XNormandie Univ, UNICAEN, INSERM, U1237, PhIND Physiopathology and Imaging of Neurological Disorders, NEUROPRESAGE Team, (Institut Blood and Brain @ Caen-Normandie), Cyceron, 14000 Caen, France
| | - François Vabret
- grid.412043.00000 0001 2186 4076Neuropsychologie et Imagerie de la Mémoire Humaine, Normandie Univ, UNICAEN, PSL Université de Paris, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, 14000 Caen, France ,grid.411149.80000 0004 0472 0160Service d’Addictologie, Centre Hospitalier Universitaire de Caen, 14000 Caen, France ,grid.417831.80000 0004 0640 679XNormandie Univ, UNICAEN, INSERM, U1237, PhIND Physiopathology and Imaging of Neurological Disorders, NEUROPRESAGE Team, (Institut Blood and Brain @ Caen-Normandie), Cyceron, 14000 Caen, France
| | - Géraldine Rauchs
- grid.412043.00000 0001 2186 4076Neuropsychologie et Imagerie de la Mémoire Humaine, Normandie Univ, UNICAEN, PSL Université de Paris, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, 14000 Caen, France ,grid.417831.80000 0004 0640 679XNormandie Univ, UNICAEN, INSERM, U1237, PhIND Physiopathology and Imaging of Neurological Disorders, NEUROPRESAGE Team, (Institut Blood and Brain @ Caen-Normandie), Cyceron, 14000 Caen, France
| | - Anne-Lise Pitel
- grid.412043.00000 0001 2186 4076Neuropsychologie et Imagerie de la Mémoire Humaine, Normandie Univ, UNICAEN, PSL Université de Paris, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, 14000 Caen, France ,grid.417831.80000 0004 0640 679XNormandie Univ, UNICAEN, INSERM, U1237, PhIND Physiopathology and Imaging of Neurological Disorders, NEUROPRESAGE Team, (Institut Blood and Brain @ Caen-Normandie), Cyceron, 14000 Caen, France
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Clergue-Duval V, Barré T, Cognat E, Brichet AL, Géraud C, Azuar J, Michaud P, Lecallier D, Arfaoui-Geffroy S, Hispard E, Paquet C, Bellivier F, Questel F, Vorspan F. Patients With Severe Alcohol-Related Cognitive Impairment Improve in Flexibility When Abstinence Is Maintained: A Comparative Study With Alzheimer’s Disease. Front Psychol 2022; 13:936639. [PMID: 35846663 PMCID: PMC9285013 DOI: 10.3389/fpsyg.2022.936639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 06/06/2022] [Indexed: 11/16/2022] Open
Abstract
The disease progression of severe alcohol-related cognitive impairment (ARCI) is debated. The aim of this study was to compare the cognitive change of patients with severe ARCI in inpatient setting to that of patients with Alzheimer’s disease (AD). Fifteen consecutive patients with severe ARCI were recruited between 2013 and 2015. They received inpatient detoxification, neurological assessment, and inpatient cognitive rehabilitation in specialized facilities. Twelve patients, with documented AD matched on sex and initial cognitive impairment severity, were selected. All have benefited from two neuropsychological assessments. The neurocognitive change was tested in both groups with pair-wised Wilcoxon tests. ARCI and AD patients’ time course was compared with Mann–Whitney–Wilcoxon test. In ARCI group, first assessment occurred at 2.9 (± 2.2) months of abstinence and follow-up 6.5 (± 2.9) months later, the mean age was 56.5 (± 7.4) years, and 12 were men. In AD group, follow-up occurred at 12.8 (± 2.9) months (p < 10–3), the mean age was 72.3 (± 8.4) years (p < 10–3), and 10 were men. ARCI patients significantly improved on one executive function test (TMT-B; p < 0.05), while AD patients have worsened memory subtests on Free-and-Cued-Selective-Reminding Test (p < 0.05). These tests showed a statistically different change between severe ARCI and AD group (p < 0.05). Severe ARCI patients have improved in executive functioning, discernible on the TMT-B test, in specific care setting, including abstinence maintenance and rehabilitation. The disease progression was different from that observed in AD patients.
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Affiliation(s)
- Virgile Clergue-Duval
- Département de Psychiatrie et de Médecine Addictologique, Site Lariboisière Fernand-Widal, GHU APHP. Nord - Université Paris Cité, APHP, Paris, France
- ResAlCog (Réseau Pour la Prise en Charge des Troubles Cognitifs Liés à L’alcool), Paris, France
- Inserm UMRS-1144, Optimisation Thérapeutique en Neuropsychopharmacologie, Université Paris Cité, Paris, France
- UFR de Médecine, Université Paris Cité, Paris, France
- *Correspondence: Virgile Clergue-Duval,
| | - Thomas Barré
- Département de Psychiatrie et de Médecine Addictologique, Site Lariboisière Fernand-Widal, GHU APHP. Nord - Université Paris Cité, APHP, Paris, France
- ResAlCog (Réseau Pour la Prise en Charge des Troubles Cognitifs Liés à L’alcool), Paris, France
| | - Emmanuel Cognat
- Inserm UMRS-1144, Optimisation Thérapeutique en Neuropsychopharmacologie, Université Paris Cité, Paris, France
- UFR de Médecine, Université Paris Cité, Paris, France
- Centre de Neurologie Cognitive, Site Lariboisière Fernand-Widal, GHU APHP. Nord - Université Paris Cité, APHP, Paris, France
| | - Anne-Laure Brichet
- ResAlCog (Réseau Pour la Prise en Charge des Troubles Cognitifs Liés à L’alcool), Paris, France
- Clinique des Epinettes, Paris, France
| | - Claire Géraud
- Département de Psychiatrie et de Médecine Addictologique, Site Lariboisière Fernand-Widal, GHU APHP. Nord - Université Paris Cité, APHP, Paris, France
- ResAlCog (Réseau Pour la Prise en Charge des Troubles Cognitifs Liés à L’alcool), Paris, France
| | - Julien Azuar
- Département de Psychiatrie et de Médecine Addictologique, Site Lariboisière Fernand-Widal, GHU APHP. Nord - Université Paris Cité, APHP, Paris, France
- ResAlCog (Réseau Pour la Prise en Charge des Troubles Cognitifs Liés à L’alcool), Paris, France
- Inserm UMRS-1144, Optimisation Thérapeutique en Neuropsychopharmacologie, Université Paris Cité, Paris, France
| | - Philippe Michaud
- ResAlCog (Réseau Pour la Prise en Charge des Troubles Cognitifs Liés à L’alcool), Paris, France
- Unité Serge Korsakoff-Maison d’Accueil Spécialisée, Villeneuve-la-Garenne, France
| | - Dorothée Lecallier
- ResAlCog (Réseau Pour la Prise en Charge des Troubles Cognitifs Liés à L’alcool), Paris, France
- Clinique des Epinettes, Paris, France
| | - Sonia Arfaoui-Geffroy
- ResAlCog (Réseau Pour la Prise en Charge des Troubles Cognitifs Liés à L’alcool), Paris, France
- Clinique Médicale du Parc, Saint-Ouen-l'Aumône, France
| | - Eric Hispard
- Département de Psychiatrie et de Médecine Addictologique, Site Lariboisière Fernand-Widal, GHU APHP. Nord - Université Paris Cité, APHP, Paris, France
- ResAlCog (Réseau Pour la Prise en Charge des Troubles Cognitifs Liés à L’alcool), Paris, France
| | - Claire Paquet
- Inserm UMRS-1144, Optimisation Thérapeutique en Neuropsychopharmacologie, Université Paris Cité, Paris, France
- UFR de Médecine, Université Paris Cité, Paris, France
- Centre de Neurologie Cognitive, Site Lariboisière Fernand-Widal, GHU APHP. Nord - Université Paris Cité, APHP, Paris, France
| | - Frank Bellivier
- Département de Psychiatrie et de Médecine Addictologique, Site Lariboisière Fernand-Widal, GHU APHP. Nord - Université Paris Cité, APHP, Paris, France
- Inserm UMRS-1144, Optimisation Thérapeutique en Neuropsychopharmacologie, Université Paris Cité, Paris, France
- UFR de Médecine, Université Paris Cité, Paris, France
| | - Frank Questel
- Département de Psychiatrie et de Médecine Addictologique, Site Lariboisière Fernand-Widal, GHU APHP. Nord - Université Paris Cité, APHP, Paris, France
- ResAlCog (Réseau Pour la Prise en Charge des Troubles Cognitifs Liés à L’alcool), Paris, France
- Inserm UMRS-1144, Optimisation Thérapeutique en Neuropsychopharmacologie, Université Paris Cité, Paris, France
| | - Florence Vorspan
- Département de Psychiatrie et de Médecine Addictologique, Site Lariboisière Fernand-Widal, GHU APHP. Nord - Université Paris Cité, APHP, Paris, France
- Inserm UMRS-1144, Optimisation Thérapeutique en Neuropsychopharmacologie, Université Paris Cité, Paris, France
- UFR de Médecine, Université Paris Cité, Paris, France
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Laniepce A, Lahbairi N, Cabé N, Pitel AL, Rauchs G. Contribution of sleep disturbances to the heterogeneity of cognitive and brain alterations in alcohol use disorder. Sleep Med Rev 2021; 58:101435. [PMID: 33578081 DOI: 10.1016/j.smrv.2021.101435] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 09/22/2020] [Accepted: 10/27/2020] [Indexed: 12/28/2022]
Abstract
Cognitive and brain alterations are common in alcohol use disorder and vary importantly from one patient to another. Sleep disturbances are also very frequent in these patients and remain largely neglected even though they can persist after drinking cessation. Sleep disturbances may be the consequence of specific brain alterations, resulting in cognitive impairments. But sleep disruption may also exacerbate alcohol-related brain abnormalities and cognitive deficits through common pathophysiological mechanisms. Besides, sleep disturbances seem a vulnerability factor for the development of alcohol use disorder. From a clinical perspective, sleep disturbances are known to affect treatment outcome and to increase the risk of relapse. In this article, we conducted a narrative review to provide a better understanding of the relationships between sleep disturbances, brain and cognition in alcohol use disorder. We suggest that the heterogeneity of brain and cognitive alterations observed in patients with alcohol use disorder could at least partially be explained by associated sleep disturbances. We also believe that sleep disruption could indirectly favor relapse by exacerbating neuropsychological impairments required in psychosocial treatment and for the maintenance of abstinence. Implications for clinical practice as well as perspectives for future research are proposed.
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Affiliation(s)
- Alice Laniepce
- Normandie Univ, UNICAEN, PSL Université de Paris, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, Neuropsychologie et Imagerie de la Mémoire Humaine, 14000 Caen, France
| | - Najlaa Lahbairi
- Normandie Univ, UNICAEN, PSL Université de Paris, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, Neuropsychologie et Imagerie de la Mémoire Humaine, 14000 Caen, France
| | - Nicolas Cabé
- Normandie Univ, UNICAEN, PSL Université de Paris, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, Neuropsychologie et Imagerie de la Mémoire Humaine, 14000 Caen, France; Service d'Addictologie, Centre Hospitalier Universitaire de Caen, 14000 Caen, France
| | - Anne-Lise Pitel
- Normandie Univ, UNICAEN, PSL Université de Paris, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, Neuropsychologie et Imagerie de la Mémoire Humaine, 14000 Caen, France; Institut Universitaire de France (IUF), France
| | - Géraldine Rauchs
- Normandie Univ, UNICAEN, PSL Université de Paris, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, Neuropsychologie et Imagerie de la Mémoire Humaine, 14000 Caen, France.
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7
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Maurage P, Pabst A, Lannoy S, D'Hondt F, de Timary P, Gaudelus B, Peyroux E. Tackling heterogeneity: Individual variability of emotion decoding deficits in severe alcohol use disorder. J Affect Disord 2021; 279:299-307. [PMID: 33096328 PMCID: PMC7738413 DOI: 10.1016/j.jad.2020.10.022] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 09/02/2020] [Accepted: 10/11/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND Severe alcohol use disorder (SAUD) is associated with social cognition deficits. Patients with SAUD are impaired for the recognition of emotional facial expressions, particularly at early stages of abstinence. These deficits damage interpersonal relations and increase relapse risk. However, uncertainties still abound on their variation across emotions and on the heterogeneity of emotional impairments across patients. We addressed these questions by exploring how the deficit varies according to emotions' type/intensity and patients' heterogeneity. METHODS Sixty-five recently detoxified patients with SAUD and 65 matched healthy controls performed the Facial Emotion Recognition Test, assessing the ability to identify six emotions (anger, contempt, disgust, fear, happiness, sadness) displayed by morphed faces with various intensities. Accuracy scores and detection thresholds were collected for each emotion. Beyond group comparisons, multiple single-case analyses determined the percentage of patients presenting decoding deficits for each emotion. RESULTS When current depression and anxiety symptoms were controlled for, patients did not present a general emotion decoding deficit, but were rather characterized by specific deficits for disgust/contempt in accuracy, and for disgust in detection threshold scores. Single-case analyses showed that only a third of patients presented a clinically significant emotional deficit. CONCLUSIONS Patients with SAUD only present emotional decoding deficits for specific interpersonal emotions (disgust/contempt) when subclinical psychopathological states are controlled for, and show no general emotional impairment. This goes against the proposal of a generalized social cognition deficit in this population. This group effect moreover masks a massive heterogeneity across patients, which has implications at experimental and clinical levels.
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Affiliation(s)
- Pierre Maurage
- Louvain Experimental Psychopathology research group (LEP), Psychological Sciences Research Institute, UCLouvain, Louvain-la-Neuve, Belgium.
| | - Arthur Pabst
- Louvain Experimental Psychopathology research group (LEP), Psychological Sciences Research Institute, UCLouvain, Louvain-la-Neuve, Belgium
| | - Séverine Lannoy
- Louvain Experimental Psychopathology research group (LEP), Psychological Sciences Research Institute, UCLouvain, Louvain-la-Neuve, Belgium; Stanford University, Department of Psychiatry and Behavioral Sciences, Stanford, CA, USA
| | - 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
| | - Philippe de Timary
- Louvain Experimental Psychopathology research group (LEP), Psychological Sciences Research Institute, UCLouvain, Louvain-la-Neuve, Belgium; Department of Adult Psychiatry, Saint-Luc Academic Hospital & Institute of Neuroscience, UCLouvain, Brussels, Belgium
| | - Baptiste Gaudelus
- Centre de Neurosciences Cognitives, UMR 5229, CNRS, Bron, France; Service Universitaire de Réhabilitation, SUR-CL3R, Centre Hospitalier Le Vinatier, Lyon, France
| | - Elodie Peyroux
- Centre de Neurosciences Cognitives, UMR 5229, CNRS, Bron, France; Service Universitaire de Réhabilitation, SUR-CL3R, Centre Hospitalier Le Vinatier, Lyon, France
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8
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Schmid F, Benzerouk F, Barrière S, Henry A, Limosin F, Kaladjian A, Gierski F. Heterogeneity of Executive Function Abilities in Recently Detoxified Patients with Alcohol Use Disorder: Evidence from a Cluster Analysis. Alcohol Clin Exp Res 2020; 45:163-173. [PMID: 33190273 DOI: 10.1111/acer.14517] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 11/08/2020] [Accepted: 11/09/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Impairments of executive functions (EF) have been consistently reported in patients with alcohol use disorder (AUD), mostly in studies which were based on comparisons of means between groups. However, given the high heterogeneity in AUD patients, this approach could actually cover a wide range of EF patterns. In the present study, we addressed the paucity of the literature about cognitive heterogeneity in AUD by applying a cluster analytical approach on EF measures. METHODS Seventy-eight withdrawn AUD patients and 77 healthy Control participants completed measures targeting a variety of EF components. We then used cluster analysis to identify subgroups of AUD patients. Furthermore, the AUD subgroups were compared to the Control group to establish their specific EF patterns. RESULTS Findings showed that AUD patients could be divided into 3 clusters based on their EF performances. A first cluster accounting for half of the AUD sample was characterized by unimpaired EF (Cluster 1). The 2 other clusters displayed major EF deficits but differed regarding the deficient EF component. While Cluster 2 was mainly impaired on measures of rule deduction and mental flexibility, Cluster 3 was mainly characterized by a lower processing speed and impaired inhibition of an ongoing motor response. Differences in EF performances of AUD patients could be related to differences in premorbid cognitive reserve, impulsiveness patterns, and withdrawal complications. CONCLUSIONS This study highlights the importance of the cognitive heterogeneity in AUD by showing that AUD patients display substantially different EF patterns. Future studies should try to go beyond mere group comparisons to further deepen our understanding about cognitive differences between AUD patients. In the long run, this could lead to more personalized prevention and treatment programs specifically tailored to the patient's impairments.
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Affiliation(s)
- Franca Schmid
- From the, Laboratoire Cognition Santé, Société (C2S - EA 6291), (FS, FB, AH, AK, FG), Université de Reims Champagne-Ardenne, Reims, France
| | - Farid Benzerouk
- From the, Laboratoire Cognition Santé, Société (C2S - EA 6291), (FS, FB, AH, AK, FG), Université de Reims Champagne-Ardenne, Reims, France.,CHU de Reims, EPSM Marne, (FB, SB, AH, AK, FG), Pôle Universitaire de Psychiatrie, Reims, France
| | - Sarah Barrière
- CHU de Reims, EPSM Marne, (FB, SB, AH, AK, FG), Pôle Universitaire de Psychiatrie, Reims, France
| | - Audrey Henry
- From the, Laboratoire Cognition Santé, Société (C2S - EA 6291), (FS, FB, AH, AK, FG), Université de Reims Champagne-Ardenne, Reims, France.,CHU de Reims, EPSM Marne, (FB, SB, AH, AK, FG), Pôle Universitaire de Psychiatrie, Reims, France
| | - Frédéric Limosin
- Paris Descartes Faculté de Médecine, (FL), Université de Paris, Paris, France.,Département de Psychiatrie, Hôpital Européen Georges-Pompidou, (FL), AP-HP. Centre - Université de Paris, Paris, France.,Institut de Psychiatrie et Neurosciences de Paris (IPNP), UMR_S1266, INSERM, (FL), Université de Paris, Paris, France
| | - Arthur Kaladjian
- From the, Laboratoire Cognition Santé, Société (C2S - EA 6291), (FS, FB, AH, AK, FG), Université de Reims Champagne-Ardenne, Reims, France.,CHU de Reims, EPSM Marne, (FB, SB, AH, AK, FG), Pôle Universitaire de Psychiatrie, Reims, France
| | - Fabien Gierski
- From the, Laboratoire Cognition Santé, Société (C2S - EA 6291), (FS, FB, AH, AK, FG), Université de Reims Champagne-Ardenne, Reims, France.,CHU de Reims, EPSM Marne, (FB, SB, AH, AK, FG), Pôle Universitaire de Psychiatrie, Reims, France.,INSERM U1247 GRAP, Groupe de recherche sur l'alcool et les pharmacodépendances, (FG), Université de Picardie Jules Verne, Amiens, France
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9
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Suchy Y, Brothers S, Mullen CM, Niermeyer MA. Chronic versus recent expressive suppression burdens are differentially associated with cognitive performance among older adults. J Clin Exp Neuropsychol 2020; 42:834-848. [PMID: 32951515 DOI: 10.1080/13803395.2020.1817862] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Introduction: Expressive suppression (ES; suppression of affective behavior) has been shown to have a deleterious impact on subsequently administered tests of executive functions (EF), threatening validity, and reliability of EF assessment. Past research has shown that recent ES (i.e., across 24 hours prior to testing) and chronic ES (i.e., across 2 weeks prior to testing) have differential impact on test performance. The present study compared the association of chronic vs. recent ES with speed vs. accuracy of performance on tests of EF and tests of lower-order processes. METHOD Participants were 255 community-dwelling older adults aged 60 and older. Participants completed timed subtests of the Delis-Kaplan Executive Function System and the Burden of State Emotion Regulation Questionnaire. RESULTS Hierarchical linear regressions examined the contributions of chronic vs. recent ES to test performance. Recent ES was related to scores of both speed and accuracy on EF tests. The association between recent ES and EF errors held beyond covariates (i.e., chronic ES, demographics, depression, and general cognitive status). In contrast, the association between recent ES and EF speed was fully explained by EF error scores. Chronic ES was associated only with speed of performance and only on lower-order tasks, but this relationship did not survive correction for cognitive, psychiatric, and demographic factors. CONCLUSIONS Recent ES appears to be a risk factor for EF lapses. Chronic ES, while related to performance speed, seems to also relate to several other cognitive, psychiatric, and demographic factors, which themselves explain slower information processing.
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Affiliation(s)
- Yana Suchy
- Department of Psychology, University of Utah , Salt Lake City, UT, USA
| | - Stacey Brothers
- Department of Psychology, University of Utah , Salt Lake City, UT, USA
| | - Christine M Mullen
- Department of Physical Medicine & Rehabilitation, University of Utah , Salt Lake City, UT, USA
| | - Madison A Niermeyer
- Department of Physical Medicine & Rehabilitation, University of Utah , Salt Lake City, UT, USA
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10
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Donoghue K, Rose A, Coulton S, Coleman R, Milward J, Philips T, Drummond C, Little H. Double-blind, placebo-controlled trial of mifepristone on cognition and depression in alcohol dependence. Trials 2020; 21:796. [PMID: 32938477 PMCID: PMC7493392 DOI: 10.1186/s13063-020-04726-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Accepted: 09/05/2020] [Indexed: 12/13/2022] Open
Abstract
Background Alcohol dependence is a significant issue contributing to disease burden. Changes in cortisol concentrations during alcohol withdrawal are associated with cognitive deficits and symptoms of depression. Current treatments are only successful for a small proportion of people and do not target cognitive deficits and symptoms of depression experienced by those who are alcohol dependent. The aim of this research is to determine the potential efficacy of mifepristone, a type II glucocorticoid receptor antagonist, to prevent symptoms of depression and cognitive deficits following alcohol detoxification. Methods This was a phase 2 therapeutic use trial. It was a double-blind randomised controlled clinical trial of mifepristone versus inactive placebo treatment. The trial aimed to recruit 120 participants who met the inclusion criteria: (1) male, (2) aged 18–60 years inclusive, and (3) alcohol dependent for 5 or more years. Participants were randomised to 600 mg a day mifepristone (200 mg morning, afternoon, and evening) for 7 days and 400 mg for the subsequent 7 days (200 mg morning and evening) or the equivalent number of placebo tablets for 14 days. Primary outcome measures were cognitive function (measured using the Cambridge Neuropsychological Test Automated Battery (CANTAB)) and symptoms of depression (measured using the Beck Depression Inventory (BDI)) at 4 weeks post-randomisation. Results Difficulties recruiting participants due to significant changes in the provision of inpatient care for alcohol dependence resulted in only 27 participants recruited to the trial, with data available for 21 participants. Fourteen participants were randomised to receive mifepristone and 13 to receive placebo. Conclusion Larger trials would be needed to draw conclusions about the efficacy of mifepristone. Trial registration ISRCTN registry ISRCTN54001953. Registered on 29 September 2011.
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Affiliation(s)
- Kim Donoghue
- Addictions Department, National Addiction Centre, Institute of Psychiatry, King's College London, 4 Windsor Walk, London, SE5 8BB, UK.
| | - Abigail Rose
- Department of Psychological Sciences, University of Liverpool, 2.32, Eleanor Rathbone Building, Bedford Street South, Liverpool, L69 7ZA, UK
| | - Simon Coulton
- Centre for Health Service Studies, University of Kent, Canterbury, Kent, CT2 7NF, UK
| | - Rachel Coleman
- Department of Health Sciences, Seebohm Rowntree Building, University of York, Heslington, York, YO10 5DD, UK
| | - Joanna Milward
- Addictions Department, National Addiction Centre, Institute of Psychiatry, King's College London, 4 Windsor Walk, London, SE5 8BB, UK
| | - Thomas Philips
- Addictions Department, National Addiction Centre, Institute of Psychiatry, King's College London, 4 Windsor Walk, London, SE5 8BB, UK.,Institute for Clinical and Applied Health Research, Allam Medical Building,, University of Hull, Hull, HU6 7RX, UK
| | - Colin Drummond
- Addictions Department, National Addiction Centre, Institute of Psychiatry, King's College London, 4 Windsor Walk, London, SE5 8BB, UK
| | - Hilary Little
- Addictions Department, National Addiction Centre, Institute of Psychiatry, King's College London, 4 Windsor Walk, London, SE5 8BB, UK
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11
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Antonucci LA, Nettis MA, Juckel G, Roser P, Pergola G, Thoma P. Selective recall deficits for heterogeneous associations in detoxified individuals with alcohol use disorder. Behav Brain Res 2020; 390:112688. [PMID: 32407822 DOI: 10.1016/j.bbr.2020.112688] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Revised: 04/29/2020] [Accepted: 05/01/2020] [Indexed: 11/15/2022]
Abstract
AIM Alcohol use disorder (AUD) has been associated with recognition memory deficits. However, it remains unclear whether these deficits occur at the general recognition memory level or whether they selectively affect its subcomponents. Evidence suggests that recognition memory deficits may vary according to the heterogeneity of memory stimuli. Our aim was to investigate stimuli pair-dependent recognition memory deficits in AUD, using a cued recall task including homogeneous and heterogeneous stimuli pairs. METHODS Twenty-three patients with AUD (days since last alcohol consumption: 11.70 ± 10.20) and 23 healthy controls (HC) underwent a neuropsychological examination tapping attention, verbal fluency, logical, working and long-term memory, and a recognition and recall task involving both homogeneous (tool-tool) and heterogeneous (tool-scene, tool-animal) stimuli pairs. Group (AUD-HC) by condition (tool-tool, tool-scene, tool-animal) ANOVAs were performed on all neuropsychological indices. RESULTS In the neuropsychological examination, AUD individuals showed deficits in delayed recall and faster reaction times compared with HC. The administration of the recognition and recall task revealed specific performance decreases in cued recall occurring in the whole sample (AUD + HC) for heterogeneous (tool-scene, tool-animal) pairs compared with homogeneous pairs. Within this pattern, AUD patients showed a lower cued recall rate than HC only for tool-animal pairs. CONCLUSIONS Our results support the existence of specific recall/recollection deficits in AUD which occurred for heterogeneous, but not for homogeneous stimuli pairs. This finding calls for further neuroimaging investigations aimed at investigating the neurobiological substrate of (i) different recognition memory subcomponents, and (ii) the processing of stimuli with different degree or type of heterogeneity.
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Affiliation(s)
- Linda A Antonucci
- Department of Education, Psychology, Communication, University of Bari Aldo Moro, Bari, Italy; Department of Basic Medical Science, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, Italy; Department of Psychiatry and Psychotherapy, Ludwig-Maximilians University, Munich, Germany.
| | - Maria A Nettis
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College, London, United Kingdom
| | - Georg Juckel
- Department of Psychiatry, Psychotherapy and Preventive Medicine, LWL University Hospital, Ruhr University Bochum, Bochum, Germany
| | - Patrik Roser
- Department of Psychiatry, Psychotherapy and Preventive Medicine, LWL University Hospital, Ruhr University Bochum, Bochum, Germany
| | - Giulio Pergola
- Department of Basic Medical Science, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, Italy; Clinical Neuropsychology, Neuropsychological Therapy Centre, Faculty of Psychology, Ruhr University Bochum, Bochum, Germany; Lieber Institute for Brain Development, Baltimore, USA
| | - Patrizia Thoma
- Clinical Neuropsychology, Neuropsychological Therapy Centre, Faculty of Psychology, Ruhr University Bochum, Bochum, Germany
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12
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Chong A, Ha JM, Chung JY, Kim H, Cho YS. Follow-Up of Brain Single-Photon Emission Computed Tomography (SPECT) and Magnetic Resonance Imaging (MRI) in a Case of Seizure Caused by Osmotic Demyelination Syndrome. AMERICAN JOURNAL OF CASE REPORTS 2020; 21:e923406. [PMID: 32641680 PMCID: PMC7370574 DOI: 10.12659/ajcr.923406] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Patient: Male, 38-year-old Final Diagnosis: Osmotic demyelination syndrome Symptoms: Seizure Medication: — Clinical Procedure: — Specialty: Nuclear Medicine • Radiology
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Affiliation(s)
- Ari Chong
- Department of Nuclear Medicine, Chosun University Hospital, Gwangju, South Korea.,Department of Nuclear Medicine, School of Medicine, Chosun University, Gwangju, South Korea
| | - Jung-Min Ha
- Department of Nuclear Medicine, Chosun University Hospital, Gwangju, South Korea.,Department of Nuclear Medicine, School of Medicine, Chosun University, Gwangju, South Korea
| | - Ji Yeon Chung
- Department of Neurology, Chosun University Hospital, Gwangju, South Korea.,Department of Neurology, School of Medicine, Chosun University, Gwangju, South Korea
| | - Hoowon Kim
- Department of Neurology, Chosun University Hospital, Gwangju, South Korea.,Department of Neurology, School of Medicine, Chosun University, Gwangju, South Korea
| | - Yong Soo Cho
- Department of Radiology, Chosun University Hospital, Gwangju, South Korea
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13
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Abstract
OBJECTIVE To review deficits in emotional processing and social cognition potentially contributing to the dysfunctional emotion regulation and difficulties with interpersonal relationships observed in individuals with alcohol use disorder (AUD) and to provide directions for future research. METHOD First is presented a review of emotional and social-cognitive impairments in recently detoxified AUD individuals that include alexithymia, difficulties in decoding others' emotions, and reduced theory of mind and empathy skills. Social cognition disorders in AUD pose different issues discussed, such as whether (1) these deficits are consequences of excessive alcohol consumption or premorbid risk factors for addiction, (2) emotional and social impairments impede positive treatment outcome, (3) recovery of social abilities is possible with sustained abstinence, and (4) AUD patients are unaware of their emotional and social dysfunctions. Finally, current knowledge on structural and functional brain correlates of these deficits in AUD are reviewed. RESULTS Emotional and social-cognitive functions affected in AUD can potentially compromise efforts to initiate and maintain abstinence by hampering efficacy of clinical treatment. Such dysfunction can obstruct efforts to enable or reinstate higher-order abilities such as emotional self-regulation, motivation to change, success in interpersonal/social interactions, and emotional insight and awareness of social dysfunctions (i.e., accurate metacognition). CONCLUSIONS The present review highlights the need to account for emotional processing and social cognition in the evaluation and rehabilitation of alcohol-related neurocognitive disorders and to consider psychotherapeutic treatment involving remediation of emotional and social skills as implemented in psychiatric and neurological disorders. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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14
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Grazioli VS, Gmel G, Rougemont-Bücking A, Baggio S, Daeppen JB, Studer J. Attention deficit hyperactivity disorder and future alcohol outcomes: Examining the roles of coping and enhancement drinking motives among young men. PLoS One 2019; 14:e0218469. [PMID: 31216319 PMCID: PMC6584013 DOI: 10.1371/journal.pone.0218469] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Accepted: 06/03/2019] [Indexed: 11/19/2022] Open
Abstract
Objective Although there is evidence that Attention Deficit Hyperactivity Disorder (ADHD) symptoms are positively related to alcohol use and related problems among young adults, little research has examined the mechanisms that might explain this association. In response, this study examined the mediating effects of coping and enhancement drinking motives on the prospective associations between ADHD symptoms and alcohol outcomes. Method Participants (N = 4,536) were young men from the Cohort Study on Substance Use Risk Factors. Measures of ADHD symptoms and those of drinking motives, heavy episodic drinking (HED) and alcohol use disorder symptoms were used from the baseline and 15-month follow-up assessments. Results Findings indicated that the associations of ADHD-inattention symptoms with alcohol use disorder (AUD) symptoms and with HED were partially and completely mediated through drinking motives, respectively, whereas drinking motives did not mediate the ADHD-hyperactivity/impulsivity-symptoms-alcohol outcomes associations. Conclusion Results indicated that coping and enhancement motives partially explained the ADHD-inattention symptoms—subsequent alcohol outcomes association. These findings suggest that interventions targeting enhancement and coping motives may help prevent problematic drinking among young men with elevated ADHD-inattention symptoms.
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Affiliation(s)
- Véronique S. Grazioli
- Addiction Medicine, Lausanne University Hospital CHUV, Lausanne, Switzerland
- * E-mail:
| | - Gerhard Gmel
- Addiction Medicine, Lausanne University Hospital CHUV, Lausanne, Switzerland
- Addiction Switzerland, Lausanne, Switzerland
- Centre for Addiction and Mental Health, Toronto, Canada
- University of the West of England, Bristol, United Kingdom
| | | | - Stéphanie Baggio
- Division of Prison Health, Geneva University Hospitals, Geneva, Switzerland
- Life Course and Social Inequality Research Centre, University of Lausanne, Lausanne, Switzerland
| | | | - Joseph Studer
- Addiction Medicine, Lausanne University Hospital CHUV, Lausanne, Switzerland
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15
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Kumar R, Kumar KJ, Benegal V, Roopesh BN, Ravi GS. Effectiveness of an Integrated Intervention Program for Alcoholism (IIPA) for enhancing self-regulation: Preliminary evidence. Asian J Psychiatr 2019; 43:37-44. [PMID: 31078094 DOI: 10.1016/j.ajp.2019.05.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2018] [Revised: 04/07/2019] [Accepted: 05/02/2019] [Indexed: 12/25/2022]
Abstract
OBJECTIVE Alcoholism could be a core problem of self-regulatory failure. Several neurocognitive theories have hypothesized hypo-functioning or dysfunction of reflective (executive) system and heightened functioning of reactive (impulsive) system in self-regulatory failure implicated in drug addiction. Similarly, stress and affect dysregulation may breakdown self-regulation. The present study aimed to develop an Integrated Intervention Program for Alcoholism (IIPA) to enhance self-regulation and to test its effectiveness in the treatment of alcoholism. METHOD Individuals with early onset alcoholism (n = 50) were recruited after getting written informed consent. The study used randomized case control design. The participants were matched on age (+/-1 year) and education (+/-1 year). The TAU group received usual treatment for alcoholism which included pharmacotherapy, 6 sessions/week yoga and 3 sessions/week group therapy on relapse prevention. The intervention group received IIPA for 18 days along with usual treatment (except yoga sessions). The IIPA included several cognitive remediation tasks and mind-body exercise (Qigong and Tai Chi Chuan). Both groups were assessed on executive function tests and affect regulation scale at pre and post-intervention. The subjects were also followed up for 6 months to compare the abstinence between groups. RESULTS Both groups were comparable at baseline. At post-intervention, the IIPA group showed a significant improvement compared to the TAU group on executive functioning and affect regulation. Follow-up results showed lower relapses in six months in the IIPA group. CONCLUSION Preliminary evidence showed that IIPA is effective in facilitating self-regulation. Further study may examine its utility and feasibility in other clinical conditions.
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Affiliation(s)
- Rajesh Kumar
- Department of Clinical Psychology, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru 560029, India.
| | - Keshav J Kumar
- Department of Clinical Psychology, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru 560029, India.
| | - Vivek Benegal
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru 560029, India.
| | - Bangalore N Roopesh
- Department of Clinical Psychology, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru 560029, India.
| | - Girikematha S Ravi
- Department of Biostatistics, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru 560029, India.
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16
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Haalboom R, van Aken L, Walvoort SJW, Egger JIM, Kessels RPC. Preserved intellectual functioning in Korsakoff’s syndrome? Actual and premorbid intelligence in patients with major or mild alcohol-related cognitive disorder. JOURNAL OF SUBSTANCE USE 2019. [DOI: 10.1080/14659891.2019.1619101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Rhody Haalboom
- Thalamus Centre for Outpatient Neuropsychiatry, Pro Persona, Wolfheze, The Netherlands
| | - Loes van Aken
- 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
| | - Serge J. W. Walvoort
- 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
| | - Roy P. C. Kessels
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
- 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
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17
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Byczewska-Konieczny K. Relation between cognitive and behavioral aspects of dysexecutive functioning in normal aging. APPLIED NEUROPSYCHOLOGY-ADULT 2019; 27:334-344. [PMID: 30719930 DOI: 10.1080/23279095.2018.1550409] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The aim of this study was to investigate the relation between cognitive and behavioral symptoms of dysexecutive functioning, understood as two aspects of dysexecutive syndrome, in an elderly nonclinical sample. Most previous studies have concentrated on clinical population. However, nonclinical population of elderly adults is, in this context, a group of special interest due to a large body of evidence indicating that executive functions decrease pronouncedly in the course of normal aging. The data were collected from 40 participants aged 67-86 years. None presented symptoms of cognitive disorder or depression or reported psychiatric or neurological problems. The Dysexecutive Questionnaire was used as a measure of behavioral aspect of dysexecutive syndrome. Participants also performed experimental tasks referring to three cognitive aspects of executive functioning (i.e., updating, inhibition, and attentional shifting). Analysis resulted in weak and nonsignificant correlations between cognitive and behavioral aspects of dysexecutive syndrome. Results are discussed in the context of previous research and diagnostic criteria of dysexecutive syndrome.
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18
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Galandra C, Basso G, Manera M, Crespi C, Giorgi I, Vittadini G, Poggi P, Canessa N. Abnormal fronto-striatal intrinsic connectivity reflects executive dysfunction in alcohol use disorders. Cortex 2019; 115:27-42. [PMID: 30738999 DOI: 10.1016/j.cortex.2019.01.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Revised: 11/19/2018] [Accepted: 01/10/2019] [Indexed: 12/12/2022]
Abstract
The neural bases of cognitive impairment(s) in alcohol use disorders (AUDs) have been explained either with the specific involvement of frontal regions mostly affected by alcohol neurotoxic effects, or with a global brain damage underlying different neuro-cognitive alterations. Novel insights into this issue might come from the analysis of resting-state brain activity, representing a baseline level of intrinsic connectivity within and between the networks underlying cognitive performance. We thus addressed the neural bases of cognitive impairment(s) in 22 AUD patients, compared with 18 healthy controls, by coupling resting-state fMRI with an in-depth neuropsychological assessment of the main cognitive domains. We assessed a relationship between AUD patients' cognitive impairment and two complementary facets of intrinsic brain functioning, i.e., intensity of activation and functional network connectivity, related to the strength of connectivity within and between resting-state networks, respectively. Alcoholic patients' decreased cognitive performance involved specifically an executive domain associated with attentional and working-memory tasks. This impairment reflected an abnormal relationship, in patients versus controls, between cognitive performance and the intensity of intrinsic activity in the dorsolateral prefrontal and striatal nodes of the executive control network. Functional connectivity between the same structures was positively correlated with executive performance in the whole sample, but significantly reduced in patients. The present data suggest that AUD patients' executive impairment reflects dysfunctional connectivity between the cortical and subcortical nodes of the networks underlying cognitive control on goal-directed behavior. This evidence provides a baseline for future studies addressing the abnormal neural architecture underlying cognitive impairment in AUDs and the outcome of rehabilitative treatment.
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Affiliation(s)
- Caterina Galandra
- Scuola universitaria superiore IUSS, Pavia, Italy; Cognitive Neuroscience Laboratory, ICS Maugeri, Pavia, Italy; LabNIT, ICS Maugeri, Pavia, Italy
| | - Gianpaolo Basso
- LabNIT, ICS Maugeri, Pavia, Italy; University of Milano-Bicocca, Milan, Italy
| | | | - Chiara Crespi
- Scuola universitaria superiore IUSS, Pavia, Italy; LabNIT, ICS Maugeri, Pavia, Italy
| | - Ines Giorgi
- Clinical Psychology Unit, ICS Maugeri, Pavia, Italy
| | | | | | - Nicola Canessa
- Scuola universitaria superiore IUSS, Pavia, Italy; Cognitive Neuroscience Laboratory, ICS Maugeri, Pavia, Italy.
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19
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Salience network structural integrity predicts executive impairment in alcohol use disorders. Sci Rep 2018; 8:14481. [PMID: 30262893 PMCID: PMC6160480 DOI: 10.1038/s41598-018-32828-x] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Accepted: 09/17/2018] [Indexed: 01/12/2023] Open
Abstract
The neural bases of cognitive impairment(s) in alcohol use disorders (AUDs) might reflect either a global brain damage underlying different neuro-cognitive alterations, or the involvement of specific regions mostly affected by alcohol neuro-toxic effects. While voxel-based-morphometry (VBM) studies have shown a distributed atrophic pattern in fronto-limbic and cerebellar structures, the lack of comprehensive neuro-cognitive assessments prevents previous studies from drawing robust inferences on the specificity of the association between neuro-structural and cognitive impairments in AUDs. To fill this gap, we addressed the neuro-structural bases of cognitive impairment in AUDs, by coupling VBM with an in-depth neuropsychological assessment. VBM results highlighted a diffuse pattern of grey matter reduction in patients, involving the key-nodes of the meso-cortico-limbic (striatum, hippocampus, medial prefrontal cortex), salience (insular and dorsal anterior cingulate cortex) and executive (inferior frontal cortex) networks. Grey matter density in the insular and anterior cingulate sectors of the salience network, significantly decreased in patients, explained almost half of variability in their defective attentional and working-memory performance. The multiple cognitive and neurological impairments observed in AUDs might thus reflect a specific executive deficit associated with the selective damage of a salience-based neural mechanism enhancing access to cognitive resources required for controlled cognition and behaviour.
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Viswam A, Nagarajan P, Kuppili PP, Bharadwaj B. Cognitive Functions among Recently Detoxified Patients with Alcohol Dependence and Their Association with Motivational State to Quit. Indian J Psychol Med 2018; 40:310-314. [PMID: 30093740 PMCID: PMC6065129 DOI: 10.4103/ijpsym.ijpsym_72_18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
CONTEXT Cognitive impairments are common among patients with alcohol dependence. It may involve frontal executive dysfunction, global cognitive impairments, or both. Motivation to quit alcohol involves recognition of alcohol use as a problem. This ability may be construed as a cognitive symptom. AIMS The aim is to study the frequency of cognitive dysfunction among patients with alcohol dependence and to study the association between cognitive dysfunction and the motivation to quit alcohol. MATERIALS AND METHODS Fifty-six adult males with alcohol dependence (International Classification of Diseases-10) who had completed a course of detoxification and who did not have active withdrawal symptoms or acute medical illnesses were recruited for this study. Their cognitive functions were tested using the Montreal Cognitive Assessment (MoCA) and Frontal Assessment Battery (FAB). Their motivation levels were assessed using the Stages of Change Readiness and Treatment Eagerness Scale. Clinical details were collected using a semi-structured pro forma. RESULTS Global cognitive impairment (MoCA < 26) was seen in 81% and frontal executive dysfunction (FAB < 12) in 16% of patients. Higher MoCA and FAB scores correlated with better education, while lower FAB scores correlated with higher age. The 14 patients (25%) with good motivation did not differ in age, education, years of dependence, or MoCA or FAB scores from poorly motivated patients. FAB scores, but not MoCA, were associated with poor motivation. All nine patients with FAB < 12 were poorly motivated to quit alcohol; likelihood score = 5.731, P = 0.017. CONCLUSIONS Four-fifths of patients with alcohol dependence had global cognitive impairments after the detoxification period. One-sixth had frontal executive dysfunction. Cognitive functions were not significantly correlated with the duration of dependence. Presence of frontal executive dysfunction was associated with almost six times likelihood that the patient will be poorly motivated to quit alcohol.
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Affiliation(s)
- Athira Viswam
- Department of Psychiatric Nursing, College of Nursing, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Padmavathi Nagarajan
- Department of Psychiatric Nursing, College of Nursing, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Pooja Patnaik Kuppili
- Department of Psychiatry, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Balaji Bharadwaj
- Department of Psychiatry, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
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Pujol CN, Paasche C, Laprevote V, Trojak B, Vidailhet P, Bacon E, Lalanne L. Cognitive effects of labeled addictolytic medications. Prog Neuropsychopharmacol Biol Psychiatry 2018; 81:306-332. [PMID: 28919445 DOI: 10.1016/j.pnpbp.2017.09.008] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Revised: 09/11/2017] [Accepted: 09/11/2017] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Alcohol, tobacco, and illegal drug usage is pervasive throughout the world, and abuse of these substances is a major contributor to the global disease burden. Many pharmacotherapies have been developed over the last 50years to target addictive disorders. While the efficacy of these pharmacotherapies is largely recognized, their cognitive impact is less known. However, all substance abuse disorders are known to promote cognitive disorders like executive dysfunction and memory impairment. These impairments are critical for the maintenance of addictive behaviors and impede cognitive behavioral therapies that are regularly administered in association with pharmacotherapies. It is also unknown if addictolytic medications have an impact on preexisting cognitive disorders, and if this impact is modulated by the indication of prescription, i.e. abstinence, reduction or substitution, or by the specific action of the medication. METHOD We reviewed the cognitive effects of labeled medications for tobacco addiction (varenicline, bupropion, nicotine patch and nicotine gums), alcohol addiction (naltrexone, nalmefene, baclofen, disulfiram, sodium oxybate, acamprosate), and opioid addiction (methadone, buprenorphine) in human studies. Studies were selected following MOOSE guidelines for systematic reviews of observational studies, using the keywords [Cognition] and [Cognitive disorders] and [treatment] for each medication. RESULTS 971 articles were screened and 77 studies met the inclusion criteria and were reported in this review (for alcohol abuse, n=21, for tobacco n=22, for opioid n=34. However, very few comparative clinical trials have explored the chronic effects of addictolytic medications on cognition in addictive behaviors, and there are no clinical trials on the cognitive impact of nalmefene in patients suffering from alcohol use disorders. DISCUSSION Although some medications seem to enhance cognition in patients suffering from cognitive disorders, others could promote cognitive impairments, and our work highlights a lack of literature on this subject. In conclusion, more comparative clinical trials are needed to better understand the cognitive impact of addictolytic medications.
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Affiliation(s)
- Camille Noélie Pujol
- Department of Neurosciences, Institute for Functional Genomics, INSERM U-661, CNRS UMR-5203, 34094 Montpellier, France
| | - Cecilia Paasche
- INSERM 1114, Department of Psychiatry and Addictology, University Hospital of Strasbourg, Fédération de Médecine Translationnelle de Strasbourg (FMTS), 67000 Strasbourg, France
| | - Vincent Laprevote
- Centre Psychothérapique de Nancy, Laxou, F-54520, France.; EA 7298, INGRES, Université de Lorraine, Vandoeuvre-lès-, Nancy F-54000, France; CHU Nancy, Maison des Addictions, Nancy, F-54000, France.
| | - Benoit Trojak
- Department of Psychiatry and Addictology, University Hospital of Dijon, France; EA 4452, LPPM, University of Burgundy, France.
| | - Pierre Vidailhet
- INSERM 1114, Department of Psychiatry and Addictology, University Hospital of Strasbourg, Fédération de Médecine Translationnelle de Strasbourg (FMTS), 67000 Strasbourg, France; Department of Psychiatry and Addictology, University Hospital of Strasbourg, Fédération de Médecine Translationnelle de Strasbourg (FMTS), 67000 Strasbourg, France..
| | - Elisabeth Bacon
- INSERM 1114, Department of Psychiatry and Addictology, University Hospital of Strasbourg, Fédération de Médecine Translationnelle de Strasbourg (FMTS), 67000 Strasbourg, France.
| | - Laurence Lalanne
- INSERM 1114, Department of Psychiatry and Addictology, University Hospital of Strasbourg, Fédération de Médecine Translationnelle de Strasbourg (FMTS), 67000 Strasbourg, France; Department of Psychiatry and Addictology, University Hospital of Strasbourg, Fédération de Médecine Translationnelle de Strasbourg (FMTS), 67000 Strasbourg, France..
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Abstract
SummaryThe relationship between alcohol use and cognitive impairment has been notoriously difficult to disentangle. We present what is known about cognitive impairment associated with alcohol use/misuse, covering the spectrum from mild and subtle cognitive change through to severe alcohol-related brain damage, including Wernicke-Korsakoff syndrome. We highlight aids to the diagnosis and management of these conditions, and emphasise the benefits of prompt treatment on outcome. We also review progress in understanding their neurobiology. Suggestions for possible service configuration based on both our clinical practice and national guidelines are given.Learning Objectives•Gain an understanding of the spectrum of clinical presentations found in alcohol-related brain damage.•Understand that the aetiology of these conditions is complex and not solely due to the neurotoxic effects of alcohol.•Be better able to plan for the rehabilitation of individuals with established alcohol-related brain damage in your local service area.
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Ewert V, Pelletier S, Alarcon R, Nalpas B, Donnadieu-Rigole H, Trouillet R, Perney P. Determination of MoCA Cutoff Score in Patients with Alcohol Use Disorders. Alcohol Clin Exp Res 2017; 42:403-412. [DOI: 10.1111/acer.13547] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2017] [Accepted: 11/01/2017] [Indexed: 11/30/2022]
Affiliation(s)
- Valérie Ewert
- Service Addictologie; Hôpital du Grau du Roi; CHU Caremeau; Nîmes France
| | - Stéphanie Pelletier
- Service Addictologie; Hôpital du Grau du Roi; CHU Caremeau; Nîmes France
- Inserm U1018; Paris France
| | - Régis Alarcon
- Service Addictologie; Hôpital du Grau du Roi; CHU Caremeau; Nîmes France
| | - Bertrand Nalpas
- Service Addictologie; Hôpital du Grau du Roi; CHU Caremeau; Nîmes France
- Département d'Information Scientifique et de Communication (DISC); Inserm; Paris France
| | - Hélène Donnadieu-Rigole
- Service Addictologie; Hôpital Saint-Eloi; CHU Montpellier; Montpellier France
- Inserm, U1183, IRMB; Hôpital Saint-Eloi; CHU Montpellier; Montpellier France
| | | | - Pascal Perney
- Service Addictologie; Hôpital du Grau du Roi; CHU Caremeau; Nîmes France
- Inserm U1018; Paris France
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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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Montgomery-Graham S. Conceptualization and Assessment of Hypersexual Disorder: A Systematic Review of the Literature. Sex Med Rev 2017; 5:146-162. [DOI: 10.1016/j.sxmr.2016.11.001] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2016] [Revised: 11/25/2016] [Accepted: 11/27/2016] [Indexed: 10/20/2022]
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Executive Functioning of Sexually Compulsive and Non-Sexually Compulsive Men Before and After Watching an Erotic Video. J Sex Med 2017; 14:347-354. [PMID: 28117268 DOI: 10.1016/j.jsxm.2016.12.235] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2016] [Revised: 11/17/2016] [Accepted: 12/16/2016] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Despite the serious behavioral consequences faced by individuals with sexual compulsivity, related neuropsychological studies are sparse. AIM To compare decision making and cognitive flexibility at baseline and after exposure to an erotic video in sexually compulsive participants and non-sexually compulsive controls. METHODS The sample consisted of 30 sexually compulsive men and 30 controls. Cognitive flexibility was investigated through the Wisconsin Card Sorting Test and decision making was examined through the Iowa Gambling Task. MAIN OUTCOME MEASURES Wisconsin Card Sorting Test categories, correct responses, and perseverative errors and Iowa Gambling Task general trends and blocks. RESULTS Sexually compulsive subjects and controls performed similarly at baseline. After watching an erotic video, controls performed better in block 1 of the Iowa Gambling Task (P = .01) and had more correct responses on the Wisconsin Card Sorting Test (P = .01). CONCLUSIONS The controls presented fewer impulsive initial choices and better cognitive flexibility after exposure to erotic stimuli. Messina B, Fuentes D, Tavares H, et al. Executive Functioning of Sexually Compulsive and Non-Sexually Compulsive Men Before and After Watching an Erotic Video. J Sex Med 2017;14:347-354.
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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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Walvoort SJW, van der Heijden PT, Wester AJ, Kessels RPC, Egger JIM. Self-awareness of cognitive dysfunction: Self-reported complaints and cognitive performance in patients with alcohol-induced mild or major neurocognitive disorder. Psychiatry Res 2016; 245:291-296. [PMID: 27567191 DOI: 10.1016/j.psychres.2016.08.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2015] [Revised: 07/27/2016] [Accepted: 08/03/2016] [Indexed: 12/19/2022]
Abstract
Patients with Korsakoff's syndrome (KS) typically have difficulties in recognizing the impact of their alcohol-related cognitive deficits on daily-life functioning. In this study, mean scores on self-reported complaints (measured with Minnesota Multiphasic Personality Inventory-2-Restructured Form; MMPI-2-RF) and cognitive performance (measured with the Wechsler Adult Intelligence Scale-Third edition; WAIS-III; and the California Verbal Learning Test; CVLT) are compared between two matched patient groups with severe (KS) and mild alcohol-related cognitive disorders or non KS (NKS). KS patients demonstrate significantly lower scores on the WAIS-III indices and on the CVLT than the matched NKS group, and significantly higher scores on MMPI-2-RF validity scales that indicate denial of psychological complaints. Both groups are in the normal range on MMPI-2-RF Cognitive Complaints (COG) and Neurological Complaints (NUC) scales compared with the normative sample. Finally, self-reported complaints and cognitive performance are not correlated significantly in both groups. Despite their alcohol-related cognitive impairments, both groups report no cognitive complaints at all indicating self-awareness impairment. In addition to KS patients, also NKS patients are at risk that their apparently "without cognitive complaints" appearance on self-report questionnaires can be easily overlooked. These findings may have important clinical implications for diagnostic and treatment purposes.
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Affiliation(s)
- Serge J W Walvoort
- 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; Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands.
| | - Paul T van der Heijden
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands; Reinier van Arkel Mental Health Institute, 's-Hertogenbosch, The Netherlands
| | - Arie J Wester
- 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
| | - Jos I M Egger
- 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; Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands; Centre of Excellence for Neuropsychiatry, Vincent van Gogh Institute for Psychiatry, Venray, The Netherlands
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29
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Ritz L, Coulbault L, Lannuzel C, Boudehent C, Segobin S, Eustache F, Vabret F, Pitel AL, Beaunieux H. Clinical and Biological Risk Factors for Neuropsychological Impairment in Alcohol Use Disorder. PLoS One 2016; 11:e0159616. [PMID: 27617840 PMCID: PMC5019388 DOI: 10.1371/journal.pone.0159616] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Accepted: 07/06/2016] [Indexed: 12/16/2022] Open
Abstract
The effects of alcoholism on cognitive and motor functioning are heterogeneous. While the role of some factors (patterns of alcohol consumption, eating habits or associated liver disease) has been hypothesized, the origins of this heterogeneity remain difficult to establish. The goals of the present study were thus to identify the clinical and biological risk factors for alcohol-related neuropsychological impairments and to determine the threshold beyond which these risk factors can be considered significant. Thirty alcoholic patients and 15 healthy controls had a blood test and underwent a neuropsychological examination. Alcohol severity measures, and liver, thiamine and malnutrition variables, were included in logistic regression models to determine the risk factors for cognitive and motor impairments (executive functions, visuospatial abilities, verbal episodic memory, ataxia), as well as those related to the severity of patients’ overall neuropsychological profile (moderate or severe impairments). Liver fibrosis was found to be a risk factor for executive impairments and also for ataxia, when it was associated with long-term alcohol misuse and symptoms of withdrawal. Altered thiamine metabolism was solely predictive of verbal episodic memory impairments. This combination of biological abnormalities was associated with a profile of moderate neuropsychological impairments. Malnutrition was associated with a profile of more severe impairments. Malnutrition, altered liver function and thiamine metabolism explain, at least partially, the heterogeneity of alcohol-related neuropsychological impairments. Our findings could allow clinicians to identify patients at particular risk of severe neuropsychological impairments before the onset of irreversible and debilitating neurological complications.
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Affiliation(s)
- Ludivine Ritz
- U1077, INSERM, Caen, France
- UMR-S1077, Université de Caen Normandie, UMR-S1077, Caen, France
- UMR-S1077, Ecole Pratique des Hautes Etudes, Caen, France
- U1077, Centre Hospitalier Universitaire, Caen, France
| | - Laurent Coulbault
- Centre Hospitalier Universitaire, Laboratoire de biochimie, Caen, France
- Université de Caen Normandie, Laboratoire EA4650, Caen, France
| | - Coralie Lannuzel
- U1077, INSERM, Caen, France
- UMR-S1077, Université de Caen Normandie, UMR-S1077, Caen, France
- UMR-S1077, Ecole Pratique des Hautes Etudes, Caen, France
- U1077, Centre Hospitalier Universitaire, Caen, France
| | - Céline Boudehent
- U1077, INSERM, Caen, France
- UMR-S1077, Université de Caen Normandie, UMR-S1077, Caen, France
- UMR-S1077, Ecole Pratique des Hautes Etudes, Caen, France
- U1077, Centre Hospitalier Universitaire, Caen, France
- Centre Hospitalier Universitaire, service d’addictologie, Caen, France
| | - Shailendra Segobin
- U1077, INSERM, Caen, France
- UMR-S1077, Université de Caen Normandie, UMR-S1077, Caen, France
- UMR-S1077, Ecole Pratique des Hautes Etudes, Caen, France
- U1077, Centre Hospitalier Universitaire, Caen, France
| | - Francis Eustache
- U1077, INSERM, Caen, France
- UMR-S1077, Université de Caen Normandie, UMR-S1077, Caen, France
- UMR-S1077, Ecole Pratique des Hautes Etudes, Caen, France
- U1077, Centre Hospitalier Universitaire, Caen, France
| | - François Vabret
- U1077, INSERM, Caen, France
- UMR-S1077, Université de Caen Normandie, UMR-S1077, Caen, France
- UMR-S1077, Ecole Pratique des Hautes Etudes, Caen, France
- U1077, Centre Hospitalier Universitaire, Caen, France
- Centre Hospitalier Universitaire, service d’addictologie, Caen, France
| | - Anne Lise Pitel
- U1077, INSERM, Caen, France
- UMR-S1077, Université de Caen Normandie, UMR-S1077, Caen, France
- UMR-S1077, Ecole Pratique des Hautes Etudes, Caen, France
- U1077, Centre Hospitalier Universitaire, Caen, France
| | - Hélène Beaunieux
- U1077, INSERM, Caen, France
- UMR-S1077, Université de Caen Normandie, UMR-S1077, Caen, France
- UMR-S1077, Ecole Pratique des Hautes Etudes, Caen, France
- U1077, Centre Hospitalier Universitaire, Caen, France
- * E-mail:
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[Alcohol-related neuropsychological impairments: Nature, impact and detection]. Presse Med 2016; 45:1124-1132. [PMID: 27039333 DOI: 10.1016/j.lpm.2016.01.030] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2015] [Revised: 01/15/2016] [Accepted: 01/20/2016] [Indexed: 01/13/2023] Open
Abstract
Alcohol-related neuropsychological deficits result from chronic and excessive alcohol consumption and are associated with structural and functional damage of Papez's circuit and frontocerebellar circuit. Alcohol-related cognitive deficits are heterogeneous but especially affect executive functions and memory abilities. They result in difficulties to change alcohol behavior combined with a tendency for patients to overestimate their capacity to succeed. Alcohol-related cognitive deficits could be a risk-factor for relapse since they hamper patients to benefit fully from treatment (especially when based on relapse prevention). Screening tools usable by non-psychologists are available and can be completed by an extensive neuropsychological examination conducted by a neuropsychologist when necessary. Alcohol treatment should be adjusted to take alcohol-related cognitive deficits into account, by promoting longer treatment in healthy environment for example. Improvements of alcohol treatment options, including specific neuropsychological rehabilitation, are required for patients with persistent alcohol-related cognitive deficits.
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Executive performance and dysexecutive symptoms in binge drinking adolescents. Alcohol 2016; 51:79-87. [PMID: 26992704 DOI: 10.1016/j.alcohol.2016.01.003] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2015] [Revised: 01/24/2016] [Accepted: 01/25/2016] [Indexed: 11/23/2022]
Abstract
Alcohol is probably the most common legal drug of abuse in Western countries. The prevalence of binge drinking (BD) pattern of alcohol consumption among adolescents is a worrisome phenomenon. Adolescents and university students who practice a BD pattern have difficulty performing tasks involving prefrontal cortex functions, such as working memory, planning, attention, and decision making. The aim of the present study was to investigate the association between BD and executive functioning in adolescents. Two hundred twenty-three high-school students between 12 and 18 years old (15.19 ± 2.13) participated in our study. They were assigned to one of three groups according to their pattern of alcohol consumption: BD (subjects who consumed alcohol intensively, n = 48), MAC (subjects who consumed alcohol moderately, n = 53), and CTR (non-drinking subjects, n = 122). The students were evaluated with two groups of testing tools: a set of performance neuropsychological tests and two questionnaires of executive functioning. The results showed that the students who drank alcohol exhibited a more pronounced dysexecutive symptomatology (disinhibition, executive dysfunction, intentionality, executive memory), but they obtained better results than controls on some of the neuropsychological tests such as Spatial Location, Five Digit Tests, or Stroop Test. According to the results, we can deduce that heavy alcohol drinking in adolescents brings a certain dysfunction of prefrontal circuits. This prefrontal dysfunction is not so clearly demonstrated in the neuropsychological tests used, but it was observed in the performance of daily activities. In the Discussion section we raise issues about sociodemographic features of the sample and ecological validity of the traditional neuropsychological tests. The neurotoxic effects of BD on prefrontal cortex can be less evident throughout adolescence, but if alcohol consumption persists, the executive dysfunction would be exacerbated.
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Donoghue K, Rose A, Coulton S, Milward J, Reed K, Drummond C, Little H. Double-blind, 12 month follow-up, placebo-controlled trial of mifepristone on cognition in alcoholics: the MIFCOG trial protocol. BMC Psychiatry 2016; 16:40. [PMID: 26912003 PMCID: PMC4765152 DOI: 10.1186/s12888-016-0757-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2016] [Accepted: 02/18/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Increased levels of cortisol during acute alcohol withdrawal have been linked to cognitive deficits and depression. Preclinical research found that the glucocorticoid Type II receptor antagonist, mifepristone, prevented some of the neurotoxic effects of withdrawal and memory loss. Clinical trials have shown mifepristone effective in the treatment of depression. This study aims to examine the extent to which the glucocorticoid Type II receptor antagonist, mifepristone, when given to alcohol dependent males during the acute phase of alcohol withdrawal, will protect against the subsequent memory loss and depressive symptoms during abstinence from alcohol. METHODS/DESIGN The study is a Phase 4 therapeutic use, "Proof of Concept" trial. The trial is a double-blind randomised controlled clinical trial of mifepristone versus inactive placebo. The trial aims to recruit 120 participants referred for an inpatient alcohol detoxification from community alcohol teams, who meet the inclusion criteria; 1) Male, 2) Aged 18-60 inclusive, 3) alcohol dependent for 5 or more years. A screening appointment will take place prior to admission to inpatient alcohol treatment units to ensure that the individual is suitable for inclusion in the trial in accordance with the inclusion and exclusion criteria. On admission participants are randomised to receive 600 mg a day of mifepristone (200 mg morning, afternoon and evening) for 7 days and 400 mg for the subsequent 7 days (200 mg morning and evening) or the equivalent number of placebo tablets for 14 days. Participants will remain in the trial for 4 weeks (at least 2 weeks as an inpatient) and will be followed up at 3, 6 and 12 months post randomisation. Primary outcome measures are cognitive function at week 3 and 4 after cessation of drinking and symptoms of depression over the 4 weeks after cession of drinking, measured using the Cambridge Neuropsychological Test Automated battery and Beck Depression Inventory, respectively. Secondary outcome measures are severity of the acute phase of alcohol withdrawal, alcohol craving, symptoms of protracted withdrawal and maintenance of abstinence and levels of relapse drinking at follow-up. DISCUSSION The current trial will provide evidence concerning the role of glucocorticoid Type II receptor activation in cognitive function and depression during acute alcohol withdrawal and the efficacy of treatment with mifepristone. ISRCTN ISRCTN54001953, Registered 29th September 2011.
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Affiliation(s)
- Kim Donoghue
- Addictions Department, National Addiction Centre, Institute of Psychiatry, King's College London, 4 Windsor Walk, London, SE5 8BB, UK.
| | - Abigail Rose
- Department of Psychological Sciences, University of Liverpool, 2.32, Eleanor Rathbone Building, Bedford Street South, Liverpool, L69 7ZA, UK.
| | - Simon Coulton
- Centre for Health Service Studies, University of Kent, Canterbury, Kent, CT2 7NF, UK.
| | - Joanna Milward
- Addictions Department, National Addiction Centre, Institute of Psychiatry, King's College London, 4 Windsor Walk, London, SE5 8BB, UK.
| | - Kylie Reed
- Addictions Department, National Addiction Centre, Institute of Psychiatry, King's College London, 4 Windsor Walk, London, SE5 8BB, UK.
| | - Colin Drummond
- Addictions Department, National Addiction Centre, Institute of Psychiatry, King's College London, 4 Windsor Walk, London, SE5 8BB, UK.
| | - Hilary Little
- Addictions Department, National Addiction Centre, Institute of Psychiatry, King's College London, 4 Windsor Walk, London, SE5 8BB, UK.
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Cabé N, Laniepce A, Ritz L, Lannuzel C, Boudehent C, Vabret F, Eustache F, Beaunieux H, Pitel AL. Troubles cognitifs dans l’alcoolodépendance : intérêt du dépistage dans l’optimisation des prises en charge. Encephale 2016; 42:74-81. [DOI: 10.1016/j.encep.2015.12.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Accepted: 12/08/2015] [Indexed: 02/08/2023]
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Walvoort SJ, van der Heijden PT, Kessels RP, Egger JI. Measuring illness insight in patients with alcohol-related cognitive dysfunction using the Q8 questionnaire: a validation study. Neuropsychiatr Dis Treat 2016; 12:1609-15. [PMID: 27445476 PMCID: PMC4936806 DOI: 10.2147/ndt.s104442] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
AIM Impaired illness insight may hamper treatment outcome in patients with alcohol-related cognitive deficits. In this study, a short questionnaire for the assessment of illness insight (eg, the Q8) was investigated in patients with Korsakoff's syndrome (KS) and in alcohol use disorder (AUD) patients with mild neurocognitive deficits. METHODS First, reliability coefficients were computed and internal structure was investigated. Then, comparisons were made between patients with KS and patients with AUD. Furthermore, correlations with the Dysexecutive Questionnaire (DEX) were investigated. Finally, Q8 total scores were correlated with neuropsychological tests for processing speed, memory, and executive function. RESULTS Internal consistency of the Q8 was acceptable (ie, Cronbach's α =0.73). The Q8 items represent one factor, and scores differ significantly between AUD and KS patients. The Q8 total score, related to the DEX discrepancy score and scores on neuropsychological tests as was hypothesized, indicates that a higher degree of illness insight is associated with a higher level of cognitive functioning. CONCLUSION The Q8 is a short, valid, and easy-to-administer questionnaire to reliably assess illness insight in patients with moderate-to-severe alcohol-related cognitive dysfunction.
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Affiliation(s)
- Serge Jw Walvoort
- Centre of Excellence for Korsakoff and Alcohol-Related Cognitive Disorders, Vincent van Gogh Institute for Psychiatry, Venray; Donders Institute for Brain, Cognition and Behaviour; Behavioural Science Institute, Radboud University, Nijmegen
| | - Paul T van der Heijden
- Behavioural Science Institute, Radboud University, Nijmegen; Reinier van Arkel Mental Health Institute, 's-Hertogenbosch
| | - Roy Pc Kessels
- Centre of Excellence for Korsakoff and Alcohol-Related Cognitive Disorders, Vincent van Gogh Institute for Psychiatry, Venray; Donders Institute for Brain, Cognition and Behaviour; Department of Medical Psychology, Radboud University Medical Center, Nijmegen
| | - Jos Im Egger
- Centre of Excellence for Korsakoff and Alcohol-Related Cognitive Disorders, Vincent van Gogh Institute for Psychiatry, Venray; Donders Institute for Brain, Cognition and Behaviour; Behavioural Science Institute, Radboud University, Nijmegen; Centre of Excellence for Neuropsychiatry, Vincent van Gogh Institute for Psychiatry, Venray, the Netherlands
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Ritz L, Lannuzel C, Boudehent C, Vabret F, Bordas N, Segobin S, Eustache F, Pitel AL, Beaunieux H. Validation of a Brief Screening Tool for Alcohol-Related Neuropsychological Impairments. Alcohol Clin Exp Res 2015; 39:2249-60. [DOI: 10.1111/acer.12888] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2015] [Accepted: 08/25/2015] [Indexed: 11/30/2022]
Affiliation(s)
- Ludivine Ritz
- U1077; INSERM; Caen France
- UMR-S1077; Université de Caen Basse-Normandie; Caen France
- UMR-S1077; Ecole Pratique des Hautes Etudes; Caen France
- U1077; Centre Hospitalier Universitaire; Caen France
| | - Coralie Lannuzel
- U1077; INSERM; Caen France
- UMR-S1077; Université de Caen Basse-Normandie; Caen France
- UMR-S1077; Ecole Pratique des Hautes Etudes; Caen France
- U1077; Centre Hospitalier Universitaire; Caen France
| | - Céline Boudehent
- U1077; INSERM; Caen France
- UMR-S1077; Université de Caen Basse-Normandie; Caen France
- UMR-S1077; Ecole Pratique des Hautes Etudes; Caen France
- U1077; Centre Hospitalier Universitaire; Caen France
- Service d'addictologie; Centre Hospitalier Universitaire; Caen France
| | - François Vabret
- U1077; INSERM; Caen France
- UMR-S1077; Université de Caen Basse-Normandie; Caen France
- UMR-S1077; Ecole Pratique des Hautes Etudes; Caen France
- U1077; Centre Hospitalier Universitaire; Caen France
- Service d'addictologie; Centre Hospitalier Universitaire; Caen France
| | - Nadège Bordas
- Centre Hospitalier Universitaire Paul Brousse; Villejuif France
| | - Shailendra Segobin
- U1077; INSERM; Caen France
- UMR-S1077; Université de Caen Basse-Normandie; Caen France
- UMR-S1077; Ecole Pratique des Hautes Etudes; Caen France
- U1077; Centre Hospitalier Universitaire; Caen France
| | - Francis Eustache
- U1077; INSERM; Caen France
- UMR-S1077; Université de Caen Basse-Normandie; Caen France
- UMR-S1077; Ecole Pratique des Hautes Etudes; Caen France
- U1077; Centre Hospitalier Universitaire; Caen France
| | - Anne-Lise Pitel
- U1077; INSERM; Caen France
- UMR-S1077; Université de Caen Basse-Normandie; Caen France
- UMR-S1077; Ecole Pratique des Hautes Etudes; Caen France
- U1077; Centre Hospitalier Universitaire; Caen France
| | - Hélène Beaunieux
- U1077; INSERM; Caen France
- UMR-S1077; Université de Caen Basse-Normandie; Caen France
- UMR-S1077; Ecole Pratique des Hautes Etudes; Caen France
- U1077; Centre Hospitalier Universitaire; Caen France
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Brevers D, Noel X. Commentary on: Are we overpathologizing everyday life? A tenable blueprint for behavioral addiction research. On functional and compulsive aspects of reinforcement pathologies. J Behav Addict 2015; 4:135-8. [PMID: 26551899 PMCID: PMC4627670 DOI: 10.1556/2006.4.2015.017] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND This paper is a commentary to a debate article entitled: "Are we overpathologizing everyday life? A tenable blueprint for behavioral addiction research", by Billieux et al. (2015). METHODS AND AIM: This brief response focused on the necessity to better characterize psychological and related neurocognitive determinants of persistent deleterious actions associated or not with substance utilization. RESULTS A majority of addicted people could be driven by psychological functional reasons to keep using drugs, gambling or buying despite the growing number of related negative consequences. In addition, a non-negligible proportion of them would need assistance to restore profound disturbances in basic learning processes involved in compulsive actions. CONCLUSIONS The distinction between psychological functionality and compulsive aspects of addictive behaviors should represent a big step towards more efficient treatments.
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Affiliation(s)
- Damien Brevers
- Brain and Creativity Institute, Department of Psychology, University of Southern California, Los Angeles, CA, USA,Laboratoire de psychologie médicale et d’addictologie, Faculty of Medicine, Brugmann-campus, Université Libre de Bruxelles (ULB), Brussels, Belgium,* Corresponding author: Damien Brevers, PhD; Brain and Creativity Institute, University of Southern California, 3620A McClintock Avenue, 90089-2921, Los Angeles, CA, USA; E-mails: ;
| | - Xavier Noel
- Laboratoire de psychologie médicale et d’addictologie, Faculty of Medicine, Brugmann-campus, Université Libre de Bruxelles (ULB), Brussels, Belgium
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Chatterjee K, Fernandes AB, Goyal S, Shanker S. Central pontine myelinolysis in a case of alcohol dependence syndrome. Ind Psychiatry J 2015; 24:198-201. [PMID: 27212829 PMCID: PMC4866352 DOI: 10.4103/0972-6748.181732] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Osmotic Demyelination Syndrome includes Central Pontine Myelinolysis and Extrapontine Myelinolysis. This condition has been described in cases of chronic Alcohol Dependence Syndrome and in rapid correction of hyponatremia. Though we frequently see patients with Alcohol Dependence Syndrome presenting with complicated withdrawal, Central Pontine Myelinolysis remains largely undetected and under-reported in literature. We present here a case of protracted Delirium Tremens where MRI brain revealed Central Pontine Myelinolysis. Subsequently cognitive assessment revealed significant dysfunction and brain SPECT showed hypo-perfusion of the frontal lobes. Osmotic Demyelination Syndrome should be suspected in protracted Delirium Tremens.
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Affiliation(s)
- Kaushik Chatterjee
- Department of Psychiatry, Armed Forces Medical College, Pune, Maharashtra, India
| | - Austin B Fernandes
- Department of Psychiatry, Lokmanya Tilak Memorial Medical College (Sion Hospital), Mumbai, Maharashtra, India
| | - Sunil Goyal
- Department of Psychiatry, Base Hospital, New Delhi, India
| | - Sunitha Shanker
- Department of Psychiatry, INHS Asvini, Mumbai, Maharashtra, India
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Segobin S, Ritz L, Lannuzel C, Boudehent C, Vabret F, Eustache F, Beaunieux H, Pitel A. Integrity of white matter microstructure in alcoholics with and without Korsakoff's syndrome. Hum Brain Mapp 2015; 36:2795-808. [PMID: 25873017 PMCID: PMC6869167 DOI: 10.1002/hbm.22808] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2014] [Revised: 03/19/2015] [Accepted: 03/21/2015] [Indexed: 12/11/2022] Open
Abstract
Alcohol dependence results in two different clinical forms: "uncomplicated" alcoholism (UA) and Korsakoff's syndrome (KS). Certain brain networks are especially affected in UA and KS: the frontocerebellar circuit (FCC) and the Papez circuit (PC). Our aims were (1) to describe the profile of white matter (WM) microstructure in FCC and PC in the two clinical forms, (2) to identify those UA patients at risk of developing KS using their WM microstructural integrity as a biomarker. Tract-based spatial statistics and nonparametric voxel-based permutation tests were used to compare diffusion tensor imaging (DTI) data in 7 KS, 20 UA, and 14 healthy controls. The two patient groups were also pooled together and compared to controls. k-means classifications were then performed on mean fractional anisotropy values of significant clusters across all subjects for two fiber tracts from the FCC (the middle cerebellar peduncle and superior cerebellar peduncle) and two tracts from the PC (fornix and cingulum). We found graded effects of WM microstructural abnormalities in the PC of UA and KS. UA patients classified at risk of developing KS using fiber tracts of the PC from DTI data also had the lowest scores of episodic memory. That finding suggests that WM microstructure could be used as a biomarker for early detection of UA patients at risk of developing KS.
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Affiliation(s)
- Shailendra Segobin
- INSERMCaenFrance
- Université De Caen Basse‐NormandieCaenFrance
- Ecole Pratique Des Hautes EtudesCaenFrance
- Centre Hospitalier UniversitaireCaenFrance
| | - Ludivine Ritz
- INSERMCaenFrance
- Université De Caen Basse‐NormandieCaenFrance
- Ecole Pratique Des Hautes EtudesCaenFrance
- Centre Hospitalier UniversitaireCaenFrance
| | - Coralie Lannuzel
- INSERMCaenFrance
- Université De Caen Basse‐NormandieCaenFrance
- Ecole Pratique Des Hautes EtudesCaenFrance
- Centre Hospitalier UniversitaireCaenFrance
| | - Céline Boudehent
- INSERMCaenFrance
- Université De Caen Basse‐NormandieCaenFrance
- Ecole Pratique Des Hautes EtudesCaenFrance
- Centre Hospitalier UniversitaireCaenFrance
- Centre Hospitalier Universitaire, Service D'addictologieCaenFrance
| | - François Vabret
- INSERMCaenFrance
- Université De Caen Basse‐NormandieCaenFrance
- Ecole Pratique Des Hautes EtudesCaenFrance
- Centre Hospitalier UniversitaireCaenFrance
- Centre Hospitalier Universitaire, Service D'addictologieCaenFrance
| | - Francis Eustache
- INSERMCaenFrance
- Université De Caen Basse‐NormandieCaenFrance
- Ecole Pratique Des Hautes EtudesCaenFrance
- Centre Hospitalier UniversitaireCaenFrance
| | - Hélène Beaunieux
- INSERMCaenFrance
- Université De Caen Basse‐NormandieCaenFrance
- Ecole Pratique Des Hautes EtudesCaenFrance
- Centre Hospitalier UniversitaireCaenFrance
| | - Anne‐Lise Pitel
- INSERMCaenFrance
- Université De Caen Basse‐NormandieCaenFrance
- Ecole Pratique Des Hautes EtudesCaenFrance
- Centre Hospitalier UniversitaireCaenFrance
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Alarcon R, Nalpas B, Pelletier S, Perney P. MoCA as a Screening Tool of Neuropsychological Deficits in Alcohol-Dependent Patients. Alcohol Clin Exp Res 2015; 39:1042-8. [DOI: 10.1111/acer.12734] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2014] [Accepted: 03/20/2015] [Indexed: 01/06/2023]
Affiliation(s)
- Régis Alarcon
- Service Addictologie; Hôpital du Grau du Roi; CHU Caremeau; Nîmes France
| | - Bertrand Nalpas
- Service Addictologie; Hôpital du Grau du Roi; CHU Caremeau; Nîmes France
- Département d'Information Scientifique et de Communication (DISC); Inserm; Paris France
| | | | - Pascal Perney
- Service Addictologie; Hôpital du Grau du Roi; CHU Caremeau; Nîmes France
- Université Montpellier I; Montpellier France
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Thalamic abnormalities are a cardinal feature of alcohol-related brain dysfunction. Neurosci Biobehav Rev 2014; 54:38-45. [PMID: 25108034 DOI: 10.1016/j.neubiorev.2014.07.023] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2014] [Revised: 07/11/2014] [Accepted: 07/28/2014] [Indexed: 01/27/2023]
Abstract
Two brain networks are particularly affected by the harmful effect of chronic and excessive alcohol consumption: the circuit of Papez and the frontocerebellar circuit, in both of which the thalamus plays a key role. Shrinkage of the thalamus is more severe in alcoholics with Korsakoff's syndrome (KS) than in those without neurological complication (AL). In accordance with the gradient effect of thalamic abnormalities between AL and KS, the pattern of brain dysfunction in the Papez's circuit results in anterograde amnesia in KS and only mild-to-moderate episodic memory disorders in AL. On the opposite, dysfunction of the frontocerebellar circuit results in a similar pattern of working memory and executive deficits in the AL and KS. Several hypotheses, mutually compatible, can be drawn to explain that the severe thalamic shrinkage observed in KS has different consequences in the neuropsychological profile associated with the two brain networks.
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41
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Ritz L, Segobin S, Le Berre AP, Lannuzel C, Boudehent C, Vabret F, Eustache F, Pitel AL, Beaunieux H. Brain structural substrates of cognitive procedural learning in alcoholic patients early in abstinence. Alcohol Clin Exp Res 2014; 38:2208-16. [PMID: 25156613 PMCID: PMC5161765 DOI: 10.1111/acer.12486] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2013] [Accepted: 04/29/2014] [Indexed: 11/30/2022]
Abstract
BACKGROUND Procedural learning allows for the acquisition of new behavioral skills. Previous studies have shown that chronic alcoholism is characterized by impaired cognitive procedural learning and brain abnormalities affecting regions that are involved in the automation of new cognitive procedures in healthy individuals. The goal of the present study was to investigate the brain structural substrates of cognitive procedural learning in alcoholic patients (ALs) early in abstinence. METHODS Thirty-one ALs and 31 control participants (NCs) performed the Tower of Toronto task (4 daily learning sessions, each comprising 10 trials) to assess cognitive procedural learning. We also assessed episodic and working memory, executive functions, and visuospatial abilities. ALs underwent 1.5T structural magnetic resonance imaging. RESULTS The initial cognitive phase was longer in the AL group than in the NC group, whereas the autonomous phase was shorter. In ALs, the longer cognitive phase was predicted by poorer planning and visuospatial working memory abilities, and by smaller gray matter (GM) volumes in the angular gyrus and caudate nucleus. ALs' planning abilities correlated with smaller GM volume in the angular gyrus. CONCLUSIONS Cognitive procedural learning was impaired in ALs, with a delayed transition from the cognitive to the autonomous phase. This slowdown in the automation of the cognitive procedure was related to lower planning abilities, which may have hampered the initial generation of the procedure to be learned. In agreement with this neuropsychological finding, a persistent relationship was found between learning performance and the GM volumes of the angular gyrus and caudate nucleus, which are usually regarded as markers of planning and initial learning of the cognitive procedure.
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Affiliation(s)
- Ludivine Ritz
- Neuropsychologie cognitive et neuroanatomie fonctionnelle de la mémoire humaine
École pratique des hautes études - Université Caen Normandie - Institut National de la Santé et de la Recherche Médicale - U1077CHU côte de Nacre, bd Henri Becquerel 14033 Caen
| | - Shailendra Segobin
- Neuropsychologie cognitive et neuroanatomie fonctionnelle de la mémoire humaine
École pratique des hautes études - Université Caen Normandie - Institut National de la Santé et de la Recherche Médicale - U1077CHU côte de Nacre, bd Henri Becquerel 14033 Caen
| | - Anne Pascale Le Berre
- Neuropsychologie cognitive et neuroanatomie fonctionnelle de la mémoire humaine
École pratique des hautes études - Université Caen Normandie - Institut National de la Santé et de la Recherche Médicale - U1077CHU côte de Nacre, bd Henri Becquerel 14033 Caen
| | - Coralie Lannuzel
- Neuropsychologie cognitive et neuroanatomie fonctionnelle de la mémoire humaine
École pratique des hautes études - Université Caen Normandie - Institut National de la Santé et de la Recherche Médicale - U1077CHU côte de Nacre, bd Henri Becquerel 14033 Caen
| | - Céline Boudehent
- Neuropsychologie cognitive et neuroanatomie fonctionnelle de la mémoire humaine
École pratique des hautes études - Université Caen Normandie - Institut National de la Santé et de la Recherche Médicale - U1077CHU côte de Nacre, bd Henri Becquerel 14033 Caen
- Service d'Addictologie
CHU Caen - Hôpital Côte de Nacre (Caen) - Avenue de la Côte de Nacre 14033 Caen Cedex 9
| | - François Vabret
- Neuropsychologie cognitive et neuroanatomie fonctionnelle de la mémoire humaine
École pratique des hautes études - Université Caen Normandie - Institut National de la Santé et de la Recherche Médicale - U1077CHU côte de Nacre, bd Henri Becquerel 14033 Caen
- Service d'Addictologie
CHU Caen - Hôpital Côte de Nacre (Caen) - Avenue de la Côte de Nacre 14033 Caen Cedex 9
| | - Francis Eustache
- Neuropsychologie cognitive et neuroanatomie fonctionnelle de la mémoire humaine
École pratique des hautes études - Université Caen Normandie - Institut National de la Santé et de la Recherche Médicale - U1077CHU côte de Nacre, bd Henri Becquerel 14033 Caen
| | - Anne Lise Pitel
- Neuropsychologie cognitive et neuroanatomie fonctionnelle de la mémoire humaine
École pratique des hautes études - Université Caen Normandie - Institut National de la Santé et de la Recherche Médicale - U1077CHU côte de Nacre, bd Henri Becquerel 14033 Caen
| | - Hélène Beaunieux
- Neuropsychologie cognitive et neuroanatomie fonctionnelle de la mémoire humaine
École pratique des hautes études - Université Caen Normandie - Institut National de la Santé et de la Recherche Médicale - U1077CHU côte de Nacre, bd Henri Becquerel 14033 Caen
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Component processes of memory in alcoholism: pattern of compromise and neural substrates. HANDBOOK OF CLINICAL NEUROLOGY 2014; 125:211-25. [PMID: 25307577 DOI: 10.1016/b978-0-444-62619-6.00013-6] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Initially, alcohol-related memory deficits were considered only through the prism of Korsakoff's syndrome (KS). It is now clear, however, that chronic alcohol consumption results in memory disorders in alcoholics without ostensible neurologic complications, such as Wernicke's encephalopathy and KS. Most of the principal memory components are affected, including working memory, episodic memory, semantic memory, perceptual memory, and procedural memory. The extent of those cognitive impairments depends on several factors, such as age, gender, nutritional status, and psychiatric comorbidity. While memory disorders, especially episodic memory deficits, are largely definitive in patients with KS, recovery of memory abilities has been described with abstinence in uncomplicated alcoholics. Neuropsychologic impairments, and especially memory disorders, must be evaluated at alcohol treatment entry because they could impede patients from benefiting fully from cognitive and behavioral treatment approaches for alcohol dependence. Screening of memory deficits could also enable clinicians to detect, among alcoholics without ostensible neurologic complications, those at risk of developing permanent and debilitating amnesia that features KS.
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Bernardin F, Maheut-Bosser A, Paille F. Cognitive impairments in alcohol-dependent subjects. Front Psychiatry 2014; 5:78. [PMID: 25076914 PMCID: PMC4099962 DOI: 10.3389/fpsyt.2014.00078] [Citation(s) in RCA: 143] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2014] [Accepted: 06/23/2014] [Indexed: 01/19/2023] Open
Abstract
Chronic excessive alcohol consumption induces cognitive impairments mainly affecting executive functions, episodic memory, and visuospatial capacities related to multiple brain lesions. These cognitive impairments not only determine everyday management of these patients, but also impact on the efficacy of management and may compromise the abstinence prognosis. Maintenance of lasting abstinence is associated with cognitive recovery in these patients, but some impairments may persist and interfere with the good conduct and the efficacy of management. It therefore appears essential to clearly define neuropsychological management designed to identify and evaluate the type and severity of alcohol-related cognitive impairments. It is also essential to develop cognitive remediation therapy so that the patient can fully benefit from the management proposed in addiction medicine units.
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Affiliation(s)
- Florent Bernardin
- Service d'Addictologie, CHU Nancy , Vandoeuvre , France ; Faculté de Médecine, Université de Lorraine , Nancy , France
| | | | - François Paille
- Service d'Addictologie, CHU Nancy , Vandoeuvre , France ; Faculté de Médecine, Université de Lorraine , Nancy , France
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Emmanouel A, Kessels RPC, Mouza E, Fasotti L. Sensitivity, specificity and predictive value of the BADS to anterior executive dysfunction. Neuropsychol Rehabil 2013; 24:1-25. [PMID: 24354937 DOI: 10.1080/09602011.2013.863731] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
In this study we investigated the validity of the BADS subtests to adequately discriminate anterior lesions (AL) from posterior lesions (PL). Therefore, we compared the performances of 30 AL patients, 22 PL patients and 29 healthy controls (HC) on the BADS subtests. Seven standard executive test variables were also examined. Our multiple comparisons showed that the BADS Zoo Map-Part 1 was not indicative for AL, whereas Rule Shifting, Action Programme, Key Search, Zoo Map-total score, and BADS-total score were found to be sensitive to AL. More importantly, the Modified Six Element Test (MSET), and the Zoo Map-Part 2 were highly specific for AL. In both BADS subtests AL patients performed significantly worse than either the PL or the HC groups, whereas no significant differences on the same variables were found between PL and HC individuals. Further logistic regression analysis revealed that the BADSMSET was the best predictor for distinguishing AL from PL patients, correctly classifying 78.8% of the patients. These results suggest that the BADSMSET is an accurate screening tool for the detection of anterior pathology. Poor performance on this BADS subtest is a significant indicator of executive dysfunctioning after anterior brain damage.
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Affiliation(s)
- Anna Emmanouel
- a Rehabilitation Centre "Anagennisi" , Nea Redestos , Oik. Filothei, Thessaloniki , Greece
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Naim-Feil J, Fitzgerald PB, Bradshaw JL, Lubman DI, Sheppard D. Neurocognitive deficits, craving, and abstinence among alcohol-dependent individuals following detoxification. Arch Clin Neuropsychol 2013; 29:26-37. [PMID: 24334264 DOI: 10.1093/arclin/act090] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Alcohol dependence, a chronic relapsing disorder, is characterized by an impaired ability to regulate compulsive urges to consume alcohol. Very few empirical studies have examined the presence of these executive deficits, how they relate to craving, and the enduring nature of these deficits during abstinence. As such, the current study aimed to characterize these cognitive deficits within a sample of 24 alcohol-dependent participants post-detoxification and 23 non-alcohol-dependent participants. Participants were administered the Sustained Attention to Response Task to measure response inhibition and sustained attention and the Random Number Generation Task to examine executive deficits. Correlations between cognitive performance and clinical measures of alcohol dependence were examined. As predicted, the alcohol-dependent group exhibited poorer performance across the domains of response inhibition, executive function, and attentional control. Cognitive performance was related to clinical measures of craving and years of alcohol consumption, whereas the duration of abstinence was not associated with improved cognitive performance. These findings highlight the need for therapeutic strategies to target these enduring neurocognitive deficits in improving the treatment of alcohol dependence.
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Affiliation(s)
- Jodie Naim-Feil
- Monash Alfred Psychiatry Research Centre, The Alfred and Monash University, Central Clinical School, Prahran, Victoria, Australia
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Beaunieux H, Ritz L, Segobin S, Le Berre AP, Lannuzel C, Boudehent C, Vabret F, Eustache F, Pitel AL. Troubles neuropsychologiques dans l'alcoolo-dépendance : l'origine de la rechute ? ACTA ACUST UNITED AC 2013. [DOI: 10.3917/rne.053.0159] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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The effect of nimodipine on memory impairment during spontaneous morphine withdrawal in mice: Corticosterone interaction. Eur J Pharmacol 2012; 695:83-7. [DOI: 10.1016/j.ejphar.2012.08.022] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2012] [Revised: 08/27/2012] [Accepted: 08/27/2012] [Indexed: 11/17/2022]
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Kapogiannis D, Kisser J, Davatzikos C, Ferrucci L, Metter J, Resnick S. Alcohol consumption and premotor corpus callosum in older adults. Eur Neuropsychopharmacol 2012; 22:704-10. [PMID: 22401959 PMCID: PMC3378772 DOI: 10.1016/j.euroneuro.2012.02.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2011] [Revised: 10/27/2011] [Accepted: 02/11/2012] [Indexed: 10/28/2022]
Abstract
Heavy alcohol consumption is toxic to the brain, especially to the frontal white matter (WM), but whether lesser amounts of alcohol negatively impact the brain WM is unclear. In this study, we examined the relationship between self-reported alcohol consumption and regional WM and grey matter (GM) volume in fifty-six men and thirty-seven women (70+- 7years) cognitively intact participants of the Baltimore Longitudinal Study of Aging (BLSA) with no history of alcohol abuse. We used regional analysis of volumes examined in normalized space (RAVENS) maps methodology for WM and GM segmentation and normalization followed by voxel based morphometry (VBM) implemented in SPM8 to examine the cross-sectional association between alcohol consumption and regional WM (and, separately, GM) volume controlling for age, sex, smoking, blood pressure and dietary thiamine intake. WM VBM revealed that in men, but not in women, higher alcohol consumption was associated with lower volume in premotor frontal corpus callosum. This finding suggests that even moderate amounts of alcohol may be detrimental to corpus callosum and white matter integrity.
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Affiliation(s)
- Dimitrios Kapogiannis
- National Institute on Aging/National Institutes of Health (NIA/NIH), Clinical Research Branch, 3001 South Hanover St., Baltimore, MD, 21225, U.S.A., , Telephone: 410-350-3953, Fax: 410-350-7308
| | - Jason Kisser
- National Institute on Aging/National Institutes of Health (NIA/NIH), Clinical Research Branch, 3001 South Hanover St., Baltimore, MD, 21225, U.S.A., , Telephone: 410-350-3953, Fax: 410-350-7308
| | | | - Luigi Ferrucci
- National Institute on Aging/National Institutes of Health (NIA/NIH), Clinical Research Branch, 3001 South Hanover St., Baltimore, MD, 21225, U.S.A., , Telephone: 410-350-3953, Fax: 410-350-7308
| | - Jeffrey Metter
- National Institute on Aging/National Institutes of Health (NIA/NIH), Clinical Research Branch, 3001 South Hanover St., Baltimore, MD, 21225, U.S.A., , Telephone: 410-350-3953, Fax: 410-350-7308
| | - Susan Resnick
- NIA/NIH, Laboratory of personality and cognition (U.S.A.)
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Pahlavan F, Mouchiroud C, Nemlaghi-Manis E. Does experience of failure decrease executive, regulatory abilities and increase aggression? Glob J Health Sci 2012; 4:60-86. [PMID: 23121744 PMCID: PMC4777000 DOI: 10.5539/gjhs.v4n6p60] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2012] [Accepted: 08/30/2012] [Indexed: 12/02/2022] Open
Abstract
Recent advances in the study of affective-cognitive regulation of aggressive behavior suggest positive correlations between poor executive capacities (ECF) and dispositional negative reactivity (Posner & Rothbart, 2000). If the global assumption is correct what are the likely implications of predicted relation? The central issue in present research was to verify this assumption and examine how situational characteristics could alter executive performance in persons with Dysexecutive Syndrome (DES, Baddeley, 1998) and healthy adults (students, health workers) to explore some of the consequences of those modifications for aggressive tendencies. Precisely, we expected the positive correlations between poor executive performances and high aggressive tendencies at dispositional as well situational levels, except for health workers, given their professional duties. In order to assess cognitive capacities and dispositional as well as situational aggressive tendencies, during two studies (First study: N=60 students; Second study: N= 60 students, N= 24 patient with Dysexecutive Syndrome, N= 45 health care workers) right-handed French-speakers participants completed twice, during an initial phase of the study and one week after, a series of standard executive functions neuropsychological tests and aggression questionnaires. During second phase, participants executed a task introducing the experimental feedbacks (success, neutral, failure) before completion of neuropsychological tests and questionnaires. The results provided evidence of a dispositional relationship between poor executive functioning and aggressive tendencies, and extended it to situational level. For all participants, it showed that increases in impulsiveness (negative emotionality and aggressive choices) due to a negative feedback were concomitant with an inability to focus individuals’ attention on ongoing tasks.
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Laloyaux J, Michel C, Mourad H, Bertrand H, Domken MA, Van der Linden M, Larøi F. Performance on an everyday life activity in persons diagnosed with alcohol dependency compared to healthy controls: relations between a computerized shopping task and cognitive and clinical variables. Alcohol Alcohol 2012; 47:240-7. [PMID: 22355014 DOI: 10.1093/alcalc/ags014] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
AIM Persons diagnosed with alcohol dependency often suffer from cognitive impairments. Little is known, however, concerning how these cognitive deficits impact complex, everyday life activities. We set out to better characterize the nature of everyday life difficulties in patients with alcohol dependency using a computerized shopping task. METHODS A computerized real-life activity task (shopping task) required participants to shop for a list of eight grocery store items. Twenty individuals diagnosed with alcohol dependency and 20 healthy controls were administered a battery of cognitive tests, clinical scales and the shopping task. RESULTS Performance on the shopping task significantly differentiated patients and healthy controls for several variables and, in particular, for total time. Total time to complete the task correlated significantly with poor performance on measures of processing speed, verbal episodic memory, cognitive flexibility and inhibition. Total time was significantly correlated with poorer everyday life functioning and longer duration of illness. CONCLUSION This computerized task is a good proxy measure of the level of everyday life and cognitive functioning of persons diagnosed with alcohol dependency.
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